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Covid vaccine prioritization is already hard. Don't make it worse by shaming obese people.

Fatphobia has been running rampant, and the vicious response to giving obese people early vaccine access shows just how cruel — and dangerous — it’s become.
People wait in line in a Disneyland parking lot to receive Covid-19 vaccinations on the opening day of the Disneyland site on Jan. 13 in Anaheim, Calif.Valerie Macon / AFP - Getty Images

New Jersey Gov. Phil Murphy’s social media pages have invited uplifting and ridiculous commentary from constituents since he first enacted state restrictions for Covid-19, and the vaccine rollout has been no different. When he recently expanded the pool of who’s eligible, trolls furious at the inclusion of obese people — who are at greater risk of dying from the virus — claimed it was a reward for bad habits like “stuffing their faces.”

Americans love to police other people's bodies, whether it’s criticizing a scantily-clad Lizzo dancing and playing the flute or two children taken entirely too soon by the virus.

Americans love to police other people's bodies, whether it’s criticizing a scantily clad Lizzo dancing and playing the flute or a son and a daughter taken entirely too soon by the virus. So many want to assume that someone’s fatness killed them, yet they don’t want obese people to jump the line to get a vaccine.

But obesity doesn’t merely result from bad habits. People are often overweight because of underlying illnesses, trauma and structural inequities in our society. And regardless of the cause, to suggest that obese people don’t deserve priority vaccination because they might have partly contributed to their increased vulnerability sounds like a soft form of eugenics, as if they ought to die off. Fatphobia in the United States has been running rampant, and the vicious response to the New Jersey vaccine guidelines shows just how cruel — and dangerous — it’s become.

Murphy, like governors of other states such as Pennsylvania and Delaware, is following the recommendation of the Centers for Disease Control and Prevention that consider obese individuals as high-risk. The CDC’s guidelines aim to “decrease death and serious disease as much as possible,” while preserving the “functioning of society” and reducing “the extra burden COVID-19 is having on people already facing disparities.”

In short, the CDC’s recommendations are designed to save lives and free up hospital beds. We should welcome Murphy’s decision to include those the agency has determined to be most at risk and most likely to contribute to overwhelming the hospitals we all rely on.

According to the CDC, 42 percent of American adults are obese, meaning they have a body mass index — using the metric system, their weight divided by their height — greater than 30, while only26 percent of Americans fall in the ideal BMI range. Someone who is unaffected by eating junk is not superior, and someone who eats healthy but remains fat is not inferior. People of all sizes stuff their faces, and people of all sizes eat healthy food.

It’s not at all clear that being clinically obese correlates with poor health, though it is the case that severe obesity — individuals who are more than 100 pounds overweight, some 9 percent of the population — is associated with a range of health conditions and shorter life expectancy. When it comes to Covid-19, however, the numbers are stark. Obese individuals, particularly morbidly obese individuals, are more likely to be put on ventilators than other coronavirus patients, and they have an increased chance of dying of Covid-19, getting a blood clot or needing dialysis. The risks are even higher for morbidly obese people under the age of 50.

Many conditions can impact whether someone falls into either of these obesity categories, and they often are not the ones we pay the most attention to. One of them is poverty, particularly the food deserts lacking affordable, high-quality food that surround many less well-off Americans.

While some of us live comfortably, donning Lululemon yoga pants and sipping our celery juice after a safe run through our neighborhood, an hour away a grandmother may be standing in line at Family Dollar to spend the last of her Social Security check buying cereal for her grandchildren. Without adequate transportation, getting to a supermarket may not be possible, and if she has mobility issues, she may have an even tougher time.

As a result, caregivers like her are more concerned about feeding their children by any means necessary, not obtaining fresh broccoli. (When’s the last time you saw a gas station sell broccoli?) And fresh, healthy food costs more — nearly twice as much as unhealthy, processed food, according to a 2017 study. Feeding America reports there are more than 37 million food-insecure people living in the U.S., with 15 percent of people in the state of Texas food insecure.

It is no surprise that places with food insecurity also have high percentages of overweight or obese individuals or that residents have less access to safe, green space for exercise and affordable health care.

Overconsumption of food is also often a response to trauma or a sign of binge eating disorder — the most prevalent eating disorder and a serious mental health condition, affecting 3.5 percent of adult women and 2 percent of men. Many studies additionally find that higher stress is associated with poor food choices and higher body weight.

Moreover, weight gain is frequently a side effect or symptom of a disease. Conditions such as asthma, lupus, chronic obstructive pulmonary disease and arthritis are treated with steroids, which can increase appetite. Some conditions, such as congestive heart failure and renal disease, cause severe swelling or water retention. Hormonal diseases like hypothyroidism, Cushing’s disease and polycystic ovary syndrome also can affect weight.

Instead of nonexperts assigning worth to obese individuals based on their eating habits, we should show empathy, and considering them high-risk is equity. Nobody is being rewarded for bad behavior. Instead, being moved up the vaccine distribution list can save them from a virus that will likely kill close to a half-million people before the majority of the U.S. is vaccinated.

Let’s not forget that so many of us have gained weight during this pandemic. We’re all reacting to a year, in some cases a lifetime, of trauma. Let’s stop putting a value on someone’s life based upon ignorant assumptions tied to their appearance.