Tag Archives: health care

Why I am NOT Shopping at CVS

Employees of “Gattica” surrender a drop of blood for analysis before starting work each day.

There’s been an awful lot of talk lately about CVS and their recent decisions regarding health care for their workers. It seems that CVS has implemented a policy that states that employees have a choice between submitting to a health screening or paying $600 more per year in health insurance premiums. The screening (paid for by CVS) will measure several “health metrics” including blood pressure, blood glucose levels, cholesterol, height, weight and BMI. Apparently this information will then be turned over to a third party. What we don’t know is what the third party plans to do with this information and how the third party and/or CVS will use this information to help their employees be any healthier. I submit that helping employees be healthier really has nothing to do with it.

Look, if you want to give your employees incentives to see their doctors twice a year–fine. Regular checkups with your doctor make sense. They help employees manage health and catch problems early. But I can think of no reason why handing this information over to anyone other than your own doctor will do anything to improve your health. Not one.

The only reason to hand this information over is so that a company–be it CVS or a mysterious “third party company” can start harassing you for being in a “higher risk” category. That harassment may come in the form of emails or phone calls. That harassment may come in the form of additional payments you need to make as long as you stay in a “higher risk” category. And believe me, the quotation marks are deliberate when I say “higher risk” category.

Every single one of these metrics has a strong, and I mean STRONG genetic component. They are not measures of behavior or lifestyle. They are statistics about bodies. Lifestyle may be a component of having diabetes in some people. Some people are simply born with a very high disposition to diabetes. So you may have two people, one diabetic and one not who engage in extremely similar lifestyles with very different outcomes. The same is true of cholesterol levels and blood pressure. So how is this not a Gattica style punishment of people who were born with less than perfect genes? How much longer before, like in the movie, we will be forced to leave a drop of blood in the scanner before starting work every morning?

And then there’s the question of collecting height, weight and BMI data. Despite the overwhelming evidence that BMI, height and weight do not serve as accurate measures of personal health, we are still collecting this data. Why? I’ll tell you why. Because fat people are discriminated against in this country. Fat people are blamed for everything in the US from rising health care costs to rising prices on airlines. If you have to look to a socially acceptable scapegoat on which to visit higher health insurance prices, you will choose the fatties. Don’t believe me? Just check out the comments section of any news story covering this decision by CVS. They are universally full of righteous thin people talking about how those fatties are driving everybody’s costs up and deserve to be punished “for their own good”.

Some argue that insurance companies already charge smokers more money. But let me be very clear about this. Smoking is a behavior. You can choose to smoke or not to smoke. You don’t need to smoke to survive. Weight and BMI are characteristics. You CAN NOT determine what a person eats, how much they exercise or how healthy they are by looking at their BMI. All you know is the proportion of their height to their weight, and the proportion of extra costs and stigma it is socially acceptable to heap upon that person.

Other risk behaviors are notoriously expensive and difficult to monitor. Behaviors like drinking, not sleeping enough, distracted driving, uncontrolled stress, not looking before you cross the street and skydiving cannot be measured with a 10 second test in a doctor’s office.

So to reiterate, why are we using weight and BMI to measure a persons health risk rather than behaviors?

1. Unless you actually watch a person or test a person all the time, it is difficult to know whether they are telling you the truth about stated behaviors.

2. BMI and weight, while poor proxies for real data about health require only extremely easy and inexpensive tests to determine.

3. It is socially acceptable in our country to blame fat people for anything and everything.

This is why I will no longer shop at CVS. They have chosen to pass insurance costs on to those who may or may not engage in higher risk behavior than their co-workers but are probably less genetically blessed than their co-workers. And they are already passing health care costs on to those of us who are already discriminated against when seeking a job and are already payed less than those of us who are thin. It’s not okay with me.

Love,

The Fat Chick

Teenage Boy “Diagnosed Fat”–Infection Missed

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How many times have we heard this same story? A vibrant, active young man goes to the doctor, in this case, with knee pain. The doctor does a routine test and doesn’t see a problem. The doctor does see a young man who fits into an “undesirable” segment of the BMI chart. The solution, the young man is diagnosed as fat, is told that his “extra weight” is probably causing the pain in his knee and sent home. Now Kaleb is an active kid. He plays rugby, and he loves to sail. But once the doctor sees Kaleb’s place on the BMI scale, he just might think something like this: “Aha! I don’t have to say that I don’t know what’s wrong with this kid’s knee. I can write obesity in the kid’s chart and then we have a diagnosis!”

Unfortunately, in Kaleb’s case there was another diagnosis besides “fat” to be found. A short while later, he was taken to the hospital via ambulance after he fell down some steps. At that point, he was referred to a specialist that he saw two weeks later. The specialist ordered an MRI and during the scan they found a serious bone infection. Kaleb was scheduled for emergency surgery the same night. He is recovering well. So thankfully, the story has a happy ending.

But how much pain could have been avoided without the “fat diagnosis”? It appears that had this infection been detected earlier, it could have been treated with antibiotics rather than emergency surgery. Now there’s no guarantee that had Kaleb been thin, they would have found the infection sooner. They might have still sent him home and told him to take some aspirin and take it easy. Thin people are misdiagnosed too. But I’ve heard time and time again about people who are “diagnosed fat” and sent home. Remember this guy who was diagnosed fat, and it turned out to be a brain tumor? Remember his emergency surgery? I wonder if doctors, frustrated by a lack of diagnosis and discouraged from ordering expensive tests don’t lean on the BMI chart as a way to have something to write in their diagnosis box. I imagine in many cases, once patients are “diagnosed fat” and are shamed and blamed, they stop asking annoying questions. They stop demanding that doctors figure out what is wrong with them. In some cases, they stop going to the doctor altogether. This is part of the collateral damage and opportunity costs in the “war on obesity”. This is another example of the casualties that arise from singling out a body type as unacceptable and trying to eradicate it.

And we’re not just dealing with misdiagnosis here. We’re dealing with fat people suffering and dying from the mutilation of otherwise healthy tissue via gastric bypass and banding surgeries. We are seeing the development of more and more new strategies for trying to make fat people “healthy” by making their digestive systems mimic eating disorders and limited blood flow to the gut. We are so focused on helping fat people get healthy by making them thin that we are willing to make them really, really sick to help them get there. And sadly, in so many cases, the fat people who undergo these treatments end up fatter or sicker or less happy than they were in the first place.

There are weapons we can use in this war. One of them is to ask the doctor if thin people also experience the same problem. In Kaleb’s case, he or his mom might have asked, “Do thin people also have knee pain? What tests might you do if I were thin. Can we do those tests please?”

Another weapon is to help make doctors and other medical professionals more aware of the pain and repercussions of fat bias. And it just so happens that we have some terrific tools to do that. The Association for Size Diversity And Health (ASDAH) along with the Size Diversity Task Force are compiling videos about fat bias in healthcare. The project is called RESOLVED. Some folks at ASDAH have informed me that the deadlines are being extended. You can hear more about the project and see my sample video HERE. In addition, the Size Diversity Task Force has a unique opportunity through one of our members to help train medical advocates about fat bias in healthcare. But in order for your video to be used in both places, you need to submit your video by March 18. If you’re interested in participating in the project and/or have any questions or concerns, please leave me a note in the comments below. Or send me an email at jeanette at thefatchick dot com. I’d be glad to help.

Let’s do what we can to limit the number of casualties in the war on fat. Let’s help kids like Kaleb get the attention and care they need at the first doctor’s appointment–not the third. Let’s see what we can do to have “diagnosed as fat” be a thing of the past!

Love,

The Fat Chick

Right Now Show–Episode 003: Healthcare and YOU

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In episode 003 of the Right Now show, we explore the new initiative by the Association for Size Diversity And Health (ASDAH) called RESOLVED: addressing weight bias in health care. Jeanette DePatie (AKA The Fat Chick) shares some stories about her journey in healthcare and shares details about the RESOLVED project with the viewers.

For more information about the RESOLVED project, go to the ASDAH website. And to read another story about a truly frightening misdiagnosis of a fat person, click on THIS LINK.

And finally, if you’re enjoying the show, don’t forget to subscribe at: http://www.youtube.com/jeanettedepatie.

Thanks so much!

Love,
Jeanette
AKA The Fat Chick
http://www.thefatchick.com

P.S. This marks my 365th blog post! (One whole YEAR of blog posts=YAY!)

Don’t forget to enter your miles in the Fit Fatties Across America page on the Fit Fatties Forum. Let’s see if we can get out of Colorado and a little further down the road!

And if you’d like more information about how to pick a doctor that’s right for you, there’s a whole CHAPTER on that subject in my book The Fat Chick Works Out! You can buy a hard copy or an e-book, whichever you like!