Cheers to five years of Dawn, Ashley , and Jillian working together at Change Creates Change!

Weight-Inclusive Eating Disorder Treatment

Reviewed by Clinical Director, Jillian Walsh, RD, RP

Please note: At Change Creates Change we do not use words such as ‘underweight,’ overweight,’ ‘healthy weight’ or ‘obese’.

What Does Weight-Inclusive Mean?

Person running on a trail outside

Weight-inclusive care shifts the focus to behaviours, rather than weight, as predictors of health. It follows the principles of Health At Every Size (HAES). It also includes a focus on respectful care and advocacy for all folks and eating for wellbeing rather than eating to change our weight. Evidence has shown that health care practices based on these principles tend to improve eating disorder symptoms, as well as other mental health disorders; including anxiety and depression.

What Does Weight-Normative Mean?

A weight-normative approach focuses heavily on weight as a predictor of health. This is what makes the weight-normative approach different from a weight-inclusive approach. The weight-normative approach assumes that as an individual’s weight increases, so does their risk of disease. A weight-normative approach may focus on BMI, and BMI is not a good predictor of health.

When healthcare practitioners use a weight-normative approach, it emphasizes weight stigma. Weight stigma is discriminating or stereotyping an individual based on their weight. Folks who are impacted by weight stigma tend to refrain from seeking health care, may end treatment early, and hold feelings of blame and social isolation. This negatively impacts their mental health and is especially harmful to folks exhibiting symptoms of eating disorders. It can worsen symptoms or increase the risk of anxiety and depression.

Why is BMI Flawed?

BMI is measured by taking your child’s weight in kilograms divided by their height in metres squared. Your child’s calculated BMI will fall into one of the following categories:

  • Underweight
  • Healthy weight
  • Overweight
  • Obese 

BMI assumes that adults’ weight is proportional to their height squared (which it often is not). They are not proportional in children and adolescents, which is why it should not be used with these populations. The BMI calculations and ranges also do not take into account several factors such as age, sex, body composition and ethnicity. Body composition refers to folk’s percentage of fat, bone and muscle mass.

For these reasons, BMI is not a good predictor of health. This is why we do not use BMI at Change Creates Change.

How We Practice at Change Creates Change

Offering weight-inclusive eating disorder care means that we do not use these words in our practice:

  • Healthy
  • Unhealthy
  • Good
  • Bad
  • Underweight
  • Overweight
  • Obese
  • Diet
  • Weight loss
  • Weight gain

Instead, we ensure to use weight inclusive language in our practice. Weight-inclusive care at Change Creates Change also means that we use inclusive equipment in our environment, such as weight-inclusive chairs in office spaces. Our aim is to minimize health disparities, improve health equity, and offer a safe space for all individuals.

Are You Interested in Learning More?

We’re here to help you and your child navigate recovery. If you would like to learn more about our weight-inclusive approach to eating disorder recovery, you can book a free consultation call with us.

*Reserved for Canadian residents.

References

Bessey, M., & Lordly, D. (2020). Weight Inclusive Practice: Shifting the Focus from Weight to Social Justice. Canadian Journal of Dietetic Practice and Research, 81(3), 127-131. http://dx.doi.org/10.3148/cjdpr-2019-034

Bhurosy, T., & Jeewon, R. (2013). Pitfalls of Using Body Mass Index (BMI) in Assessment of Obesity Risk. Current Research in Nutrition and Food Science, 1(1), 71-76. http://dx.doi.org/10.12944/CRNFSJ.1.1.07

Hunger, J. M., Smith, J. P., & Tomiyama, A. J. (2020). An Evidence-Based Rationale for Adopting Weight-Inclusive Health Policy. Social Issues and Policy Review, 14(1), 73-107. https://doi.org/10.1111/sipr.12062

Tylka, T. L., Annunziato, R. A., Burgard, D., Danìelsdóttir, S., Shuman, E., Davis, C., & Calogero, R. M. (2014). The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss. Journal of Obesity, 2014(4). https://doi.org/10.1155/2014/983495

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