Is Discrimination Acceptable? Fat People Need Not Apply

In certain instances, job discrimination is considered acceptable.

For example, a Catholic Priest would have a tough road to hoe to get hired as a Rabbi, no matter how extensive his career background. There’s really no reason NOT to hire him, but it’s just not going to happen, is it? We accept that.

So when is discrimination out of line?

Under federal law, employers generally cannot discriminate on the basis of several factors, including (but not limited to) race, sex, religion, disability, or age (for workers over 40). Yet only Michigan and six U.S. cities ban discrimination against hiring overweight people.

I understand — to a point. After all, a severely obese person might also be very unhealthy. She might not be able to perform her duties, especially involving physical activity. However, is it tolerable to discriminate against her because she doesn’t “look the part?”

Citizens Medical Center in Texas now requires potential employees to have a body mass index of less than 35 (about 210 pounds for someone who is 5’ 5”). Their controversial policy states an employee’s physique

“Should fit with a representational image or specific mental projection of the job of a healthcare professional,” including an appearance “free from distraction” for hospital patients.

Lifestyle discrimination has precedent.

For example, certain companies will not hire employees who smoke. That, however, is because of the side effects of their behavior, such as higher health care costs or insurance premiums. It is NOT because they do not approve of the smoker’s appearance.

What’s different here is that the policy doesn’t indicate costs or side effects; nor does it suggest that obese employees are incapable of performing their tasks. Mostly, it refers to physical form, placing overweight applicants in the same category as those with visible tattoos or facial piercings (which is a whole other discussion).

The National Association to Advance Fat Acceptance claims, “discrimination plain and simple.”

I agree.

And You Thought You Were Healthy...

Why do flags flap on a windy day?

Believe it or not, this is just one of many questions science cannot surely resolve. There are others: What is gravity? Why do we dream? How many species inhabit our planet? Why is it that the freeway lane I choose is always the slowest? (Okay, in all fairness, I really doubt if scientists spend much time on the last question.)
Each of us has unanswered questions.

Since my field is health, I’ve often wondered why is it that we determine someone’s correct weight based on the Quetelet Index of Obesity, a formula dating back to nineteenth-century Europe? Granted, about a century later we shifted to Body Mass Index (BMI), which is weight divided by height squared. Yet the main premise remained in tact: how tall you are is virtually the sole factor to determine how much you should weigh.

That has never made sense to me. Why would a 5’ 6” forty-four year old vegan woman who enjoys yoga and jogs with regularity; and a sedentary man of equal stature who scarfs red meat, French fries, and drives his car 100 yards to the corner store; be considered healthy at the same weight? I have always thought something’s messed up.
It appears I’m correct – but I take no comfort in what I found out.

A recent study found that the BMI misclassified 39 percent of Americans. Instead of being “overweight,” it turns out they were more accurately “obese.” This is because BMI doesn’t distinguish between fat and muscle, and some folks with “normal BMIs” may harbor dangerously high amounts of fat in their bodies. Without an accurate measurement of how much body fat, the researchers say, millions of people don’t know they are at high risk for a number of obesity-related diseases such as heart disease and cancer, among others.

Dr. Eric Braverman, co-author of the study, points out

“Without knowing how much fat you have, you can't really save people from illness. It is the number one predictor of who's going to live or die.”

This new method of determining who is healthy is revealing some frightening stats. Of the almost fourteen hundred people studied, 26 percent were classified as obese using their BMI. That number almost tripled to 64 percent when measured with a Dual Energy X-ray Absorptiometry (DXA) scan, which is commonly used to check for osteoporosis, measure percentage of body fat, muscle mass, and bone density.

The study discovered that misclassifications were more common in women then men and also increased with age. For example, among women in their fifties, 48 percent more were classified as obese using the DXA instead of their BMI. For women over 70, it climbed to 59 percent. This is because as women age, they lose more muscle to fat than do men. Since BMI does not distinguish between muscle and fat, their classification of “obese” instead of “overweight” — or “even healthy” — would go unnoticed.

Braverman and his co-author Dr. Nirav Shah, are suggesting that we lower the definition of obesity to include more people. Currently, “obese” means a BMI of 30 or above. They recommend dropping that to 24 for women and 28 for men. To put that in perspective, under present standards, a 5’ 6” woman is considered healthy at 150. Under these new guidelines, she would be considered obese. (Ouch!)

Just when we thought we were starting to turn the corner on the fight against obesity, it looks like we have a lot farther to go.