A recent study from the University of Georgia addresses a major gap in medical education and highlights the urgent need for improved nutrition education for physicians. Currently, there is an overemphasis on weight and BMI in medical education, which often leads to unfounded anti-obesity bias and an oversight of the risks of eating disorders.
“Mainstream medicine is still very focused on linking weight and health,” said lead author Carney Gunsalas, assistant professor at the Augusta University/University of Georgia Health Partnership. The researchers argue that equating weight gain with health problems is misleading, and that weight loss is not always the solution.
Recent findings suggest that being overweight does not necessarily mean being unhealthy. This finding calls for a shift from a BMI-focused assessment to more comprehensive measures of cardiometabolic health, including blood pressure, cholesterol levels, and insulin resistance. These metrics provide a much more accurate picture of an individual’s health status.
For example, nearly half of Americans who are overweight by BMI standards are metabolically healthy, but one-third of people with a BMI in the “healthy” range are actually unhealthy. Even advances in treatments such as bariatric surgery and drugs like Ozempic and Wegovy have been shown to have health benefits independent of weight loss. “When the benefits appear to be upfront and unrelated to weight loss, the conversations physicians have with their patients need to change to focus on health instead of weight loss,” said Ellen House, PhD, co-author of the study.
Moreover, current medical education often overlooks the harmful effects of weight bias, which unfairly associates obesity with moral failings and ignores important biological and systemic factors. These factors range from the availability and affordability of healthy foods to access to safe exercise environments. This distorted perception can lead to less compassionate care for overweight patients and poorer health outcomes.
“Doctors miss asthma and cancer because they attribute symptoms to weight, when weight isn’t the cause of the patient’s concern,” says House. Negative experiences with healthcare rooted in such stigma can discourage patients from seeking medical help in the future, exacerbating health problems.
Reframing the doctor-patient conversation to focus on healthy behaviors instead of weight is crucial. Encouraging behaviors like increased physical activity and not dichotomizing foods as “good” or “bad” can significantly improve patient health. “If I could wave a magic wand and get doctors to do one thing differently in their interactions with patients, it would be to start from the premise that every patient wants to be healthy and has the ability to be healthy,” says Gunsalas.
