When Fatphobia Can Cost You Your Life: Unconscious Bias in Medicine

The social stigma of obesity and the accompanying fatphobia is causing difficulties and disadvantages for overweight and obese people. Weight stigma has been broadly defined as bias or discriminatory behaviors targeted at individuals because of their weight.
According to the Centers for Disease Control and Prevention, approximately 42.5% of Americans are now considered Obese. Some 73.6% of Americans are also now above their optimal weight.
Weight discrimination, or fat-shaming, has become prevalent in American society. Although associated consistently with psychological and economic outcomes, less is known about whether weight discrimination is associated with a bias regarding healthcare.
A recent example of weight discrimination happened to Los Angeles-based actress, singer, and photographer Amanda Lee.
After experiencing severe stomach pain and rapidly dropping 35 lbs., Amanda Lee visited a gastroenterologist. To her dismay, the doctor dismissed her concerns, and she was body-shamed.
Amanda Lee knew that something was wrong with her body. The then-27-year-old had spent the last few months dealing with intense stomach pain and gastrointestinal distress that made it difficult to eat, causing her to lose a worrying 35 lbs rapidly.
When she finally secured an appointment with a gastroenterologist to figure out the issue, he brushed off her symptoms, body-shaming her, according to Lee. I’ve been dealing with abdominal cramping for months now, and no doctor will listen to me, so I thought I’d go to this new GI doctor that I had to fight for, and I told him that I hadn’t been eating because it causes pain and I have pain when I eat. He looked at me and had the audacity to say, ‘Maybe that’s not such a bad thing,’ ” Lee says, sobbing. “I’m so upset. I’m so upset.”
“He said, ‘Maybe that’s not such a bad thing’ that I couldn’t eat because of my pain,” she said. “He was praising the fact that I was not eating.”
He went on to say that her ability only to eat easily digestible foods like apple purées was a “blessing,” Lee said, and that she “doesn’t look malnourished.” Lee said the doctor would not run any diagnostic tests on her, and she left the appointment crying.
Lee eventually sought out a new doctor. Once she found one, she was immediately sent to get a colonoscopy, which showed a large tumor, and after surgery to remove it, Lee was diagnosed with Stage 3A colon cancer, which had spread to her lymph nodes.
Lee is now undergoing chemotherapy and has a few more months to go, but “everything seems to be going as planned,” she said.
According to the article “Perceived Weight Discrimination and Obesity,” Obesity discrimination has become the 4th largest cause of discrimination, behind Age, Sex and Race. Healthcare professionals must keep this cautionary story in mind and ensure that any unconscious bias towards obese patients does not interfere with the care that all patients are entitled to.
Sources:
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0070048
https://www.health.com/syndication/woman-body-shamed-by-her-doctor-about-losing-weight-later-learns-she-has-stage-3-colon-cancer?did=642778-20210609&utm_campaign=hth-thedaily3_newsletter&utm_source=health.com&utm_medium=email&utm_content=060921&cid=642778&mid=59458546750
https://www.cdc.gov/nchs/fastats/obesity-overweight.htm