Systemic Weight Bias Means Not Considering Systemic Weight Bias As A Factor In Disease Outcomes For Patients With Obesity
It's something that must be considered in any study on the impact of obesity on any disease's course or outcomes
A few months ago I bookmarked, The effects of obesity and metabolic abnormalities on severe COVID-19-related outcomes after vaccination: A population-based study. My hunch was that there would be no discussion about the possibility that disparity in COVID-19 related outcomes between people with obesity and people without is the systemic healthcare bias faced by people with obesity.
But I still held out hope that with years of time and reflection, perhaps this very plausible confounder would start to at least be mentioned when discussing COVID and obesity.
No such luck. Not a word.
While I’ve been interviewed about this possibility in the past, and recorded a podcast on same with On The Media, briefly, the two primary means weight bias may impact patients with obesity are:
Patients with obesity seeking care later in the disease course consequent to their distrust of a healthcare system in which they’ve faced discrimination in the past.
Patients with obesity being treated differently by the healthcare system in terms of the timing or the even the offer of therapeutics, admission, or in hospital management.
And again, as I point out in the aforementioned interviews, there’s actual precedent for weight bias and its impact on care possibly being a major player here in that during the 2009 and 2011 H1N1 pandemic years people with obesity were found to have far worse outcomes. Yet that finding disappeared once researchers controlled for the timing of the provision of early anti-virals whereby people with obesity received them less frequently.
And of course the impact of systemic weight bias on disease outcomes in patients with obesity is not likely solely relegated to respiratory viruses. We know weight bias is rampant in society, and that society includes healthcare, and we know that bias influences care.
Consequently it strikes me as something worthy of consideration in any study looking the relationship between weight and disease severity, and that it’s not an automatic consideration is yet another example of systemic weight bias.
For those interested, here’s a brief talk I gave on all of the above in 2021 at Obesity Canada’s biannual conference
Have a great weekend!