Hi Friend!
Weight is such a sensitive topic. It’s deeply personal, yet we are inundated with messages and advertisements for weight-related services, medications, and products on social media, TV, and the radio.
It’s everywhere, and it’s inescapable.
Do you know what else is everywhere?
Weight stigma.
Weight stigma refers to societal devaluation of people because of their body weight or size. At the root of weight stigma are prejudicial attitudes and inaccurate stereotypes that people with higher weights are lazy, lacking willpower, unmotivated to improve their health, and personally to blame for their weight. These negative attitudes and stereotypes conflict with scientific evidence and our current understanding of obesity as a chronic disease.1
Obesity is driven by the interaction of multiple factors beyond lifestyle, many of which are outside an individual’s control.2 Patients struggling with obesity experience judgment and ridicule by the public at large, but what happens when they face that same judgment from their doctor?
Unfortunately, weight stigma is not just a societal issue; it’s prevalent in healthcare, a place where patients should feel safe and supported. This stigma can lead to delayed or avoided medical care, increased stress, and worsened health outcomes.
You don’t have to be a doctor or even in the healthcare field to know that obesity increases a person’s risk for health problems. Patients who are overweight know they are overweight. When they decide to seek medical support to address weight loss, they are looking for a doctor who will empower them, not humiliate them.
IT’S A SHAME.
Have you heard of the term fat shaming? It’s a thing. It’s a very, very real thing.
Fat shaming is not just a term; it’s a damaging reality, and it’s not a practical approach to treating weight concerns. It can cause irreparable harm, especially when the shaming comes from a healthcare provider.
Healthcare professionals are not immune to societal weight stigma, and some providers express weight-biased attitudes and stereotypes toward obese patients. Stereotypes that patients with higher weight are lazy, lack motivation and willpower, have poor self-control, have poor self-management behaviors, are at fault for their weight, and are less compliant with treatment are common thoughts among these healthcare professionals.
Evidence also suggests that patients with higher weights are aware of the biased attitudes in healthcare. In fact, in a study of 2500 overweight individuals in the US, it was found that 53% reported receiving inappropriate comments from doctors about their weight.3
THE CHANGE STARTS HERE.
The current state of weight stigma in healthcare is not acceptable. I strive to provide a more compassionate and understanding approach to obesity treatment. As such, you can expect to be treated with respect and empathy in my clinic.
If a patient isn’t comfortable with their provider, is it surprising if the treatment plan isn’t successful? I would say no. It’s not surprising. It’s basically a given.
These negative interactions with healthcare professionals can deter patients from pursuing medical care for weight-related issues, general treatment, and even proactive health screenings. Avoiding medical care of any kind creates a domino effect of preventable/treatable conditions that go unchecked and untreated, which only serves to compound any underlying weight concerns.
It’s a vicious cycle that I have seen time and time again.
But it stops with my practice.
I know that is a bold proclamation, but I cannot overstate how important your well-being and comfort are to me. That is the very heart of my practice.
I understand on a deeply personal level how derogatory comments and the negative weight stigma can profoundly affect someone because I have experienced my own weight-related biases and judgment. You might think that, as a physician, I would be immune to any negativity related to my weight. But that isn’t the case.
Perhaps because I am acutely aware of the implicit bias of some healthcare providers toward people struggling with their weight, I am also acutely aware of how those same biases apply to me as a healthcare provider working on her own weight.
WHAT, LIKE IT’S HARD?!
I believe obesity and weight-related struggles are profoundly misunderstood. Society would have you believe that a person with obesity simply lacks discipline and that the solution to solving their weight problems lies within their want-to.
I’m here to tell you that obesity is so much more nuanced than that.
Obesity is a chronic disease driven by multiple factors, including biologic and genetic factors, environmental influences, and social determinants of health. The heritability of body weight has been estimated at 40–77%.4
If only it were as simple as self-discipline.
Recognizing that everyone’s weight loss journey is different and uniquely theirs was one of the motivating factors for me to become certified by the American Board of Obesity Medicine. This certification allows me to provide the best care for patients struggling with the chronic disease of obesity and its related conditions by offering evidence-based treatment to improve their health and well-being within the walls of my clinic.
I have never subscribed to a cookie-cutter approach to medicine or patient care, and treating obesity is no exception. My approach is holistic and tailored to your needs.
Because obesity is multifaceted, we will create a comprehensive plan tailored to your needs and circumstances. This plan may include medication, nutrition, physical activity, therapy, or a combination of these, all aimed at giving you the best chance of success in your journey to better health.
I wish I could make the world understand that negative attitudes toward people because of their weight only serve to further the problem. Evidence suggests that weight stigma is not only a psychosocial consequence of obesity but also a psychosocial contributor to obesity.
The stigma surrounding being overweight or obese can lead to an array of mental and physical consequences like depression, social isolation, disordered eating, higher cortisol, higher C-reactive protein (CRP), increased blood pressure, reduced physical activity, using food as a coping strategy, and less self-monitoring of food intake, to name a few.
When I became a physician, I took the Hippocratic Oath. Part of the oath says, “I will remember that there is art to medicine as well as science and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.”
In other words, treating patients with kindness, respect, and compassion is not optional; it’s part of the treatment protocol, no matter what the number on the scale says. The level of care you receive from me doesn’t change based on your BMI. And while we’re on the subject, your BMI is not the ultimate authority over your health. A BMI is a tool that, when used in conjunction with other information, can help guide a plan of care. It’s not the end all, be all.
Again, it’s nuanced.
Are you noticing a pattern here?
WHAT I KNOW AND WANT YOU TO KNOW.
I know you would lose weight on your own, without any medical assistance, if you could.
I know making an appointment to see a physician about something so intensely personal is difficult.
I know it takes a lot of courage to ask for help.
I know you want so much more out of life than you’re getting right now.
Because I know these things, I also want you to know a few things.
I will never judge you, make assumptions, or generalize.
I will actively listen when you speak.
I will see you. The whole you. Not just your weight.
My office will be a safe place where you will be supported and loved, and we will celebrate every win, no matter how small it may seem.
I understand that the journey to health and weight loss can be exhausting and disheartening. But I want you to know you are not alone in this struggle. My staff and I are here to support you every step of the way, and together, we will work towards a healthier, happier you.
There will likely be hard days, but I want you to see the potential that lies within you and use it to fuel your fight. As the saying goes, it won’t always be easy, but it will be worth it.
You are worth it.
More than anything else, I want you to believe with your entire heart that you are worth it.
Whatever the ‘it’ may entail.
If you have ever felt judged or dismissed by a healthcare professional because of your weight, I am so sorry.
While I can’t undo the hurt you’ve experienced, I can offer an alternative. When you’re ready, come see me.
I’m not saying I am perfect or will never make a mistake. What I am saying is that I would be honored to have the chance to meet you and show you how we do things differently here, free from judgment and full of open hearts.
With love,
Dr. Ronni Farris
- What is Weight Stigma? – Handout ↩︎
- Bray GA, et al. Lancet. 2016;387(10031):1947-1956. 2. Schwartz MW, et al. Endocrine Reviews 2017;38(4):267-296. ↩︎
- Puhl RM, Brownell KD. Confronting and coping with weight stigma: an investigation of overweight and obese adults. Obesity (Silver Spring)2006; 14:1802-15. ↩︎
- Home | Supportive Obesity Care ↩︎
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