Bennett’s obituary revealed she died from cancer days after finally being diagnosed — after years of seeking help.
Her diagnosis came so late, beyond the point where treatments were
possible, because the 64-year-old woman was repeatedly told her health
problems were caused by her weight — or more specifically, by the amount
of fat on her body.
She died because of bad assumptions that caused poor quality care. And she used her own obituary to share her dying wish:
“Ellen’s dying wish was that women of size make her death matter by
advocating strongly for their health and not accepting that fat is the
only relevant health issue.”
How to know if this might be happening to you? When do you need to advocate for yourself? I studied the phenomenon of anti-fat stigma in Canadian primary care clinics for my PhD. Knowing how it happens might help.
Poor quality clinical care due to anti-fat stigma occurs when doctors or nurses assume the stereotype holds true.
One common way this happens: a clinician simply tells you to “lose
weight,” as Bennett heard many times when seeking help. That’s like
telling patients to “lose blood sugar.” Telling people to produce an
outcome is not good quality clinical care.
After years of feeling unwell & seeking help only to be told that the problem was simply her weight, Ellen Maud Bennett was diagnosed with terminal cancer & given only days to live. When fat people say fat hatred kills us, this is what we mean.
Unfortunately, some clinicians give very simplistic weight loss advice, such as “eat more salads,” without any assessment of what the patient already knows, does, has tried or can afford and fit into their lives.
Simplistic advice is patronizing at best; it assumes patients are
ignorant, as per the stereotype. This approach vastly underestimates the
knowledge of a patient, gained in part through repeated past attempts
to change body composition. One Canadian study found that half of those
classified as overweight, and 71 per cent of those categorized as
obese, had attempted to reduce their body weight in the last year.
Simplistic messages — “lose weight” or “exercise more” — assume thinness is easy and simply involves some lifestyle tweaks.
When such advice is given without assessment of health concerns — for instance, headaches — anti-fat biases can endanger lives.
Bias trumps science, sometimes
Clinicians should, at minimum, recommend actions that have a chance at
producing an outcome. Lifestyle changes only produce modest effects for
most, yet many clinicians assume much bigger impacts.
Patients can advocate for themselves, to change discrimination in health care.(Obesity Canada)
You can help. When clinicians make one of these common mistakes or in
some other way block you being diagnosed or treated, you are on good
grounds to challenge them. Say something like: “What would you do if
someone with a thin body had this problem?” Then encourage them to treat
you in the same way.
After receiving poor quality care, register a complaint with the
provider’s professional licensing body. They may not investigate your
individual complaint but do track trends. Patient advocates are also
available in some hospitals to help you get the care you need.
News stories come and go. But the issues Ellen Maud Bennett raised in
her obituary should not disappear from our consciousness so quickly. You
deserve good care, just as she did.
This article is written in memory of Ellen Maud Bennett, with the permission of her sister.
