Weight-bias and Anti-fat beliefs

Why does weight-neutral care matter when helping people prevent or manage diabetes? Because as healthcare providers, we can play a role in reducing the effects of Anti-fat beliefs by not contributing to it ourselves, but also by providing evidence-based care that’s focused on changing behaviors, not losing weight (weight isn’t a behavior). That’s important because fatphobia contributes to weight bias and weight stigma, which has been shown to have negative effects on physical and mental health as well as contributing to the avoidance of preventive healthcare.

ADCES: Weight Bias

What is the harm in promoting weight loss in diabetes care?

The typical messaging surrounding diabetes is goal-based, or outcome-focused, such as lose weight or lose 10% of your current body weight.

Unfortunately, this messaging erroneously associates weight loss with curing or treating diabetes. This unintentional association is popularized in the media and press, with books, websites, and health campaigns to “prevent, beat, defeat diabetes” instead of focusing on the day-to-day support needed to manage diabetes. It is easy to concentrate or emphasize weight-based outcomes, which only reinforce the fallacious notion that weight loss is a behavior. The level of harm that is associated with promoting weight loss is far more complex than avoiding treatment, and it is woven into the research of weight-stigma, weight-bias, and the impact of disordered eating, which we have addressed in separate questions. 

On the right is an image taken on May 28, 2019, about a client delaying care because he thought eating ‘better’ would cure diabetes. 

The diabetes community is encouraged to look at the erroneous messaging that associates health with weight. The ADCES has clear language guidelines and the ADCES 7 self-care behaviors to help the diabetes community reduce weight stigma and focus on behaviors (not weight) to provide nonjudgmental, patient-centered medical care.

Helpful Resources to Expand Your Knowledge