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What does health equity look like and how do we know we are getting it?
In this episode, Louise shares a story about a client who recently had an appointment to see a specialist due to knee pain. Her story of anxiety around doctor's blaming her weight is one we've heard, time and time again. In this episode we dig into something bigger: the difference between correlation and causation, and how mixing the two up drives real harm in both healthcare and fitness spaces. This episode covers research on weight bias among physicians and medical trainees, patient avoidance of care, and discrimination in gyms — alongside the more hopeful research on weight-neutral care, Health at Every Size programs, and how quickly trainable bias actually is with the right intervention. Louise also shares patterns she's seen again and again coaching women through both worlds. Fair and equitable care isn't a soft ask — it's what accurate diagnosis and good coaching actually require.
- 00:00 – the coaching call, and why my client was anxious about her knee appointment
- 02:00 – what this episode covers and why it matters
- 03:45 – how my client found a doctor who never once mentioned her weight
- 07:00 – Correlation vs. causation: why weight gets blamed for things it may not have caused, and the "metabolically healthy obesity" research
- 10:40 – The hard numbers: weight bias among physicians and medical trainees, patient avoidance of care, discrimination in gyms
- 14:10 – Why this matters to me: patterns I've seen coaching women through healthcare and fitness spaces
- 18:15 – The hopeful data: weight-neutral care outcomes, Health at Every Size research, and how trainable bias actually is
- 20:45 – What fair and equitable care actually looks like in practice
- 23:20 – Close
Key Stats Mentioned
● Nearly 40% of surveyed resident physicians agreed "fat people tend to be fat pretty much through their own fault"; about a third reported feeling more irritated treating patients with obesity.
● Across a six-country study, 56–61% of adults reported experiencing weight stigma, with 63–74% of those experiences coming from healthcare providers.
● 84% of plus-size and underweight gym-goers reported experiencing negative weight-related judgment at the gym.
● Weight stigma itself — not body size — was linked to elevated cortisol and oxidative stress in one study, independent of participants' actual body composition.
● In a 2-year randomized trial, a weight-neutral approach produced sustained improvements in cholesterol, physical activity, self-esteem, and quality of life — without weight loss as the goal.
● A 2-hour weight-inclusive training for fitness professionals produced measurable, sustained improvements in attitudes three months later.
Louise Green is an award-winning coach with 20 years invested in working with women of all body sizes. She has coached thousands of women from all over the world, if you're ready take the next step in your strength, check out her coaching program: https://www.louisegreeninc.com/size-strong
