Prescribing Size-Inclusive Home Fitness Routines in the Era of COVID-19

Larger-bodied woman working out in home

By Jamie Marchetti, MS, RDN, LD
September 17, 2020

In the time of COVID-19, routines have changed drastically and frequently. This has impacted many areas of the lives of Americans, including fitness routines. Gyms, if open, often have restrictions. So how can you best support your patients who need physical exercise?

Fitness Participation

For those who are mainly staying at home or do not have access to a gym as a result of COVID, continuing or beginning and routine of movement can be a new challenge. This is even more difficult for people who are in larger bodies. The reason is simple: People in larger bodies typically do not see bodies like theirs represented in the fitness industry. Research with plus-size women has found that women in larger bodies often feel unwelcome and stigmatized in the realm of fitness, and therefore less likely to participate in physical movement.1,2 There is limited research on whether this data can be generalized to men. 

Complicating Factors

An additional complicating factor is that there is widespread belief that individuals in larger bodies are at greater risk of mortality due to COVID-19. However, peer-reviewed evidence on this topic is equivocal at best and fails to control for socioeconomic status, race, and bias of healthcare providers in making care decisions for COVID-19 patients in larger bodies.3

The result of this is that people in larger bodies experience weight stigma both in the current state of the world with the COVID-19 pandemic, as well as in the fitness industry. This means that larger bodied people are likely not seeking care they may need, and also not feeling safe to participate in health behaviors such as moving their bodies outdoors in their neighborhoods or communities.

Patient Resources

In order to best support your larger-bodied patients, it is important to connect them with size-inclusive home exercise resources. Louise Green, CPT, compiled an excellent list of at-home fitness resources that are body- and fat-positive.4 Since many resources are electronic, it is likely best to provide lists electronically. However, it is important to be mindful of whether patients have reliable internet access at home or at a public place like a library or coffee shop. If they do not have consistent, reliable internet access, it could be helpful to print the list or search the internet for printable “body positive workouts.”

Harvard Medical School has CME Online resources available to support your patients with their nutrition well-being:

Lifestyle Medicine: Nutrition and Metabolic Syndrome

Culinary Health Education Fundamentals (CHEF) Coaching—The Basics


  1. Schvey NA, Sbrocco T, Bakalar JL, Ress R, Barmine M, Gorlick J, Pine A, Stephens M, Tanofsky-Kraff M. The experience of weight stigma among gym members with overweight and obesity. Stigma and Health. 2017; 2(4): 292-306.
  2. Vartanian LR, Shaprow JG. Effects of weight stigma on exercise motivation and behavior: A preliminary investigation among college-aged females. 2008 January 1; 13(1): 131-138.
  3. Harrison, C. Covid-19 does not discriminate by body weight. Wired. Published April 04, 2020. Accessed September 14, 2020.
  4. Green, L. 12 places to find fat- and body-positive workouts you can do at home. Self. Published April 29, 2020. Accessed September 14, 2020.

Author Jamie Marchetti profile picJamie M. Marchetti, MS, RDN, LD, is a Health At Every Size ® dietitian. She is also a freelance writer and a MA Mental Health Counseling candidate who plans to combine her skill sets to provide nutrition and body acceptance therapy through her private practice, Wonderfully Well.

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