Will I end up dying while waiting to be seen by doctors who consider my weight a death sentence?

I felt a tickle of panic run across my brow when I saw the comment going around on Twitter. Were doctors really using high BMI as grounds for refusing people ventilators?

As a self-identified fat person, I needed to get to the bottom of this. That said, I’ve also learned to be wary of social media as a news source. I went on a search to see if this claim was accurate.

I didn’t find proof that BMI was being used to decide who got a ventilator, and I couldn’t find anyone from the medical field to confirm or deny the claim.

However, I did find several proposed triage guidelines cited in The Washington Post and The New York Times that list pre-existing conditions as potential marks against a patient receiving one of the few coveted ventilators.

There are guidelines in 25 states that may put some people with disabilities at the back of the priority list. In four states, Alabama, Kansas, Tennessee, and Washington, formal complaints have been filed by disability rights advocates. In response, the Department of Health and Human Services put out a bulletin that their COVID-19 plans should not discriminate.

Some states’ guidelines, like Alabama and Tennessee, were removed because of public outcry. Many states haven’t publicized their guidelines at all, or don’t have any. This has left the question of who gets prioritized in a ventilator shortage unanswered.

Old age was one guideline, as was dementia or having AIDS. “Morbid obesity,” which is classified as having a body mass index (BMI) greater than 40, is among the reasons a person under 60 may not receive a ventilator in a crunch.

My BMI, meanwhile, is almost 50.

BMI is a frustrating and dangerous metric to use to determine health. For a start, it was invented in the 19th century, back when cocaine was recommended as a health supplement and we believed bad smells cause disease. BMI as a measure of health has been challenged by new research.

Despite this, many doctors reportedly cite BMI when determining the health of a patient, sometimes zooming in on weight to the detriment of hearing the patient and their symptoms.

It’s possible people have died directly because of this medical fatphobia. Not from being fat, but from illnesses going untreated when doctors refused to treat anything but their weight.

One study cites 21 percent of patients feeling judged by their medical professional, which may lead them to hesitate seeking out care.

That said, there are real difficulties with providing care to obese patients, as Dr. Sy Parker, a junior doctor with the United Kingdom’s National Health Service, told me via email.

In larger patients, it’s “more likely to be difficult to get a tube down [the throat], as there is less room in there for the anesthetist/anesthesiologist to see,” Parker says.

“Additionally, obesity can reduce the effective size of your lungs, as you’re more likely to breathe quite shallowly — taking big breaths takes more effort,” Parker adds.

Add to that hospital overwhelm, and the need to make snap decisions, and it’s possible for a doctor under pressure to make a choice based on what they see. For an obese patient, that might be deadly.

Still, the idea that fat folks might be denied COVID-19 care because of their body is grimly unsurprising to me. I’ve experienced prejudice in the doctor’s office because of my weight before.

I have a permanent disability in my knee, now affecting my foot and my hip, which has steadily destroyed my mobility since I was originally injured as an 18-year-old. When I asked for physical therapy for the MCL tear I knew had occurred, I was scoffed at and told to lose 50 pounds instead.

I will need a cane by the time I’m 40, and physical therapy could have prevented my ACL tear from becoming a permanent disability in need of surgery. Incidentally, my injury also caused me to gain weight. And so it goes.

At least with my knee, I’m still alive. I wake up sometimes terrified of what might happen if I ended up needing to be hospitalized for COVID-19. Will I end up dying while waiting to be seen by doctors who consider my weight a death sentence?

Meanwhile, I’m seeing lots of memes and jokes about how sheltering in place is going to make people fat. There are plenty of articles offering advice on how to avoid stress-related eating habits, and how to exercise when you can’t go to the gym.

“Tested positive for having a fat ass,” one tweet declares. “You may be social distancing from your refrigerator, I’m social distancing from my scale,” another says. Plenty of tweets discuss the dreaded “Corona 15,” modeled after the 15 pounds college students often gain freshman year.

Friends of mine who are normally body positive are bemoaning their new habits now that their patterns are interrupted. They complain about weight gain in a way that makes me wonder if, deep down, they believe it’s really so awful to look like me.

It’s not just jokes. It’s also in the news. “Shelter in place does not mean shelter on the couch,” scolds Dr. Vinayak Kumar for ABC News. Looking at Twitter, you would think the real risk was gaining a few pounds, not contracting a potentially life threatening disease.

Slowing down and examining our relationship with our bodies, our eating habits, our exercise routines can be overwhelming. When we no longer have work and social commitments to plan our lives around, we see our behavior clearly.

For many, food intake is an area of life we can control. Maybe this fatphobia stems from people who are seeking to have power over their lives in a time when there is little control.

It’s understandable that people are concerned when news sources are feeding the fear that gaining weight will lead to worse outcomes if you get COVID-19.

The New York Times recently put out a piece saying that obesity is linked to severe coronavirus disease, especially in younger patients. On reading the article, however, you discover that one of the studies mentioned is preliminary, not peer reviewed, and the data is incomplete.

Another study cited, this time from China, also isn’t peer reviewed. The other two, from France and China, are peer reviewed but fail to check their findings against other significant factors.

“None of them control for race, socioeconomic status, or quality of care — social determinants of health that we know explain the lion’s share of health disparities between groups of people,” notes Christy Harrison in Wired.

It won’t matter. Some doctors could use that thread of hypotheses to bolster their already proven fatphobia.

It’s not clear whether an obese person has been denied a ventilator. Still, there are many examples of doctors not taking obese patients seriously.

One day, this virus will have run its course. Fatphobia, however, will still be lurking, both in the world at large and quietly in the minds of some medical professionals. Fatphobia has real consequences and real health risks.

If we don’t stop joking about this and start addressing it, it’s possible that fatphobia will continue to endanger people’s lives if they are denied medical care.

Let people know their fat jokes aren’t funny. Take care of your own mental health by muting people who post weight-related memes. Report crash diet ads as inappropriate.

If your doctor is making you feel uncomfortable, file a report. I ended up being assigned a doctor who was able to give me sound medical advice and see me as a person, not as my weight. You deserve a healthcare provider you can trust.

If you want to find something to manage in a world spinning out of control, manage your intake of negative body messaging. You’ll feel better for it.

Kitty Stryker is an anarchist cat mom prepping a doomsday bunker in the East Bay. Her first book, “Ask: Building Consent Culture” was published through Thorntree Press in 2017.