Tuesday, 31 March 2020

Getting the Healthcare that Thin People Get – And More

margaret + aaronI have written a lot about strategies that fat people can use to attempt to overcome their healthcare provider’s weight bias in order to get competent evidence-based care. From cards that can help people have conversations, to lies that may have to be told in order to get necessary care. As always, I want to point out that fatphobia (medical and otherwise) becomes our problem, but it is not our fault and it shouldn’t be happening. We shouldn’t have to gear up for a doctor’s appointment.

I have found that one of the most helpful things to ask a Healthcare Provider when they attempt to prescribe weight loss for a health condition is:

How do you treat this issue in thin people?

I hear from blog readers all the time who were able to use this question to get healthcare beyond the suggestion that they should try to look different (of course it isn’t foolproof, sometimes the HCP is simply unable to get beyond their weight stigma.)

This is good, but there’s actually quite a bit more to it. Getting the care that thin people get isn’t good enough, because that care is created FOR thin people. We deserve more than that. There are so many areas of healthcare that need to be fixed.

Let’s start with medical research. Research is typically done on “average weight” people, without even an attempt to understand how medications or procedures could best be created/used for fat people (despite the fact that we keep hearing about how many fat people are in society.)

Should dosage be increased by weight? Is this pill ineffective after a certain weight (like Plan B which starts to lose effectiveness at 165 pounds and becomes completely ineffective at 176 pounds.) The fact that they don’t even bother to consider fat people in most health research is a serious type of institutionalized oppression. (And, of course, fat people aren’t the only ones – people of color, trans and non-binary people, and women are a few of the groups who aren’t adequately represented in research, those with intersecting marginalizations even more so.)

This one’s a bit graphic, but those responsible for handling cadavers for medical schools won’t bother work with larger bodies, which means that future doctors don’t practice on fat bodies. (Considering that they had no problem flying a fat body 5,000 miles for an exploitative television show it seems like they already know how to solve this.)

Then, of course, there’s the fact that surgeons often tell fat people that they can’t do routine procedures on us because they are “too risky,” then recommend…wait for it…weight loss surgery. Not only is bariatric surgery often more dangerous than the surgery that the fat person actually needs, and not only are those who have had the stomach amputation surgery at additional risk for the surgery that they could have just had in the first place, but the idea that surgery is no problem if you want to mutilate your digestive tract in the hopes of creating a disease state that will force you to starve, but an arthroscopic surgery to fix your knee is just way too risky, would be laughable if it wasn’t being used to harm so many people.

At the absolute least, fat people deserve care that is based on research that includes fat patients, with equipment that was made to work for fat patients, from doctors who were educated on how to work on fat bodies, and are not operating out of weight stigma. It’s really not that much to ask.

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