To increase the comfort level of all patients, it’s imperative to weigh people privately. Displaying inclusive images on our walls and avoiding stigmatizing language is essential to make all patients feel welcome.
The first thing someone will notice about me is my dark skin. Next they’ll see my breasts, my hips, and my plum lipstick and they’ll assume I’m female. Their eyes will spread over my size 14 shape and they’ll realize that I’m a full-bodied Black woman.
For as long as I can remember, I’ve been on a diet, “cleansing,” or “cutting back.” From the moment my mom noticed I was “packing it on” in kindergarten, I’ve been made aware that I must limit my food and exercise regularly. I’ve done yoga, Zumba, strength training, and more. I’ve been low-carb, keto, low fat, you name it. I’ve done my fitness pal and accountability partners. I’ve weighed myself twice a day, once a day, weekly, and monthly. I’ve told everyone that I’m trying to lose weight and I’ve also tried to shed pounds privately. Even with all of the effort, tears, and frustration, my weight has continued to trend upward.
As a medical student, I sit in rooms where I learn that “obese patients” (people with a BMI over 30) are at a higher risk for every disease under the sun. It makes me feel self-conscious, out of place, and scared that one day my future patients will see me as a hypocrite. It doesn’t help that the people in medical school tend to be the athletic health-types whose habits and genetics coexist.
For the record, I’m a size 14 and I look at the nutrition facts for almost everything that goes into my body. I’m a size 14 and I walk the beach five times a week. I’m a size 14 and I eat cauliflower rice, drink almond milk, and sprinkle chia seeds on everything. Weight isn’t a comprehensive indicator of health and medical education needs to integrate that into the curriculum. Patients aren’t obese—they have high BMIs. Patients don’t need to be judged or stigmatized for weight gain, they need to be heard and nurtured.
I knew that my journey with weight was more than physical when I visited my university dietitian and sobbed in her office. I learned that my years of battling the scale complicated my relationship with desirability, induced trauma, and further opens the door for my medical student imposter syndrome.
It’s difficult to be hyper-aware of my diet and exercise and feel like I’m making no progress. Meanwhile, I have friends that can eat all day and avoid the gym without a single inch added to their midsection. All of our bodies are different. The disregard of body diversity in conversations around health is damaging and discouraging. One of the most powerful things that the university nutritionist shared with me was when she illustrated body diversity with dogs. She said, “some of us are Pomeranians and some of us are mastiffs.” If only we could apply the same understanding of health “coming in different shapes and sizes” to everyone.
Like many of the women in my family, I’ll probably continue to war with my weight for the rest of my life. I understand that when I feel inadequate or unworthy that it’s necessary for me to speak life into the mirror, surround myself with people who affirm my value, and understand that my journey isn’t linear. I’ll continue to wear the crop-top, the two piece, and my arms exposed. I’ll continue to shower my body in love, even when I feel anger towards her. I know that I represent millions of women who experience a love-hate relationship with their bodies, and I’ll bring our voice to the table.
As a future physician, I look forward to giving full-bodied women the compassion, detail-oriented attention, and empowerment that we all deserve by practicing the following:
1. Make getting weighed private.
For many, the scale is the worst part of an appointment. Stepping on the scale in front of others can make patients uneasy. In order to reduce unnecessary stress, make the weighing process as private as possible. Scales should not be in public hallways and the numbers should never be read aloud.
2. Ensure images on clinic and hospital walls are inclusive.
The average American woman is not a size two and white. Make the visuals in your office representative of the people in this country. Show brown bodies, disabled bodies, curvy bodies, and slim bodies living full and healthy lives on the walls.
3. Avoid stigmatizing language.
What added benefit is there by using the word obese? Use words that don’t stigmatize bodies. Consider language that’s more neutral like “BMI over 30.” I prefer “full-bodied,” as like certain wines I’m rich, deep, and pleasant. Use language that dignifies.
4. Promote health at every size
The culture around weight loss and restriction can be toxic physically, emotionally, and spiritually. Empowering people to pursue health and wellness at any size is a more encouraging and accessible way to counsel patients. The Health At Every Size (HAES) movement “promotes balanced eating, life-enhancing physical activity, and respect for the diversity of body shapes and sizes.” Consider incorporating some of their suggested techniques and readings found on their website and blog with your patients.
5. Be positive.
I’m grateful to my body for dance, how I feel in a sundress, and hugging loved ones. I speak power, radiance, and strength. I understand that my value and purpose doesn’t fluctuate like weight. These messages should be reinforced by healthcare professionals. While counseling patients to live their healthiest lives, be intentional about bolstering the self-love of everyone who crosses your path.