5 Questions With Medical Students for Size Inclusivity

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On the days when I need some hope and good news, I think about Medical Students for Size Inclusivity. In their own words “We are a community of medical students raising awareness about the harms of weight discrimination in the healthcare system. We believe all people, regardless of their weight, body shape, and size, deserve equitable medical treatment and the right to pursue health".

They do incredible work, including the GLP-1 Agonist informed consent project that I’ve linked to here before.

The fact that these incredible people are the future of medicine gives me more hope than I can say.

Today in our “5 questions with…” series we have 5 questions with three amazing MSSI members!

Rachel Carpenter she/her
Touro College of Medicine, class of 2025

1. Tell us a bit about yourself and your work 

I am a third year medical student who has been involved with the curriculum side of MSSI work for the past year. I am interested in pediatrics, and hoping to apply the concepts of weight-inclusive healthcare within this field!

2.     How did learn about the concept of weight-neutral, body-affirming care?

I started to learn about weight-inclusive care from working within the eating disorder community. Through events hosted by NEDA and other eating disorder organizations, I began to grow exposed to this concept of weight-inclusive care, and slowly the network of providers and practitioners who would preach these concepts grew. 

3.     How have you/do you apply those concepts to your work?

Through my work both as a student studying for medical board exams and my current work within the clinical field, I attempt to examine questions and cases through the lens of weight-inclusive care.

4.     What’s one thing that you wish people who are still working from a weight-focused paradigm could learn/know? 

Would this application change the course of care of a patient who had been examined and treated by a traditional model of care, and what are the ways in which it would differ? 

Be patient. There is a lot of resistance to this paradigm, as is true for any major shift in medical thinking. Know your resources well, and be prepared to meet resistance and skepticism. 

5.     How and where do we find you and your work?

You can find me fighting weight-stigma at South Brooklyn Health, where I am currently completing my 3rd year rotations! 

Marisa Langton she/her/hers
Drexel College of Medicine, Class of 2026

1. Tell us a bit about yourself and your work 

I am a second-year medical student and a Co-Director of MSSI’s Advocacy Committee! Prior to medical school, I received an undergraduate degree in Nutritional Sciences and spent gap years working as a nursing assistant and a size-inclusive personal trainer, where I provided a gentle approach to finding enjoyable movement practices!

2.     How did learn about the concept of weight-neutral, body-affirming care?

I first learned about weight-inclusive care through my personal eating disorder recovery. From there, I began to familiarize myself with a lot of size-inclusive Instagram pages and I found myself enraged by the anti-fat bias that I began to recognize everywhere. Not only did I recognize this on the day-to-day in our highly weight-biased society, but I also saw how it negatively impacted patient care through various healthcare experiences and became adamant about helping to build a more size-inclusive future healthcare.

3.     How have you/do you apply those concepts to your work?

As a weight-neutral personal trainer, I work with clients to find a movement practice they enjoy, aiming to celebrate the many health benefits of movement (improved cardiovascular health, mental health, bone density, etc.) without the intention of weight change. Within my role as a medical student, I challenge and advocate for revisions in weight-biased material within our curriculum. For example, I recently advocated for the addition of a weight-inclusive provider panel as part of an anti-bias series in one of our courses. In the future as a physician, I will bring my experiences and advocacy work with MSSI to continue fighting anti-fat bias, promoting positive health behaviors, and helping to build a system where patients in all body sizes receive equitable and comprehensive healthcare.

4.     What’s one thing that you wish people who are still working from a weight-focused paradigm could learn/know? 

One thing I wish people in a weight-centric mindset would consider is how they would treat an identical patient case if the patient were in a smaller body. This simple consideration forces providers to consider evidence-based medical interventions without being blinded by any biases around weight. Asking this question may also increase awareness of existing biases and how they can impact the care a patient receives.

5.     How and where do we find you and your work?

You can find me fighting weight bias alongside my incredible colleagues in MSSI! https://sizeinclusivemedicine.org/ Instagram: @sizeinclusivemedicine

Bonus: Anything else you’d like to say?

I think one thing that has been hard as a student is to see how deep weight bias runs across medical curricula, licensing exam questions, or clinical experiences. If we continue to teach in a weight-biased way, it means we continue to graduate weight-biased providers, which is discouraging. With that said, there are many schools, including my own, that are becoming a lot more aware of biases in the curriculum and beginning to address them. Although this is a slow process, I am hopeful that we will see this ripple into an increasing number of size-inclusive practicing physicians in the years to come.

Madeline Breda she/her/hers
Hackensack Meridian School of Medicine, Class of 2025

1. Tell us a bit about yourself and your work 

 Hi, I'm Madeline and I am a 3rd year medical student at the Hackensack Meridian School of Medicine. I am a co-founder of MSSI and although I have dabbled in many of our organization's initiatives since its founding, I am currently working with the community outreach team on our social media presence. I am undecided on my future specialty, but I am particularly interested in reproductive health, psychiatric access and care, and of course size-inclusive medicine, which I hope to carry forward into my future career as a physician.

2.     How did learn about the concept of weight-neutral, body-affirming care?

Ever since my teens, I remember feeling dissatisfied with the American medical system's (and our culture at large's) hyperfocus on weight as a metric of health. However, at the time I didn't have the language or resources to articulate or really share that frustration with anyone. I struggled with body image issues and disordered eating throughout my teens and 20s and I felt so isolated and confused witnessing both the media at large and my own healthcare providers continue to champion weight loss as a tool of health above all else. Then, when I started long-distance running in my 20s, I observed and encountered more negative biases about health and physical fitness as related to body size, which motivated me to prove them wrong! The final puzzle piece on my path away from a weight-centric paradigm was listening to the Maintenance Phase podcast. The show opened up an entirely new framework for understanding health, body size, and our cultural preoccupation with thinness-as-morality which I then brought forward into my personal and professional life. When I started medical school and saw just how prevalent antifatness was in our education, I was emboldened to speak out in opposition - a decision which initiated a chain of events eventually leading to the converging of my path with Jessica and Hannah, the founding of MSSI, and our incredible work thus far.

3.     How have you/do you apply those concepts to your work?

Being aware of the concept of weight-inclusive care has afforded me with the gift of asking "why". When I am taught that a particular health outcome is linked to body size, I now know to stop and think about why and how that conclusion came to be. I wonder how social determinants may affect outcomes, and how intersecting identities, including and compounding upon body size, may change individuals' experiences interacting with the healthcare system. I wonder about how deeply entrenched cultural ideals have influenced past research - whether our assumptions about fatness and health have led to premature, foregone conclusions. Simply stopping for a moment and asking questions - both of others and of myself - will, I hope, lead to a broader and more nuanced perspective on body size that can be carried over into both direct patient care and the education of our next generation of physicians.

4.     What’s one thing that you wish people who are still working from a weight-focused paradigm could learn/know? 

On a very basic level, I think as healthcare providers we can all agree that our goal is to support and improve the health and wellbeing of our patients. If fat patients actively avoid routine preventive care or even urgent medical treatment due to very real fears about stigmatization and medical gaslighting, the end result is that an already-disadvantaged population will have negative health outcomes - not due to their bodies, but due to our own negligence. If our goal is true health equity, we need to include fat patients in our efforts to make healthcare accessible, approachable, and inclusive for all.

5.     How and where do we find you and your work?

You can find me on Twitter at @MadelineBreda as well as amongst my incredible colleagues in MSSI.

Bonus: Anything else you’d like to say?

I have been heartened and surprised by the overwhelmingly positive response I have had from classmates when the topic of weight-inclusive care has come up. Although I still witness fairly prevalent weight stigma amongst the older generation of doctors and from laypeople of all ages, it seems that many medical trainees at least agree that our system disadvantages and harms people in bigger bodies and we should be working to change that. It's small solace, but I'll take it. 

I want to thank these three MSSI members for taking time out of a grueling academic schedule to share their experiences, and all of the leadership and membership of MSSI for the incredible work they do and for the hope and change they are inspiring.

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More research and resources:
https://haeshealthsheets.com/resources/

*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight” to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings’ Fearing the Black Body – the Racial Origins of Fat Phobia and Da’Shaun Harrison’s Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.