Caring for Fat Bodies: Bridging the Gap Between Intention and Practice in Primary Care

Healthcare providers work hard to support patients in optimizing their health. Typical care prioritizes use of the body mass index (BMI) which has widely been criticized for its ineffectiveness at measuring health, and which perpetuates a white European male body as “normal”. From individual care to public health policy, the measurement of health through BMI and thinness has created and enforced weight stigma. Literature over the past 20 years has continued to demonstrate the negative health impacts of weight stigma, not only in harming physiological, psychological, and behavioral health, but also in fact contributing to weight gain. Notably, the research also shows that weight loss is not achievable or sustainable for the vast majority of people, and that weight cycling, or losing and re-gaining weight repeatedly, which is the most common outcome of weight loss attempts, is profoundly harmful to metabolic health. Evidence-based practices which empower patients to focus on individualized measures of health rather than weight loss may provide providers an opportunity to support and improve the health of patients of all sizes