Maddy Servais, RD, 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 provide individualized care to all clients, regardless of their body size. There is ample evidence that weight/body size varies amongst both "healthy" and "unhealthy" individuals and therefore, I do not make assumptions about my clients health or lifestyle based on what they look like. I do, however, take into account that a client in a larger body is more likely to have experienced various forms of body oppression due to weight stigma in society and the medical field.

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

  I do not believe a person's weight alone, is appropriate to use as an indicator of health. I am much more interested in the wide range of personal, social, economic, and environmental factors affecting my clients' ability to nourish their bodies and thrive in their life. I do monitor weight status and changes as this may indicate a change in a client's nutrition status/metabolism function. However, I reject the assumption that weight loss/lower weight = good and weight gain/higher weight = bad.

• Finish this sentence: “Fat people are…” 

  capable and deserving of health and wellbeing despite the challenges they face in our fatphobic society.

• 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 use BMI unless it is absolutely required of me for a clients' insurance coverage. There are no BMI cutoffs/requirements for accessing services. I do not include BMI on any charts or printouts.

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

  If I feel weight monitoring is helpful in a client's care, I will provide explanation as to why and ask for consent. If a client consents, I will facilitate a blind weight. If they decline, that will absolutely be respected.

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

  I respect my clients' autonomy in conversations. Weight, nutrition, and exercise are topics that will often come up in discussion during sessions, but clients can opt out at any time.

• 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?

  I do not offer weight loss as a service and do not offer assistance around intentional weight loss. My clients have bodily autonomy and if they choose to pursue intentional weight loss, I will continue to support them through a harm reduction approach.

• 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? 

  The Wholehearted Healing waiting rooms and offices have size-inclusive furniture and arrangements. Our buildings are also ADA accessible with ramps and elevators. We optimize accessibility to care by offering telehealth.

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

  Our offices include multiple options for seating including couches and chairs of various sizes and design. I intentionally include art and other media displays that promote diversity and size inclusivity.

• 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 a cis, white woman of small stature. I identify as queer although I do not feel this would be visually assumed by the general public. I recognize the immense amount of privilege I have in my identity and hold space for any effects this may have on a client's trust/comfortability in working with me.

Profile last updated November 2026