Another Reason to Move it and Lose it--Doctors Hate Fat Women

Health.com's Ginny Graves offers interesting insight into another reason why it is unhealthy to be obese or overweight in her article "The Surprising Reason why being Overweight isn't Healthy." Being just 13 pounds overweight as a woman (i.e., 13 lbs above your highest healthy weight measured by BMI) can result in health care discrimination based on weight. To put this in perspective, as a 5'9" woman, I could be discriminated against if I weighed as little as 182 lbs.

Beyond the humiliation of being treated with less courtesy or attention, this healthcare discrimination can be harmful or even deadly. Recent studies confirmed what many people suspect through anecdotal evidence: Medical professionals tend to misdiagnose, refuse to treat and fail to detect serious medical issues impacting overweight women. One Harvard Medical School professor commented that doctors tend to be more dismissive and less patient with overweight people, rendering them prone to diagnostic errors as a result of clouded judgment. This attitude also discourages overweight patients from seeking needed preventative care or follow up on a health concern, leading to more serious health emergencies from neglect.

Some doctors refuse to operate on or treat patients beyond a certain weight threshold. They do this to keep their success rates high and to avoid difficult and time consuming procedures. This occurs with respect to needed surgeries, organ transplants, infertility treatments and important diagnostic tests such as heart catheterizations.

Granted, obese patients present practical problems for medical professionals and diagnostic equipment like ultrasound, mammogram and CT scanners. The more layers of fat, the harder to get an accurate image, and the more difficult for a surgeon to operate successfully. Morbidly obese patients may be too large to fit in a machine or pose a large recovery risk from an organ transplant. Larger patients often receive false positives leading to costly tests and treatment for suspected breast cancer.

Perhaps the most startling was in cancer treatment. Because cancer trials are based on average weight people, oncologists do not know how to accurately adjust chemotherapy drug dosages to treat overweight women. This could be one reason why their mortality and recurrence rate is higher than in normal weight women.

Being overweight myself and a person who has struggled with weight issues her whole life, I find myself angry at the injustice of being treated like a 2nd class patient and being labeled as "lazy," "noncompliant," or "undisciplined" when I am not. However, like a smoker, a person who abuses food cannot expect to pay the same insurance premiums as a healthy weight person who does not smoke. But I have to wonder if smokers are denied access to expensive medical procedures, organ transplants, etc., until they successfully quit? Do they experience the same level of derision from their health care providers, leading to misdiagnoses? I do think there are some ethical issues involved--e.g., do you give a needed organ to an obese person when the possibility of a bad health outcome is higher than for a healthy weight person equally in need of that organ?

What do you think about this type of bias? Warranted? An injustice? A little of both?