Table 1.

Recommendations to foster a weight-inclusive paradigm in ED treatment and research.

Acknowledge the influence of weight stigma on current ED treatment.
Understand and communicate with patients, policy-makers, and other providers that weight is not synonymous with health and, accordingly, weight is inadequate as a criterion for ED diagnosis or recovery
Re-examine the rationale for and unintended effects of weighing in ED treatment
Shift from weight-centric to weight-inclusive care practices and philosophy.
Stop recommending or engaging clients in weight loss or weight management
Focus on modifiable health behaviors (regardless of weight status, with respect for an individual’s history), for the purpose of improving quality of life rather than moralization of health and health behavior
Ensure treatment plans and goals function to increase a client’s flexibility in behavioral responses (rather than “managing” their weight)
Work to increase client autonomy, access to care, and social justice across the weight spectrum (76) by explicitly addressing weight stigma in treatment
Increase provider education and competency.
Promote widespread dissemination of weight-inclusive care as an empirically-supported alternative to the weight-centric medical paradigm in training programs for anyone working with clients to improve health
Encourage use of functional behavioral assessments and other direct health measures instead of reliance on weight/BMI
Utilize shared treatment plans to enhance provider communication and continuity of care
Build in mechanisms to increase accountability for provider weight bias, prioritizing meaningful behavior change and structural interventions to reduce stigmatizing behaviors (versus unrealistic expectations of trying to “eliminate” personal bias)
Prioritize addressing gaps in research and clinical care.
Increase clinical training and research with diverse populations to better understand variability in symptom presentation and how to assess ED severity across the weight spectrum
Incorporate and evaluate the effects of addressing weight stigma as an explicit part of treatment, particularly at areas in which weight is interconnected with other areas of historical bias and social marginalization (race, gender, sexual orientation, class, ability, etc.). Such research should utilize mixed methods to better contextualize findings
Policies should be regularly reviewed and responsive to the data, including increased funding for weight-inclusive care (rather than additional weight loss interventions)