It’s about time!
While physician attitudes and biases toward and around gender identity, sexuality, mental health have evolved (and varied) over the years, my experience as a woman, a daughter, a sister, a mother, and a psychotherapist indicate that attitudes toward weight and what we weigh has been slower to follow. This is true for the broader medical community as well. I am therefore thrilled to see the shift outlined in this article that moves health care away from looking at obesity as a “lifestyle problem” that is about choice – to one that considers many factors including “overall health and lived experience”. It also moves away from using “Body Mass Index (BMI)…as the primary tool to identify obesity… and the term “diet” is replaced with “medical nutrition therapy.”
The results of medical discrimination based on weight or ‘sizeism’ are well documented as this article suggests The results have been internalized by women specifically, and by society more broadly. We as a society have normalized fat shaming / weight shaming / body shaming — across generations (eating disorders and body loathing can often be traced back many generations — I can attest to that in my own family). Even a few extra pounds were considered a result of laziness, and slothfulness. Body loathing crosses the life span sadly, and eating disorders return for many women in middle age — after having children, going through menopause, and other normal life changes that change our bodies. These are largely seen as unacceptable — internally and externally.
The consequences have been devastating as entire generations deal with the manifestations of body shaming that present as anxiety, depression, low self esteem, fear of judgment, fear of being ‘seen’, fear of speaking. It has been a barrier for many people seeking medical help for other conditions, to enjoying good food, their clothing, and so on. Our focus on individual so called free choice has not helped matters. It ignores genetics, the role of certain medical conditions, body types, and so on. A change in attitudes will hopefully work to destigmatize, and normalize body health and body love at different sizes.
There is more work to do but this is a good start.