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 Based on interviews with severely obese men and women about their
experiences with international travel, the small study found that
airport facilities and procedures, physical discomfort and
embarrassment on flights, and limitations associated with obesity
were recurring themes, according to the report in the Journal of
Travel Medicine.
"Obesity is a common condition and we know that obese individuals
are subject to physical restrictions and weight bias in their
everyday lives," said lead author Dr. Gerard Flaherty of the School
of Medicine at the National University of Ireland Galway.
"There is a dearth of research relating to the actual travel
experiences of travelers with chronic medical illness, how their
underlying conditions impact their travel or how travel affects the
management of their pre-existing illness," he told Reuters Health by
email.
Flaherty and colleagues interviewed 12 patients who were attending a
bariatric lifestyle modification program in Ireland. Most were in
their 50s and each had a body mass index in the "obese" or "severely
obese" category.
The participants talked about having to build in extra time to
traverse the long distances between check-in counters and departure
gates in airports and the lack of wheelchairs sized to fit larger
travelers.
They also discussed embarrassment during air travel, the discomfort
they feel on flights and bias they sense from other passengers.
Participants mentioned the narrow aisles, standard-sized airplane
seats, the need for seatbelt extenders - which are often a
conspicuous bright orange - and being barred from sitting in the
emergency exit rows.
Several expressed a preference for cruise ship travel because it is
more comfortable and seems to better accommodate the needs of obese
travelers.
Participants also sometimes had challenges with accessing hotel
rooms and raised concerns about fire evacuation procedures for obese
guests. They also faced heat issues in travel destinations with hot
weather, and tended to restrict their choices in leisure activities
such as historical walking tours. This limited their ability to
enjoy activities with family members on the trip.
A few interview participants said medical evacuation insurance was
essential because of the logistical difficulties they could face if
medical emergencies occurred in a remote destination.
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Overall, the group saw benefits in travel, but also regarded obesity
as a barrier to international trips. They discussed greater cultural
openness toward the needs of travelers with obesity in the U.S. and
Asia but more discrimination in northern and western Europe, which
led to much greater self-blame and self-deprecation.
One interviewee said of international travel, for example, "So
suddenly . . . your weight problem really magnifies . . . it just
hits you psychologically and physically."
Another said, "I haven't traveled much due to obesity, I traveled to
Turkey twelve years ago. I think that was my last major holiday.
That was hard going. It was just exhausting, and embarrassing.
Having to ask for a seat belt extender and you looked like a lower
class citizen, and I didn't travel again after that."
Pre-travel health consultations could be a great time for doctors
and travelers to talk about their itineraries and any concerns
during the planning process.
"Obesity is a subject which unfortunately tends to get ignored in
some clinical settings, but this does not serve the needs of the
patient well," Flaherty said. "An open and supportive discussion
about the potential challenges faced by the obese traveler would
surely benefit them."
Another next step is to increase awareness among travel companies
and consumers, who can help fellow travelers feel comfortable.
"Obesity is a disease, which is often not considered by airlines or
other companies involved in the travel business," said Dr. Carel le
Roux of University College Dublin, who wasn't involved in the study.
"We should as far as possible facilitate people with diseases to
participate in international travel, not because it is their right,
but that is what good people do in a civilized society - we care for
those who are less fortunate than us," he said in an email.
SOURCE: https://bit.ly/2FKarmc Journal of Travel Medicine, online
March 22, 2019.
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