Disclaimer: This article uses the word fat. I use fat as an objective descriptor, not as a derogatory term. I also own that I am a straight-sized, cis-gender, heterosexual female that is also a weight-inclusive practitioner. This does not make me the expert and my knowledge is constantly evolving as I listen to those with lived experience. This reflects my current understanding of weight inclusive nutrition at the time of publishing.
First let’s start with what a dietitian is.
When I say dietitian, what I mean is a Registered Dietitian Nutritionist (you may see it abbreviated RD or RDN). A dietitian is an individual who is an expert in the field of nutrition. Dietitians, as opposed to nutritionists or health coaches, have extensive training, and must meet rigorous standards, including:
Obtaining a Bachelor’s degree in nutrition
Completing a supervised, practice-based dietetic internship
Passing the credentialing exam
Obtaining a state license (as required by the state)
Maintaining your credential/license with continuing education
Dietitians can be found in many business sectors: hospitals, long term care facilities, colleges, food service, public policy, public schools, food bank, private practice, and beyond. It’s an expansive field that allows for practitioners to find their true niche.
While dietitians meet rigorous standards, this doesn’t mean that all dietitians practice in the same way.
This brings me to weight-inclusive nutrition.
Weight-inclusive nutrition is an approach to nutrition counseling that accepts and respects body diversity and focuses on access to respectful and equitable care that offers evidence-based, instead of weight-based, recommendations.
Why does weight-inclusive nutrition matter?
Our current approach equates health with a slender body type. This has allowed fatphobia and weight bias to remain present in our healthcare, workplaces, and social interactions. As a result, widespread negative, inaccurate stereotypes are spread about fat people as lazy, unmotivated, lacking self-discipline, sloppy, noncompliant, etc. Because of this, providers and fellow humans make assumptions about a person’s health based on their body and give them advice on how to help “manage their weight.”
Think about how this must feel for a fat person. A fat person experiences multiple microaggressions or outright aggression daily simply for existing. They may walk into a coffee shop and decide that they want a donut with breakfast and receive a negative comment about how they shouldn’t eat that. They may walk into an interview and despite interviewing well may be overlooked for a position for a slenderer individual. They may go to the doctor’s office for knee pain and instead of being prescribed physical therapy they are told to lose weight. They may be watching TV and see how a fat person is portrayed as mean, ugly, sloppy, etc. Unfortunately, this happens way too often and has the potential to create a trauma response. That trauma response may include: avoiding healthcare and social settings all together and/or feeling the need to change their body.
Our current system funnels a fat individual into dangerous dieting behavior. We have significant evidence that while weight loss may happen and the weight may stay off for the first 6 months to a year, that a vast majority of individuals will regain the weight that they lost – thus promoting weight cycling. So, in effect, we are pathologizing people’s body size, chastising them into a trauma state, encouraging them in disordered eating patterns that only serve to increase their body size and set them up for more ridicule under the current system.
As a weight-inclusive dietitian, I cannot stand for that.
As a fellow human, I cannot stand for that.
This is the reason that weight-inclusive nutrition is so important. Instead of feeding into this current system, I view myself as an advocate against the system. As a weight-inclusive dietitian, I educate my clients on the harms of dieting and help them replace those learned disordered eating patterns with body attunement and eating foods that are physically and psychologically satisfying. Instead of focusing on managing their weight, I focus on their access to quality, evidence-based care. Instead of forcing health behaviors on them, I collaborate with them to see what health behaviors they feel ready to pursue, if any.
Does that actually help people be healthier?
The short answer is: if a person’s goal is to be healthier, then yes a weight-inclusive approach can help an individual become healthier by focusing on health behaviors, such as:
Stopping eating disorder/disordered eating behaviors
Balancing food groups at meals and snacks
Incorporating nutrient rich foods within a person’s preferred foods
Incorporating joyful movement as desired/able
At the same time, I also honor a person’s body autonomy and encourage them to decide if pursuing these health behaviors is aligned with their values and abilities.
Weight-inclusive nutrition also goes far beyond an individual’s health status. Weight inclusive nutrition is about recognizing the inherent worth of an individual and that their size (or other characteristics – race, ability, gender identity, sexual preference, etc) should not exclude them from quality healthcare.
I believe in every person’s inherent value and believe that quality healthcare is a basic human right. I am a strong advocate for weight-inclusive care on behalf of my clients and all people.
I love being a weight-inclusive dietitian that recognizes each person’s value and helps them pursue health behaviors on their own terms. As a weight-inclusive dietitian, I educate my clients on the harms of dieting and disordered eating patterns; help them make peace with food and their body; and encourage their autonomy in making health decisions.
As a straight-sized, cis-gender, heterosexual female I also recognize my privileged status and continue to pursue knowledge and understanding to best serve my clients that exist in more marginalized populations.
About Health At Every Size. Association of Size Diversity and Health Website: https://asdah.org/health-at-every-size-haes-approach/