Appendices – Healthcare Disparities: Exploring Inequities Across the Spectrum
Disclaimer: All names portrayed in this production are fictitious. No identification with actual persons (living or deceased), should be inferred
This was the first time I had experienced such excruciating pain, and it was beginning to worry me. As an overweight man, I was no stranger to the occasional aches and pains, but this was different. This was something I could not ignore. As I walked into the clinic’s waiting room, I peered around the room to see if there was a chair I would be able to sit and wait on. However, as I scanned the room, I saw only narrow chairs with stiff arms at the side. Now, I am a pretty big guy, tall and fairly wide. I knew just by looking at these chairs that I would not be able to sit and fit comfortably. I opted to stand in the corner feeling the eyes of other patrons in the waiting room turn my way as I found myself a space to lean against the wall in the waiting room. Already feeling unwelcome, I pulled out my phone, and kept my head down as I waited for my name to be called. At least the fact that I maintained an active lifestyle hiking and swimming as well as other activities made it so that it was not too difficult for me to stand for long periods of time.
Finally, my name was called, and I entered the examination room, hopeful that the doctor would provide some answers. The doctor, a middle-aged woman with a clinical demeanor, glanced at my chart, and immediately honed in on my weight. She peered at me up and down as I pushed myself off the wall, placing my right hand at my lower back, where I felt a sharp pain at the movement.
“Hello Mr. Bromini, Please follow me into the exam room.” She stepped aside, allowing me to enter the room in front of her before she entered herself, closing the door, taking a seat at the desk, and pulling up my file. I sat down gingerly, using the step stool to allow me to reach the exam table.
“So, you’re here because of back pain?” she asked, her tone tinged with skepticism.
“Yes,” I replied, trying to convey the seriousness of my discomfort. “It came on suddenly, and it’s been getting worse. I’ve never experienced anything like this before.”
The doctor’s gaze shifted back to the screen, as she seemed to lose interest. “Well, it’s not uncommon for people with your body size to experience back pain,” she remarked casually.
I attempted to interject. “I have been active all my life and, barring athletic injuries, I have never had–”
“I would suggest losing weight and exercising more. That should help alleviate the strain on your back,” the doctor replied, cutting me off. She handed me her card and a pamphlet displaying exercises and stretches that can alleviate back pain, and instructed me to do them twice a day before grabbing her clipboard, and leaving the room.
Plus-size individuals often face significant disadvantages within the healthcare system. Doctors frequently dismiss or overlook the concerns of larger patients, attributing health issues solely to weight without thorough investigation. This approach not only fails to address the root causes of health problems, but also undermines the trust between patient and provider. From entering the clinic Johannes felt unwelcome beginning from being unable to fit in the waiting room chairs. Following this, the health care provider immediately made assumptions about patient’s lifestyle based on his appearance. She did not take the time to dive deeper and gave him a surface level diagnosis without doing her due-diligence. Advocating for yourself, and asking your doctor to document denied requests for further investigation, can help to persuade doctors to take certain concerns more seriously. Addressing fatphobia should commence with the recognition that obesity is a matter of social justice not a medical or public health emergency. It’s important to note that implementing solutions won’t be straightforward, especially given the global history of stigmatizing larger bodies over many years. Nevertheless, resolving the issue of fatphobia is within reach if we are ready to muster the political determination and allocate the required resources.
I felt a pang of frustration and defeat. She had dismissed my concerns without truly listening; but I knew something was not right. The pain was too severe, too persistent, to be attributed solely to my weight, especially given its very sudden onset. Days turned into a week, and the pain continued to worsen. I was also running a fever, and had incredible fatigue. A few days later, I saw blood in my urine. Alarmed, I made my way back to the doctor’s office, determined to make her take my pain seriously.
This time, the doctor seemed slightly more attentive as I recounted my new symptom. Reluctantly, she agreed to run further tests. Four days later, I received a call from the doctor’s office. It was not the call I expected. “Sir, we’ve reviewed your test results,” the voice on the other end of the line said. “You have a kidney infection that requires immediate treatment with antibiotics. Please come in as soon as possible to collect your prescription.”
Relief washed over me, knowing that I had finally found the cause of my pain, but along with that relief came a sense of frustration. Why had the doctor not taken me seriously from the beginning? Why had my symptoms been attributed solely to my size?
As I reflected on my experience, I could not help but think about the countless overweight individuals who might face similar dismissals from healthcare professionals. Our symptoms are often attributed to our size, leading to delayed diagnoses and inadequate treatment. It was a sobering realization, one that highlighted the urgent need for healthcare providers to look beyond weight and listen to their patients, regardless of their size.
Instead of immediately attributing health issues to weight, healthcare professionals can serve patients better by conducting comprehensive assessments to identify potential underlying factors. Healthcare professionals need to be open to engaging in open and non-judgmental discussions about health concerns, while acknowledging the unique experiences of plus-size individuals.
Medical practitioners could also offer evidence-based recommendations that are tailored to the individual’s needs, accounting for factors beyond weight, such as genetics, medical history, and lifestyle. When addressing health issues it is best to focus on improving overall well-being, rather than solely pursuing weight loss. By promoting healthy habits and discussing achievable goals, doctors can empower patients to take charge of their health without feeling marginalized or stigmatized.
Furthermore, healthcare professionals could also undergo training to recognize and confront their own biases, ensuring that they provide unbiased and respectful care to all patients, regardless of their size. Implementing these changes can create a more inclusive and effective healthcare experience for plus-size individuals, ultimately leading to improved health outcomes, and a stronger healthcare professional-patient partnership. 
- Stoll, L. C., Meadows, A., Liebenstein, S. v., & Carlsen, C. E. (2022). "four: Fatphobia". In Global Agenda for Social Justice 2. Bristol, UK: Policy Press. Retrieved Sep 8, 2023, from https://doi.org/10.51952/9781447367420.ch004 ↵
- Fidancı, İ., Aksoy, H., Yengil Taci, D., Ayhan Başer, D., & Cankurtaran, M. (2021). Evaluation of factors affecting the FAT phobia level. International Journal of Clinical Practice, 75(8). https://doi.org/10.1111/ijcp.14297 ↵