Heather Bergeson, MD

Approach to care

• What does it look like for you to provide care to patients in larger bodies? How is, or isn’t, your approach different from how you care for patients in smaller bodies? If you work with children, how is or isn’t your approach different when working with children?

  I provide weight-inclusive and patient-centered care to all of my patients. We will discuss all available treatment options and create a collaborative plan of care. When working with children, I engage directly with them, addressing my questions and advice to them in an age appropriate way. We talk about body trust, autonomy, intuitive eating, joyful motion and how our bodies change in amazing ways through each transition of life.

• What is your perspective on how weight is or is not related to health?

  Body weight does not always correlate with health. My goal is to improve your ability to do the things that bring joy to your life so that you can be as “healthy” as you can, whatever that means to you.

• Finish this sentence: “Fat people are…” 

  Human Beings worthy of high quality, non-stigmatizing standards of care.

• How do you, your clinic, and the healthcare system you work in use BMI (i.e BMI cutoffs for accessing certain services, BMI on charts and printouts, etc)? Is this flexible?

  I do NOT weigh my patients nor use BMI. However, the larger health system I work within and most of my orthopedic colleagues still do. There are BMI cutoffs for surgical procedures, but there are some orthopedic surgeons I refer to who will operate on larger bodies, but may still have a conversation with you about weight loss. I will try to prepare you for those conversations if that were the case.

• If a patient declines to be weighed, how do you and/or your staff proceed?

  I don’t weigh my patients. There are rare times when someone that is not part of my usual team is rooming patients and forgets or doesn’t know that this is my policy and will attempt to weigh a patient. If this should happen, please accept my apology and know that you have the right not to be weighed.

• If a patient declines to discuss weight loss, nutrition, and/or exercise, how do you proceed?

  I do not discuss weight loss. If I ask about nutrition or exercise, it is to better understand your relationship with food and movement. If you decline to talk about it, no problem.

• What does the physical accessibility of your office space look like? What kinds of accommodations are present for people in larger bodies? Are there things you wish were in place that are currently not? 

  TRIA is accessible with elevators or an escalator and wide chairs without arm rests. We still need some more size inclusive exam shorts. We have a limited number of 4-5X, but sometimes they are not readily available. Please feel free to wear your own clothes for the exam. If you are not comfortable on an exam table, I can examine you seated or standing. There is a weight limit on tables for procedures or imaging, but there are ways we can accommodate.

• What do you do to allow fat people to feel comfortable and welcome in your office? 

  I provide a safe place for non-stigmatizing and compassionate care for all patients. I take time to listen to your concerns and create a collaborative treatment plan. If necessary, I can refer you to physical therapists or other specialists who also provide weight neutral care. When that is not possible, I will help you navigate that situation and advocate for you.

• If you’d like to use this space to talk about any identities (gender, race, size, sexuality, etc.) you hold and how this relates to your care, please do so. 

  I acknowledge my own privileges and biases and will continue to learn from others in this space and champion weight neutral care until it is the norm in medicine.