Body Liberation + Public Health Project

 

But, . . . What Do The Doctors Say?

December 29, 2025

Medicine and public health have a lot in common, and some people hold academic degrees in both fields.  The difference between the two can be explained most basically as diagnosing and treating health issues in the individual (medicine) versus preventing the conditions that lead to the health issues (public health).  As public health shifts toward a more weight-inclusive approach, and seeing body liberation as part of our social justice and equity work, what about the people working directly with individuals in a clinic setting?

Increasing numbers of health care professionals are also moving toward a weight-neutral or weight-inclusive approach in their clinical work as they become more aware of the harms and ineffectiveness of medicine’s weight-centric focus.  They see their patients discouraged and demoralized when they regain weight after a weight-loss attempt (Chastain, 2021). Or, they have patients who are avoiding routine preventive care or delaying needed care due to experiencing anti-fat bias at the doctor’s office in the past. Or, recommended weight-loss attempts do not lead to the desired health outcomes, or worse, result in disordered eating (Dennett, 2018).

Medical professionals are also becoming more aware of the negative role of weight cycling and weight stigma in health, and their relationship to weight loss recommendations (Hunger, 2020; Welsby, 2025; Zou, 2019). While people are increasingly acknowledging the harms of weight stigma, the proposed “solutions” often do not align with genuine body liberation, and more often than not, people in larger bodies or those with a social justice lens are left out of the conversation altogether.  For example, it is currently common for groups or companies promoting weight-loss drugs to acknowledge that weight stigma causes harm.  But, to remedy this, they recommend using “person first language” (e.g., person with “ob*sity”), claiming that it reduces stigma.  While we certainly do not represent all of the opinions of the body liberation or fat justice communities, we know of no one who believes this reduces stigma. (You can find preferred language here.)  In fact, this strategy is more often seen as a red flag for someone who is not genuinely interested in reducing stigma or promoting equitable treatment for people of all body sizes. And, in a clear case of blaming the bullied rather than the bully, physicians will sometimes encourage weight loss as a way to reduce stigma.  

Fortunately, we are able to recommend some excellent resources where health care providers can learn from other health care providers about a weight-inclusive approach to clinical practice. For example, groups of dietitians, doctors and other clinicians at Kaiser Permanente in Oregon and Washington have organized to learn about weight-inclusive health care, and to educate others and advocate for change in their system. They have made presentations and created CME-eligible modules on weight-inclusive topics specifically related to clinical care. These are individuals and organizations using a social justice and weight-inclusive approach and putting the voices and experiences of people in larger bodies at the forefront of their work.

  • Association for Weight and Size Inclusive Medicine (AWSIM) – We are an international medical organization working to advance weight-inclusive care. We challenge the pathologization of body size, which continues to drive healthcare disparities and disproportionately harm larger bodied patients. By providing mentorship, education, and advocacy, our organization serves as the professional home for physicians practicing and learning about weight-inclusive care. We envision a world where patients of all sizes have access to empathetic and evidence-based health care.

  • Medical Students for Size Inclusivity  – We are a community of medical students raising awareness about the harms of weight discrimination in the healthcare system. We believe all people, regardless of their weight, body shape, and size, deserve equitable medical treatment and the right to pursue health. With 19 affiliates in the US and Canada.

  • Association for Size Diversity and Health (ASDAH) – ASDAH’s purpose is to create the conditions for people of all sizes, particularly those most impacted by systemic anti-fat bias, to have equitable and barrier-free access to the care and healthcare resources we need to support our wellbeing.  If you are looking for information on Health At Every Size (HAES), this is the group that holds that trademark.

  • Dr. Lisa Erlanger – Lisa Erlanger, MD, is a board-certified family physician and clinical Professor of Family Medicine at the University of Washington School of Medicine in Seattle, WA.  As a physician, educator, author, and speaker she focuses on anti-bias, weight-inclusive, trauma-informed care for patients of all sizes and backgrounds.  She speaks nationally about weight-inclusive care, anti-fat bias, and eating disorders.   Dr. Erlanger is passionate about supporting the next generation of providers in the compassionate care of patients in typically marginalized bodies or with stigmatized conditions.

  • Dr. Mara Gordon  – I’m a family doctor in Philly, and I’m also a mom, a spouse, a friend, a daughter, a reader, a writer, and citizen. I am on a crusade to make medicine more fat-friendly, and help my patients — and myself! — explore body justice and radical bodily autonomy. Please join me as I try to figure out how to live a good life, one 15-minute primary care appointment at a time.  Check out this article for starters: Being an Anti-Diet Doctor Isn’t Radical.

  • Lisa Du Breuil, LICSW – I am a fat activist, and clinical social worker. Since 2003 I’ve been doing group and individual psychotherapy through the Department of Psychiatry at Massachusetts General Hospital in Boston, treating people with co-occurring substance use disorders and eating disorders as well as people with new-onset SUDs and compulsions following weight loss surgery. . . . I work with people diagnosed with binge eating disorder, people tired of chronic dieting, and people dealing with various problems following weight loss surgery. In short, I help people learn how to ally with their bodies rather than view them as a problem to be solved. And I love my work!

  • Ellyn Satter Institute’s “Treating the Dieting Casualty: Assessing and Treating Established Adult Eating Problems” – At the heart of a good relationship with food is the principle of Eating Competence: Practical, reliable, joyful, food-neutral and weight-neutral eating that supports physical, nutritional, and emotional well-being. Dieting casualties experience the opposite of Eating Competence: They are trapped in the anguish and frustration of struggling with their eating and/or weight. Treating the Dieting Casualty is an in-depth workshop that trains you, the health/mental health professional, to help your clients become Eating Competent.

  • Center for Body Trust – “We have a responsibility to unearth weight bias and challenge the status quo in our work.”  Check out their trainings for professionals, including motivational interviewing for genuine weight neutral and inclusive conversations. 

ALLY ACTION

Take the time to learn about the benefits of a weight-inclusive approach to health and health care, and share the information with colleagues.  The above resources are a great place to start.  Join AWSIM to take advantage of their events, newsletters and other resources.

CURIOUS TO LEARN MORE?

In addition to the resources listed above, these articles provide additional background information:

CATEGORIES

Healthcare, In Practice, Weight Stigma

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