Diet Culture Rebel Podcast · Bonnie Roney

232. Weight Stigma in Healthcare Is NOT in Your Head (and What You Can Do About It) with Dr. Vicky Borgia

·58 min·4 clips

Dr. Vicky says the system rewards checking boxes like A1C, weighing patients, and counseling weight loss.

1. Diet Culture Rebel Podcast episode 232 centers on weight stigma in healthcare and how Dr. Vicky Borgia responds to it in family medicine. 2. Bonnie Roney hosts the interview, and Dr. Vicky Borgia is a board-certified family medicine physician with over 20 years of experience who practices weight-inclusive care. 3. The episode asks what patients can do when medical appointments leave them dismissed, ashamed, or pushed toward weight-loss advice. 4. Bonnie opens with a pregnancy appointment where a doctor said, "Thank God you're skinny," and with a gestational diabetes call that told her to "walk more and eat better." 5. She says those comments felt especially loaded because she has a history of disordered eating and was already moving her body and eating a balanced diet. 6. Dr. Vicky says her own undergraduate degree was in women's studies, and she describes arriving in medicine with an early intersectional lens. 7. She says medical school taught her ideas such as "fat is bad," "If you lose weight, you're healthier," and "It's just exercise," even though those ideas never sat right with her. 8. She also says residency in Northern California had a social justice bent but still absorbed the same diet-culture and fat-phobia messages that she heard throughout training. 9. Dr. Vicky says clinicians often tell patients to lose weight because it is a fast way to get through an "eight-minute visit" without asking what they actually eat. 10. She adds that physicians are under heavy pressure to look a certain way themselves, and that pressure can be projected onto patients. 11. Dr. Vicky says opening her own direct primary care practice let her avoid MIPS measures and insurance-linked incentives tied to weighing people and counseling weight loss. 12. She describes one turning point after a federally qualified health center pressured her to focus on a patient's A1C even though the patient was in a horrifically abusive relationship. 13. In her definition, weight stigma appears when weight is the first item on the differential diagnosis and the clinician stops thinking through other causes. 14. She gives examples like a thumb tendon injury, ear infection, or sleep apnea being wrongly linked to body size. 15. Dr. Vicky says the stigma also shows up through gatekeeping for knee surgery, top surgery, facial feminization surgery, and IVF using arbitrary BMI limits. 16. She argues that a person's zip code can matter more for health than body size and says people of all sizes experience chronic disease, but fat patients get different meanings attached to the same problems. 17. The conversation sounds direct, skeptical of medical gatekeeping, and grounded in clinical examples rather than abstract theory. 18. Bonnie pushes for practical translation, and Dr. Vicky answers with scripts, boundary-setting, and repeated reminders that patients are not responsible for caretaking a provider's feelings. 19. People who want scripts for doctor's visits, weight-inclusive care, or medical self-advocacy will get the most from this episode. 20. People looking for a light conversation about health without discussion of medical trauma may skip it.

As heard by us

A calm, practical listen for anyone who has felt judged in the exam room.

This episode looks at how dismissal and shame can surface in medical care, especially when a patient is already braced for it. Bonnie Roney and Dr. Vicki Borgia keep things grounded and practical, and Dr.

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Why you'd press play

For when you need language for being dismissed by doctors.

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