Size Prejudice Is Alive and Well, Part 2

Last time I talked about how size-based discrimination in the workplace is still a big problem in this country--as discussed in The New York Times essay For Obese People, Prejudice in Plain Sight.

This time I'll focus on the other area the essay highlights where fat people face prejudice: the doctor's office. Yes, you read that right. The doctor's office.

Source: istockphoto.com

Saying, "Some of the most blatant fat discrimination comes from medical professionals," the essay uses the following examples:

• Over half of doctors in one study "described obese patients as 'awkward, unattractive, ugly, and unlikely to comply with treatment.'"
• "Despite the abundance of research showing that most people are unable to make significant long-term changes in their weight, it’s clear that doctors tend to view obesity as a matter of personal responsibility. Perhaps they see shame and stigma as a health care strategy."
• Another study found that "the higher a patient’s body mass, the less respect doctors express for that patient." 

And doctors can be pretty open about their bias:

• "Dr. Delos M. Cosgrove, a cardiac surgeon and chief executive of the prestigious Cleveland Clinic, told a columnist for The New York Times that if he could get away with it legally, he would refuse to hire anyone who is obese. He probably could get away with it, actually, because no federal legislation protects the civil rights of fat workers, and only one state, Michigan, bans discrimination on the basis of weight."
• Dr. Rebecca Puhl, who conducted the first study linked above, said, "If I was trying to study gender or racial bias, I couldn’t use the assessment tools I’m using, because people wouldn’t be truthful...They’d want to be more politically correct."

In response to all of this I was all set to write, "Doesn't the Hippocratic oath say, 'First, do no harm'?" (for, in ways we will see shortly, bias certainly does harm). But when I went to find the Oath online so I could link to it, I discovered that neither the classical version nor a commonly-used modern one have that phrase. But the modern one I'm linking to here does include this:

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

So how does doctors' fat bias effect their patients? The essay gives these examples:

• Many fat people will just avoid going to the doctor, for routine or sometimes even serious stuff. Of course this can potentially put the patient in grave danger.
• "'Stigma and prejudice are intensely stressful,' he [Dr. Peter A. Muennig, an assistant professor of health policy at Columbia] explained. 'Stress puts the body on full alert, which gets the blood pressure up, the sugar up, everything you need to fight or flee the predator.'"
• "Over time, such chronic stress can lead to high blood pressure, diabetes and other medical ills, many of them (surprise!) associated with obesity." So it becomes a maddening cycle.
• "[T]he less respect a doctor has for a patient, says Dr. Mary Huizinga,...assistant professor at Johns Hopkins School of Medicine, the less time the doctor spends with the patient and the less information he or she offers."
• "[D]octors who think patients won’t follow their instructions treat and prescribe for them differently."

The bottom line is this: Like all other people, fat people deserve respectful treatment by doctors and other medical professionals. And doctors of all people should strive to provide it.

If you are a doctor or other medical professional and see yourself in any of this, I have one message for you: It's time to do better. Remember that inside the body of every one in your care is a person who deserves to be treated with the same amount of respect and caring as you would hope to receive.

Your patients--and potential patients--can no longer afford your bias.

Size Prejudice Is Alive and Well, Part 1

source: istockphoto.com

In March, 2011, The New York Times published an essay called For Obese People, Prejudice in Plain Sight, which explores a couple of areas where people of size still face discrimination or at least stigma, specifically: the workplace and the doctor's office (yes, of all places, the doctor's office). I'll talk about the workplace in this post and tackle the doctor's office in Part 2.

One of the biggest revelations to me from this essay was that there is one place in this country that bans discrimination based on weight. That place is the state of Michigan. Well...Ron (see "About This Blog," left) lived his entire life in Michigan. During the time I knew him, he worked for a major airline, and I've always been grateful to that airline for not discriminating against him. Well, now I know they couldn't have done so without breaking the law. Really, it makes me wonder if that law was the only reason he had a job. Well, I don't mean that exactly. I know he had great skills and was a good employee. I just can't help but wonder whether he would have been unemployed if that law didn't exist. (And if he'd been unemployed, would we have ever met? It's not like membership in an online dating site, which is how we met, is something you spring for when you're struggling to afford gas and food.)

As the essay points out, "no federal legislation protects the civil rights of fat workers." That means that any company in America-sans-Michigan could refuse to hire a candidate or make employment decisions about an employee based on weight--with that as the stated reason, even--and it'd be perfectly legal.

One argument I hear sometimes is: Shouldn't an employer be able to refuse to hire an overweight person since they'll have to pay more for that person's health insurance? I have a few responses to that: First, one of the things I've learned is that size (whether gauged visually or in number of pounds) is not a foolproof indicator of a person's health. It'd be easy to think that if someone falls outside the parameters of a given height and weight chart or has a certain Body Mass Index that they're not only overweight but patently unhealthy. Well, I heard once that height and weight charts were originally developed by the insurance industry, who were looking for ways to exclude people from coverage. (I'll have to research that and do a post about it sometime.) Plus, it appears the experts don't even agree on where the line should be drawn for what is "obese," much less for the precise point at which a person's weight becomes a true health issue. Second, people who are or appear perfectly healthy can contract serious illnesses at any time. So it's not like a company can know that person A would be any more expensive to insure than person B, regardless of weight. And third, do we really think that a way to improve people's health is to deny them a job? I think not. Clearly...we need a better way.

I think what bothers me the most about size prejudice in the workplace is the apparent implication in the minds of many that an overweight or obese person is somehow less competent. Unless the very nature of the work requires a certain level of fitness, a person's weight has no real bearing on their ability to do the job. It's high time we realized that in this country.

Sexy From the Inside Out

source: zeldalily.com

NPR is doing a series called Living Large: Obesity in America. One of the recent stories talked about how the sex lives of some obese people suffer because of their obesity. As they point out near the beginning of the story, it's an aspect of obesity that's not often covered. But it's becoming more prevalent as obesity rates rise in this country. You can read or listen to the entire story here.

There are several things I appreciate about this story. First, the (unnamed) reporter made a point to say that there are plenty of obese people who have satisfying relationships, including sex lives. This story could so easily have been painted in broad brushstrokes; I'm very grateful it was not.

Also, I have to give props to Larry Boynton, one of the men featured in the story. When he and his wife, Dana Englehardt, first met, she was already heavy. (It was after they married that she gained 60 pounds and that their sexual problems began.) Anyway, speaking of when they first met, the reporter says, "Boynton says he didn't focus on Englehardt's size. 'Once I decided to put that out of my mind and allow the relationship to grow with the person I was falling in love with — her personality and how much fun we had together — it just really wasn't an issue,' Boynton says."  

How rare is that?!? My instincts say it's quite rare, but I'm curious: Is that more common than I think? Are there plenty of good men out there who'll look past an exterior that might not make it onto most magazine covers...and focus on the woman's personality and character? If you know of such men or if you are one, I'd really like to hear your experience (please comment below!).

And finally, Eric Leckbee, another man featured in the story, struggles to believe that his wife finds him attractive despite his weight (which can be as high as 300 pounds). He quotes his wife as saying to him, "I love you and I'm attracted to you regardless of your weight." Well, this one really resonates with me, as I was in love with a man much larger than 300 pounds, and I can tell you...the attraction was definitely there.

Now, should obese people work toward greater overall health? Yes, absolutely. (Though if they do, some may still be larger than the average person—size alone is not necessarily a definite indicator of health.) Will their sex lives improve if they do? Perhaps. But in the meantime...take it from one who knows: they can still bring—and with the right partner, receive—the sexy.

Melissa McCarthy Gets the Last Laugh

Almost a year ago, a blogger for Marie Claire magazine wrote a horrible post about fat people on television, prompted by the hit TV Show Mike and Molly. (Full disclosure: I have yet to see an episode of the show. I hear they make jokes at fat people's expense, so I'm not sure if I could handle it. You'd think with plus-sized people as the main characters...sigh.)

Here's the worst of the blog post, in case you missed it:

source: justjared.buzzfeed.com

I think I'd be grossed out if I had to watch two characters with rolls and rolls of fat kissing each other ... because I'd be grossed out if I had to watch them doing anything. To be brutally honest, even in real life, I find it aesthetically displeasing to watch a very, very fat person simply walk across a room — just like I'd find it distressing if I saw a very drunk person stumbling across a bar or a heroine [sic] addict slumping in a chair.

Now, don't go getting the wrong impression: I have a few friends who could be called plump. I'm not some size-ist jerk. And I also know how tough it can be for truly heavy people to psych themselves up for the long process of slimming down. (For instance, the overweight maintenance guy at my gym has talked to me a little bit about how it seems worthless for him to even try working out, because he's been heavy for as long as he can remember.)

But ... I think obesity is something that most people have a ton of control over. It's something they can change, if only they put their minds to it.

Wow, right?!? So much wrong there. I won't refute every point; the author does a pretty good job of making clear just how sizeist she actually is. I will say: I intend to write a future post about the control issue. Let's just say that while I'm not an expert, I have learned a few things, one of which is that it's much more complicated than many believe.

Anyway...I remember hearing about this when it happened, and I think I didn't write about it 'cause I just didn't want to get that angry...which would be even angrier than when I first heard about it!. So I'm happy to to be able to write this post!

This week Melissa McCarthy, star of Mike and Molly, won the Emmy for Outstanding Lead Actress in a Comedy. So cool! Oh and at Amy Phoeler's suggestion, all the ladies nominated in the category did something special...it's worth a watch: