After around three months of quarantining, states are beginning to re-open, and many people are concerned about the possibility of a second wave of coronavirus. This fear is especially strong amongst those with underlying conditions. After all, the virus is hardest on people with compromised immune systems.
But the plus-size community is not only left terrified by news of increasing numbers of Covid-19 cases; it’s also being shamed by these reports.
In late April, Alison Schwartz, former digital director of People magazine, lost her life to coronavirus. She was 29 years old. But the touching obituary that People posted online became a vehicle for fatphobic trolls. Schwartz was belittled for her size, and effectively blamed for her own demise.
This type of response is not new, but that doesn’t make it any less painful. For decades, people who are fat (a word that’s been reclaimed by body positivity activists as a neutral descriptor, rather than a derogatory slur) have been told by medical professionals, by the media, and by trolls on the internet and in real life that their size will lead to their untimely death — and that ultimately, it will be their own fault for dying.
For Sydney Holmes, a plus-size comedian from New York City, the backlash surrounding Schwartz’s tragic death hit close to home. Around six months before, Holmes lost her father to a heart attack. Since then, she’s struggled to cope, spiraling with thoughts of whether her weight would cause her to die from a similar illness.
“With the fat-shaming online [around COVID-19], it feels like people are rejoicing in the death of people in a way that makes me really uncomfortable and really sad,” Holmes tells Refinery29. “It’s a major anxiety of mine… because people immediately jumped to: If you're fat, you're going to die of COVID.” Seeing the reaction to Schwartz’s death only intensified Holmes’s fear.
Carlie Pendleton, a London-based writer, feels similarly. “I was waiting for the ‘obesity epidemic’ rhetoric to be used to treat fat people who have died of COVID with less humanity,” she tells Refinery29. “When fat people die, regardless of the cause, there's always a comment along the lines of, ‘This is sad, but also, they were fat, and they brought it on themselves.’”
She adds, “This insidious move of taking responsibility away from governments and putting it onto individuals [is ridiculous]. To say that your health is solely a matter of your own choice and your own personal responsibility, and therefore if you become ill or if you die, it's your fault [doesn’t make sense].”
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The Centers for Disease Control and Prevention currently views weight as a risk factor for coronavirus, stating that “severe obesity... puts people at higher risk for complications from Covid-19.” The organization states that “obesity increases the risk of a serious breathing problem called acute respiratory distress syndrome (ARDS), which is a major complication of COVID-19 and can cause difficulties with a doctor’s ability to provide respiratory support for seriously ill patients.”
So far, there’s no concrete answer to why that might be. Carrying around more weight adds excess pressure on the diaphragm which needs to move to breathe, notes David Kass, MD, professor of medicine at John Hopkins Medical Institutions and director of the Institute of CardioScience. Fat people may already have to work harder to do this, so the added difficulty of Covid-19 attacking the lungs makes the situation much worse — especially if one winds up in the hospital, lying in bed for hours on end.
“If you take that [extra weight] and now lie flat… in bed the way all the doctors have been saying is best for this, which is to lie on your belly — we call it proning — most of the lung tissue is then pointing upward away from the ground, which makes it actually easier to move air in and get the fluid in the more dependent, smaller parts of the lung that are now face down,” Dr. Kass explains. "But if you’re pushing against your 80-, 100-pound abdomen with all that adipose tissue, that’s going to push up against your diaphragm, and it’s also going to make it hard to breathe. So, that’s the physics [aspect of this].”
Additionally, Dr. Kass says that fat cells may impact how the body reacts to SARS-CoV-2 virus. Ultimately, more research needs to be done into this area before any conclusions can be drawn.
There are some flaws in the existing studies that look at the association between weight and Covid-19 complications, WIRED reports. “None of them control for race, socioeconomic status, or quality of care,” dietitian Christy Harrison, RD, wrote in the article. She added, “They don’t control for known individual health risks that may be associated with worse outcomes for this virus, including asthma and other chronic respiratory conditions, cancer, and immunosuppressive medication use.”
This sort of back-and-forth over science isn’t surprising to most, or new. Extensive research has been done over the years on how weight impacts various aspects of the body and illness. It’s hard to find a fat person who hasn’t heard both the facts and the myths. And there’s value in knowing this information; it can serve as a reminder to take precautions when leaving your home, or be used by doctors to more effectively treat their patients.
But the way we talk about the data matters.
“Blaming and shaming does nothing to treat the patient, and only disadvantages them further,” says Kelsie Nick, a nurse and plus-size blogger in California. When it comes to Covid-19, belittling fat people who have died reduces their entire lives — their accomplishments, their milestones, their personalities — down to a number on a scale. It places blame on them for something that is, in truth, largely out of their own control.
This message — that a fat person will likely be responsible for their own death — has long been used against the plus-size community in a flawed attempt to shame them into losing weight. But no one should be forced into changing their body.
In fact, fixating on weight may be especially harmful right now, says Shira Rose, an eating disorder psychotherapist in New York. Many people are opening up about how the coronavirus has spurred eating disorder-related thoughts to enter their minds. “[Eating-disordered patients are] coming to me with so much terror and fear. It's hard enough to face the fear of possibly getting COVID,” she says, “and on top of that to face the fear of knowing that people will judge you as if it's your fault or you asked for it.”
Rose adds, “It’s not like thin people are not getting COVID and dying from it every single day. Everyone that I know actually that was impacted and in the ICU are thin. But somehow, when it’s a fat person, they are at fault and they’re causing it.”
This intense fat-shaming may also stem from a desire to play the blame game in a time when governmental officials refuse to acknowledge their faults in the handling of the coronavirus, says Jessi Gold, assistant professor in the Department of Psychiatry at Washington University. “It’s easier to point fingers and say someone caused something, as opposed to just saying it’s a natural thing that happens because viruses exist,” she tells Refinery29.
The Black community is being especially affected by the damaging conversations around weight and coronavirus. Black adults are 2.3 times more likely to die from Covid-19 than their white peers; up to six times more likely in certain states, according to June 9 data from AMP Research Lab. When officials are asked why this is, one reason given is that Black people have higher rates of obesity. This explanation is frustrating, racist, and just plain incorrect.
“The cultural narrative that Black people’s weight is a harbinger of disease and death has long served as a dangerous distraction from the real sources of inequality, and it’s happening again,” wrote Sabrina Strings, PhD, associate professor of sociology at the University of California, in a May 25 op-ed in The New York Times. “According to the Centers for Disease Control and Prevention, 42.2 percent of white Americans and 49.6 percent of African-Americans are obese. Researchers have yet to clarify how a 7 percentage-point disparity in obesity prevalence translates to [this much higher] disparity in fatalities.”
In a previous article she wrote for Refinery29, infectious disease epidemiologist Gabrielle Perry points out that Black people “make up a disproportionate amount of American essential workers, are the most likely to use public transit, and are the most likely to suffer from comorbidities while having less access to healthcare,” all of which may contribute to the racial disparity in Covid-19 deaths. She cites studies that show that white physicians treat Black patients differently than white ones: They run fewer tests, give them less attention, think of them as more passive. So why the insistence that any single factor — such as a person’s weight — is to blame? As Perry wrote, “Medical racism kills you and blames you for your own demise.”
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“I think that in many ways, [the pandemic] is revealing the cracks in a lot of our systems,” Gold says. “As a healthcare provider, this shows a lot of the problems with healthcare. As a mental health provider, this shows a lot of the problems with mental health. As a person who’s aware of health disparities, this is very much highlighting them. We still have a ways to go.”
Oftentimes, through the media and the few fat-centered films we see each year, we’re led to believe that the body positivity movement has made much more progress than it actually has. But the way fat people have been treated during the pandemic exposes that at the end of the day, those marginalized because of their size will still be blamed and ridiculed to their graves, all because they couldn’t slim into the thin ideal. It’s crucial to dismantle this type of fatphobia going forward, as ignoring it allows the issue at hand to continue in harming the lives of many.
Many studies conducted prior to the spread of Covid-19 show that plus-size people often have a distrust in doctors, largely because of how entrenched the medical industry is in fatphobia. Many fat people avoid going to the doctors altogether, even when faced with a serious concern, out of fear that they’ll be attacked or, on the flip side, casually brushed off and told to “lose weight,” as if that will solve their ailments.
While they may be able to miss out on their yearly checkup, few can escape the fat-shaming that routinely happens on the internet, now more than ever. In today’s social media landscape, existing as a fat person online seems to serve as reason enough for trolls to attack and belittle you every chance they get. And Covid-19 was an opportunity they fully jumped on.
Weight and health are both multifactorial issues. Many contributing factors are out of individuals’ control. Poverty, lack of resources, unemployment, and systemic fatphobia all contribute to what many medical professionals deem the “obesity epidemic.” To blame someone’s death solely on their weight strips them of their humanity. In a time when a majority of the population is scared, it’s essential to fight back against fatphobia and fat-shaming, and to remind society that regardless of weight, each human is deserving of proper healthcare, proper treatment, and respect — in life and in death.