September marks Weight Stigma Awareness Week—a time to name, confront, and disrupt the prejudice that shows up in exam rooms, clinics, and hospital policies every single day.
Weight bias isn’t “just words.” It undermines trust, discourages care, increases stress, and worsens health outcomes.
If you’ve ever left an appointment feeling dismissed because of your weight—or if your lab results were waved off with a “just lose weight” lecture—you know how damaging this bias can be.
The truth: weight stigma causes more harm than weight itself. And you have the right to push back.
Note: I have included a lot of citations in this post, as well as in the letter – it has been my experience that doctors respond more favorably to other doctors and to published research. It is important, though, to read and assess the research standards and science in these articles. Nothing is more important than critical thinking when you are challenging the status quo!
Below is a professional, grounded statement you can adapt and submit to your providers. I’ve also included a short script you can use in real time. Both are available as a free PDF download so you can carry them into your next appointment.
What Is Weight Stigma?
Weight stigma refers to the negative attitudes, stereotypes, and discrimination directed at people based on their body size. In healthcare, it often shows up as:
- Providers assuming weight is the cause of every symptom.
- Patients being denied diagnostic tests or referrals until they “lose weight.”
- Overemphasis on BMI despite its lack of clinical validity as a measure of health.
- Routine weighing without consent.
- “Advice” that reduces complex health concerns to oversimplified diet and exercise lectures.
This isn’t benign. It shapes medical decisions, alters the course of treatment, and can cause real physical and psychological harm.
The Hidden Costs of Weight Stigma
1. Delayed and Avoided Care
Many patients avoid annual check-ups or screenings because they expect to be shamed about their weight. Delayed care means delayed detection of conditions like cancer, diabetes, or thyroid disease—conditions where early treatment makes all the difference.
- The roles of experienced and internalized weight stigma in healthcare experiences: Perspectives of adults engaged in weight management across six countries, Puhl, et al, 2022
- Overcoming Stigma and Bias in Obesity Management, 2024
2. Misdiagnosis and Missed Diagnoses
When everything gets blamed on weight, providers can miss underlying conditions. Joint pain might be chalked up to “extra pounds” instead of being properly evaluated for autoimmune disorders. Fatigue could be waved off as “not exercising enough” instead of investigating thyroid or iron levels. Clinical focus on weight often leads providers to overlook or misattribute symptoms, such as atypical eating disorders or endocrine dysfunctions
- Weight Stigma’s Effects on Misdiagnosis of Eating Disorders Among Laypeople and Healthcare Professionals, Moreno et al., 2025
- Balancing The Scale: Kennedy, 2022
3. Worsened Health Outcomes
The stress of weight stigma itself is linked to higher cortisol levels, inflammation, and increased risk for cardiovascular disease. In other words: the prejudice is part of the health risk. The stress of weight stigma itself has measurable physiological effects. Tomiyama et al. (2014) found that weight stigma is associated with “greater biochemical stress, independent of level of adiposity.”
- Weight stigma and bias: standards of care in overweight and obesity—2025
- Weight stigma is associated with increased physiological stress responses (e.g. elevated cortisol, cardiovascular reactivity) independent of body weight or adiposity (Tomiyama et al., 2014; Panza, Puhl, Taylor et al., 2023).
4. Lost Trust in Healthcare
Just like racism, sexism, or other forms of bias, weight stigma erodes the patient–provider relationship. When people feel judged or stereotyped, especially by those who are meant to care for them, that trust breaks down. Trust is essential for disclosure, follow-through, and a therapeutic relationship; when it’s compromised, medical advice becomes less effective.
- A study by Gudzune et al. found that patients who feel judged about their weight report significantly lower trust in their physicians, poorer satisfaction, and worse adherence. ScienceDirect
- Heidebrecht et al. (2024) documented how weight stigma in healthcare settings undermines trust and leads some patients to avoid seeking care altogether. They also show that intersections with race, gender, and other identities magnify distrust. BioMed Central
- Phelan et al. (2015) demonstrated that stigma from providers reduces openness, dissuades asking questions, and increases delays in seeking treatment—leading to worse outcomes. PMC
Why “Just Lose Weight” Isn’t Evidence-Based
For decades, weight loss was presented as the universal solution. But research is clear:
- Up to 95% of diets fail long-term. (also: The Dieting Dilemma Utah State Extension)
- Weight cycling (losing and regaining) increases health risks, including hypertension, cardiovascular issues, and mental health strain.
- Intentional weight-loss attempts often lead to disordered eating, food preoccupation, and reduced self-esteem.
- Meanwhile, weight-neutral approaches—such as improving nutrition quality, movement for joy and strength, managing stress, and addressing social determinants of health—show equal or better outcomes without the harm of stigma.
Put simply: weight loss is not a behavior, and prescribing it is not medicine.
A Patient Letter You Can Use
You don’t have to sit silently while providers make biased assumptions. Here is a ready-to-use statement that you can submit to your provider or add to your medical record.
Patient Statement on Weight Bias and Medical Care
To My Healthcare Provider:
I am requesting that my care be provided without weight- or BMI-based assumptions, interventions, or recommendations. Unless weight is directly and clinically relevant to the specific concern at hand, I do not consent to weight-centered approaches.
Key Points
- Weight bias causes harm.
Studies show weight stigma leads to poorer patient–provider communication, avoidance of care, reduced adherence, and worse overall health outcomes. (National Library of Medicine: Overcoming Stigma and Bias in Obesity Management; Rudd Center on Weight Bias in Healthcare) - Trust matters.
Weight stigma—like racism and other forms of discrimination—erodes trust between patients and providers. Lower trust reduces the effectiveness of healthcare interventions and increases the likelihood that patients disengage from care. - The evidence does not support weight-loss interventions.
Research shows that the overwhelming majority of intentional weight-loss attempts fail long-term (up to 95%). Cycles of dieting and weight regain are associated with negative physical and psychological health outcomes. (Utah State Extension: The Dieting Dilemma; BMC Medicine: How Weight Stigma Harms Health; Weight stigma and bias: standards of care in overweight and obesity—2025) - Ethical standards require better.
Medical ethics obligates providers to “do no harm.” Weight stigma causes measurable harm and cannot be justified as sound practice (First Do No Harm; Weight Bias in Healthcare).
My Expectations
- I do not consent to routine weighing unless it is medically necessary and explained.
- I do not consent to BMI being used to justify care decisions.
- I expect recommendations to be based on my symptoms, labs, and evidence-based medicine—not stereotypes or assumptions about my body size or diet.
Please add this statement to my medical record. I expect respectful, patient-centered care that addresses my actual health concerns, not my weight.
Sincerely,
[Your Name]
➡️ Download the Full Letter as a PDF
Short Script for Appointments
Sometimes you only get a minute to set boundaries. Try this line:
“I don’t consent to weight or BMI-based recommendations. Please focus on my actual labs and symptoms. If you believe weight is directly relevant, I need you to explain the evidence for that connection.”
Save it to your phone, write it on a card, or screenshot the graphic below to keep it handy.
Practical Ways to Advocate for Yourself
- Ask before you’re weighed. You can say: “I decline to be weighed today unless it’s medically necessary.”
- Request documentation. If weight or BMI are cited as the reason for a recommendation, ask for the clinical evidence in writing.
- Bring a support person. Sometimes having an ally in the room helps keep conversations accountable.
- Use the patient portal. Upload your letter so it becomes part of your official chart.
- Know your rights. Patients are entitled to informed consent, respectful treatment, and evidence-based care—not moralizing.
Why This Matters (Expanded)
- Weight stigma undermines trust. Like racism or sexism, it reduces the efficacy of medical interventions.
- Weight-loss interventions don’t work long-term. Up to 95% fail, and repeated weight cycling increases risk of health complications.
- Bias leads to harm. Patients delay or avoid care, receive misdiagnoses, or are denied treatment altogether.
- It’s not about “hurt feelings.” It’s about accurate, ethical, evidence-based care.
Resources & Further Reading
- National Library of Medicine: Overcoming Stigma and Bias in Obesity Management
- Rudd Center: Weight Bias in Healthcare
- BMC Medicine: How Weight Stigma Harms Health
- Utah State Extension: The Dieting Dilemma
- ASDAH: Health at Every Size® Principles
- NEDA: Weight Stigma
- The Intersection of Biased Mental Models, Stigma, Weight Bias, and Obesity
- Healing Without Harm: What Weight-Neutral Care Actually Looks Like (WSAW 2025)
Healthcare should heal, not harm. Speaking up against weight stigma is one step toward reclaiming your right to respectful, effective, bias-free care.
This Weight Stigma Awareness Week, download the statement, share it widely, and start the conversation that too many providers still avoid.
➡️ Download the Patient Letter PDF
➡️ Share the Short Script on Social