All about that bass and using the F word
For massage therapists, seeing and touching human bodies becomes routine and is seen from a professional viewpoint. What we can tend to forget is that for some clients it can be anxiety-inducing to strip down to their underwear even when covered with proper draping to receive massage. For those who are morbidly obese, the worries related to getting a massage are not whether or not the LMT will be judgemental, or that they feel insecure, but whether or not the table or chair will be able to hold their weight. Will they be able to lie comfortably or fit comfortably during the session? What if the sheets/blankets are not wide enough?
To be clear, the word OBESE is a term that applies to a person whose body mass index (BMI) is over 30. A person’s BMI equals their weight divided by height. “Morbid obesity” can be defined as having a BMI greater than 35, having a serious obesity-related condition, or weighing more than 100 pounds over the healthy body weight for your age, gender, and height. The word morbid has different meaning to patients and healthcare professionals so the medical community now defines the levels of obesity based on class to sound less negative.
- Overweight: BMI 25.0-29.9 kg/m²
- Class I Obesity: BMI 30.0-34.9 kg/m²
- Class II Obesity: BMI 35.0-39.9 kg/m²
- Class III Obesity: BMI ≥ 40.0 kg/m²
The added burden to a human body carrying several hundred pounds extra puts immense pressure on that body. Knees, hips, back, feet likely have consistent ongoing pain in different degrees. If dealing with constant pain the idea of exercise or physical activity becomes a reason to become sedentary and causes decreased circulation, increased inflammation, water retention and weakened muscles. Massage therapy can help with these secondary conditions but there is still a social stigma associated with obesity which makes it uncomfortable for some to seek or to give massage.
Although massage schools have plenty of specialized classes on pregnant women, cancer patients, infants or the elderly, the classes for working with 1/3 of the population, the obese, is far and few in between which leaves many LMTs ill-equipped. The word obese is a medical term which carries a stigma with it much as the word “fat” can be used as an insult. With an exception to the National Association to Advance Fat Acceptance most do not prefer to be called fat or call others fat believing it is offensive and judgemental. Size acceptance and body positivity are gaining momentum on social media platforms and causing people to question who is setting the standards for beauty.
If you have a client who is 100-200 pounds overweight then they are likely painfully self-aware of their obesity. Simple things like sitting at a desk for hours, fitting into a compact car, shopping for proper-fitting clothes, playing with your children at a park, going on a flight, are no longer simple. Someone weighing 400 pounds that booked a massage knows they are going to be in a state of vulnerability. They need to know that while they are in your space they are not going to be lectured about diet or exercise advise or made to feel anything but hopefully pain/stress relief and acceptance.
A part of my job and responsibility is to provide a safe and comfortable environment for clients of all sizes. I have recently upgraded my equipment to accommodate this. The massage chair can hold up to 600 pounds of working weight and adjust to varying heights. The new table can handle 800 pounds working weight, has 2 extra inches in width and an additional 5 inch wide arm rests if needed. The massage sheets and blankets I use have always been more than enough coverage and I have plenty of bolsters for extra comfort and adjusting.
For many whom are obese there are emotional and psychological complications connected to their body weight. At work, in a doctor’s office, the obese may find themselves being unfairly judged or presumed lazy or discriminated against. There are higher rates of depression, anxiety, and low self-esteem in the obese population. While loads are able to bounce the negative experiences or feelings off and live healthy and happy lives, they are still fighting a stigma about their body and if fought alone it can become draining. I aim to maintain a level of care that is welcoming and provide a place of respite from the world whether that be for one half hour or two! I hope with time as a society we can work through the stigmas associated with obesity and help those with goals to improve their health with positivity and encouragement.