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Source: Massey University

Dr Cat Pausé.

A research paper co-written by a Massey academic takes a critical look at a public health narrative she says links fatness to risk factors for COVID-19, despite little evidence for this.

Senior lecturer at the Institute of Education and fat studies scholar Dr Cat Pausé co-wrote the paper: Resisting the problematisation of fatness in COVID-19: In pursuit of health justice, with George Parker of Otago Polytechnic and Lesley Gray of the University of Otago, which was recently published in the International Journal of Disaster Risk Reduction.

The authors say the paper is the first of its kind to; “analyse the problematisation of fatness in COVID-19, highlighting that lessons can be learned about health justice in disasters from the work of fat activists during this COVID-19 pandemic.”

Dr Pausé says the researchers wanted to highlight how fat people were being scapegoated when it comes to the COVID-19 pandemic. “It was important to us to highlight that fat people are being thrown under the bus yet again with the rhetoric and planning around COVID-19.”

“We know from the literature how fat people are often completely left out when making plans for natural hazards and disasters, and we see that implemented when they are left behind in real situations such as Hurricane Katrina. People chose not to evacuate fat people – and because they didn’t plan to evacuate them and didn’t have the right equipment, in the panic and urgency fat people are simply left behind to die.

“Unfortunately, we know that happens for fat people just as it happens for people with physical disabilities. We wanted to take the opportunity to highlight that public health officials are throwing around fatness as a risk factor/death sentence for COVID with very little evidence,” she says. 

Their research draws on reports from journalists informed by an array of non-peer reviewed scientific literature documenting the relationship between fatness and COVID-19.

The paper states that linking fatness to COVID-19 risk in a pandemic has diverted responsibility for preparedness and well-being away from health systems and governments and “onto the back of fat people and communities.”

“This is unjust and unethical. In juxtaposition, fat activists around the world have challenged the problematisation of fatness and its effects, finding ways for fat people to subvert fat phobic institutions in the midst of the COVID-19 pandemic by collectively organising to support one another.”

The researchers cite the example of the H1N1 virus, which was claimed to have a higher risk and death rate among fat people. “The link between fat people being more likely to die from H1N1 turned out to have nothing to do with the physiology of fat people, but rather the attitudes of healthcare providers who were less likely to provide timely care for fat people. That is why fat people had higher mortality rates.”

Sounding a warning

Dr Pausé says they wanted to show how the same story is playing out with COVID-19, and share their concern with a warning. “There are care and triage plans that include fat people as those who won’t receive care when places have to start rationing care. Healthcare providers are having to engage in triaging and care rationing because they are simply overwhelmed.”

She suggests the “obesity epidemic” framework is the reason fatness has been linked to a higher COVID-19 risk, despite little evidence. “Fatness is always brought out as the bogeyman regardless of the issue, so I wasn’t surprised when early into the discussions about COVID-19 they were positioning fatness as a risk factor for getting it and a contributing factor for higher mortality.”

“Early research might find a relationship between body size and how well someone does if they have COVID, but instead of then digging in further to understand why, because it fits in with what everyone knows (fatness is “unhealthy”/fatness is “bad for you”) then they’re very comfortable to report ‘fat people are more likely to get COVID-19/fat people are more likely to die from COVID-19’. The obesity epidemic framework also allows governments to shift responsibility for the health and well-being of their fat citizens onto fat people themselves, even during the time of a global pandemic such as COVID-19.”

Dr Pausé says they want to amplify the work that fat activists have done around the world, such as coming together to establish mutual aid organisations, putting together handouts and documents on how to advocate for yourself as a fat person with COVID-19, or information if you’re a fat person worried about COVID-19.

She says the fat activist community has come together to fill the gaps that the public health spaces leave. “While public health leaves fat people behind, fat activists work together to ensure that even the fattest of us have access to health and safety during times of global pandemics.”

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