Episode 101 Transcript

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Welcome to the Fierce Fatty Podcast. I'm your host, Victoria Welsby and this is episode 101. Today, we're talking about are fat people at higher risk from covid.

You're listening to the Fierce Fatty Podcast. I'm Victoria Welsby TEDx speaker, bestselling author and fat activist. I have transformed my life from hating my body with desperately low self-esteem to being a courageous and confident fierce fatty who loves every inch of this jelly. Society teaches us living in a fat body is bad. But what if we spent less time, money, and energy on the pursuit of thinness and instead focused on the things that actually matter. Like if pineapple on pizza should be outlawed or if the mullet was the greatest haircut of the 20th century. So how do you stop a negative beliefs about your fat body controlling your life? It's the Fierce Fatty podcast. Let's begin.

Tinkle tingles behind me, that's doggy the little tippy taps on the floor. He's gonna go in his little house going on in the Dougie. Whenever I'm recording a podcast, he'll come and sit in his little house next to me, his little cage where he hides away. And it's so funny to call Google the dog. If you're confused. He knows when it's the end, like he knows when I've ended a call or recording a podcast with the words I say like he must recognize me saying okay, bye or whatever it is. I say any. He'll come out of his cage right there. And then to say, come on now. You're done. Now let's go and have some fun. So for toxic stones are funny and cute, aren't they? I love them that day. Hey, is it just me? I think it is this morning. I'm always like, I'm, I'm gonna ask the fears fatties. This is just me.

But you know, when you put on your clothes in the morning and you put on your underwear Am I the only definitely I'm not the only person but like often thinking, if I get hit by a car today, when they cut off my clothes with those scissors, they're gonna be like, Oh, I like I like the underwear. Oh, nice underwear. Oh, what a shame it is to cut this underwear. Do you think? Do you think that all the time? Often often? I'm like, Oh, I'll put on my mat. I'll put on matching underwear with matching socks today. You know, just in case the paramedics got off my wife today. No, but I'm thinking oh, I might die today. I'm just thinking oh no one else is gonna see me.

Hopefully some lucky paramedic does not hopefully but do you think that is that just me? It's probably just me. Thinking about city dogs, I just Oh my god. Okay, I don't know if you've seen on Tik Tok on on the Instagrams on the Instagrams people doing these things called Diamond paintings. But it's this thing you might you might have seen or not know what it is where people are putting, like de Montes or like crystals on onto paper or onto canvas or something with this thing that looks like a pen and it kind of they make no clicky noises like little clique as they do it and it's kind of on these on these accounts where it's satisfying videos.

Anyway, I was in Dollarama the other day also can be some felt to to put on the back of a cross stitch that I did my mum for her 70th birthday it said Ma M er that's her nickname that we call them and then some shamrocks and hearts around it and I needed to back that and I saw in the art aisle a diamond painting of a stupid little dog one of them and diamonds just fell off another diamond just holding it up if you're watching on the camera if you're watching on YouTube stupid look at this stupid little thing.

Anyway And so it was like $4 for this thing which is like a whole kit with the wax that you put on the pen to pick up the the diamonds are not diamonds so like pieces of plastic. Oh one to two fell off when it lost its some of its stickiness. Three fell off. Oh, anyway, it's a load of shit anyway, but I mean like, you know, it's a bit it's just a bit silly, but it's so fucking satisfying. Oh my god, if you are in any way crafty. This I tell you what, I just finished my cross stitch for my mom and so I was like, you know, I'm okay for a bit of a creative project for a while. But then I was like, Nah, go and have a look on that diamond thing.

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God, I was up late in the night doing it, and then finished it the next night. So this little thing, suddenly, like the size of like twice the size of a postcard of this stupid looking dog with a sad face anyway. And it's done. Now I'm just like, I need to get. I'm going to do a custom one. I'm going to do it you because you can do do what you can do. You can get like, you can send it to send a photo in and then they'll they'll pixelate it, basically because it's pixels, right? They'll pixelate it, and send the kit back to your donor how much it costs. It's not that expensive.

But, you know, apparently I was been watching videos about it. This is how so much I'm into it after doing this one silly thing that it costs like 1520 bucks for a whole big ass kit that takes a while to do. Anyway. So if you're looking for a new hobby or something to do while you're watching TV, you probably I did it on my kitchen table last night because the night before to finish it off the night before I did it on my sofa. And for fucksakes The amount of times that the crystals went flying everywhere. I literally was had to take apart my sofa to get all the little bits that fell everywhere, multiple times because I was doing it like perched on a stack of books with my phone as a light like anyway, so now now I'm going pro I'm on the kitchen table. I might even get a lamp or something. I don't know. But you know, stay tuned for a huge crystal painting behind me with the face fatty logo or I know Oh, I could do like a custom one which is like, you know fat people just doing cool fat shit or something else like that. Oh, I'm so. Oh, yeah. So yeah, check it out. Check it out in your in your local dollar Rome, if you want to have a go and see if you like it or not. Yeah, so today we're talking about COVID and shit like that. So trigger warning on this on this episode, because it's talking about like medical fatphobia. And that can be really gross for people, because it's awful.

So if that's not feeling like something that you're up to today, then skip this episode. We're also talking about needles. And so we talked about needle links throughout the episode. So again, if that is not feeling good for you today, then see you in the next episode. But if you're feeling cool, let's do it. Let's do it. Okay, so I got an email from Dr. cat paws say I've been on cats. Podcast. Cat is a senior lecturer at the Institute of Education and fat studies Scholar at scholar, Dr. Cap was a amazing human being has a website and everything.

So I'll link to everything in the show notes face valley.com forward slash 101 For this episode anyway, so I got an email from cat palsy to share a survey and some for some COVID vaccinate vaccination research that cat is doing. Dr. Cat. Dr. Katz email says I'm part of a team who are exploring the experience of fat people receiving a vaccination for COVID-19. I would appreciate if you could take our survey and share it across your networks. We're hoping to get fat people from around the world to tell us about their experience. If you are keen to learn more about the guidelines for vaccinating people with fatty arms, you can read my blog post about this, please share this as desired. Anyway, so I had heard before that if you're fat, you need a longer needle. That's all I knew. If you're fat, you need a longer needle. And so when I went to get my vaccine, actually, when I've had a few shots in the last I've always said like, do I need a longer needle? And I've always been told no. And looking at the survey and reading cats blog post about it. I'm like is that accurate? It's so this is this is cats that I'm going to read a little bit from CATS post and so I'm going to share a little bit more about this. So cats post it's a that's about the study on protecting fat people from COVID-19. So cat says I'm very pleased that I was able to receive my first shot of the COVID-19 vaccination several months ago as a member of group three, which is in New Zealand they have people who are

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people who are at risk of getting very sick from COVID 19 Because of my high BMI. So cat is a super fat person. When I am doubtful that fat while I am doubtful that fat people are at greater risk for getting sick from COVID 19 Let's see my recent publication on this, I do know that fat people are likely to receive poorer care in the healthcare system, which is, which is likely to result in poor health outcomes and even death. See this meta analysis.

And I'm going to I'm going to talk about these two, these two these two publications that kept talking about I'm going to talk about them in a second. So don't worry, don't worry. Thanks to Allie Garrett, I'm gonna talk about Aligarh in a minute, I was aware that I would need to be vaccinated with a longer need needle syringe than is normally used. I arrived at my vaccination appointment ready with this information. My vaccinator, however, was less educated and ready than I was. So cat shares a beautiful graph on the guidelines from various places in the world. And we've got Australia, Canada, England, Ireland, Israel, New Zealand, Netherlands, United States, of what needle length? The guidelines. So the standard is. Is it 25 millimeters is a standard and then 3838 is a long one, or 1.5 inch is a long one. And so because in the past when I've been vaccinated or had any injections, I always say, Do I need a longer needle? Because I'm fat? And they say, No, you're, you're fine. Like you're not fat enough, basically. And so here is the is what you should, who should be getting the longer needle on? So for Australia, the designation of someone who should be getting a 38 millimeter noodle is someone who is very large, or quote unquote, obese person. Canada says men who are I'm going to mention weights here in a second. Skip ahead. 10 seconds, we don't hear weights, men who are 118 kilos or 260 pounds, women who are 90 kilos or 200 pounds. Now I'm in Canada, I'm way more than 200 pounds, I should have got the 38 millimeter noodle. England it says quote unquote, morbidly obese. Gross, fucking hate it. Oh, fuck that. Ireland, same weight, as same weight weight guidelines are in Canada, Israel says similar weight guidelines for any gender or a wide arm. And basically goes on pretty much like that. So it's pretty much the same all over.

And so with the weight guidelines of who gets the 38 millimeter needle or the 1.5 inch needle, it's pretty small. It's, it's, it's probably if someone is a woman. I'm someone who is probably a size 1614. And as we know, most women are plus sized. So theoretically, most people should be getting this longer needle. And in cats, blog post here, cat talks about saying, oh, yeah, so is 25 millimeter cat talks about saying, hey, I want the longer needle and they said no, we're going to give you the 25 millimeter and then cat advocate advocate for herself and then was given the subpar kind of they they switched out the needle, not the syringe. And you're not meant to do that. So they just unscrewed the needle and gave her that which is not the guidelines recommend it. And then the next time for the second dose. The cat had to go and wait because they didn't have a New York at hand. And it's wild to me and also cat was in this blog cat is saying almost every fat person that that she has spoken to didn't know that they needed to have a longer needle.

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And cat says quote it should not be the fat person's responsibility to know that they need to be vaccinated with a longer needle. That knowledge should be held by the vaccinator. Yeah, it should be like, I mean, I don't know about the job of vaccinating someone you know, it looks like it's it's putting a needle in of someone's arm is locating the right the right place for it. It's checking health stuff and answering questions. And there's probably a lot more to go on to go with it as well. But It seems like a pretty basic thing, doesn't it? That seems like a pretty basic thing of, you're injecting a needle into someone's arm. And with this vaccination, it's going into the muscle.

And so if you know the location where this needs to be delivered as a muscle, and you can see someone's arm and know that they have fat on their arm, wouldn't you just be like, hey, if I was a vaccinator, wouldn't you? I would just be like, Hey, okay, give me a mix of 25 millimeter and 38 millimeter like half and half, versus just giving everyone the 25 Unless they speak up. And in some, in some cases, you would have just been given a 38 millimeter and you don't know because they wouldn't have said, and in some places people had to advocate for themselves.

So let me talk more about Allie Garrett. So Allie Garrett so cow was made aware of this because of a post in The Guardian a a piece in The Guardian by Abby Garrett that says even when getting vaccinated against COVID fatphobia still fat barrier runs rampant again link in the show notes. So in this this article, quote, a registered nurse I spoke to explain to me that the COVID vaccine just like the flu vaccine, is designed to be given into the muscle. The needle usually use for this is 25 millimeters long, but it is recommended to use a 38 millimeter needle needle in fat people as a needle needs to pass through a more sub cutaneous fat layer to reach the muscle. She said, quote, all COVID immunizes in Australia, which is where Ali is from, are required to complete training provided by the Australian Government. And this training advises that 38 millimeters needles are required for individuals with Oh word. My asked if this was a new requirement, the test nurse told me a study in 1997 found that the amount of fat over the deltoid muscle deltoid muscle is a muscle in your arm, where we have our vaccinate vaccines injected injected varies, especially for women. If a vaccine made to be injected into the muscle is injected into the fat layer, this has less blood flow than the muscle and the immune reaction likely won't be as strong.

So that's how so the the injection, the it goes into the muscle, the muscle has lots of blood vessels and then the the juicy stuff, don't ask me the scientific term in the vaccine gets taken in the blood vessels and then spread around our body. But then in our fat layer, there are less there are there are blood vessels, but there are a lot less than the muscle doesn't mean that the vaccine is just going into the fat and then it just lives there and nothing happens. It does still get taken away by blood vessels. But the because there is less blood vessels. What this nurse is saying is the immune reaction won't be as strong also it takes longer.

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So cat continues in that the original blog post I was talking about cat continues. No one really cares about fat people and their well being outside of being able to complain about them as a burden or to make fun of them for their own delight. If vaccinated fat people end up being more likely to be hospitalized with breakthrough case with a breakthrough case of COVID. In New Zealand, most people will find that acceptable dismissing it as another example of fatness being unhealthy, if more fat people die from COVID. Few will be surprised and that blame to will for slope solely on the fat feet of the individuals. I will be one of the few who will wonder if those fat people were in fact vaccinated. Or if they only thought they were protected. Did an improper vaccination result in them being unprotected from COVID leads to their hospitalization did an improper vaccination result in their death count also links to a post by fat besties besties besties because they're Canadian. They're from the Iraq from the island from the island Vancouver Island which is next next to Vancouver. So they're close but not close enough for me.

Anyway, so fat besties a group of fat people have a website have a Instagram page they did events before COVID And one of the fat besties Courtney, who is a fat public health nurse talks about this too. If you're really panicking right now and thinking, oh my god, I'm not vaccinated correctly, I'm not safe. I want to read this to you so that you can feel a little bit more your mind put at ease. Okay, so, Courtney writes, so the post is called vaccine injections for fat people. Quote, The typical new length for Iam intramuscular injections is one inch, but it is considered best practice to use a 1.5 inch noodle when immunizing someone who has enough fat on their upper arm that one inch may not reach the muscle. That being said, if the needle does not reach the muscle, that will not render the vaccine invalid. If this were true, we would not give vaccines sub cutaneous li subcutaneously is into the fat. So some vaccines are given into the fat, not into the muscle. So a number of vaccines go into the fat, and a number of vaccines go into the muscle. And so if vaccines going into the fat didn't work, there would be no vaccines going into the fat.

So the reason why so continuing the reason why we prefer to inject into the muscle is because the muscle has a lot more a lot of blood vessels, blood vessels, which means a medicine is moved quickly out of the muscle and into the rest of the body. The most significant benefit of this is it that it it helps minimize side effects. Often, the redness, swelling and soreness you experienced in your arm from a vaccine is not necessarily from the needle going into the muscle, but rather the fluid going into the muscle. This is also why sometimes nurses will tell you to move your arm after an injection. Using the muscle increases blood flow, which moves the muscle out of which moves the fluid out of the muscle quick, quicker. Such sub i this i don't know why I struggle with this word. It's like A, B and a C together subcutaneous tissue, which is basically a fancy word for fat tissue has significantly significantly fewer blood vessels, which means any fluid fluid injected into the tissue will take longer to be absorbed into the bloodstream. This will increase your chances of experienced and localized side effects such as redness, swelling and soreness. Regardless of the location of the injection, your body will still absorb the full dose of the vaccine.

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Continuing I have seen a lot of arms of various sizes, including fat arms, my experience has been that many people with fat arms don't have enough fat directly above the deltoid to warrant the use of a 1.5 inch needle 1.5 inches 38 millimeters. And so what Courtney is saying is that when we look at our arms, most of the fat is actually at the back of our arms. And on the kind of the side here, the deltoid muscle where we're where we're actually injected. Sometimes when we think of an injection, we think of it like right in the middle of our arm, right. But the deltoid muscle is actually very high up. And it's if you look at your arm, you'll see there's kind of like a dip, a dip at the top, and then it kind of gets fatter. But there's like a little dip, and it almost feels like it's going into the shoulder. And so that is around about where the injection is going. It's like very high up in your arm. And so if I'm looking at my arm, actually, that there isn't that much fat right there. It's kind of like a little dip of thin arm. And then the fat is on the top. And behind. Now most of the fat is definitely behind. There's probably like, I don't know, five inches of fat there. But right there where theoretically the injection goes. It is definitely a lot thinner.

Also, what Courtney says is that, that people who are giving the immunizes are trained to also push the fat aside. And so I'm like, I'm just trying to see what it what that looks like for me. And yeah, I mean, I can see it, I can see it. And so we don't know whether that's the thing we don't know, right? We don't know whether the person injecting you is considering these things. We don't know if they're trained. We don't know if they're aware. And so when I've said before, hey, I need do I need a longer noodle here because I'm fat. They've said no, you're not fat enough. And I felt okay, that's fine. I you know, I felt like they knew what they're talking about.

And hopefully it was because they knew what they were talking about versus them being like, can't be bothered to go and get a longer noodle. We don't have any longer noodles. Somewhere I read I think it was in one of cats posts. Someone was told that there I've run out of long needles in the hole of New Zealand. And that was just a straight up lie. And so the thing is, we don't know, right. And so the reason why I think it's important to read Courtney's words on this as well is that, if even if you think that you've been given the wrong needle, you probably it sounds like regarding this, this is what Courtney says, regardless of the location of the injection, your body will still absorb the full dose of vaccine, but you're going to have more localized side effects. And it just it takes longer for the vaccine to get around your body.

Also, I wonder then, I wonder, I just wonder, I just wonder about this. So I don't want you to panic, like me, me reading cats. stuff, which is perfect, great. We need all this stuff. I was like, Oh, shit. I thought I was immunized. But what if I'm not? And whites? I mean, if you're really stressed about it and worried about it, go and talk to your doctor and your doctor can have a look at your arm and be like, yeah, actually, you know, your arms actually not that fat, even though you're you're fat. Or it, maybe it is and maybe your doctor will say, Hey, go and get another vaccine, someone in my building got a third vaccine, it was something to do with having a vaccine passport, you have to have to have the same.

So I don't think having a third is bad, you know, don't think is gonna hurt you. And if you haven't got your vaccine, if you haven't got your vaccine yet, if in doubt, just ask for a longer needle. And if they say, oh, no, you don't need it. You know, what a why is that? And if they say Oh, actually, if you look at this right here, you can see that you've got less fat here. And I can, you know, estimate from from looking at this. And actually what I'm going to do is I'm going to press here so that the fat is pushed out pushed out the way. Yeah, so I'm definitely still going to, whenever I get an injection, say, Do I need a longer needle? Oh, no, you don't? Why is that?

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And then say the guidelines for the COVID vaccine is if I am X amount of pounds, go back into the episode if you want to hear what amount? And I will say I'm over that. And so why then, am I am I not getting along? Or not getting a longer one and hear what they say if they're just like, Oh, I'm like, Bitch, give me the fucking longer one. Oh, they could say, Angelina, actually, for this type of vaccine. This is going into the fat not into the muscle. And so we use a shorter one. Okay, cool. But the thing is, most people don't know about this. Did you know about this? I don't know. I must have mentioned it on the podcast before but but still, you know, probably probably didn't know.

And so anyway, so Are Fat People at higher risk from COVID talking about all of this stuff, which is kind of you know, talk about this stuff. It's kind of interesting, if we think about the bias that we have in healthcare. This is just a prime example of that bias. You know, we think about people saying, oh, people are the worst, and they're just using up all of our money on NHS money and all that type of stuff. And it's like, Well, hello, you're not vaccinating us correctly. Hello. You're not thinking about us in in, you know, anything that you're doing Hello. You don't have beds big enough. You don't have gowns big enough, you don't have blood pressure cuffs big enough when a blood blood pressure cuff is is too small, it'll give a to higher reading, etc, etc. You know, it's like, anyway, so another we're still talking about cat Dr. Cat Jose, the fabulous Dr. cat paws, paws a, what a great name, isn't it? There is a post called resisting fatphobia in the times of COVID-19 from medical Express. And so this this is about cats research paper, which she mentioned.

Remember I said there was two research papers that I'm going to be talking about in what Kat was saying. And we were talking about them right now. So the research paper is called resisting the problematization. of fatness in COVID-19. In pursuit of health, justice, justice, I'm going to link to the article and also to the research paper. You have to pay to get access to the research paper but you can look at the the abstract. So quote from this, this article that's featuring Dr. Paul de quote Dr. Paul's A says the researchers wanted to highlight how fat people were being scapegoated when it comes to the COVID 19 pandemic. So, because this this is about the paper resisting Problem is like problematization of fatness. This is what this is about. Okay, so quote, it was important to us to highlight that fat people are being thrown under the bus years again, with the rhetoric and planning around COVID-19. We know from the literature literature how fat people are often completely left out when making plans for natural hazards. Because there's this, she mentioned natural hazards because this isn't like the natural hazard section of this website.

Anyway, natural hazards and disasters. And we see that implemented when they are when they are left behind in real situations such as Hurricane Katrina, people chose not to evacuate fat people. And because they didn't plan to and because they didn't plan to evacuate them, they didn't have the right equipment. In the panic and urgency, fat people are simply left behind to die. That's so that's so tough. It's so painful to hear those words. And this is absolutely true. It's just skip ahead a couple of minutes. If this is too tough, I'm going to talk about this for a minute or two. Hurricane Katrina in the hospitals, they you know, had this you know, the hurricane warning coming we have to evacuate evacuate the largest patients. I didn't have equipment that didn't have those who were not able to walk, they didn't have the equipment to put them from their bed into wheelchairs, they didn't have wheelchairs, to get them into that were big enough.

And literally, they were left in the hospital just left, everyone evacuated apart from the the fat people that they couldn't move and they died. Which is just horrifying. And one of the accounts that I read was that one of the fat patients was apologizing was apologizing for his body, his body size.

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And they didn't have the resources because we don't think of fat people. And it's just absolutely heartbreaking. Okay, let's continue. Unfortunately, we know that happens for fat people just as it happens for people with physical disabilities. We wanted to take this opportunity to highlight that public health officials are thrown around fatness as a risk factor slash death sentence for COVID with very little evidence, she says so the I'm going to read the kind of the abstract for the the actual paper research paper resisting the problem a tie problem a tight resisting the problematization of fatness in COVID-19 in pursuit of health justice. Okay, so abstract the purpose of this paper is to explore the problem as high as ation of fatness in contemporary resop response to the COVID 19 pandemic. This paper draws from the catalogues catalog of reports from journalists informed largely by an array of non peer reviewed scientific literature documenting the relationship between factors and COVID-19. So what Kat and her colleagues are saying here is that all of a lot of the reporting that journalists I've spoken about this before or other reporting that journalists do are from studies that are not peer reviewed, that are really fucking shit studies.

And so they'll see this headline, fat people spontaneously combust if they get COVID. And the journalist who's under pressure, who doesn't really give a shit if that's true or not, who's not looking at? Oh, is it a good study? Oh, are they studied one person? Oh, was a was a person? Did they spontaneously combust? Oh, no, doesn't Oh, actually, it looks like they they didn't Oh, it's a load of shit. They don't do that type of stuff. And obviously, this is hyperbole. It's not as egregious as that but they see the headline study shows that fat people at 5000 times more likely to die from COVID. The journalists isn't doing the in depth reporting due to do due diligence. They're just busting out as many articles as they can because they're under pressure. They're under timeline and how sexy is a headline to say that, you know, something like that? You know, to you know, because we all hate fat people sort of thing. So whose evidence that people are All right.

Continuing our method of inquiry is to examine fatness and COVID-19 through a problem problematization lens that enables us to interrogate the scientific, political and economic processes implicated in the production of fat bodies as problems. fatness has been problematized in the COVID 19 pandemic, this has diverted responsibility for preparedness and well being away from health systems and governments and onto the back of fat people and communities. Here's the thing, right? Yeah, 1,000% Right. The government is not prepared.

And then they're like, well, it's not our fault. It's your fault. We're being fair. You know, the government like well, if he wasn't fucking fat, and what and you know, it's not a it's not about being fat. It's about realizing that you have a population of diverse body types. And being serving that population versus serving the, the, you know, one body type which is straight sized. Continuing, this is unjust, and an ethical in juxtaposition. Fat activists around the world have challenged the problematization of fatness and edit its effects, finding ways for fat people to subvert fat phobic institutions in the mists of code, let go of the COVID 19 pandemic, by collectively organizing to support one another. Which is just so sad that we haven't to do this for ourselves. You know, our countries and governments and health care is not doing this for us.

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Continuing the ways in which fatness has been taken up in current COVID COVID-19 pandemic responses diverts responsibilities for health system preparedness and community resilience to fat individuals. This is both unjust and also obstructs meaningful actions to address the health inequalities laid bare by COVID-19. This paper is believed to be the first to analyze the problem and problematization of fatness in COVID-19, highlighting that lessons can be learned about high health, health justice in disasters from the worker, fat activist during this COVID 19 pandemic. That's really cool. That last sentence, it's kind of like, hey, learn from the fatties they're fat, he's already doing it. Listen, listen to the fact listen to fat activists, then they know what they're talking about, they're gonna help you be able to do better next time there is a health justice disaster is not going to happen. Likely maybe in 50 years time.

So the other thing that that that cat mentioned, and, and I've mentioned this before, is because you know, this is this is an active thing. This is this is still ongoing. It's it's how quickly can science catch up and research catch up? And, and show us good science. And I mean, it's gone on for a year now. And so, I mean, they're not, that's, you know, they're not that slow. But still, sometimes it takes time to get good information out there. And so, using the information that we know about h one, n one, and so this paper is called Wait, and the prognosis of an influenza A paycheck h one n one infection during the pandemic period between 2009 and 2011, a systematic review of observational studies with meta analysis. So I'm gonna read this and then and then and then give it to you in plain language. Here's the thing with with like studies and stuff, or studies and stuff, and I think this is why sometimes people like, the way that I speak is, a lot of times this stuff is not accessible to most people reading this stuff. And cats is not a good example of that because cats is readable, right? There's no stuff in there. That's like, What the fuck is this? Cats is readable, but a lot of studies, a lot of papers, that they're not accessible to the general public. And it's not due to not being smart enough. It's due to not using plain language. And, you know, in the legal word, what do they call it, legalese. And, a lot of times, I just wish that they could be like, here's a study with all the fancy words. Here is a really plain language version. We did ABC, and we found XYZ that's it, you know, like in a sentence or two.

And even when they do do a little kind of like summary is the summary is like, well, you Anyway, so I, you know, I, I wish that things were instead of having to kind of it's almost like poetry you know? Like, you know what is the hidden message under these words? Okay so anyway me going on about how these things are not accessible some people like yes I Oh what are you talking about stupid okay. So we they did this this this meta analysis this is the abstract okay background in 2009 a novel influenza h1 and one virus was detected and caused influenza pandemic, it is important to identify the risk factors for severe outcomes. However, inconsistent results regarding the effect of fatness they use the old word reported in previous studies. Let me read that again. inconsistent results regarding the effect of fatness were reported in previous studies. Oh wow. Well, basically what they're saying is, people said that fat people are higher risk, but actually

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the results were inconsistent. Okay, methods, we can dust it, we conducted a systematic review to assess the association between fatness and poor prognosis for laboratory confirmed haitch one in one. We searched three English databases and three Chinese databases for relevant studies from April 2009 to October 2015, blah, blah, blah, they say which they are. Two investigators independently identified eligible articles assessed quality and extracted data. We performed meta analysis and meta regressions to estimate the association between weight and poor prognosis for h1 and one infection when date when data were available. So they took they got all of these studies, these separate studies that people in in England and China did.

So continuing, we identified 22 articles enrolling 25,000 laboratory confirmed patients and so patients who are confirmed to have hate one on one, they didn't just say I feel a bit sick or whatever they were confirmed in a laboratory testing. The pooled estimates indicated fatness significantly increased the risk of fatal and critical complications of h one n one. Okay, so the pulled estimates indicated fatness significantly increased the risk of fatal and critical complications of page one and one. So, what they found was the estimates was that fat people were dying a dying at a higher rate and then we're having worse reactions. However, done we found significant interaction between early antiviral treatment and fatness. After adjustment for early antiviral treatment, relationship between fatness and poor outcomes disappeared. Okay, let me let me tell you what that means in plain plain language, basically, early antiviral treatment, so they were treated the same time that straight size folks were treated and the supposedly poor outcomes disappeared. Well, well, well.

So conclusions, the rest of the meta analysis showed fatness significantly increased the risk of death, critical complications and severe complications of h1 and one, especially among high quality studies in Asia in the Asia Asia region. Importantly, the result from our meta regression indicated that the conclusion should be interpreted with caution because early antiviral treatment might be the key confounding factor. So it turns out if you treat fat people the same way that you treat straight size people and you give them antiviral treatment that they have, there is there is the poor outcomes as this study says disappear. So, what is that? What is that? Oh, weight bias and weight bias and so basically you know what this is? is saying his other fat people had poor outcomes because of the treatment that they got not because of having more adipose adipose tissue on their body.

So knowing this, and there's you know, there's a other studies like this. This is 25,000 People across China and England. And I mean, how fat phobic is China in England? I'd say pretty, pretty fat phobic. I mean, how does that differ between different places? I know that I mean, fucking New Zealand sounds like a shit show. Or fatphobia. I know, the I know, UK, the UK compared to Canada, UK is more of a shit show. And obviously, this is anecdotal evidence just from from what I've seen. And with all the whole whole show, that is healthcare in the States, I mean, an insurance and people being denied insurance because of BMI.

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Belly, I mean. So, anyway, all that to say that, you know, if early studies are coming out saying, Oh, hold on dying, because I've kind of and what it's like, okay, well, have you like this meta analysis? Have you looked at all of the other confounding factor factors. So it's like, Oh, two people walked into the emergency room, both with a broken leg, the straight size person was seen immediately, the leg was straight and put in a cast. And they were sent on the way the fat person wasn't, they were left in the waiting room and the lead leg turned gangrenous, and they had to have it removed. Fat people suffer poor poor health outcomes, if they break their leg is you know, so you could have a study, say fat people are twice as more likely to suffer poorer outcomes if they break their leg. Okay, what was going on for that to happen? Was it because they had a bigger body? Or was it because of the way that they were treated, when they arrived, and even how they treated before they arrived? How they treated in society that makes them want to go or not go to the doctor's, all fat people know what it's like going to the doctor's, all fat people know that. It's unless you've got a unicorn, magical doctor, that is stress inducing. And a lot of, of what we know about it is that a lot of fat people avoid going to the doctors. And when they do go to the doctors, they're told all Hey, yo, you stubbed toe, have you thought about stop being so fat? And so they're not, they're not given? They're given a prescription of weight loss, which doesn't work, and makes people more unhealthy. And so then they don't want to go back. They don't want to go back. Because they failed, they failed. Yeah, so so. So it's basically it's, it's complicated, and not the fault of fat people.

So our fat people at higher risk from COVID, the fat fiber, it fatphobia is rampant in health care spaces. And from the offset fat people were immediately blamed saying, we're going to be at higher risk, and we're going to be dying much more. And like that's the headline. Where does the research come from? Is it a junk research? Yes, probably junk research. And what else is going on? So when we think about what else is going on, for example, we've got vaccines amazing, great love a bit of vaccine. And we've got vaccines, but fat people are not told that we actually need longer needles. And so we need 38 millimeter needles if you're a fat person, and the threshold is is very low. So small fat people up need that longer needle.

Even though immunize isn't meant to be trained in this, a lot of them aren't aware that fat people need longer needles, and so fat people are not being immunized correctly against COVID. This is just one example of many in regards to the inequalities in health care that fat people experience. There's nothing about having more fat tissue, more adipose tissue on your body. That means that you're more likely to get COVID Some folks have suggested,

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fat people could be at higher risk because they're less likely to be paid fairly. And so they're less likely to, they're more likely to have minimum wage positions and work in roles that are public facing, which were less likely to be closed down during the various shutdowns, for example, food service workers. And so we know that those who are exposed to more people have a higher chance of getting sick. When we look at how fat people do when they do get COVID. There is a lack of evidence to that shows that fat people do badly. And they have poor outcomes for the sole reason of having more fat tissue on their body. In fact, we're seeing evidence that fat people do better in ICU compared to their street size counterparts. And if we look at what happened in happened with fat people in the h1 and one outbreak in a meta analysis of 25,000 people, first off, it looked like that fat people were at higher risk. But when they looked at how fat patients were treated, there was a difference in how fat patients are treated, they didn't get the treatment as quickly as straight sides, folks, and so they had poor outcomes. When they removed that from the study, they said that there was zero difference in the outcome across 25,000 People who had confirmed cases of hate one and in one, depending on their body size, there was no difference if everyone was treated in the exact same way. Their outcomes were exactly the same.

So any reported differences in the way fat people fared with h1 and one and presumably with COVID was down to weight stigma and poor health care. So a lot of the headlines that we see like fat people are more likely to die fat people are more likely to get into ICO ICU fat people are rolling, run around the streets, eating people and giving them COVID All of that stuff those headlines a lot of the time and cat paws a doctor cat Posey from New Zealand is doing work on this to show that those types of headlines are taken from studies that are not peer reviewed, that are not controlled for weight bias. So all fat people are at a higher risk from COVID. Some say yes, some say no. But when we do see that there is a higher risk. It's not because fat people have more fat tissue on their body. It's from weight bias and subpar health care, which is not the fault of the individual. It's the fault of institutions, governments, health care providers, it's their job to provide all people with equal access to health care. So I hope you enjoyed our episode today. If you've been a bit stressed about I'm feeling a bit stressed about today's episode, especially the Katrina thing. So if you're feeling a bit stressed, like me, Go in, go and do something nice for yourself. I'm going to go and take God out for a little walk. It's a great day, but the sun is trying to shine it's not raining. And know that no matter what, listen, we live in a fat phobic world. It's not okay. It's not your job to have to do this to advocate for yourself, you should not have to do this.

But just having that education on the fact that that you deserve equal access to health care. You deserve evidence based care. And so when a doctor says have you thought about you're on a diet you can say thank you so much. I really appreciate that. And I really appreciate evidence based care. Can you provide me with the same thing that you provide someone who has a lower body weight? Can you show me any study that shows that any diet is effective? Oh, you can't because they don't exist. That's what I thought giving gave me some evidence based care my life and if you want to do cats survey research, go check out the the show notes facebook.com forward slash 101. Count cat's website is called friend of Marilyn, friend of Marilyn. And that blog post is the first one on there with all of that information.

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Okay, well I'll see in a bit dogshit no see in a while alligator stay fears fatty and I'll see you next time goodbye thanks for listening to the episode and if you feel ready to get serious about this work and want to know when the doors open to fears fattier Academy which is my signature program, where I teach all about how to overcome your fat phobic beliefs and learn to love your fat body, then go to first party.com forward slash waitlist again that is phase fatty.com. Forward slash waitlist to get your name on the waitlist. For when first party Academy my signature program opens