Do Doctors Discriminate Based on Obesity?
Sarah Bramblette’s doctor placed her on a diet to lose weight. The scale at his office measured only up to 350 pounds, which she exceeded. To determine her weight, she was forced to go to a local junkyard.
People with extreme cases of obesity routinely encounter problems with medical equipment, such as M.R.I. units that are too small to accommodate them. In addition, most medications are not tested to determine appropriate levels for the overweight.
Patty Nece, of Virginia, says many providers are unable or unwilling to address her health concerns beyond her weight. She visited an orthopedist due to hip pain, which he diagnosed as “obesity pain” without conducting an examination. Later, another doctor determined she had progressive scoliosis. Research suggests many physicians are unwilling to provide adequate care or conduct basic diagnostic testing on the obese. The result is:
- Obese patients have a heightened risk of dying from all types of cancer.
- Up to 30% of obese individuals are moved to intensive care following a procedure because of complications from anesthesia.
- Obese women are less likely to have critical screening for cervical, breast, and colorectal cancers.
- Obese women diagnosed with cervical or breast cancer are much more likely to die from it.
What Counts as “Obese”?
Harvard’s School of Public Health explains that excesses in body weight are measured by your body mass index (BMI), a basic calculation based on height and weight. BMI is an “imperfect measurement” because it does not differentiate between body fat and lean mass. People classified as overweight have a BMI between 25.0 and 29.9, and those with 30 or higher are considered obese.
Centers for Disease Control and Prevention (CDC) data shows that in the U.S., roughly 34% of the population is overweight and 36% obese. Approximately 27% of children between the ages of 2 and 11 are obese. For females, those with lower income and education are more likely to be obese. Among men, these variables have no significant relationship. Obese individuals are at greater risk for heart disease, diabetes, cancer, and stroke.
Do the Obese Get Worse Care?
Jan, a 59-year-old woman, visited an OB/GYN complaining of vaginal bleeding, abrupt weight loss, and pain in the pelvis area. The doctor dismissed her concerns in a demeaning way. Her conditions persisted and another doctor ordered blood tests. A large mass was discovered in her abdomen. A surgeon removed the tumor (described as being volleyball-sized), but the cancer had spread to her bladder. She underwent chemotherapy, but ultimately died from the disease six months later. Her family wondered if the cancer would have been detected much sooner if her doctor wasn’t prejudiced against her obesity.
Medical Providers Perceive Greater Risk
A recent survey found that roughly 90% of emergency departments lacked scanners capable of accommodating very heavy people. Many physicians and hospitals view the obese as a great risk; 62% of those who perform hip and knee surgery have a BMI limit. Facilities face penalties such as lower reimbursement from Medicare when surgical outcomes are poor, which leads providers to only operate on lower-risk candidates. The CDC estimates that yearly medical costs are $1,429 higher among obese people.
Dr. Louis Aronne, who founded the American Board of Obesity Medicine, agrees that obese patients often experience substandard medical care. One example was a 46-year-old woman who developed severe respiratory problems, making it difficult to walk without gasping for air. She visited a clinic where the doctor said the problem was excessive weight pressing against her lungs and suggested weight loss. Months later, it was determined she had blood clots in her lungs.
University of Pittsburgh Medical School professor Adolph Yates Jr. says many orthopedic physicians require obese people to lose weight before they will be considered for surgery. Many offices have their staff screen patients over the phone by inquiring about weight, and many surgeons find operating on the obese to be more difficult and more risky in terms of medical malpractice.
Why Obese Patients Avoid Doctors
Many obese people are reluctant to see a doctor. Some reasons for delay or avoidance include that examination gowns, exam tables, and cuffs for measuring blood pressure are too small. Many feel their health concerns are quickly dismissed as being weight-related. Many feel a social stigma against obesity, which equates it to a flaw in their character.
Overall, obese people receive negative reactions and poorer medical care, which makes them less likely to seek medical care, and their health problems to continue and worsen. Providers, policy makers, and medical institutions should provide quality care to all, rather than avoiding patients based on their weight.
If you have experienced poor medical care due to your weight, talk to a Kansas City medical malpractice attorney at Norton & Norfleet, P.C. When patients are harmed by the negligence of a medical provider—and negligence could include something as simple as taking a look at your weight and testing no further—you need an attorney to make it right. For a free consultation, call (816) 454-5800.