Discrimination against fat people

A pretty interesting article in the Star Tribune about workplace discrimination against fat people.

Meanwhile, in today’s competitive job market, bias against overweight people is commonplace, obesity-rights advocates say. The overweight are slighted in the areas of hiring, promotion, compensation and layoffs, according to Mark Roehling, an assistant professor at Michigan State University, who reviewed 49 studies on the subject.

Roehling has interviewed dozens of heavy people about their job-hunting experiences. One woman told him that she sat at a job interview and watched in horror as her interviewer wrote in big letters across the top of her résumé: “TOO FAT.”

Discrimination is especially acute in workplaces where a premium is placed on personal appearance, such as executive-level positions, sales, public relations and other areas where client contact is key, said Mary Story, a University of Minnesota professor who studies obesity.

In a 1990 study of several hundred people by University of Vermont professor Esther Rothblum, the heaviest were most likely to report they’d been denied benefits including health insurance because of their size. Many said they had been fired or threatened with dismissal for weight reasons.

Women suffer the greatest unfairness, she said. “They don’t have to weigh very much for employment discrimination to kick in.”

Rothblum once showed a set of identical résumés to a group of students. Half the résumés stated that the fictitious female job seeker was 120 pounds. The other half put her weight at 180 pounds. She asked the students to rate the woman’s professional competence and suggest her appropriate salary range.

The 180-pound woman scored dramatically lower. “The amazing thing about that experiment,” Rothblum said, “is that, actually, 180 pounds is not that heavy. Imagine what larger people experience. I think fat people underestimate how much of their daily encounters are different because of their weight.”

The article also attempts to justify the discrimination by pointing to a RAND study which found that obese people spend more on health care than smokers or chronic drinkers, leading to higher health care costs of hiring obese workers. From what I can tell, the Rand study in question is pretty flawed.

  • The study doesn’t account for ways in which obesity might be an effect of, rather than a cause of, chronic health conditions. Many health conditions can lead to large weight gains, either directly, as a side effect of medication, or through decreased exercise. It’s incorrect to count these instances as cases in which obesity causes disease, but that’s what the RAND study does.
  • Due to massive discrimination against fat people, it wouldn’t surprise me if obese people were more likely to seek treatment for depression. But if so, the cause may be prejudice against fat people, and not fatness itself.
  • Obese people are extremely likely to see doctors and take medications as part of weight-loss plans. This shouldn’t be counted as equivalent to the way smokers are more likely to need cancer treatments – but that’s what the RAND study does.

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143 Responses to Discrimination against fat people

  1. Evan says:

    Studies of the health effects of weight also generally neglect to consider the stress that reduced-calorie dieting (which is, essentially, voluntary starvation, and has all the same health effects as the involuntary kind) places on one’s body.

    Larger people are, of course, more likely to subject themselves to this for longer periods of time.

  2. Elayne Riggs says:

    I look forward to testing this theory if any prospective employers ever call me back to arrange an interview!! With me I think it’s going to be much more a function of age than weight, but we’ll see…

  3. lucia says:

    Hmmmmm…
    I’m looking at the bullets in the “rebuttal” and I can’t help but sigh.

    Assuming that the person making the hiring decision is trying to avoid paying for extra health care costs… Does it matter to them whether the weight caused the expensive health problems, or wether the expensive health problems cause the weight gain?

    The el cheapo hiring manager figures, on average, he saves money not hiring the fat person either way.

    It is unfair discrimination either way…..
    Honestly, I doubt if the hiring manager is really thinking of health care costs when they turn away a candidate. Don’t actually know.. but I doubt.

  4. loauren says:

    sorry

  5. loauren says:

    sorry

  6. Lis says:

    An interesting aside. After attending a seminar on female sexual dysfunction, I noticed a common thread among the patients stories of having medical complaints dismissed by doctors as “all in your head.” I started up a survey to asking how many women and men have heard this from their doctors, to determine whether this is gender bias.
    And, I’m definitely seeing a strain, independent of gender, of people being told their problems are all due to being overweight.

    Meanwhile, I’d love more answers to my general survey.

  7. Jacqueline Homan says:

    I am unfortunately overweight, just like my mother and grandmother were. I do not eat junk food, and I have often observed the lucky thin people eating much more than I, yet I am the one who struggles and suffers with weight problems. While I am not morbidly obese, according to the BMI standards, I am too fat (I am 5’7″ and weigh 175)Since I was out of the workforce for 12 years, graduating from a university in my mid-thirties, I found myself getting denied job opportunities that got extended to less-qualified “Barbie Dolls”. Joining the YMCA or a gym is not possible when one has no money because no one will give a “fat” girl a decent job, despite her credentials.

  8. Jack says:

    [Post deleted by Ampersand]

  9. Jake says:

    Amp, bean, I know y’all don’t generally like to delete posts but…

  10. Raznor says:

    BMI is bullshit. I’m 6’1 and 207 pounds, and according to it I’m overweight. Since I have pretty much a pitcher’s build (same height and weight as Russ Ortiz, I started checking to see what Major League pictures. I found out that Brandon Webb is bordering close to obesity, CC Sabathia is already obese, and even scrawnly little Byung-Hyun Kim is overweight.

    Yep, that BMI is a pretty useful system.

  11. Raznor says:

    “Major League pictures” should be “Major League pitchers”. It’s late.

  12. lucia says:

    I’m confused… are you saying BMI doesn’t tell us if people are fat because….. these guys aren’t fat?!

    Lots of baseball pitchers carry lots of body fat. You can see big ol’ guts on many of them. (Some pitchers are not fat, and have no guts. )

    I don’t watch enough baseball to recognize the specific names but I looked at the pictures in the links you posted. CC Sabathia has one heck of a chubby face… and I swear.. that’s a double chin!

    Are you telling me the rest of him is rail thin?

    My guess: Based on their face pictures, bodies of many baseball pitchers I’ve seen on tv, ….well… these pitchers are carrying a lot of body fat.

    We can argue about whether that makes them “fat”, “too fat” or “average weight”.. but these guys are carrying plenty of body fat! They are pitchers, and likely fairly healhty. Hopefully, the will remain healthy.

    But.. the original question was: Should we accept workplace discrimination against fat people?

    The answer is: No, we shouldn’t accept it.

    Denying that some people are fat (some are), or pointing out that BMI is an imperfect measure of health (it is), isn’t going to remedy workplace discrimination!

  13. Raznor says:

    No, I’m saying the BMI doesn’t tell us who’s fat, because what it gives us is an arbitrary number of (I believe) kilograms per meter cubed. What this completely leaves out is body types (height alone doesn’t give a good indicator of body type) nor muscle mass. I mean when all it tells us is this guy (Byung-Hyun Kim) is overweight you know you have a seriously flawed system.

    And the problem is HMO’s using this entirely arbitrary system to determine whom they will and will not cover for what costs. And there you have the discrimination and the bigger problem in general.

  14. carla says:

    It’s a floor wax AND a dessert topping!

    BMI is not a fool-proof guide to who’s fat, and any responsible mention of it will note that it doesn’t work well for people who, for example, have a lot more muscle tissue than average. Someone who lifts weights a lot but who is slim could easily have a high BMI. (There’s also usually little discussion of someone whose BMI is too low, which is at least theoretically possible.)

    At the same time, it’s useful for people to have some kind of guide, some kind of wake-up call. I recognize that the nexus of weight and health–in many of its guises–makes a frequent appearance on this blog, and many posters are well-informed, but many other people seem unaware of the possible effects of weight on health (e.g., Type 2 diabetes). If BMI helps people learn to eat more healthily and exercise more–even if it doesn’t cause them to lose whole bunches of weight–then hooray. If it helps parents and kids get active, to get some vegetables and fruit, rather than a chemical/salt/sugar-laden microwave meal, hooray. If it’s used to beat people over the head, deny them health benefits, or deny them jobs, then NOT hooray.

  15. lucia says:

    Ok.. the face picture of Kim didn’t load… he’s obviously not fat! Although, I wouldn’t call him ‘thin”… I’d call him muscular. (My husband at 5’7″ and 122 lbs is thin. My sister is thin. )

    I do concur with Carla: no one says BMI definitely measures fat! But…for many people and physicians it’ still a useful value for people who do self evaluations.

    Most health authorities suggest that, when doing a self evaluation you determine your BMI… and then also look at things like your waist circumference. (Those with high BMI’s but small waists are not… ahem… at a serious risk of heart disease, cancer, diabetest…… )

    It is certainly true that some people don’t read the “whole” story on BMI, and some people don’t understand that no one says BMI is the one and only indicator of being “overfat”. (No.. wait….. Everyone understands BMI is not a perfect indicator of “overfat”, and then constantly want to say it’s not useful at all because it doesn’t tell you “everything”! LOL!)

    Clearly, BMI by itself should not be used to diagnose “overfat” ! Some groups do use it that way, which is improper. (I think the military and pollice sometimes do so.)

    But.. on the medical restrictions… When do HMO’s use high BMI to limit or refuse payment for medical care? (I’m familiar with doctors refusing to perform operation they think are dangerous because of poor health and or excess weight. That’s a slightly different issue.)

    I know few would cover the cost of a gastric bypas for me.. at a relatively low BMI of 22, but….sheesh.. I HOPE no doctor will give me gatric bypass!!! (What.. so I could fade away, die and stop posting to blogs? :D)

  16. sarah says:

    its wrong to be Discriminated, by people that have more aprecation from people that only see them for their bodies.

  17. tiffany says:

    well listen to sublime they are the best band ever!! o and sorry if you are fat and feel insicure about yourself

  18. claire says:

    im sickend by the amount of discrinonation towards large people. You wouldnt go up to an annorexic person and laugh? or a black person and call them a nigger? so why do people find it amusing to take the piss out of the “token fatty”?! “hey, hey large ass, when you sit down the earth moves” Oh, BRAVO! Thats sooo funny!

    Its not on! yeah, im larger than most, but im certanaly not “jolly” when it comes to this subject.
    peoples deliquenty to wards this subject are NOT funny and NOT clever. its DISCRIMONATION! And like other anti-scociable behaviour, should be out lawed.

    So fat haters, get over youreself, and pull youre heads out of youre butt!

  19. claire says:

    im sickend by the amount of discrinonation towards large people. You wouldnt go up to an annorexic person and laugh? or a black person and call them a nigger? so why do people find it amusing to take the piss out of the “token fatty”?! “hey, hey large ass, when you sit down the earth moves” Oh, BRAVO! Thats sooo funny!

    Its not on! yeah, im larger than most, but im certanaly not “jolly” when it comes to this subject.
    peoples deliquenty to wards this subject are NOT funny and NOT clever. its DISCRIMONATION! And like other anti-scociable behaviour, should be out lawed.

    So fat haters, get over youreself, and pull youre heads out of youre butt!

  20. claire says:

    im sickend by the amount of discrinonation towards large people. You wouldnt go up to an annorexic person and laugh? or a black person and call them a nigger? so why do people find it amusing to take the piss out of the “token fatty”?! “hey, hey large ass, when you sit down the earth moves” Oh, BRAVO! Thats sooo funny!

    Its not on! yeah, im larger than most, but im certanaly not “jolly” when it comes to this subject.
    peoples deliquenty to wards this subject are NOT funny and NOT clever. its DISCRIMONATION! And like other anti-scociable behaviour, should be out lawed.

    So fat haters, get over youreself, and pull youre heads out of youre butt!

  21. claire says:

    im sickend by the amount of discrinonation towards large people. You wouldnt go up to an annorexic person and laugh? or a black person and call them a nigger? so why do people find it amusing to take the piss out of the “token fatty”?! “hey, hey large ass, when you sit down the earth moves” Oh, BRAVO! Thats sooo funny!

    Its not on! yeah, im larger than most, but im certanaly not “jolly” when it comes to this subject.
    peoples deliquenty to wards this subject are NOT funny and NOT clever. its DISCRIMONATION! And like other anti-scociable behaviour, should be out lawed.

    So fat haters, get over youreself, and pull youre heads out of youre butt!

  22. janny says:

    i am obese my weoght is 597 i 5 foot 1 my bmi is 101 is that good

  23. Don P says:

    ampersand:

    I think your objections to the RAND study are very weak. Yes, it is possible, perhaps even likely, that some portion of the increased health care costs employers incur for obese employees are due to factors other than the obesity itself, but there really is no serious doubt that obesity is a huge source of health problems. The AMA, or some similarly reputable health authority, now ranks obesity as second only to smoking as a preventable cause of health problems and early death.

  24. Don P says:

    lucia:

    It is unfair discrimination either way….. [for employers to refuse to hire people because of their obesity]

    Why is it unfair? Is it also unfair for employers to refuse to hire smokers? Drug users? Alcoholics? What about airlines who force obese people to buy two seats? Is that also unfair discrimination, in your view?

    I’m not saying that the employer is necessarily justified, just that discrimination is a complicated question, and that it is certainly not clear to me that refusing to hire a job candidate on account of his obesity is unfair.

  25. Ampersand says:

    Why is it unfair? Is it also unfair for employers to refuse to hire smokers? Drug users? Alcoholics? What about airlines who force obese people to buy two seats? Is that also unfair discrimination, in your view?

    It’s unfair to discriminate against smokers, drug users, or alcoholics, unless what’s actually being discriminated against is a real lack of ability to do the job as a side effect of smoking, drug use, or alcoholism.

    I’ve read about several cases of airlines forcing fat people who can fit in one seat to buy two seats. I’d call that unfair discrimination.

    The case of someone who genuinely needs two seats is a bit different. How do you feel about someone who requires two seats due to a disability – for instance, someone who cannot sit up straight and fit in a single seat due to a spine deformity?

    (Busy drawing today, so don’t look for many more posts from me.)

  26. wookie says:

    I guess the question rapidly devolves to this: Discrimination is, to a large extent, the natural human condition. You don’t look/act like me, so I’m going to treat you differently. Some characteristics are inborn, some are learned, some have positive effects, some have negative effects. Most forms of discrimination are based on things that are visible (can’t discriminate against something you don’t know is there). Fair enough.

    So at what point does that “natural” discrimination become a problem? When it prevents someone from performing to their potential.

    Is it discrimination to not give a job sorting colours to someone who is blind? No, they honestly don’t have that ability. Is it wrong to not give a job lifting 150lb loads by hand to a 5’1″ woman with no upper body strength? Probably not, although if she had adequate upper body strength/endurance, then not giving the job would be discrimination.

    Is it discrimination to deny someone a job because they are a smoker/alcoholic or obese? Yes, because none of those things limit a persons effectiveness for your average position.

    Many highly successful and competent people smoke and drink themselves to death, but you can’t tell them by appearance, and it doesn’t always affect their ability to do their job (my father was an extremely brilliant engineer who drank himself to death. Work loved him, but he was definately an alcoholic). Obesity is visible (as is gender), therefore it can be used to discriminate unfairly.

  27. Don P says:

    ampersand:

    It’s unfair to discriminate against smokers, drug users, or alcoholics, unless what’s actually being discriminated against is a real lack of ability to do the job as a side effect of smoking, drug use, or alcoholism.

    Why? If these people would impose higher health care costs, and other kinds of higher costs, on the employer, why is it unfair for him to refuse to hire them? And what about, say, charging higher health care insurance premiums to smokers than non-smokers, a very widespread practise. Do you also claim that that is unfair discrimination too?

    I’ve read about several cases of airlines forcing fat people who can fit in one seat to buy two seats. I’d call that unfair discrimination.

    I’m not sure what “fit in one seat” means exactly, but anyone who flies regularly knows how miserable it is to be stuck in a seat, especially a center seat, next to a fat person whose body spills over into their own seating space. The fat person may technically be able to sit down in a single seat, his body mass may be so great that he overflows into the seats next to him. This has happened to me on numerous occasions. The airlines can and do make this call about a fat person when he presents himself at check-in. Do you consider this policy unfairly discriminatory? If so, why?

    The case of someone who genuinely needs two seats is a bit different. How do you feel about someone who requires two seats due to a disability – for instance, someone who cannot sit up straight and fit in a single seat due to a spine deformity?

    I think the airlines may fairly charge them for two seats, but in the case of a disabled person I would expect that airlines would often waive the extra charge. I do not believe airlines have any such obligation regarding fat people.

  28. Don P says:

    wookie:

    Is it discrimination to deny someone a job because they are a smoker/alcoholic or obese? Yes, because none of those things limit a persons effectiveness for your average position.

    But ability to do the job obviously isn’t the only issue that matters. Another consideration is the costs of the employee to the employer, regardless of his ability to do the job. Why is it unfair for an employer to disfavor fat job candidates, who are likely to impose higher health care costs than people of normal weight?

  29. wolfangel says:

    Why shouldn’t employers disfavour women, who are more likely to take time off for pregnancy?

    Why shouldn’t airlines make tall men — who also take up more room than just their single seat — buy two seats too?

  30. manda says:

    I think that fat people should be discriminated against. i mean really…..do something about your weight!I ued to be somewhat large and then i worked my ass off and became anorexic. Today i am happy with what i look like because of what i did. If i am fat that is my own fault. i did something about it. I am doing a project on gastric bypass surgery. Some people cannot help their weight so thats why they are having their surgery. I believe if you are under a size 12 then you can do something about it. that is my opinion…. sorry if it offends you.

  31. zuzu says:

    Hooray for eating disorders! Hooray for dangerous surgery! Hooray for dumping syndrome!

  32. zuzu says:

    Why? If these people would impose higher health care costs, and other kinds of higher costs, on the employer, why is it unfair for him to refuse to hire them? And what about, say, charging higher health care insurance premiums to smokers than non-smokers, a very widespread practise. Do you also claim that that is unfair discrimination too?

    Well, if Bush gets his way and the employer deduction for health insurance costs gets passed, soon nobody will have health insurance, so it just won’t matter! All those pesky high-risk people will just die off on their own dime.

  33. wookie says:

    Don P. please see my notes about visibility and how it plays an important role in discrimination. Employers DON’T discriminate based on wether or not someone is an alcoholic or has cancer running in their family. Neither are visible, they “can’t” know it. Obesity is cited as “appropriate” to discriminate for the health care reasons, but really, it’s just easy to pick up because it’s visible.

    So either you SHOULD be able to discriminate on someone based on health care risks, in which case family history and all the other invisible factors should be considered (huge privacy issues there), or obesity should not be a valid grounds to deny someone employment on the health-care angle.

  34. Don P says:

    wolfangel:

    Why shouldn’t employers disfavour women, who are more likely to take time off for pregnancy?

    One reason is that it is (currently) an immutable biological fact that the burden of pregnancy falls uniquely on women. Obesity is not an immutable biological fact, except perhaps in a relatively small number of cases. In most cases, it is the result of poor diet and lack of exercise, and is thus more akin to smoking or alcoholism than to pregnancy.

    Why shouldn’t airlines make tall men — who also take up more room than just their single seat — buy two seats too?

    How does being tall cause a person to need two airplane seats?

  35. Don P says:

    wookie:

    How have you determined that employers do not consider medical information when evaluating job candidates? Most employers require prospective employees to undergo a physical, which would normally include questions about individual and family medical history, and perhaps blood or urine tests. Many employers require job candidates to undergo drug testing. How do you know this information isn’t used in employment decisions?

    And regardless of whether it is or not, your argument is illogical anyway. It does not follow from the fact that we may impose limits on the ability of employers to investigate the health status and lifestyle of prospective employees, on privacy grounds or whatever other grounds may be, that it is unfair to consider all such information in hiring decisions.

  36. wolfangel says:

    It is indeed the case that women are the only ones who get pregnant. But so what? Just rephrase it that “women are more likely to take parental leave” (no biological fact there).

    If you are tall and wide — not fat, just wide — you overflow the armrests and the shoulder space. If you are tall you’ve also got long legs which, generally, don’t fit (unless you’re on an aisle) under the seat.

  37. Don P says:

    wolfangel:

    It is indeed the case that women are the only ones who get pregnant. But so what?

    So, women should not be penalized for this fact of nature. It’s not their fault.

    If you are tall and wide — not fat, just wide — you overflow the armrests and the shoulder space. If you are tall you’ve also got long legs which, generally, don’t fit (unless you’re on an aisle) under the seat.

    Well, if you’re talking about someone who is just a naturally large person, big both horizontally and vertically, and who causes the same kind of problems and discomfort to other passengers as an obese person, then perhaps airlines are justified in charging that person for two seats. But again, if it’s a natural condition rather than the result of a lifestyle choice (e.g., poor diet and lack of exercise), a claim of unfair discrimination would have more merit.

  38. wolfangel says:

    Ok, so you can penalise women for choosing to take more time off after having a child than men — you’ve not quite explained why we can’t justify hiring men more than women because women choose to take longer parental leave.

    If an airline charges people for not fitting into one seat, then it shouldn’t matter why they don’t fit into one seat — especially given that there *is* a genetic component to weight, so we can’t assume for any given person that they’re just choosing to be fat (oh, how fun, I’m sure).

  39. Don P says:

    wolfangel:

    Ok, so you can penalise women for choosing to take more time off after having a child than men — you’ve not quite explained why we can’t justify hiring men more than women because women choose to take longer parental leave.

    Huh? If post-birth leave is the issue, then one solution would be to provide the same leave to all parents of newborns regardless of sex.

    If an airline charges people for not fitting into one seat, then it shouldn’t matter why they don’t fit into one seat

    Why not?

    — especially given that there *is* a genetic component to weight, so we can’t assume for any given person that they’re just choosing to be fat (oh, how fun, I’m sure).

    We can assume that in the vast majority of cases obesity is the result of poor diet and lack of exercise, which are certainly not determined by genes but are matters of lifestyle, like smoking or drug-taking or alcohol consumption. The same is obviously not true for people who are just naturally tall or big-boned. But as I said, I don’t think it’s necessarily unfairly discriminatory for airlines to require large people to pay for an additional seat regardless of the cause of their size. With respect to this question, I’m just saying that a claim of unfair discrimination would have more merit if the condition were caused by genes rather than by the choice to eat too much and exercise too little.

  40. zuzu says:

    I’ve been asked in interviews whether I have children and whether I plan to have children. The subtext being, of course, that You Women Just Get Married And Have Children And Waste Our Training Money (Even Though Associates At Any Level Are Cash Cows).

    I’ve never taken a job that asked me that; in fact, I’ve complained about it to relevant authority figures. As much as there’s a stink recently about the JAG Corps being able to recruit on law school campuses, this kind of thing has been going on for a while. 12 years ago, Baker McKenzie, the second-biggest law firm in the world, was banned from law school recruiting because of overtly sexist and racist policies.

    As for weight in job interviews, I’m pretty lucky. I’m significantly overweight, but I’m also hourglassy and I have a pretty face and good bone structure (not to mention a good resume and writing samples). I have BRILLIANT classmates who have had trouble getting work because of their weights, skin, looks or voices.

  41. wookie says:

    We can assume that in the vast majority of cases obesity is the result of poor diet and lack of exercise

    So without having a way to prove that one persons obesity (lifestyle choice) from the other (genetic, thyroid, whatever), some sort of litmus test, we should assume all overweight persons to be that way by choice?

    And while I’ve heard and experienced urine tests for drug reasons in an interview, I have NEVER heard of anyone having to get a physical for the job interview… only for the health insurance portion, after being hired. I think Don P is making a lot of assumptions about a great many things, without a lot of consideration to how these things actually play out in “reality”.

    Seriously… if there was a way that you could run a scanner over a person and say “Well, their cancer/obesity/alcoholisim/fertility/whatever is a matter of choices they have made, therefore they should be denied healthcare/a free airline seat/a job/whatever” then you could “justify” that type of discrimination. I’m not sure how ethical it would be, but you could make a case for it that way.

    But with technology currently available, you can not determine those things definatively, so what gives you or I the right to assume the worst case scenario just because it may or may not be the majority?

    Has anyone here read “Holy Fire” by Bruce Sterling? One of the background things in that book is the complete and utter medical catolouging of every aspect of a persons life, every choice, every genetic code. Very cool book :-)

  42. Don P says:

    wookie:

    So without having a way to prove that one persons obesity (lifestyle choice) from the other (genetic, thyroid, whatever), some sort of litmus test, we should assume all overweight persons to be that way by choice?

    In this context, since the vast majority of them are overweight by choice, yes. I don’t know why you think there’s anything wrong with this. Virtually all public policies rely on generalizations.

    And while I’ve heard and experienced urine tests for drug reasons in an interview, I have NEVER heard of anyone having to get a physical for the job interview… only for the health insurance portion, after being hired.

    Most hirings involve a probationary period or are contingent in some way. I ask again, how do you know that employers don’t already use medical and lifestyle information about prospective employees in their hiring decisions? It would be very surprising if they did not.

    I think Don P is making a lot of assumptions about a great many things,

    No, you’re the one who’s making assumptions. What is the basis for your assumption that employers do not use health status in hiring decisions?

    Seriously… if there was a way that you could run a scanner over a person and say “Well, their cancer/obesity/alcoholisim/fertility/whatever is a matter of choices they have made, therefore they should be denied healthcare/a free airline seat/a job/whatever” then you could “justify” that type of discrimination.

    Why would it have be a matter of choice to be grounds for justified discrimination? And as I said, we already know that in most cases obesity is a matter of choice, like alcoholism and smoking and drug use.

    But with technology currently available, you can not determine those things definatively, so what gives you or I the right to assume the worst case scenario just because it may or may not be the majority?

    It’s not an assumption. We know that obesity is a matter of choice for the majority of fat people.

  43. Q Grrl says:

    “I ask again, how do you know that employers don’t already use medical and lifestyle information about prospective employees in their hiring decisions? It would be very surprising if they did not.”

    at $50,000 a pop for each fine accrued, I very much doubt employers are taking this risk [see HIPPA regulations].

    Don: even if someone chooses obesity, what are your ethical grounds upon which discriminatory practices would be upheld?

  44. Don P says:

    Qgrl:

    at $50,000 a pop for each fine accrued, I very much doubt employers are taking this risk [see HIPPA regulations].

    What are “HIPPA regulations?” Do you have a link to a description of these regulations?

    Don: even if someone chooses obesity, what are your ethical grounds upon which discriminatory practices would be upheld

    I already explained this. Obese employees impose greater costs on employers, and obesity may therefore be grounds for justified discrimination in hiring practises.

  45. wookie says:

    It’s not an assumption. We know that obesity is a matter of choice for the majority of fat people.

    And I’m saying *most* doesn’t make the cut. Most isn’t good enough. Close only counts in horseshoes and hand-grenades. And my reference to Don P’s assumptions are on why “most” should or should not translate into standard policy for all persons.

    Thank you QGrrl, I’m mostly familiar with Canadian regulations, but haven’t had the time to get out all my material from my Disabilities in the Workplace course or look up what all the different acts and laws are actually called rather than going by memory. And I’ve never had enough time to get the info on what the repercussions are (fine of $xxx, for example).

    Employers can’t at this time use potential health problems (cancer, fertility) or lifestyle choices (smoking, alcoholism, not sure if obesity is listed) as a basis for making a hiring decision. It is illegal as it violates your right as an individual to privacy. In fact, I’m not sure they’re even allowed to dig for that information once you’re hired, that information is privy to yourself, your doctor or caregiver and your insurance company (or in Canada, the provincial government as well as your insurance company).

    If you want the official names of the bills and acts that protect your right to these things from me, you’re going to have to wait until January when I will have time to unpack my old course notes, as I refuse to spend more time arguing this with someone who is repeating the same thing over and over.

    So I’ll repeat myself one last time ;-)

    Most doesn’t make something justifiable for all, *even if* you were going to make the argument that it is ethical to deny someone something on basis of a choice they have made.

  46. Don P says:

    Apparently, what Q grl means is “HIPAA regulations” (not “HIPPA regulations”). HIPAA is the 1996 Health Insurance Portability and Accountablity Act. Here is a link to the text of the statute.

    Q grl seems to be under the false impression that HIPAA prohibits the use of medical information in employment decisions. It does no such thing. Her reference to “$50,000 a pop” fines is apparently a reference to the provision of the Act that prohibits the unauthorized disclosure of private medical information. This provision deals with privacy rights violations, not the use of medical information in employment decisions.

  47. Don P says:

    wookie:

    And I’m saying *most* doesn’t make the cut. Most isn’t good enough. Close only counts in horseshoes and hand-grenades.

    Good enough for what? Why isn’t it good enough? What standard would be good enough, in your view?

    And my reference to Don P’s assumptions are on why “most” should or should not translate into standard policy for all persons.

    I don’t understand this sentence. What alleged assumption of mine are you referring to here?

    Employers can’t at this time use potential health problems (cancer, fertility) or lifestyle choices (smoking, alcoholism, not sure if obesity is listed) as a basis for making a hiring decision. It is illegal as it violates your right as an individual to privacy.

    Show me the statute that prohibits employers from using potential health problems or lifestyle choices in hiring decisions.

    The HIPAA Act prohibits the wrongful disclosure of medical information by one party to another party. It says nothing about the use of such information in hiring decisions.

    If you want the official names of the bills and acts that protect your right to these things from me, you’re going to have to wait until January when I will have time to unpack my old course notes, as I refuse to spend more time arguing this with someone who is repeating the same thing over and over.

    You’re the one claiming these laws exist, so you have the burden of substantiating that claim. Please do so.

    Most doesn’t make something justifiable for all,

    Yes, it does. As I said, virtually all public policies are based on generalizations that aren’t true in every case. Social Security is based on the generalization that the elderly tend need additional income. Affirmative Action is based on the generalization that members of certain minorities are disadvantaged with respect to educational and employment opportunities. Restriction of voting to those aged 18 or more is based on the generalization that minors lack the knowledge and experience to meaningfully exercise the right. And so on. All our laws rely on gnerelizations of one kind or another.

  48. Q Grrl says:

    Maybe I’m missing where you think an potential employer is going to get a potential employee’s health information. Can you clarify the scenario that you have in mind?

  49. Don P says:

    Q grl:

    Maybe I’m missing where you think an potential employer is going to get a potential employee’s health information.

    From the potential employee. The HIPAA Act recognizes that employers possess private health information about employees and potential employees. It prohibits employers from wrongfully disclosing that private information to a third party. It does NOT prohibit employers from using the information in hiring, firing or promotion decisions.

  50. Q Grrl says:

    Hmmm. What compels a person to answer the employer’s questions?

  51. Ampersand says:

    Don: Most employers require prospective employees to undergo a physical…

    I’m still stuck on this. I’ve never been asked to take a physical as part of applying for a job. Aside from jobs in the military, is this normal? Has anyone here (other than Don) had job-application experiences which justify Don’s statement? Don, can you provide evidence to support this statement?

    We can assume that in the vast majority of cases obesity is the result of poor diet and lack of exercise, which are certainly not determined by genes but are matters of lifestyle, like smoking or drug-taking or alcohol consumption.

    No, we can’t assume that. What evidence or logic is this assumption based on?

  52. Don P says:

    Q grl:

    Hmmm. What compels a person to answer the employer’s questions?

    Nothing compels it. So what?

    ampersand:

    No, we can’t assume that. What evidence or logic is this assumption based on?

    Medical evidence. In the vast majority of cases, the cause of obesity is poor diet and a lack of exercise. That is why the obesity rate in America used to be very low and is now relatively high (and growing). That is why the obesity rate in other countries is low. Americans eat too much in general, eat too much of the wrong kind of foods in particular (foods high in sugar and saturated fat), and lead a sedentary lifestyle. That’s why so many of them are fat.

    Of course, a lot of fat people don’t want to accept responsibility for their condition.

  53. alsis38 says:

    Of course, a lot of fat people don’t want to accept responsibility for their condition.

    “Responsibility” is a two-way street. Perhaps employers should stop working people to death with unreasonable 40+ hr work weeks for shit wages with little in the way of childcare, if they want us all to dine on organic veggies and get to the gym three times a week. More decent housing for low-income folk that was close to one’s low-income job might also encourage people to walk more, in lieu of driving.

    Oh, but only the least powerful, the employees, need come to heel when “responsibility” is at stake. Silly me. I always forget that.

    Mmmm… Social Darwinism. Tastes like chickenshit, as usual. :p

  54. Sally says:

    Are you in the U.S., Don? Because in the U.S., it’s illegal to require a prospective employee to undergo a physical. At least, that’s what the Department of Justice’s page on the Americans with Disabilities Act says. And as I understand it, the relevent piece of legislation here is the ADA, not the HIPAA. HIPAA is about privacy, while the ADA is about protection from discrimination.

  55. Don P says:

    Sally:

    Are you in the U.S., Don? Because in the U.S., it’s illegal to require a prospective employee to undergo a physical.

    No, it’s illegal to require a prospective employee to undergo a medical examination before a conditional offer of employment is made. After the conditional offer is made, the employer can require the prospective employee to undergo a medical examination as a condition of employment.

    And as I understand it, the relevent piece of legislation here is the ADA, not the HIPAA. HIPAA is about privacy, while the ADA is about protection from discrimination.

    Yes, the HIPAA is irrelevant, as I pointed out in earlier posts. The ADA provides protections against wrongful employment discrimination on the basis of disabilities, not on health status more generally.

  56. Don P says:

    alsis:

    Perhaps employers should stop working people to death with unreasonable 40+ hr work weeks for shit wages with little in the way of childcare,

    Your description above is exaggerated and silly, but I’m all for a shorter working week, better child care, a higher minimum wage, and other employment reforms.

    But I really don’t think you can seriously blame America’s obesity epidemic on employers. It is first and foremost a matter of personal responsibility, personal choices about diet and exercise.

  57. Ampersand says:

    Medical evidence. In the vast majority of cases, the cause of obesity is poor diet and a lack of exercise. That is why the obesity rate in America used to be very low and is now relatively high (and growing). That is why the obesity rate in other countries is low. Americans eat too much in general, eat too much of the wrong kind of foods in particular (foods high in sugar and saturated fat), and lead a sedentary lifestyle. That’s why so many of them are fat.

    First of all, Don, it’s already been established on this thread that you say things that you can’t back up, and that seemingly aren’t true, to support your case (that is, your claim that job applicants are usually required to take a physical). So it’s odd to expect me to take your word for it that unnamed, unspecified “medical evidence” proves your case.

    First of all, what evidence – in terms of real peer-reviewed studies, not a “mountain of evidence” that you refer to without specifics – can you specifically cite?

    Second of all, what evidence is there that a person, once they are obese, can reliably choose to be thin?

    As far as I’m aware, the overwhelming majority of the peer-reviewed evidence indicates that weight-loss plans fail 95% of the time, and that the failure rate goes up the longer the measurement period. (In other words, diets that appear to show measurable success over the course of a year are much less likely to do so if outcomes are measureed over five years).

    However, even that’s overstating the success of weight-loss plans, because an obese person who is in the tiny “successful ” 5% will frequently still be obese. Studies generally count a sustained 10% or 15% weight loss as a success for the weight loss plan. However, a formerly 350lb man who now weighs between 295 and 315 pounds is still obese, by most standard measures.

    If the success rate of weight-loss plans was measured by their success in turning obese people into non-obese people, rather than by their success in showing a small amount of maintaned weight loss, it probably be below 1%.

    References regarding the failure of weight loss programs: “Losing Weight” New England J of Medicine v338(1) 52-54; “How effective are traditional dietary and exercise interventions for weight loss?” Medicine and Science in Sports and Exercise 31 no8 1129-34; “Confronting the fialure of behavioral and dietary treatments for obesity,” Clinical Psychology Review vol 11 p729-780; “Dietary Treatments of Obesity,” Annals of the NY Academy of the Sciences v499 250-263.

  58. Ampersand says:

    Of course, a lot of fat people don’t want to accept responsibility for their condition.

    Remember, if Don’s debating, the backhanded insults and ad homs can’t be far behind.

    It is first and foremost a matter of personal responsibility, personal choices about diet and exercise.

    If this is true – if it’s a personal thing, and not an environmental or social question – then there must be a huge and ongoing drop in personal responsibility in the USA, and in many other wealthy nations as well, over the course of the last fifty years. How do you account for this change?

  59. alsis38 says:

    Ah, yes. But the “persons” that employ other “persons” have no civic responsibility, only that of caretaking their own “persons,” no matter how detrimental this is on the “persons” in their employ.

    Nothing like a little regurgitated Ayn Rand to make a wage slave’s afternoon. But I would’ve rather had chocolate. :p Thanks anyway, Don.

  60. Q Grrl says:

    “Q grl:

    Hmmm. What compels a person to answer the employer’s questions?

    Nothing compels it. So what?”

    A prospective employer has no legal access to private health information (as stipulated in HIPAA). I don’t understand how you think the employer is legally getting this information.

  61. Q Grrl says:

    official link to HIPAA: http://www.hhs.gov/ocr/hipaa/

    HIPAA is absolutely about protecting private health information (not privacy rights). And individuals who violate are subject to a $50,000 fine for each violation.

    When most employers charge employees for health insurance in the US, it is not the employer carrying the burder of “obese” people. If anything, in your scenario, employers and insurance companies are making money off of people’s obesity.

  62. Sally says:

    “No, it’s illegal to require a prospective employee to undergo a medical examination before a conditional offer of employment is made. After the conditional offer is made, the employer can require the prospective employee to undergo a medical examination as a condition of employment.”

    That’s true, but there are all sorts of safeguards in place to make sure that employers don’t use post-offer physicals to commit unjust employment discrimination. If an employer offered me a job, made me take a physical, and then took away the job offer because of my health issues, the employer would be required to document why I couldn’t do the job with reasonable accomodations, and if the case wasn’t airtight, I could use that documentation to sue. Do these safeguards sometimes fail? No doubt, just as rules against racial or gender discrimination sometimes fail. But you seem to be arguing that discrimination on the basis of health is perfectly legal, and that’s not generally true. The ADA defines “disability” extremely broadly, and it forbids most health-related discrimination.

  63. Q Grrl says:

    For that matter, even after employment an employer does not have access to PHI without the individual’s written consent. Nor, in some instances, do health insurance agencies, for that matter.

    FTR: I work in healthcare informatics, so I’m up to my ears in protected information and HIPAA guidelines.

  64. Don P says:

    ampersand:

    First of all, Don, it’s already been established on this thread that you say things that you can’t back up, and that seemingly aren’t true, to support your case (that is, your claim that job applicants are usually required to take a physical).

    No, that has not been established. You asked me for evidence that most employers require prospective employees to take a physical and I haven’t yet provided it. That obviously does not establish that I cannot do so. And the only evidence you have offered to justify your “seemingly aren’t true” claim is anecdote (your personal employment experience).

    Whether it is “most” employers or merely “some” is irrelevant to my arguments anyway, so if you’re still hung up on this irrelevant issue, just replace “most” with “some” in the statement of mine in question.

    So it’s odd to expect me to take your word for it that unnamed, unspecified “medical evidence” proves your case.

    I did specify it. The rate of obesity amoung Americans today is much higher than it was 40 or 50 years ago. The rate of obesity amoung Americans is much higher than amoung the people of other countries. No known genetic or medical difference between Americans now and Americans of 50 years ago, or between Americans and non-Americans, can account for this. It is simply a matter of differences in diet and exercise. You put on weight when you consume more calories than you burn. Americans are consuming more calories and burning less. That is why they are so obese.

    Second of all, what evidence is there that a person, once they are obese, can reliably choose to be thin

    The fact that they must choose to continue to consume more calories than they burn to maintain that obese state. As soon as their calorie intake falls below their energy requirements (that is, as soon as they eat better and exercise more) they will lose weight. It’s a matter of basic physics and biochemistry.

    As far as I’m aware, the overwhelming majority of the peer-reviewed evidence indicates that weight-loss plans fail 95% of the time, and that the failure rate goes up the longer the measurement period.

    So what? The reason they fail is that their subjects choose to return to their old habits of diet and exercise. No one is forcing them to eat Big Macs and drink 64oz Big Gulps rather than salads and diet soda. No one is forcing them to sit around and watch television rather than get up and go for a walk. These are personal choices.

    If this is true – if it’s a personal thing, and not an environmental or social question – then there must be a huge and ongoing drop in personal responsibility in the USA, and in many other wealthy nations as well, over the course of the last fifty years.

    It is in part a matter of environment. But that obviously doesn’t mean that the primary responsibility for being fat lies with something other than the fat person himself. Food is cheaper than it used to be. Labor-saving devices are more common. But the individual must still choose to eat the additional food. He must still choose to use the labor-saving device. These are personal, individual choices.

  65. Don P says:

    Q grl:

    A prospective employer has no legal access to private health information (as stipulated in HIPAA).

    Yes, he does. HIPAA does not stipulate that a prospective employer has no legal access to private health information. It restricts employers (and others) from wrongfully disclosing private health information to others.

    HIPAA is absolutely about protecting private health information (not privacy rights).

    Huh? Yes, HIPAA is about protecting the confidentiality of private health information. That is a privacy right. HIPAA is not about preventing employers from using private health information to make hiring decisions.

    When most employers charge employees for health insurance in the US, it is not the employer carrying the burder of “obese” people.

    Yes it is. Obese people tend to have more health problems than people of normal weight. That means they consume more health care resources. This imposes additional health care costs on their employer.

  66. Don P says:

    sally:

    That’s true, but there are all sorts of safeguards in place to make sure that employers don’t use post-offer physicals to commit unjust employment discrimination. If an employer offered me a job, made me take a physical, and then took away the job offer because of my health issues, the employer would be required to document why I couldn’t do the job with reasonable accomodations, and if the case wasn’t airtight, I could use that documentation to sue.

    You’d only be successful if the employer’s actions were found to be a violation of the Americans with Disabilities Act or some other applicable anti-discrimination law. “Health issues” is not the same thing as “disabilities.” Can you cite an example of a successful lawsuit alleging unlawful employment discrimination on the basis of obesity? And I mean here obesity itself, as opposed to some recognized medical condition that causes obesity as a symptom.

  67. zuzu says:

    I’ve never had to have a physical for work; I’ve never even had to take a drug test, and I even worked for city government.

    Is Michigan still the only state that explicitly forbids discrimination on the basis of weight?

  68. Don P says:

    Bean:

    And I’m sure you have the statistics to back this up. I’m sure that your very next post will be providing some sort of proof to back up this statement.

    See, for example, this:

    CDC: Obesity Approaching Tobacco As Top Preventable Cause of Death

    Actually, that’s not true. According to the World Health Organziation, the rate of obesity among children outside of the US is about 17%, a dramatic increase over the last several decades and nearly the same as the rate in the US.

    Citation?

  69. Q Grrl says:

    Don: you have yet to tell me HOW the employer is getting the health information. Show me a legal means for an employer to do so.

  70. Hestia says:

    I don’t understand why, if a company could refuse to hire someone based only on his or her obesity (because insurance costs would be higher, or something–how would this work, anyway? How would a company’s refusing to hire someone who weighs more than X pounds lower their health insurance costs? I didn’t think they made these decisions on an individual-by-individual basis), the company couldn’t refuse to hire someone who smokes, or drinks, or drives, or has high cholesterol or high blood pressure, or eats a lot of fried food or candy, or engages in any number of behaviors that increase their risk of serious illness or death. (Speaking of which, if obesity is such a concern, why do most companies have candy and soda machines?)

    It doesn’t make sense to me that only obesity could be considered a health factor. Why obesity and not these other things?

    Plus, wouldn’t the ADA Act and its stipulation of “reasonable accommodations” apply in the case of obesity?

  71. Don P says:

    Q grrl:

    Don: you have yet to tell me HOW the employer is getting the health information. Show me a legal means for an employer to do so.

    No, I answered this question the first time you asked it: from the employee.

  72. Don P says:

    Hestia:

    I don’t understand why, if a company could refuse to hire someone based only on his or her obesity (because insurance costs would be higher, or something–how would this work, anyway? How would a company’s refusing to hire someone who weighs more than X pounds lower their health insurance costs? I didn’t think they made these decisions on an individual-by-individual basis), the company couldn’t refuse to hire someone who smokes, or drinks, or drives, or has high cholesterol or high blood pressure, or eats a lot of fried food or candy, or engages in any number of behaviors that increase their risk of serious illness or death.

    They probably could. Anti-discrimination laws generally protect people from employment discrimination on the basis of specific, enumerated grounds, most often race, sex, religion and national origin, and less commonly, marital status, sexual orientation and age. The Americans with Disabilities Act provides certain protections for people who suffer from certain kinds of disability, but I doubt that any of the things you list above would be recognized as disabilities for the purposes of that law.

    As for how insurance costs would be higher: obese people tend to have more health problems than people of normal weight. This is likely to cause higher health care costs to the employer.

    Plus, wouldn’t the ADA Act and its stipulation of “reasonable accommodations” apply in the case of obesity?

    Only if obesity is an ADA-recognized disability.

  73. Q Grrl says:

    No, Don, you did not answer it. The employee is not under any obligation to give out health information. So the only means that an employer might get this information is through…. you tell me.

  74. Don P says:

    Q grrl:

    No, Don, you did not answer it. The employee is not under any obligation to give out health information.

    Yes, I did answer it. I’ve answered it twice now. Your question was: How is the employer is getting the health information? And my answer was: From the employee. The fact that a prospective employee can refuse to provide health information or submit to a medical examination does not alter the fact that employers do in fact legally obtain medical information about potential employees (or existing ones) in precisely these ways.

  75. Don P says:

    I found the following article on findlaw: Is Obesity A Disability?

    The case law on this question seems to indicate that courts have generally refused to recognize obesity as a disability for the purposes of the ADA, and have therefore generally rejected claims of unlawful employment discrimination on grounds of obesity.

    The article does cite some cases of courts siding with the plaintiff, but in at least one of those cases, the ruling rested on the finding that the plaintiff was disabled by virtue of being “morbidly obese” (at least 100 pounds overweight) and that her obesity was the result of a permanent physiological disorder. In other cases, it appears that courts may have found that even simple obesity qualifies as a disability under the ADA, although the article is somewhat vague on the details of those cases.

  76. deja pseu says:

    I’ve been asked in interviews whether I have children and whether I plan to have children.

    I don’t know about other states, but that question is illegal to ask in California.

  77. Ampersand says:

    Whether it is “most” employers or merely “some” is irrelevant to my arguments anyway, so if you’re still hung up on this irrelevant issue, just replace “most” with “some” in the statement of mine in question.

    In other words, you don’t plan to support your original statement? That’s fine, but please say it straight out.

    I agree it’s not very relevant to our disagreement, Don. I’m just interested in whether you have the intellectual integrity to back down from a statement that (so far) you can’t support.

    The rate of obesity among Americans is much higher than among the people of other countries. No known genetic or medical difference between Americans now and Americans of 50 years ago, or between Americans and non-Americans, can account for this. It is simply a matter of differences in diet and exercise. You put on weight when you consume more calories than you burn. Americans are consuming more calories and burning less. That is why they are so obese.

    First of all, it’s not correct that Americans are the fattest people in the world. According to the CDC’s Katherine Flegal (Medicine & Science in Sports & Exercise, Volume 31(11)):

    To summarize the available information from [the scientific literature review] and from data published by the World Health Organization, the prevalence of obesity is highest in Western Samoa and other Pacific island populations, intermediate in European countries, and populations such as those in the United States with considerable European admixture and lowest in less developed countries such as Brazil and in Asian countries such as China and Japan. Large recent increases in overweight or obesity for adults (>5 percentage points) have been noted in Canada (based on self-reported data), Finland (men), New Zealand, the United Kingdom, the United States, and Western Samoa. Smaller increases, less than 5 percentage points, appear to have occurred in several other countries, including Australia, Brazil, China (men), Germany, Israel, Mauritius, the Netherlands, and Sweden (self-reported data).

    It’s certainly not true that environment has been a constant over the last fifty years; so even the logic you provide to support your case is unable to distinguish between individual and environmental effects.

    Furthermore, quite a bit of research has shown that there are thin people who don’t exercise and eat poorly, and fat people who exercise and eat well. (The fat people live longer, on average; although being obese – like being very thin – is bad for health, regular moderate exercise is a far better predictor of longevity than weight is. People who are slightly “overweight” and exercise regularly live longest, on average).

    The fact that they must choose to continue to consume more calories than they burn to maintain that obese state. As soon as their calorie intake falls below their energy requirements (that is, as soon as they eat better and exercise more) they will lose weight. It’s a matter of basic physics and biochemistry.

    First, even if I accepted your extremely simplistic theory, the logic doesn’t hold up. It takes (in your view) overeating to build up weight, but why should it take overeating to maintain it? The weight already exists; why couldn’t normal eating and exercise simply maintain a status quo among fat people, as you presumably believe it does among the non-fat?

    Second of all, the fact is that there are people who eat well and exercise who remain fat. There are several studies of fit, fat people’s morbidity – see for example, American J of Clinical Nutrition 1999; v69:373–80. Such studies would not be possible if, as you claimed, no fit and fat people existed. Another example is Annals of Internal Medicine 138(5) 383-390; fat people who were on a healthy-food-and-exercise regimen all saw health benefits, but not all of them lost weight. According to you, that shouldn’t be possible.

    So what? The reason they fail is that their subjects choose to return to their old habits of diet and exercise. No one is forcing them to eat Big Macs and drink 64oz Big Gulps rather than salads and diet soda. No one is forcing them to sit around and watch television rather than get up and go for a walk. These are personal choices.

    It’s funny that now your argument now pretends that there is no such thing as a biological influence on behavior. But I disagree; people have a strong biological imperative not to starve, and it’s not something that can reasonably be expected to be overcome through sheer willpower. The amount of food-reduction necessary for a 300-pound man to become thin would be called “anorexia” in a normal-weight person; I don’t think that ordinary willpower is enough to sustain anorexic-levels of food intake over many years, except in anorexics. Furthermore, the side effects of sustained low-calorie diets can be nasty – and they have to be sustained, in effect, forever.

    Furthermore, “overeating” as a useful concept for discussing weight gain is logically questionable. To quote William Bennett – not the famous one, but the one who edits the Harvard Medical School Health Letter –

    A recent, and useful, editorial on the complications of very-low-calorie diets begins with the statement, “Once we attain our adult size, usually by age 18 to 20, chronic overeating with a positive caloric balance results in obesity.” Sentences of this type permeate the literature on obesity. They do not mean anything. No plausible definition of the term overeating is independent of the observation that the person or animal in question is overweight. If eating behavior did not produce deposits of body fat, we could not call it overeating. Thus, to say that people get fat because they overeat is no different from saying the sun comes up because it is morning. The assertion is, in its way, true, and it relates to a physical reality, but it is empty of content because it simply restates the definition of terms.

    The first law of thermodynamics, by the way, is irrelevant to this discussion, although it is often brought in. The law constrains the equations that can be written to describe energy flow, but it does not explain how or why a body allocates its available energy to useful work, metabolic heat, or storage as fat. Indeed, the second law, which is sometimes cited by people who confuse it with the first, is probably more germane. The second law points out that real systems have rather wide latitude in the efficiency with which they convert incoming energy to mechanical work or heat. The efficiency of a system, or the way it allocates available energy, cannot be predicted a priori…

    These points are not logic-chopping. Such sentences as the one I just quoted can be decomposed into two propositions: positive caloric balance is equivalent to obesity (a tautology) and animals are heterotrophic, which is a meaningful, but not terribly specific or helpful point to make. To leap from the true and self-evident, but vacant, identification of overeating with obesity to the conclusion that control of food intake is the sole or most important modality for reversing the condition is as unwarranted as inferring that we could make the sun rise by taking suitable measures to make it be morning. Yet this is precisely the intellectual maneuver that launches the fundamental… [approaches to] behavior modification as a treatment for obesity.

    He goes on to point out that experimental data on rats fails to support your “simple physics” notion of how weight is lost and gained – and, more importantly, on how it is lost and not regained. Bodies can resist change; dieting can lead to loss of muscle mass more than fat; a normal, non-starvation diet can lead to a large weight gain in someone who has lost weight. In short, bodies aren’t nearly as simplistic as you’re suggesting.

    It’s true that there are more labor-saving devices and cheaper foods today, but there are also more diet aids, diet books, diet foods, exercise places, and pressure on fat people to be thin than ever before. Considering the huge punishments inflicted on fat people in our culture, I find it implausible that there would be so many fat people if simply, ordinary levels of willpower were all that’s required to become thin.

    Finally, you have no way of knowing that all fat people eat big macs and huge diet cokes (I don’t – I can’t stand any sodas, and when I go out I most often eat chicken at Subway or an asian place). But it’s telling that so much of your argument relies on stereotypes.

    (By the way, multiple studies have shown that fat people either don’t each much more than thin people, or don’t eat more period. Contrary to your stereotypical beliefs, it is not true that fat people all eat big macs all day long while thin people all eat undressed salads).

  78. Ampersand says:

    Don provided a link to a “Sky is falling! 400,000 deaths a year!” type article. Here’s a critique of the study Don’s link drew the 400,000 statistic from.

    If you’re willing to read pdf files, this article and this pamphlet both address the research behind the “400,000” figure. (The first link deals with a previous incarnation of the same study, which came up with a 300,000 figure; but the same critique applies, since the methological flaws have mostly gone uncorrected).

  79. Don P says:

    ampersand:

    In other words, you don’t plan to support your original statement? That’s fine, but please say it straight out.

    I don’t know. I may look for a citation later. It’s not relevant to my arguments, so I don’t plan to put a lot of effort into it.

    First of all, it’s not correct that Americans are the fattest people in the world. According to the CDC’s Katherine Flegal (Medicine & Science in Sports & Exercise, Volume 31(11)):

    I didn’t say that exactly. I said that Americans are fatter than non-Americans, by which I meant non-Americans in general, rather than every single non-American or every single other country. I’m sure there are some nations where the average citizen is fatter. I don’t know of any country of significant size whose people are fatter. Germany, perhaps. But it doesn’t really matter anyway. The point is that comparisons with other countries demonstrate that the cause is not genetic or otherwise biological. It’s a matter of differences in diet and exercise between Americans and non-Americans.

    It’s certainly not true that environment has been a constant over the last fifty years; so even the logic you provide to support your case is unable to distinguish between individual and environmental effects.

    I never said that “environment has been a constant over the last fifty years.” I never said that environment plays no role (I explicitly said that it does play a role). What I said is that regardless of changes in environment, obesity is still primarily a matter of personal choices about diet and exercise.

    Furthermore, quite a bit of research has shown that there are thin people who don’t exercise and eat poorly, and fat people who exercise and eat well.

    Yes, but so what? They’re the exceptions. In general, thin people are thin because they choose to consume fewer calories and/or to exercise more, and fat people are fat because they choose to consume more calories and/or exercise less (in many cases, not at all).

    First, even if I accepted your extremely simplistic theory,

    In what way is it “simplistic?”

    It takes (in your view) overeating to build up weight, but why should it take overeating to maintain it?

    It doesn’t. All that is necessary to maintain the built-up weight is for calories consumed to equal calories burned. The built-up weight will only go down if the body needs to burn stored reserves of fat in response to a reduction in calorie intake and/or an increase in calories burned (via more physical activity).

    The weight already exists; why couldn’t normal eating and exercise simply maintain a status quo among fat people, as you presumably believe it does among the non-fat?

    If by “normal eating” you mean a balance between the person’s consumption of calories and his expenditure of energy, then it would maintain the status quo. Once you’ve become fat, you need to consume less than you burn in order to lose weight.

    Second of all, the fact is that there are people who eat well and exercise who remain fat.

    Again, so what? Even those unusual people are still failing to balance their calorie intake with their energy expenditure. And most fat people do not eat and exercise well, as I keep telling you. They eat badly, and they don’t exercise enough. That’s why they’re fat.

    There are several studies of fit, fat people’s morbidity – see for example, American J of Clinical Nutrition 1999; v69:373–80. Such studies would not be possible if, as you claimed, no fit and fat people existed.

    I never said that no fit, fat people existed. But most fat people are not fit.

    Another example is Annals of Internal Medicine 138(5) 383-390; fat people who were on a healthy-food-and-exercise regimen all saw health benefits, but not all of them lost weight. According to you, that shouldn’t be possible.

    Nonsense. I never said that losing weight is the only way in which a healthy diet and exercise regimen can improve a person’s health.

    Please respond to what I actually write, and stop attributing to me statements I have not made and beliefs I do not hold.

  80. Mary Garden says:

    I just wanted to put my two cents in as a fat person who has actually “taken responsibility” and lost 100 lbs.

    I wouldn’t have been able to lose that weight if I weren’t an enormously privileged person with few responsibilities, no kids and a job that pays me enough to live on at 30 hrs a week. I spent about four years completely reshaping my life to make that weight loss possible – I sold my car, moved into a house that was close enough to the city for me to commute by bike, became a vegetarian and sank thousands of dollars into counseling to unravel a few generations’ worth of dysfunctional eating. After spending two years building gradually up to 4 hours of exercise a day and, by the by, remaining a healthy 300 lbs more or less the whole time, I finally tackled and gradually cut my caloric intake in half.

    Having lost 100 lbs and being now in incredible physical condition, I still weigh over 200 lbs and barely fit into the largest sizes at the regular department stores. In order to lose the last 60 lbs I need to, I will have to restrict food intake still further and exercise still more. I get lots of compliments from people who have been watching me lose this weight, but to anyone casually seeing me on the street, I look like a Big Mac eating, Big Gulp swilling fat person. Some great reward, eh?

    I would like to challenge Don Pat to follow this regimen for four years, like I have. I don’t think he would be able to do it (and certainly not willing). I don’t think that most people could or would, especially lacking my incredibly privileged lifestyle, and I don’t think they can reasonably be expected to. People are not, by and large, heroic. This American idea that everyone should be able to pull themselves up by their bootstraps and rise above the temptations that keep our economy afloat or else face well-deserved censure and loss of opportunity is really, really impractical – and mainly serves to take the heat off those who are shaping the world so that it takes a heroic effort to be healthy.

    Also, when it comes to fat, I don’t think healthy has much to do with it when a thin person points an imperious finger at the fatty and says “you’re weak.” It’s just that old human story of loving feel superior to someone whose “sin” doesn’t tempt you.

    MG

  81. Ampersand says:

    Don, you most certainly did state that Americans were fatter than people in other countries: that’s what the sentence “The rate of obesity among Americans is much higher than among the people of other countries.” I can’t be blamed if you meant that sentence to mean something other than what it says.

    Regarding my other supposeed “misreading,” I understood you to argue that any fat person who exercises regularly and eats a low-calorie diet – as opposed to “big macs and big gulps,” or whatever it is you moronically claimed fat people eat – could reasonably be expected to lose so much weight that they’d no longer be fat, and to maintain that weight loss; and that anyone who remains fat is primarily eating “big macs” and not exercising. That’s simply not true, as the evidence I cited shows.

    If that’s not what you were claiming, then I’m sorry I misundestood you; but I don’t think I’m solely responsible for the misunderstanding.

    It is true, as a matter of ivory-tower theory, that anyone could lose any amount of weight by eating little enough for the remainder of their life. However, “little enough” might be far below the level needed to maintain an ability to live an ordinary life, to lead a happy life not consumed by constant thoughts of food, to hold a job, etc.. Or it might require the kind of resources (dieticians, the ability to spend 4 hours a day exercising and 2 hours more arranging meals, etc) that most people lack (and even then, there’s no proof such plans work over the long term for the majority of fat people).

    I don’t think you can reasonably claim that most fat people can be expected to do this, or that discrimination against any fat person who doesn’t do this is fair.

    What I said is that regardless of changes in environment, obesity is still primarily a matter of personal choices about diet and exercise.

    I don’t see how you can logically determine this, since there’s no way to distinguish between environmental changes over the past 50 years and – what shall I call it? – willpower changes over the past 50 years.

    Furthermore, even as people eat fatty foods less and exercise more (according to the JAMA article your link cited), and even as dieting and weight loss have become national obsessions, Americans have gotten fatter.

    As I understand it, your argument is circular: obesity is caused by people eating more. How do you know people are eating more? Because there are more obese people. As far as I can tell, there’s no non-circular evidence to support your claims, Don.

    * * *

    If there were a way that ordinary fat people could reasonably, reliably become thin and stay that way, there would be almost no fat people. Remaining fat if thinness were readily available would be irrational, given the problems of being fat in our culture.

    Saying that people “choose to be fat” is like saying that people “choose to be gay”; it may be true in some narrow, literal sense. But for most people, given the lived day-to-day realities, it’s nonsense.

  82. Don P says:

    ampersand:

    It’s funny that now your argument now pretends that there is no such thing as a biological influence on behavior.

    Huh? My argument doesn’t “pretend” anything, let alone that obviously false claim. I said that the reason diets fail is because people choose to go back to their old eating and exercise habits. How you construe that statement as entailing the denial that biology influences behavior, I have no idea.

    people have a strong biological imperative not to starve, and it’s not something that can reasonably be expected to be overcome through sheer willpower.

    Yet another bizarre nonsequitur. I’m not expecting people to overcome the biological imperative not to starve. I have no idea how you could interpret anything I have said to imply that expectation. What I said is that diets fails because people choose to go back to their old eating habits. Nothing about starvation. Nothing about biology. Nothing about expectation. I really wish you would address what I actually write.

    The amount of food-reduction necessary for a 300-pound man to become thin would be called “anorexia” in a normal-weight person;

    Nonsense. He would only have to reduce his calorie intake or increase his exercise level modestly in order to lose, say, half that weight within a year or two. Most people build up their weight gradually as a result of a relatively small excess of calories consumed over calories burned over a period of time, and the weight can be lost by the same process in reverse.

    Furthermore, “overeating” as a useful concept for discussing weight gain is logically questionable. To quote William Bennett – not the famous one, but the one who edits the Harvard Medical School Health Letter –

    I have no idea what point you’re trying to make with this quote other than some trivial one about the use of the word “overeating.” I see nothing in the quote that contradicts anything I have said about the relationship between obesity, eating, and exercise. If you think it does contradict something I said, please describe the nature of the alleged contradiction in detail and I’ll respond.

    He goes on to point out that experimental data on rats fails to support your “simple physics” notion of how weight is lost and gained – and, more importantly, on how it is lost and not regained.

    It’s rather hard to respond to this claim when you fail to quote the material that allegedly fails to support my physics notion.

    Bodies can resist change; dieting can lead to loss of muscle mass more than fat; a normal, non-starvation diet can lead to a large weight gain in someone who has lost weight.

    Yes to all three.

    In short, bodies aren’t nearly as simplistic as you’re suggesting.

    I haven’t suggested that bodies are simplistic. I have said that weight is a matter of calorie intake and energy expenditure. The effciciency with which a person’s body extracts calories from food may vary in response to changes in body weight and other factors. The amount of energy a person’s body expends in ordinary metabolic function may also vary. But none of that alters the fact that people put on weight when calories exceed energy and lose weight when the opposite condition exists.

    Perhaps the point you’re trying to make is that weight gain and weight loss are not exactly symmetrical in terms of diet and exercise. That’s true, but it doesn’t alter the fact that losing weight is a matter of diet and exercise. Not “starvation” or “anorexic” levels of dieting, but a diet and exercise regimen in which the fat person expends a modestly greater amount of energy than he consumes in calories. Anyone can lose weight in this way, because food intake is the only source of energy.

  83. Ampersand says:

    Mary, thanks very much for posting your story. :-)

  84. Don P says:

    ampersand:

    Finally, you have no way of knowing that all fat people eat big macs and huge diet cokes (I don’t – I can’t stand any sodas, and when I go out I most often eat chicken at Subway or an asian place). But it’s telling that so much of your argument relies on stereotypes.

    I never said that “all fat people eat big macs and huge diet cokes” (I didn’t suggest that diet soda promoted obesity at all). I mentioned Big Macs and giant (sugar-laden) sodas because they are typical of the kind of poor food choices (yes, choices) that Americans commonly make and that cause them to become fat. If you are overweight, it is almost certainly because you are making similarly poor choices about what you eat, and how much you eat, and/or are not getting enough exercise. Most likely, it’s a combination of these things. It may not be McDonalds hamburgers in your case, but in whatever way you are doing it, you are consuming more calories than you are expending in energy. (Asian food, by the way, is often loaded with fat and calories. And chicken sandwiches may also be a poor choice, depending on how the chicken is prepared and what else there is in the sandwich.)

    By the way, multiple studies have shown that fat people either don’t each much more than thin people, or don’t eat more period.

    That may be true, although it rather depends on what “eat more” means. If your diet is rich in bulky low-calorie foods like raw fruit and vegetables, you can “eat more” without gaining weight than you can if your diet is rich in high-calorie fats and sugars. And as I said, it’s not just a matter of how much you eat, but also of how much physical activity you engage in. If you go to the gym regularly, you can consume substantially more calories without gaining weight than you would be able to if you spent the same amount of time watching television or sitting in front a computer instead.

  85. deja pseu says:

    That may be true, although it rather depends on what “eat more” means. If your diet is rich in bulky low-calorie foods like raw fruit and vegetables, you can “eat more” without gaining weight than you can if your diet is rich in high-calorie fats and sugars. And as I said, it’s not just a matter of how much you eat, but also of how much physical activity you engage in. If you go to the gym regularly, you can consume substantially more calories without gaining weight than you would be able to if you spent the same amount of time watching television or sitting in front a computer instead.

    Don P, I think you’re blind to your own priveledge here. For many people, fresh fruits and vegetables are often not readily available (in some poorer inner city areas there are no grocery stores within miles) or are much more expensive than the processed foods. For many people, gym memberships are prohibitively expensive. Even if they want to exercise without joining a gym there may be no sidewalks where they live, or it might otherwise be unsafe (especially for women) to go out walking or biking alone. Many fat women get harrassed when they try to go out and walk or bike, which can also be a deterrent. For many people who may work long hours or at multiple jobs to make ends meet, finding time to continually shop for fresh veggies and exercise 60 minutes a day is untenable.

    I think you’re conveniently ignoring the fact that “choice” doesn’t happen in a vaccuum. It’s not like we all have the same resources and choices available.

    Regarding the issue of weight loss, I’m sorry but you are woefully ignorant, and seem determined to remain so. Trying to live day in and day out on a calorie level that is below what the WHO categorizes as “starvation” is not something many people can sustain over the long haul. And that is the calorie level that most people who are overweight (especially women) would have to sustain to get and stay thin, regardless of how much they exercise. There is plenty of good, credible evidence, some of which Amp has already cited, that *fitness* is a more reliable indicator of health than body size. If you don’t think that most fat people haven’t for large portions of their lives made heroic efforts to get and stay thin, then you either don’t know any, or are turning a blind eye.

    Saying that all fat people are choosing to be fat is like saying that all poor people are choosing to be poor. It’s just absurd.

  86. mythago says:

    “Weight” isn’t the issue, either. It’s a matter of good cardiovascular health and eating a healthy, nutritional diet. As deja pseu notes, the ability to make those choices is not always there–try joining the gym when you’re a single mom working at WalMart–but Americans fetishize numbers on the scale and clothing sizes, way above any relationship those numbers have to actual health.

  87. Don P says:

    ampersand:

    If a person is fat, why does the primary responsibility for that condition not lie with the fat person himself? He is the one who makes the choice every day about what to eat. He is the one who makes the choice every day about how much exercise or other physical activity to engage in. So why is it not, first and foremost, his personal responsibility?

    Why is it unreasonable to expect Americans today to behave comparably to Americans of the 1950s and 1960s, who were much less likely to be fat than Americans today, with respect to the quality of their diet and their exercise habits?

    Why is it unreasonable to expect Americans to behave comparably to the citizens of other nations, who are much less likely to be fat than Americans, with respect to the quality of their diet and their exercise habits?

    On what basis do you claim that fat Americans would have to endure unreasonable burdens (onerous exercise regimens, “anorexic” diets, constant obsessing over food, inability to hold a job, mass supervision by dieticians, etc.) to maintain a normal weight, given that so many more Americans of the 1950s and 1960s were able to maintain a normal weight without incurring these burdens?

    On what basis do you claim that fat Americans would have to endure unreasonable burdens to maintain a normal weight, given that the citizens of other nations who are much less likely to be fat than Americans do not seem to incur them?

    How is “choosing to be fat” (which really means choosing a bad diet and bad exercise habits) like “choosing to be gay,” given that homosexuality is, as far as we know, an involuntary condition of sexual attraction to members of the same sex?

  88. Don P says:

    deja pseu:

    Don P, I think you’re blind to your own priveledge here. For many people, fresh fruits and vegetables are often not readily available (in some poorer inner city areas there are no grocery stores within miles) or are much more expensive than the processed foods. For many people, gym memberships are prohibitively expensive. Even if they want to exercise without joining a gym there may be no sidewalks where they live, or it might otherwise be unsafe (especially for women) to go out walking or biking alone. Many fat women get harrassed when they try to go out and walk or bike, which can also be a deterrent. For many people who may work long hours or at multiple jobs to make ends meet, finding time to continually shop for fresh veggies and exercise 60 minutes a day is untenable.

    Oh please. There are far more gyms today than there were 40 or 50 years ago, when obesity was relatively rare. And if you really can’t get to a gym then you can go for walks, or ride a bike, or work in your yard, or exercise at home. There is a huge variety of inexpensive exercise equipment available today, most of which was all but unknown a few decades ago–exercise bikes, treadmills, stair-steppers, home gyms, etc. The reason people fail to exercise is not that they cannot do so but that they choose not to do so. And the same applies to eating healthy foods. The price of food in real terms has never been cheaper. Supermarkets and food stores offer a vast variety of healthy and low-calorie food choices, far more than were available in the 1950s and 1960s. Even fast-food joints typically offer healthy, low-calorie alternatives to their standard menu items–salads, grilled chicken, diet sodas, etc. So the idea that Americans are fat because they cannot obtain healthy food is nonsense. The reason they don’t eat well is not because they cannot do so, but because they choose not to do so.

    Regarding the issue of weight loss, I’m sorry but you are woefully ignorant, and seem determined to remain so.

    You’re the one who is ignorant.

    Trying to live day in and day out on a calorie level that is below what the WHO categorizes as “starvation” is not something many people can sustain over the long haul. And that is the calorie level that most people who are overweight (especially women) would have to sustain to get and stay thin, regardless of how much they exercise.

    If by “thin” you mean supermodel-level thinness, I’m not talking about that. I’m talking about maintaining a body weight within the normal range for your size and stature. The claim that one must adopt a “starvation” diet to maintain such a weight is utter nonsense. Are you seriously suggesting that Americans of the 1950s and 1960s, who were much less likely to be obese than Americans today, were able to maintain their weight only by “starving” themselves? Are you seriously suggesting that this is how people in other countries today prevent themselves from becoming obese? The excuses being offered here to refuse to confront the simple fact that the fundamental reason why fat people are fat is because they eat too much, eat the wrong kinds of food, and exercise too little are becoming increasingly absurd.

  89. mythago says:

    Again, Don, “body weight” is not the real issue.

    And the problem is that you’re missing a step here: why are those fat people sitting around and not eating well? “They choose not to” is very self-satisfying, if one wants to pat oneself on the back for virtuously exercising and eating broccoli. It does nothing when looking at whether WIC recipients are able to make healthy food choices, how people working backbreaking, minimum-wage jobs can manage to fit in exercise, and why cheap, unhealthy food is cheaper than the good stuff. (I’m not talking about sirloin steak, either.)

  90. Ampersand says:

    Don:

    I don’t really know for sure why Americans are fatter nowadays (although, again, your claim that Americans are more likely to be fat than any other nationality isn’t true). Many experts aren’t sure, either. Is it environmental or not?

    Yes, there are more McDonalds now than 50 years ago – but not really many more than there were 30 years ago. There are more exercise gyms than ever, more diet foods than ever, more pressure to diet than ever, more restaurants offering low-fat (and, now, low-carb) foods than ever. There’s diet mayonaisse and diet coke and 1% milk and butter substitute and a thousand similar products, none of which was readily available when my parents were growing up. Americans are more weight-conscious than ever, and are more likely to be trying to lose weight than ever.

    As I pointed out earlier, even according to your source’s citation, Americans nowadays eat less fatty foods and exercise more than in the past – yet we’re fatter than ever. It’s a documented fact that some fat people exercise and go on healthy “weight-loss” diets and still don’t lose weight (even though they become healthier).

    Many fat people spend their entire lives attempting to lose weight – and th eoverwhelming majoirty make at least a couple of serious attempts – but nearly all of them will fail, over the long run. To you, that means, apparently, that nearly all fat people are weak-willed and aren’t really trying (or at least, not trying hard enough) to lose weight.

    To me, that indicates that – whatever the CAUSE of increased obesity among Americans – losing weight (especially enough to no longer be fat) is simply too difficult to be reasonably done by most fat people.

    The fact is, even experts are split on this issue. If you want to take a side on the issue and say “I think this viewpoint makes more sense,” then that’s cool. If you want to point to an issue that extremely smart, well-educated people of good faith (including published experts) obviously disagree on, and say “I’m the only one who’s right, everyone who disagrees with me is an idiot offering increasingly absurb excuses,” then I don’t think you’re being reasonable.

    By the way, you’ve misunderstood my point. I didn’t say that normally-sized people, or people in the 50s, had to eat “starvation” diets to remain “normal” sized. I did say that for many (not all) already obese people to become and remain thin, they’d have to stick to a level of food intake that would be called “anorexia” in thinner people. And I don’t think that’s a reasonable thing to expect anyone to be able to do – or a healthy approach to food.

    I’ll be defending my analogy of gay people and fat people in a separate post, later today.

  91. Sally says:

    You’d only be successful if the employer’s actions were found to be a violation of the Americans with Disabilities Act or some other applicable anti-discrimination law. “Health issues” is not the same thing as “disabilities.”

    For the purposes of the ADA, a disability is “a physical or mental impairment that substantially limits one or more major life activities.” People who have a history of such impairment or are perceived to have such impairment are also covered. There are some “health issues” that aren’t covered, but not a whole lot of them. All sorts of things that wouldn’t be considered a disability in common parlence are covered by the ADA.

    Can you cite an example of a successful lawsuit alleging unlawful employment discrimination on the basis of obesity? And I mean here obesity itself, as opposed to some recognized medical condition that causes obesity as a symptom.

    According to that findlaw article that you linked to and somewhat disingenuosly summarized, “Although courts initially were reluctant to recognize obesity as a qualifying disability for purposes of ADA protection, courts are increasingly willing to consider obesity as a disability giving plaintiffs status to raise ADA claims.”

    But obesity actually isn’t my fish to fry here, although I think you’re as ignorant about that as you seem to be about everything else. This isn’t an academic issue to me. I have a (non-obesity) medical condition that might make employers look askance, and I worry a lot about employment discrimination. I would really rather not have to take potential employers to court. It would make my life a lot easier if word got out that it’s not legal to discriminate on the basis of health. So it irks me that you’re spreading a lot of disinformation about something that you don’t seem to know very much about.

  92. Don P says:

    mythago:

    Again, Don, “body weight” is not the real issue.

    Huh? What is the “real issue,” then? I’m talking about fatness and obesity. Obviously, the actual body weight of a fat or obese person will depend on his stature and body type. An obese person who is short and has a small frame may weigh no more than a taller person with a larger frame whose body weight is within the normal range for people of his stature and body type.

    And the problem is that you’re missing a step here: why are those fat people sitting around and not eating well? “They choose not to” is very self-satisfying, if one wants to pat oneself on the back for virtuously exercising and eating broccoli.

    “They chose not to” is the correct answer. Whether it’s “self-satisfying” or not is irrelevant. Are you seriously suggesting that fat people have no choice about their diet and exercise habits? That claim is absurd on its face.

    It does nothing when looking at whether WIC recipients are able to make healthy food choices, how people working backbreaking, minimum-wage jobs can manage to fit in exercise, and why cheap, unhealthy food is cheaper than the good stuff.

    More nonsense. If someone really is working a “backbreaking” job with such long hours that he has no spare time in which to exercise (a situation that cannot apply to more than a small fraction of the U.S. population, anyway), he’ll most likely be getting all the physical exercise he needs from that job. And your claim that inexpensive, healthy food is not readily available is similarly nonsensical. Raw and unprocessed foods are almost always cheaper than cooked and processed ones. Raw chicken and meats in a grocery store are almost always cheaper than cooked and processed ones. Raw fruit and vegetables are almost always cheaper than processed ones. Every supermarket has a large produce section with a wide variety of inexpensive fruits and vegetables. And even processed foods that are healthy and inexpensive are readily available, anyway. A typical supermarket will have a large selection of low-calorie frozen meals that are no more expensive (and are often less expensive) than the regular ones. Canned or frozen fruit that is low in calories is readily available and is cheaper than ice cream, pies, cakes and other processed desserts high in fat and calories. And even processed desserts like ice cream and yogurt are available at typical grocery stores in low-fat or fat-free versions that have around half the calories per serving of the regular versions. There is fat-free milk, fat-free salad dressings, fat-free cookies, fat-free everything. So this claim that affordable, healthy, low-calorie food is not readily and inexpensively available is just nonsense.

  93. Don P says:

    sally:

    All sorts of things that wouldn’t be considered a disability in common parlence are covered by the ADA.

    As I already explained, the claim that obesity is a disability under the ADA has generally been rejected by the courts.

    According to that findlaw article that you linked to and somewhat disingenuosly summarized, “Although courts initially were reluctant to recognize obesity as a qualifying disability for purposes of ADA protection, courts are increasingly willing to consider obesity as a disability giving plaintiffs status to raise ADA claims.”

    There’s nothing disingenuous about it. Courts may be “increasingly” willing to consider obesity a disability, but in general they are not willing to consider it a disability, and in cases where courts have recognized obesity as a disability, there seem to be special circumstances (the obesity is extreme, and/or is caused by some recognized medical disorder) that have led to that finding.

    But obesity actually isn’t my fish to fry here, although I think you’re as ignorant about that as you seem to be about everything else.

    And I think you don’t have the foggiest clue what you are talking about.

    It would make my life a lot easier if word got out that it’s not legal to discriminate on the basis of health.

    It is legal to discriminate on the basis of health.

    So it irks me that you’re spreading a lot of disinformation about something that you don’t seem to know very much about.

    What disinformation? You’re the one who suggested that obesity is covered under the ADA. I am the one who found evidence that obesity is generally not recognized as a disability under the ADA. You’re the one who doesn’t know what she’s talking about.

  94. Ampersand says:

    Saying “you don’t know what you’re talking about,” or “you’re ignorant,” or whatever, is in practice not a very effective way of making the person seem ignorant to other readers.

    In general, if there are any reasonably objective readers lurking, they’ll judge who seems ignorant and who seems to know their shit by what knowlege is demonstrated in the writing. Saying someone doesn’t know what they’re talking about won’t gain you any ground with any readers, other than the ones who were already inclined to agree with you.

    Plus, it’s a form of personal attack, which I prefer folks not do on my website. Argue the issues, not the people, please.

    I’m not saying I’m perfect in this regard. But I am trying, and I’ll ask all of you to try, as well.

  95. Don P says:

    ampersand:

    I don’t really know for sure why Americans are fatter nowadays

    But we do know for sure why Americans are fatter nowadays. They consume more calories and/or expend less energy than they used to. There is no other possible explanation.

    (although, again, your claim that Americans are more likely to be fat than any other nationality isn’t true).

    How many times do I have to explain this? When I said that Americans are fatter than non-Americans, I didn’t mean that every single American is fatter than every single non-American. I didn’t mean that the probability that an American is fat is higher than the probability that a citizen of any other country in the world is fat. I meant that in general Americans are fatter than non-Americans. In general, the probability that an American is fat is higher than the probability that a European, African, Asian or Oceanian is fat. There may well be some countries, most likely small and wealthy ones, where the fatness and obesity rates are higher than the rates in the U.S. But those are the expections. In general, Americans are fatter than their counterparts in other countries. Please don’t make me explain this yet again.

    Yes, there are more McDonalds now than 50 years ago – but not really many more than there were 30 years ago. There are more exercise gyms than ever, more diet foods than ever, more pressure to diet than ever, more restaurants offering low-fat (and, now, low-carb) foods than ever. There’s diet mayonaisse and diet coke and 1% milk and butter substitute and a thousand similar products, none of which was readily available when my parents were growing up. Americans are more weight-conscious than ever, and are more likely to be trying to lose weight than ever.

    Right. I’m not sure what relevance you think these observations have to your claims.

  96. Sally says:

    “If someone really is working a “backbreaking” job with such long hours that he has no spare time in which to exercise (a situation that cannot apply to more than a small fraction of the U.S. population, anyway), he’ll most likely be getting all the physical exercise he needs from that job.”

    Lots of people work long hours at sedentary jobs. Lots of them spend two to three hours every day on the bus or in a car commuting. It’s just silly to claim that there’s some correlation between the hours someone works and the physical demands of his or her job.

    As for your assertion that everyone has access to healthy food, it’s just not true. Lots of people don’t have access to supermarkets and rely instead on small groceries that don’t have produce (or that only have disgusting, rotten produce.) I lived in a neighborhood like that for a year, and it was a serious chore to schlepp groceries home on the bus. I could do it, because I worked reasonable hours and didn’t have childcare issues and wasn’t physically disabled. A lot of my neighbors couldn’t.

    I have a friend who wrote her Masters thesis on obesity in a poor, urban neighborhood, and she found all sorts of hidden challenges to eating right and getting sufficient exercise. For instance, a lot of people couldn’t cook because their kitchen appliances were broken, and their landlords ignored their complaints about it. People didn’t want to walk for exercise, because their neighborhood wasn’t safe. (And a lot of parents preferred to have their kids inside watching T.V. or playing video games rather than running around in parks that they perceived to be dangerous.)

    This isn’t a simple issue. And uttering the word “nonsense” a lot isn’t going to convince me that it is.

  97. Ampersand says:

    Sally: I have a friend who wrote her Masters thesis on obesity in a poor, urban neighborhood, and she found all sorts of hidden challenges to eating right and getting sufficient exercise. For instance, a lot of people couldn’t cook because their kitchen appliances were broken, and their landlords ignored their complaints about it. People didn’t want to walk for exercise, because their neighborhood wasn’t safe.

    It’s complicated, Sally. I hear what you’re saying, and I think you’ve got a good point. What you’re saying is a large part of the reason that there are more obese poor people than obese rich people.

    However…

    There’s simply no reason to think, from the research on weight loss treatments, that any more than a tiny minority of obese poor people could turn themselves into non-obese people, even if they had more access (both geographically and timewise) to good food and exercise.

    It would certainly be worth it – research overwhelmingly shows that eating well and exercise are good for everyone, fat or thin. But imo, we should avoid analsis which implies that being fat or not is the appropriate measure of health we should be talking about. And I also want to avoid approaches that seem to imply, “poor people can’t be blamed if they’re fat, but well-off fat people should be blamed.”

    I’m not saying, of course, that such conclusions are what you intended. But, although it’s not intentional, I do think that the arguments you put forward would tend to support such views.

  98. Don P says:

    ampersand:

    As I pointed out earlier, even according to your source’s citation, Americans nowadays eat less fatty foods and exercise more than in the past – yet we’re fatter than ever.

    Could you identify the citation and quote the text you’re referring to here? And, obviously, eating less fatty foods will not help if total consumption of calories remains the same or increases. Obesity is not just a matter of the type of food you eat but the quantity as well. Limiting the size of the portions you eat at a meal, and the frequency with which you eat, is important as well as choosing lower-calorie types of food.

    It’s a documented fact that some fat people exercise and go on healthy “weight-loss” diets and still don’t lose weight (even though they become healthier).

    You keep citing these irrelevant (alleged) facts. So what if some people have gone on weight-loss diets and didn’t lose weight? Are you suggesting that this somehow disproves the relationship between calorie intake, energy expenditure and weight? Or what? Who knows what special factors may have been present for those people? Perhaps they had unusually efficient metabolisms. Perhaps they were lying about their food consumption. Perhaps they didn’t really exercise as much as they claimed to.

    Many fat people spend their entire lives attempting to lose weight – and th eoverwhelming majoirty make at least a couple of serious attempts – but nearly all of them will fail, over the long run. To you, that means, apparently, that nearly all fat people are weak-willed and aren’t really trying (or at least, not trying hard enough) to lose weight.

    The fact that most people fail to lose weight does not alter the fact that they choose their diet and exercise level. They choose to live a lifestyle that makes them and keeps them fat. No one is forcing it on them. If they fail to lose weight and keep it off, the obvious implication is that, however much they dislike being fat, they dislike giving up the lifestyle that makes them fat even more.

    To me, that indicates that – whatever the CAUSE of increased obesity among Americans – losing weight (especially enough to no longer be fat) is simply too difficult to be reasonably done by most fat people.

    It doesn’t indicate any such thing. What it indicates is that given the choice between being fat and giving up the diet and inactivity that cause them to be fat, they choose to be fat. That doesn’t mean they like being fat. They may hate it. But they hate doing what is needed to lose the weight and keep it off even more.

    The fact is, even experts are split on this issue.

    What issue, exactly, are you referring to here? Whether diet and exercise are a matter of choice? Show me these supposed experts who claim that people do not have a choice about their diet and exercise.

    You haven’t answered my questions about Americans of previous generations and about non-Americans. If they can manage to achieve much lower levels of obesity without all the intolerable burdens that you claim fat Americans today would have to endure to maintain a normal weight (or, indeed, without any kind of serious burden at all), why can’t Americans do that too?

  99. Don P says:

    sally:

    Lots of people work long hours at sedentary jobs. Lots of them spend two to three hours every day on the bus or in a car commuting.

    It is not remotely credible that anything more than a small fraction of the American population are required to spend such long hours working at sedentary jobs, commuting in cars or buses, or engaged in other necessary activities that preclude physical activity they have no time in which to exercise. They can jog to the bus stop instead of walking. They can go for a run during their lunch break at work. They can park a few blocks from their place of work and walk or run the rest of the way. The idea that people literally have no time in which to engage in calorie-burning physical activity, that they just cannot fit it into their schedule at all because they are required to be sedentary virtually all the time, is just nonsense.

    It’s just silly to claim that there’s some correlation between the hours someone works and the physical demands of his or her job.

    Well, yes, that claim would be silly. I didn’t make that claim.

    As for your assertion that everyone has access to healthy food, it’s just not true.

    Here we go again. Okay, so it may not be literally everyone. Some people, a small minority, may really and truly have no reasonable way of obtaining inexpensive, healthy food. But the vast majority of people can do so. Even a street-corner convenience store is likely to carry some low-calorie convenience foods. Compared to the 1950s and 1960s, when far fewer people were overweight, far more people today have cars or access to cars, there is more public transit, more places carrying health foods and low-fat foods. Nor does your claim about crime wash. Crime levels have been going down for many years and are now comparable to levels in the 1960s and 1970s, and yet people are still getting fatter. So the idea that people cannot obtain healthy food like they used to because of the risk of crime is also not remotely credible. And your “kitchen appliances” argument is even more ridiculous. Even with all these supposedly broken kitchen appliances that you claim are around, it isn’t remotely credible that Americans today have less ability to prepare food than they did 40 or 50 years ago. A single invention alone–the microwave oven–which was unheard of just a few decades ago can now be purchased for a few tens of dollars, and has made food preparation much quicker and easier.

  100. Sally says:

    Sorry, amp. I can see how what I said could be read that way, and that’s not how I meant it. But I do think it’s worth pointing out that the “personal responsibility” rhetoric about diet and exercise is kind of a sham. And that’s not just true for poor people. Americans across the board are working incredibly long hours, and that doesn’t leave a lot of time for cooking, exercise, or a lot of other activities that are conducive to good health. I can’t say whether or not that’s the reason we’re more likely to be obese. I do know that it’s not good for us.

    DonP, you seem to be under the impression that “nonsense” and “not remotely credible” are magical phrases that will make people believe what you say, wether or not you provide evidence.

    They can jog to the bus stop instead of walking. They can go for a run during their lunch break at work.

    See, this sounds great in theory, but I’m really skeptical in practice. Leave aside for a second the whole question of whether running is a good form of exercise for everyone. When I run, I sweat a lot. I’d need to take a shower before I could go back to work, and I’ve never had a shower available at work. Plus, I’ve usually had half-hour lunch breaks, which isn’t enough time for a reasonable run and a shower, especially if you’re assuming that I’d actually have to eat lunch at some point during my lunch break.

    Even with all these supposedly broken kitchen appliances that you claim are around, it isn’t remotely credible that Americans today have less ability to prepare food than they did 40 or 50 years ago.

    I would say that not only is it “remotely credible,” it’s a virtual certainty that the average adult American works more hours and has less time to devote to food-preparation than was true forty or fifty years ago. That’s largely because forty or fifty years ago, a lot more women devoted themselves full-time to domestic pursuits. As a society, we haven’t figured out how to redistribute domestic tasks to compensate for that change, and I think it’s kind of silly to argue that the microwave somehow offsets it.

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