#weight stigma

Pre-diabetes was rejected as a diagnosis by the World Health Organization (although it is used by the US and UK) - the correct term for the condition is impaired glucose tolerance. Approximately 2% of people with "pre-diabetes" go on to develop diabetes per year. You heard that right - TWO PERCENT. Most diabetics actually skip the pre-diabetic phase.

There are currently no treatments for pre-diabetes besides intentional weight loss. (Hmm, that's convenient, right?) There has yet to be evidence that losing weight prevents progression from pre-diabetes to T2DM beyond a year. Interestingly, drug companies are trying to persuade the medical world to start treating patients earlier and earlier. They are using the term “pre-diabetes” to sell their drugs (including Wegovy, a weight-loss drug). Surgeons are using it to sell weight loss surgery. Everyone’s a winner, right? Not patients. Especially fat patients.

Check out these articles:

Prediabetes: The epidemic that never was, and shouldn’t be

The war on ‘prediabetes' could be a boon for pharma—but is it good medicine?

Also - I love what Dr. Asher Larmie @fatdoctorUK has to say about T2DM and insulin resistance, so here's one of their threads I pulled from Twitter:

1️⃣ You can't prevent insulin resistance. It's coded in your DNA. It may be impacted by your environment. Studies have shown it has nothing to do with your BMI.

2️⃣ The term "pre-diabetes" is a PR stunt. The correct term is impaired glucose tolerance (or impaired fasting glucose) which is sometimes referred to as intermittent hyperglycemia. It does not predict T2DM. It is best ignored and tested for every 3-5yrs.

3️⃣ there is no evidence that losing weight prevents diabetes. That's because you can't reverse insulin resistance. You can possibly postpone it by 2yrs? Furthermore there is evidence that those who are fat at the time of diagnosis fair much better than those who are thin.

4️⃣ Weight loss does not reverse diabetes in the VAST majority of people. Those that do reverse it are usually thinner with recent onset T2DM and a low A1c. Only a tiny minority can sustain that over 2yrs. Weight loss does not improve A1c levels beyond 2 yrs either.

5️⃣ Weight loss in T2DM does not improve macrovascular or microvascular health outcomes beyond 2 years. In fact, weight loss in diabetics is associated with increased mortality and morbidity (although it is not clear why). Weight cycling is known to impacts A1c levels.

6️⃣ Weight GAIN does NOT increase the risk of cardiovascular OR all causes mortality in diabetics. In fact, one might even go so far as to say that it's better to be fat and diabetic than to be thin and diabetic.

Dr. Larmie cites 18 peer reviewed journal articles (most from the last decade) that are included in their webinar on the subject, linked below.

shocker, treating people shitty for being unhealthy (not based in fact, based on appearance) makes people less healthy. 🙄

[image description: instagram post by @nutrifoodie.ca aka Cristel Moubarak, RD, with a drawing of a brown-skinned doctor in the corner.

Text reads: If your doctor diagnoses you based off of your Body Size, SWITCH DOCTORS!

end description]

Good advice. Sadly, it's not that simple for all of us. I'm on medicaid, and finding new doctors that take my insurance is not so simple as just switching! Especially if the only HAES doctors are nowhere near me. If you can switch doctors, you can use an HAES directory like these:

Bare health: https://barehealth.co/

ASDAH: https://asdah.org/listing/

Sometimes you're stuck with a fatphobic doctor and you need to advocate for yourself. There are resources out there for us too!

Download self-advocacy cards here: https://haeshealthsheets.com/resources/

How to advocate for yourself (article): https://www.verywellhealth.com/self-advocacy-guide-at-doctors-weight-stigma-8609846

HAES health sheets on different conditions: https://haeshealthsheets.com/the-health-sheet-library/

By: Do No Harm Staff

Published: May 21, 2026

What happens when parts of the American public-health apparatus are commandeered by ideologues pushing yet another victimization narrative? Thanks to the “Fat Justice Working Group” at the Oregon Health & Science University-Portland State University School of Public Health (SPH), we may soon have an answer.

“The purpose of the Fat Justice Working Group,” its website declares, “is to engage students, faculty and staff … in learning, activities and advocacy to reduce weight stigma and anti-fat bias in ourselves, our School and society at large.”

Beneath that word salad is a meatier agenda: “We imagine a future where public health is openly and firmly committed to ending discrimination and other oppression of people in larger bodies.”

This is sloppy thinking, directly antithetical to the principles of public health.

The National Institutes of Health (NIH), for example, defines its mission in part as “enhanc[ing] health, lengthen[ing] life, and reduc[ing] illness and disability.” By presenting obesity as an “oppress[ed]” identity category rather than a treatable medical condition, Oregon’s SPH makes this work more difficult.

We have been here before. Last year, Do No Harm catalogued efforts by the Lewis Katz School of Medicine at Temple University to downplay the adverse health consequences of obesity.

For instance, the school hosted a presentation entitled “Introduction to Weight Stigma & Weight Inclusive Care,” the purpose of which was, in part, to “promote a non-judgmental and inclusive environment for patients of all body sizes.”

Unbelievably, the presentation made the assertion that “health and well-being are achievable for all regardless of weight.” One need only read the relevant medical literature to grasp the inaccuracy of this claim.

Medical science demonstrates that obesity correlates strongly with elevated mortality. It is often, in the words of a Ghana Medical Journal article, “a major risk factor for the development of several non-communicable diseases, significant disability and premature death.”

Moreover, as Do No Harm wrote last year, obesity is not an immutable condition. In many instances, obese patients “who lose significant amounts of weight have been shown to live longer, with better quality of life.”

None of this means that men and women suffering from obesity deserve public censure or scorn. Physicians and other public-health officials should treat all patients with respect, even as they bring their expertise to bear on conditions that lead to significant medical complications.

In short, the medical establishment needs to help people struggling with obesity to make lifestyle improvements or, in some cases, to choose appropriate pharmacological or surgical interventions. Obese patients need assistance, not a team of social-justice warriors telling them that everything is okay.

Faculty and staff at Oregon’s SPH must know this. Yet the work of the Left is always and everywhere to expand the ranks of the “oppressed,” thus granting political power to those who would “rescue” them.

In medicine, this has often meant fixating on identity and compassion at the expense of patient care. Yet evidence-based medical science should not be deemphasized by those who wish primarily not to give offense.

In the normal course of things, such a tendency is often merely obnoxious. When it helps convince doctors not to tell necessary truths, however, the consequences can be deadly.

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Stigma about indisputably bad things is a good thing.

Not being able to fit into clothes at the store is not your body's fault. It's the store's fault for not accommodating various body sizes and shapes.

Your insurance going up because of your BMI is not your body's fault or your fault. It's the insurance company's fault.

Planes not accommodating your body size is not your body's fault. It's the airline's companies' fault.

Your body is not a problem. Weight stigma is the problem.