Oftentimes, patients are too obese to even attempt an image--since they either exceed the weight limit on the table or they're too wide to fit into the machine. Once, doctors could get around this problem by taking the admittedly embarrassing step of sending extremely obese patients to veterinary facilities, where table limits on imaging machines went as high as 1,100 pounds....Worse, the people who are treating you probably don't like you:
A 2003 survey of 620 primary care physicians, for instance, found that at least 50 percent of them believed obese patients were awkward, ugly, and noncompliant. A 1989 sample of over 100 nurses, meanwhile, found that one in four of them were "repulsed" by caring for obese patients....Are they laughing about you behind your back? Or do they disrespect you to your face or your...
One explanation is simple class bias. "When you think about the socio-demographic and economic backgrounds of many physicians, they often do not belong to groups that have the highest BMIs, " says Christina Wee, an internist at Beth Israel Deaconess who researches obesity and health disparity issues. "So, in general, we physicians often have a different perspective-- the people whom we know are often not obese, or at least not as obese as the patients we see in clinical practice."
Another explanation is that the medical profession often leans more toward the profane than the sacred, as doctors and nurses seek to leaven a stressful work environment with black humor--which frequently comes at the expense of those they're caring for. That some of that black humor would be internalized and converted into actual negative attitudes is, perhaps, inevitable.
As Lynn McAfee, a 400-plus-pound Philadelphia-area woman who serves as the director of medical advocacy for the Council on Size and Weight Discrimination, elaborates: "You're laying there with your feet in stirrups, holding your own fat thighs apart and being lectured by somebody to lose weight. Or you're told, as I was by my gynecologist, 'So you're not sexually active.' And I said, 'Yeah, I am.' And she said later on, 'If you were sexually active,' and I interrupted her and said, 'I am sexually active!' And then it happened a third time. ... Gynecologists are generally not our friends."Disturbing, but there's money to be made:
[T]he market for plus-sized medical equipment is booming--to the tune, according to some estimates, of as much as $3 billion per year. Companies with names like Big Boyz and Amplestuff now sell everything from extra-extra-large patient gowns and blood-pressure cuffs to 1,000-pound-weight-bearing hospital beds with built-in scales and double- wide wheelchairs. Even medical settings as prosaic as doctors' waiting rooms and hospital bathrooms are getting the super-size treatment: A 2002 article in the journal American Family Physician counseled doctors to equip their reception areas with "sturdy, armless chairs and high, firm sofas"; and many hospitals have begun replacing wall-mounted commodes with ones that sit on the floor.