Gen Z Is More Likely to Challenge Weight Stigma in Medical Settings

This article is part of Verywell Health’s 2024 survey on obesity care. Read the full analysis of the key findings here.

Jessica Diaz France went to see a doctor for a rash on her arm, but the conversation started with something unrelated to her skin: weight loss.

Diaz France said she wanted to talk about her skin condition rather than her weight, but the provider assumed she had high blood pressure because of her weight. When Diaz France requested her blood pressure be checked, the results were within the normal range.

“Just looking at me, there was the assumption that I had high blood pressure," Diaz France, 37, a clinical social worker based in Marin County, California, and treasurer for The Body Positive, told Verywell. "People make a lot of assumptions just based on how I look when I enter a doctor’s office."

Many larger-bodied individuals who encounter weight-based stigma in a healthcare setting lose trust in their providers.

In a Verywell survey of over 2,000 adults who identify as larger-bodied, fat, or as having obesity or overweight, nearly one in six respondents said they’ve experienced weight-based discrimination in a medical setting. Half of the respondents who experienced weight-based discrimination either stopped treatment, visited the doctor less often, or delayed a health decision.

However, Gen Z and Millennials are more likely to advocate for themselves at a doctor's office. According to the survey, 46% of Gen Z and 37% of Millennial respondents have either asked not to be weighed, stepped on the scale backward to avoid seeing their weight, or asked for their weight to be omitted from medical records.

For Diaz France, it's important to speak up and ask for what she needs. While she was giving birth in a hospital, she repeatedly asked for a larger blood pressure cuff.

"It would be helpful if every room had all different size cuffs, and providers listened to you when you say 'This doesn't fit,'" Diaz France said.

Younger Generations More Likely to Refuse Being Weighed

Most healthcare visits start with the patient stepping on a scale. That number can influence the rest of the appointment. While 64% of the respondents have been told to lose weight by a healthcare provider, only one in three said this recommendation was related to a current medical condition.

“Knowing my weight has been challenging for me. That’s because I focus on the number instead of other indicators of health,” Diaz France said. “My weight might go up and down, but I know that I’m healthy based on what I’m able to do in my life, my movement, what I’m eating, and how I feel about myself.”

Gen Z and Millennial respondents were more likely than older generations to feel comfortable asking not to be weighed or for their weight not to be told to them. However, advocating for size-inclusive health care is not always easy.

“I have maintained a practice of not weighing myself when I go to the doctor. Over the years, I’ve seen it become more of a choice,” Diaz France said. “Previously, I noticed a lot of reactions—sometimes anger—from providers because I didn’t want to be weighed.”

What Size-Inclusive Care May Look Like

Many young adult respondents believe that people can be healthy at any size, and almost 20% of respondents reported seeking out a healthcare provider specifically because they had an inclusive approach to weight and health.

Groups like Medical Students for Size Inclusivity (MSSI) are actively working to make healthcare more equitable for everyone. This community of current medical students aims to reform medical school curricula and help educate future healthcare providers about the harms of diet culture and weight discrimination.

“From day one, we’re taught how to counsel patients to lose weight, to exercise more, and eat ‘healthier.’ All of us were discouraged by the lack of size-inclusive aspects to medical education,” said Jessica Mui, 26, president of Medical Students for Size Inclusivity and a medical student at Cooper Medical School of Rowan University.

The MSSI community believes that health looks different for everyone. They aim to challenge weight stigma in medical education.

“I’ve seen my school making efforts to address more of the social side of medicine and incorporating things like public health, but I think there’s a long way to go,” said Taylor Lees, 27, co-director of community engagement and education for MSSI and a medical student at the University of Minnesota Medical School.

Medical schools are now populated with Gen Z students who support a holistic view of well-being that includes mental and emotional health. Lees said she hopes this expanded view of health will trickle down into the way she and her medical school peers work with future patients.

“Giving blanket recommendations when your patient isn’t on board with them just is more harmful than it is helpful,” Lees said. “You’re on the same team as your patient, so what you can do together to achieve their goals is more important than just checking off a list of the things you need to talk about with every patient.”