Welcome to the Age of the Default Obesity Diagnoses

We constantly hear how dangerous fatness is, how it is killing us. And – you might be surprised to hear that I agree. But not in the way that you might think.

I do not believe fat bodies are intrinsically less healthy than thinner bodies. In other words, the fat on a person’s body does not have as much influence on their general health and well-being as is currently accepted as common sense. So, while I don’t think being fat is a direct danger to our health, I am becoming more and more convinced that indirectly, our feelings, attitudes, and treatment of larger bodies is the real danger.

Let me introduce you to Ellen Maud Bennett.

You may have seen her face in your social media feed in the last couple of weeks. You see, Ellen passed away recently in Victoria BC and used her obituary as a chance to speak out against the injustices she faced trying to access health care as a fat woman in this country. Her obituary state

“Over the past few years of feeling unwell she sought out medical intervention and no one offered any support or suggestions beyond weight loss,” it continued. “Ellen’s dying wish was that women of size make her death matter by advocating strongly for their health and not accepting that fat is the only relevant health issue.”

Here is a link to her obituary:

https://www.legacy.com/obituaries/timescolonist/obituary.aspx?n=ellen-maud-bennett&pid=189588876

How heartbreakingly tragic for a woman to lose her life and never know if intervention and treatment might have helped her. This happened because it is so easy for medical professionals to assume any ill health she was experiencing was due to her larger sized body.  Doctors felt they did not need to look beyond her fatness. Now, lest you are tempted to think this is an unfortunate, but surely isolated, experience of one woman accessing health care while fat, let me absolve you of that notion right off. Ellen’s experience is all too common.

A few years ago, I undertook a study of the experience of fat women accessing health care in my then home province of Saskatchewan. The studies I read as part of my research painted a picture of widespread weight bias in health care providers in the U.S., U.K., and Canada. This weight bias was documented to express itself both explicitly (medical professionals making derogatory comments and expressing disgust at fat patients) to the more polite, but still very damaging, implicit bias (assumptions of people’s behaviours based on their size). The most dangerous expression of weight bias in the medical profession is what is known as Default Obesity Diagnoses. This is the tendency to look at all healthcare issues brought forward by fatter patients as a problem of their body size first and foremost and usually only prescribing weight loss as the solution. High blood pressure? Lose weight. Trouble breathing? Lose weight. Knee problems? Lose weight. Migraine headache? Lose weight. Digestive problems? Lose weight.

And all too often, that is a far as it goes.

What this means is people living in fatter bodies are not getting the health care they need. They face many barriers ranging from lack of proper equipment (blood pressure cuffs that don’t fit, for example) to having to face the fear of fat shaming comments, and the dreaded Default Obesity Diagnoses. Whether Ellen Maud Bennet experienced the first two is not certain, but likely.  However, like the women in my study, she certainly experienced the last one.  Her medical providers were only able to consider her health care through a lens of body size, and thus missing the chance to see what was really going on with her.

Ellen’s story is the story many fat people face when they need medical intervention.  A tragically common story.  What does make Ellen’s story stand out is that she recognized what happened to her for what it was – unfair treatment and oppression.  Sadly, many people do not wake up to the injustice they face in the doctor’s office.  They experience what is known as internalized stigma and have accepted the lie that fatness is inherently bad and is indeed the root of any ill-health they experience. And because we are told that we can control the size of our bodies through diets and will-power, those of us who are fat also internalize the belief that if we are ill, it is our fault. And as a result, we do not feel empowered to demand health care that is our right.

I am grateful to Ellen using her obituary in this way, and I will do my part to share her message and raise awareness the best I can to end weight bias in health care. If you have had experiences similar to Ellen’s when seeking health care, I hope you are inspired to take notice and be willing to advocate for yourself. Start demanding our doctors look further.  Insist on tests and treatments that are offered thinner patients. I know it it isn’t easy, but it so important!  If you are not sure where to start, here are a couple of resources to help you:

What to say at the Doctor’s Office
by Regan at Dances with Fat
https://danceswithfat.wordpress.com/2013/04/01/what-to-say-at-the-doctors-office/

Health Care Providers: Providing Sensitive Care for People of All Sizes
a sample letter for your doctor by Linda Bacon, author of: Health at Every Size.

https://lindabacon.org/HAESbook/pdf_files/HAES_Providing%20Sensitive%20Care.pdf

And if you would like to read the stories of the women who participated in my study and more on the impacts of weight bias in health care, a copy of my thesis can be found here: http://www.sydneybell.ca/the-stories-of-fat-women-accessing-healthcare-in-saskatchewan/

 

Thank you for reading!

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Want to work with me?  Online Individual Counselling and Coaching to Support Your Body Sovereignty Journey. For more information or to book a session:

Email: sydney@sydneybell.ca
Call/text: 519-501-8953