This is Uncomfortable March 28, 2024 Transcript

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Reema Khrais: When Lindsey Niehay was younger, trying to figure out what she wanted to do with her life, she asked herself some questions: 

Lindsey Niehay: what do I think I’m good at? What do I think I could, you know, do for, decades? What do I think is gonna, be the best way that I can help, you know, the world?

Reema: Lindsey chose medicine. She made it her mission to become a doctor.

Lindsey: Like I wanted to set a big goal for myself. And so, you know, to me at the time, I was like, yes, that that’s a big goal. That’s something to get me excited, you know, something to work towards

Reema: So she was thrilled when Texas Tech University accepted her to their very competitive medical school, and then after she graduated… they selected her for their residency program in emergency medicine. She was ranked fourth among everyone who applied. 

Residencies are like a training program for doctors, to put their knowledge into practice before they start working with patients unsupervised. 

These programs are high stress and high stakes, and if you don’t complete the program, you might not get another chance to become a practicing doctor. Lindsey leaned into that pressure, and at the beginning, everything seemed to be going great. But then, not even a year into her program, things started going downhill.

Her bosses kept scolding her for these little mistakes….mistakes that seemed pretty normal for a doctor in training.  

Lindsey: It was like they were, like, picking these really small issues that were very common amongst my peers and then making them a big deal for me. Um, and I didn’t really know why

Reema: She wondered, what’s going on? 

Lindsey: I thought that it could mean the end of my career, uh, essentially.  Before it even hardly got started. 

Reema: Residency is stressful enough… even without extra tension with your boss. Lindsey barely had time to eat or sleep. When she’d get home from a 12-hour shift, she’d just collapse on the couch. At the same time, she loved being a doctor and connecting with patients. She’d think, I just need to keep my head down and get through this. 

Lindsey: I’m overall an optimist. And so I tried to, you know, make it so that I was like, well, you know, we can, we can overcome this, you know, no matter what is thrown in our way, we’ll figure it out.

Reema: Until one day, months later, she learned something that made her feel like she’d completely lost her footing.

One of her colleagues knew something Lindsey didn’t…she told Lindsey…

Lindsey: “Hey we should go get lunch one day” and I was like…okay 

Reema: On a Saturday afternoon, Lindsay sat down with her colleague in a crowded French bakery…

Lindsey: And you know, she reveals to me that the reason why all of this was going on, in her opinion, was because of my weight. she, even herself, didn’t, you know, believe, want to believe that that’s what was happening. But, you know, finally, because things had gone so far, she felt like she had to say something to me.

Reema: Lindsey has been big her whole life, she’s used to her body being the first thing people notice about her, but she could hardly believe what her colleague told her next. 

She told Lindsey about a meeting she’d observed between the residency’s program director and Texas Tech’s lawyer.  

Lindsey: The program director, you know, asked the attorney how she could fire me without it looking like discrimination. 

Reema: Wow. Like weight discrimination.

Lindsey: Yeah. 

Reema: How did it feel hearing that? 

Lindsey: It was also incredibly hurtful and disappointing and worldview destroying, um, to be quite honest. It was extreme anxiety about what the future holds. It was just a huge rush of emotions.

Reema: And did you have any inkling that you were getting singled out because of your weight? Or, like, had that thought crossed your mind and you brushed it off?

Lindsey: I… I had given it thought, but I also like to give people the benefit of the doubt, um, you know, almost until the, the facts are slapping me in the face. 

Reema: And the facts would hit hard. Lindsey was put on probation. And that was just the beginning. 

Reema: I’m Reema Khrais and you’re listening to This is Uncomfortable.

Growing up, we learn that discrimination is wrong and, in many cases, illegal. But proving you’ve been discriminated against, particularly in a workplace, isn’t always so simple. 

An employer isn’t going to jump at the opportunity to admit they’re being unfair. 

And then there’s the insidious reality that certain forms of discrimination are still considered pretty acceptable. Size discrimination is especially tricky, because our culture tells us that thinness and health are one and the same. “Obesity” is often framed as an epidemic with calls to “eradicate” it. So it can be easy to disguise prejudice as genuine concern. 

Lindsey found herself in the crosshairs of this battle. 

And she wanted to fight. But the harder she fought, the more she found herself in uncharted territory that put her career, and her livelihood, at stake. 

Reema: In some ways, Lindsey’s experience at Texas Tech felt familiar. Her weight has drawn negative attention for as long as she can remember. 

By medical standards, her weight puts her in the category of morbid obesity…which I should say is a charged and controversial term. Obesity is determined by BMI, which is widely considered a faulty measure. 

When Lindsey was in grade school, the bullying she experienced because of her weight made her want to hide, which was difficult in a world built for smaller people. 

Lindsey: I remember, you know, barely fitting into the desk. And sometimes, um, other kids like from other class periods would put their chewed gum up on under the edge of the desk. 

Reema: Oh god. 

Lindsey: And I remember like so many days at school where I would get gum on my shirt because the, you know, it would be you know, pressing up against my stomach.

Reema: Lindsey felt embarrassed to have gum stuck to her shirt. But then, it would have also been embarrassing to ask for a bigger desk. There was no right answer. Lindsey tried to channel her energy into her future. She’d often fantasize about a career in medicine, ever since she’d started watching ER with her parents. It looked exciting. 

Lindsey: You know, you’re rushing around from one emergency to the next. And, you know, you have multiple patients who are crashing at the same time

Reema: And then, teenage Lindsey got to see the real thing. She went on a school trip to watch an organ transplant. She was mesmerized, not because it was like watching ER, but because it was like nothing she’d seen before. There wasn’t blood and chaos everywhere. The operating room was clean and draped. The staff was turning a terrifying situation into something controlled, even kind of beautiful 

Lindsey: Everything was going exactly according to, you know, plan a procedure. It was very orderly, and so like, that’s what stood out to me was, you know, everybody working together and knowing exactly what was supposed to happen. It was, you know, um,  I don’t know, it was just like really satisfying to watch something work exactly as, you know, it should. 

Reema: She could imagine herself in those doctors’ shoes. And in Lindsey’s mind, medicine would be a safe, trusting place, nothing like high school. A place where everyone would be so focused on saving lives they’d never even think about anyone’s appearance. 

For years, Lindsey stayed laser focused on her goal of becoming a doctor. A lot of late nights, a lot of sacrifices. And as she progressed through medical school, she instinctively tried to avoid drawing attention to her body. During rotations, she often had to stand for hours. Her joints ached. But she wouldn’t ask for a chair. 

Soon after her residency started though, she was in a position where she couldn’t downplay her discomfort. Her class went on this adventurous retreat in the mountains for a series of team building exercises. 

Lindsey: There’s just some, you know, kind of weird overlap in the Venn diagram of outdoorsy people and emergency medicine. I guess, you it’s because of the adrenaline or what, but they like to be outdoorsy. And so a lot of people really enjoyed this wilderness medicine expedition. 

Reema: One of the group activities was a ten-mile hike, meant to simulate a rescue mission in the woods on a steep trail. It wasn’t the type of thing Lindsey would ever actually have to do at work. 

Lindsey:  Physically, I was like, I can’t participate in this activity in this way. 

Reema: Hmm. Mm

Lindsey:  And so they had to, you know, kind of make me the person that was like, um, you know, the communications person at the base camp to kind of coordinate people or whatever. But you could tell that this was not something that they had anticipated or that they had really thought about

Reema: Lindsey felt self-conscious about not being able to participate, but she brushed it off. She was used to the feeling. 

Aside from that hike, the first few weeks of her residency were going smoothly. She was getting good feedback and enjoying her interactions with patients. 

And then, a new program director took over. The one we mentioned at the top of the episode. 

She started making some comments that felt off to Lindsey, although it wasn’t anything she hadn’t heard before. The program director told Lindsey, emergency residency is physically taxing. It’s important to stay in shape. She even suggested that she and Lindsey work out together. 

Lindsey: I was like Oh yeah, that’s a little strange… and I didn’t take her up on it, because You know, who necessarily wants to go work out with their boss.

Reema: But Lindsey assumed the program director had good intentions. After all, they were in a medical setting.

Lindsey: I sort of tried to, like, detach myself from my emotional reactions to people expressing their concern about my health or whatever, and, you know, tried to just think, okay, well, science, According to medical science at least, um,  this is a problem and so of course they should be, you know, calling my attention to it. It would be irresponsible of them not to

Reema: Conventional wisdom says that losing weight will make us healthier, and in some cases, that’s true, but recent developments in medical research tells us that the relationship between weight and health is much more complicated than that. 

As much as Lindsey tried to not call attention to her body, some things made it unavoidable. For example, the emergency department didn’t stock sterile gowns that were large enough for her. Lindsey says sometimes that made it hard for her to do her job, it was an annoying problem. This also annoyed some of her colleagues who blamed her. They reported that Lindsey refused or was late to performing procedures. 

Lindsey tried to stay positive, despite the toll the work took on her. The long shifts, multiple days in a row, juggling several patients at a time with not a lot of breaks to eat or use the bathroom. 

But as time went on, she grew more confident that medicine was the right path for her. Her favorite part was interacting with patients. 

It was always nice when they’d show their appreciation, like there was this one patient who’d come in often, and he’d tell Lindsey that he was happy to see her in particular… cause when other doctors did this one procedure, it always left him in pain. 

Lindsey: He’s like, Oh, every time you do it, it’s, you know, easy. I get in, I get out, you know, it’s, you know, doesn’t hurt. It was really nice to hear, you know, that positive feedback. Um, because, you know, especially as an intern, you know, um, you automatically assume that whatever you’re doing is, you know, inferior to what somebody who is like a senior to you could do.

Reema: Lindsey thought everything was happening the way it should, minus the gown situation. And sure, she encountered some hiccups here and there, but she was brand new. It seemed normal. And then the program director came around for mid-year evaluations…

Lindsey: everybody else she was just quietly, you know, kind of pulling them to the side in the hall and saying like, Oh, hey, you’re doing great. Keep up the good work or whatever. But then for me, um, she wanted to have a one-on-one meeting in her office, you know, in a couple of days.

Reema: It was going to be a formal meeting where they’d talk about her performance. Lindsey felt restless, she couldn’t take the suspense, so not long before the meeting, she called the program director and asked if there was anything she could do to mentally prepare for it…

Lindsey: And she’s like, “Well, what do you want me to say that you’re not fired? You’re not fired.”   

Reema: Lindsay felt totally blindsided. Even though the program director was telling her she wasn’t going to be fired, it was starting to seem like firing was at least on the table. 

Reema: You know, it’s one thing to have a tense relationship with the program director, but what would it mean to get fired? Would it make it infinitely harder to get back into a residency program?

Lindsey: Yes, um, absolutely. It would make it an extremely difficult endeavor.

Reema: Getting fired from your residency program is a resident’s worst nightmare. It can spell the end of your career as a doctor. Getting into residency is hard, it’s competitive, there are more students than there are spots.. And getting fired raises a lot of red flags, why would another program take a chance on you when there are so many other qualified applicants? 

Finally the day of the meeting arrived. Lindsey sat across from the program director in her office. She told Lindsey, we’re placing you on probation. Lindsey could feel her throat tightening.

Lindsey: I was big, ugly crying. And, um, you know, through my sobbing, I was just like trying to, you know, salvage the situation and be as agreeable as possible because this person holds all the cards for me.

Reema: Lindsey was told she had deficiencies in patient care and was given a remediation plan to help her better evaluate patients and perform procedures. She also got broad feedback about how she needed to improve her professionalism and communication skills — none of that made sense to Lindsey, she thought she was doing fine. Nobody had brought up any of these issues before. And she’d completed all of her rotations with satisfactory evaluations. 

But at the same time, she thought well, I’m not actually going to get fired. This is a training program and it’s rare for residents to get fired. One study found that less than one in five hundred are dismissed from their programs.

She still had hope, even when the program director and some other coworkers brought her in for a meeting, and told her she should resign because of patient safety issues, which we’ll get more into later. Lindsey refused. 

Reema: Why did you refuse to resign? 

Lindsey: Well, because I didn’t think that anybody should resign for something that they essentially didn’t do. Um, I felt like that would be legitimizing their claims against me. I felt like that that just wasn’t the right thing to do.

Reema: They told her, if you resign, things will be easier for you. We won’t have to document what’s happening, your future employers won’t see your records. Still, Lindsey wasn’t swayed. Then, shortly after, she was at dinner one night with her family…

Lindsey: I got a text from one of my co workers saying that the program director announced at their morning conferences that day that, um, I was no longer with the program, but that they wished me the best. 

Reema: Wow.

Lindsey: So that’s how I found out that I got fired. I was, I was incredulous. I thought that was the most disrespectful thing. 

Reema: Were you feeling anger in that moment?

Lindsey: Oh, yes.

Reema: Lindsey couldn’t believe that this was really happening. She’d apologized even when she disagreed with the accusations, she’d tried to be cooperative during the probation process. And now, with no ceremony at all, she’d been fired. 

And it’s around this time that Lindsey met with the coworker who told her she thought that all of this was happening because of Lindsey’s weight…

And that was just the tip of the iceberg. 

‘Cause after she was fired, a medical board lawyer investigated Lindsey’s case—which is a routine procedure. And that’s when Lindsey learned what colleagues had been saying about her. 

Lindsey: You know, there were emails where people were talking about how they just felt that because of, you know, my body habitus, which is, you know, a way of saying like, you know, my, my weight, body shape, you know, they didn’t think that it was safe for me to be practicing medicine or, you know, professional. Because, you know, if a patient saw me huffing and puffing during a procedure that, you know, they might be concerned about whether the procedure was being handled properly.

Reema: We saw some of these emails. One of them, from one of her colleagues, reads “over the weekend, I had a procedure with Lindsey. It was a shame! She really struggled and I blame it primarily on her habitus.” The email goes on to say that Lindsey was “sweating profusely” and that patients might feel uncomfortable “as they see her suffer through, sweating and panting along the way.”

Lindsey: It was after I saw the documentation, I Um, of the emails and what they were saying that I was talking about that, that really is what gave me the push to say, yeah, I definitely need to pursue a lawsuit here.

Reema: The emails felt like a smoking gun. Her colleagues were openly saying they thought her body made her worse at her job. But the reality would turn out to be more complicated. That’s after the break. 

<<MID ROLL BREAK>>

Reema: When Lindsey decided to sue her former employer, she hoped it would restore her reputation, and secure her future as a doctor. She’d already dedicated years of her life to this profession, and has 270-thousand dollars worth of debt because of it. Sure, she has an MD…but that’s not enough if you want to be a practicing doctor. She’d have to finish a residency program. Lindsey thought if she could win a wrongful termination case, then maybe there was still hope.

Lindsey: I felt like it would, you know, clear the air, and,, help, you know, make sure that, that in the future people wouldn’t view me as, you know, being,  you know, a difficult person to work with, so to speak.

Reema: Lindsey wanted to show that she wasn’t fired because she was incompetent, but rather because of weight-based discrimination. She assumed that if she could prove that in court, Texas Tech would face consequences. And to her, the evidence seemed strong. Her colleagues had left a trail of emails that showed they believed her weight made her a worse doctor. 

Reema: And can you spell out for us what exactly your argument was? 

Lindsey: So essentially,  our argument was that under the ADA, the Americans with Disabilities Act, people are covered from workplace discrimination, whether it’s for a disability or a perceived disability, and that Texas Tech perceived me to have a disability, and therefore they discriminated against me based upon that perceived disability and made moves to dismiss me. 

Reema: Hmm. And what is that perceived disability? 

Lindsey: Um, so the perceived disability was obesity, um, morbid obesity specifically. Um, and so in the, you know, department emails that they were exchanging with each other, for example, they were discussing my weight, my eating habits, um, the fact that my body habitus might, you know, um, impair my ability to perform procedures, even though I had been performing procedures without issue prior to that, things like that.

Reema: The ADA states that it is illegal to fire someone because they are disabled. Or someone who is “perceived by others” to be disabled. The “perceived by others“ part is crucial for cases like Lindsey’s. Because we’re so conditioned to see fat bodies as unhealthy, people often assume that a larger bodied person is inherently disabled, even if they’re not. 

But I just want to back up for a second… like I wasn’t sure why Lindsey would need to use the Americans with Disabilities Act in the first place. I found it confusing. Like, wouldn’t it make more sense to just sue them for firing her based on her weight? Like the same way you’d sue on the basis of race or or gender discrimination? 

But then I talked with Rebecca Puhl, a psychologist at the University of Connecticut who specializes in weight bias. And she told me something that I found pretty shocking.

Rebecca Puhl: Protections for weight discrimination are virtually absent in the legal landscape in our country and almost everywhere in the world.

Reema: Wait Does that mean that almost everywhere in the U.S. it is legal to discriminate against people because of their body weight? 

Rebecca: That’s correct, and it’s just not something that people are protected from.

Reema: There’s no federal law protecting people from size discrimination of any kind. Only two states have laws —Michigan outlaws size discrimination full stop, and Washington specifically includes “obesity” as a legally protected disability. Texas, where Lindsey lives, has no laws whatsoever that prohibit weight discrimination. So that’s why Lindsey relied on the American with Disabilities Act, the ADA. 

Rebecca: The ADA is really the only option and so many times it doesn’t end up working.

Reema: We’ll get more into Lindsey’s case in a bit, but Rebecca basically says the laws aren’t on Lindsey’s side. So she had that going against her. Plus.. 

Reema:  How do we see size discrimination show up specifically in the medical field?  

Rebecca: Our research shows that doctors are usually the second most common source of weight stigma reported by people with higher body weight. In our studies, when we ask people who have higher weight who they’ve been stigmatized by in their lives, we give them a list of about 25 different people, ranging from family members to employers to their health care professionals, peers, etc. Doctors are number two on the list.

Reema: And maybe this sounds like it makes sense. After all, doctors should know what’s going to make their patients healthier. But in fact… 

Rebecca: like obesity and nutrition don’t get very much coverage in medical school, let alone weight stigma. 

Reema: One recent survey of 40 medical schools found that only TEN percent of medical students felt “very prepared” to care for patients with obesity. 

Rebecca: And so it pops up in a lot of different ways, um, and a lot of patients, uh, report feeling very, uh, stigmatized and, uh, blamed and stereotyped by health care providers.

Reema: Plus, the idea that fat automatically means unhealthy…it’s not that simple.

Tigress: The reality is, we can’t just look at somebody’s body and know anything about their health profile. 

Reema: That’s Tigress Osborn, the executive director of the National Association for the Advancement of Fat Acceptance. She says that a lot of people will justify discrimination toward larger-bodied people by arguing that it will motivate them to be healthier. But research suggests that size discrimination doesn’t just arise from assumptions about health— it’s often about aesthetics. 

And not everyone is an equal target. Studies have shown that women especially earn less the more they weigh. And it’s harder for larger bodied women to get jobs where they’ll be pretty visible. One study showed that, all in all, larger bodied women were 25% more likely to be unemployed. 

And Tigress says these realities apply to healthcare settings.

Tigress: So there’s this idea that you are failing as a role model if you are a healthcare practitioner and you don’t quote unquote “look the part” because you are bigger. And also, there are, you know, talented and capable caregivers who may have health challenges of their own. It doesn’t exempt them from being able to do their jobs well. But that attitude gets in the way of them being able to do their jobs well. 

Reema: She also says internalized fat-phobia is very common, and it’s why larger bodied people, like Lindsey, might be slow to recognize that they’re dealing with discrimination.

Tigress: None of us like to think of ourselves as the victim and um, and when we think about being discriminated against, there is shame associated with that even though there shouldn’t be. We have been taught and told our whole lives that if we are fat, it is our own fault. And that it is, that there’s something wrong with it and something that we need to change about it. And that if we’re not changing that, we are failures.

Reema: But there’s a lot about the system that still needs to change. Like the fact that it is still legal to fire people based on their size in most of the world. 

Which brings us back to Lindsey relying on the Americans with Disabilities Act in order to seek justice. The lawyers she found immediately got on board. 

Reema: How did it feel when the lawyers were like, you know what? I think we’ve got a, we’ve got a good case here.

Lindsey: It felt like finally somebody, um, you know, who actually had the power to do something was you know, um, we do think that there has been an injustice here. Like, there has been a wrong, an official wrong, and there was something we can do about it. 

Reema: It was validating.

Lindsey: Mm hmm.  Exactly.

Reema: But it would prove to be a years-long process, partly because Texas Tech kept trying to find ways to get the case thrown out. In 2019, when both sides had had time to gather their evidence, Texas Tech filed to have the case dismissed.  They made a few different arguments. They said the conversation between the program director and Texas Tech’s lawyer was inadmissible because of attorney-client privilege. They also said that “morbid obesity” wasn’t really a disability unless you could find an “underlying physiological cause.” Basically, they argued, unless there was a specific illness that could explain Lindsey’s weight, that her weight was her own responsibility and not protected under the law.

The trial court wasn’t convinced: the judge rejected Texas Tech’s plea to have the case dismissed. 

Reema: How, how did it feel to hear the court’s choice to move forward with the case? 

Lindsey: Um, that was a really, really affirming and validating, uh, moment. Um, you know, I, I remember sitting in the courtroom and hearing the judge tell Texas Tech that it was the most obvious case of pretext that she had heard in her 20 years on the bench and that they needed to pay me, um, in her words.

Reema: Texas Tech appealed that trial judge’s ruling, kicking the case up to the appellate level, with another hearing in the state’s Court of Appeals. That appellate court also ruled in Lindsey’s favor… she hadn’t won yet, but both courts agreed Lindsey had a case worth hearing.

She had offered enough proof that she was fired because of a perceived disability. The court also said that Lindsey didn’t need to prove that her weight was caused by an underlying condition. 

We read through the opinion from this appellate court case. And there’s a lot to suggest that Lindsey wasn’t being treated like other residents. There’s the incident with the gown… the fact that she was put on probation even though she completed all her rotations with satisfactory evaluations… the way her colleagues talked about her body and her eating habits when discussing her professional performance. (One email seems to suggest that Lindsey isn’t taking her work seriously enough because she’s eating Doritos.)

Texas Tech denied any discriminatory motivations, they said the complaints were about patient safety issues.

And they pointed out other things about Lindsey’s performance. Like, when she went home sick and didn’t CC all the right people in her email about it. Or, when she prescribed herself a refill of heart medication…which is allowed, but she didn’t follow the right procedure. Other accusations seem more serious… that Lindsey was rude, that she’d leave notes unfinished, or didn’t properly evaluate all her patients. But the documents also show that Texas Tech didn’t investigate these reports before choosing to fire Lindsey. And Lindsey says nobody even talked with her about some of these issues. 

I wanted to get Lindsey’s thoughts on some of these accusations. Like that email that suggested her size and her sweating might cause patients safety issues after they observed her doing this one procedure. I read some of that email back to her after: 

Reema: They were questioning your ability to adequately perform physically challenging procedures and said that it would not instill the greatest amount of confidence in the patients you treat as they see you suffer through sweating and panting along the way.

Lindsey: Um I felt like it was a very unfair depiction of what actually occurred during that procedure because, um, you know, there’s two sides to every story, right? And there’s a lot of details that are left out to, you know, create narrative there that I don’t think is accurate.

Reema: Lindsey says the procedure just took an unusually long time… there was a huge amount of fluid to drain from the patient’s knee. 

Lindsey: in any case, like, I might have been sweating, but I wasn’t, like, contaminating a sterile field or anything like that. I’m a human being, you know. We all sweat. It’s a normal part of life. Some do it more than others. Um so yeah, it was an exceptional procedure with some hiccups that weren’t my fault or anybody’s fault. 

Reema: Ultimately, Lindsey argued, none of these things would have led to her firing were it not for her size. She wanted more than anything to prove this in court. 

All this time, as Lindsey was waiting for her case to move forward, she was applying to other residency programs. Year after year but without any luck. 

Lindsey: I got a lot of promising interviews and people saying that, you know, they, they, uh, really liked me. They gave me good feedback and stuff, but ultimately they ended up going with other candidates

Reema: All the while, these applications and rejections were costing Lindsey her time, money and her sense of self worth.

Lindsey: Every time I would try and get my hopes up, only to have them dashed in the end. Um, so yeah, it was, it was a really difficult process, and, and there were, there were times where I was like, “I don’t know if I can do this again. I don’t know if I can put myself through this again.”

Reema: Throughout that time, how were you making, how were you paying your bills? How were you staying afloat financially? 

Lindsey: Um I ended up moving back in with my parents, and so then, you know, I was, um, pretty much fully dependent upon them. 

Reema: More than ever, Lindsey felt that having her case heard and winning… it would mean everything. It would be her chance to get her life back. 

But she still had to fight to even get a trial. Because Texas Tech had filed to get the case dismissed yet again, appealing to the highest level of the Texas judicial system. 

Then in 2023, the next step was a hearing in the Texas Supreme Court to see again, if Lindsey’s case could move to trial. Lindsey’s lawyer as well as Texas Tech’s lawyer made arguments in front of the judges. 

The judges were trying to figure out if morbid obesity could qualify as a perceived disability under the Americans with Disabilities Act. So they started throwing out hypotheticals…they were comparing a common misperception—that a heavier weight makes someone less capable—to unlikely scenarios. 

Justice Jimmy Blacklock: Well, let’s say I think baldness makes your, uh, circulatory system work poorly. And I’m just, I’m wrong about that, but I perceive that baldness impairs a, a, uh, you know, physical function of the body. And then I fire someone because they’re bald. Is that, is that a characteristic or is that a, is, have I perceived an impairment and therefore violated the statute? 

Justice Jane Bland: What about someone who is diagnosed with severe nearsightedness and, you know, wears Coke-bottle thick glasses, and the employer says, “She’s not attractive. I don’t want to hire her because of those glasses.” Is that an actionable claim under the ADA?

Reema: Texas Tech’s lawyer also argued… if morbid obesity counts as a disability, wouldn’t that mean too many people are protected by this law? 

Ari Cuenin: But I would note, there are projections that even 1 in 4 Texans by 2030 would meet Dr. Nita’s conception of morbid obese. 

Reema: Lindsey listened as they talked about her as though she was a theoretical person with a theoretical problem.

Reema: I’m wondering how you feel about the phrase “morbid obesity,” and what it was like seeing yourself referred to in that way over and over again in the legal documents?

Lindsey: Um,  I feel like it’s a little, uh, dehumanizing, honestly. Uh, it, it, it’s, um, you know, you think “morbid,” you think death, you think, you know, disease, you think…I don’t know, there’s, there’s definitely a negative stigma attached with that phrase.

Reema: The oral arguments concluded. And it was time, yet again, to wait. Lindsey was staying in a hotel, waiting to move into a new apartment, when she got the news. 

Lindsey:  I got an email from my lawyer and, um, it said, you know, something to the effect of, you know, I, I, I, I’m so sorry… [fade out]

Reema: Those words were enough. She could hardly even process what came next. 

Reema: Do you remember what it felt like in your body when you, when you read that? 

Lindsey: Um, it felt kind of like somebody had knocked the wind out of me. And like, I, I felt kind of nauseous and, um,  yeah, I just, I felt, I felt sick. Like just this deep, like pit of my stomach kind of feeling of, of despair. 

Reema: When the dust settled, Lindsey was able to start to understand what happened.

The Texas Supreme Court’s decision had nothing to do with whether Lindsey was fired because of her size. Instead, the decision hinged on the same technicality that had worked in Lindsey’s favor at the appeal’s court. The Texas Supreme Court said they didn’t view morbid obesity as a disability if it’s not caused by a known physiological disorder or condition. 

And this could have gone either way, because there was legal precedent for both arguments. Courts use past cases to justify their rulings, and since past rulings came down on both sides, it was basically up to the judges’ discretion if they sided with Lindsey or not. One of the arguments the Texas Supreme Court made was that, if they ruled in Lindsey’s favor, that would mean Texas disability law protects TOO many people. 

So the judges who dismissed the case didn’t disagree that Lindsey had faced discrimination. But they were saying that, according to the law, it didn’t matter. Lindsey never even got to defend herself against the accusations of rudeness and incompetence. 

We reached out to Texas tech for comment on this story, but they said because it’s a confidential, personnel-related inquiry, they can’t provide any comments. 

It took a while for Lindsey to process the case being dismissed. 

Reema: Do you remember the moment when it really hit you? 

Lindsey: It’s been kind of  slowly sinking in over time. Um,  It would, it’ll be like I’m driving in the car and I’ll, you know, just think, think about things and, you know, realize that the hopes that I had for, um, you know, my getting any sort of validation from the legal system about this are over. Like the idea that I’m going to come out on the other side of this and have the legal system say, “Yes, you were in the right” – that that’s never gonna happen. Like that idea has been really hard to digest.

Reema: In the future, there might be more legal pathways for people who find themselves in a similar situation as Lindsey. There are a lot of statewide laws in the works to ban weight discrimination. And last November, New York City successfully passed a law banning size discrimination in employment, housing and public accommodations. Tigress Osborn, who we heard from earlier, says she hopes we’ll see more sweeping laws banning size discrimination. But at the same time…

Tigress Osborn: what should change is the fact of the discrimination itself, right? 

Reema: Tigress says discrimination is damaging to everyone. It doesn’t just hurt the direct targets, but it also keeps people from working with valuable colleagues—just because of their size. 

Tigress Osborn: We should not need laws in order for people to treat their co workers or, you know, other employees at their job fairly. That’s what’s supposed to happen in the first place, but because that doesn’t happen, what should change is that jurisdictions across the U.S. – and ultimately, in the long run, the US. federal government – should adopt laws that make it illegal to discriminate against people based on their body size.

Reema: But no matter what happens in the future, what Lindsey experienced in her workplace left an indelible mark on her life. 

Reema: So what, what are you up to these days? Like, what is your financial situation like? Um, do you, do you have a job these days? 

Lindsey: No, I, uh, I currently do not. Um, and that’s something that I’ve been struggling with quite a bit. Um, uh, so, yeah, I’m dependent upon my parents still, um, to, you know, a huge degree, um, which we’re hoping won’t be for very much longer. 

Reema: How has this whole experience  changed how you see yourself? 

Lindsey: Um,  I think that I am much more forgiving and kind to myself than I used to be. Um, you know, there was a long time where there was an intense amount of shame that I felt regarding my body, because even if I didn’t feel like I had a problem with it, I knew that a lot of other people did. And so, you know, if there’s a lemonade outta lemon situation here, I guess that’s it.

Reema: Lindsey no longer ties her sense of self-worth to her size. But she still has to grapple with the fact that others will. As she’s thinking about finding her next job, hopefully in healthcare administration, she’s already planning to hide her body as much as possible. She thinks a remote position might be best. That way she won’t have to worry as much about colleagues judging her body. And she won’t have to worry about whether her employer will provide her with accommodations to make her comfortable. Given all she’s experienced, I get why that would be her instinct. But it’s also kind of sad. 

Lindsey: From a realistic perspective, I know that sometimes, um, sometimes it’s easier to go around rather than through. But that’s kind of how I’m thinking about things now, is that you know, how to present myself in the most palatable light to, you know, the broad, you know, people of society, while also being true to myself.

Reema: Being true to yourself in a world that demands you to shrink or suffer consequences can feel like an impossible balancing act. But when Lindsey fought her dismissal, she was doing what felt right to her. After a lifetime of trying to hide, she made stories like hers just a little more visible. 

Alright that’s all for our show this week…if you want to reach out with any thoughts or even a story idea, you can hit us up at uncomfortable@marketplace.org  

And as always, be sure to check out our newsletter. We’ve got great recommendations for how to spend your time, things to read or watch, or listen to. And this week, we’ve got a bonus Q & A about weight discrimination policy with Tigress Osborn, who you heard from earlier. She’s a wealth of information, but we just couldn’t fit everything into this episode. If you’re not signed up for that already you can do it marketplace.org/comfort  

Hannah Harris Green: This episode was lead-produced by me, Hannah Harris Green, and hosted by Reema Khrais. We wrote the script together. 

Additional support from producer Alice Wilder and our intern, Marika Proctor. 

Zoë Saunders is our senior producer.

Jasmine Romero is our editor. 

Sound design and audio engineering by Drew Jostad

Bridget Bodnar is Marketplace’s Director of Podcasts

Francesca Levy is the Executive Director of Digital.

Neal Scarbrough is Vice President and general manager of Marketplace.

And our theme music is by Wonderly.

Reema: Alright we’ll catch y’all next week.