People with obesity can experience stigma in the healthcare community. Healthcare professionals’ weight bias can lead to harmful attitudes and lower quality care. Self-advocacy may help people set boundaries and receive better care.

A person can self-advocate by gaining and using knowledge that allows them to participate actively in healthcare decision making. This can involve expressing preferences for evidence-based treatment options, voicing discomfort with certain healthcare practices, and questioning healthcare professionals on their methods.

Self-advocacy can help people with obesity navigate stigma and biases about their weight in healthcare settings. This could lead to better, non-weight-focused healthcare and higher treatment satisfaction.

A person writing a symptom diary.Share on Pinterest
Jacques Julien/Getty Images

People with obesity may experience stigma in relation to their weight in healthcare settings.

Healthcare professionals may consistently aim treatment toward weight loss, regardless of a person’s reason for making a medical appointment. They may also use diagnostic methods that can cause discomfort, such as weighing people even when it is not necessary.

Research suggestsTrusted Source that weight stigma is prevalent in healthcare settings and can affect treatment quality. For example:

  • In a 2021 study, 66% of people who reported experiencing weight stigma also experienced it from healthcare professionals.
  • In a 2022 study involving almost 1,700 people in Israel, 48% of people with a body mass index (BMI) higher than 25 reported suboptimal healthcare treatment.
  • In the same 2022 study, more than 50% of the participants reported that healthcare professionals had made judgmental and insensitive comments.
  • Older studies cited in a 2019 research review found that healthcare professionals spend less time with people with obesity during office visits.
  • The results of a 2003 studyTrusted Source suggest that healthcare professionals’ weight bias affects their ability to offer empathy and support to people with obesity, which can affect the quality of their treatment.
  • According to a 2019 review, healthcare professionals’ weight bias can deter people with obesity from seeking healthcare.
  • Healthcare professionals are more likely to view people with obesity as a “waste of time.”
  • Some doctors report reluctance to perform pelvic examinations on people with obesity despite their higher risk of ovarian and endometrial cancer.
  • People with a higher BMI are three times as likely as those with a “normal” BMI to report that healthcare professionals have denied them appropriate medical care.

Before a healthcare appointment, a person with obesity may want to gather relevant information about diagnostic procedures, treatments, and their rights as a patient.

Self-advocacy involves gaining and using knowledge from reputable sources so that a person may question healthcare professionals’ methods and ask for alternative diagnostic procedures and treatments when necessary.

A person may also contact a healthcare professional’s office in advance to request certain preferences, such as not having weigh-ins.

Self-advocacy tips may include the following.

Seeking information

By educating themselves about their health concerns through research and gathering knowledge, people can take greater ownership of their health.

This can help them ask questions and make decisions about their health and treatment with greater confidence.

Practicing self-compassion

Self-compassion involves self-kindness and mindfulness. Self-compassionate people acknowledge their past or current challenges and nurture a desire to heal themselves with kindness.

Acknowledging personal challenges and treating themselves kindly can help buffer people against negative emotions that may occur during a healthcare appointment. Doing so may also contribute to improvements in physical symptoms and mental health.

Asserting preferences and participating in decision making

Self-advocacy can involve asking healthcare professionals to accommodate certain preferences and actively participating in decision making.

Examples include:

  • expressing preferences for alternative diagnostic methods, such as requesting a body composition analysis rather than a body weight measurement
  • asking for the use of evidence-based nutrition and physical activity routines
  • requesting specific, evidence-based medications or surgery options
  • asking healthcare professionals to set health goals that are not focused on weight

Asking to keep a record of concerns

If a person with obesity has a negative experience with a healthcare professional, they can ask that the medical office record their concerns.

A person can also provide online reviews of a healthcare professional to help others with obesity decide whether to seek healthcare from them.

Self-advocacy cards contain prepared statements that people with obesity can use to respond to common issues that they may face.

The Health at Every Size (HAES) Health Sheets Projects Team is an organization that offers printable self-advocacy cards.

The cards can be for personal use. They contain phrases and information resources that a person can learn by heart or read when necessary.

Examples of questions and phrases on a self-advocacy card that people with obesity can use when speaking with healthcare professionals include:

  • “Do those without obesity have this health problem? What would a doctor typically recommend for them?”
  • “Research shows that conventional weight management has a high failure rate and many people who diet regain the weight.”
  • “Is there clinical evidence that shows a majority of people succeeding at the amount of weight loss suggested?”

People can also give certain self-advocacy cards to healthcare professionals to help clarify preferences. These may include requests to:

  • consider prescribing the same treatment as they would for a thin person
  • provide shame-free care
  • avoid prescribing weight loss as a health intervention

A weight-friendly healthcare setting includesTrusted Source medical equipment that can accommodate larger bodies, such as larger examination tables, longer needles, and larger blood pressure cuffs.

As part of self-advocacy, a person may decline healthcare with inappropriate equipment, such as an ill-fitting blood pressure cuff, and ask for inclusive equipment.

In addition to contributing to stigma, inappropriate medical equipment can negatively affect healthcare treatment and outcomes.

A person can practice self-advocacy when speaking with a healthcare professional who shows weight bias. This can include questioning treatment decisions and asserting preferences.

Using self-advocacy cards can help a person respond to common issues that people with obesity face in healthcare settings, such as requesting equitable treatment.

If a person does not feel safe with a healthcare professional or is unsatisfied with their level of care, they may want to leave the appointment and seek alternative care.

The rights of people as patients align closely with self-advocacy goals. According to the American Medical Association Code of Medical EthicsTrusted Source, patients have the right to:

  • be treated with courtesy, respect, and dignity
  • make decisions about the care a healthcare professional recommends, including a right to refuse any intervention
  • receive information about and the opportunity to discuss the risks, benefits, and costs of alternative treatments
  • ask questions about their healthcare and treatment and have their questions answered

A person can use various resources to help them find a weight-friendly healthcare professional, such as:

  • Examining a healthcare professional’s online profile: Terms such as “weight-inclusive” and “Health at Every Size (HAES)” can indicate that a health professional is weight-friendly. Conversely, a focus on obesity treatment and weight management may indicate that they practice weight-centric healthcare.
  • Assessing medical equipment: A person may be able to visit a medical office, call ahead, or view it online to determine whether it has appropriate furniture and equipment, such asTrusted Source waiting room chairs, robes, examination tables, needles, blood pressure cuffs, and vaginal specula that accommodate larger bodies.
  • Checking online reviews: Online reviews from other people with obesity may help a person assess whether a healthcare professional is weight-friendly.
  • Getting referrals: A person can ask other people with obesity or trusted healthcare professionals to recommend weight-friendly doctors.

A person may find the following resources helpful:

  • HAES Health Sheets: a website offering several resources that may be helpful for people with obesity, including self-advocacy cards, a list of weight-friendly health professionals, and healthcare research
  • The Obesity Action Coalition: an organization that provides various resources for people with obesity
  • The Council on Size and Weight Discrimination: an advocacy organization that aims to change public perceptions and policies on weight discrimination
  • The Association for Size Diversity and Health: an organization that provides community and resources for addressing weight stigma in healthcare
  • The National Association to Advance Fat Acceptance: an organization that offers obesity advocacy, support, and education

Many people with obesity experience stigma from healthcare professionals. Weight bias in healthcare settings can affect treatment and healthcare outcomes for people with larger bodies.

Self-advocacy can help people with obesity address weight bias in healthcare. Self-advocacy involves maintaining compassion for oneself, asserting healthcare preferences, and actively participating in healthcare decision making.

Many healthcare professionals are weight-inclusive. People may find unbiased healthcare professionals through various resources, including online searches and referrals.