Weight Bias, Obesity Stigma and Covid-19: A Call to Action

by Ximena Ramos Salas, PhD; and Sarah Nutter, MSC, PhD

Last week, the OAC (among other international organizations) helped support a Call to Action from Obesity Canada about weight stigma and the COVID-19 pandemic. The effort was in response to a lot of uncertainty in our communities about the link between obesity and COVID-19 (Coronavirus).

Although there is limited research on the experiences that people with obesity are having during this pandemic, decades of research show that people with obesity experience stigma in their everyday lives, including in healthcare. Research also shows that most of the time, obesity is portrayed negatively in the media.

With the pandemic, there have been many news stories about the risks of obesity for those who contract COVID-19. Some of these news stories may create more uncertainty in the community, due in part to a lack of research.

For example, since obesity is not recognized as a chronic disease in many countries (including the U.S.), many clinics, hospitals and public health departments are not collecting data about obesity during the pandemic.

From the studies that have emerged from China, Europe and the U.S., we have seen a link between BMI and :

  • More severe cases of COVID-19
  • Increased hospitalization
  • The need for critical care
  • Even death

However, obesity cannot be diagnosed just by looking at a person’s BMI. To understand the link between obesity and COVID-19, we need more clinical data about how a person’s weight is impacting their health. This could be done by getting lab tests that measure inflammatory and metabolic factors, for example.

Furthermore, by looking at weight bias and obesity stigma research, we know that people with obesity may avoid going to hospitals or clinics for fear of being blamed and shamed for their weight. Since many COVID-19 studies show that people with a high BMI are developing more severe complications and require more critical care, we should be investigating the reasons behind this. For example:

  • Could it be that people with obesity are going to the hospital when their COVID-19 symptoms are too advanced?
  • What obesity-related factors are causing more critical illness?

As scientists are looking for Coronavirus treatments, how are they including the needs of high-risk groups, including people with obesity? How will policymakers prioritize high-risk groups when treatment is available?

Finally, consider how high-risk groups are being supported during this pandemic. How are healthcare systems going to maintain treatment services for chronic diseases such as obesity?

We believe these are important questions we must answer in order to protect people living with chronic diseases such as obesity, now and potentially in future pandemics.

There are many questions that remain unanswered. This can create a situation where weight stigma might influence the medical care of patients with obesity and COVID-19.

About the Authors:

Ximena Ramos Salas, PhD
Ximena Ramos Salas, PhD

Ximena Ramos Salas, PhD, is the Director of Research and Policy at Obesity Canada. The network engages health professionals, researchers, policy makers and people affected by obesity and is Canada’s authoritative voice on evidence-based approaches for obesity prevention, treatment and policy. 

Since 2018, Dr. Salas has been based in Sweden where she is also a Policy Consultant with the European Association for the Study of Obesity – Europe’s leading voice for obesity science, medicine and community. She is also a technical consultant with the World Health Organization’s regional office for Europe. 

As a public health researcher, Dr. Salas’ goal is to prevent the perpetuation of weight bias and obesity stigma through public health policies and strategies. She has authored and co-authored numerous scientific articles and lectured widely on the impact of weight bias on population health outcomes and inequalities.

Sarah Nutter, MSC, PhD
Sarah Nutter, MSC, PhD

Sarah Nutter, MSC, PhD, is currently a postdoctoral researcher at the University of Calgary and a member of Obesity Canada’s “Every BODY Matters” collaborative. She is passionate about conducting research related to weight bias and is particularly interested in better understanding the nature of weight bias, especially among diverse populations. Dr. Nutter is also interested in better understanding the impact of weight bias on the health of individuals and the quality of healthcare they receive. She conducts her research with the goal of increasing the recognition of weight bias as a social justice issue, and reducing the impact of weight bias on the day-to-day experiences of people living in large bodies.