The proposed solution hinges on three critical phases – activism, partnerships and decision-making efforts. These phases are ongoing once they start. Once they accomplish the first objective of reducing weight bias in family medicine in Ontario, they can continue working for another healthcare aspect or a different location. Activism must not stop once partnerships are established, and partnerships must not get ignored once decision-makers take the lead. Both activism and partnerships are maintained while resolutions are being formed. All three need to be working in tandem.

The circular timeline below shows that all phases are ongoing until goals are met. Its circularity conveys that this plan goes beyond the first ten years, as it tackles other healthcare sectors after finding success in family medicine. The healthcare landscape is huge and weight bias is prevalent in every part of it. Therefore, the efforts do not stop.

Strategic Roadmap

The following roadmap gives an overview of the transition steps. It is based on the Roadmap for Transition tool. While it would be preferred to achieve the goal in the shortest amount of time possible, realistically, it would require about five to ten years to mobilize and carry out the plan. Keeping this in mind, this roadmap is based on a ten-year timeline.

A Summary

This paper sifted through a description of the issue, findings from primary research, a synthesis of the problem using systemic design methods, and a high-level strategic proposal and plan that lays out the essential steps required to tackle the issue of weight bias in Ontario healthcare. A review of the landscape revealed that there are more actors than just patients and doctors that directly or indirectly contribute to the issue.

The prominent research finding that family medicine is the most pervasive environment for weight bias against fat patients narrowed the synthesis to concentrate on this sector of healthcare in the province. Mapping the system revealed the disconnect between the scientific perspective of weight bias and obesity, and the social advocacy side.

Defining the future led to the comprehension that it is not just about functional systemic changes, but primarily about emotions and the fabric of a doctor-patient relationship. Ultimately, these discoveries led to four different solution spaces consisting of policy-making, curriculum, research and corporate involvement. The decision to focus on policies and education was made to concretely respond to the research question – How might we reduce weight bias to improve healthcare for overweight patients in Ontario? The solution model and the roadmap was based on a three-prong model of activism, partnerships and decision-making.

Moving Forward

Despite all of those steps, this paper is just a drop in the bucket of the healthcare weight bias issue. Unfortunately, that bucket barely has anything in it. The issue of weight bias affects millions of individuals globally; however, it only accounts for a small number of research studies. Therefore, moving forward, a lot more research is required from all disciplines. Scientific research on the effects of weight bias on physical and mental health, investigative research on the viability of the BMI, economic research on the burdens of weight bias and much more. From these research studies, proposals need to be made to try to solve the issue in various sectors of health in different places.

However, that is just the beginning. The issue faces a fair share of dismissal and critique from society and any improvement means continuous, constant and lasting efforts are mandatory. It is a long battle. Unfortunately, with the arrival of the COVID-19 pandemic and its worsening effects, touching on any other issue in the healthcare space has been delayed. Currently, the focus is on controlling and ending the pandemic, but through that, a number of discrepancies in the healthcare system are surfacing. This pushes the issue of weight bias further back on the priority list. However, vaccine distribution is underway, and there is light at the end of the pandemic-filled tunnel. The time will eventually arrive to address the ‘weight bias epidemic,’ and preparations must be underway. The movement has begun. It is now time to propel it forward.

Next Steps

A Note From The Author

I want to thank you all for taking the time to read through this paper. As mentioned earlier, this issue is very close to me and I plan to continue the work. However, as the paper indicates, I cannot manage it alone. If you are a fellow researcher, a healthcare professional, a social media activist/ influencer, an academic or someone who cares about the problem and wants to do something about it, please reach out to me. I would love to collaborate and take this forward. Email me at ireenahaque@outlook.com and we can get started!