You are on a mission, the “find a great fat friendly doctor near me” mission.
Why? Because too many times, you’ve shown up to the doctor with a cold, or a sprained ankle and you’ve been told the treatment was to lose weight! Wait, what?
Isn’t there a list of body-positive doctors or fat-friendly healthcare professionals so I can show up to my medical appointments knowing that I’ll be heard for real, not judged for how I look?
You feel like the doctor just sees you for your weight. Do they even care about your habits or history?
The last time you went to see him about your knee pain, he just went off about keto and told you to give it a try. Did he even think about your history of disordered eating before he recommended keto?
If you’ve ever been dismissed or shamed by a doctor for your weight, I will help you find a fat-friendly doctor near you.
You will be seen, and better cared for by the people who are trained to do so.
By the end of this blog article, you’ll have tools to help you work through interviewing medical professionals so you can compile a fat-friendly healthcare professionals list.
what is a fat-friendly doctor?
Doctors and other healthcare providers that identify as fat-friendly, body positive, or embrace health at every size (HAES) are those that recognize that people can be healthy in thin or larger bodies.
Folks in larger bodies may have healthy habits and thin people may have unhealthy habits. There’s no way to know without actually completing an assessment.
There’s also an element of health that is outside our control – through genetics, circumstance, or environment. These factors have nothing to do with size, and everyone deserves respectful care.
Check out my previous blog post “can you be obese and healthy” because you can’t tell if someone is healthy just by looking at them!
Fat-friendly healthcare providers are focused on your symptoms and won’t automatically send you away to lose weight before being treated or referred to a specialist that you need to see.
Healthcare providers like this exist but unfortunately, weight stigma in the medical community is not a thing of the past (but maybe we’ll get there).
medical weight stigma is real and wrong
Clients come to me all the time and tell me stories about going to the doctor and feeling unseen and unheard because the doctor only saw them for their weight.
It is not okay to show up at the doctor’s office for an ache or pain and be told, “Lose some weight, then we’ll talk.”
Does losing weight even help pain and mobility? On one of my podcasts, I talk about this with a physical therapist to try and set the record straight.
To his point, everyone (in larger or smaller bodies) can experience knee pain. “We all go through wear and tear, right?”
Regardless of your size, the treatment is to stabilize the joint, making sure it’s able to accept activity. Even if weight is a factor, weight loss doesn’t treat the pain!
And that’s not the only example.
Clients have shared many other experiences:
- Told to lose weight before knee surgery
- Told to lose weight for familial high cholesterol
- Misdiagnosed or sent away and told to lose weight first before making a referral to a specialist.
- Pushed to try keto (despite a history of an eating disorder)
None of this is appropriate. They didn’t even ask you about your eating habits, your activity levels, or your mental health history. Ugh.
You eat healthily and move your body daily. And even when you were at your smallest weight, your body image was no better!
If you’ve been dismissed and instructed to lose weight before you can get further treatment, you probably left feeling defeated. And did that make you feel like going back?
That’s the worst part of it – feeling like no one will listen. So you just avoid going to the doctor altogether because “what’s the point?”.
If you take nothing else from reading this article, remember this:
Avoiding care is WAY more dangerous than living in a larger body when it comes to disease risk. You deserve to find supportive, respectful care providers.
It’s wrong that you even have to advocate for yourself in the first place. But I’m in your corner!
You are not alone if you’ve experienced weight discrimination at your doctor. Unfortunately, weight stigma still seems to be an acceptable form of bias.
In fact, its prevalence has increased by 66% over the past decade and is now comparable to the prevalence of racial discrimination in America (1).
Why is this? There are lots of reasons but one may be the media’s misguided “war on obesity” that oversimplified and wrongly pathologized weight loss.
Your doctors just CONTINUOUSLY push weight loss and it’s a no-win scenario.
The truth is that prescribing weight loss doesn’t work long-term. You may lose substantial weight initially, but a very low percentage of people keep it off long-term (2).
Furthermore, those that lose the most may achieve that weight loss by doing things that are even harmful to their health! (2) As a former weight loss researcher, I saw the failure of weight loss prescriptions in healthcare.
People may lose weight to start with, but then it comes back. And the diet cycle continues – preoccupation with food, guilt, binges, and on and on.
It wasn’t just in my work that I heard the influence of weight stigma and diet culture either. I remember my mother telling me, “I don’t want you to be fat like me.”
I realize now why she told me this, and it breaks my heart. She had learned to feel unsafe and unworthy in her bigger body and she didn’t want the same for me.
I paired my professional experience with my mother’s story only to realize: we are doing harm!
So I found a network of providers that felt the same, learned everything I could, got trained and certified in Intuitive Eating counseling and here I am!
I’m so glad you’re here with me.
When my clients find me, they are relieved to find someone who can help them with health for REAL, taking into account their history with disordered eating and not just suggesting the same old weight loss advice for the 29580987th time!
Like them, maybe you didn’t know that providers like me are out there.
When they find me, clients say they are relieved to find someone who can help them recover from diet trauma, is relatable, and sees value in them as a person, no matter what size. You can read more about what my past clients are saying to get a feel for what it’s like to work with me.
Weight stigma clearly exists – you know because you’ve experienced it firsthand. Do you know how it’s impacted your healthcare?
impact of weight stigma – it’s harmful
Thin privilege and fatphobia are products of weight stigma and are all around us.
In a previous blog post, I go into more detail about thin privilege and its contrast to fatphobia as it contributes to discrimination.
It is clear that there are social consequences of being in a larger body and no one wants to be labeled as “obese.”
Weight stigma and fatphobia can lead to harmful consequences in healthcare and wellness:
- It can lead to healthcare avoidance. Many people will delay getting medical screening and general healthcare services due to experiencing weight stigma at their previous appointments (3).
- Lower self-esteem and exacerbation of depression and anxiety. You feel the burden of weight stigma and shame imposed by healthcare providers
- Increased risk for disordered eating, and eating disorders which can impair physical and mental health
- Weight discrimination may even be associated with a higher incidence of chronic illnesses, including heart disease, diabetes, and high cholesterol (4).
Healthcare providers may think they’re trying to motivate you but in fact, they are taking an otherwise healthy larger body and putting you into a state of chronic stress and avoidance.
how can healthcare providers do better?
Not all doctors are stigmatizing their patients, but the healthcare system makes it hard. The body mass index (BMI) is ingrained in their training.
But guess what – BMI is a bogus tool for assessing your health risk (more on that here).
I sat down with Dr. Maggie Landes, MD in my podcast (listen here) – “What would it take for doctors to stop focusing on weight?”
We talk about why weight and BMI are so ingrained in the healthcare world and how Dr. Landes’ own life experiences helped change her perspective.
The medical world needs to know that it’s OK to admit that they have limited training and support to push back on prevailing beliefs about weight.
Ironically, focusing on weight loss as an intervention may be triggering changes linked to weight gain (5).
The good news is that the healthcare community is starting to take notice of weight stigma and the need to make changes (6).
Teaching needs to happen with new learners in healthcare professions and public health messaging needs to be adjusted.
The bottom line is that it’s not your job to train providers to be weight inclusive and it’s been identified that medical training needs to address weight bias (5).
Until it is more mainstream, how can you find fat-friendly doctors or healthcare professionals?
how to find fat-friendly doctors near you
If you’ve experienced weight stigma, then it can be a great breakthrough to find a body-positive healthcare provider.
But this can be a difficult task because there isn’t a standard fat-friendly healthcare professionals list in an internet search.
Even if you search with language like fat-friendly doctors near me or HAES doctors you may find a practice more in tune with your needs…but not always.
However, an organization called the Association for Size Diversity and Health (ASDAH) is working on a database to help you find a health at every size provider. Check out their website for updates on the process.
For now, in your search for a fat-friendly doctor, you may get some red flags that will help you steer away from certain providers.
I contributed to this article 3 Red Flags To Help You Spot Medical Fatphobia and Weight Bias. Check it out for what to look out for when searching for healthcare providers, how to prepare for the visit, and how to practice self-care after.
When you know who to steer clear of, how do you work on finding providers that align with your needs?
Here are 4 tips for building your fat-friendly healthcare professionals list:
1 – ask around
Ask plus-size friends and family about their experiences and if they have any recommendations – either positive or negative. If you happen to have a provider you trust, ask them for a referral. Very often, they know of folks in other disciplines they like to work with! I give my clients access to my network as often as I can.
Consider what your own specific fears are. Is it being weighed or prescribed weight loss?
Fertility and prenatal care can be particularly difficult to navigate as weight seems to be a topic of focus and sometimes an exclusion criterion for receiving health care.
As someone who went through IVF personally and knows the rollercoaster of fear and uncertainty it brings, it’s heartbreaking to see this inequity in care.
In general, seek fat-positive, diagnosis-specific spaces as often as you can.
Finding community and connecting with others that are similar to you will help you feel less alone.
Talking about the stigma that you may have experienced as a person in a larger body helps reduce the shame.
Connecting and talking with others will help you take steps towards clearing your heart and mind and taking care of yourself in spite of the stigma you may face.
Once you have some options gathered, make contact with potential providers.
2 – call ahead
Calling ahead and asking some questions can be a good next step.
Let the office know you have a history of disordered eating and ask if the doctor is familiar with weight-inclusive care. If you hear crickets on the other end, you may want to keep looking.
Ask if they have things like larger-size blood pressure cuffs and gowns.
Are they willing to bypass the scale as part of your health assessment? Sidebar – no, they don’t need it for your visit except in rare cases of prescribing medicine.
AND – as a dietitian, I don’t recommend it either! If you need a little more of a push to break up with your scale, check out my article about weekly weigh-ins.
Ask what the doctor’s approach is to weight loss. Are they willing to avoid prescribing a diet and instead focus on what behaviors or medical treatments they would recommend?
If they satisfy your questions on the phone, go to the next step and check them out in person.
3 – check the vibe when you get there or take a tour
You can get a feel for what type of care is provided by seeing the office.
Are their chair sizes inclusive? Are there “diety” materials around the office – posters on the wall or handouts on the table?
Trust your gut here – if it’s not a fit, it’s not a fit.
However, depending on your area, it may be a privilege to be able to walk away. There may be limited options depending on your insurance or geography and you may not be able to switch providers if they don’t align with your needs.
I’ll be honest – this sucks! And it breaks my heart.
In this case, I’d recommend finding a support person. Maybe a good friend, family member, social worker, or dietitian to help advocate for you.
You don’t have to go it alone – just don’t avoid getting the healthcare you need.
Lastly, show up to your appointment prepared.
4 – know your needs for the visit
Before you show up to your appointment, make sure you’re clear in your mind about why you are there.
You can’t control what your doctor already thinks, or believes or what they’ll say or do. BUT if you understand your values and priorities before you go, you’ll be better prepared to communicate them.
They may not be “fat positive” but if they are patient-centered then they will honor your request to avoid weight loss in your care.
Do your best to stay on the same team and work WITH them.
If they can’t work with you to provide behaviors or actions (other than weight loss), ask to be referred to a specialist who can – an anti-diet dietitian, a weight-inclusive mental health therapist, or a physical therapist.
If you are feeling brave, challenge them to dig deeper into their own expertise and think about what medical treatment options they’d be thinking of for someone of a smaller size. For example, a gentle ask of “how would you approach pre-diabetes in a smaller bodied person?” may help them think beyond weight loss.
If you’re here, you may already be familiar with Intuitive Eating and HAES principles. You don’t need your doctor to sign off on these principles for you to get started.
You can feel confident that this practice is evidence-based and that intuitive eating dietitians (like me) have way more experience in nutrition and health, especially for those with a history of disordered eating.
Intuitive Eating is the best form of care to reduce the harm of weight loss prescriptions.
get the care you need, and deserve
If you’ve struggled to get your point across to your doctor or healthcare provider and you feel unheard and unseen, please don’t give up.
You are entitled to receive care that is unbiased and addresses your needs, no matter your size.
To help your conversation at your next doctor’s appointment, I’ve developed a free guide – How to talk to your doctor about health at every size.
Download it now and you’ll leave your next appointment feeling empowered, instead of defeated because of your BMI.