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Feeling comfortable with our doctors is a key to ensuring we stay healthy and happy. If it doesn't seem like they understand us, then there's the possibility that we won't open up about ailments that keep us from being well.


A recent study from the US has revealed that women with higher body weight are especially at risk of keeping away from the doctor. This avoidance happens because of past weight stigma and discrimination these women have experienced when visiting their GPs.


The Body Image-published study surveyed over 300 women, looking at the information used to determine their body mass index (BMI), which is weight in kilograms divided by height in metres squared. 


The researchers also asked the women about any times they'd experienced or felt weight stigma, body guilt, healthcare stress, body shame, and avoidance of healthcare.


Janell Mensinger, PhD, led the study coming out of Drexel University's Dornsife School of Public Health.



"What is important here is that women with higher body mass index tend to avoid healthcare and the reasons for that are often due to their experiences of weight discrimination," Mensinger, who is an associate research professor in the Dornsife School of Public Health, told Science Daily.


"We need to help healthcare professionals understand that seeing a provider is highly charged with stress and anxiety, and there are methods to reduce those feelings."


Mensinger and her team made a distinction between a 'weight inclusive approach' for doctors to use, which involves medical professionals ridding themselves of biases against patients with higher body weight, and a 'weight normative approach', which most US doctors use.


With this 'weight normative approach', doctors set benchmarks related to body size and often dispense unsolicited advice using this data.


"Weight is a data point, but that is it," Mensinger pointed out.



"Tracking how it changes might provide clues to things going on in someone's life and body, but it is much more complicated than we are made to believe."


Mensinger acknowledged that BMI is a problematic measure, as many others have noted. However, it was referenced in this study because doctors still use it as an indicator of health. 


"We worked in the reality of what is happening, not what should be happening," she said, "Of course, we wish BMI were not considered, but the aim of this study was to understand the mechanisms connecting an existing relationship that has long been established in healthcare settings."


The study found that the higher women's BMIs, the more they tended to avoid visiting the doctor.


"Experiences of weight stigma often lead to self-directed stigma," Mensinger observed, "Self-directed stigma tends to lead to body-related shame and guilt, which then leads to stress regarding the healthcare encounter. And people who are stressed about the encounters tend to avoid them."



In relation to how women are treated based on their BMIs, a 'weight normative approach' posits that BMIs of 25 or above are considered 'overweight'. Based on this, doctors often give unsolicited lifestyle advice.


Those with BMIs of 30 or more are recommended exercise regiments and calorie-restricted diets, with assumptions made about their level of activity and what they are eating.


Mensinger believes that the continued use of this approach is proving more harmful than helpful.


With this in mind, she stated, "We're talking about a vulnerable population and we're putting them at a greater risk. We need to be aware of these system-level problems that are keeping people from going to appointments that would be saving lives."


And while this study took place in the US, there is no doubt women around the world have felt this issue personally, as a stigma against higher body weight persists in many cultures.



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