Fat Bias in the Medical World

fat bias
When I was in college, it was a well-know fact that if you were female and went to the student health center, the staff would likely blame whatever ailed you on a potential pregnancy. Strep throat? Pregnant. Bee sting? With child. No matter what is was, you could be pregnant and they’d need to run a test. It became a running joke among the coeds.

Not so funny is a similar bias, that which folks in larger bodies face when they seek out medical care. Many fat people will report that every doctor’s visit turns into a weight-loss lecture and that every condition or complaint is ascribed to “excess” weight.

The problem with this assumption is that it can lead to dangerous, potentially life-threatening, errors in the form of false positives and false negatives. An example of a false positive is a doctor communicating that your health is in danger, prescribing unnecessary medications based on this assumptions, or recommending weight loss, which can backfire in the form of weight cycling and disordered eating. In reality, health indices can improve through behavioral change without any corresponding reduction in weight. A false negative would be a doctor failing to run important medical tests or not taking your complaints seriously, believing everything to be related to weight.

Doctors who fall prey to fat bias can make critical medical errors and can promote weight stigma, which creates stress, associated with its own medical complications. More, patients who are stigmatized are less likely to see out medical care, leading to potential health concerns and missed opportunities to address treatable conditions. Facilities that fall prey to fat bias can lack adequate and/or comfortable equipment for assessing patients in larger bodies. A fat individual who is unable to fit into a provider’s CT scan machine will have to be referred out, delaying diagnosis and treatment to potentially dire consequences.

Symptoms and illnesses among college student are often unrelated to pregnancy, and symptoms and illnesses in fat people are often unrelated to weight. Doctors who practice from a weight-inclusive, Health at Every SizeⓇ approach, exhibit reduced bias and achieve greater patient engagement, creating a better chance at successfully managing their patients’ health and wellness.