Compassion for Fat Patients Doesn't Replace Actual Healthcare

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I was reading a conversation online where a fat person was saying that they wanted evidence-based care from their doctors. A man replied that he teaches nurses and that he makes it a point to teach those future nurses to treat “ob*se* people” with “compassion and never cruelty.”

This guy is certainly well-meaning but check again, because he is completely missing the point. There’s nothing wrong with compassion, and it’s certainly a step up from how a lot of healthcare professionals treat fat people. But it’s not a substitute for competent, evidence-based healthcare.

Believing that simply existing in a higher-weight body is a health condition that requires treatment is a problem, whether someone has compassion or not. It’s a paternalistic view rooted in weight stigma. A focus on “compassion” is how we end up getting harmful “people-first language” instead of evidence-based healthcare. Calling me a “person with ob*sity” doesn’t help me*, having a blood pressure cuff that actually fits me and getting healthcare that isn’t just a command to “get thinner” does.

We aren’t asking healthcare providers to see us and think “oh, that poor fat person” we’re asking them to see us and think “there’s a larger patient, I have done the necessary work to know how to give them ethical, evidence-based care.”

Again, it’s not that compassion is a bad thing, it’s that all too often “compassion” just ends up being a condescending pity for the fatty who the practitioner believes isn’t smart or strong-willed enough to succeed at diets, rather than realizing that we don’t fail diets, diets fail us. Compassion doesn’t do any good if it gets substituted for giving us sub-part treatment but, you know, more nicely.

The kind of compassion we need from healthcare practitioners is compassion for the issues (which can include health problems) that can come from weight stigma, weight cycling, and healthcare inequalities, compassion for the fact that we may have serious anxiety about visiting a healthcare practitioner because of the horrible experiences we’ve had with fatphobic HCPs. We need compassion in the form of armless chairs and loveseats in the waiting room and medical equipment that is built to accommodate us, and HCPs who want to give us ethical, evidence-based healthcare and don’t just see us as a walking, talking pathology.

Fat people deserve compassion from HCPs but we deserve far more than that. Fat people deserve compassionate ethical, evidence-based healthcare with the goal of supporting our health, not manipulating our body size.

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More research and resources:
https://haeshealthsheets.com/resources/

*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight” to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings Fearing the Black Body – the Racial Origins of Fat Phobia and Da’Shaun Harrison Belly of the Beast: The Politics of Anti-Fatness as Anti-Blackness for more on this.

Note I don’t link to everything I discuss in every post because I don’t want to give traffic and clicks to dangerous media, I always provide enough information to google if desired.