Nirit Pisano, Ph.D., is a Licensed Clinical Psychologist and Chief Psychology Officer at Cognovi Labs.

Fat talk and body shaming accompany COVID vaccine distribution

Nirit Pisano, Ph.D., is a Licensed Clinical Psychologist and Chief Psychology Officer at Cognovi Labs.

A mid 30’s client arrives for our weekly telehealth session fighting back tears, recalling the letter he received in the mail specifying his eligibility for the Covid-19 vaccine due to his designation as “obese.” No further explanation is offered as he is directed to a state-run website to schedule his vaccination appointment (which, when he checks, has no openings). My client, working through severe childhood bullying that helped shape the vigilant, generous man I know, is devastated at having triggered the body mass index (BMI) ratio that led to this classification. In the best moments, he identifies himself as a survivor; an avid, competitive athlete; a man increasingly comfortable in his body and seeking firmer footing in the world. But in quieter, darker moments, he experiences his earliest trauma acutely; feels powerlessly transformed into the “fat” boy attacked by coaches and peers; left wincing through waves of deep self-loathing. In one fell swoop, without consideration of the person beyond the label or the repercussion of trapping a human in a singular category, the medical system sends my client into a spiral.

Intentionally and unintentionally induced emotions have far-reaching consequences for a campaign of any kind, motivating people towards a goal or immobilizing their effort. The above session prompted my search on Cognovi Labs Emotion AI, an advanced psychological Artificial Intelligence platform, which tunes into people’s emotional reactions through free-flowing conversations, at scale and in real time. What resulted was an outpouring of anger and disgust, and plummeting hope and trust, brought on by this public and private humiliation.

Source: Cognovi Labs

In the two-week period around February 15, when New York State listed obesity as one of the underlying conditions that deems residents eligible for the Covid vaccine, Twitter flooded with more than 100,000 impassioned Tweets on the topic, and that number is steadily rising. The content of the discussion is alarming:

“Got my Covid vaccine appointment. Now I just need to stay fat.”

“Getting my first Covid vaccine because I’m FAT! Fatphobia and BMI scale won this round.”

“Tired of people helpfully informing me that overweight people qualify for early vaccination.”

“Been told countless times recently my life has less value for being fat because I’m taking someone else’s vaccine who deserves it more.”

“Still unclear on whether or not I need a doctor’s note saying I’m fat to get vaccinated.”

One year into the global pandemic, the Covid vaccination campaign is in full swing: establishing immunity, restoring hope of “normalcy” and – as we see here via “fat talk” and body shaming – wreaking havoc on self-esteems around the globe. What happened to the concept of mental health in the structuring of this campaign remains a mystery. In an effort to vaccinate people at increased risk of Covid exposure or severe Covid illness, priority groupings were developed based on age, BMI, or smoking history, with seemingly little recognition of what it means to label a person along one of these (or for that matter any) category. The campaign essentially declares: “We are assessing your body,” or “Your addiction is what matters most about you,” or “Your age makes you vulnerable.” It reduces every person to a single demographic, condition, or habit, and asks each of us to do the same – both to ourselves and one another.

I am entirely supportive of the life-saving rationale behind priority groupings. We should protect the people most vulnerable to the disease, stop the spread and safeguard the medical system’s resources. Yet the concrete execution of the plan often fails the very people it aims to shield, for example when sending an unsolicited letter containing a previously unknown diagnosis without further clarification. The effect of Covid on mental health has been jarring, even without postmortem studies to confirm it (yet). Suicidality, domestic violence and mood disorders have spiked, and how people talk can exacerbate or soothe the already heightened atmosphere of distress. We’ve seen it a million times before; requiring “isolation” has different implications than insisting people “stay home.” Identical messages are delivered, with or without the added emotional toxicity.

Exact words matter. Convincing “data” is all around us, but particularly palpable when witnessing an individual gripped by shame and insecurity, functioning more slowly across the board but even more so in an ambivalent pursuit of the product that shamed him. Whether or not lawmakers and administrators anchor the vaccine distribution in a psychological framework, it is imperative they consider the impact of their communications. Otherwise, we will continually prioritize individuals’ physical wellbeing at the expense of their mental health.