Fatphobia in Healthcare

How many times have you looked at someone who is fat and immediately assumed they were unhealthy? Or that they have poor eating habits? Without even knowing the person, a judgment has been made and most commonly, it's so ingrained into society that you don't even realize you are doing it. It's important to state the people are biased, and healthcare providers are also people. In this article, I dig into the stigma of being overweight and how it relates to healthcare access.

Fatphobia in healthcare

If you're a woman, chances are you've experienced fatphobia in some way, shape, or form. Whether it's being told to lose weight, being told your health issues are related to your size, or simply feeling like you're not being taken seriously because of your weight, fatphobia is a very real and harmful issue in healthcare, especially for women. In a study found, women cited doctors as the most common source of weight bias, while men cited doctors as the second most frequent source. Research articles indicate that healthcare professionals are the most common sources of stigmatization for individuals who are overweight.

Sadly, this discrimination is all too common, and it can often lead to lack of access to health care. By raising awareness and working to change the way we see body size we can change the stigma of being fat, and help make a difference.

“There is considerable evidence that such attitudes influence person-perceptions, judgment, interpersonal behavior and decision-making. These attitudes may impact the care they provide” - Phelan SM, Burgess DJ, Yeazel MW, Hellerstedt WL, Griffin JM, van Ryn M.

The prevalence of fatphobia in healthcare settings

It is incredibly disheartening to think that fatphobia still has such a strong prevalence in healthcare settings. In an environment which should be non-judgmental and focused on improving patients’ health, many are still stigmatized and discriminated against based on their size. The stigma and bias held by healthcare professionals leads overweight patients to often feel like second class citizens.

A scoping review revealed an unsettling trend of discrimination and mistreatment faced by patients due to their weight. From contemptuous treatment, lack of training, ambivalence through barriers in healthcare utilization and distrustful communication - too many are being denied access to the health care they need because primary care professionals harbor bias against them.

Studies have shown that medical students believe that patients who are overweight lack self-control, are less likely to adhere to treatment, and are more “sloppy,” “unsuccessful,” and “unpleasant” than skinnier patients.

Furthermore, this stigma can have a knock on effect of reducing people’s willingness to seek medical aid leading to further damage from leaving ailments unchecked or undiagnosed. This outdated attitude towards those with obesity in healthcare settings needs to be tackled as soon as possible for the benefit of all.

A particular story comes to mind, seen in the New York Times, of how a woman was dismissed by her doctor, who wouldn't even listen to her symptoms just to tell her she needed to lose weight. This woman later learned she had progressive scoliosis, a condition not caused by obesity.

Studies show that doctors are significantly more likely to dismiss an overweight patient than a thinner one with the same issues. Oftentimes this bias stems from prejudice and lack of understanding, leaving those affected feeling defeated or hopeless in seeking out medical care. It is essential that doctors be educated on the implications of dismissing patients based on their weight, as it can lead to serious complications with health care and can further contribute to a sense of marginalization.

Examples of a few stereotypical and shame-inducing statements that could indicate weight bias are expressions like "You need to move more,” “Cut out carbs,” “You need to learn self-control,” and “Just don’t buy ‘bad’ food.” Other examples of weight stigma include thinking that they are lazy, irresponsible and not smart.

Steps that can be taken to address fatphobia in healthcare settings

Addressing fatphobia in healthcare settings begins with awareness and advocacy. Healthcare providers must become familiar with the complexities of weight stigma, size discrimination, and fatphobia so that they can offer appropriate care to all of their patients. Empathy is also essential: healthcare providers must strive to understand their patients on an individual level and what unique obstacles may be impeding the patient’s wellness. Lastly, a key step for healthcare providers to take is the deconstruction of traditional ideas about wellness. Traditional ideas that equate thinness with health should be challenged and replaced with more person-centered views on health. Ultimately, awareness and active steps towards inclusivity within healthcare settings are needed to address fatphobia.

The importance of creating a safe and welcoming environment for all patients

Creating a safe, welcoming environment for all patients is essential in providing comprehensive and effective healthcare. It is important to stop making assumptions about a person's wellness or the interactions they have had with healthcare services in the past, instead approaching each patient from an open and non-judgemental perspective. Taking the time to properly diagnose and listen to the patient in their care helps foster trust between them and their medical team, leading to improved health outcomes overall. Listening to a patient's concerns also helps determine potential physiological or psychosocial issues that may have gone otherwise unnoticed and create treatment solutions tailored to their individual needs. A safe, welcoming environment promotes active participation of both patients and providers alike in navigating optimal healing paths together.

The truth is, judgment of someone’s health doesn’t need to be based on their physical appearance. To move forward, people must start to open up and have dialogue about body size. We must recognise fatphobia and the way it affects our language and thoughts surrounding bodies; without this we can’t make any progress. There needs to be an understanding that each individual is different, with different needs for their own body; whether these needs equate to more exercise or nutrition changes, or no change at all depends wholly on the individual. We should stop assuming knowledge of another person's health status based on sight alone and rather spend our efforts listening to and respecting what it is they wish for themselves. In conclusion, let's all take a minute to ponder on our inner fatphobia and how we can use this moment of reflection to grow into being kinder human beings.