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In recent years, the conversation around food and nutrition has shifted from weight loss to Health at Every Size, and it’s about time. This is a movement that focuses on improving your health regardless of your body size. A weight inclusive approach to nutrition takes this idea one step further, by incorporating principles of Health at Every Size into the way we talk about and think about food and nutrition.
Weight inclusive nutrition isn’t about counting calories or macros – it’s about making informed food choices based on your own inner body wisdom. So what does a weight inclusive approach to nutrition look like? Keep reading to find out!
Weight stigma and how it affects care
Weight stigma is discrimination or prejudice against individuals who are in larger bodies. It ranges from negative attitudes and beliefs to outright discrimination and abuse. This stigma can lead to reduced opportunities for work, education, and social interaction, and can also impact the quality of health care people receive (1).
Weight stigma is harmful because it can contribute to feelings of shame, guilt, and inferiority. It can also lead to stress and anxiety, which can have a negative impact on health. Additionally, weight stigma can prevent people from seeking necessary medical care, which can lead to more serious health problems.
Because of this stigma, women especially are less likely to bring up any symptoms to their providers if they feel embarrassed or ashamed of their weight. As this article points out, “45 percent of women have cancelled or postponed an appointment with a doctor until they were able to lose a few pounds”.
Some studies (2) suggest that physicians spend less time with patients who are in larger bodies and provide them with less information about their health.
Patients who have experienced weight bias from healthcare professionals often have poorer treatment outcomes. They may also be less likely to seek future care. Weight bias also makes it more difficult for people to get age-appropriate cancer screenings, which can lead to delays in detecting breast, gynecological, and colorectal cancers (3).
What is a weight centric approach?
Weight centric care is the dominant paradigm in healthcare today, but this approach is harmful for a number of reasons.
First and foremost, weight is highly subjective, mostly genetically pre-determined, and can vary widely from one individual to the next. As such, weight centric care tends to pathologize weight and body size, viewing weight as inherently unhealthy or problematic.
In addition, weight centric care tends to focus largely on weight loss and weight management, placing an emphasis on reducing body weight as a primary health concern. This focus not only ignores other important factors in health outcomes, such as mental well-being, access to healthcare services and social support, but also places undue and unrealistic pressure on those struggling with their weight.
Dieting and weight cycling
Intentional weight loss through dieting more often than not leads to becoming stuck in an endless dieting and weight cycle. Weight cycling, otherwise known as yo-yo dieting, has been associated with an increased risk of coronary artery disease and risk of dying due to heart disease (4).
Most public health strategies openly embrace stigmatization of individuals who live in larger bodies, based on the assumption that shame will motivate them to change behavior and achieve “weight loss” through a self-directed diet and increased physical exercise.
However, both observational and randomized-controlled studies (5) show that these strategies can result in the opposite effect, and may instead induce exercise avoidance, adoption of unsafe dietary practices, and increased mental and emotional stress. This can lead to poor metabolic health, increased weight cycling, and reduced quality of life.
Ultimately, a weight inclusive approach to care presents a much healthier and more compassionate paradigm for healthcare moving forward.
What is a weight neutral approach?
A weight neutral approach is an approach to health and body image that recognizes that weight and body size are not inherently a problem in and of themselves. Rather, weight neutral approaches (such as the Health at Every Size paradigm) seek to promote health and well-being for all people, regardless of their weight or body size.
This can be done by avoiding weight discrimination and stigma, as well as fostering a supportive environment where people feel free to make choices about their health based on personal priorities rather than weight-related pressures.
A weight neutral approach can help to support people of all sizes in achieving health and balance in their lives, without shaming them for their weight or seeking to transform them into the “thin ideal”. By promoting weight neutral thinking and behaviors, this approach represents a new way of thinking about weight and well-being that empowers individuals to prioritize their physical, emotional, and social needs over weight concerns. As such, it can be truly transformative for anyone who embraces it.
Ultimately, a weight neutral approach seeks to promote positive body image and respect for all people, regardless of their weight or appearance.
What does weight inclusive mean?
Weight inclusive is an approach that recognizes the unique needs and experiences of individuals of all body sizes. This approach recognizes that weight stigma can have negative effects on both physical and mental health, and seeks to eliminate weight-based discrimination by promoting positive messages around weight.
At its core, weight inclusive thinking is about acknowledging the complexity of body size and promoting understanding, compassion, and care for people of all sizes and shapes. This can take many different forms, such as non-diet nutrition counseling, body positivity workshops in schools and communities, or public education campaigns that focus on weight diversity and respect.
By embracing diversity and creating spaces where all body types are welcomed and accepted, weight inclusive advocates hope to build healthier communities for everyone. Weight inclusive spaces encourage you to embrace your body without judgment or shame. Ultimately, this movement is about promoting self-love and celebrating all bodies as worthy of respect and equality.
What is weight inclusive care?
Weight inclusive care is a growing movement in the healthcare community that prioritizes the needs and concerns of all patients, regardless of their weight or size.
This approach recognizes the unique challenges and obstacles that people with weight issues face in their interactions with healthcare providers, such as stigma, discrimination, and idealization of weight loss. By adopting weight inclusive care practices, healthcare practitioners can provide more affirming and compassionate treatment for all patients, helping to eliminate weight stigma and improve overall health outcomes for individuals of all sizes. Ultimately, weight inclusive care represents a major step forward in promoting health equity and social justice within our healthcare system.
Benefits of weight inclusive care
People who use a weight inclusive approach see significant improvements in their health. This includes (6):
- Improved physical movement
- Sustainable, balanced eating habits
- Lower blood pressure and cholesterol levels
- Better self-esteem and mood
- Reduced disordered eating behaviors
- Weight stability
Intuitive eating has also been associated with improvements in blood glucose control in those with diabetes (7).
In contrast, research (8) shows that focusing on weight loss can be unsustainable and harmful. People often feel bad about themselves when they are trying to lose weight, which can lead to worsened mental health, body image and relationship with food.
What are the Health at Every Size® principles?
Health at Every Size is at the heart of a weight inclusive approach to health and nutrition. Let’s take a closer look at this paradigm.
The HAES model is based on the following principles:
- Weight Inclusivity: Accepting and respecting the fact that bodies come in all shapes and sizes. It also means rejecting idealized and “specific” weights or body shapes.
- Health Enhancement: Considering the individual as a whole when providing health services, such as taking into account their individual physical, emotional, spiritual, social and economic needs. This also means supporting health policies that improve and equalize access to information and services.
- Respectful Care: Understanding that weight stigma is influenced by age, race, gender, sexual orientation, socio-economic status, and supports environments that address these inequities. This principle also helps health care providers acknowledge our own biases, and work to end weight discrimination, weight stigma, and weight bias.
- Eating for Well-being: This principle calls for promoting “flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure…”, instead of externally regulated eating plan focused on weight control (read: diets).
- Life-Enhancing Movement: Instead of structured physical activities, this principle is about supporting physical activities “that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose”. Choose is the key word here. What good is it to practice physical activity if it’s something that we don’t enjoy or that doesn’t make us feel good, right?
Weight-inclusive nutrition
Weight-inclusive nutrition is a type of nutrition counseling that places emphasis on health, rather than weight loss. This approach focuses on non-diet techniques such as intuitive eating, gentle nutrition, and overall wellness.
Rather than trying to restrict calories or evaluate food based on its weight-loss potential, weight-inclusive counselors emphasize cultivating a healthy relationship with food and one’s body. They help their clients to develop a more balanced outlook on food and eating, recognizing the importance of pleasure, satisfaction, and emotional well-being in addition to physical health.
Overall, weight-inclusive approaches seek to create an empowering environment in which people can learn to listen to what their bodies are telling them about their individual needs and goals. Whether you’re looking to improve your blood glucose levels or simply engage in balanced eating habits, weight-inclusive nutrition can help you achieve your goals in a supportive and holistic way.
Here is how weight inclusive nutrition helps you nourish yourself in a much more gentle way:
- Looking at the overall picture. Weight inclusive nutrition emphasizes that one meal, snack or food choice is not going to make or break you. How you eat and relate to food over time is what matters in terms of your health.
- Including a wide variety of foods. Diet culture frequently encourages us to cut out foods and food groups based on the “good food”/”bad food” mentality. But our bodies aren’t meant to cut out whole food groups. In fact, the more varied our diets are, the more nutrients we’ll be including.
- Allowing yourself flexibility. Intuitive eating is not about eating perfectly. It’s about acknowledging that you don’t have to eat a certain way to promote your health. Flexibility means that some days you’ll eat more play foods, and some days you’ll eat more nutritionally dense foods, and it’s OK. Everything will average out over time and your health won’t suffer. It’s about having your cake and eating it too!
- Learning to trust yourself around play foods. Know that your body never wants too much of anything. If you slow down long enough while you’re eating and truly learn to listen to what your body is telling you, you’ll find out there’s really no such thing as being “out of control” around food. Especially when it comes to including play foods without unnecessary food guilt.
- Making intentional choices. Choosing to eat (or not eat) a food from a place of honoring your health and your taste preferences. This will eventually help you identify which foods feel and taste good to you. It can also show you how you can incorporate those foods sustainably into your eating pattern.
When gentle nutrition is applied instead of following strict food rules, making food decisions based on what your body needs becomes second nature and you learn to eat in the way you were born to. This form of nutrition focuses on getting rid of the diet mentality and instead, getting back to basics.
Conclusion
I hope this article has helped to underscore the importance of a weight inclusive approach to nutrition and health care. No one should feel like they are left out or that their needs are not important.
As health care recipients, we need to demand these types of services from our providers. If you don’t have a provider who is willing to work with you in this way, please consider seeking out one who will. You are worth it! And if you need a Registered Dietitian to provide you with weight inclusive nutrition care, click here to schedule a FREE 15 minute discovery call with me!
Hi! I’m Melissa, Registered Dietitian and mother of two dragons. When I’m not talking nutrition you can find me rolling around the floor with my kids, sewing, crafting, cooking or missing the 90s (seriously, music just isn’t the same). Read More…
