Shame Is Not a Health Care Strategy
Apparently, it is now fashionable to bash the obese.
For the sake of health care, you understand. Nothing personal.
Dr. Toby Cosgrove, the Cleveland Clinic's CEO, got the ridicule rolling. The New York Times reported some comments he made last month at a conference on obesity. If he could get away with it legally, Cosgrove said, he would not hire obese people.
The Wall Street Journal quoted Cosgrove griping about federal employment protections for obese people under the Americans with Disabilities Act.
"We are protecting people who are overweight rather than giving people a social stigma," he said.
What? Oh, he must mean all those obese people bragging about the compliments from strangers and the big, welcoming grins on the faces of fellow airline passengers. Not to mention the parade of size-20 models on fashion runways.
Yep, obesity is really popular in America. Who wouldn't want to be called fat?
I can see the strategy behind demonizing the obese. It makes us feel so superior; we may be more twisted than a corkscrew, but at least we're not fat.
Last week, The Plain Dealer's Harlan Spector reported that Cosgrove refused to retract the statement about not employing the obese, but he did say that he meant only to get people talking about the growing medical costs of this epidemic.
OK. Let's talk.
The growing rate of obesity in this country is alarming. The Centers for Disease Control and Prevention reports that more than 60 percent of Americans are either overweight or obese. This is a complex problem, with complex solutions.
Too many want to depict the obese as over-consuming slackers who refuse to eat right and get moving. That works if you see obesity as a price tag without a beating heart. Acknowledging overweight people as fellow human beings — mom, brother, co-worker, schoolteacher, best friend — makes it harder to condemn them as just a big sucking drain on the resources of health care.
Let's take another whack at our hubris and consider reasons for obesity that have nothing to do with self-control. For starters, we could go a long way in whittling waistlines if we eliminated health disparities in this country.
When you have health insurance, you are more likely to benefit from the consistent monitoring and timely interventions of regular checkups. When you don't, you usually see a doctor only when you have an emergency. At that point, no one is focusing on your body mass index.
We also could help to reverse the trend in obesity, not by raising taxes on junk food, but making healthy foods more affordable and accessible. Especially in neighborhoods where obesity rates are rising.
Studies have shown that fruits, vegetables and whole grains are more expensive than soda pop, cheeseburgers and potato chips. For that we can blame the U.S. Department of Agriculture's crop subsidy program, which overwhelmingly supports the production of soybeans and corn that become — ta-da! — soybean oil and high-fructose corn syrup. There's a lot of this stuff, and it's cheap, and it's in all kinds of low-cost fattening foods.
Increasingly, even middle-class people are having a tough time putting healthy food on the table, but they can at least see the good stuff whenever they walk past the bounty of suburban stores offering eight varieties of lettuce, four types of tomatoes and peppers in more colors than a Crayola box has. After dinner, most of them can take calorie-burning walks in their neighborhoods without fearing for their lives.
We also could have a long conversation about cutbacks in physical education and recess in schools, particularly in neighborhoods that need those things the most. We could talk about depleted energy after a long day at work and a bus ride home. There are also issues of food addiction and genetics. Some people are born to struggle with weight all their lives.
Talking about punishing the obese addresses none of the underlying causes of this medical epidemic.
Treating them like human beings should never go out of style.
Connie Schultz is a Pulitzer Prize-winning columnist for The Plain Dealer in Cleveland and the author of two books from Random House, "Life Happens" and "... and His Lovely Wife." She is a featured contributor in a recently released book by Bloomsbury, "The Speech: Race and Barack Obama's 'A More Perfect Union.'" To find out more about Connie Schultz (firstname.lastname@example.org) and read her past columns, please visit the Creators Syndicate Web page at www.creators.com.
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