Weight-based decisions in health systems are unjustly disadvantaging fat people during COVID-19.

Fat bodies have been portrayed as a major health problem publicly and in our health system. This is based on assumptions that have been challenged, for example that fat people are unhealthy and that fatness is in the control of the individual. The resulting stigmatism of fatness prejudices fat people who are discriminated against in the health system with important differences in treatment options.

Senior Lecturers George Parker (Otago Polytechnic), Cat Pausé (Massey University) and Lesley Gray (University of Otago) have investigated how fat people are faring with COVID-19. Their review shows that fatness has been problematised in the COVID-19 pandemic. Despite a lack of data on the weight of COVID-19 sufferers, it has been assumed and publicly claimed that fatness is a risk factor for severe COVID-19. As a result fear about COVID-19 is being used to persuade people to lose weight. Where health resources are insufficient to give everyone optimal treatment, there have been examples of weight-based decisions about prioritising patients. Higher BMI is more prevalent in ethnic minority populations and poorer populations, so the attitude to fatness reinforces underlying inequities. Another issue is that one-size-fits-all protective equipment for COVID-19 does not in fact fit everyone.

Fat activists are challenging the discrimination and the underlying assumptions. There are also support groups for fat people. COVID-19 will be with us for a long time yet and it is important that decisions about access to health services are evidence-based to ensure health justice.


March 2021

Image credit: Fat Yoga, used under Creative Commons Attribution-NonCommercial-NoDerivatives licence CC BY-NC-ND 2.0