Holding Space for Complexity: When "Weight-Neutral" Feels Confusing
Holding Space for Complexity: When "Weight-Neutral" Feels Confusing
I hope this post finds you well. Something has been on my mind lately: the concept of "weight-neutral" care.
Last week, a friend reached out to discuss the Health at Every Size (HAES) approach in the context of a newly diagnosed health condition. We covered several important topics including comprehensive care that is free of weight bias, bodily autonomy, and the necessity of informed consent when treatments involve dietary changes. Beneath our conversation, however, I sensed a deeper, unspoken question: "Is it okay for me to desire weight loss if I believe it might help my health condition?"
We discussed how "weight-neutral" care typically involves decentering weight as the primary treatment target, choosing instead to focus on other indicators of well-being, such as lab values, energy levels, and quality of life. Yet, reflecting on our conversation, I found myself pondering: Does weight-neutral care really exist?
The short answer is: Maybe. It requires careful consideration and a thoughtful, nuance-driven approach to what "neutrality" actually means. This conversation feels particularly timely during Weight Stigma Awareness Week.
On the surface, weight is simply a measurement of mass. In practice, however, it is far from simple. Weight is a complex, sensitive metric where many conflicting truths can exist simultaneously:
Weight measurements do not necessarily reveal one's overall health, well-being, or body composition.
Rapid or unexplained weight changes are clinically concerning and require immediate medical assessment.
An individual’s current weight may be influenced by existing medical conditions, medications, or other physiological factors.
An individual’s current size or "ideal" size may not be the weight that is most physiologically sustainable or healthy for them.
Everyone carries a personal, meaningful story regarding their body, weight, and appearance.
A common refrain I hear within the HAES community is, "The focus is not on weight," or "Can we put the discussion of weight on the back burner?" While these statements are often intended to minimize weight stigma and promote inclusivity, they can inadvertently feel dismissive to someone who is actively grappling with their body image.
Rather than putting these discussions on the back burner, I believe it is more important than ever to bring them to the forefront as a standard part of care and informed consent. Avoiding these topics can inadvertently generate shame, particularly when someone holds strong feelings about their current body.
There is nothing wrong with wanting to have nuanced, open conversations about weight, health, well-being, and medical treatment. Bodily autonomy and informed consent are the cornerstones of truly compassionate care. I celebrate your desire to wrestle with these big questions, and I am here to hold that space for you.
If you’d like to learn more about my services, click here!