Obesity’s Impact on Access to Medical Care

The barriers that limit access to medical care routinely encountered by people with obesity bear consideration for a full understanding of obesity and health. When a recent study prompted broad attention to the fact that doctors treat slender patients with more respect, comments flooded discussion forums that brought this finding to life. Said one reader of the New York Times:

Two years ago I lost 140 pounds, and through that process I have been both disgusted and amazed with how differently the world, including medical professionals, treats me. When I was morbidly obese, I felt very harshly judged by doctors, and I often would stop going to doctors who I felt treated me inappropriately because of my weight. Yes, I expected my doctors to discuss my weight, but there are ways to do it that, create empathy. Now that my B.M.I. is 21, the weight is a non-issue, whereas before it was pretty much all we talked about.

Another reader was more blunt:

You could walk in with an ax sticking out of your head and they would tell you your head hurt because you’re fat.

Anyone with a chronic condition feels vulnerable and deserves respect from their healthcare providers. Delivering it is a mark of professionalism. But too many healthcare providers feel a duty to deliver admonition to a patient with obesity to “take responsibility” for their obesity. A cancer surgeon summed up this point of view in commenting on this same study:

Obesity is a CHOICE. I dont care what Oprah, Suzanne Summers and Tom Cruise say it is a choice. Genetic obesity is probably true in about 5% of patients. I am not talking about people that are 10, 20 or 30 #s overweight. But people that are 100#s overweight didnt get that way because mother nature made them but because their OWN mother fed them poorly or they chose not to eath a healthy diet.Between 20# overweight and 80#s overweight was 60#s of fast food, french fries and burgers. Nobody force fed these people a bad diet.

Issues of access to medical care confronting people with obesity go beyond disrespect from providers. In the last decade, healthcare facilities have begun to recognize the need make their facilities accessible for larger patients. Approximately a third of U.S. hospitals invested in renovations in the past year to accommodate patients with obesity, according to Novation LLC, a hospital supply company that publishes an annual report on the cost of bariatric care.

The need is clear. Before one hospital made the investment, they turned away three to four patients weekly who were too big for their MRI, recommending they go to a veterinary facility. “That’s a hard conversation to have with somebody,” said the hospital’s MRI imaging team leader.

Obesity is a serious chronic disease which leads people to need and seek medical care. Respect and encouragement to muster a resolve for living in good health are essential. Blame and barriers to medical care are intolerable.

Click here to read more about how some doctors treat people with obesity in the New York Times and click here to read about making hospital facilities accessible in USA Today.

Catacombs Access, photograph © monsieurlam / flickr

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