Is Your Physician Curious About Weight-Inclusive Care?

How the Association for Weight and Size-Inclusive Medicine is opening providers minds

I enjoyed interviewing Lisa Erlanger, MD, president of the Association for Weight and Size-Inclusive Medicine, this month for our Voices of Inclusion segment of the Inclusive Diabetes Care Newsletter.

Q. Inclusive Diabetes Care talks about the felt experience of belonging (See IDC Pyramid). Can you share some ways healthcare providers can or have made you feel like you (personally) belong?

Lisa Erlanger: I’ve been reflecting on this question. Traditionally, in medicine, specifically medical training, we prioritize belonging by constantly proving to others that we are the smartest, most productive people in the room. That's how we gain our foothold in terms of respectability and belonging. Unfortunately, the hustle feels incredibly hollow and inauthentic because we're not being seen for ourselves, and there's a constant fear of losing that ground. There's always someone smarter, better, or quicker. This way of thinking gets in the way of just “being.” When I'm in the room with a patient, I know that knowledge is available to people these days, but what they want (and need from me) is a human that listens and hears and assimilates information that's responsive to them.

That deep sense of belonging is possible because I've experienced that in my personal and professional life. I've had people bring their whole selves to their mentorship of me, to their collegiality, and I have physicians who have done that for me as a patient.

Megrette: “That is so powerful. I agree we really have to have that sense of belonging to provide a sense of belonging. And when we haven't had that sense of belonging because, as you said, I don't feel authentic or we haven't been encouraged to be authentic, that sense of belonging is lost.”

Lisa Erlanger: Even when we feel like we belong in our personal life, there's often a division with work where we don't trust that we'll belong if we bring our whole selves. We're all bringing masks to work, and we carry those masks into the exam room. That's one of the ways we “Other” our patients because if we feel we have to pretend to be smart and productive and entirely free of any mental or physical diseases, we stop being human.

Megrette: “That is beautiful. Thank you for connecting those dots.”

Q. Ease is a basic human need, yet many folks still need to experience it. What/How is the Association for Weight and Size-Inclusive Medicine doing to create a sense of ease at a medical session in general or specifically for the diabetes community?

[To learn more about Stigma, this brief video can help you understand perceived stigma]

Lisa Erlanger: What a person anticipates about their experience in the visit affects how a session will be experienced. Therefore, it is essential to start with the physical space. For example, what do they see on the walls? What is their experience around the choice to be weighed, where is the scale, and does it even accommodate their body size? So much happens before we sit in the room with the patient, and that affects their ease. These physical and process cues of belonging are key to what we train our members to see.

Weight-inclusive medicine creates ease for the patient and the provider. The person sitting in front of us, particularly someone with a traditionally stigmatized body or disease (I think diabetes is ground zero for this because diabetes is often considered a “lifestyle choice”), has questions that they want me to hear. When I drop the idea that “I have to make everybody” reduce their carbs, reduce their body weight, increase their exercise, and take certain medicines, it becomes easier for me, too. I can now ask an effective question, such as, “What do you think would make the biggest difference for you right now?” This shift helps my sessions feel spacious and patient-centered. We’re teaching our members to avoid the hyper-focus on weight. We want them to listen deeply to patients, address past medical trauma, and provide evidence-based, compassionate care that isn’t focused on unchangeable things about their bodies.

Q: Feeling seen and heard is essential in healthcare. How can your position as the President of the Association for Weight and Size-Inclusive Medicine foster a deeper understanding of people with diabetes needs during medical appointments?

Lisa Erlanger: How can we possibly expect our patients to feel comfortable with who they are and what they're bringing into the room if we can’t drop that mask with each other? One of the most common requests for support I receive from other healthcare professionals is when they have a new diagnosis of diabetes. They feel ashamed because, like their client, they are human. They have also internalized diet culture and believe they should be able to avoid disease if they do X or Y. It rocks their professional core. Providers share with me that they feel they have failed, not just as a physician, but as a person. A physician may also feel like they haven't practiced what they preached, which is hard emotionally to sit with.”

Being human helps ease the way for other people to be human. I intend to create a space where physicians can embrace their humanity and their very human experience of illness and aging without guilt, shame, or judgment. From this foundation, we can learn to care for others more fully.

Q: Could you share some insights about the inspiration and goals behind the Association for Weight and Size-Inclusive Medicine

We created AWSIM as a professional home for physicians practicing and learning about weight-inclusive medicine. We provide mentorship, education, and advocacy. Our vision is a world where patients of all sizes have access to empathetic and evidence-based health care, and we challenge the pathologization of body size, which drives healthcare disparities and disproportionally harms larger-bodied patients.

Membership is open to healthcare professionals and others who share our vision or are interested in learning about weight-inclusive medicine. Members attend CME events for free and have access to our growing library of references and resources, including recordings of past events. Our calendar of events for 2025 is taking shape! Registration is now open for our first journal club with Ragen Chastain: "The Usual Suspects of Weight-Centric Healthcare." The event is free for members and students in the healthcare profession, and it costs $35 for non-members. We are pending approval for

You can find AWSIM at www.awsim.org. You can follow us on Instagram @awsim_official and on Facebook.

1.5 AMA PRA Category 1 CME credits. Following the presentation, there will be a 30-minute opportunity for networking and socializing.