The Fat Tax in Medicine

People with obesity are accustomed to paying a “fat tax” at clothing stores, and when buying tickets for air travel, and in other ways both tangible and intangible. One type of fat tax is extracted by some medical professionals who have an attitude, or perhaps just honestly believe that being fat is 100% a person’s own fault, and anyone so irresponsible deserves whatever comes their way, be it disrespect, neglect, or even negligence.

This anecdote is one of many that illustrate the effects of the stigma that can affect a large-bodied person who seeks medical help:

Patty Nece told NPR affiliate WBUR that […] oftentimes clinicians attribute her pain to her weight rather than examining further causes. Upon becoming emotional in a doctor’s office about hip pain, she was once told “See, you’re even crying because of your weight,” by the physician, she recounted.

However, another medical professional later found that her pain was being caused by a severe curve in her spine, not her weight, according to WBUR.

This is from the text intro to a 34-minute podcast where experts and patients speak. An informant named Deana began to doubt her ability “to even be seen fully as a human being, let alone as a patient.” She told the interviewer:

I am an obese person. I am also a professional dancer. I avoided the doctor for eight years because of consistent dismissiveness. I went to a chiropractor for a dance injury and was met with doubt that the injury was in fact dance-related — and it happened because I did a drop split.

Regarding her book, You Just Need to Lose Weight and 19 Other Myths About Fat People, Aubrey Gordon was interviewed by Stephanie Sy for PBS. She reports that for office visits, fat patients are allotted less time than those who weigh less. Their acute problems are more likely to be misdiagnosed. They may go to a healthcare provider with a chronic or terminal illness, and be told to come back after they have lost weight. Gordon says,

Many patients end up postponing care, many patients end up avoiding contacting health care providers and many patients have worse health outcomes as a result.

We will say more about person-first language, which has been an important topic in the decade since the American Medical Association deemed obesity to be a disease, “in contravention to the recommendations of their own scientific committee.” Because nothing is easy, that decision has been shown to have both pros and cons. But, says a paper titled “What’s in a Word? On Weight Stigma and Terminology,” which deserves a more thorough reading,

[T]he result has not been that heavier people are treated more respectfully, or viewed by the medical profession in their complete personhood. Rather, anti-fat attitudes remain high among health professionals and specialists in the field.

Your responses and feedback are welcome!

Source: “Medical schools need to improve obesity training, physicians say,” 02/01/23
Source: “Medical Bias Against Obesity Is Preventing Patients From Receiving Proper Care,”, 06/23/22
Source: “Bestselling author dismantles myths about fatness in latest book,” PBS NewsHour on YouTube, undated
Source: “What’s in a Word? On Weight Stigma and Terminology,”, 10/05/15
Image by Dennis Sylvester Hurd/Public Domain

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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