Why Health At Every Size? (Warning: weight discrimination and death mentioned)

I feel like it is important to explain why I am so passionate about the Health At Every Size (HAES) approach for my patients. Why someone who has had thin privilege their entire life is focusing so much attention on health equity for larger bodied patients in particular?

This is a personal issue to me as I have witnessed first hand the way the health concerns of larger bodied people can be dismissed or even outright neglected when misinformation and assumptions about certain bodies (fat shaming in this case) interfere with quality care.

My dad was most likely a victim of substandard interventions due to his weight. He died suddenly in my last year of acupuncture school. I was deeply immersed in my studies and my dad was many states away, so many of the details are lost to me. But here’s what I do remember and know.

Earlier the previous year he had suffered from pancreatitis. During that hospitalization he had complications with medications that were dismissed by a provider. He was having what were clearly listed as negative side effects and possibly severe reactions to one of his medications in particular. The provider dismissed our concerns outright.

During subsequent followup visits, a heart condition was discovered. My dad was told to lose weight before any surgery to address the heart condition. Over the next 7 months, my dad lost weight. A significant amount of weight. Everyone praised this weight and no one discussed the permanent damage that rapid weight loss can have to already compromised cardiac tissue. No one addressed his sleep apnea beyond weight loss suggestions as far as I know.

Months after losing the weight, my dad fell in the middle of the night, most likely due to a cardiac event. He unfortunately hit his head when falling and broke cervical vertebrae that led to complete paralysis. He also most certainly suffered brain damage while lying paralyzed after the fall waiting for medical assistance as they lived in a pretty rural area and he was trapped alone in a room against the door. His heart was never strong enough at that point for him to be taken off life support to confirm any of that, to perform additional tests that required removal of some support or to talk to us if he could. Less than a week after the accident we took him off life support and allowed him to pass.

There’s so much more I could say, so many feelings that I could describe. But I will always wonder, now that I know what I know about the stress of weight loss on the body, especially the heart, if he would still be alive today if he had not lost the weight and if he had been given the heart surgery. I also have mixed feelings about how quickly end of life support was suggested and encouraged despite no living will.

Aside from the countless friends I have that are larger bodied, this is my main motivation to be involved in the HAES community, to advocate for improved patient care, and to follow a Body Trust informed model of care.