Patients who are overweight often experience some form of “fat shaming” from healthcare providers. Even when a patient is otherwise healthy, their doctors may focus on the patient’s weight instead of addressing the patient’s actual concerns. Unfortunately for larger patients, obese patients can also be more likely to be misdiagnosed with medical conditions they don’t have, or by doctors failing to notice more serious health concerns.
Doctors are supposed to have the education, training, and experience to properly diagnose and treat patients. When doctors go outside the standard of practice by focusing on only one aspect of a patient, they can miss more important signs and symptoms of dangerous medical conditions. If you were misdiagnosed by a doctor because of your weight, your doctor could have committed medical malpractice. If you want to know more about filing a medical malpractice lawsuit, contact an experienced medical malpractice law firm to get more information.
What Is Weight Bias in Medicine?
Weight bias is associated with negative attitudes, stereotypes, and judgments based on an individual’s weight. Weight bias in medicine can negatively impact healthcare. Medical professionals are supposed to approach patient care without preconceived ideas, judgments, or stereotypes. However, healthcare workers can bring the same types of stigma to overweight patients.
According to a study published in Obesity Reviews, “many healthcare providers hold strong negative attitudes and stereotypes about people with obesity.” As a consequence of these attitudes, “stigma can reduce the quality of care for patients with obesity despite the best intentions of healthcare providers to provide high-quality care.”
According to the University of Illinois Chicago School of Public Health, it is important for healthcare providers to decouple height and weight in public health. A study looking at health and BMI found that nearly half of overweight individuals were “metabolically healthy.” Meanwhile, about 30% of normal weight individuals were considered “metabolically unhealthy.”
Weight bias can even impact the basis for the patient’s obesity. Many obese patients are prescribed simply reducing calories and increasing exercise. Eating less and moving more can be beneficial for many patients but it is not the cause of obesity in all patients. Other causes of weight problems can be endocrine disorders that may not be diagnosed because a doctor focuses on the simplest explanation instead of giving the patient a full evaluation.
When Is Weight Bias Considered Medical Malpractice?
Medical malpractice is a breach of the doctor’s duty of care that causes an injury and harm. When a doctor deviates from the standards of care which causes injury and harm to the patient, the doctor may be liable for any damages. The patient can file a medical malpractice lawsuit to recover compensation for their losses, medical bills, and pain and suffering.
Weight bias could be considered medical malpractice when a doctor deviates from the standard of care by inappropriately focusing on the patient’s weight instead of taking a holistic view of the patient. Weight can be a factor in diagnosing a patient but it is not the only factor. When diagnosing a patient, doctors may look at all the patient’s signs and symptoms, complaints, medical history, family history, medications, other medical conditions, and any other relevant information.
If the doctor’s bias is a deviation from the standard of care, any injuries caused could be attributed to medical malpractice. Some examples of how weight bias can impact patient care include:
- Delayed diagnosis
- Cancer misdiagnosis
- Failure to diagnose
- Surgical errors
- Medication errors
- Anesthesia errors
- Delayed treatment
Delayed Treatment for Weight Loss
One of the most frustrating experiences for larger patients is when their surgeon wants to put off surgery until after they lose a certain amount of weight. According to Doctor Scott Kahan, as reported in an article from Today, “Doctors commonly ask patients to lose weight before knee and hip replacements as well as bariatric surgery. But weight loss isn’t required for any kind of surgery unless a person’s weight prevents them from being medically cleared; for example, if they have uncontrolled blood pressure.”
Many patients are asked to put off surgery until they lose 10, 20, or 50 pounds or more. This can be a very difficult task for most people. It can take months or longer to lose weight and some patients may never accomplish the goal set by their surgeon. As a result, treatment can be delayed for months or put off indefinitely. In many cases, the patient’s weight would not prohibit the surgeon from operating but the surgeons may still make this a requirement before surgical treatment.
Overweight patients can be misdiagnosed by their doctors, leaving their actual diagnosis untreated. After a misdiagnosis, the healthcare team can waste time and resources on providing unnecessary care. Unnecessary treatment can also put patients at risk for side effects and injury.
As an example of a medical misdiagnosis related to obesity, there are several medical symptoms that have different possible causes, including shortness of breath. Shortness of breach can be caused by a variety of conditions, including asthma, obesity, heart attack, pneumonia, pulmonary embolism, or a panic attack. If a doctor focuses unequally on the patient’s weight, they may have other possible causes for a differential diagnosis.
According to a study published in the medical journal CHEST, there is evidence of misdiagnosis of asthma in patients who were obese. There was a negative correlation with health-related quality of life which could relate to the diagnostic uncertainty of treating of obese patients with breathing difficulty.
Another study published in The Lancet for respiratory medicine looked at the prevalence of misdiagnosis for obese patients with chronic obstructive pulmonary disease (COPD). According to the study, “Researchers in the USA have noted that most overweight and obese patients with a clinical diagnosis of COPD have not had airflow obstruction confirmed on spirometry, but are often treated with inhaled drugs.”
Patients who are undiagnosed may never be able to get the care they need to recover or improve quality of life. Unfortunately for larger patients, there is a greater risk for having medical conditions that are never diagnosed. According to Science Daily, “in one study of over 300 autopsy reports, obese patients were 1.65 times more likely than others to have significant undiagnosed medical conditions (e.g., endocarditis, ischemic bowel disease or lung carcinoma), indicating misdiagnosis or inadequate access to health care.”
Finding a suspicious tumor or growth can be frightening for patients who may have to face the possibility that they have cancer. However, early detection and treatment are associated with higher rates of recovery and better overall outcomes. Obese patients may be at risk for having cancers left undetected and undiagnosed, increasing the risk that the cancer will grow, spread, and eventually lead to death.
According to U.S. News & World Report, several studies “found that 50- to 64-year-old women with obesity were less likely to have mammograms than women whose weight was normal.” Overweight women are also less likely to be screened for cervical cancer.
Anesthesia is a common part of any invasive surgical procedure. Anesthesiologists, like other doctors and surgeons, can have weight bias that impacts their ability to perform proper patient care. Bias towards obese patients can impact preoperative assessments, anesthesia induction, maintenance of the airway, and perioperative pain management.
When an anesthesiologist makes mistakes, it can have tragic consequences, including permanent brain damage, organ failure, and death. Anesthesia errors can include administering too much or not enough medication, failure to properly monitor the patient under anesthesia, or delayed treatment of complications, including cardiac arrest and lack of oxygen.
Obesity can be observed visually and for some patients, the first thing their doctor sees is weight before looking at anything else. This can commonly lead a doctor to focus on the weight to the exclusion of looking at other historical and diagnostic information.
In a Today article, a patient who was overweight complained to her doctors of hip pain. When the patient was sent to an orthopedic surgeon, before getting a full evaluation, the surgeon told the patient that the pain was caused by her weight and diagnosed the patient with “obesity pain.” After getting a second opinion, another doctor discovered spinal curvature caused by scoliosis as the cause of the pain. If the patient had stayed with the first doctor, the medical condition may never have been diagnosed.
Patients deserve to have a full medical evaluation based on their complaints, signs, and symptoms before a doctor jumps to conclusions. Focusing on a preconceived idea before giving the patient a full medical review can cause the doctor to miss a more serious medical condition.
The Emotional Costs of Weight Shaming
Weight shaming and weight bias can be costly to patients physically and mentally. Women who experience weight shaming by doctors and medical professionals can suffer depression, anxiety, and low self-esteem. Shamed patients may also be at higher risk for substance abuse or eating disorders. When a patient is misdiagnosed because of obesity, the patient may be able to claim damages for mental distress as part of a medical malpractice lawsuit.
Weight Bias More Likely for Female Patients
Many female patients already face difficulties in seeking medical care because doctors may not treat women the same as male patients, including failing to listen to their complaints, ignoring or speaking over what the patient says, or failing to address the needs of the female patients with the same attention as male patients. To add to this inequality, women often experience the negative effects of weight bias more than men.
The issue of weight bias in healthcare is becoming more widely known as more patients come forward with their stories of misdiagnosis and mistreatment. The American Medical Association (AMA) recently approved a resolution that is intended to reduce obesity stigma and improve obesity treatment by educating doctors.
According to the Obesity Medicine Association (OMA), “The resolution encourages physicians and health care providers to use person-first language in all discussions, resolutions and reports with regards to obesity. Person-first language places the person before the disability or disease when describing individuals affected by obesity.”
Fat Shaming Can Make Patients Less Likely to Seek Medical Care
Overweight patients may have experienced a lifetime of their doctors, nurses, and healthcare professionals shaming them for their weight. Even if the patient’s weight is not at issue for a given medical care appointment, it always seems to get brought up. Some doctors can even be condescending about a patient’s weight or make unnecessary side comments that only act to make the patient feel embarrassed or ashamed.
After years of fat shaming from people who are supposed to be medical professionals, patients may be less likely to continue to seek out care unless absolutely necessary. Inappropriate healthcare attitudes towards obese patients can harm the patient’s trust and faith in the healthcare industry. Patients may be less likely to seek out routine and preventive care. This can have the negative effect of allowing diagnosable conditions to go on without treatment until they become much more serious.
According to a 2018 study in Body Image, “women with high BMI are less likely than thinner women to seek healthcare.” “Higher BMI was related to greater experienced and internalized weight stigma, which were linked to greater body-related shame. Internalized weight stigma was also related to greater body-related guilt, which was associated with higher body-related shame. Body-related shame was associated with healthcare stress which ultimately contributed to healthcare avoidance.”
Can a Medical Malpractice Lawyer Help?
Having a medical misdiagnosis blamed on your weight does not mean that it is your fault. Your misdiagnosis could have been caused by a doctor’s failure to follow the standards of medical care. Every patient deserves the same level of respect when it comes to medical care. Mistreatment based on weight can negatively impact healthcare.
Obesity rates in the U.S. continue to increase. According to the Centers for Disease Control and Prevention (CDC), from 1999 to 2020, U.S. obesity prevalence increased from 30.5% to 41.9%. This means weight bias will impact more people every year.
If you believe you were misdiagnosed by a doctor, contact experienced medical malpractice attorneys who can look at your case, answer your questions, and help you understand your legal options to file a claim against a doctor or hospital after a medical error. Contact Gilman & Bedigian online or at 800-529-6162 for a free consultation.