weight-inclusive care and HAES philosophy
and more about my trip to Brazil!
This week, while traveling in Brazil, I had a career highlight. A big, colossal moment that felt like a culmination of all of my training thus far in nutrition, medicine, and community health.
A little backstory: I work in a multicultural community health center and ~30% of our patients are from Brazil and speak Portuguese. For this reason, my bestie coworker and I have been taking Portuguese lessons for the last year or so. We also both precept medical students from a school in Brazil. After precepting for a semester, we both were granted the title of professor at the school (so cool!). There are other providers across the institution that are part of the program, and it’s an amazing offering to be able to regularly precept students from another country.
About 4-6 months ago, all of the providers across the institution where I work were offered the opportunity to come to Brazil, see the school, and have a more interactive and immersive experience with not only the students, but the healthcare system.
We spoke with our medical director who had already taken part in this opportunity and knew we had to do it. Flash forward to today and we just finished our week at the school on Friday. It was absolutely incredible. At the time of writing this, I’m sitting in the airport about to travel to another state in Brazil and am having trouble coming up with adequate language to describe the experience.
The people of Brazil are the warmest I’ve ever encountered. Each step of the way was met with an openness and a friendliness so earnest and tender it brings tears to my eyes. I now have such a broader appreciation and understanding of the beautiful land so many of my patients call home.
Also as part of this experience, my coworker and I presented a few lectures to the students. The first was about the PA profession, and the second was a lecture of our choice. I asked if I could present on weight-inclusive care and HAES® philosophy, and they agreed.
I was particularly interested in presenting this topic to Brazilian medical students because aesthetic culture is so big in Brazil. There is an enormous amount of pressure to look a certain size and so many of my patients from Brazil come in desperately wanting to lose weight.
This post will piggyback and echo much of what I wrote about in the post about injectables for weight loss. Though it’s more focused on the research and a quite compelling argument as to why this work is so important.
In order to understand why I align with this philosophy and why I practice medicine in this way, it’s good to learn about the reasoning and research behind it. While it may seem like this content is geared towards healthcare providers and professionals, it’s important for all audiences.
This post will discuss weight bias and weight stigma and how they impact patient care access and experience. It will also review the difference between a weight-centered vs weight-inclusive approach, the downfalls of dieting and using BMI as a health metric, and review the obesity paradox. Furthermore, it will create actionable and sustainable ways to think about wellbeing for all patients, regardless of weight or size (and 25 research studies cited and linked for additional reading for those interested).
At the very end, I’m also including some questions the students asked after the presentation, as well as my responses.
TW: this post includes a lot of discussion about weight, dieting, and restrictive eating patterns. If you are currently engaging in disordered or disorganized eating thoughts or behaviors, this may be a post to skip.