I’ll start by sharing this important information from Christy Harrison (copied with permission):
“The large study (CW: weight-stigmatizing language, BMI numbers) of more than 10,000 people with COVID-19 found that having a high body-mass index (BMI) is NOT a risk factor for hospitalization, mechanical ventilation, or death.
This is one of few studies on this topic to fully adjust for confounding variables, and definitely one of the largest that I’ve seen to date.
Interestingly, it found that although Black patients were more likely to be hospitalized and to receive mechanical ventilation than white patients, they WEREN’T more likely to die.
This unusual finding may have to do with the fact that healthcare access is far more equalized in the Veterans Administration (VA) system, where this study was conducted; outside that system, unequal access to care means that folks who are Black, Indigenous, and People of Color tend to have higher mortality as well as other poor health outcomes.
This study also found that Hispanic ethnicity was not associated with an increased risk of adverse outcomes, which again may reflect the better access to quality care that patients of color receive in the VA system.
That access and quality may be why larger-bodied patients fared just as well—and in some cases even better—than smaller-bodied patients in this study. (Fellow science nerds, see for yourselves in Table 1—though again, CW for weight-stigmatizing language and BMI numbers.)
In short, this evidence supports what I’ve been saying for months: reporters and commentators need to stop jumping to the conclusion that high BMI independently raises COVID-19 risks (and researchers need to stop deliberately looking for evidence to support that belief)—because when we have good studies that control for confounding variables, those supposed risks can dissipate or disappear.
Blaming weight itself for poor health outcomes (instead of looking for the underlying causes that have nothing to do with body size) is a form of weight stigma—and ironically, that kind of bias creates the very health problems that we’re trying to solve.” –Christy Harrison
I’ve talked about the issues with studies suggesting that body size was a risk before, as has Christy. Sadly, the likelihood that body size doesn’t increase risk doesn’t actually mean that fat people aren’t at greater risk when it comes to COVID-19 (or any other health condition) and that’s because weight stigma actually DOES increase our risk. And it shows up in a lot of ways:
- Lack of Equipment/Accommodation
- Everything from blood pressure cuffs, to gowns, to beds, and more. Despite knowing full well that fat people exist, healthcare facilities often fail to meet our most basic needs.
- Lack of research
- Research is typically only done on thin bodies. In some cases, fat people are then actually BLAMED when the practices and drugs that were created without including us don’t work for us.
- Lack of training
- Health Care Practitioners – HCPs – often don’t have training on working with fat patients and, worse, weight stigma is often part of their training program.
- Practitioner Bias
- Plenty of research tells us that fat people’s ability to get competent, ethical care is made difficult or even impossible due to practitioner’s weight stigma. We live in a fatphobia world where everyone – including HCPs – is encouraged to stereotype fat people and treat us badly.
There are, of course, amazing HCPs out there and I don’t want to discount that, but the truth is that all of the issues above can harm any fat person who needs healthcare. Which is why even if the study did show that higher weight people had poorer outcomes, we could not actually draw any conclusions about fat bodies, and why we MUST work to dismantle weight stigma in healthcare.
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