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We are going to start out today with the story of Dr Thomas Kraut and then talk about what it that story demonstrates and what we can do about it. Content note that this story is tragic. This was originally brought to my attention by reader Suzanne. I read every account I could about the situation and pieced them together.
Dr. Kraut spent twelve years being told by doctors to lose weight. He was enrolled in weight loss programs and nutrition courses, he was put on semaglutide (Ozempic/Wegovy). He became thin, gaunt, and malnourished but his stomach remained large. At that point he was approved for weight loss surgery to amputate the majority of his stomach. During a pre-surgery CT scan a malignant, almost 20 inch, 60.18 pound tumor (that’s 52.3cm and 27kg for those of you on the metric system) was discovered.
Two weeks later doctors were able to diagnose the rare type of cancer and found that it had spread to his right kidney and small intestine and it was pressing against other vital organs. Then he had to endure a 10 hour operation which removed most, but not all, of the tumor because, again, it was pressing against vital organs and was too risky to excise.
As he told a number of media outlets, the experience left him getting regular therapy and with two oncologist visits each year to monitor the malignant material that cannot be removed.
The weight-centric paradigm that the weight loss industry has created in which higher-weight is seen as a health issue and (attempted) weight loss is seen as a healthcare treatment has generated tens of billions of dollars in profit but it has also generated something else among healthcare providers - something I call Provider Weight Distraction.
Dr. Kraut’s experience is an an extreme example of this. It happens when providers become so obsessed with higher-weight people’s weight and making us smaller that they miss actual health issues and/or opportunities to offer us options that could support our health.
The harm that comes from provider weight distraction is compounded when the issues are blamed on higher weight people.
Dr. Kraut filed a lawsuit which was initially dismissed because doctors argued that since the cancer he had was rare, they couldn’t have been expected to identify it. He said that he has filed an appeal and I truly hope he wins because they sure as hell could have TRIED instead of just prescribing more and more dangerous and expensive methods of weight loss.
Another way that the blame gets passed is when the weight loss we are prescribed leads to actual health issues but then those health issues get blamed on fat bodies. I’m working on some research right now to start to get a sense of how often this happens and how much harm it does.
This also represents yet another healthcare situation which is not higher-weight people’s fault, but becomes our problem. We shouldn’t have to fight for basic healthcare but the reality is that we often do.
The good news is that this type of weight stigma can be helped by a pursuing weight-neutral health. When we decline weight loss as a healthcare intervention and instead ask things like what would they offer a thin person with these symptoms? Or, if we ask for a diagnostic (like a CT scan) and are refused, and we ask that they chart their denial and then get a second opinion if they still refuse, we can support our bodies.
Pushing for the healthcare we deserve is often much easier said than done and our ability to do so is impacted by things like privilege/marginalized identities, access and more and there are no guarantees that our efforts to advocate will bring success.
That’s why systemic change is the solution. Even if we don’t take weight loss attempts off the table, weight-neutral health MUST be considered a viable option that is offered and weight loss should not be prescribed for health issues for which a thin person with the same presentation/symptoms/diagnosis would be offered something different.
I’m glad that Dr. Kraut survived this egregious treatment and I’m reminded that others don’t. Ellen Maud Bennett sought care for literally years, telling doctors that she felt unwell and being offered nothing but weight loss. When they found the cancer, Bennett had just days to live. Her blood is on the hands of every single doctor she saw. She used her own obituary to speak out against fat shaming saying:
“A final message Ellen wanted to share was about the fat shaming she endured from the medical profession. Over the past few years of feeling unwell she sought out medical intervention and no one offered any support or suggestions beyond weight loss. 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.”
None of of can fix this situation on our own, but we can all look for places where we have power, privilege, and leverage to speak out and create support for ourselves, and for others whose healthcare and health are being compromised by the current weight-centric paradigm.
We shouldn’t have to fight for healthcare, but that’s the current reality. Higher-weight people deserve far, far better than a healthcare system that has been (purposefully and well-intended-but-misguidedly) designed to put weight loss industry profit over higher-weight people’s health.
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More research
The Research Post
More resources
The Resource Post
*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’
These stories are so heartbreaking and so important. Thank you for talking about them.
I think about this a lot. There’s also 20-year-old Allison Fisher with a 104-pound ovarian tumor, because doctors. (How many more of these stories will we hear now that we are obsessed with kids’ fatness?) and Elly Mayday the model who was told she just needed to lose weight and strengthen her core to fix an ovarian tumor doctors couldn’t be bothered to identify.
There’s just so many stories like this, and it’s so frustrating.
I was diagnosed with celiac in my 30’s. I probably had it my whole life starting around age 2, based on my childhood symptoms, but no one considers a fat child might have celiac. Untreated celiac and refractory celiac (where even a gluten-free diet doesn’t prevent intestinal damage) can lead to intestinal lymphoma. I thought I was in the clear once I figured out I had celiac (doctors get no credit for the diagnosis because they actually refused to test me the first two times I requested testing, delaying my diagnosis by years), but I’m still struggling with symptoms despite being militantly gf, and I learned in the past year that I have refractory celiac. I am 100% convinced it wouldn’t have been this bad if I’d been diagnosed sooner. I think even 5 years sooner could’ve made all the difference.
Wow, that is awful. I hope he gets justice and goes on to live a long life.