Do Bariatric Chairs Send The Wrong Message?

bariatric chairAccommodation has to do with inclusion – we live in a society where we often go to great lengths to accommodate anyone with special needs – be it a physical disability or a dietary whim.

In the context of severe obesity, this includes providing access to care in a setting that accommodates bariatric patients – larger blood pressure cuffs, larger gowns, larger scales and larger furniture.

But how is this viewed by the very people that these measures are meant to accommodate?

This is the topic of a thoughtful opinion piece by CON bootcamper Nicole Glenn and Marianne Clark, published in JAMA.

The paper describes  comments of patients with severe obesity interviewed in a bariatric centre that tries its best to accommodate:

“Incredibly considerate and incredibly insulting at the same time.” This is how a woman describes the expanded chairs in the waiting room of the bariatric clinic….This woman is not describing the hospital administrators who purchased the chairs nor the designers from whose imaginations they sprung. Instead, she refers to the chairs directly, as if it were they doling out insults and praises in turn.

That these chairs were designed for the unique needs of these patients is obvious: they offer comfort and accommodation by way of sturdy metal arms and extended seats and backs. Nevertheless, these chairs are experienced in multiple ways; not all patients who encounter them find their welcome welcoming.

A woman waiting for her appointment at the bariatric clinic explains, “This giant chair makes me feel so very fat, and so very skinny at the same time…‘You are not normal,’ it seems to say to me.”

As the authors note,

By considering the experience of such ordinary things as enlarged chairs in the bariatric clinic waiting room, we must acknowledge how extraordinary these things actually are: how they have meaning and shape and are shaped by people’s lives. Listening to patients’ experiences allows us to see the world, if only momentarily, from their perspective, enabling deeper understanding of their lives, and ultimately leaving us better equipped to address their needs as they seek treatment and care.

At least it may be useful to consider that objects may be have unintended meanings and consequences:

Rather than finding chairs that accommodate larger bodies, these patients often seek a body that accommodates the world, one that slips easily and unthinkingly into “regular” chairs. Instead of providing rest and reprieve, the temporary comfort and accommodation afforded by the altered chairs in the bariatric clinic waiting room may act as a reminder of the shrunken world that exists outside these walls, ultimately marking a journey far from complete.

What are your thoughts on accommodation – what is the alternative?

Edmonton, AB

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