Challenge Accepted! Learn How To Reduce Weight Stigma In Diabetes Care!
Savor this interview with Chevese Turner, a co-founder of Weight Stigma Awareness Week, who shares her experience addressing weight stigma as someone with diabetes.
The Voices of Inclusion amplifies how we can reduce the many types of stigma in diabetes care. This month, we are excited to share the work of Chevese Turner, who has been helping the world understand the impact of weight stigma.
Chevese Turner and Dr. Wendy Oliver-Pyatt of Within Health co-founded Weight Stigma Awareness Week. She owns the Body Equity Alliance.
Please consider this issue a formal invitation to attend this annual awareness week, September 23 to 27, 2024, focused on educating and empowering people to challenge harmful anti-fat biases in our society. The week will include two days of free educational sessions and CEUs on the 24th and 25th. You can sign up to attend at www.weightstigmaawarenessweek.com.
Q. Inclusive Diabetes Care talks about the felt experience of belonging. Can you share some ways healthcare providers can or have made you feel like you (personally) belong?
A. The biggest thing that makes me feel like I belong is when a provider listens to me. Understanding what I want and don’t want is the foundation of a trusting relationship.
It seems like a simple request, but it is easy to forget how top-down the healthcare system is. The PCP is envisioned as the expert, and the patient is to follow what is said or asked. It takes courage and effort for healthcare professionals to question this power imbalance. Like I said, feeling heard builds trust, which is needed to create a solid relationship for all future appointments.
Q. Can you give a clear example?
A. When I met my endocrinologist, I told her about my eating disorder and that maintaining my recovery from my EDO is a central part of my health. I am not interested in pursuing intentional weight loss because it will trigger disordered eating behaviors. You can imagine the situation: I was newly diagnosed with diabetes and trying to maintain my eating disorder recovery. I was nervous about this conversation, but my experience in the office was respectful. She asked permission to be weighed, and I could advocate for myself. Things like having blind weights, and not being told if my weight went up or down were helpful. It was necessary to be very clear about weight, which can’t be a topic of care for me. I felt heard and validated by this experience and understood that my goal was not to jeopardize my eating disorder recovery.
It is hard for fat people to go into an office because we don’t know how the provider feels about fat bodies or if they have checked in with their own internalized weight bias. Many providers have personal feelings about a Health At Every Size, HAES approach. Her model was to treat “obesity” as a disease and to help pursue intentional weight loss, but she was recommended by a peer that I trusted. This personal recommendation allowed me to meet with her.
Q. What/How can healthcare providers and organizations do to create a sense of ease at a medical/nutrition session?
A. I agree that ease is missing and that bringing ease into the medical setting happens before the first appointment. We have to look at everything, from the website to answering calls. How do these interactions land? For example, when the person speaking with you is rushed or lack compassion, it is draining and can be emotionally triggering. While it isn’t always easy to answer questions compassionately, it helps marginalized folks imagine letting their guard down. That seeking medical care is a safe experience.
Focusing specifically on the needs of fat people, if the practice isn’t informed about weight stigma, the sense of ease can be eroded even before I enter the building.
Medical practices also need to look at the acceptability of their whole space—every step, from the parking lot to the waiting room chairs, from blood pressure cuffs and gowns to magazines. Imagine what it is like for a fat client. Take the time to see all the messages where the underlying assumption is that everyone wants to lose weight or be thinner.
Q: Feeling seen and heard is essential in healthcare. How has your position as a weight-stigma expert fostered a deeper understanding of health/nutritional needs during medical appointments?
Sharing our weight-inclusive voice is different from pharmaceutical efforts, which are tied to drugs that are tied to intentional weight loss.
A. I work in the field of eating disorders and weight stigma, and it is helpful to explain how weight stigma is harmful. Organizations need to listen to lived experiences. Sharing our weight-inclusive voice is different from pharmaceutical efforts, which are tied to drugs that are tied to intentional weight loss.
Q. If you had one wish that health/diabetes professionals could know/realize about healthcare for a weight-inclusive approach to diabetes, what would that be?
A. I want everyone to understand that an inclusive approach is compassionate. It upholds the vow healthcare professionals take to ‘do no harm.’ That is what inclusiveness in care is about - reducing harm.
This approach interrupts weight cycling and helps our mental health. When people experience shame, they don’t seek care. Understanding a weight-inclusive approach would decrease anxiety and support clients seeking care to overcome the shame and guilt that has been tied to fat bodies.
The following article Consequence of a Weight-Centric Approach makes a case for a paradigm shift in how clinicians view and address body weight. In this review, we (1) address common flawed assumptions in the weight-centric approach to healthcare, (2) review the weight science literature and provide evidence for the negative consequences of promoting dieting and weight loss, and (3) provide practice recommendations for weight-inclusive care.
Q: Could you share insights about the inspiration and goals behind Weight Stigma Awareness Week and your work at Body Equity Alliance?
A. My work with the Body Equity Alliance helps corporations, institutions, and individuals understand and overcome discrimination or internalized weight bias. Weight stigma is at the core of how it impacts our lives. We are all steeped in anti-fat bias, and we all need a community and culture where people can be at ease around their bodies.
Q. Wow, that is amazing. Please share more about Weight Stigma Awareness Week
A. It started in 2011 as part of the programming for the Binge Eating Disorders Association, which I founded and operated until 2018 when we merged with another organization. Back then, people with BED avoided treatment due to body shame. What is worse is when they did seek help, they were told to lose weight as a treatment for BED.
Many professionals are unaware that Binge Eating Disorder is a mental health issue. It doesn’t make sense to assume that weight loss would address a mental health issue. At the time, the disorder-eating community needed to get what was underlying this mental health issue, which is weight stigma.
Weight Stigma Awareness Week is a free two-day conference with ten speakers who present different aspects of weight stigma and explore how it manifests in our lives. The program also offers a toolkit, resources for individuals, and a weight-inclusive approach to healthcare professionals.
The following bullets are from the WS Toolkit and are for you to share.
Weight-based discrimination impacts quality of life and even life expectancy. Urgent action is needed to create a more inclusive society. #WeightStigmaAwarenessWeek #WSAW24 #WSAW
Fat people must be included in decisions impacting them. Diversity of voices is key to ending weight stigma. Your experience matters. #WeightStigmaAwarenessWeek #WSAW24 #WSAW
Eliminating diet culture and weight stigma requires diverse perspectives and respect for all bodies. Embrace diversity for true inclusivity.” #WeightStigmaAwarenessWeek #WSAW24 #WSAW
Addressing weight stigma requires rethinking societal values around weight and privilege. Let’s create a more inclusive world together. #WeightStigmaAwarenessWeek #WSAW24 #WSAW
Companies need to innovate and create products for all sizes to truly be inclusive. Inclusivity boosts both society and business. #WeightStigmaAwarenessWeek #WSAW24 #WSAW
Harnessing voices from fat liberation spaces can help industries understand the diverse impacts of weight stigma. Listen, learn, and include. #WeightStigmaAwarenessWeek #WSAW24 #WSAW