NEEDHAM, Mass. — The paint is still drying, the floors aren’t in -- but in a couple of weeks, a new type of primary care medical clinic will open in Needham: one which stresses ‘weight-inclusion.’
“And what that means is, the doctors don’t totally ignore your weight,” said Brooke Boyarsky Pratt, co-founder of Knownwell. “They see it as just one data point in your overall health, and they work with the patient in setting goals and meeting them.”
The clinic, which will accept all insurance, is Boyarsky Pratt’s answer to a childhood of weight-shaming at the hands of doctors.
“Weight has been a common thread throughout my life,” she said. “One of my earliest experiences was going to the pediatrician as a kiddo and the doctor telling my Mom that I should go to Fat Camp.”
Boyarsky Pratt was in elementary school at the time.
“One of my earliest experiences was having a stigmatizing experience with the doctor, and, unfortunately, that really followed me into adolescence and into adulthood,” she said.
On a subsequent medical visit, for example, Boyarsky Pratt was told a sinus infection would get better if she lost weight.
“I started to get really curious about whether other people face this problem,” she said. “And in statistics that we’ve shared, it’s the most common stigmatizing experience for Americans.”
And it’s a stigmatizing experience that’s actually keeping some from seeing the doctor at all -- even when they need to. One survey found more than half of women with severe obesity delayed or canceled appointments for fear they would be weighed.
“For years, physicians and clinicians have told patients just to eat less and exercise more,” said Angela Fitch, MD, president of the Obesity Medicine Association and former associate director of Mass General’s Weight Center. “And we know that while that works for a small percentage of people -- about five percent -- the other 95 percent it doesn’t work for. When you keep telling people to do the same thing over and over, that’s not successful, it feels very defeating.”
And it also feels like victim-blaming, something the field of obesity medicine has gotten past in recent years. Clinicians now regard obesity as a chronic disease that is treatable, using not only lifestyle modifications -- but highly effective weight-loss drugs such as liraglutide (Saxenda) and semaglutide (Wegovy).
“There’s hope for people to get treatment if they can get access to treatment,” Fitch said. “That’s our biggest challenge at the moment -- getting access.”
Fitch said the Obesity Medicine Association is working to get more doctors educated and equipped to handle patients with obesity -- so that the relative handful of weight loss specialists in the country can deal with the most serious, complicated cases of the disease.
And that’s where Knownwell comes in. All of its medical personnel will be trained in dealing with the disease of obesity -- if it’s something that the patient needs.
“I want a clinic that I would want to go to as a patient,” Boyarsky Pratt said.
And that isn’t one where clinicians express weight bias, she said, considering that approach is not only callous -- but doesn’t seem to work.
“We know that if a patient has a really stigmatizing experience with a doctor about their weight -- the doctor being condescending in discussing it, they are often more likely to gain weight than if they had been told nothing,” Boyarsky Pratt said.
This is a developing story. Check back for updates as more information becomes available.
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