The Short Answer: Research shows that shaming patients about weight actually causes weight gain, not loss. Health organizations now recommend that doctors emphasize regular exercise over weight loss for people with chronic conditions like autoimmune disease. For autoimmune patients, including those with Hashimoto’s low thyroid, exercise improves health and energy regardless of body weight, making it easier to manage your condition long-term.

Why weight stigma backfires for people with autoimmune conditions

If you have an autoimmune condition, you likely know what it is to struggle with weight gain and the frustration of dieting.

Do you avoid the doctor because you know they’ll tell you to lose weight? Studies show feeling shame and stigma around body weight actually causes weight gain and not the reverse. Researchers are now asking doctors to emphasize exercise over weight loss, especially for patients managing chronic illness.

The last thing someone with an autoimmune condition needs is to feel bad about their body. Although obesity is linked to inflammatory health disorders, diets eventually fail for most people and can even lead to weight gain. The reasons people carry extra weight are often complex: genetics, history of restrictive dieting, eating disorders, childhood trauma, or, in the case of autoimmune patients like those with Hashimoto’s low thyroid, metabolic changes from the condition itself.

Many thyroid patients know from experience that a low-calorie diet simply doesn’t work when an autoimmune condition is affecting metabolism.

When you’ve spent a lifetime battling weight and the negative feelings that come with it, a doctor’s visit can trigger shame, despair, and self-loathing. Many people decide it’s easier to avoid medical care altogether, but for autoimmune patients, this means neglecting the important work of managing a condition that impacts every aspect of health.

The CDC now recommends exercise over weight loss

Recognizing decades of weight-loss industry failure, the Centers for Disease Control and Prevention is asking doctors to stop telling overweight patients to lose weight.

A CDC essay called for health care practitioners to quit shaming patients who don’t meet BMI guidelines and instead help them develop a regular exercise habit. The evidence is clear: stopping “fat shaming” in the doctor’s office builds better rapport and trust, helping patients feel more positive, empowered, and willing to adopt healthier habits.

At RedRiver Health and Wellness, we recognize that autoimmune patients, including those with Hashimoto’s low thyroid, lupus, and rheumatoid arthritis, need doctors who understand both their condition and the complexity of weight management. We work with patients to address the underlying autoimmune dysfunction, not judge their body.

Dieting and negative self-beliefs both trigger weight gain

Studies consistently show that dieting leads to long-term weight gain and obesity. All mammals, not just humans, develop binge eating behavior when placed on restrictive diets.

Even more striking: simply believing you are overweight leads to long-term weight gain, even if your original body weight was in the normal range.

For doctors, this means telling a patient they are too heavy can actually make them gain weight, not lose it. The same applies to your own internal dialogue; telling yourself you’re too fat will have similar effects.

If you’re carrying extra weight, the most important thing is regaining your health and managing any underlying autoimmune or thyroid condition. Don’t beat yourself up.

How regular exercise improves health regardless of body weight

The evidence is clear: telling people they are too heavy and need to lose weight doesn’t work.

A person can be healthy at any weight. Teaching this to patients requires reducing stigma, establishing trust, and working together to encourage exercise and healthy eating behaviors, while also considering social and financial circumstances.

When autoimmune conditions like Hashimoto’s low thyroid are properly identified and managed, excess weight often normalizes naturally without needing to diet.

According to recent research, regular exercise improves health regardless of a person’s weight. It also lowers the risk of chronic diseases such as diabetes, heart disease, and Alzheimer’s.

Regular exercise shifts focus away from judging a person’s body and instead emphasizes behaviors that can be influenced, barriers that can be addressed, and measurable progress. A person can increase their strength and stamina over time regardless of body weight.

While diets fail the majority of people, most can succeed at exercise regardless of fitness level or body size.

For autoimmune patients experiencing fatigue or low energy from their condition, managing your underlying health is the first step. Once properly treated, especially for those with Hashimoto’s low thyroid, energy levels improve, making regular physical activity more achievable.