How old were you the first time you thought about your weight? For many, it’s likely a lot younger than you realize.
“From a very young age, we’ve inadvertently been taught to put a lot of value on body size and shape,” explains Andrea Donalty, MD, MultiCare Mary Bridge Children’s Pediatrics. “There is so much pressure for young girls and boys to look a certain way.”
As society and medicine move forward, health care professionals want to reshape how people define and talk about what it means to be healthy through the practice of weight inclusivity.
What does ‘weight inclusivity’ mean?
Weight inclusivity focuses on a person’s overall health and well-being, not a number, to ensure equitable health care for people of all body shapes and sizes.
The principles of weight inclusivity follow the understanding that weight does not define your health or value as a person or patient, explains Erica Lewis, MS, RD, CD, pediatric wellness program manager at Mary Bridge Children’s Hospital. Weight is one indicator of lifestyle habits and health conditions, but it doesn’t reflect the full picture of someone’s health.
Weight inclusivity also requires a more mindful approach to how you speak about weight, your body, food and physical activity. For example, using terminology like “higher weight,” “person in a larger body” or “movement” rather than other commonly used phrases.
It doesn’t mean ignoring numbers entirely, though.
For health care providers, Dr. Donalty emphasizes the importance of inclusive language and knowing what’s being conveyed to patients when talking about weight — especially pediatric patients. Each person and family will have their own definition of “healthy,” and it’s important to take that and other health and lifestyle factors into consideration with their care.
Providers should look at things like growth patterns/sudden changes, genetic and cultural differences, lifestyle habits, how your family views and interacts with food, and financial limitations.
Why is weight inclusivity important?
Following weight-inclusive practices is key to ensuring equitable health care for everyone, and just as important, helping people develop positive relationships with their body, food and movement.
Many studies show that patients who experienced weight stigma or shame by a health care provider are significantly less likely to seek medical care in the future, which can lead to missed preventive care or delayed diagnosis of more serious conditions, Lewis adds.
“We don’t need kids to have a certain body type; we just want them to be healthy … Healthy at whatever size or weight that means for them.”
The ripple effect of weight stigma can be both physical and mental. Physical conditions like heightened cortisol levels from stress, long-term metabolic changes or eating disorders, among many more, can occur. The stigma — real or perceived — can exacerbate anxiety, depression and suicidal thoughts.
Weight-inclusive practices instilled early in life give children the best chance to develop those positive relationships and allow their bodies to grow as they need to.
“We don’t need kids to have a certain body type; we just want them to be healthy,” Dr. Donalty says. “Healthy at whatever size or weight that means for them.”
How can families implement weight-inclusive practices at home?
Weight inclusivity is also about helping kids feel motivated and confident about their bodies, as well as how they fuel and move them, Lewis says.
MultiCare follows the 5 Keys to Feeding Well, a pediatric feeding best practice developed by Ellyn Satter that focuses on dividing the responsibilities of mealtime between parents and children. Parents decide what, when and where to eat, while the child decides whether and how much to eat.
“No parent truly knows if their child is hungry or not. Genetically we don’t know which parent they’ll take after or what their stomach is signaling,” Lewis explains. “We get into this struggle of telling them what they should or shouldn’t eat, which is often rooted in our own fear of how they’ll be judged or how it reflects back on us.”
Weight-inclusive practices focus instead on teaching kids how to listen to their bodies’ cues, how to fuel them properly for what they want to do, that there’s no good or bad food or movement, and to appreciate all that their body does for them.
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