For years, individuals living with obesity or those in larger bodies have faced more than just the physical effects of excess weight, they’ve also endured a lesser-known, but equally harmful issue: weight stigma. Defined as the discriminatory acts or negative attitudes toward individuals based on their weight, weight stigma in healthcare is a serious and pervasive problem that can discourage people from seeking timely and appropriate medical care.
In Sri Lanka, it is not uncommon for doctors and healthcare professionals (HCPs) to focus solely on a patient’s weight during consultations. Instead of addressing the health issue at hand be it irregular periods, joint pain, or skin conditions, patients are often told to “just lose weight.” Frequently, this advice comes without any supportive guidance or personalised recommendations. Instead, oversimplified phrases like “eat less, move more” are used. This oversimplified message, often delivered without compassion or practical support, leaves patients feeling unheard, blamed, and demoralised.
This pattern of care discourages people from returning for follow-ups or seeking help in the future. Studies have shown that weight stigma can lead to serious consequences such as increased rates of depression, anxiety, eating disorders, self-harm, and even avoidance of medical care altogether. A 2020 review published in Nature Medicine emphasised that weight stigma is a significant contributor to both physical and psychological health risks, independent of a person’s body mass index (BMI). Adding to the problem is the persistent use of Body Mass Index (BMI) as a diagnostic tool. While BMI can be useful in population-level studies, it is not recommended for assessing individual health. It doesn’t account for genetics, muscle mass, bone structure, or the complex interplay of biological, psychological, and environmental factors that influence a person’s weight and health. The World Health Organization (WHO) and Obesity Canada both discourage the use of BMI as a sole diagnostic tool, advocating instead for a more comprehensive and individualised assessment approach.
In many local hospitals and clinics, patients are weighed without consent, and weight is often the first and only metric considered in their treatment. Such experiences can be demeaning and demotivating, leading patients to delay or completely avoid follow-up visits. This delay can result in the worsening of underlying health conditions, ironically, the very issues healthcare is meant to address.
Despite the rigorous scientific and clinical education HCPs receive, there is often little emphasis on the development of interpersonal skills, especially when addressing sensitive topics like weight. Addressing obesity as a complex, multifactorial condition requires more than medical facts; it requires compassion, empathy, and an understanding that each patient’s experience is unique.
In many local hospitals and clinics, patients are weighed without consent, and weight is often the first and only metric considered in their treatment. Such experiences can be demeaning and demotivating, leading patients to delay or completely avoid follow-up visits.
Contrary to popular belief, obesity is not a simple issue of willpower or laziness. It is a complex, chronic condition and is influenced by a range of genetic, biological, psychosocial, and environmental factors.
In Sri Lanka, where health appointments are often rushed and may last less than 10 minutes, patients rarely get the opportunity to discuss their lifestyle, mental health, or personal challenges related to weight. This systemic limitation exacerbates the issue further, leaving patients unsupported and unheard.
To improve outcomes, healthcare professionals must first reflect on their own biases. Creating a weight-inclusive environment where people of all body sizes feel safe and respected is crucial. Evidence shows that patients who engage in compassionate and collaborative conversations with their providers are more likely to feel motivated and follow through on health-promoting behaviors.
Interventions that emphasise self-care, intuitive eating, stress management, and self-compassion, not just weight loss have been shown to be more effective and sustainable. Healthcare systems must shift from weight-centric care to health-centric care, where the goal is not merely to change a number on a scale but to improve overall wellbeing.
Ultimately, recognising and addressing weight stigma in healthcare is not just about being politically correct, it is about improving lives, reducing health disparities, and restoring dignity to every individual who seeks care. It is time we moved beyond blame and embraced a more empathetic, informed, and inclusive approach to health.
