A Healthy Approach to Weight

Body dissatisfaction is a potent eating disorder risk factor that is especially common among young people(1).

Experiences of weight stigma can contribute to body dissatisfaction and disordered eating, and are associated with increased risk of other adverse physiological and mental health outcomes(2,3,4).

Research shows that body dissatisfaction is modifiable, and GPs can help to reduce risk by incorporating evidence-based primary prevention interventions into their day-to-day practice.

Refrain from making comments or judgements based on weight, which may negatively affect body image. For example, avoid comments such as "Okay, that was a low/high weight".

Modelling body acceptance

Weight alone does not indicate health but comprises only one marker in a range of physical and psychological indicators of health.

GPs are encouraged to adopt an evidence-based approach to health promotion, which focuses on overall wellbeing and is not weight-centric.

Tips on approach to health promotion:

• Take the focus off weight, weight loss, shape, and appearance; instead focus on overall health and wellbeing
• Refrain from using body weight or shape as sole indicators of health or physical fitness
• Encourage the acceptance of a wide variety of different body shapes and sizes
• Focus on eating for health; discourage extreme dieting and exercise behaviours
• Avoid labelling food as either "good" or "bad"
• Talk about exercise for strength, functionality and enjoyment; avoid talking about exercise for weight loss

To support this approach, GPs are encouraged to consider:

• What is the rationale for weighing this client?
• How will weighing this client improve the provision of healthcare?

It may not always be medically necessary to weigh a client to address their health concerns.

If it is necessary to weigh a client, assessing an individual's weight should be done sensitively, with consideration, and within a weight-neutral and non-judgemental approach to avoid weight stigma.

When assessing weight history, it is advised to ask the individual for permission to discuss their weight. You could start this conversation by asking: "Would you be open to discussing your weight/weight history?"

Education for parents

Parents and caregivers play a central role in the development of their child's body image and body dissatisfaction5.

This can occur both directly (i.e., comments/criticisms parents make about their child's body and eating behaviours) and indirectly (i.e., modelling an unhealthy relationship with food and their own body)(6).

GPs are ideally positioned to:

• Model a body acceptance approach to parents and their children.
• Take every opportunity to talk to parents about the important role that they play in their child's developing body image.
• Provide parents with psychoeducation and resources about promoting healthy body image and the harms of dieting.

Note: Body image concerns can emerge even before children start school(7), so it is important that parents are aware of their role in fostering positive body image from a young age.