THE BIG ISSUE
Marie Claire Australia|February 2022
Systemic fat-phobia in medicine has led to poor healthcare for maligned and maltreated overweight women for decades. Now, they are fighting back for their right to quality treatment.
Bek Day

Lying flat on her back in the metal tube, a solid, heavy bar bearing down on her chest, Elissa Jenkins tried to remind herself to breathe. It wasn’t her first MRI – a benign pituitary tumour meant she’d seen her fair share over the past two decades – but the setup was different this time. The Brisbane children’s entertainer had gained weight since the last time she had undergone a scan, and this particular machine included a head capsule that needed to fasten down over her chest – something it couldn’t do properly because it was too small.

“I could feel this panic rising inside me,” she recalls. “The radiologist had tried to shuffle me down to get a better fit but she was unable to make it work, so she told me I’d have to put up with the pressure on my chest.”

It became physically impossible to fill her lungs, at which point a distraught Jenkins knew she couldn’t take another 20 minutes like this. Hot tears of humiliation pricked her eyes as she asked the radiologist to stop.

This wasn’t the first time the failure of medical equipment to properly accommodate her body would pitch a barrier to healthcare for Jenkins, and it wouldn’t be the last. Once, she’d been in hospital for a routine treatment and two trainee nurses refused to let her go home because her blood pressure was too high. They’d failed to realise the blood pressure cuff they were using was too small, causing a false high reading.

Out of the MRI machine and able to catch her breath once more, Jenkins waited for the radiologist to come up with an alternative. “She told me to go away and take a Valium, in the hopes that I would ‘cope better’ with the ill-fitting machine next time,” she recalls. “When I asked what happened with people larger than myself – people who couldn’t fit at all – the radiologist told me that bigger people simply couldn’t have the scan.”

... When accessing healthcare in Australia, there is an inverse correlation between a person’s BMI and the quality of care they receive. Despite 31 per cent of Australians falling into the obese category, there has been a failure to address or procure the equipment required to properly treat larger people.

As Jenkins experienced firsthand, medical equipment and protocols have failed to keep up with changing norms in body size.

“Gowns that are too small, inadequate examination tables, waiting rooms with tiny chairs – the barriers are there for fat people the moment the healthcare experience begins,” explains Dr Cat Pausé, a fatstudies scholar whose research focuses on the effects of fat stigma on the health and wellbeing of fat individuals. It’s worth noting here that many fat activists and members of the fat acceptance movement prefer to use the word fat as a descriptive tool, in spite and also because of its often-jarring impact. It’s a way of reclaiming a word that has been weaponised, medicalised and needlessly attached to moral judgement. “I am fat,” states Pausé matter-of-factly. “Some people are tall. Or short.” The fact that it continues to provoke a bristly reaction from some is evidence of how needed this reclamation actually is.

Pausé believes the reasons for the inequality of care between fat and non-fat individuals are multilayered, but ultimately all find their roots in systemic fat-phobia.

MRI weight limits are an increasingly common problem. Several years ago, two patients in Melbourne who exceeded hospital MRI weight limits were reportedly referred to a veterinary clinic to be scanned in a CT machine designed for horses. The smarting indignity of this almost doesn’t bear thinking about.

And if the logistical failure to properly care for fat bodies is dehumanising, then anti-fat attitudes among healthcare providers are downright disturbing. Weight stigma among doctors in particular has been shown across several studies to impact the quality of care their overweight and obese patients receive.

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