Right around the time Ozempic came out, I started to change the way I practice medicine. As the new class of weight-loss drug ushered in a highly medicalized era of Americans’ obsession with being thin, I decided I was done with trying to get my patients to lose weight.
Sometimes I call myself a “body-positive doctor,” but that isn’t it, exactly, because I don’t expect all of my patients to love their bodies at all times. With my students, I call it practicing “weight-neutral medicine.” I’ve found a great community of like-minded health care providers with the Health at Every Size movement, which promotes the idea that people can be healthy without focusing on weight loss.
This change started for me, as many of my major realizations do, from reading. I read memoirs by fat authors like Roxane Gay, Lindy West, and Kiese Laymon, who wrote about the many ways they were made to feel terrible about their bodies, often at the doctor’s office.
It was unsettling to recognize myself in some of the encounters they described. I had told my own patients, dozens of times: “Your knee pain might get better if you just lost a few pounds.” As if my patients hadn’t thought of that already. As if they hadn’t already tried.
Reading these books also forced me to reckon with my own relationship to my weight and my experiences in health care.
As a chubby teen, I remember a visceral unease before each appointment at the pediatrician’s office, the fear I felt stepping on the scale. I remember the doctor who chided my mom for buying 2% milk, not skim.
Then, when I lost weight in my 20s, appointments with the doctor were transformed. I could focus on the issues I wanted to discuss, rather than visits being dominated…
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