What We Don't Talk About When We Talk About Fat

by Aubrey Gordon

Over the last two decades, a growing body of research has indicated a frightening trend of anti-fatness among healthcare providers. In 2001 the International Journal of Obesity published a study that found those anti-fat judgments caused material differences in the outcomes of care received by fatter patients. In office visits with fat patients, the study found that many physicians wrote notes “suggesting a belief that those who are overweight must also be unhappy and unstable,” including comments like “this woman has a very unhappy life,” “suffering underlying depression,” and “most likely a drug addict.”24 Of the 122 primary care physicians who participated in the study, 10 percent suggested anti-depressants for their fat patients. Fat patients also received shorter visits. The average office visit for a thin patient with a migraine headache is 31 minutes. For a patient with an BMI considered as “obese,” that time drops to twenty-two minutes. “Certainly if physicians give additional tests (whether weight-related or not) to heavier patients, they may be giving compromised care—they are doing more tests in a much shorter period of time. [. . .] The pattern of responses seems to reflect that physicians feel more negativity toward heavier patients.”25 The fatter the patient, the more likely the doctor will describe the office visit as “a waste of their time” and the patients as “more annoying.” If a physician saw more fat patients, they said, they “would like their jobs less.”