BODY SIZE INCLUSIVITY

To recognize that body size bias influences health outcomes, social interactions, and decisions across workplaces and healthcare settings; further,

To promote the use of body size inclusivity in practice to ensure a comprehensive, patient-centered approach to care; further,

To encourage adoption of best practices that minimize body size bias across professional and healthcare settings.  

Rationale

Body size inclusivity is defined as “accepting and respecting a wide range of body types and ensuring that all individuals, regardless of their body size, feel valued and included.” It is the intentional acknowledgment, respect, and accommodation of people of all body sizes in personal, professional, and organizational settings. In contrast, weight stigma refers to discriminatory acts and ideologies targeted towards individuals because of their weight and size, favoring smaller body sizes and perpetuating stigma, bias, and discrimination. Research demonstrates  that weight-based stigma is a social determinant of health, associated with increased psychological stress, anxiety, depression, and lower self-esteem, contributing to both mental and physical health burdens for affected individuals.

Several healthcare organizations have developed policies and initiatives to promote body size inclusivity, aiming to reduce psychological harm and stigma associated with weight bias. For example, the World Obesity Foundation has advocates for system-level change to eliminate weight bias in healthcare and other sectors. The Massachusetts Medical Society emphasizes that with increased risk of weight bias comes increased incidence and prevalence of depression, social rejection, anxiety, and suicidality across all ages. Guidelines from the American Diabetes Association and other groups recommend comprehensive provider training, inclusive clinical environments, and respectful, person-centered communication to reduce stigma and improve obesity care. Lastly, the Health at Every Size (HAES) movement promotes body size inclusivity while focusing on overall health rather than weight. HAES emphasizes holistic well-being, self-acceptance, and the removal of weight-centered biases from health assessments and social interactions. It offers the following HAES principles and framework of care:

• Healthcare is a human right for people of all sizes, including those at both extremes of weight.
• Comprehensive care is free of anti-fat bias and considerate of all body types.
• Wellbeing, care, and healing are collective and deeply personal resources.
• Health is a sociopolitical construct that is often reflective the of society’s values.

Professional policies can play a central role in promoting body size inclusivity by setting clear expectations for equitable treatment, implementing anti-discrimination protections, and providing training to staff and leadership on recognizing and counteracting weight and height bias. Organizations can also audit existing policies and practices through a body-size lens to identify areas for improvement, while maintaining the collection of body size information needed for patient care decisions. By institutionalizing these changes, organizations signal a commitment to the psychological safety and dignity of all employees, reducing stigma, and promoting an environment where health, productivity, and professional success are not contingent on body size. Pharmacists and pharmacy technicians with education and training on the importance of body size inclusivity represents an opportunity to be a trusted and patient-centered professional.