Fatphobia and the medical bias that surrounds it

Illustration by Jaida Noble | An illustrated image of two panels, the first showing a pair of feet on a scale that reads normal while the second pair of feet stands on a scale that reads defected.

The fact of the matter is that doctors would rather treat all cases of being overweight as the disease itself rather than a symptom.

When I was 16, both of my parents and I saw an informative documentary about gastric bypass surgery and how it can help save the lives of those who are morbidly obese. I was in the living room, sitting on the couch, and watching the two discuss the possibility of getting it for me, listening to them say, “Maybe it would be good for them to get the surgery. It will help them stop eating so much all the time!” 

For a sixteen-year-old who had no support network outside of their immediate family, if they wanted to get me the surgery, then I would have been unable to say no and, as a child, they had the final medical say. 

Gastric bypass surgery is a procedure in which they surgically change the size of your stomach to make it smaller and thus feel full with less food. My parents’ reaction to my overweight size as a teenager, when my body didn’t respond like it supposedly should have to doctor-suggested diets, was to consider surgery. 

After they saw the insurance wouldn’t pay for it, they put me on weight loss pills. This led to me losing 100+ pounds in under a month and being unable to gather the energy to even leave my bed. After going off the pills I rapidly gained the weight back as my body was allowed to eat and process the food correctly. A few months after that, my parents wanted me to go back on the pills. 

This is only a small example of the fatphobia that exists across our country. 

There is a very distinct bias against overweight people when it comes to asking for and receiving medical care. 

The majority of doctors will treat being overweight as the disease itself rather than a symptom, as it can be in multiple diseases, issues and chronic conditions. An example would be someone with breathing problems who is overweight being told to lose weight rather than being tested for asthma. Spoiler alert: this was me and yes, I had asthma. 

A large number of claims that are said to be common knowledge are actually ones that, with research, have been disputed or proven false. 

A research article by Paul Campos, Abigail Saguy, Paul Ernsberger, Eric Oliver and Glenn Gaesser titled “The epidemiology of overweight and obesity: public health crisis or moral panic?” published in Volume 35 of the International Journal of Epidemiology does an excellent job as an introductory resource towards combating fatphobia in the medical field. 

The article argues against claims such as there being an obesity pandemic, obesity increasing mortality rates and significant long-term weight loss being a practical goal for better health. All of these claims are supported by the research that was available when it was published in 2006. While the article is roughly 16 years old, it can be used as a base for doing further research on the argument that the medical fields are dismissive of overweight people. 

Other research studies, such as a study done by the Ohio State University and reported on by Science Daily in 2021 titled “Survival tip: Start at normal weight and slowly add pounds” discusses how adults with a normal body mass index (BMI) who later move to being labeled as overweight in their later adult lives tend to have a higher life expectancy. This does not include those who are labeled as morbidly obsese or have overweight BMIs in early childhood or adulthood. 

Another article on the American Psychological Association published in 2018, titled “Why do dieters regain weight?” and written by Traci Mann, a psychology professor at the University of Minnesota, reveals that calorie deprivation such as those seen in dieters leads to changes in hormones, metabolism and cognitive/attentional functions that make it difficult to enact the behaviors needed to keep weight off.

All of this is not to say that being morbidly obese does not come with its own dangers. There are times where weight loss surgery is a valid and even safe option for people to consider, especially if they’re hundreds of pounds past the ideal and healthy weight for their body specifically. Those with a BMI of 40 or higher, which is when one is labeled as morbidly obsese, do face health concerns. The problem is when that weight is not a simple case of overeating or overindulging. 

The truth is that many doctors are either not trained to look past those with higher weights or do not inform their patients of cases where that weight is a symptom. 

In my own personal case, I have what is known as insulin resistance, which both myself and my parents were aware of when they discussed gastric bypass surgery. Due to doctors not informing us what this truly meant, we didn’t understand how it affected me. I didn’t learn until my third year of college that being insulin resistant meant my body did not break down food correctly. 

I was not diabetic like many, including some doctors, believed. My body still produces insulin, but it does not know how to correctly use it. Instead of storing half the caloric energy from what I eat and processing the other half like in the average, healthy body, my body would store everything. This meant that all food I ate went directly to my fat stores and I was constantly left feeling faint and weak as my body broke down those fat stores rather than getting energy from what I immediately ate. 

My body is genetically designed to delay any energy I get while making me fat. So when I was on weight loss pills that made me unable to eat, it meant that I had no energy and no reserves to get backup energy and was unable to even stand or move from my bed. The doctors never explained this to me. Instead, they said, “Try losing 20 pounds and come back after that.” 

When genetic arthritis began appearing in my body, instead of x-rays or any medical tests being done, the doctor looked at my weight on my chart and said the pain in my knees was from being overweight. I lost 60 pounds over the next seven months and the pain grew worse, but upon going back they told me to try losing another 20 pounds.

From the doctors to the world around us, the world is not designed for those who are overweight. 

Seatbelts on airplanes often require extenders, of which there are only a few on board, rides at amusement parks are unable to be boarded or attendants have to ask people to step off the ride, and even plus size clothing stores will tell overweight people to look online for the right size. 

The truth, or at least what feels like the truth, is that the average doctor would rather their patients die skinny than live fat. Anyone interested in learning more about fatphobia, the dangers of how it affects people and their mental health and how to combat the stereotypes surrounding it can read a recommended list of books here at: https://www.charisbooksandmore.com/anti-fatphobiabody-imagefood.

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