EDMONTON - When you see the doctor for a flu shot, you expect a jab in the arm — not a jab about your weight.

But for the severely obese, a medical appointment about chest pain, asthma, or a routine vaccination can turn into a lecture or discussion about weight. Sometimes patients never have their original concern addressed.

Mary Forhan, a University of Alberta professor who specializes in obesity issues, says stigma and insensitivity toward the severely obese in the health care system can prevent these patients from seeking help for simple issues, sometimes leading to more serious health complications.

It was a problem she saw repeatedly during her 20 years as an occupational therapist. She also saw specialists and program co-ordinators who seemed uninterested in adapting programming or equipment to accommodate the severely obese.

“As a health professional, it’s really frustrating when your colleagues are disappointing you.”

Forhan will help host a workshop Saturday for health care professionals from across the country on treating the severely obese. There will be sessions on weight bias and sensitivity and sessions on practical skills, such as how to lift and transfer a very obese patient.

It’s all part of efforts to change the tone of treatment toward the severely obese, a population classified as having a Body Mass Index of over 40 or who are 100 pounds, or more, overweight.

“We often think weight loss is the best solution, but that’s not always the case ... some of the individuals still classified as having severe obesity have already lost a large amount of weight, maybe 100 or 125 pounds. That’s their best, healthy weight,” Forhan said.

“There’s a disconnect where the focus is on body weight. We attribute health with body weight, rather than looking at the physical fitness and mental health of an individual.”

Edmonton resident Adrianna O’Regan went to the emergency room five days after undergoing gastric bypass surgery to reduce the size of her stomach to lose weight. She knew something was seriously wrong and went to an emergency room, but the triage nurse told her she was vomiting because she needed to lose weight.

O’Regan remembers thinking: “I don’t have the energy to fight you right now, but I can’t believe you won’t even admit me to get someone to look at me.”

The next day, her surgeon determined her bowel was severely swollen.

Changing attitudes toward the severely obese takes time, but Forhan said there are relatively quick and easy things that health care professionals can do to make patients feel more comfortable.

There should be sturdy chairs that can support the weight of a severely obese patient in the waiting room, proper-sized gowns and blood pressure cuffs should be available. Doctors should have empathy for a severely obese patient who might need two hours to get to an appointment due to mobility issues.

“What that says to a patient is you’re welcome here, we’ve been expecting you, and we’re not scrambling to try to make things comfortable for you,” she said. “It says, we know you’re part of the health care system, that you’re an important part of patient care.”