The New 2025 Guidelines That Finally Address Weight Stigma

Jennifer Hardy
May 20
6 min read

If you've ever felt judged at the doctor's office, this is the update you've been waiting for. How healthcare professionals talk about and address obesity is about to change!

You can talk all day about access to GLP-1 medications, but if your doctor still treats you like your weight is your fault—or worse, avoids treating you altogether—then we’re not getting anywhere. The American Diabetes Association Obesity Association just dropped new 2025 clinical guidelines, and this time, weight stigma is front and center.

That’s not a buzzword. It’s the name for the real, measurable harm caused when people in larger bodies are treated differently by providers, by policy, and by the physical setup of the clinics they walk into. Weight stigma is also referred to as weight bias.

And the ADA is officially calling it what it is: a barrier to care.

Experiences with Weight Stigma

In 2021, I suddenly dealt with crippling knee pain. It came out of nowhere, and as a kickboxer, I was devastated. I quickly made an appointment with a local orthopedic clinic. As I hobbled into the office, the doctor sized me up and clearly had made his diagnosis before I even got the X-rays back.

"Your knees look fine," he said, almost sounding bored. "You just need to lose some weight, and your knees won't hurt as bad." The word "bad" was barely out of his mouth when his hand extended to shake mine, and faster than you can say "fat shamed," he was gone.

I pressed for a better answer after the shell-shock wore off the next day. In a 46-second phone call, he sighed and said, "I dunno - maybe stop eating meat and cut meal portions in half?"

It wasn't even that I was embarrassed about being overweight. It was that nothing else could've possibly been true in his mind BECAUSE I was overweight. As it turned out, I have two shredded menisci and bone-on-bone arthritis in both knees. But I had to suffer for two more months until a healthcare provider cared enough to find answers by ordering MRIs.

This is the type of treatment the new ADA guidelines are hoping to quash.

What Is Weight Stigma?

Weight stigma isn’t just about fat jokes or bad headlines (though those matter). It’s the systemic devaluation of people based on body size. In healthcare, it shows up as everything from blaming unrelated symptoms on weight to dismissing concerns entirely. Sometimes it's subtle. Often (such as in my case) it isn’t.

The 2025 ADA guidelines define it in three ways:

Structural: Policies and clinics that exclude larger bodies
Interpersonal: Bias in one-on-one interactions
Internalized: When people start believing the stigma themselves

Each type undermines care. All three are preventable.

What the ADA Guidelines About Weight Stigma Are NOT

This isn’t about telling people to just love their bodies and asking everyone else to celebrate every shape and size, no matter what. Weight stigma is beyond aesthetics—it’s about access, treatment, and how people are (or aren’t) cared for in medical settings.

You can believe in the value of health interventions, including weight loss, and still reject the idea that someone deserves less empathy, fewer options, or worse care because of their size.

Calling out weight stigma doesn’t mean weight is off-limits as a topic. It means it’s handled with nuance, respect, and a focus on the whole person, not just their BMI.

This isn’t about ignoring or celebrating obesity. It’s about refusing to let shame be the delivery method for care.

Why Weight Stigma is Dangerous

Let’s be clear: weight stigma is not just “hurt feelings.” It’s directly tied to worse health outcomes. People avoid checkups because they don’t want to be weighed in public. They delay treatment because they’re sick of being blamed. They internalize shame, which increases stress and worsens physical and mental health.

"Weight bias is partly driven by the inaccurate belief that weight is entirely within an individual’s control."

While the new report states that "Weight bias is partly driven by the inaccurate belief that weight is entirely within an individual’s control," one would think the medical community was aware of this. However, the guidelines are directed at the very people making those struggling with weight issues feel so damn uncomfortable.

A mountain of data links weight stigma to anxiety, depression, disordered eating, and reduced healthcare access. And that’s before we even talk about how it affects chronic disease management, including obesity, diabetes, and cardiovascular disease.

With nearly two-thirds of American being overweight or obese, you can bet this impacts someone close to you, even if it doesn't resonate with you personally.

Fixing Weight Bias Habits Starts with Training

The ADA is blunt: most healthcare workers are undertrained when it comes to obesity, and that gap fuels bias. The new guidelines recommend all clinicians and staff—not just doctors—receive ongoing, evidence-based education to reduce weight stigma.

That means structured training during medical school and continued professional development for practicing clinicians.

What works best? Programs that go beyond lectures and actually include things like empathy interviews, simulation exercises, and feedback from people with lived experience. In one study, medical students who completed this kind of training not only reduced their bias but also retained more empathy a year later. That’s the goal.

The Clinic Environment Also Needs to Change

You shouldn’t have to scan a waiting room like a hawk to figure out if the chairs will hold you. Or wonder whether the scale will register your weight. Or wear two gowns because one doesn’t close. These are not minor inconveniences—they’re reminders that the system wasn’t built for you.

The ADA now recommends baseline accommodations that include:

Private weighing spaces
High-capacity scales (at least 500–800 lbs)
Exam tables that adjust in height and width
Gowns up to 4XL
Blood pressure cuffs that fit
Media and posters that don’t promote weight stigma

They also call out specific fixes for bathrooms, elevators, and hallways to make clinics physically accessible. The goal is simple: create environments where people with obesity feel safe, respected, and seen.

Language Matters More Than You Think

The way healthcare professionals talk about obesity can either build trust or shut it down. That starts with asking permission before discussing weight—and using whatever terms the patient prefers. (And yes, that includes scrapping terms like “morbidly obese.”)

The ADA recommends person-first language ("person with obesity," not "obese person") and avoiding loaded words like “non-compliant” or “failed” in charts and diagnoses. New ICD-10 codes rolled out in 2024 already reflect this shift.

And here’s something you might not have considered: even if you’re on a GLP-1 and making progress, the language your provider uses still matters. It shapes your experience, your self-perception, and whether you feel safe coming back.

As an example, I'm taking Zepbound for Obstructive Sleep Apnea (OSA). Imagine my surprise when my pulmonologist directed me to my family physician to get that prescription. I pushed back with, "You are treating me for OSA, so you should be the one giving me the script."

Shared Decision-Making Instead of Shame

The guidelines also emphasize shared decision-making (SDM), meaning your goals are part of the care plan, not just your doctor’s agenda. If your reason for taking GLP-1s is to reduce arthritis inflammation or take long walks with your kids, that’s valid. Treatment shouldn't be framed solely around a target weight.

And if you’ve ever had a provider treat your use of GLP-1s as “cheating,” a "quick fix," or “taking the easy way out”? That’s weight stigma, too.

SDM works best when weight stigma is removed from the room. Without it, you’re free to discuss options, including behavioral, medical, or surgical interventions, without fear of judgment. And providers are more likely to respect your long-term goals, not just short-term metrics. It also sets the stage to celebrate non-scale victories (NSV).

This type of communication can also potentially limit the risk of disordered eating to reach a goal weight.

What You Can Do

If you’re a patient, you don’t have to wait for your clinic to catch up. You can bring your own tools—literally. The Obesity Action Coalition offers conversation starters and patient handouts you can take with you. UConn’s Rudd Center also has toolkits designed for both patients and providers.

If you’re a provider, get familiar with these new standards. Adjust your clinic policies, rethink your language, and actively seek feedback from patients who may not have felt welcome before.

Even more? Share this article or its message on all your social media accounts. People who struggle with weight issues or metabolic syndrome need to speak up at a time when more people than ever are listening.

Bye Bye to Weight Bias

Weight stigma isn’t just a social issue. It’s a clinical one. It warps care, limits access, and makes people feel less than human in spaces that are supposed to help them.

The 2025 ADA guidelines don’t pretend that one checklist or training will fix decades of harm, but they do lay out a path forward.

If you’re working in obesity care in any capacity—from prescribing GLP-1s to designing office layouts—this matters. And if you’re someone navigating treatment yourself, know this: you deserve care that respects your body, not care that judges it.

Let’s stop acting like weight stigma is an unfortunate side effect. It’s the main problem. And now there’s a blueprint for doing something about it.