“We have to stop the kinders”… medical fatphobia, or when violence replaces kindness

“We experience comments almost everywhere. But I think it’s in the medical field where it’s worst. » After becoming overweight, Elizabeth lost track of the number of derogatory comments or humiliating situations she experienced in the medical office. “In fact, we give you a systematic idea of ​​your weight,” explains the president of the “Weight, Shapes, Well-Being” association in Tours. I have already lost 20 kg, and it is still not enough! If I have trouble getting on the exam table, it’s always my fault… The problem is that obesity is not considered a disease, but a defect. When we go to the doctor, we expect kindness, not such violence. »

While this Monday, March 4, is World Obesity Day, many patients like Elizabeth denounce the fatphobia from which they are – and this is a paradox – suffering in the medical environment. A phenomenon that some health professionals have recognized and are trying to combat. “First there is systemic stigma, such as inappropriate equipment, for example blood pressure cuffs that are too small,” explained Rudy Caillet, nutritionist at the Colmar Civil Hospital, during the scientific days of the French Association for Study and Research on Obesity last month ( Afero). But even the world of health cannot escape the overt, or unconscious, stigma caused by an overly simplistic view of the link between diet and body size. »

Depreciation, crime…

In recent years, many studies have focused on this distinction. Similar to the general medicine thesis defended in 2022 by Aurore Le Merle and Raphael Peure which showed that 87% of respondents had experienced a state of grossophobia during a medical or paramedical consultation. It mainly concerns “paternal-type behavior with moral attitudes, but also the devaluation associated with guilt,” notes the study, which reports some comments: “During the MRI, the radio technician laughed that “he’s not coming back or he’s going. .” to get stuck”; “We should stop eating Kinder and start exercising again, my little lady.”

Sometimes the comments are beyond understanding. In the Afero scientific days, it was reported that a radiologist, for example, advised a woman to go to veterinary school to take her exam. Another patient with osteoarthritis was told that “prostheses for mammoths do not exist”. “A gynecologist told one of our members that in Auschwitz, there was no such thing as a weight problem,” says Elisabeth, who conducted a study on medical fatphobia with her organization. As a result, it has been more than twenty years since this woman visited a doctor. »

Avoid the medical profession

If some doctors imagine that this will cause electroshock in their patients, it is a failure. “You should avoid words like “motivate yourself”, “I already told you what to do”, advises Vanessa Follop, endocrinologist and nutritionist at Rouen University Hospital. Because this sends patients back to their fear, the belief that their worth is based on their body size, and they will isolate themselves, avoiding the medical profession. It is a vicious circle. » For this doctor, it is above all necessary to raise awareness among the staff about the care of these patients, especially those in the so-called morbidly obese situation.

“I bought 200kg suits so the carers could already experience the physical but also the mental challenges and I trained,” explains Vanessa Folop. During the evaluation, 87% of respondents indicated that they had changed professional practice. » Workshops are also organized to change the mindset of medical students, especially in Toulouse. “This old paradigm that says “I eat less, I move more, and everything is fine” must evolve, hopes Rudy Kellett. And wonder if stigma is not the first complication of obesity.”