Annie Janzen, MPH, RDN, LD

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 primarily see people in larger bodies. I think fat folks require holding a lot of space for the fatphobia we've encountered in healthcare systems and in navigating nutrition advice. Unpacking whether something was recommended in hopes we lose weight or because it has real health benefits takes time and care and isn't a linear process. It is core to my approach to offer support that is rooted in fat liberation.

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

  I believe (from my lived experience and my understanding of the research) that there is no inherently healthy or unhealthy weight. Weight changes are a common side effect of health conditions, but they are also just part of being human. I don't center weight or weight changes as health outcomes, but I do hold space for processing our complex relationship to health, weight, and food.

• Finish this sentence: “Fat people are…” 

  freaking awesome!

• 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?

  As a private pay dietitian, I get the immense privilege and pleasure to discard use of the BMI entirely.

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

  Weighings are not a part of my practice.

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

  As a dietitian, nutrition and physical activity are core to my work with clients and are generally the reason we are working together. However, if any specific topic is off limits, I will always honor your autonomy and consent to discuss anything.

• Do you offer weight loss as a service, and if so, how much of your practice is this? What do you do if a patient requests your assistance with losing weight?

  No - I can offer some harm reduction support for folks pursuing intentional weight loss, however I do not directly support the pursuit of weight loss.

• 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? 

  I am currently fully virtual.

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

  I think being fat myself is a big part of making larger folks feel welcome! Besides that, as a virtual practice with no other staff, I don't have anything else in place.

• 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 am part of the queer community, I'm fat (if you couldn't tell already), and I am somewhat neurodiverse but don't have any diagnoses. All of these experiences have helped me tune in to the diversity of human experience and I aim to make my work accessible and inclusive of all identities.