Source: The Conversation (Au and NZ)
Have you ever gone to your GP to find out why you’re always tired, only to be told to lose weight?
Or perhaps you’ve joined a gym hoping to move more, only to be bombarded with messages about “burning fat” and achieving the “ideal body”.
These experiences reflect a common approach to health promotion that treats weight loss as the primary pathway to better health. But decades of research shows that focusing on weight worsens weight stigma.
Weight stigma refers to negative attitudes or behaviours towards larger-bodied people based on their weight. It includes unfair assumptions that larger-bodied people are lazy, unintelligent or lack willpower.
These attitudes are so common that treating larger-bodied people badly is often considered “socially acceptable”. We even see this play out on popular TV shows like Parks and Recreation and The Office. Larger-bodied characters are often the target of cruel “jokes” for comic relief.
Weight stigma can affect many areas of daily life. Larger-bodied people may avoid playing sport, visiting the doctor, or dating because of concerns about how they will be treated.
Weight stigma has also been linked to health and wellbeing concerns, such as increased disordered eating, suicidal ideation and stress.
Because of this, researchers and advocates have called for approaches to health promotion that support health without focusing on weight loss. Our new research shows how this can be done.
What’s wrong with the status quo?
Health promotion aims to create the conditions that make it possible for people to control and improve their health and wellbeing.
A key commitment of health promotion is making sure everyone has a fair chance to improve their health and wellbeing. This means addressing the broader factors that shape health and wellbeing like income, housing, education, transport and access to health care.
Improving financial security, for example, can make it easier for people to afford nutritious food and stable housing.
Health promotion that focuses on weight loss has been criticised for not aligning with these goals. Encouraging weight loss and lifestyle changes to improve health promotes the idea that improving public health is primarily a personal responsibility.
Our new research explores an alternative approach that addresses these concerns: size-inclusive health promotion.
What size-inclusive health promotion looks like
Health promotion practice that moves beyond weight-loss and addresses weight stigma is known as size-inclusive health promotion.
We conducted a scoping review (which maps what evidence there is on a certain topic) of size-inclusive health promotion. Across 58 studies, we identified 27 different initiatives, including guidelines, campaigns, programs and local health strategies used in health care, education, recreation and fitness settings.
Some examples already exist in Australia, including VicHealth’s This Girl Can campaign, Better Health Network’s Towards Size Inclusive Health Promotion resource, the National Eating Disorders Collaboration’s Eating Disorder Safe Principles and The Embrace Collective’s Body Blocks program.
While initiatives varied, three practical and widely applicable strategies for adopting size-inclusive health promotion appeared repeatedly:
1. Use non-stigmatising, neutral language
Any communications about health, weight and bodies should avoid language that is stigmatising or harmful.
Instead, terms such as fat, higher-weight and larger-bodied (depending on people’s preferences) should be used.
A health service or gym, for example, might review newsletters, posters and websites to remove any stigmatising language (such as “unhealthy weight”, “overweight” or “obesity”). While these may seem “medical”, larger-bodied people often find them stigmatising.
Read more:
How we think about ‘obesity’ and body weight is changing. Here’s why
2. Represent people of diverse body sizes in health promotion materials
Health promotion materials should include images and videos of larger-bodied people, like footage used in This Girl Can showing women of diverse body sizes moving their bodies.
3. Make sure environments are safe and welcoming for people of all sizes
People of all sizes deserve to feel comfortable and included in different environments.
This might look like sporting clubs ensuring their sporting equipment is safe and comfortable for larger-bodied people to use. Or a health service making sure blood pressure cuffs and seating in waiting rooms are suitable for larger bodies.
These three strategies provide “easy-wins” that can be implemented across different settings, including government, health care, education, fitness, recreational and community settings.
So far, evaluation data suggest size-inclusive health promotion may benefit psychological and behavioural outcomes such as appearance satisfaction and exercise intent.
However, broader policy action is still needed to truly progress size-inclusive health promotion. This includes:
- recognising weight stigma as a public health issue
- increasing government and industry funding for size-inclusive health promotion
- creating, reviewing and updating health policies to be size-inclusive.
Progressing size-inclusive health promotion requires action from government, health-care providers, policymakers, researchers, community organisations and beyond. Ultimately, we all have a role to play in reducing weight stigma.
Evangeline Gardiner is a PhD candidate at the University of Queensland, exploring size-inclusive approaches to health promotion. Her PhD is supported by an Australian Government Research Training Program Scholarship. She is a member of Size Inclusive Health Australia (SIHA), and sits on the Health System Advocacy Working Group. Evangeline is a larger-bodied person, drawing on her lived and professional experience to advocate for approaches to health and wellbeing that support people of all shapes and sizes.
Original source: https://analysis1.mil-osi.com/2026/11/01/sick-of-being-told-to-just-lose-weight-health-promotion-shouldnt-come-with-weight-stigma/