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Ever heard of it?obesity paradox?” This refers to a healthcare phenomenon in which, although high BMI is often cited as a major risk factor for cardiovascular disease, when a cardiac event occurs, these patients manage to have a high survival rate.
In addition, many patients with a high BMI have better surgical outcomes and live longer than men with a “typical” BMI with the same diseases.
What Does the Medical Field Get Wrong About Fat People?
We are constantly bombarded with messages. healthcare professionals, family members and “concerned trolls” that our weight is detrimental to our health. The truth is, a lot of old research “supports” that this claim is correlational, not causal.
Scientists now believe, based on available research, that the relationship between weight and health can be explained by factors such as: bodily stigma, avoidance of health care, or maltreatment by health care providers.
Where Does the Lack of Knowledge of Large Size Persons Cause in the Health Sector?
Doctors are taught very little about plus-size people in medical school. They are not taught how to talk meaningfully with fat people, they are not taught to be stigmatized as fat or how to control their own prejudices.
Oftentimes, primary care physicians offer nutritional advice to obese patients without being asked completely. However, most students during their medical school education, 20 hours focused on nutrition. Nutritional time does not include meal planning or how to ask patients about their daily eating habits through motivational interviewing.
You may be shocked to learn that fat people cannot donate their bodies to science. Many body donation programs such as Mayo Clinic, Yale School of Medicine, and UCLA Health won’t accept organs for postmortem research on a given BMI.
This excludes a large portion of the US population. How will medical students learn about fat bodies without being given the opportunity to study them?
Other Examples of Fat-Bias in Medicine
If you’ve ever tried to become a bone marrow donor, you will notice that there is a BMI limit. Medical professionals may have justified this in the past because of where the bone marrow was taken from, making it “more difficult” for someone with more body fat. However, currently 83% The peripheral collection of donations completely invalidates this argument.
Even to have an organ transplant, you must be below a certain BMI. This leads us to ask the question: “So I’m too fat to save a life? And am I too fat to save myself? Doctor Rebecca PohlThe director of research and weight stigma initiatives at the Rudd Center for Food Policy and Obesity at Yale University, says: “We know that weight stigma is very common in the healthcare setting and it manifests in a variety of ways. Sometimes it is very obvious and occurs in patient-provider interactions, and sometimes it manifests at a much more complex level regarding access to treatment, denial of services, and in this more complex medical risk conversation. “And it’s all expressed in the justification of it. It’s different, the safety issues. But we have to be really sure that it’s legitimate, as there can be legitimate medical risks in some cases. But in some cases it might not be.”
Did you know that obese people need longer needles for vaccinations? This was something that was discussed during the Covid-19 era. Vaccine became available. A newspaper dated 2022 Vaccine magazine points to current needle length guidelines for vaccines and suggests that some people, particularly above a certain weight, may not be properly vaccinated against Covid-19 because standard needles cannot penetrate the deltoid muscle.
The Centers for Disease Control and Prevention (CDC) does not offer specific guidelines for needle length in Covid-19 vaccines, but gives general guidelines for intramuscular vaccines. A one-inch needle is sufficient for adults who are assigned female at birth and weigh less than 200lb.. This guideline is consistent for HPV, tetanus, flu vaccines and any vaccine administered intramuscularly.
The debate about the effectiveness of emergency contraceptives in people with a higher BMI is a hot topic that resurfaces on social media every few months. Alison Edelmanprofessor of obstetrics and gynecology at Oregon Health and Science University, “When birth control was developed, it really was a one-size-fits-all model, but right now our population is very different from the population when drugs were developed, and the most common emergency contraception might not work for women with higher BMIs.
The two emergency contraceptive pills available in the US are Plan B and Ella. Studies have been done on both as an attempt to determine if there is a weight-related efficacy threshold. However, these studies reach different conclusions.
The Food and Drug Administration (FDA) reviewed Plan B and found that the data were conflicting and too limited to draw any firm conclusions about whether it was less effective in women weighing more than 165 pounds or with a BMI over 25. Plan B may be less effective in women over 170 pounds.
This leads many doctors to recommend Ella, especially for obese people. Ella doesn’t seem to have that much of a drop in effectiveness for people with higher BMIs, but still claims it’s the best. Most effective in persons under 195 lb..
Is Anyone Actively Seeking To Include Fat People In Their Health Care?
Yes! This We All Research Program trying to include people who would typically be excluded from medical research. Unlike many research studies that focus on a specific disease or population, this program through the National Institutes of Health (NIH) provides a national research resource for thousands of research questions and covers a wide range of health conditions.
More than 1 million different participants contribute to electronic health records (EHRs), biosamples, surveys and other measures to create a comprehensive dataset that will be available to researchers worldwide.
There has also been an increase in research into the weight stigma, how poor evidence-based care affects the obese community, and the reasons behind fear of fat in medicine.
like people fat doctor (@fatdoctoruk On TikTok), they share their first-hand experience and knowledge of the medical industry to spread a message, including weight, to their followers.
There are many dietitians and nutritionists working to spread similar messages on social media, and they often work in a field that doesn’t seem inclusive. @dizibff, @elainaefirdAnd @findfoodfreedom.
Our hope is that with broader advocates and medical researchers keeping fat bias in check, we will one day have better access to evidence-based medicine.
One day, we won’t come to mind afterwards.
One day we will be actively involved in medical research.
One day we will not be seen as unworthy.
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