Weight Bias in Healthcare Is Harming Patients And We Need to Talk About It
As a Registered Dietitian Nutritionist practicing from a Health at Every Size framework, I’ve heard countless stories from clients about the weight stigma they face in medical settings. One recently shared, “When trying to sell me on a GLP-1 I never asked for, nor was weight loss a priority of mine, my doctor told me it's surprising how little we really need to eat to survive. All I had wanted from this appointment was a blood test to check on my thyroid because I just don’t have energy lately.”
This wasn’t just an offhand comment, it was a clear message. “Your body size makes your needs irrelevant. Your low energy is obviously the result of the weight you are carrying. And I, as your doctor, cannot see past the size of your body in order to provide you comprehensive healthcare.”
Weight bias in healthcare isn’t just hurtful; it’s harmful. Research shows that individuals in larger bodies routinely receive substandard care due to providers' assumptions about their lifestyle, health behaviors, or competence in managing their own health (Puhl & Heuer, 2009). They’re more likely to have their symptoms dismissed or misattributed to weight, and less likely to receive appropriate diagnostic tests or follow-up care (Himmelstein et al., 2017).
It is clear this bias doesn’t work to improve health outcomes, and in fact it drastically worsens them. People who experience weight stigma are more likely to avoid seeking medical care, delay appointments, and develop mistrust in the healthcare system (Amy et al., 2006). In some cases, this delay can be detrimental.
GLP-1 medications, originally developed to treat type 2 diabetes, are now being widely prescribed off-label for weight loss. It is easy to see that not every patient wants or needs these medications when we are looking beyond weight alone. Treating each patient with individualized and unbiased care leads to the realization that people in larger bodies may have no biochemical health parameters indicative of the need for any pharmaceutical intervention. Or perhaps, that weight loss is not the ultimate solution for any abnormal biochemical parameters they do have.
When a provider pushes medication solely based on body size without considering the patient's values, goals, or context, that’s not medicine - it’s bias. Healthcare should be collaborative, respectful, and free of assumptions. As Registered Dietitians, we must advocate for weight-inclusive care that prioritizes the whole person, not just the number on the scale. That is our ultimate goal at Northern Nutrition Group. If you have experienced mistreatment, weight stigma, or difficulty being heard throughout your healthcare endeavor, know this: we hear you, we believe you, and we will be your advocates.
References:
Puhl, R. M., & Heuer, C. A. (2009). The stigma of obesity: A review and update. Obesity, 17(5), 941–964.
Himmelstein, M. S., Puhl, R. M., & Quinn, D. M. (2017). Weight stigma in men: What, when, and by whom. Obesity, 25(10), 1978–1985.
Amy, N. K., Aalborg, A., Lyons, P., & Keranen, L. (2006). Barriers to routine gynecological cancer screening for White and African-American obese women. International Journal of Obesity, 30(1), 147–155.
Written by Kylie ConnerKylie specializes in: Oncology - supporting individuals through cancer treatment, remission, malnutrition, food aversions, enteral nutrition, and preventive strategies. PCOS & Fertility - weight-inclusive care for hormonal balance, menstrual health, and fertility support. Cardiovascular Disease - heart disease, high cholesterol, high blood pressure, and related conditions. Chronic Disease Prevention and Management - focusing on sustainable, non-restrictive approaches to improve long-term health and reduce risk.