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Monday 16 March 2020

Is “Ob*sity” a Risk Factor For Coronavirus (COVID-19)?

medical fatphobia killsI want to start by saying that I’m not trying to give anyone advice on how to handle the current pandemic. I am personally taking as many precautions as possible. I also want to acknowledge that our choices as to how to handle this are all affected by our privilege and that the most marginalized people face the most harm.

A question that I am getting A LOT recently is “I’m hearing that “ob*sity” is a risk factor for contracting COVID-19 – is that true?”

I’ll start here by saying that I think the biggest concern is medical fatphobia – that fat people will not be able to access the same care as similarly situated thin people.

I also want to point out that the word “ob*sity” was created for the sole purpose of pathologizing a body size and it is not a word that I think is appropriate to use in any context (for the reasons below and more) and I’m only using it here because it’s what’s used in the lexicon and it’s (mis)use is part of the issue.)

When it comes to risk factors, correlation is not causation and weight stigma within the medical field, including in practice and research, is well established and so must be considered when considering any “data” that involves weight/BMI.

“Ob*sity” is the result of a math equation (weight in pounds time 703 divided by height in inches squared is greater than or equal to 30) By the “logic” here I’m at greater risk along with a good portion of the NFL and a whole lot of bodybuilders, so unless all of us have been shown to be at greater risk, this is a very questionable statement of risk.

Even if they are trying to talk about actual presence of adipose tissue, there would have to be data that showed that the actual presence of adipose tissue increased risk – and if that were the case “ob*sity” would be the incorrect word to use since BMI does not, in any way, measure body composition.

So-called “ob*se” people don’t have anything in common except a height/weight ratio.  This group has that as much diversity as any group of people who happen to share a single physical characteristic.

In fact, the things that this group is most likely to share are experiencing weight stigma, and a lifetime of dieting/weight-cycling. Both of those are also correlated with the same health issues that are commonly correlated with having a larger body, and neither of which are ever controlled for in studies about health outcomes making these confounding variables.

Bottom line: conflating “ob*sity” with health/risk status is not an evidence-based practice and while it may not be a negative outcome for fat people to take extra precautions, it can create direct harm, including when blaming fat people for our health issues creates barriers to healthcare access.

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