Advocating for your child in a medical setting can be complicated, emotional, and maybe a little intimidating. If that’s your experience, you’re not alone! The first step in talking to your pediatrician about weight-inclusive care is understanding what it is.
What is weight-inclusive care?
Weight-inclusive care emphasizes health as the ultimate outcome while also acknowledging that factors contributing to health are varied and complicated. Health is a continuum with many possible outcomes and possibilities. Weight-inclusive care also aims to improve access to unbiased healthcare and reduce weight stigma experienced by those in larger bodies.
Some examples of weight-inclusive care include focusing on:
- Health Promoting Behaviors rather than changing the number on the scale
- Overall wellness instead using BMI
- Setting SMART goals to address modifiable risk factors for individuals
Weight-inclusive care is still a relatively new approach in the medical field. It makes sense if this is the first time you’re discussing it with your pediatrician. The good news is that you’re in the driver’s seat – you get to control how to approach and continue the conversation, and you don’t have to settle for biased care.
What’s the best approach?
Weight-inclusive care is a broad topic, so your approach will depend on lots of factors. These could include your child’s health background, your communication style, and/or your relationship with your pediatric provider. And, while there isn’t one “best” approach, here are some ideas to get you started:
1. Plan ahead
Because these conversations can be draining, it may help to have a plan beforehand. You can start by asking yourself questions including:
- What is my goal in having this conversation?
- What is my definition of weight inclusive care?
- In a perfect world, how would I like to see the provider using this method?
- What are some examples of weight exclusive care?
- What will I do if the pediatric provider isn’t as receptive as I’d hoped?
- What will the next steps be after the conversation?
2. Bring evidence to the conversation.
Whether or not your pediatrician is knowledgeable about weight-inclusive care, you’ll want to highlight its importance. If you’re not quite sure how to start the conversation, that’s okay! You can do this in-person, or via phone or messaging if you have access to that. Some people even write down their concerns the old-fashioned way, and give their provider’s office a hand-written note. Here are some good talking points from the Centers for Disease Control and Prevention:
- Healthy at Every Size movement: Health at any weight.
- The harms of stigmatizing weight: Shame is not an effective motivator, decreases desire to seek medical attention, and causes a strained provider-patient relationship.
- The benefits of weight-inclusive care: Empowering the patient, effectively achieving health goals, and building a strong patient-provider relationship.
3. Provide specific examples.
Examples of the kind of care you’re seeking can help you and your pediatrician get on the same page. Concrete direction can also prevent or at least decrease confusion later. Some examples you might give are:
- Not weighing your child or discussing weight/size unless medically necessary
- Not discussing BMI, as it Isn’t a measure of health
- Encouraging movement instead of discouraging stillness
- Assessing stress, sleep, and other health promoting behaviors
What should I do next?
After you’ve had the conversation, keep checking in to make sure your pediatrician is honoring your request. Here’s how:
- Observe how your pediatrician interacts with your child in the office
- Ask your child how they feel about their care after they’ve had a visit
- Check in with your pediatrician regularly
Remember, you’re empowered to start and continue this conversation in whatever way you feel is right for you and your family.
Reviewed by the Ovia Health Clinical Team
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- “Center for Disease Control and Prevention” homepage. Center for Disease Control and Prevention. https://www.cdc.gov/
- Dollar, E. “Do No Harm: Moving Beyond Weight Loss to Emphasize Physical Activity at Every Size.” Centers for Disease Control and Prevention. Preventing Chronic Disease. April 20, 2017. https://www.cdc.gov/pcd/issues/2017/17_0006.htm
- Humphreys, S. “The unethical use of BMI in contemporary general practice.” National Library of Medicine. 60(578): 696–697. Web. September 1, 2010.
- Tylka, T. “The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss.” National Library of Medicine. 2014; 2014: 983495. Web. July 23, 2014.