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Last year I treated a young patient struggling with body image issues. This child’s parents feared that being fat was a harbinger of a horrible future. Their fear was not uncommon, as we live in a culture that idolizes thinness and equates fatness with moral failing.

I, too, internalized these cultural messages, and as a result developed a complicated relationship with my body that I am working hard to repair. Despite my own journey toward achieving health at every size, I worried about my ability to help my young patient become more resilient and find peace in theirs.

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I expressed this concern to one of my clinical supervisors who told me that it’s important for my patient and his family to see that everybody and every body can thrive. I was the embodiment of that message.

I’d never considered my visibility as a plus-sized woman to be an integral component of my social justice work. I had assumed that my body did not deserve to take up space in my work as a physician. My attending physician’s advice really prompted me to explore that assumption. I began to examine the image of the ideal physician. 

In middle school, I remember doing a research project on an influential woman. Recognizing my love of science, my teacher encouraged me to do a my report on Dr. Jocelyn Elders, the first African-American appointed surgeon general of the United States. While learning about her accomplishments, I remember reading articles that criticized her body and suggested that she was too fat to be America’s physician role model. 

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As a premed student in college, I also witnessed our surgeon general at the time, Dr. Regina Benjamin, get torn down for her weight. Throughout my medical education and training I’ve been quietly nagged by the worry that my accomplishments would be undermined, too. But in caring for this young patient, I was forced to face this fear head on. 

Nearly two decades later, fatphobia persists. It is also promoted by modern medical apparel brands that sell the image of the ideal physician. Figs, a company that blends fashion with practicality in a direct-to-consumer model, is thriving in the $50 billion medical apparel industry. Like other fashion enterprises, Figs uses its marketing materials to express who its ideal customers are and the lifestyle potential customers can aspire to. The Figs image excludes bodies like Elders’ and Benjamin’s. Bodies like mine. 

The company’s most recent campaign, “Outside the Box,” can be found everywhere from Instagram to Boston’s subways to billboards in New York City’s Times Square. It features nine medical professionals the brand describes as “AWESOME HUMANS who embody the outside the box mindset through their perseverance, innovation and dedication.”

Figs sells apparel up to 2XL, but the racially diverse models and brand ambassadors chosen to showcase its products are all straight-sized — reinforcing the idea that medical professional role models cannot be fat, not to mention differently abled or gender nonconforming. I admire the physicians celebrated by the campaign because they are, in fact, awesome. But the stigmatizing exclusion of larger doctors is not. This choice fails to challenge conventions of body privilege while it promotes a stereotype of who can be a steward of health. In this regard, Figs woefully neglects to think “outside the box.” 

It will take time to undo the impact of fatphobia on my own consciousness, but also that of my patient, my patients’ parents, and the public at large. The reality is that physicians have all types of bodies. Embracing a more inclusive image of physicianhood that celebrates body inclusivity, acceptance, and positivity will not only honor the diversity of the human experience, but also challenge the cultural assumptions that health and wellness cannot be promoted by a fat physician.

While fashion houses and big box stores alike are being held accountable to this socially conscious standard, this conversation about body inclusivity has not made its way into the medical apparel industry. I think it’s time for that to change. 

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