Written By: Tisha Misquita, Clinical Therapist MEd, Registered Psychotherapist (Qualifying)
When Health Is Reduced to a Number
Imagine going to the doctor for ongoing fatigue, joint pain, digestive issues, or anxiety, and before you have finished explaining what is happening, you are told to lose weight.
No tests.
No curiosity.
No conversation about stress, sleep, or nourishment.
Just weight.
For many people, this is not hypothetical. It is reality. For some, moments like this become the beginning of a longer pattern of doubt, self-blame, and silence around their health.
Being Dismissed Leaves a Mark
If you have ever felt blamed, brushed off, or reduced to a number in a healthcare setting because of your body size, your experience is real and unfortunately common.
People in larger bodies are more likely to be told that weight is the cause of nearly any health concern, even when symptoms suggest something else entirely. Over time, these encounters change how people relate to care. Many stop seeking help. Others begin to believe that their body itself is the problem. That belief does not stay contained. It often shows up in how people eat, how they move, and how they think about and speak to themselves.
When people are repeatedly told that their body is the problem, many turn to food and movement as ways to regain control, safety, or legitimacy. This is often where disordered eating begins.
How Weight Stigma Fuels Disordered Eating
Weight stigma does not simply delay care. It actively fuels disordered eating.
When health is framed as something you must earn by shrinking your body, food becomes moralized. Restriction and overexercise are often praised, even when they are signs of distress. This becomes especially clear when we look at how thinner and larger bodied people are treated for the same health concerns.
A thin person with knee pain may be referred to physiotherapy or imaging.
A person in a larger body with knee pain may be told to lose weight first.
A thin person reporting fatigue may be screened for anemia, sleep concerns, or mental health conditions.
A larger-bodied individual is more likely to be advised to diet, even when dieting worsens fatigue and reinforces disordered eating patterns.
These responses send powerful messages that care is conditional and that relief must be earned through weight loss.
Why Weight Fails as a Measure of Health
One tool that reinforces this conditional approach to care is the Body Mass Index, commonly known as the BMI.
The BMI was created in the nineteenth century as a population-level statistical measure – as a tool designed to look at patterns and averages across large groups of people, not to assess the health or needs of an individual person. It can identify trends in populations, but it does not account for individual differences like genetics, lived experience, or overall wellbeing. It was never intended to assess individual health. It does not account for muscle mass, bone density, genetics, age, race, gender, cardiovascular fitness, or metabolic health.
According to the BMI, a person with significant muscle mass may be labelled overweight while a person who is malnourished may fall into the normal range.
Despite these limitations, BMI continues to be used to determine access to care, dismiss symptoms, justify weight loss recommendations, and invalidate disordered eating concerns in larger bodied people.The result is a painful contradiction. People are praised for weight loss even when the behaviours that lead to it may be physically and emotionally harmful.
The problem is not just that the BMI is flawed. It is that tools like this teach us to collapse health into a single visible metric. When weight becomes the primary way health is understood, everything else gets lost—context, lived experience, and the realities of how people are actually living in their bodies.
Over time, this does not only shape medical care. It shapes how people come to understand themselves. Many begin to measure their worth, their wellbeing, and even their right to support through a number that was never meant to hold that much power.
This is why expanding our definition of health matters.
Health is more than what you weigh
A number on a scale cannot tell you whether someone is nourished, stressed, supported, or struggling. Two people at the same weight can have entirely different relationships with food and vastly different levels of physical and emotional wellbeing. Weight does not capture how someone feels in their body.
Health is more than how you look
Many people who appear healthy by cultural standards are privately struggling with anxiety, exhaustion, or disordered eating. Health is not about maintaining an image. It is about how someone actually functions and copes beneath the surface.
Health is more than how you move
Movement is often framed as something that must be intense, frequent, or productive to “count.” But health can look like gentle movement, rest, or changing how you relate to exercise altogether. For some people, stepping back from movement is a necessary part of healing, not a sign of failure or lack of discipline.
Health is more than what others can see
Health is not always visible. People of all sizes can be malnourished, exhausted, or deeply unwell. Someone may be restricting food, ignoring hunger, overexercising, or living with constant anxiety around eating while appearing perfectly fine to the outside world.
When we expand our understanding of health beyond appearance, we make room for struggles that are often hidden, and that shift weakens the grip of disordered eating by allowing people to be seen, supported, and taken seriously before thoughts and behaviours become all-consuming.
You Deserve Care Without Conditions
No one should have to change their body to have their health and wellbeing taken seriously. When weight becomes the filter through which health is judged, care is missed, and shame grows.
If food or body image concerns are affecting your wellbeing, you deserve care that looks beyond size, charts, numbers, assumptions, and appearance. Care that begins with listening and that understands health as complex, contextual, and human.
From February 1st – 7th, we observe Eating Disorder Awareness Week. This year, the spotlight is on the reminder that ‘Health does not have a look’, and that challenging appearance-based definitions of health is essential to reducing stigma and supporting recovery.
Seeking Support at CITC
If you are carrying experiences of feeling dismissed, misunderstood, or judged in healthcare spaces, especially around food, weight, or your body, these experiences can leave lasting marks. You don’t have to navigate them alone.
I’m Tisha, a Registered Psychotherapist (Qualifying) at CITC, and I work with individuals who are navigating disordered eating, eating disorders, body image concerns, and the emotional impact of weight stigma. My approach is client-centred, compassionate, and grounded in the belief that health is complex, contextual, and deeply personal. Therapy with me is not about changing your body, it’s about understanding your relationship with it, unpacking the messages you’ve absorbed, and creating space for care that honours your lived experience.
I draw from evidence-based approaches including Emotion-Focused Therapy (EFT), Interpersonal Therapy (IPT), Internal Family Systems (IFS), Cognitive Behavioural Therapy (CBT), and trauma-informed care. Our work is collaborative and paced to feel safe and supportive, with your values and goals guiding the process.
I offer both in-person sessions in Midtown Toronto and virtual therapy across Ontario. Whether you’re struggling with food, body image, or the impact of feeling unseen in healthcare spaces, you deserve care that begins with listening.
If you’re curious about working together, you’re welcome to reach out to our Clinical Coordinator to learn more.
