the HAES® files: For Want of a Chair — Standing Up for the Right to Sit Down

by Health At Every Size® Blog

by Miriam Villchur Berg

A chair is the most mundane of objects. It can be beautiful, of course, but it is first and foremost functional. It is considered a symbol of the ordinary, everyday things we take for granted. But when that chair is found in a health care practitioner’s waiting room, its importance is magnified many times. If it is a standard waiting room chair with arms 17 inches (or 43 centimeters) apart, that chair is an often insurmountable barrier to health care for plus-sized people.

Doctors today should be outfitting their offices with big people in mind. Larger blood pressure cuffs, examination tables that are bolted to the floor, extra large gowns, and other such accommodations are important. But the chair is by far the most important item, because without it, patients won’t even make the appointments to see the doctors.

This was brought home to me by a letter I received recently. Clarissa, the daughter of a patient with multiple health problems, wrote to the Council on Size & Weight Discrimination to see if we were working on getting better diagnostic equipment for large patients (we are, but that is another article). At the age of twenty-one, she lost her mother. Despite multiple serious health conditions, Clarissa’s mother would not go to the doctor because there was no place for her to sit in his waiting room. She could not stand for long periods of time, so she just stayed away. By the time her health problems became serious enough to warrant going to the hospital, it was too late, and she died in the ICU.

Medical discrimination comes in many forms, including:

  • Doctors who attribute every ailment to excess weight and therefore prescribe diets (and offer no other form of treatment) for every condition
  • Doctors, such as orthopedic surgeons, who refuse to treat patients until they lose weight
  • Doctors who treat plus-sized patients with disrespect or contempt
  • Manufacturers who build equipment with unrealistically low weight limits
  • Insurance companies that treat larger patients differently by charging them more, setting limits on their care, or refusing to insure them.

But even before these forms of discrimination can occur, lack of seating stands in the way of proper health care for large people. Proper chairs could have made it possible for Clarissa’s mother to go to the doctor when she needed to. An armless chair could have prevented the escalation of health problems that ultimately led to her death.

If she were a person with a disability, or a pregnant woman, people would gladly, even voluntarily, give up their seats to her. Office staff would make sure such a person had a comfortable place to sit. We can ask why it should be different for a heavy person, but we already know the answer—deep-seated, widely pervasive, socially accepted prejudice against fat people. Television, magazines, the internet, and every other medium bombards people with the false message that weight loss is not only possible but easy, that it will solve all your problems, and that your failure to lose weight is a moral failing.

Clarissa was not ready to call herself a political activist on the issue of size rights. But she wanted to do something to help others who might have the same experience her mother had. I helped her put together a letter to doctors’ office managers urging them to outfit their offices with seating for plus-size people. If we can change one doctor’s office waiting room, and show a few people how to get their doctors to make their offices more accessible, then perhaps those doctors will talk to other doctors, and a trend will have been started.

In the community organizing world, this is called Think Globally, Act Locally and Each One Teach One. But even without the activist labels, people can relate to taking a small action on their own behalf, or on behalf of their loved ones.

Here is a sample letter that you may wish to adapt for your own use:

Dear Doctor X,

I consider you a caring person and someone who went into the profession of health care in order to help people be as healthy as they can be. It is in that spirit that I write to you with an earnest request.

I would like to urge you to put some armless chairs in your waiting room. I am a large person, and none of your chairs is comfortable for me. This makes it difficult for me to consider making an appointment with you, since I know that I will either be cramped and in pain, or else I will have to stand, which is also uncomfortable.

I notice that your office is accessible to people with disabilities. My request is for you to make your office accessible to people of all sizes. Larger patients need health care too, and we need to feel that our doctors take our comfort into consideration.

A chair may seem like a trivial thing, but it makes all the difference in the world. If I know a doctor’s office has chairs that fit me, I am much more likely to think of that doctor as someone who has my best interests at heart.

If, on the other hand, I know that there is no place for me to sit in a practitioner’s office, I find myself putting off making that appointment, even if it is for something vital to my health and well-being.

Please make armless seating available in your waiting room. It would make visiting the doctor so much easier for your plus-size patients.

 Thank you,

 Your patient, Y

There are many styles of activism. Some people might work best in person, one on one, talking to the office manager at the medical office. Others prefer to make phone calls. Email is a very popular way to make comments about ways to improve the world. I am one of those who prefer to write letters. I like to write. I want the recipient to have a piece of paper that they have to deal with. The more effort that goes into my letter, the more difficult it will be for that office manager to ignore it, file it, or throw it away.

If I can get him or her to read it and really understand the problem, there is a good chance that something might change for the better. The next plus-size mom who comes to the office might be surprised and pleased to find a love seat or an upholstered bench in addition to the individual chairs with arms. That might make her decide to come back for a physical. She might tell some of her plus-size friends, some of whom may not have been to the doctor in many years.

And one of those chairs, in one of those offices, could save someone’s life.

© 2015 Miriam Villchur Berg

Miriam BergMiriam Villchur Berg is a writer and editor, a political activist, and the president of the Council on Size & Weight Discrimination. Her special areas of interest are employment discrimination, accessibility issues, and health care rights. Miriam is the author, compiler, and editor of most of the material on the Council’s website (www.cswd.org). She also writes the program notes for the oldest chamber music series in the US, Maverick Concerts (www.maverickconcerts.org) in Woodstock, NY.

5 Comments to “the HAES® files: For Want of a Chair — Standing Up for the Right to Sit Down”

  1. Thank you for this excellent column.

  2. I am in UK, so health care organised differently. There are two hospitals in my area who provide for the needs of large people. The first is the local cancer centre, which makes a huge effort to cater for all patients. I worked there for a while, and was involved in the group which was responsible for the patients’ and their visitor’s experience of the the hospital. So I said a lot of stuff about fat people; it was well accepted, partly because they knew that a lot of patients put a lot of weight on as a result of their treatment, but also to give a better experience to fat people using the hospital. Armless chairs was one of the issues I raised when they were refurbishing, and there is a variety of chairs to suit all people now.

    The other hospital is the local private hospital, which has everything you could ever think of for fat people. Because they are only place in the area who carry out bariatric surgery! Not the same thing as the cancer hospital in any way!

  3. St Thomas Hospital and Guys Hospital in London have fantastic new clinical areas and departments but one main problem is the chairs!!! Not been well but intend to do something about it.. I have Lipoedema and many side effects. I have just got a fantastic bed as I also have heart problems.
    I had an accident some time back and was in St Thomas for 44 days, they had to hire a chair for me to sit out,
    There is a group for Lipoedema in the UK but they are more interested in going to conferences than discussing practicle problems,. I am not popular with them as I have taken on some of the medical profession!! I used to be the Nurses Militant Leader in the 70’s.

  4. Was at Guys hospital Gastrology unit, chairs all one size with arms. I sat in a wheelchair and it was comfortable. Staff great. Pleased to receive my literature on Lipoedema and this included an Australian Consultant gaining experience in the UK!!

  5. Thank you for this thoughtful and sensitive article. it is very frustrating that being overweight is considered somehow a person’s “fault” or “choice” and that ridicule and discrimination in society at large (no pun intended) is still acceptable. However, I think that many healthcare practitioners, when made aware of providing accessible facilities with proper equipment, will make changes, It’s a matter of awareness and this article is very helpful toward that end. Thank you!

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