Last month, the story of Ellen Maud Bennett gripped the media. Ellen included a message for the world in her obituary, which was published after she passed away from cancer. In it, she chided some of her healthcare practitioners for ignoring her health issues beyond recommending weight loss, and lashed out at what she called a fat-shaming society. Obesity Canada patient advocates penned a response to this tragedy to raise awareness and spark discussion with policy makers. It read:
We are writing you on behalf of Obesity Canada to address a critical issue. Based on population surveillance studies, as many as 5 million Canadians are living with obesity and every day many of these individuals are treated differently simply based on the size of their body. The reduction of weight bias and discrimination is our key mission and tragically is a topic that has generated a great deal of attention the last few weeks across our country.
I am sure you are aware of the tragic story of Ellen Maud Bennett of Victoria who passed away May 11 – just days after being diagnosed with cancer. What has brought Ellen’s story to the spotlight and gained so much attention this week is that she experienced unforgivable weight bias that prevented her from receiving the diagnosis and care she desperately needed – simply because of the size of her body. Our Canadian healthcare system ignored or dismissed her years of complaints of feeling unwell and discomfort, simply brushing her off as needing to lose some weight. Doctors failed to properly investigate, did not take Ellen seriously, and could not see past Ellen’s weight. We failed Ellen.
Sadly, the bias and discrimination that Ellen faced is not uncommon, in fact it is the norm.1-3 All of us individuals living with obesity experience this discrimination on a daily basis. Doctors spend significantly less time with us than those not living in large bodies, they dismiss our concerns and frequently attribute every ailment we experience to our weight, from a sore shoulder to tumors growing unchecked in our bodies. Weight bias is prevalent in Canada and disproportionately affects women.
Physicians have the ethical obligation to operate evidence-based practice, that is for everything except an individual’s weight. Far too many Canadians walk into an examination room seeking help only to be provided the unethical and factually incorrect advice of simply eating less and moving more. Weight bias in healthcare is well documented and negatively impacts quality of care and patient outcomes.4 Our health is not something to barter with – we deserve respect and due diligence now not once we have earned the right to care with an arbitrary number of pounds lost.
Obesity, like most non-communicable chronic diseases, such as hypertension and diabetes, can be positively influenced with interdisciplinary interventions, yet it is the only disease that we moralize as the responsibility of the patient to fix entirely on their own. This systemic ignorance, blinds doctors from fully investigating symptoms and cost Ellen her life. And she is not the only one.
As the country’s authority on obesity treatment and management as well as a driving force in the reduction of weight bias and discrimination, we would like for you to consider including Obesity Canada as advisors in your efforts to address this important issue; an issue that warrants your time and attention.
Ian Patton, PhD, RKin, Public Engagement Coordinator,
Lisa Shaffer, Patient Advocate,
Candace Vilhan, Patient Advocate,
Forhan M, Ramos Salas X. Inequities in Healthcare: A Review of Bias and Discrimination in Obesity Treatment. Canadian Journal of Diabetes. 2013;37(3):205-209.
Phelan SM, Burgess DJ, Yeazel MW, Hellerstedt WL, Griffin JM, Ryn M. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obesity reviews. 2015(4).
Nutter S, Russell-Mayhew S, Alberga AS, et al. Positioning of Weight Bias: Moving towards Social Justice. Journal of Obesity. 2016:1-10.
Puhl RM, Heuer CA. The Stigma of Obesity: A Review and Update. Obesity (19307381). 2009;17(5):941-964.