Fat does not equal Unhealthy!

A new study published in Nature Medicine looked at nearly half a million people and confirmed something we’ve known for years. “Fat” does not always mean unhealthy.

The researchers found eight different genetic subtypes of obesity. Some people carried more body fat but still had a healthy metabolic profile, while others had mixed or higher risks. Some cultures are genetically pre-disposed to have more adiposity (fat), yet be healthier than other cultures with the same adiposity levels, other cultures are at higher risk of metabolic diseases with LESS adiposity. The key message is that weight and health are not automatically linked.

Having this understanding is a major step forward, and in my mind, should give pause for thought when it comes to the ‘obesity is a disease’ narrative we are being sold by big pharma currently (for obvious reasons!). However, without psychological assessment and support for disordered eating being standard elements of care, healthcare services will continue to fail people. Clients may be prescribed life-changing medication or referred to weight management programs, yet nobody asks them the most basic questions about their relationship with food or their lived experience of stigma and trauma.

One way to show clients they are safe with you is to avoid centring weight in your questions – EVEN IF they are taking weight loss medication.

Here are three you can try:

How does your body feel day to day in terms of energy, mobility and sleep?
What do you notice about your relationship with food, especially during stress or difficult times? Or even more straightforward: “do you ever eat for emotional reasons?”
What kind of support would help you feel understood and safe here?

These questions communicate without words that your office or online room is a safe space. You will never be judged or shamed for your size here. That message alone can be life changing.

With clear guidelines from NICE (UK) and JAMA (USA) for the mandatory provision of comprehensive ‘wraparound’ support with GLP-1 medications – physical, nutritional, psychological as well as medical – there’s never been a better time to up-skill and offer your services as the key support person to provide that support.

We can be the ones to bridge the gaps and provide the recommended support, not just by supporting clients directly, but also by being the practitioner who provides support that doctors do not have the time or the training to provide themselves. Letting all medical practices in your area know that you are available to provide this support is a great way to open up regular referral pathways and grow your practice.

The future of weight management MUST NOT just be about medication, BMI charts or genetic tests. It is about practitioners like you who see the whole person and create a space where complete healing is possible. And the relevant bodies like NICE and JAMA already know it. But the doctors aren’t trained and don’t have the time.

This is a key gap in the market. Are you going to help fill it?