Today in the Melbourne Herald Sun, an incredibly brave woman Amanda Bell spoke out about the treatment she had received in hospital because of her weight.
Amanda (who has a medical condition which has caused her to be obese) described in the article how she was told by a member of the nursing staff to get her ”lazy fat arse” out of bed to have a shower.
The point of this post is not to go into detail about Amanda’s case. I wasn’t there, I have never spoken to Amanda and the hospital has conducted a review and said that the care was appropriate.
But I do think that Amanda should be applauded for speaking out. Because that is not easy.
The vast majority of people who percieve that they have been treated unfairly or inappropriately by their health professionals DO NOT SPEAK OUT. Most are too ashamed and embarrassed to speak publically about their experiences.
Instead, many people just stop going to the doctor - including for essential preventative health services like breast exams, prostate exams, and cervical smears.
Some have internalised the stigma they receive on a daily basis so much, that they even believe that they deserve to be treated badly by the people around them – including their family, friends, colleagues, and health professionals.
And who can blame them. Here are a few of the comments that were directed towards Amanda on the Herald Sun website:
Jac of Victoria: Ms Bell – if you help yourself, life will be much more pleasant for everyone that shares your life – including other patients and nursing staff. As a regular hospital patient for a genetic disorder – I’ve had to share space with patient’s like yourself and it impacts on my stay and care.
Elle of Warragul: OK, I feel sorry for this person if she was belittled, and that isn’t acceptable. However, try looking after anyone of that size. She weighs 220kg. How much weight is a nurse to lift? How many staff or what equipment is available to help? ….. Looking after obese patients adequately is a nightmare, with pressure care and hygiene very difficult to provide.
Jagger of Melbourne: “She decided to speak out because she wanted to prevent others being treated the same way?” What did she say, “Don’t CHOSE to become morbidly obese”? If so, good on her! If she said anything “Be nice to masochists who chose to become so disgustingly unfit that taxpayers must pay to hose them down, because they are precious snowflakes”, then I say fly her to Rwanda. Only western nations suffer obesity. You don’t see South Africans waddling down the supermarket hours, “suffering” from such a terrible affliction like obesity, crying out for society’s “understanding”
Doctors have been recently been told to pull no punches in bluntly telling their patients that they are fat and advising them to take part in commercial diet programs. Just a few weeks ago it was reported that British Doctors are not only financially incentivised for keeping lists of their obese patients, but would reap extra financial rewards for telling them to lose weight by joining commercial slimming clubs. Apparently, this is a successful way forward because according to the studies quoted in the article people who join these clubs lose more weight over a 12 week period than those who go it alone.
Obviously a serious case of Policy Makers: 1 vrs Insight and Understanding: 0
But I digress.
In other cases, doctors are just not prepared to listen to experiences. I gave a talk a year ago where a Professor stood up and stated that the research I was presenting (on how fat people felt they were stigmatised by their GPs) was unhelpful because in his words “I don’t think talking to highly stigmatised groups is that useful in informing policy and health care services”.
In 2003, Schwartz et al published a paper on the implicit weight bias of health professionals. Their results showed that:
Health professionals exhibited a significant pro-thin, anti-fat implicit bias… In addition, the subjects significantly endorsed the implicit stereotypes of lazy, stupid, and worthless.
Interestingly, those health professionals who had lower levels of implicit anti-fat bias were male, older, and who indicated an understanding of the experience of obesity.
No matter what you think about fat people, how they got to be fat, or what they should do about their weight, they deserve the same treatment as any thinner person within the health care system.
So here is what I think. Fat people should continue to be brave and speak out about their experiences. Not necessarily on the front page of the Herald Sun, but through other forums – blogs, twitter, in studies etc. And this includes not only the bad experiences, but the good experiences too. Frances at Corpulent has started the All Bodies Directory, where you can go and share the contact details of a health professional you thought was fat friendly.
More importantly, Health Care Professionals need to start LISTENING to these experiences.
Because surely you want a good relationship with your patients too?