Things truly are larger in Texas. Just…not the employees at one Texas hospital, apparently.
A Victoria hospital already embroiled in a discrimination lawsuit filed by doctors of Indian descent has instituted a highly unusual hiring policy: It bans job applicants from employment for being too overweight.
The Citizens Medical Center policy, instituted a little more than a year ago, requires potential employees to have a body mass index of less than 35 — which is 210 pounds for someone who is 5-foot-5, and 245 pounds for someone who is 5-foot-10. It states that an employee’s physique “should fit with a representational image or specific mental projection of the job of a healthcare professional,” including an appearance “free from distraction” for hospital patients.
“The majority of our patients are over 65, and they have expectations that cannot be ignored in terms of personal appearance,” hospital chief executive David Brown said in an interview. “We have the ability as an employer to characterize our process and to have a policy that says what’s best for our business and for our patients.”
Employment lawyers say Citizens Medical Center’s hiring policy isn’t against the law. Only the state of Michigan and six U.S. cities — including San Francisco and Washington, D.C. — ban discrimination against the overweight in hiring.
As Americans are expected to get larger, expect hiring policies like this to become more prevalent, especially in the health care sector. And I’m saying this as a big guy working in the health care sector who wouldn’t make the 35 BMI requirement. Our friends in the GOP will tell us of course that employers should have the right to be able to hire and fire based on weight and that it makes good economic sense to do so in order to stay competitive with healthier employees, never mind that the same GOP tells us that pink slime in our burgers and pollutants in our food and water are FREEDOM and stuff.
I honestly think that weight is going to be the next major issue in employment discrimination, and you’ll see SCOTUS get a case involving this before too long. Still, not everyone is okay with this policy at Citizens. Existing employees will keep their jobs and will get help in losing weight, but…
A doctor at Citizens who declined to be named acknowledged that employees — and patients — who are overweight cost the health care system more. But he said body mass index as a primary measure of obesity is not a good indicator: A professional football player might have a body mass index of 32, which is technically obese, but only have 7 percent body fat.
And unless obese job applicants have other precipitating health factors, he said, their weight wouldn’t get in the way of being a successful hospital employee. “If more people knew about it,” the doctor said of the employment policy, “they would be justifiably pissed.”
Consider this my contribution to the whole The More You Know thing.
Steve
Some patients in the over-65 age group probably have expectations regarding the whiteness of their doctors, too. It would be irresponsible to ignore their preferences.
beltane
But Michelle Obama is a fascist for trying to encourage children to eat more vegetables.
Unsympathetic
It makes good economic sense for a company to force people to meet certain health requirements because free market, bitches.
But when the gubmint forces companies to agree that CONSIDERING meeting health requirements would be a good thing, soshulizm.
However, both parties agree that the government is run for the interests of companies.
What am I missing here?
Belafon (formerly anonevent)
As long as the exercise program is on company time and company expense, go ahead.
jibeaux
As an employment policy, that seems like overkill. I understand why there can’t be obese firefighters, it makes less sense in a hospital context…although I take the point that if your doctor is a giant lardass, his/her lecturing you on being a giant lardass probably carries less weight. But I think in contexts less freighted than hiring, yes, we’ll see more emphasis on obesity and I don’t necessarily think it’s a bad thing. Our health plan, for example, automatically shifted everyone from an 80/20 plan (20% copay) over to a 70/30 plan. You could get put back into the 80/20 plan with an affidavit that you were a nonsmoker and were not obese. You could also get back into the plan with documentation that you smoked but had enrolled in a program to quit; or that you were obese but were in a weight loss program. It’s logistically complicated and who knows whether or not it will save money. I wish everyone could stay in the 80/20 plan. But when the costs go up every damn year from 6 to 10%, I think there’s a good justification that people who are voluntarily choosing paths that contribute statistically to higher health costs bear more of that expense. We’ve made a lot of progress on tobacco in this country and we need to make some of that progress on obesity.
Capri
I’ve read that being obese actually lowers a person’s overall health care costs. Sure, they get heart attacks or strokes more frequently than thin people. But then they die in their sixties.
Contrast that to a fit person who lives an extra thirty years – the final 5-10 of which are spent bedridden in an assisted living facility capped off by their final hospital visit, a $3000,000 ICU stay.
Of course, as long as they survive to retirement, that’s not the companies problem.
burnspbesq
I don’t like this policy. But I’m sure you don’t need me to remind you that if you’re in your mid-30s and have a BMI north of 35, you’re at risk for all kinds of nasty shit and should do something about it.
General Stuck (Bravo Nope Zero)
Speaking of Health Care, For those interested Cspan will be covering LIVE audio, the opening arguments for the three day marathon that in all will be 6 hours of Scalia talking down to everyone.
edit – sorry, that will be same day recording of the oral arguments.
Genine
I would argue that not all situations involving obesity are “voluntary”. Sure there are people who have a terrible diet and don’t exercise. But there are also metabolic disorders, gland disorders, medicines and all sorts of situations where weight gain is a result.
And the fact that weight-loss is a multi-billion dollar industry, along with other facts should throw into question the concept of “voluntary”.
The idea of obesity as a voluntary thing has a lot of assumptions behind it.
Shinobi
@jibeaux: Considering that there is no weight loss program that consistently creates permanent weight loss, it would be difficult for that to be particularly helpful.
95% of dieters regain, even people who get gastric bypass often regain some or all of the weight they lose. Twins studies indicate that weight is as heritable as height or eye color.
We all know people who eat whatever they want and don’t gain weight. We know normal weight people who hardly ever make it to the gym. And we know fat people who diet constantly and work out every day and are still fat.
What we’re really doing is discriminating against people whose bodies tend to store excess calories, and expecting them to live an ultra healthy lifestyle. While naturally thin people can eat McDonalds every day, and no one will say boo to them about it.
tofubo
is the center justified layout a new certainty ?? please make it left centered so this site is actually readable
thanks
Dork
I want my nurses to be young thin females, nubile blondes with big junk and tight asses. Hopefully they will argue about my care and end up in tickle fight.
Shinobi
Rather than spend all day here arguing with people about how all fatties are not about to drop dead, I’m going to leave a link.
If you are at all interested in thinking critically about THE OBESEITY EPIDEMIC OMG! then you should read this link, and the links that it links.
Water balloon
It doesn’t take an ultra healthy lifestyle to stay south of 250 pounds.
A lot of hospital jobs are very physical, helping people to the bathroom, turning over people recovering from surgery etc.
Steve
It’s kind of funny how many people blithely assume that obesity is the result of a “choice” that someone can just choose to unmake, even people who scoff when conservatives make similar claims about welfare recipients or the unemployed. Diet and exercise are important, but luck and genetics are important too. Some people who won the genetic lottery are desperate to believe that their weight is strictly a function of their hard work and smart choices and that everyone else could make the exact same choices if they really wanted to. Maybe it’s not that simple.
Punchy
Who wrote this post? Where do I go to look to see the author of each post? I see nobody’s name anywhere.
Emrventures
@Capri: Yes, the most costly medical patients over the long haul are the ones who are the healthiest and live into their 80s and 90s, often consuming massive quantities of health care resources in exchange for moderate increases in longevity. That’s an issue for Medicare. Companies couldn’t give a hoot. They just don’t want someone getting sick on their watch.
rlrr
@Punchy:
The author only appears on index pages, but no the article pages…
Hal
@Punchy:
Names are at the bottom of the articles now. It took me awhile to notice as well because I keep looking at the top for the article author still.
becca
OT but Krugman has a must-read on ALEC today.
Sunlight is reaching the kochroaches lair at long last!
CynDee
@Shinobi: Dr. Fuhrman’s Super Immunity does. Overweight is due to malnutrition– processed foods/not enough real food, lack of exercise, and stress. Dr. Fuhrmann looks and is healthy. What about your doctor and his staff? A clinic staffed by the pale, tired, and obese is probably not where you’re going to get healthy unless you do it yourself.
Marcellus Shale, Public Dick
what it think will solve this is some good old american violence, workplace style.
someone slaps a snickers bar out of someone’s mouth, because their obesity is killing the premiums on the group health plan, then some one mentions that the snicker-slapper has two kids with heritable conditions that require ongoing medical treatment and supervision.
another person breaks off another person because they had knee and hip replacements, then its on like donkey kong.
just another step until the deeply retarded realize that single payer is the only way to go.
Ben Cisco
Props for the title.
dave
unrelated, but why does dick cheney need a heart now, he never had one before.
Shinobi
@CynDee: Are their studies that prove consistent reduced weight after 5 years?
You are going to get healthy by yourself regardless. Your doctor is not the one who gets you off the couch and to the gym, nor is he the one that gets you to eat an extra serving of vegetables.
But really, are we discriminating against pale people now too?
Hal
You know what’s worse for a persons health than obesity? Unemployment.
Also, it would be truly wonderful to work in a place where every overweight person suddenly has a target on their backs.
Linda Featheringill
My day job is transcribing medical reports. I was recently switched to a different client. This particular practice routinely includes height and weight in their physical examination reports. Not every practice does this.
The point is, I’ve been surprised by how much people weigh. I’ve battled fat all of my life and jokingly compare myself to Jabba the Hutt but it looks like I’m slipping into the bell curve of what real people actually weigh.
And no, I have absolutely no words of wisdom on the subject.
Punchy
@Hal: The names are not at the bottom on my screen. I’m using IE and there’s no FP names on any of the posts anywhere on the screen, top or bottom.
rlrr
@Punchy:
They’re not appearing on the individual post page. They do appear on index pages (the front page, for example).
Mojotron
I have no desire to “fat shame” and i don’t agree with this policy, but our country has gotten far more obese in the last 25 years, diabetes prevalence has skyrcketed in the last 25 years, and the vast majority of other countries (except Samoa) aren’t facing these issues. Stating “diets don’t work” and pointng out that skinny people can have bad diets and heart problems comes across as McMegan-like hand waving to avoid the point that our country has issues with poor nutrition coupled with sedentary lifestyles. Yes, if you diet for a brief period and then return to your original bad eating and exercise habits you will put the weight back on, but if you make a long-term commitment to lowering your calorie intake coupled with a balanced nutritious diet and a regular exercise regimen you will likely find long term health benefits including weight loss.
Linda Featheringill
@dave:
:-)
Zach
I’m against hiring discrimination like this of this sort or any sort; it’s an artifact of our insane refusal to nationalize healthcare and save trillions of dollars while decoupling employment and healthcare. However, the argument that we should ignore BMI comes up over and over again in discussions of obesity and public health. The most common anecdote that you see in the “don’t discriminate against the overweight” articles that McMegan loves is that even George Clooney is technically obese. It’s used to counter the objectively true claim that obesity and extreme obesity are rising and that it has real public health implications. BMI isn’t a perfect definition of obesity and people certainly shouldn’t be fired for being above some arbitrary line, but the fact is that weight and height are two of the few things that have been well-measured across the population for long enough to use to judge trends in obesity.
Lastly, while it’s stupid, this is a lot more rational than other discriminatory reasons to fire people that are perfectly legal unless specifically prohibited by law. You could probably talk to the recently unemployed in Texas and find far more absurd or inexplicable firings because it’s an at-will employment state. If you want this sort of thing to end, you need reverse the assault on employees’ rights in general — require firings to be justified for objectively rational business purposes or, at a minimum, require employers to heavily subsidize unemployment when folks are fired for no reason.
Mudge
The administrator says, “The majority of our patients are over 65, and they have expectations that cannot be ignored in terms of personal appearance,” hospital chief executive David Brown said in an interview.”
This is aesthetics, nothing more. He’s not talking health care, or absenteeism..he says the patients ( a majority, which is often one complaint to these people) do not like to see overweight workers. This is the shabbiest excuse I have ever heard.
liberal
@Shinobi:
Heritability is a pretty slippery concept. There’s different definitions, and depending on how it’s used and defined, it maybe or may not track with the intuitive concept of “really, really depends on the genes and not the environment.”
In your example, IMHO eye color really is dependent on genes and not the environment. Height and weight, depends on what you mean by “environment.” If you allow for sufficient variation in environment…
liberal
@Zach:
IIRC the value of BMI that is used to define obesity has not been constant but rather revised downwards.
fester
@Capri: That line of logic “works” fairly well in a single payer model where there is a single payer that can appropriately discount long time horizons and make the decision that someone dead at 58 and a BMI of 44 is cheaper than a marathon runner who might die at 87.
However our model, even a PPACA model, does not work that way. Employee provider healthcare means the payer has at most a 1 or 2 year time frame to do net present value calculations, and in the short run high BMI individuals probably will use, on average, more expensive care than low BMI individuals. Anyways, Medicare will pick up the tab for both the marathon runner and the lard-ass once they make it to either 65 OR 2 years of disability.
Zach
@Capri: “I’ve read that being obese actually lowers a person’s overall health care costs. Sure, they get heart attacks or strokes more frequently than thin people. But then they die in their sixties.”
This is not so relevant (as to whether it makes business sense to deny employment to the obese) in our new age in which few companies provide lifetime medical benefits and health insurers profit by gouging the healthy and push the chronically ill into bankruptcy and Medicaid.
Schlemizel
@Punchy:
Please try again – not that it matters ultimately but the authors name is right there on the front page.
WTF is with this fixation on authorship? Does it affect anyones response?
Schlemizel
@Linda Featheringill:
And how long must poor boy blunder wait for a brain?
Felinious Wench
1. Get some exercise.
2. Eat healthy.
3. Sleep.
And what you look like, you look like, but you’ll feel better.
I have a thyroid that has basically decided working is optional. I would not qualify to work at this hospital. I also go to the gym 5 times a week and work HARD, and eat very well. I weight what I weigh. I know I’m healthy, and the tests I take prove it.
So, basically, these people are idiots.
Wonkie
I have very heavy co-worker. because of her wieght she cannot do her job. I don’t resent this on my behalf because it doesn’t affect me, but I do resent it on behalf of our clients. We do in-home care for disabled people and she cannot give the care she is paid to provide. She is in effect disabled herself.
I guess my point is that I believe employers should be able to put restrictions on the wieght of emplyees if it afects job perfomance.
On the voluntary/not voluntary debate. It is sort of voluntary for someone to be obese but it is a choice that is very very very hard to aviod or unmake. There is a genetic predisposition component. There is a learned behavior component. There is an individual personality makeup component. There is a habit component. There’s millions of years of human heredity that says, “Eat while you can because the hunters won’t kill another mammoth until next year!” There’s a cultural component: many Americans work sitting down. drive home, arrive there exhausted to face children and household duties and have no tiime to add exercise to their routine. In other words while people can chose how what and how much to eat and how much to exercise, in real life the choise is very very hard.
In fact is is probably harder to lose and keep off weight than to quit smoking or drinking alcohol.
So I don’t think that people with wieght problems should be sneered at. My sister has been obses allher life. She has a personal trainer and runs for two miles every day. Under her weight she is in better shape than I, the genetically-predisposed-to-be-skinny sib, can claim to be.
eemom
@Schlemizel:
Moreover, it’s usually pretty easy to tell who the author is by the, erm, signature styles generally on display here.
Schlemizel
As for weight control I really do recommend throat cancer! I now weight 10 pounds less then I did as a high school Junior. If Neru jackets come back in style I am all over that dog!
Seriously though we do have a national crisis brewing. Between heart disease, diabetes and assorted other long-term health problems we have to do something. Baring employment is hardly helpful and there will be such whaling & gnashing of teeth if the government steps in to even suggest something let alone do anything.
Certainly personal responsibility is key but corporate responsibility, starting with portion control (who needs a 64 oz soda or a 3000 cal burger meal?) and eliminating high fructose corn syrup from everything is a start.
Zach
@Genine: “But there are also metabolic disorders, gland disorders, medicines and all sorts of situations where weight gain is a result.”
It’s worth noting a paragraph that wasn’t excerpted here:
I doubt it’s a rigorous BMI=35 cutoff, and suspect that obesity with a clear link to disease might be excused… it could even be a plus for hospitals that treat people with related disorders. Who knows, though; this article doesn’t make the hospital administration sound like the most competent crew. Everyone comes across as a loser in this article… of course, the “National Association to Advance Fat Acceptance” is ready to provide a quote to support it’s anti-anti-obesity quackery.
gibsojj
Genetics schmetics. If you cut calorie intake and increase exercise you will lose weight. I’m tired of watching my fellow citizens turning themselves into buffalo.
jibeaux
@Genine: Yup. But to opt back in to 80/20, you don’t have to be non-obese. You have to enroll in a weight loss program. I would assume if you try and fail that, and get some sort of medical recommendation as to where to go next, that would probably be sufficient.
Pongo
@Genine: Bingo. We don’t have a clue about the genetics of obesity now and while personal habits certainly are important, there is ample evidence developing that even those habits may be genetically induced to some degree. There are known genetic syndromes tied to severe obesity (Prader-Willi, Alstrom syndrome, Bardet-Biedl, etc), many of which are due to genetic mutations affecting the function of sensory cilia. Obviously, these disorders are rare, but we have no idea how prevalent milder mutations are or what role they may be playing in contributing to obesity. After all, there have always been obese humans–granted not to the extent we see today–even when food resources were scarce. Habits cannot account for everything.
I totally support healthy lifestyle and maintaining appropriate weight, but worry that policies like this are premature until we have a better handle on the causes for obesity. This strikes me as a slippery slope that is destined to appear very ignorantly discriminatory in the future. Plus, BMI has been largely discredited among obesity scientists.
jibeaux
@Linda Featheringill: I read one once in which a five year old girl weighed 90 pounds. I know that’s not even a record or anything, but that blew me away. That’s approximately twice the size of a regular five year old.
Mojotron
The other thing is that “exercise” in the USA has come to mean getting on a treadmill or a stationary bike for half an hour a few days a week; we need to get people back in the habit of walking or biking to & from work by making it the path of least resistance. I’m also willing to bet that the reduction in smoking has contributed to our obesity, but recommending we go back down that road is a little too Dr. Nick for me.
Linda Featheringill
[hospital spokesperson]
Maybe they should just hire people who are older than 65?
Mino
Do you imagine that our scientist stopped at addicting folks to cigarettes? Humans are very easy to addict. If you’re eating from the center isles of the supermarket, you are probably directed by your cravings for fat, salt, and sugar.
I’ll be curious to see if the childhood obesity epidemic changes with the reduction of HFCS from their diets. It’s broken down in the liver and many suspect it’s the smoking gun with diabetes. Time will tell.
Of course, given the possible future of scarcity, gut efficiency could be an evolutionary advantage.
jibeaux
@Shinobi: But there are also people who do not make any attempts to do anything, because society doesn’t require any attempts to do anything. We once invited an overweight coworker to lunch, and she initially agreed. When she learned we were walking, she declined. The walking distance was, maybe, a quarter of a mile. It’s quite likely that someone with that attitude will not be helped by being in a weight loss program, but it’s also conceivable that she would begin to feel better and keep it up for that reason.
FridayNext
@jibeaux:
I can see the logic and can sympathize, but ultimately I suspect most of us do something that contributes to higher health care costs. I run regularly and while that is good for my heart it is bad for knees. I may not need cardiac care later, but I am much more likely to need orthopedic surgery. And if I turn out to have some sort of congenital heart disease unbeknownst to me so far, like my uncle or Jim Fixx, my running could even be bad for my heart. Unless we start to quantify and define exactly what we mean by “voluntary” and “contributes to higher health care costs” I will be skeptical of such arguments because they could use to discharge, drop, or charge huge premiums to just about anyone.
jibeaux
@Felinious Wench: Do you take synthetic thyroid meds? Getting that properly dosed helps a lot.
ruemara
I don’t think this policy would stand up to a lawsuit. Unless VP Rand gets his way. I also don’t care for the lack of author names on the blog posts themselves. Sure I can see them on the main page, but it’s a little silly that it’s not on the article itself. Bugs. I’m sure this will get worked out.
Mnemosyne
If it’s any consolation, this administrator has probably screwed himself:
IIRC, federal employment law does not allow companies to discriminate on the basis of appearance — that’s why airline companies are no longer allowed to dictate that flight attendants have to weigh a specific amount.
.
To the larger issue (no pun intended), obesity often seems to be a symptom rather than a cause of health problems. There are a lot of physical problems (ie thyroid issues, PCOS, etc.) that have weight gain and/or difficulty in losing excess weight as symptoms.
.
But excess weight can also exacerbate existing problems like high blood pressure, asthma, or type II diabetes, and for those situations, simply losing some weight can help improve the underlying health problem.
.
Honestly, I think our “obesity epidemic” is far more due to our crappy cultural incentives than individual genetics. I was reading a book about bicycling (yes, I’m obsessed right now) and there was a huge drop-off in adult bicycle sales during the 1980s. We’re only just starting to get back up to the same level of bicycle sales as we had in the 1970s, and we have about 100 million more people in the population.
We’re not going to be able to solve this “problem” without cultural change.
catclub
@Shinobi: I read it. Important and sensible.
I especially liked “You cannot hate someone for their own good.”
jibeaux
@FridayNext: Oh, I think everyone should be covered at a reasonable price. But all I’ve ever seen, year in and year out, is premiums up, benefits down. Copays up, benefits down. It’s a completely unsustainable system. I have an open mind towards anything we can do that attempts to change that dynamic and encourages people to change behaviors that are known to be unhealthy and expensive for the system. (We had a voluntary pilot program that I felt had much better potential, but it got cut.) Clearly I’m only talking about factors for which there are no health advantages whatsoever and over which the person has some control. I don’t think other than obesity and smoking, anything else qualifies.
Shinobi
@jibeaux: It’s also possible she has a health issue that contributes to her lack of exercise.
I’m not saying that all fat people are healthy, but neither are all thin people, yet somehow they escape judgement.
Mnemosyne
@Mino:
Every American should read Brian Wansink’s Mindless Eating, which is all about how the food industry uses science to trick people into eating too much.
Okay, that description makes it sound like some kind of crazy conspiracy book, but it’s more along the lines of Fast Food Nation and has some serious science to back it up.
Shinobi
@catclub: Right? My father’s been trying that on me for years. I’m still fat, who would have thought.
debit
@jibeaux:
So your assumption was that she didn’t want to walk because she was lazy. Nice. Maybe she has bone spurs and walking is painful. Maybe she was worried about excessive perspiration and potentially offending the group. The thing is, you don’t know.
jibeaux
@Shinobi: She had knee surgery, but that was a year ago. She did a lot of PT and said she had a good recovery. Haven’t noticed any limping or anything. One of the points of getting the surgery, she said, was that it would make exercise less painful. So, sure, it’s possible that her knees bother her again, or she has some other health issue, but she’s shared health issues in the past and what it seems like at this point is that she just hasn’t changed the behaviors that contributed to the need for knee surgery. I don’t bring it up as anything other than an anecdote, but there’s really not a shortage of anecdotes for Americans not taking basic care of themselves.
Mnemosyne
@jibeaux:
.
The Giant Evil Corporation I work for is trying a series of carrots (but, so far, no sticks). So, for example, the company put an extra $300 in my Flex account because (1) I got a screening at the company-sponsored health fair (2) my blood pressure is normal and (3) I have a BMI under 25. I could get $100 for each of those actions, so even someone who was in bad health could get $100 just for getting screened.
.
They’re also really trying to encourage exercise — there are three company gyms and an organized Couch to 5K program, among other things. It’s also part of the carpooling program — you get $1 a day if you carpool or take public transportation, but you get $2 a day if you bike, walk, or run to work.
.
Since, as I said above, I think the biggest part of the problem is cultural, I think employers offering carrots rather than sticks is going to be the way to go.
jibeaux
@debit: She walks around the office all the time with nothing visibly bothering her. She has walked with us before, to a slightly closer location. And as I’ve just responded, she has not been shy about sharing health information in the past and offered no explanation this time other than declining as soon as she learned we were walking.
jibeaux
@Mnemosyne: I think that’s great and very preferable. We had a pilot program that was much more in that direction although not as generous; basically you could take advantage of an on-site NP with no copay if you enrolled and tackled any health issues they determined you to have, cholesterol, tobacco, etc. It was much more carroty, but got cancelled. The carrot thing requires employers and insurers to be interested in the longer game, since the initial cost is likely to be greater. The stick lets them go ahead and cut, cut, cut. With budgets like they are now, I am not surprised by it. But I agree that the carroty option is much more likely to work out better.
pat
When I leave the clinic, I always think, well, guess I’m not so fat after all. The only department where they are all thin and trim is Sports Medicine.
I wonder what it would do if the hospital were to make a rule that there would be NO SNACKS in the department, no birthday cake, no donuts, nothing in the back room.
Of course people don’t exercise as much as they ought to, but the fact that food is readily available all day long must have something to do with it.
Zach
@Mnemosyne: “IIRC, federal employment law does not allow companies to discriminate on the basis of appearance—that’s why airline companies are no longer allowed to dictate that flight attendants have to weigh a specific amount.”
Only to the extent that it’s done so to perpetuate a sexually hostile work environment, which has been interpreted as being a Title 7 violation of the Civil Rights Act. You can imagine a United States in which the Federal judiciary wasn’t largely a product of a few decades of near-consecutive Republican rule where Title 7 was extended to cover discrimination based on appearance in all cases, but that’s not the case.
Pen
This organization gets zero sympathy from me just based on their own emphasis on aesthetics, but I’ll be damned if I ever say that extreme obesity isn’t a problem. Until he died of a major heart attack at 43 I worked with a “supervisor” who only had his position he was friends with our employer’s family. The simple fact of the matter was that he weighed nearly 500 lbs, couldn’t walk without a cane, and could not perform the duties the rest of the staff were being paid for.
Now was this a genetic problem? I don’t know, I wasn’t his doctor. But once we cross the aesthetics line and start saying we “can’t discriminate” against people who are physically incapable of performing their jobs… that’s when we’ve gone too far. Just like smoke breaks if your habits OR health prevent you from doing your job properly why are you getting paid, exactly?
the fugitive uterus
love this site with all my heart but, yeh, the centered text is messing with my mind
Villago Delenda Est
@Mnemosyne:
Or by it being much more expensive to ride around in an automobile.
Chris
One day, maybe people will finally stop desperately seeking for ways to break off this or that segment of the population and find excuse to treat them differently… ah, who am I kidding. Prejudice is as human as it gets and as American as apple pie.
daveNYC
I actually do sympathize with those people that have medical or genetic issues that contribute to excess weight. One of my friends pretty obviously has a strong genetic tendency towards excess weight (like her entire family is morbidly obese) but she manages to keep it under control. Of course she does this by going to the gym every day and doing one of those ultra-high calorie burning classes (as opposed to stretching for beginners) and that’s something that not many people are going to be willing to do.
I’ve also got another friend with similar issues, and she doesn’t exercise a damn bit, so I’ve got slightly less sympathy when she starts complaining about her weight.
Regardless, this requirement is complete crap. If there’s a job that requires a certain level of physical fitness, then you have a physical fitness test to make sure someone qualifies, not some magic number test. And I’m pretty sure that being a doctor doesn’t require being buff.
catclub
@Mnemosyne: “you get $1 a day if you carpool or take public transportation, but you get $2 a day if you bike, walk, or run to work.”
The federal government is more concerned about parking at this point. You get the full subsidy if you take public transport or Vanpool, but a minimal benefit for bicycle/walking. OTOH, the benefit is much larger – covers entire commuting cost ( I think – no vanpool available for me.)
Of course, I am in the sticks and commute to a federal site even further in the sticks, but the rules are made based on the parking conditions in DC.
Shinobi
@jibeaux: There’s also not a shortage of anecdotes for Americans who do. The plural of anecdote is STILL not data.
There are social factors at work, and policing the behavior of individuals, by expecting them to be up for a hike whenever and to never eat more than you think they should just doesn’t seem to be the way to solve them.
Shinobi
@daveNYC: But why should someone who’s genetically predisposed to weight gain have to participate in a hardcore crazy workout every day just to get some respect?
It’s great that that is what your one friend has chosen to do, but why judge the other for not wanting to spend a significant portion of her non work time torturing herself just to be acceptable?
I mean, you’re obviously free to judge whoever you like. But if they were both thin, would you even care?
cckids
I haven’t read all comments yet, but having this as an overall policy seems to be overkill. I have had to deal with nurses when my son has been in hospital who truly can’t do all their job requirements (lifting, turning patients) because of their weight. They usually got me to do it for them. I would think, though, that dealing with people on a case-by-case basis would be smarter & much less offensive. Because I’ve also seen many nurses or aides who would probably be classed as obese who can perform all job requirements.
Violet
Wow, this is my first time visiting the site since the site update. I don’t even feel like I’m on Balloon Juice. I can’t see any comment numbers? Is that just me or have they been eliminated?
As for overweight people working in the health care industry, there are plenty of them. Most of the doctors I visit have nurses or other assistants who are overweight. In fact, the majority of the non-doctors at the doctors offices I visit seem to be overweight. One of my relatives is a doctor as as he’s aged he has gotten rather heavy. I wonder what his patients think. Well, outside of that they’re lucky to have him as their doctor because he’s a really great family doctor.
EDIT: I put two returns to space the paragraph about the new site design and the paragraph about the topic, but they show up as one paragraph. Anyone else having that problem? Is there a new trick to getting it to space properly?
drst
@jibeaux: Define “basic care.”
I live in rural West Virginia. There are no sidewalks, no parks, no gyms unless I’m willing to drive about an hour. I have arthritis in both knees already (immune system issues are really common in my family). I don’t make a lot of money but I work between 60-80 hours a week. So am I supposed to tell my boss “Sorry, other people will judge me if I don’t work out an hour a day”? Am I supposed to try to climb hills even though my knees will feel like someone’s stabbing knives into them? Or can I just define taking care of myself for myself without random people deciding to judge my worth as a human being based on how unattractive they think my fat is?
I hope you also realize that for someone with an eating disorder, the act of eating regularly without panicking about it is the definition of basic care.
The Other Bob
Wow. Michigan is the only state that bans this form of discrimination? I haven’t had a point of pride in my state for quite some time. Good job Michigan.
TooManyJens
Am I the only one who thinks this also opens the door for not hiring people because, for instance, they are black and wear their hair in a natural style? Natural hair on black women is considered “unprofessional” by a lot of people.
I also wonder why people seem to get so personally and morally offended by what they claim to be other people’s ill health. You can’t tell someone’s health just by looking at them, except in extreme cases. And even if you could — they don’t have a moral obligation to you to optimize their health. If someone’s weight is making them unable to do their job, that’s a problem that’s actually your business. Otherwise, it’s really not, except to the extent that it’s everyone’s business that we have a healthy environment and people have access to the resources they need to manage their own health.
drst
@gibsojj: Gosh nobody has ever said “Just eat less and move more” to fat people before! I’m sure once this news gets out there will be no more fat people anywhere, because nobody in history has ever proved that this is bullshit! Oh wait.
jenn
@Violet: The comment numbers are temporarily out. The paragraph trick is the same as before, with 2 underlines together. Yesterday/last night, John put up a thread that talks about some of the redesign issues – the author will be put back up at the top of the post, and the numbers will be put back as well, among other things. If you have comments/suggestions on the redesign, that’s probably the best place to put them, where they’re assured of being looked at.
jibeaux
@Shinobi: Look, it’s not my business what people eat or how they exercise. I am sympathetic to people who have a hard time with their weight. But the data and the anecdotes all show we are getting fatter, we are getting less exercise and eating worse all the time, and our health care costs are climbing every year. It doesn’t help to say it’s all in our genes or there’s really nothing we can do about it. Health care costs are a serious concern and all we ever seem to do about it is shift more costs onto employers and individuals, we never actually try to do anything to control the costs in a way that doesn’t compromise quality of care. Sending people into a worse plan if they smoke or are obese is an axe and not a scalpel, I would much rather see an overhaul of health care delivery that incentivizes care and better outcomes for the whole patient rather than fee-for-service, but that isn’t the change we got.
drst
@Mojotron: No, you really won’t. 97% of people who lose weight on a diet gain it all back within 2-5 years. 40% of those people gain back more weight than they originally lost, so in other words, depriving your body of calories can end up making you fatter, as your metabolism fights to maintain itself. There is no permanent, safe way to make fat people thin. The idea that all the hundreds of millions of people out there who’ve tried to diet and had it fail them just lack willpower is magical thinking. The Occam’s Razor answer is that diets don’t work, really, even if you don’t call them diets.
Daaling
Speaking of healthcare, I got a kick out of how the so called liberal media (more like corporate media) has been reporting the demonstrations outside the supreme court which is hearing challenges to ObamaCares.
Although there are supposedly more supporters than teabaggers, you would never know it from corporate media reports. All they are talking about is how ‘religious groups’ are laying flowers because, you see, ObamaCares is an attack on religious freedom apparently.
Sigh…..there really is not hope for America when the media can show this much bias in reporting an obvious political stunt. Republicans just love to wrap everything in an ‘attack on religion’, attack on teh freedoms, attack on American family values blah blah. All poll tested hotbutton phrase.
The stupid it burns.
jenn
@drst: I think part of the problem, is that we’re all talking on 2 different levels, and so we tend to talk past one another. At the individual level, who the heck knows why a particular person is overweight, and there are a lot of medical reasons why that can be so. On the population level, though, eating less and moving more are going to do a lot of good. I agree with you on the not-judging part, though! Speaking for myself, I have an impressive genetic ability to gain weight – I’d be AWESOME as a hunter-gatherer. Sadly, I’m not a hunter-gatherer! But when I’m able to do the eat-less-move-more, I do see results, thank goodness. I love Mnemosyne’s company’s approach. That’s fantastic.
Ella in New Mexico
The issue that will stick in overturning this kind of policy is using BMI only as a way to measure the overall health of their staff. It’s time to throw it away as anything other than a highly inaccurate indicator of a person’s general body size.
BMI is worthless, but it keeps getting used because of it’s convenience, period.
Violet
@jenn:
Thank you. I went all the way down the front page and there was no thread for the site redesign, so I figured it was old news. Some people don’t visit much on weekends, so it might be an issue for others this morning.
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The paragraph trick with the two underlines was only necessary before when using blockquote. Do you have to do it for all paragraphs now, even just regular posts? Note: I’m trying it to separate the first paragraph from this one about paragraphs. Guess I’ll see if it works. That’s clunky if you have to do it for every paragraph and not just blockquoted ones.
jibeaux
@drst: By “basic care”, I am talking about people who make no attempt to get any exercise or to sometimes choose foods that are not crap. It’s a pretty low standard. If your regular lunch, a la someone else who used to be here, is a 2-liter of Coke, a bag of Doritos, and half a package of hot dogs heated up in the microwave, I think I can determine why said person is 300 pounds.
Comrade Dread
@Linda Featheringill: I’m not convinced so much that he had it transplanted into his body, so much as he tore it from the chest of one of his willing acolytes and devoured it, sending it to the infernal, dark, abyss of his thoracic cavity so that the victim’s soul could see the diverse Eldrich horrors that mankind with the trappings of sanity have convinced themselves do not exist, and the Dark Lord could continue to feast on its terror until the end of time.
Violet
@jibeaux:
The typical lunch of an extremely overweight doctor I used to work with was six slices of mass produced spongy white bread (like Wonder bread), an entire packet of American cheese singles and a pack of lunch meat. And a liter of soda. He used to eat in our office so I got to see him go through a loaf of bread in 2-3 days on a regular basis. He was morbidly obese and eventually became incapacitated. And he was a doctor who worked with other doctors teaching medical students. It’s not like he didn’t know better.
Fwiffo
Most alcoholics will continue to fall off the wagon, even if they join AA or whatever and try to quit drinking. Some of them may even have a genetic predisposition to addictive behavior. Does that mean they’re not at fault for their alcoholism?
TooManyJens
@Fwiffo: It sure as hell means that shaming and punishing them is done not for their own good, but to make other people feel better.
debit
@jenn: I think too that we’re not taking into consideration what it is we’re eating. There was a series of posts on the Great Orange Satan about David Kessler’s assertion that food producers have figured out that we cannot say no to the combination of sugar, fat and salt. (Link to NPR story.) People go to, say, Wendy’s and get a salad instead of a burger, and think they’re making a healthy choice when in actuality a single burger has fewer calories.
jibeaux
@Violet: Yeah, it’s a common story. I watched enough of Jamie Oliver’s show to have built up years’ worth of food disgust. And I like some pretty fattening and unhealthy things, so I know the appeal, but they have to be tasty, you know? A good bleu cheese burger and house-made real potato chips with ranch dressing and a pint of beer sounds fantastic to me, and I might get it on a weekend night sometimes. But I know how many fat and calories are in that kind of thing, so it’s going to be a treat, and I’m really going to enjoy it. If you’re having a thousand plus nearly empty calories with every meal you eat, not only are you going to be very overweight, I just don’t see how you enjoy or appreciate food.
s
@Felinious Wench: I hear that. My husband is blessed with a speedy metabolism, and I’m not. To look at the two of us together, it’s easy to assume he’s healthier.
But when we go for our annual physicals, invariably my cholesterol numbers are better, my blood pressure is lower, my blood sugar is better. Because I eat a salad with some lean turkey for lunch while my husband gets a big, honking burrito from Chipotle, washes it down with a Coke, then has dessert two hours later.
But he’s got the much better BMI. And as such, he’s not the one who has to deal with the simmering disgust and resentment that society generally feels toward people who are overweight. And hey, I’m glad for him, and dearly hope that our children have inherited this quality, but ugh, it’s just not fair. I hate that people look at me and assume I’m eating Fritos on the couch when I actually get up at 5am to work out every day.
Mnemosyne
@jibeaux:
.
I think that part of the calculation by my Giant Evil Corporation is that they still have some employees who are on pensions and retiree healthcare, so it actually is to their long-term @catclub: financial benefit to make sure everyone is healthy. Also, having people work here for 15, 20, or 30 years is not at all unusual so, again, a healthy workforce is to the company’s benefit. Companies that have a more transient workforce will probably decide that it’s not to their benefit to encourage these kinds of programs because they’ll be paying for someone else’s employees to be healthier.
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@catclub:
We’re in SoCal, so our requirements are based on air quality (specifically, the regulations that the AQMD puts out). That’s one of the reasons why biking, walking and running to work get a bigger subsidy — they don’t contribute to pollution like carpooling or mass transit do. The company has to pay penalties to the state depending on how many solo drivers they have parking at their facilities, so it’s really to their financial benefit to encourage people to walk or bike.
Fwiffo
I’m not saying people ought to be shamed or punished, I’m just saying that it’s pretty silly to throw up our hands and say it’s nobody’s fault and we can’t do anything so why try.
jibeaux
@debit: In those cases, it’s usually the dressing, which is generally loaded with HFCS and very sweet, and there’s a lot of it. I ditch it and use my own, or if I’m on the road I just use a small amount.
Pococurante
@Zach:
Not to mention in Right to Work states the supervisor only needs to be smart enough to avoid stating appearance.
That said, courts make exceptions for businesses where appearance is a significant part of the business model. My 24 year old daughter is a beautician in a high end stylist business that caters to very wealthy young women. There is constant pressure on her to stay at an unhealthy too-low body shape. It is legal for her to be terminated if they decide any of the men and women are no longer conforming to their marketing.
As far as the folks who think bicycling to work is the answer, that’s great if you live in a pre-auto city with high density and decent weather. Try that in a Southern city and you’ll die of heat exhaustion and respiratory disease from the pollution.
Brachiator
<blockquote
What a load of horse manure. This has absolutely nothing to do with either the health or the competence of the staff.
@Violet:
Was he a good doctor? Was he a good teacher?
@drst:
Well said.
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jenn
@Violet: I always used the underscore trick inside or outside of blockquotes, so it’s all the same for me! It sounds as though there were some changes that worked fine on the initial rollout, and then went kablooie awhile later (the centered text on some browsers being one of them).
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@debit: Absolutely. I think there’s a lot to be said on the knowledge-worker/ego-depletion front, too. There’s a great book out, I can’t pull the author out of storage, but the title is _Thinking, Fast and Slow_. It’s AWESOME, I’m really enjoying it. But one of the (many cool) things it discusses is just how much energy our thinking consumes, and how much sugars help keep us thinking complicated thoughts over longer periods. It seems like a difficult balance to strike, getting in just enough energy to keep us thinking, and not so much that it goes into body fat! If you haven’t read this book, I really really recommend it.
ThresherK
This is not the way to address obesity.
Likewise, some punky rental car place assessing fines (mentioned in lawyer-only language amidst the fine print) to renters who were recorded exceeding certain speeds is not the way to address driving safety.
(Remember this?)
sparrow
@Capri: I used to wonder about that too, but it’s not the case. The end-of-life is about the same either way, and the during-life care of very obese tends to be more expensive.
Either way, hiring people because of “perceptions” (versus qualities related to fitness for the job) is clearly wrong. I do think it’s ok to put in incentives to lose weight, though — but only if they’re balanced by sensible measures like keeping the food in the dining areas healthy.
ruemara
I gained weight regularly when I came to America (nice diet you guys got here), but when I tried Depo Provera way back in the 80’s, I gained 40lbs in 2 months and this was from someone who eat what she wanted, was kinda big but never gained weight past about 140lbs. Fast forward over 10 fat years of struggling to figure out how to drop those 40. I started on blood pressure meds, those increase your tendency to gain weight. Gained another 20 lbs. Went on birth control pills, got a DVT in 30 days. Hello medical issues! Gained more weight in the 8 months of recovery and this was even after I started back exercising to repair the leg damage. Just gave up and stabilized at (embarrassing number here), all the while being more physically fit than even the skinnier people around me and being a total health maven. I’ve lost a whole supermodel in weight now, by following pure quackery, but as I’ve told people who’ve asked, I work my ass off, I don’t eat any bread or root vegetables during diet phases, I hardly get to eat any even during normal eating, I measure, I weigh, it’s hard-at times-and if you’re healthy and do not need to lose weight, shut up and eat your goddamned pizza. I know I’ve lost out on jobs due to appearance bias’ and this policy only surprises me because it is so explicit. People are heavy because some are lazy and eat very, very poorly, some are addicted to foods and cannot control themselves (seriously, that doctor who ate 4 slices of bread and cheese and bologna for lunch, he really may not have been able to stop himself) and some, like I’ve experienced, have the bad fortune to be on medications that increase either appetite or weight gain, even if you eat normally. And noting that some people simply don’t want to change, no matter how much they bitch about their weight, isn’t judging them, it’s noting the truth.
daveNYC
@Shinobi: It’s respect in regards to their opinion of their weight. I’m chock full of not caring one way or another about their weight, but when the one who doesn’t exercise ends up talking about losing weight, but then doesn’t exercise, doesn’t eat healthy, and then mentions various medical and genetic conditions, it’s kind of annoying. If you don’t want to lose weight, that’s whatever, but don’t complain about it and then not do anything about it.
Violet
@Pococurante:
I lived in a large southern city known for traffic jams, hot, humid weather, and for being very bike-unfriendly. I rode my bike to work for years. The key to making it successful is to have some place to take a shower available at or near your work location.
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My employer encouraged alternative transportation to work because of parking and congestion issues and subsidized our access to a gym. Being female, that made biking to work a realistic option. Without that, it would have been almost impossible to look professional after biking to work.
Cassidy
@gibsojj: Not only is that inaccurate but exercise science will disagree with you. That can be accomplished in the short term, but is not a long term solution. Your body needs fuel. Period. If you don’t fuel it, then all the exercise you’re doing is a wasted effort. No “bro science” please.
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I won’t read the rest of the comments. Fat hate pisses me off. I’m a big guy. I go to the gym 5 days a week. I have a bit of a belly. My largest weight gain? I started taking Zoloft for PTSD. Boom 35 lbs. I’ve knocked a lot of it off, but still. I have a resting heart rate below average, run a 1.5 in 12 mins, can do 45-50 p/ups and s/ups in a minute. My blood pressure is below average. I’m just a big dude.
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My wife is a bigger woman. Would she love to go to the gym more? Absolutely. But she spends 10-12 hours a day at at/going/coming from work and the evenings taking care of our family while I work. You know what I see? I don’t see the formerly 90 lbs girl I met in high school. I see the women who had 4 children with me.
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Fuckin’ fat hate and bro science. Pisses me off.
TooManyJens
@Cassidy: Oh God, SSRIs. They sure as hell beat being mentally ill, but they’re tough on weight (and sex drive, sigh).
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Loved your comment. There’s more to life than a number on a scale or on a clothing tag. And people who try to rationalize their aesthetic revulsion at fat as “concern for our health” can bite my shiny metal too-big ass. I’ll just be over here with my low blood pressure and low blood sugar training for a half-marathon.
WereBear
Hassling people for overweight might be defensible if they had a clue what to do about overweight.
In my twenties I starved myself because of a emotionally based eating disorder. Fixed that, and in my thirties I worked out like a bandit, ate low fat/whole grains, lots of salad with fat free dressing. Fine… until I hit my forties and it stopped working.
I struggled for a few years until I rebooted my head, checked the latest research, and went low carb/high fat/no grains. Continued to live on the third floor with walks now and again, and hikes in the summer. Now I’m at my slimmest ever.
And I did it by bucking every nutritional concept currently promoted by doctors and nutritionists. So when we get THAT truly nailed down, we can start bugging people about their weight.
Violet
@Brachiator:
I don’t know if he was a good doctor because he’d mostly gone into academia and research when I knew him. He was a good teacher and had won teaching awards. He had endurance and mobility problems due to his weight and this caused problems when he tried to teach because he couldn’t stand for any length of time, which affected his ability to demonstrate some of the medical things he needed to be able to demonstrate, and he’d get winded easily.
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He also smelled. We guessed it might be due to his large size making it hard for him to clean himself. His clothes were dirty too, and he’d often wear the same thing for days, but the smell was there whether the clothes were worn the first time or the sixth time. His smell would be bad enough that it was difficult to be in the same room as him, which I know from personal experience because he’d eat in our office. We heard from students that it was challenging to be in his class for the same reason.
Gretchen
The place that I work pats themselves on the back for providing free fruit in the lunchroom, discounted gym memberships, and wellness screenings. They also force people to work 10-12 hours a day indefinitely, and see no relationship between their rising health care costs, and people who are too busy or tired to go to the gym or eat lunch. It’s a mystery! They’re such kind, caring employers, and yet these people keep on getting sick! The real burn is that the bosses and HR folks who see no problem with long-term, fast-paced overtime, themselves work an 8 hour day sitting down, with plenty of breaks. And have no compassion for the people they oversee who don’t.
Cassidy
@TooManyJens: I stopped taking them cold turkey. When I was on them, I worked out 6 days a week and ate reasonably and only lost 6 lbs. In the past I’ve told people to shitcan weight loss as a fitness goal, but the Army is archaic and it was affecting my career. I just had to learn what my triggers were and learn un-medicated coping methods. It works most of the time.
Corpsicle
So sick of “diets are scientifically proven not to work!” types chiming in every time obesity is discussed. Ignoring the science about vaccinations or climate change would be stupid, but when it comes to nutrition suddenly science means nothing, and the cause of obesity becomes a magical fairy who injects fat into us as we sleep.
Obese people deserve as much respect and dignity as anyone else, but denial of cause and effect helps no one.
lovable liberal
Uh, no. One professional football player – say, a cornerback – might have 7% body fat, but his BMI won’t be close to 32. Another football player – defensive tackle – might have a BMI of 32, but there’s no way he’d have 7% body fat. Seriously, those guys are obese, even though they’re tremendous, specialized athletes.
Not that I give a rat for the BMI…
This sort of assholery was pioneered by Rick Scott (R-fuck you) in Florida. Texas is just catching up on the Teapublican hate scale.
Cassidy
Btw, I’m gonna pimp our weekly fitness threads. If you’re interested in exercising as a beginner, looking for new ways to exercise, tips on weight loss and diet and nutrition in a non-judgmental “there is nothing wrong with you” environment, then join us on Sundays. It’s everything from your usual lifting weights and cardio to people who bike, hike and orienteer many miles. I’m currently writing a primer on supplements and SP&T is soliciting user generated posts on what we do. So come and ask for advice or be willing to offer it.
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Also, on Fitocracy, we have a Balloon Juice group. We have some studs among us. I’m trying to catch up and find I’m willing to work harder and not be mentally weak and go home early when I know I’m logging my workouts for others to see. If you want an invite, let us know.
Cassidy
@Corpsicle: So you’re sick of facts? Here’s the deal. Diets don’t work. Diets are short term solutions for quick weight loss. The facts are they are not sustainable and while marketed as such, aren’t meant to be. Diets involve running at a calorie deficit and you’re body will not accept that.
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Now, learning a more healthy eating lifestyle is different, which is what I’m sure you meant. ;)
Clime Acts
@Fwiffo:
No one is at “fault” for having the disease of alcoholism.
How we respond to that fact however, is entirely our responsibility.
Similarly, people who have genetic predispositions or disorders which render them prone to overweight are responsible for how they behave in response to that fact. And let’s not kid ourselves, though many here prefer to do so: Genetics and other such factors are responsible for a small percentage of obesity.
Gustopher
Isn’t obesity covered by the ADA?
Corpsicle
@Cassidy:I appreciate what you’re saying, but don’t think that is the meaning of diet. When we talk about an animal’s diet we simply mean what it eats, not a week’s broccoli and lemon juice enema binge. So yes, when I say diet I mean what we eat over the long term.
Jonathan
@Clime Acts: Thank you. Genetics and hormonal disorders, etc., do not contribute to the increase in obesity. It would be amazing if somehow, our genes have mutated so much since 1960 that the rate of obesity has doubled in that time across ethnicity’s, given our long life spans, this is incredibly unlikely. This seems to point to environmental factors. Watch this:
http://www.cdc.gov/obesity/data/trends.html
Over that same period, daily caloric intake has increased quite a bit:
http://www.cdc.gov/nchs/pressroom/04news/calorie.htm
Not surprisingly, much of the increase in caloric intake is in the form of carbs.
Also, why has obesity increased at a much faster rate in some states than others? (I’d be interested to know.)
Maybe it’s processed foods and chemical farming, growth hormones, etc, that are leading to hormonal issues, and blah blah blah. But I think the real answer lies in the changing lifestyles and diets, which we all can control for ourselves. I don’t think it’s that easy… it really is hard to find time for exercise, and to find affordable foods that are healthy, etc., but many people on this thread seem to think that being obese was something that happened to them or others, and not the other way around.
Cassidy
@Corpsicle: I kinda figured that’s what you were at, but you have to think in terms of our culture. A diet is a calorie/food restricted product marketed to people who are desperate to not be looked down upon. That’s why they fail. They don’t address the many issues and areas of a healthy lifestyle. And this isn’t a high horse; I just got done eating two pieces of fried chicken. I’m not a vegan/vegitarian or paleo, both arguably more healthy than my “I eat what I feel like” method of consuming.
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The word “diet” has a lot of horrible implications with big people. And people shutdown when you use key phrases with them. If I’m talking to someone and they say “small gov’t”, I immediately tune them out. I “know” that they have nothing worthwhile to say to me. I would imagine that “diet” has the same effect on bigger people.
TooManyJens
@Jonathan: There are a lot more people taking, say, SSRIs than there were in the 1960s. I happen to think this is a good thing — I think taking an antidepressant beats the hell out of killing yourself or trying to self-medicate and drinking yourself to death. But these drugs tend to lead to weight gain and/or inability to lose weight. I wonder how much that’s a factor. Also, far fewer people smoke now than did in the 1960s, which means they don’t have the artificial suppression of appetite. (When my mother-in-law was pregnant with my husband in 1967-68, her doctor encouraged her to smoke so she wouldn’t put on too much weight.)
Omnes Omnibus
@lovable liberal: Clay Matthews of the Packers is a Pro-Bowl linebacker with a fantastic physique. He is 6’3″ 255lbs. That figures out as 31.9 bmi. John Kuhn , a fullback, is 6′ 250lbs. No fat on him either. 33.9bmi.
Cassidy
@TooManyJens: And how did a lot of people quit smoking? SSRI’s.
Nimm
@Cassidy:
“Diets involve running at a calorie deficit and you’re body will not accept that.”
Mighty ironic that you were complaining about “broscience” in an earlier post, when this is just about the dictionary definition of it. Your mass is a function of energy balance. Period.
Does your resting metabolic rate decrease as you lose mass, above and beyond the reduction that will necessarily result from the lower mass? Yes. Is it great enough to overcome whatever calorie deficit you’re in? No.
You may disagree that calorie counting is an effective strategy, but there’s no reducing your mass without a negative energy balance. Every diet book on the shelf is trying to sell a different way to achieve that through unnecessary and often arbitrary and counter-productive strategies.
Now, replacing an unbalanced diet that is high in calorie-dense foods, and probably deficient in protein and dietary fats, with a diet that is balanced, sufficient in both macro- and micro-nutrients, and made up of primarily whole and less-processed foods will make long-term compliance much, much more likely – and be healthier overall. But the reduction in mass accompanying that isn’t because of the additional micronutrients in the “healthy” foods. It’s because of a negative energy balance.
The micronutrients, protein, and fiber, will make a calorie deficit tolerable and sustainable, but doesn’t cause fat loss.
Brachiator
@Violet:
So it sounds like this person’s issue was more than morbid obesity.
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Of course, if it were San Jose or Santa Cruz and the doctor didn’t wash because he thought that everyone should put up with his natural smells, and colognes and perfumes were pollutants, well I guess everyone would have had to just held their noses and put up with it.
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@Corpsicle:
Nuitrition and the inadequacy of most diet regimes are two different things. As hard nose a professional as Dr Dean Edell pointed this out time after time in his radio shows. He read the research, and summarized it in his books on the subject. It ain’t rocket science here.
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And lay people use “obesity” as a weasel word. Not every fat person is obese, nor is being fat always the same thing as being unhealthy. On the other hand, there is so much dumbth in this thread from fat and food puritans that it might make you want to go out and get a big slice of cake.
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Cassidy
@Nimm: Ummm…no. Calorie counting and dieting are two different things, for one. Secondly, you can eat at a 700 calorie deficit of nothing but carbs and I guarantee you’ll have less results of someone who eats 1 gram or protein per pound for a net positive, as part of a 5-6 meal a day plan involving all the food groups.
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The purpose of calorie counting is to watch what you take in so that you aren’t taking in phantom calories. You’re still encouraged to eat a healthy volume of food to maintain your system.
TooManyJens
@Cassidy: That’s a good point.
Cassidy
@Cassidy: I have no issue with calorie counting. I think it’s a great tool for someone to use to learn how to eat in moderation and vary their food selection. I encourage people to calorie count all the time.
Nimm
@Cassidy:
Ummm….yes. Your answer is simply non sequiturs and strawmen.
First, try not to argue with something I didn’t say. What I said was, you need a calorie deficit to reduce your body mass. Unless you’re talking about amputation, this is true.
Second, I don’t know why you think macronutrient composition has any bearing on that. Also, you don’t define what you mean by “less results.” At equal 700 calorie deficits, a purely carbohydrate diet will likely result in MORE weight loss than one with sufficient protein, because the latter is far more muscle sparing. This is, of course, not a desirable result however.
Finally, please produce some research supporting your claim that 5-6 meals results in greater body fat loss than an isocaloric, protein-matched diet with 1 meal. Or two. Or three. Or 15.
Comrade Mary
@Violet: The double underline is just a hack we’re using until the web goddesses whack this site into shape. It’s a bug that showed up Sunday evening: the new site didn’t need it before.
Shinobi
@Corpsicle: Show me a diet or other intervention that causes weight loss consistently across the population after 5 years, and I will TOTALLY AGREE WITH YOU. But right now that doesn’t exist.
Without a way to reverse obesity, haranguing already fat people for being fat seems more like harassment than something based on science.
Cassidy
@Nimm: 1) Reducing body mass is not the equal of fit and healthy. Obesity is not a simple matter of body mass. You’re premise is wrong from the start. You seem to think that a simple reduction in body mass is the way to go if I understand you properly? If that’s the case why hasn’t the coke and meth diet taken off?
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2)Bullshit. Reducing calories and increasing burn on a high carb diet is a recipe for fat storage. Go for it. Let me know how that works for you. Increased protein intake, as well as a well rounded diet, combined with exercise will reduce body fat, which is what is really being sought.
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3) Will have to get back to this one. Gotta go to work. I’ll allow you to do the same while I’m gone.
Shinobi
@jibeaux: There are serious health concerns about the current US lifestyle. A sedentary lifestyle and poor diet predicts poor outcomes regardless of a person’s weight. But we’re not talking about policing people’s behavior, we’re talking about discriminating against people based on their body fat. We’re assuming that anyone who is fat sits around and eats horribly. But research doesn’t agree.
I would love to see more society wide initiatives to improve health, perhaps initiatives to make workplaces less sedentary, more walkable spaces, cheaper vegetables. I don’t see anything wrong with society wide initiatives to improve everyone’s health. But targeting just the fat people ignores the thin people with health risks and unfairly singles out fat people.
Mnemosyne
@Nimm:
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Actually, macronutrient composition is very important, at least in terms of sustainable weight loss and permanently changing habits. The latest science shows that your body needs to use extra energy to digest protein.
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I work (part-time) for Weight Watchers and the reason they did a huge program change two years ago was because the science changed and they realized that macronutrients really are important. A 100 calorie pack of cookies and an apple may have the identical number of calories, but choosing the cookies over the apple is NOT nutritionally neutral.
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Now, this doesn’t mean that the Atkins people are right and we should all be eating bacon until we drive our bodies into ketosis. It does mean that satisfaction is important when you’re changing the way you eat and substituting low-calorie junk food for high-calorie junk food isn’t going to help very much in making permanent changes.
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Mnemosyne
@Shinobi:
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Except that the reason it doesn’t exist seems to have more to do with human behavior than with human genetics. It is very, very, very difficult to make a permanent lifestyle change because you already have 30 or 40 or 50 years of habits and beliefs that you have to change, plus you have constant interference from the people around you, plus you have the inherent problems with the American lifestyle. If you go off to a spa and lose 30 pounds because you’re exercising every day and eating controlled portions, you will re-gain that weight when you go back home and back to driving everywhere and eating fast food because you’re working 12 hours a day and don’t have time to cook.
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It does drive me crazy that every time people try to talk about how the American lifestyle is unhealthy, people take it personally and think they personally are being criticized because the size of the McDonald’s french fry box has increased by something like 50% since 1970. And, yes, we have the people on the other side who use the overall cultural criticism to target specific people, but that shouldn’t be allowed to shut down the discussion about how our culture and society are making it easier and easier for people to gain weight and harder for them to lose it once they gain.
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Interrobang
You want to gain weight quickly? Run a perpetual sleep deficit. How many North Americans actually get as much sleep as they need every day?
JoyfulA
@Cassidy: Me, too, with the Zoloft. I’ve been losing a pound a month for a year or two now, and I’ve only just realized it’s because my doc switched me from Zoloft to a drug that’s labeled for depression but more often utilized for nerve damage—one capsule for two problems—after I had horrid side effects from gabapentin. Previously, of course, I was gaining a pound a month from Zoloft for all those years.__
Sister Machine Gun of Quiet Harmony
@Cassidy:
In addition to the studs on the Fitocracy group, there is me, slogging behind the rest. So if you are more of a beginner, slowly working up to your fitness goals, join and we can support each other!
Mnemosyne
Also, too, for people who have found that SSRIs are making them gain weight, ask your doctor if you’re a candidate to be switched to Wellbutrin. There are some major contraindications (if you have anxiety it could make it worse, and bulimics and alcoholics both need to stay away because it can cause seizures), but it is not an SSRI and doesn’t cause weight gain.
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Just make sure your doctor specifies the name brand, because the medical journals are reporting that the generic is not as effective.
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Corpsicle
@Shinobi:@Shinobi: Give my regards to the magical fat fairy when she visits tonight.
Some Loser
@Corpsicle: What is your problem? Do you just enjoy being nasty?
TXG1112
Anyone who thinks that obesity in the US is anything other than a toxic mix of culture and bad choices has never been to Europe. Seriously, spend a week there and you’ll be amazed at how fat you think most Americans are when you get back.
Violet
@Brachiator:
I suspect that most people who are morbidly obese have more than one issue at play.
__
If you are speaking of the fact that he smelled and why that was, well, we don’t know. What we do know is that he was a brilliant man who didn’t change his clothes very often, and even when he did, he still smelled bad. Did he not care? Perhaps he couldn’t wash himself? Maybe washing clothes and changing clothes was too hard for him? Did he not have a sense of smell? I don’t know what the reason was. What I do know is that eventually my boss had to step in and ask him not to eat in our office because the smell was so bad and would linger so long that it made our working environment very unpleasant.
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Like I said, this was a brilliant man who had access to the most cutting edge medicine, top notch doctors and other medical professionals available and for some reason he preferred or chose to live as he did. And he ate massive numbers of calories in not very healthy food.
Nimm
@Cassidy:
1) You don’t understand me properly then. The only claim I made is that a negative energy balance is necessary for reducing your body mass. I said that because you made the bizarre, unsupported assertion that the human body can’t “accept” a calorie deficit. Of course it can. And you can’t reduce your mass without one, unless you want to get into amputation. When you want to discuss long-term effective strategies for sustainable fat loss while maximizing LBM retention and overall health, sure, then we can discuss that.
2) Be happy to. I do it every time I need to cut after a bulk. As long as my total energy intake is less than my TDEE, I lose weight, regardless of the absolute level of CHO in my diet. Not that anecdote means anything, but between Nov 2011 and Feb 2012 I lost about 6 lbs during an injury layoff from working out, with an average daily CHO intake over 300g combined with a small calorie deficit. Once again, I’d like you to present evidence that body mass will increase in a calorie deficit, at a certain level of dietary CHO. Seriously, even the most ardent Atkins zealots have abandoned that claim, and will admit that a negative energy balance is a sine qua non.
3) Well, I did not make any assertion about meal timing or frequency. You did. As such, it’s your burden to support your claim. But since you asked, I’ll offer some contrary evidence:
http://www.ncbi.nlm.nih.gov/pubmed/19943985
“Increased meal frequency does not promote greater weight loss in subjects who were prescribed an 8-week equi-energetic energy-restricted diet.”
http://www.ncbi.nlm.nih.gov/pubmed/9155494
“More importantly, studies using whole-body calorimetry and doubly-labelled water to assess total 24 h energy expenditure find no difference between nibbling and gorging. Finally, with the exception of a single study, there is no evidence that weight loss on hypoenergetic regimens is altered by meal frequency. We conclude that any effects of meal pattern on the regulation of body weight are likely to be mediated through effects on the food intake side of the energy balance equation.”
Is there anything wrong with frequent meals? Of course not. Some people perform better and have greater satiety eating more frequently. Others don’t. As such, it’s only -indirectly- relevant to body composition. It doesn’t “stoke the metabolic fires” or whatever silly rationale is usually offered.
Corpsicle
@Some Loser: My problem is that I have nothing but contempt for those who ignore science and reality when it does not conform to their personal prejudices. I don’t care if it is vaccinations, climate or the age of the earth. Having contempt for those people has nothing to do with their weight, only their intellect, or lack of it.
Mnemosyne
@TXG1112:
To paraphrase a very wise man, we’re not going to solve the obesity problem in this country by changing the lightbulbs in our house (ie by trying to shame individual people into losing weight). It’s going to take collective action, but Americans are unfortunately very bad at collective action.
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And just because I’m currently obsessed with urban cycling, I present to you the #1 cycling city in the United States: Minneapolis, MN. And the extreme weather is apparently not as much of a barrier to year-round commuting as one would think.
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Mnemosyne
@Corpsicle:
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Since I actually work with people who are having trouble losing weight and/or keeping it off, I am sympathetic to the people who point out that it’s hard to do, and it’s even harder to maintain a weight loss. I’m not at all surprised that so many people give up in despair, because you’re constantly having to fight everything around you that makes it so easy to not exercise and to eat processed food.
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But I’m becoming more and more convinced that the problem lies in the way our culture and society is structured, not in genetics. If we were able to structure our society so people could work shorter hours, have easy access to healthy food, and have safe public spaces to walk, run or cycle, I think our obesity rate would go way down, and even the people who are naturally at the high end of the weight scale would be healthier (ie lower blood pressure, less diabetes, less asthma).
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But, like I said, that kind of change would take collective action, and Americans don’t do collective action.
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Mojotron
I think there’s a disconnect here between “diet” and “a diet”. Going on a diet where you radically alter your eating habits for a brief period will lead to short-term weight loss, but completely eliminating carbs, or eating only bacon/grapefruit/steamed veggies is not a viable long term plan and unless people make sustainable long-term changes in order to get a well-balanced, nutritious, and lower calorie diet the weight will likely come back.
That and exercise.
TXG1112
@Mnemosyne:Agreed on all counts. I have lost weight and decided to get fit. It is not easy, a constant vigil.
If you look in places like NYC people are generally more fit than elsewhere as it encourages walking and healthy food choices are available. When I go to a suburban mall I am always surprised at how hefty people are. High gas prices may spell the end of suburban living and the lifestyle and culture that goes along with it.
Jonathan
@TooManyJens: Good point about the decline in smoking, not sure about the anti-depressants, but we’re talking about a full 1/3rd of the population being obese. Not “a bit heavy” not “a little overweight” not “she’s big boned”, but obese. I’m sure there are a million contributing factors, but it will always be the case that genes and hormones and chemicals in our body will have to obey the Laws of Thermodynamics.
Corpsicle
@Mnemosyne: Exactly, good health is beneficial to our society, so society should make it as easy as possible. Sidewalks, bike lanes, education, maybe even subsidizing some foods. Changing a lifetime of behavior is extremely difficult, but we can make it significantly easier.