In this issue:
Meet the Advocacy Committee
November Panel Event Recap
Bring MSSI to your school: MSSI Chapters and Affiliates
NEW: GLP-1 Receptor Agonist Medications: Informed Consent Resource for Patients
NEW: Lecture Analysis Tool
NEW: Resources for Anti Weight Bias Advocacy as a Medical Student
Latest research
Who are we?
We are an interscholastic community of medical students raising awareness about the interplay between eating disorders and the weight bias in medicine.
Our mission is to educate future physicians about the harms of diet culture and weight discrimination in the healthcare system, and to advocate for equitable care on behalf of patients in larger bodies.
Our goals include advocacy among current and future healthcare providers, community outreach and education, student-led research, and medical school curricular reform.
Meet the Advocacy Committee
Marisa (she/her) is a 2nd year medical student at Drexel College of Medicine, who serves as a co-director of MSSI’s Advocacy Committee. Prior to entering medical school, she worked as a size-inclusive trainer, providing a gentle approach to helping others find movement practices they enjoyed. Faced with resistance to this approach in both the fitness and healthcare spaces, Marisa was thrilled to discover MSSI shortly after entering medical school. As a future physician, she aims to bring her training experience and advocacy work with MSSI to continue fighting anti-fat bias, promoting positive health behaviors, and building a system where patients in all body sizes receive equitable and comprehensive healthcare.
Caroline (she/her) is a medical student at Geisinger Commonwealth School of Medicine and serves as the co-director of the Advocacy Committee at MSSI. She first learned about weight neutrality on a personal journey of increased body acceptance and has been striving to incorporate it into her professional sphere ever since. She is currently applying into Pediatric residency programs and hopes to pursue a career centered on social justice and advocacy through an intersectional LGBTQ+, anti-racist, and fat liberation lens.
I am Arielle, an M2 at Saint Louis University SOM in Saint Louis, MO. As a preclinical student, my patient interaction is still pretty limited, but I’ve found conversations with fellow students to be a great avenue for engaging in MSSI work. I expected lots of skepticism and pushback, but I have found my peers to be really open to listening and learning about the idea of size-inclusive healthcare! Most med students are deeply passionate about providing compassionate, respectful care to patients, and that’s really what the core MSSI principles are about.
November Event Recap
Instagram post by @sizeinclusivemedicine
Thank you to everyone that attended our ‘Size Inclusive Healthcare: Across the Specialties’ event on Thursday, November 2nd. And thank you to Drs. Erlanger, Griffith, and Dodell for their wisdom and support of MSSI.
Here are some key takeaways from our speakers:
How can I be more size inclusive in my clinical rotations?
Be specific and purposeful in the language you use. Though others may be perpetuating stigma, make a conscious effort to use the language that feels right to you. Others will pick up on this.
Keep an eye for accurate weight-based dosing. Are we underdosing heparin? Are we underdosing antibiotics? Are we overdoing their sepsis bolus?
Be mindful of the risk of malnutrition across the size spectrum. We are often quick to consult dietitians in a smaller body person, but be aware that malnutrition can occur with risk in all bodies.
Watch out for people blaming bodies rather than systems. For example, “you’re too big for our MRI machines”. Blame the system, not the body.
Do not take time from other treatable issues to discuss weight.
Address the patient’s chief complaint and reflect on what you would do for someone in a differently shaped body. Do not include BMI on problem list, ID, or CC.
Have accessible furniture, gowns, equipment readily available for your patients. If not available, ask your preceptors why they aren’t.
How can I work with patients coming to me seeking weight loss?
First, don’t assume that a patient wanting to lose weight is a patient wanting to lose weight. Fat people will often come to the doctor’s office feeling the need to “perform” diet culture in order to receive equitable health care and so that we think they are engaged.
Empathize with the request. Validate how normal it is to want to lose weight in our society and how anyone who would be able to shed a stigmatized identity would want to.
Share your perspective. “I don’t have a safe and sustainable way to suppress your weight long-term. But I do have ways to approach any concern you have in terms of symptoms, disease management, disease prevention, or health promotion”.
Work on healthy behaviours. “If we were to set weight aside, what do you think would make the biggest difference in your health? How can I help you that?”. Make it clear that weight is not the target and is not how we’re going to measure success.
Reinforce that whatever decision your patient lands on, that you support them.
Interested in bringing Medical Students for Size Inclusivity to your school?
Click below for those wanting to form a chapter of Medical Students for Size Inclusivity (MSSI) at your school, or affiliate an existing organization at your school with MSSI.
Once received, a member of MSSI will reach out with additional details, and our Chapter & Affiliate Application form!
NEW: GLP-1 Receptor Agonist Resource for Patients
We have seen the huge increase in GLP-1 agonist prescriptions specifically aimed at promoting weight loss, and are concerned that patients may receive misleading or insufficient information from their healthcare providers before being started on them.
While MSSI does not believe weight & BMI are accurate measures of health, or that weight loss improves health outcomes, we also champion patient autonomy. Weight discrimination permeates so many aspects of society, and the physical and mental harm it directly causes fat people is immeasurable and far-reaching.
Our goal is to give patients desiring to start medications to lose weight a more comprehensive understanding of the risks and benefits associated. Knowing what alternatives are available is part of full informed consent, so we also include evidence-based options for improving health that do not require weight loss.
Excerpt from the GLP-1RA Resource
NEW: Lecture Analysis Tool
Created by: Laurel Neufeld, Monica Kriete, MPH, and Rachel Fox
Students: Have you….
…ever felt troubled by a lecture that discussed weight or fatness, but had a hard time explaining what about it was harmful?
…wanted to collect student perspectives on a fatphobic lecture, and needed a way to structure that feedback?
…wanted to lead a workshop on understanding fat oppression in class, and needed a framework to review class materials?
Instructors:
Are you leading a session that involves weight?
Use the lecture analysis tool below to check if you are causing harm to students and/or patients in larger bodies!
If you use the Anti-Obesity Assemblage Lecture Analysis Tool, please fill out the short tracker survey to support the authors’ work.
Page 1 of The Anti-Obesity Assemblage Lecture Analysis Tool
NEW: Resources for Anti Weight Bias Advocacy as a Medical Student
Are you a medical student or related health professions student interested in advocating for size inclusive care and education at your school? Here are some resources you might find helpful!
Jessica Mui, MSSI President and MS-3 at Cooper Medical School of Rowan University, has created a 30-minute video, presentation, and resource list for medical students.
Research Spotlight: High BMI Is Not Associated With Serious Complications After Top Surgery
Researchers at the Johns Hopkins Center for Transgender and Gender Expansive Health released a study entitled ‘Association of High Body Mass Index With Postoperative Complications After Chest Masculinization Surgery’ in the journal Annals of Plastic Surgery on November 1, 2023.
This national retrospective study of 2317 patients who underwent chest masculinization surgery (“top surgery”) found negligible overall incidence of significantly morbid complications in patients with high BMI.
The authors recommend re-evaluation of BMI cutoffs for transmasculine patients.