By: Ashleigh G. Whittington | Apr 1, 2025

When folks hear that I practice Weight-Inclusive nutrition, the first thing they ask is: "what is THAT?". Until about 3 years ago, I was also unaware of this term, so I can fully understand feeling in the dark. Without officially declaring so, modern healthcare, in the US and in a number of other westernized countries, uses a weight-loss paradigm that prizes a thinner body above any other and that thin automatically equals healthy. I've heard countless tales of clients going to see their doctors for various ailments, or simply a yearly wellness check, only to be told that the only remedy is weight loss and if they are unsuccessful, it is wholly their fault and there's nothing more to be done. If this sounds horrifying and like medical malpractice, I'm right there with you, but it is how so many healthcare practitioners are taught to respond that it's become mainstream and, unfortunately, accepted. 

The Dangers of a Weight-Normative Approach

This approach not only ignores the person sitting in front of you (and let me emphasize PERSON, with feelings!), it also ignores years of good science contrary to this belief that intentional weight loss is the panacea to all ailments; this is called a Weight-Normative approach. It rests on the assumption that weight and disease are related in a linear fashion, with disease and weight increasing together. While there is evidence that a higher BMI has a corollary relationship to some diseases like sleep apnea, osteoarthritis, coronary heart disease, and hypertension, no evidence currently shows that a higher BMI causes these or any other disease. Things that have been associated with diminished health are all staples of and results from a weight-normative approach to health care:

1. The failure of weight loss interventions: Despite innumerable weight loss initiatives, none of the interventions presented in the available credible studies have generated long term results for the majority of participants.
2. Weight cycling (or yo-yo dieting): Repeated periods of weight loss and weight gain have been directly connected to compromised health including higher mortality and higher risk of cardiovascular disease, hypertension, chronic inflammation, and some forms of cancer such as renal cell carcinoma, endometrial cancer, and non-Hodgkin's lymphoma.
3. The risk of eating disorders: Rigid dieting is associated with eating in the absence of hunger and episodes of overeating; in some individuals, these temporary losses of control are met with certain behaviors intending to compensate for calories consumed during a binge episode, like purging, laxative misuse, excessive exercise, and fasting.
4. Heightened weight stigma: When health providers attribute weight-related stereotypes to their patients, the affects the quality of care that patients across the weight spectrum receive. Experiencing weight bias in health care settings might discourage higher-weight individuals from making health-supporting lifestyle changes, seeking routine prevention care, and lowers psychological well-being. 

This approach fails in many ways but two in particular stand out: it does not improve health and it severely harms people. Those two things are not within the medical code of ethics; in fact, they are the exact opposite of the oaths that many practitioners take! Thankfully, there is a growing movement for a paradigm shift and the embrace of a Weight-Inclusive approach.

How a Weight-Inclusive Approach Can Be the Change We Need

Weight-inclusive providers believe that every body is capable of achieving health and well-being independent of weight. We do not adhere to the belief that a particular BMI reflects a particular set of health practices, health status, physical ability, or moral character. This approach tries to minimize weight stigma and may help folks feel comfortable in the health care setting and more able to discuss their health concerns. 

Some of the ways I support my clients through a weight-inclusive approach include:

1. Developing awareness and trust in hunger and satiety cues after years of dieting and/or eating disorders
2. Understanding and applying the principles of intuitive eating 
3. Abandoning the idea of "good" and "bad" foods and addressing the morality around food restriction
4. A compassionate approach to behavior change and emphasis on body acceptance or neutrality
5. Experimenting with what kinds of movements are pleasurable and sustainable
6. Developing some self-care practices that reframe body blame and shame

Although we may be a ways off from seeing a weight-inclusive approach become the mainstream form of care, there are promising gains being made and more and more practitioners adopting this new model of health care. Organizations like The Association for Weight and Size Inclusive Medicine, Medical Students for Size Inclusivity, and The Association for Size Diversity and Health are a few of the amazing advocacy groups working today.

My Goal, and Promise, as a Weight-Inclusive Practitioner 

I want to support my clients to feel empowered, heard, and supported throughout our time together, and I believe that the best way I can do that is through this weight-inclusive approach. I don't think only a select few deserve health care. I don't think we should be treating a potential future version of a person rather than the person sitting in front of us. I want everyone to feel welcome in wellness and health care spaces and I hope that, over time, more practitioners will shift their approaches to do the same.

If you are interested in learning more about weight-inclusive nutrition or movement, click the banner above to book your 15 minute call, or shoot me a message below.