Reader Question - What's the Difference Between Weight-Neutral Health and Weight-Inclusive Health

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Reader Jen asked

“I’ve seen people use the terms “weight-neutral health” and “weight-inclusive health” are these interchangeable? Or is there a difference?

First, I’m definitely not in charge of naming or defining things for all of fatkind, so I’m just talking about the ways in which I think about and use these terms. In the past I think I have sometimes used these interchangeably, but I do feel like there is a difference.

To me, weight-neutral care is care in which people of all sizes who have the same symptoms/diagnoses etc. are given the same interventions, and weight loss is not utilized as a healthcare intervention. It is, essentially, achievable now. We stop calculating BMIs, stop pathologizing higher weight bodies, stop prescribing weight loss diets/drugs/surgeries, and give fat people the interventions we would give thin people with the same symptoms.

Weight-inclusive care would take things to another level. Even if we give fat people the same interventions we give thin people, we are typically still giving interventions developed from research that didn’t include fat people, using tools and equipment that wasn’t made for fat people, using best practices that were developed with/based on thin bodies, administered by doctors who were taught weight-stigma while only learning on thin cadavers, who often harbor and wield the weight bias unchecked (or supported) by the healthcare system. To me, weight-inclusive care is care that is created for bodies of all sizes from the ground up including research, tools, equipment, best practices etc., practiced by fully fat-affirming healthcare practitioners. This one will take longer to institute across the board, but is well worth the time and effort.

Finally, I just want to be clear that fat people aren’t the only ones who aren’t receiving truly inclusive care. People of color, trans and nonbinary people, cis women and other marginalized people are often under- or un-represented in similar ways, an issue that is compounded for multiply-marginalized people.

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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.