Weight Bias is Limiting Access to Weight Loss Surgery

I read an article today written by a doctor who found himself examining his sense of bias when he was faced with a 600 lb patient in the emergency room. Nurses and technicians around him made snide remarks and a surgeon made it clear he wanted to find a way to foist the patient off on another hospital. Treating the patient presented challenges as it was, making it even more difficult to maintain an appropriate tone. Medical staff expressed frustration when an x-ray machine could not penetrate down to the patient’s bones and when they did not have proper equipment to transport the patient around the hospital. The article closed with an ambiguous remark that suggested a few months after the hospital incident, the man had passed away at his home for undisclosed reasons.

As you might guess, the opinions about this article ran the gamut but my take away from it was that we need to find a way to reach out to people dealing with extreme obesity. No one should ever reach 600 lbs but I know from experience that when your weight is rising into the high 200s and beyond, you dread going to the doctor for anything. It’s bad enough that stigma and judgment come from all corners of society. It’s much worse that even medical professionals will share the same deeply biased views.

Let’s pretend for a minute that weight loss surgery really was “the easy way out.” As if going under general anesthesia and having your insides permanently rearranged and living forever with the results is “easy.” First let’s consider, “the way out” from what? A way out of living with high blood pressure? Diabetes? The pain of stressed joints? Heart disease? A fatty liver? Asthma and sleep apnea? If there’s an “easy” way to relieve those conditions and regain health, wouldn’t that be a really good thing to do? Critics argue that fat people “let” themselves get that way by willful choice. We bring a lot of medical conditions on ourselves from heart disease and cancers to injuries sustained while engaging in risky activities. Do we require anyone to ever “earn” medical care? Do we tell sufferers of ANY other condition that treatment is the “easy way out”?

To say that a fat person should not take the “easy way out” is to say that they deserve to suffer and struggle. It is to say that they do not deserve relief from their medical conditions unless they endure a penalty of what we might call the “difficult and painful way out.”

Now let’s consider this idea that weight loss surgery is “cheating.” Cheating against whom? For what? Cheating is about taking something of value from someone by deceitful or underhanded means. How does the way in which a person loses weight cause someone else to lose something of value to them? Are we all in some kind of real-life “Biggest Loser” competition and people who have surgery are beating out others for some prize?

Weight bias is targeted at a belief that fat people deserve to suffer for the assumptions made about their behavior. Biased medical professionals, who should always be committed to “do no harm,” are willing to ignore the growing body of research that is proving just how ruthlessly complex obesity really is. As the Affordable Care Act is rolling out, I was hoping that weight loss surgery was going to be available to more people under the various new insurance plans. BUT NO. Weight loss surgery will be available under just 41% of ACA insurance plans across 23 states.

According to Antonia Namnath, president of the Weight Loss Surgery Foundation of America, only about 35% of the people whose medical conditions may indicate surgery actually have access through insurance coverage but of those people, about 75% of them will have to fight their insurance coverage for surgery approval for up to three years. Why is access to weight loss surgery so limited? Because our society, including much of the medical profession, judges why overweight people need medical care and their pain is deemed unworthy.