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Millions Of Americans Qualify For The COVID-19 Vaccine Based On BMI. Why Should We Apologize For It?

When I reach out to Dr. Fatima Cody Stanford, a leading obesity expert at Harvard Medical School and Massachusetts General Hospital, one of the first things she does is gently correct my use of the term “obese person,” redirecting me to the more neutral term “person with obesity” instead (and demonstrating, in the process, that fat people are very capable of playing into the culture of fatphobia). “When we call a person obese, it doesn’t take into account that there is an actual disease process controlled and regulated by the hypothalamus in the brain that causes each of us to regulate our weight differently,” explains Dr. Stanford, adding, “When people look at patients that have obesity—whether it’s mild, moderate, or severe—they presume, ‘Oh, it’s something they did to themselves, and they got this way because of something they did.’ We don’t put that same thought processing or blame on individuals who have cancer.”

Stanford agrees that doctors, in general, are one of the “worst groups” in terms of perpetuating fatphobia, but she’s determined to set a different standard of care for her patients. She takes care to place obesity within its greater socio-cultural context, noting that racial minorities are more likely to have obesity in addition to already being at greater risk for contracting COVID-19. “When patients with obesity come to me and ask if they should get the vaccine, I give them a statement that is an unequivocal yes, because data shows that COVID-19 outcomes are significantly worse for patients that have obesity. I want my patients to be protected, so I’m going to give them whatever advice I can to make sure that they are best protected against this virulent disease that has affected all of our lives,” says Stanford.

While medical bias is a risk factor for many—if not most—fat people, our own internalized fatphobia and self-judgment can be just as psychologically damaging. “At first, I thought [my BMI qualifying me for the vaccine] was ironic, because I may not have qualified had I not gained the weight I have during the pandemic,” says Catherine, 24, who will soon be receiving her first dose of the vaccine in Brooklyn: “I’m already dreading some of the things people may say or think about me getting the vaccine, not only because I’ve gained weight but also because I’m unemployed. It’s really hard not to feel like being both fat and unemployed means I’m worthless or lazy.” Catherine is glad to be receiving the vaccine based on BMI, but she’s cognizant of the dissonance that a deeply diet-culture-addled society has inculcated in her, too: “It feels weird that I am ostensibly being rewarded for failing.”

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