The impact of a weight-centred treatment approach on women's health and health-seeking behaviours

Abstract

Background Dietetics relies on a conventional weight-centred paradigm that attributes disease risk to fatness and encourages weight loss. This research examines the impact that this weight-centred paradigm has on the health, health-seeking behaviours, and everyday experiences of women who self-identify as large. Methods This was a qualitative, community-based study using semi-structured interviews and focus groups. The participants were 18 women who self-identified as being large, either previously or currently, where large was understood among participants as an appropriate descriptor for fatness. Interviews and focus groups were recorded and transcribed verbatim and data were manually sorted. Coding categories were developed and participants' quotes were assigned to these using thematic analysis. The study had ethics approval. Results Participants described that health professionals’ assumptions and recommendations about their weight negatively affected psychosocial variables and behaviours known to impact on health, such as depression, self-esteem, eating/exercise habits and interpersonal relationships. The assumptions of a weight-centred paradigm underpinned experiences of size discrimination outside the clinic. Conclusions The conventional position towards weight results in attitudes and practices that negatively impact on health and health-seeking behaviour through a range of interlinked pathways. A professional commitment to reappraising the weight-centred paradigm is required to promote good health and avoid overt and inadvertent size discrimination.