Creating Inclusive Environments: How to Make Patients of All Sizes Feel Welcome

| January 1, 2022

by Ethan Lazarus, MD, FOMA

Dr. Ethan Lazarus has practiced obesity medicine since 2004. He has served on the Board of the Obesity Medicine Association since 2013, and also serves as their delegate in the American Medical Association.

Funding: No funding was provided for this article.

Disclosures: Dr. Lazarus serves on the speaker’s bureau for Novo Nordisk.

Bariatric Times. 2022;19(1):20

With each new year comes an opportunity to renew our efforts and redouble our purpose as healthcare providers. For many others, the new year presents a new opportunity to invest in their own health and wellbeing. That might manifest in a lot of different ways, but one we can anticipate is people with obesity reaching out to seek clinical help and care. As providers, we can support those journeys in more ways than one. Perhaps the easiest action to overlook is the attention we pay to the patient environment. For people living with obesity, clinical settings frequently lack comfort and compassion. Everything from the language used by staff to the furniture in the office can prove to be ostracizing without proper consideration.

As we know, obesity remains a highly stigmatized disease. People navigating obesity are constantly judged unfairly by others because of their weight. A healthcare location and team should always strive to challenge the stigma and cultivate an environment that makes every patient feel welcome. Failing to do so can make patients with a higher body mass index (BMI) feel unwelcome and even discourage them from returning for future appointments. 

Personal interactions. How practitioners engage with patients sets the tone for the whole office. Take deliberate steps to use person-first language. Rather than using the term “obesity,” use terms like “unhealthy body weight” or “unhealthy BMI.” We should be the first to reinforce the notion that people have diseases but should not be defined by them. Similarly, we can employ language and practices that are less likely to create embarrassment or discomfort for patients. One option might be helping patients to separate themselves from the disease by speaking about lowering health risks by lowering their BMI versus simply declaring a need to lose weight.

Similarly, understanding the scope of the care we provide can make all the difference. A simple directive, such as “lose weight,” fails to make the measure when we consider holistic care. Doing so would be akin to telling a person with depression to “think happy thoughts” and considering the case closed. Instead, we have the opportunity to engage patients in comprehensive obesity treatment and help them understand the breadth of the care we propose. Engage your patients in discussion of every treatment option you consider important for their journey, including: 

  • Intensive lifestyle intervention
  • Structured nutritional intervention
  • Structured physical activity prescription
  • Medical management
  • Stress management
  • Good quality and quantity of sleep

Unfortunately, it only takes one interaction to completely alienate a patient and undo the work put into cultivating a compassionate environment. Set aside time to share the intention of your thoughts and actions with staff and ensure they take steps to incorporate similar practices into their interactions with patients.

Furnishings and equipment. The tools we use should enhance the care we give. When planning or updating your office, consider the following accommodations:

  • Privacy: We don’t deliver diagnoses or discuss other personal information in public settings; we should treat weigh-ins the same way. Rather than in a hallway or waiting room, weigh patients in a private space.
  • Sizing: Blood pressure cuffs and hospital gowns are not always size-inclusive. Improperly sized cuffs can create discomfort and inaccuracy, while improperly sized gowns can leave patients feeling exposed and embarrassed. Make sure to have an array of sizes available for larger patients.
  • Dimension: Similarly, many exam tables, scales, and chairs are not designed with patients with a higher BMI in mind. Make sure to have appropriately rated exam tables, chairs, and scales that can accommodate up to 600 pounds so that all patients can sit comfortably in all areas of the office.

Go the extra mile. With the essential considerations sorted out, providers can consider going the extra mile to make the patient experience not just tolerable, but even somewhat enjoyable. Tools that go beyond the surface level, such as body composition scales that break BMI down into fat, fat-free weight, skeletal muscle, and visceral fat, can help patients see the big picture—and their progress. To that end, providing a simple report that charts weight loss progress and improvements in body composition numbers can help patients more keenly feel the progress they are making.

This year, and every year, challenge yourself to take the few extra steps that can make all the difference for your patients. For more tips and methodologies to enhance patient experiences and start the new year on strong footing, join Obesity Medicine Association today.1


  1. Obesity Medicine Association. Join the Obesity Medicine Association. Accessed 22 Dec 2021.

Tags: ,

Category: Medical Methods in Obesity Treatment, Past Articles

Comments are closed.