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I live in New York State, which in February opened eligibility for people with a Body Mass Index (BMI) of 30 or higher. When my roommate told me about BMI eligibility, I weighed myself for the first time in years and wasn’t surprised to find that I had made the cut. I would have qualified before the pandemic, but – ironically – my extra 19 pounds of Covid-19 puts me more firmly in the range.
At first I thought I would only sign up for an appointment for a vaccine because there is nothing wrong with me. I didn’t want to take a niche from someone who really needed it.
But there is clear evidence linking the results and the weight of Covid-19. Studies have shown that death rates from coronaviruses are higher in countries with higher obesity rates. And although having a higher BMI does not increase the chances of contracting Covid-19, it has been linked to a higher risk of becoming seriously ill from the disease.
Weeks after the pandemic spread in the UK, GP Natasha Larmie began to see the first published studies linking poor Covid-19 results to obesity.
“All it showed was that there were more obese people suffering from some kind of severe Covid than non-obese people,” Larmie, who works to end the stigma of the disease, told me. weight in medicine.
“I will never deny that this is a problem because the facts speak for themselves. The problem is people then assumed it was obesity that was causing these poor Covid results.”
There are many factors that contribute to and influence weight, Larmie noted, factors that most studies so far have overlooked. They include social determinants like poverty, education, access to health care, and even the stigma of weight itself.
Studies show that weight stigma can lead to delayed or misguided treatment for people with high BMIs and may cause some to avoid the doctor altogether. No full conclusion can be drawn about obesity without considering these details, and no one’s weight is a complete picture of who they are.
The BMI metric was first used in the 1800s for population studies, and it does not measure excess fat or take into account body shape, weight distribution, or body size. muscle mass. It was never intended to be used as an individual assessment. But it is easy to calculate and widely used around the world, which makes it convenient for vaccine distribution.
Larmie doesn’t think very strongly about using BMI as a medical tool. If it were up to her, she says, obesity wouldn’t be considered a medical condition at all.
“If I want to diagnose diabetes, I look at your blood sugar, you can see and there is a threshold. If I want to diagnose gallstones, I will give you an ultrasound. If I want to diagnose cancer, we have to do a biopsy and look at it under a microscope, ”she said. “If I want to diagnose obesity, the only way I can diagnose it right now is by using body mass index.”
As stimulating as Larmie’s approach was, I still felt deeply conflicted about signing up for a vaccine appointment. I have alternated between the shame of qualifying for something because I’m fat and the outrage at how fat is based on such an outdated and non-specific standard.
The idea of showing up somewhere and publicly “admitting” to being obese was almost overwhelming. This is because of the weight stigma and derision that has come from my loved ones, doctors and society. Did bending to my BMI equal letting them win?
Aurielle Marie, a cultural strategist who advocates and consults for body positivity in the United States, helped me resolve this internal conflict.
“I think I can remember two truths at the same time,” they told me. “And those two truths are that I want to have access to a vaccine that’s been proven to keep people… safer. And the other truth is, I don’t agree with the system that told me my body is at risk, and I don’t prioritize their understanding of fat over mine, even though their understanding of fat gives me access to the vaccine. “
Aurielle Marie has asked not to include her last name due to online harassment. They have unfortunately learned a lot about how to deal with the health care system from personal experience, such as when a doctor refused to investigate further into the cause of their pain until they lost weight because he had said it would be expensive and a waste of time. .
Since then, Aurielle Marie has been their most fervent lawyer in the doctor’s office. They actually started going to the doctor telling the provider they know they are fat and avoiding the monologue. Aurielle Marie says this both eliminates time spent on a topic they’re not at the doctor’s for and helps them assess how a provider is going to treat them.
Their opinion on my anxiety about the vaccine? Go get what you qualify for. “Don’t feel any shame and don’t be afraid to stand in line for the vaccine because we don’t skip the line or jump in front of someone else, unquote quote, more worthy. We are at the place where someone told us to do it. be because of the size of our body, ”they said.
Finally, I accepted. I received my first dose of the Pfizer vaccine earlier this month. My next dose is April 7th. I didn’t set the rules that gave me this measure of safety and peace of mind after a devastating pandemic year, and I’m doing nothing wrong by following them.
My body deserves no less health and protection than anyone else because of its size. These words are easy to write, but believing them is a lifelong struggle I’m not sure I will ever win. All I know for sure is that it’s worth a try.
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