{"id":20681,"date":"2023-07-01T12:13:17","date_gmt":"2023-07-01T17:13:17","guid":{"rendered":"https:\/\/www.zocdoc.com\/blog\/?p=20681"},"modified":"2023-08-31T12:36:28","modified_gmt":"2023-08-31T17:36:28","slug":"health-at-every-size-exploring-anti-fat-bias-in-healthcare","status":"publish","type":"post","link":"https:\/\/www.zocdoc.com\/blog\/guides\/health-at-every-size-exploring-anti-fat-bias-in-healthcare\/","title":{"rendered":"Health at Every Size: Exploring Anti-Fat Bias in Healthcare"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">The ideal future is one in which healthcare equality exists. Health equity involves fair opportunities for everyone, regardless of demographics, to achieve optimal health and wellness. As the goal of healthcare is to help the public stay healthy, one would assume health equity would be attainable. However, insidious biases still pervade the healthcare system which makes this philosophy unachievable.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The <\/span><a href=\"https:\/\/www.cdc.gov\/nchhstp\/healthequity\/index.html\"><span style=\"font-weight: 400;\">CDC describes health equity<\/span><\/a><span style=\"font-weight: 400;\"> as the advancement of healthcare for those who have historically faced and currently face stereotyping and injustices. These injustices are described as avoidable, and the system strives to close gaps in healthcare accessibility for these marginalized groups.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The CDC found that <\/span><a href=\"https:\/\/www.cdc.gov\/obesity\/data\/adult.html\"><span style=\"font-weight: 400;\">obesity affected 41.9% of adults from 2017 to 2020<\/span><\/a><span style=\"font-weight: 400;\">. This means that the majority of the U.S. population is categorized as overweight or obese by the CDC \u2014 and this majority may be on the receiving end of anti-fat bias because of the way weight is unduly associated with unhealthiness.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Understanding anti-fatness<\/span><\/h2>\n<p><a href=\"https:\/\/www.bmc.org\/glossary-culture-transformation\/fatphobia\"><span style=\"font-weight: 400;\">Anti-fatness is defined<\/span><\/a><span style=\"font-weight: 400;\"> as the implicit or explicit bias against people who are deemed overweight. It is rooted in Western culture\u2019s stigmatization of being fat, often with the blame for \u201cmoral failing\u201d being placed on the person who is overweight.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Whether it is a conscious or unconscious bias, anti-fatness is a societal viewpoint that is deeply ingrained into media and daily life. The anti-fat bias oppresses most of the U.S. population and extends to the healthcare system.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">About calling it \u201cfatphobia\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cFatphobia\u201d is another term for anti-fatness that\u2019s popularly used in the public discourse on the topic. However, there are conceptual failures around calling anti-fatness \u201cfatphobia.\u201d <\/span><a href=\"https:\/\/www.self.com\/story\/fat-activist-fatphobia\"><span style=\"font-weight: 400;\">Fat activists don\u2019t use \u201cfatphobia\u201d<\/span><\/a><span style=\"font-weight: 400;\"> to describe the categorically egregious treatment of people who are overweight. While it is a layman\u2019s term that most can understand, it erases the true meaning of being anti-fat by associating this discrimination with fear.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The suffix \u201c-phobia\u201d leads people to interpret fatphobia as an irrational fear of fat. This can mean many things, but it does not cover the actual motivation behind most discriminatory acts toward this group of people.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Stereotypes and stigma surrounding fatness<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Instead, \u201canti-fatness\u201d and \u201canti-fat bias\u201d encompass the marginalizing, oppressive behaviors that happen as a result of stereotypical beliefs about being fat. <\/span><a href=\"https:\/\/www.worldobesity.org\/what-we-do\/our-policy-priorities\/weight-stigma\"><span style=\"font-weight: 400;\">Weight stigma<\/span><\/a><span style=\"font-weight: 400;\"> can include:<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">Lack of willpower;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Laziness;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diminished morals;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Poor hygiene;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Low intelligence levels;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Unattractiveness.<\/span><\/li>\n<\/ul>\n<p>These beliefs find their beginnings and perpetuation in a whole array of areas. Media like TV shows and movies depict overweight characters as lazy or the butt of the joke.<\/p>\n<p><span style=\"font-weight: 400;\">Anti-fatness can even be seen in educational settings \u2014 students with obesity are less likely to obtain higher education and more likely to be targeted negatively by their peers and teachers. Workplaces have been known to put overweight employees in non-customer-facing roles and are less likely to advance them up the ranks.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Finally, anti-fatness is perpetuated in healthcare \u2014 with providers behaving inappropriately toward overweight patients and prioritizing their \u201cnormal-\u201d and underweight counterparts.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Fat and health: Misconceptions<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">One of the most common misconceptions about people who are fat is that they are also unhealthy. This is not always the case. Of course, fatness can coexist with unhealthiness. However, each factor, alone, is not inherently indicative of the other. To achieve health equity, health providers, patients, and the general public need to understand that health and weight aren\u2019t always connected.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Although being overweight or obese may increase your risk of developing certain diseases, there are often extraneous caveats patients and healthcare providers should be aware of.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Eating habits<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Anti-fat biases lead people to assume that overweight people must have poor eating habits in comparison to their counterparts with smaller figures. However, the ways in which people eat don\u2019t always match outward appearances. For example, someone with a smaller body type may eat high-calorie, fatty foods without affecting their outward appearance, but they may develop an \u201cinvisible illness\u201d such as <\/span><a href=\"https:\/\/www.cnbc.com\/2022\/12\/30\/cardiologist-shares-worst-foods-for-high-cholesterol-and-what-she-eats-for-a-healthy-heart-and-brain.html\"><span style=\"font-weight: 400;\">high cholesterol or diabetes<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">On the other hand, people who are overweight may eat healthy, balanced meals but experience weight fluctuations due to medications or <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4044302\/\"><span style=\"font-weight: 400;\">underlying diseases like thyroid problems<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Cardiometabolic health<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It\u2019s typically assumed that excess weight puts strain on a person\u2019s heart and metabolic processes, presumably leading to a whole host of cardiometabolic disorders.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Cardiometabolic diseases can include issues like heart attacks, strokes, diabetes, and fatty liver disease. The results of a thorough study analysis of 177,792 participants uncovered that body fat \u2014 but not body weight \u2014 was positively correlated with a <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8987277\/\"><span style=\"font-weight: 400;\">higher risk of cardiometabolic disease<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Therefore, someone with a lower weight and body mass index (BMI) may not appear stereotypically fat, but they could be at higher risk of developing these diseases than someone with a higher weight and BMI.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">BMI: A deeply flawed measurement<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The CDC touts BMI as a \u201c<\/span><a href=\"https:\/\/www.cdc.gov\/healthyweight\/assessing\/bmi\/index.html\"><span style=\"font-weight: 400;\">reliable indicator of body fatness for most people<\/span><\/a><span style=\"font-weight: 400;\">.\u201d However, BMI is still hotly contested in regard to its accuracy. In its simplest form, BMI can be calculated by dividing a person\u2019s weight by the square of their height. Modern interpretations also take age and sex into consideration.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Developed in the 1800s by Adolphe Quetelet, <\/span><a href=\"https:\/\/journalofethics.ama-assn.org\/article\/use-and-misuse-bmi-categories\/2023-07\"><span style=\"font-weight: 400;\">BMI has a controversial history<\/span><\/a><span style=\"font-weight: 400;\">. It was created based on data drawn exclusively from Western European men and has not been accurately updated to reflect differences in race, ethnic groups, gender, sex, or age. The American Medical Association <\/span><a href=\"https:\/\/www.ama-assn.org\/press-center\/press-releases\/ama-adopts-new-policy-clarifying-role-bmi-measure-medicine\"><span style=\"font-weight: 400;\">(AMA) has released a clarification of BMI\u2019s use<\/span><\/a><span style=\"font-weight: 400;\"> as of 2023 that acknowledges these shortcomings, but its indoctrination into the healthcare system is far-reaching and has already caused widespread issues related to anti-fatness.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Further, the creator explicitly stated that it cannot and should not be used to indicate the level of fatness in an individual. However, that\u2019s exactly what the CDC says it is a reliable indicator of. Instead, it is used in almost every clinical setting up until today, regardless of its lack of evidence to support its long-term benefits for health outcomes related to morbidity.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In reality, BMI use has perpetuated weight-related discrimination. The measurement fails to account for the relative proportion of bone, muscle, and fat in the body. This means that a person with a higher weight will always have a higher BMI, regardless of whether or not they have excess fat in their body. Some studies have even provided evidence that <\/span><a href=\"https:\/\/www.nmcd-journal.com\/article\/S0939-4753(16)30101-6\/fulltext\"><span style=\"font-weight: 400;\">low muscle mass is a better indicator of health risks<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In turn, using BMI as a measure of fatness and relative health status miscategorizes many people, which may affect their overall treatment at healthcare facilities.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Bariatric surgeries<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Healthcare providers shouldn\u2019t treat patients by solely looking at their BMI and outward appearance. Instead, each patient should be treated equally, catering to their conditions and actual health status. Instead, different interventions are suggested for patients to lose weight. <\/span><a href=\"https:\/\/www.zocdoc.com\/doctors\/bariatric-surgeries%5C\"><span style=\"font-weight: 400;\">Bariatric surgery<\/span><\/a><span style=\"font-weight: 400;\"> is one such intervention.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There are several types of bariatric surgeries, including gastric sleeve, gastric bypass, gastric banding, and biliopancreatic diversion with a duodenal switch. Broadly speaking, they all serve the same purpose: to reduce the effective size of the stomach to help facilitate weight loss. This action may also indirectly improve a variety of comorbid health conditions such as:<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">Heart disease;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sleep apnea;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">High blood pressure;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">High blood sugar;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">High cholesterol;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Non-alcohol-related fatty liver disease;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Type 2 diabetes;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Asthma;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Urinary incontinence;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kidney disease.<\/span><\/li>\n<\/ul>\n<p>The procedures themselves are minimally invasive and carry a <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK513285\/\"><span>low risk if done by a qualified bariatric surgeon<\/span><\/a><span>. However, they can fail to produce the desired results or even cause complications. Comorbid conditions may not be adequately addressed, particularly if bariatric surgery is suggested for weight loss alone.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Post-procedure complications<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Some <\/span><a href=\"https:\/\/www.verywellhealth.com\/is-bariatric-surgery-worth-the-risk-3496413\"><span style=\"font-weight: 400;\">risks of undergoing bariatric surgery<\/span><\/a><span style=\"font-weight: 400;\"> include:<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">Acid reflux;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Anesthesia-related issues;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Esophagus dilation;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Inability to tolerate certain foods;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Infection;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Internal bleeding;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nausea and vomiting;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Organ injury;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Stomach obstruction;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Weight gain or failure to lose weight.<\/span><\/li>\n<\/ul>\n<p>Patients are not guaranteed to lose weight after bariatric surgery. It can also lead to long-term issues like:<\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">Blood clots;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bowel obstruction;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dumping syndrome;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.zocdoc.com\/procedure\/hernia-1065\"><span style=\"font-weight: 400;\">Hernias<\/span><\/a><span style=\"font-weight: 400;\">;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.zocdoc.com\/doctors\/gallbladder-surgeons-near-me\"><span style=\"font-weight: 400;\">Gallstones<\/span><\/a><span style=\"font-weight: 400;\">;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Low blood sugar;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Malnutrition;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ulcers;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vitamin deficiency.<\/span><\/li>\n<\/ul>\n<p>This isn\u2019t an all-inclusive list, and it is recommended for patients to ingrain healthy habits before and after the surgery in their routine to minimize risks and help them achieve their desired results.<\/p>\n<h2><span style=\"font-weight: 400;\">Examples of anti-fat bias in healthcare<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Historically, research has shown a clear anti-fat bias in healthcare providers. Patients have reported being <\/span><a href=\"https:\/\/www.statnews.com\/2016\/06\/03\/weight-obese-doctors-patients\/\"><span style=\"font-weight: 400;\">told to lose weight at every doctor appointment<\/span><\/a><span style=\"font-weight: 400;\"> \u2014 even if their concerns have nothing to do with their weight. This leads to overweight patients being less likely to engage with providers for fear of mistreatment and judgment.<\/span><\/p>\n<p><a href=\"https:\/\/www.health.harvard.edu\/blog\/addressing-weight-bias-in-medicine-2019040316319\"><span style=\"font-weight: 400;\">Medical education perpetuates the weight stigma<\/span><\/a><span style=\"font-weight: 400;\"> by providing minimal instruction on obesity and touting unhelpful mantras like \u201ccalories in, calories out.\u201d This limited view fails to acknowledge the complexities of obesity and boils it down to the stereotypes that are harmful to the treatment of the majority of Americans \u2014 and <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3930920\/\"><span style=\"font-weight: 400;\">few medical students are aware of their biases against fatness<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Discrimination in care<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6650789\/\"><span style=\"font-weight: 400;\">scoping study analysis on anti-fat bias in providers<\/span><\/a><span style=\"font-weight: 400;\"> revealed that between the years 2000 and 2017, the following themes occurred:<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">Ambivalence;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Assumptions about weight gain;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Attribution of all health issues to excess weight;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Avoidance or delay of treatment;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Barriers to healthcare utilization;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Contemptuous, patronizing, and disrespectful treatment;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The expectation of differential healthcare treatment;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Increased \u201cdoctor shopping\u201d;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Lack of training;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Low trust levels;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Poor communication.<\/span><\/li>\n<\/ul>\n<p>The negative treatment of fat patients by healthcare providers is correlated with their decreased ability and eagerness to seek further care.<\/p>\n<h2><span style=\"font-weight: 400;\">Impacts of anti-fat bias on higher-weight patients<\/span><\/h2>\n<p><a href=\"https:\/\/www.scientificamerican.com\/article\/the-weight-of-stigma-heavier-patients-confront-the-burden-of-bias1\/\"><span style=\"font-weight: 400;\">Heavier patients feel burdened<\/span><\/a><span style=\"font-weight: 400;\"> by the pervasive anti-fat bias in healthcare \u2014 and rightfully so. The impacts on patients&#8217; mental and physical wellness often have the potential to be quite detrimental.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Mental health<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Perceived <\/span><a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1038\/oby.2009.131\"><span style=\"font-weight: 400;\">weight discrimination affects mental health<\/span><\/a><span style=\"font-weight: 400;\">, correlating significantly with higher rates of psychiatric disorders and overuse of substances. A bombardment of anti-fatness, especially in healthcare, can lead to internalized weight stigma. Feeling like society views you negatively due to your weight can lead to a whole host of psychological issues, such as:<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">Anxiety;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Depression;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Disordered eating;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Distorted body image;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Low self-esteem;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Reluctancy to access medical care.<\/span><\/li>\n<\/ul>\n<p>It\u2019s a vicious cycle in which the patient feels discriminated against, they internalize that judgment against their weight, and they slip into unhealthy habits that affect their mental health and ability to stay healthy.<\/p>\n<p><span style=\"font-weight: 400;\">Physiological effects<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Even if a person who is overweight is also perfectly healthy to start with, healthcare can do them a disservice. Weight stigma stops heavier patients from being able to access proper care in one way or another, and this ultimately can result in:<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">Increased blood pressure;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Increased cortisol levels;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Inflammation;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fat deposition.<\/span><\/li>\n<\/ul>\n<p>Mental health issues can cause physical health issues, and vice versa. Further, disordered eating, aging, imbalanced sex hormones, and total body fat contribute to body fat distribution that leads to a greater risk of chronic disease and obesity-related comorbidities. In essence, <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6795075\/\"><span>obesity alone does not indicate a higher risk of physical issues<\/span><\/a><span>, but anti-fatness in healthcare contributes to advancing the actual indicators of poor health.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Health at every size: Foundations for a new paradigm<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Anti-fatness has infected the healthcare system for a long time and continues to seep into patient care and the psyche of patients and the public. Luckily, strides are being made to improve healthcare for heavier individuals. For example, the Association for Size Diversity and Health (ASDH) has put forth a program called <\/span><a href=\"https:\/\/asdah.org\/health-at-every-size-haes-approach\/\"><span style=\"font-weight: 400;\">Health at Every Size<\/span><\/a><span style=\"font-weight: 400;\"> (HAES). It perpetuates the idea that health falls along a continuum. It is not black and white. It is ever-changing and not dependent on size at any given time.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The holistic approach of HAES includes the following principles:<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">Weight inclusivity;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Health enhancement;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Eating for well-being;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Respectful care;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Life-enhancing movement.<\/span><\/li>\n<\/ul>\n<p>This framework can be used by healthcare professionals and patients alike to bring forth a new and necessary perspective.<\/p>\n<p><span style=\"font-weight: 400;\">Core tenets<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To <\/span><a href=\"https:\/\/www.npr.org\/transcripts\/1149079686\"><span style=\"font-weight: 400;\">push back against anti-fatness<\/span><\/a><span style=\"font-weight: 400;\">, patients are taking matters into their own hands through HAES ideology. HAES advocates stand up for themselves in their communities and spread the word that:<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">Human bodies come in all shapes and sizes.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Health extends beyond the physical \u2014 focus on boosting mental wellness.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Eating and exercise aren\u2019t solely about weight management.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Your body knows what it needs \u2014 trust it.<\/span><\/li>\n<\/ul>\n<p>Of course, healthcare officials and educators have their own responsibilities when it comes to HAES \u2014 mainly by changing how medical students are taught about weight-related topics. Providers should focus on opening their points of view and becoming aware of these biases, first and foremost. It may be challenging at first to find a provider who can overcome these deep-seated biases around weight. It may never happen. You have to be your own advocate to reap the benefits.<\/p>\n<p><span style=\"font-weight: 400;\">Health benefits<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A HAES framework is the inherent belief that your health is your priority. This means advocating for yourself in and out of doctor\u2019s offices. With these actions among others mentioned earlier, you can enjoy the following health benefits:<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">Healthier relationships with food and exercise;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Positive social and emotional health impacts;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">More respectful, purpose-driven medical care.<\/span><\/li>\n<\/ul>\n<p>The more people that adopt this framework, the more change will occur \u2014 especially among perceptions of fatness.<\/p>\n<h2><span style=\"font-weight: 400;\">Improving healthcare for higher-weight individuals<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Healthcare institutions and paradigms must recognize that there is much room for improvement when caring for higher-weight patients. A peer-reviewed discussion on policy in the AMA Journal of Ethics outlines <\/span><a href=\"https:\/\/journalofethics.ama-assn.org\/article\/five-ways-health-care-can-be-better-fat-people\/2023-07\"><span style=\"font-weight: 400;\">five ways in which healthcare can improve for fat people<\/span><\/a><span style=\"font-weight: 400;\">. In summary, these include:<\/span><\/p>\n<ol>\n<li><span style=\"font-weight: 400;\">Acknowledging the diversity in weight amongst the human race.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Recognizing fat people as a community that has faced systemic oppression.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Representing fat people in leadership and decision-making positions.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Providing inclusive healthcare equipment and spaces that can accommodate all sizes and weights.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Avoiding recommendation of weight-loss surgeries without cause beyond societal pressures.<\/span><\/li>\n<\/ol>\n<p>Recognizing the importance of compassionate and inclusive care should be the first step. Healthcare professionals can at times lack the social and interpersonal skills necessary to provide adequate care. This is something that needs to be addressed in addition to the overall recognition of anti-fat biases. Further, it must be acknowledged that, while correlated, weight is not the only cause of most illnesses and patients should be examined more closely to determine effective treatment plans.<\/p>\n<h2><span style=\"font-weight: 400;\">Promoting body positivity and health equity<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Although holistic health for all seems like the obvious choice, body-positive groups and movements need to lobby for this change. Start by incorporating ideas from these groups into your daily habits, like intuitive eating and moving your body for wellness instead of aesthetics. With patience and resilience, the healthcare system can improve to be inclusive of all shapes, sizes, and weights. For the health of the public, it must.<\/span><\/p>\n<h1 style=\"text-align: center;\">Need a doctor? Find one on\u00a0<a href=\"https:\/\/www.zocdoc.com\/\">Zocdoc<\/a>.<\/h1>\n","protected":false},"excerpt":{"rendered":"<p>The ideal future is one in which healthcare equality exists. Health equity involves fair opportunities for everyone, regardless of demographics, to achieve optimal health and wellness. As the goal of healthcare is to help the public stay healthy, one would assume health equity would be attainable. However, insidious biases still pervade the healthcare system which [&hellip;]<\/p>\n","protected":false},"author":82,"featured_media":20682,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[227],"tags":[],"class_list":["post-20681","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guides"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Health at Every Size: Exploring Anti-Fat Bias in Healthcare - Guides<\/title>\n<meta name=\"description\" content=\"Anti-fatness has permeated the healthcare system for far too long. Stigma and stereotypes about the weight and size of patients impact mental and physical wellness. 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