Should obesity be considered a disability?

I read on a recent post:  "apparently obesity is not covered under the ADA." I don't think people that are obese should be discriminated against, however, I'm not convinced that it should be protected under the American's with Disabilities Act.  Any thoughts? 

Original Post by trustwomen:

My point was rather that if you have universal health care without the remainder of a reasonable social safety net, you wind up with a lot of people staying in hospitals (or prisons) at great public expense whereas they would have been able to be more self-managing at a much lower cost with just a little cheque each month.

If someone can't work, and you don't give them money to live, they aren't just going to starve quietly. They are going to use up your public dollars in other ways that are far more expensive. The same applies to people who won't work, for that matter. I know it's tricky from a "deserving vs. undeserving" moral standpoint, but honestly that distinction is academic and completely impractical in the real world of social service provision.

yep.  the deserving/undeserving question really has to be set aside, or the whole thing starts to fall apart.  not that those distinctions aren't made every day in practice, but in theory at least, they can't be part of the equation.

wait - did i just said the exact opposite of what you did?

Original Post by pgeorgian:

um...enchantingimage, i think i've been fairly open about my absolute, unconditional support of universal health care and the social safety net.  i'm a socialist.  i like paying for other people's healthcare, and i especially like having access.  Great. The whole intent in pretending otherwise was to stir your pot.

but you can't suggest that people are personally and individually responsible for the consequences of their choices and then cite universal health care.  those are two opposing positions.  you either believe in self-sufficiency and personal responsibility or you believe in collective responsibility and taking care of others.  you can't have it both ways.  Says you. It comes down to the fact we're all human. As humans nobody should be denied treatment for healthcare. Healthcare isn't something that should be used to punish people for their actions or choices. It's fine if you believe others should suffer the consquences for their choices/mistakes. That's your view. However. Some believe that people should have the right as humans. People should be treated for ANY health condition as needed... Regardless of nonesense. That doesn't mean they should be given payment for known risk/consquences. They shouldn't. However, they should still be given treatment as humans. It's considered humane treatment to give them healthcare as needed. Not issuing them a benefit,imho.

so - what do you believe in?^

I agree with the posters who say that obesity should only be considered a disability if it leads to an actual disability. When I was clinically obese (BMI 31), I was still entirely capable of walking to work and back every day (over a mile each way), jogging for a mile or so, climbing a couple flights of stairs, and fitting in one coach class airplane seat quite comfortably. There is no reason to give someone like that any extra legal protection. If an individual has mobility issues, it is a disability, regardless of whether it is caused by obesity, trauma, age, disease, or something different entirely.

However, I believe it is problematic to treat individuals as responsible for their own obesity. No one wants to be obese. Obesity isn't becoming more accepted, yet obesity rates continue to rise. The sad truth is that we still don't understand how to treat obesity. According to a report by the Institute of Medicine entitled Weighing the Options, typically over two-thirds of weight lost by an individual will be regained within one year and almost all within five years. Even gastric bypass surgery, which is a last resort for many individuals, isn't a panacea - patients typically lose only 50-60% of their excess weight, and there are a wealth of possible medical complications.

Many obese people do not have an underlying medical pathology, like hypothyroidism. There are numerous other uncontrollable factors that show a statistical correlation with an increased risk of obesity, though, such as low socioeconomic status or not having been breast fed as an infant. Is it these people's fault that they are obese, any more than someone who is insulin resistant due to PCOS? Should we hold obese children, or individuals who have been obese since childhood accountable for their size? The fact remains that some individuals will have a much harder time controlling their weight than others, and should not be stigmatized as having moral problems such as low self control.

This does not mean that I think obesity is ok. It isn't. It is just not healthy. Everyone should strive to be a healthy weight. However, it is much more complicated than just saying "you need to have better self control." I will not consider myself morally superior to someone just because I am thinner than them.

Just my rant...

Original Post by enchantingimage:

Original Post by kladdrn:

Well, what about smokers?  Many receive disability becouse they need oxygen, have other severe respiratory issues, heart disease, stroke, etc.  They chose to smoke thus bringing on those disabilities themselves.  The same could be said about alcoholics and drug addicts.  No easy answer!

Any condition brought on by choice shouldn't be considered the same way, imho. Smoking is another choice with known consquences/risk factors. Those that are willing to take the risk should consider that. The consquences that surface are something that could've been avoided for free.  Perhaps if they started before the known risk factors, the tabacco companies should pay those customers disability because of the addiction.  Nothing beyond that should be paid to them by anybody.  However, obesity is sometimes not the person's fault, which is very rare.  If they were born with diabetes from their parents, or born with some condition.  They should qualify for some assistance.  But general obesity from overeating or lack of self control, no.

 As humans nobody should be denied treatment for healthcare. Healthcare isn't something that should be used to punish people for their actions or choices. It's fine if you believe others should suffer the consquences for their choices/mistakes. That's your view.

um...no.  that's not my view.  it's yours.

Original Post by pgeorgian:

yep.  the deserving/undeserving question really has to be set aside, or the whole thing starts to fall apart.  not that those distinctions aren't made every day in practice, but in theory at least, they can't be part of the equation.

wait - did i just said the exact opposite of what you did?

Yes, you just said the exact opposite of what I said. In theory there is nothing wrong with claiming that those who can work should work and "incentivizing" them to do so by not giving them free money.

In practice, if they still don't work, they will use up far more public money in ways that you can't prevent them from doing (health care, incarceration).

The same economic argument to be made for universal health care (namely, get people treated earlier and you don't have the huge expense as they all turn up at the emergency room, so you save money) can be made for social safety net dollars (give people affordable housing, cash subsidies, etc. and they won't spend their time in the hospital or in jail just to get three hots and a cot).

Original Post by pgeorgian:

Original Post by enchantingimage:

Original Post by kladdrn:

Well, what about smokers?  Many receive disability becouse they need oxygen, have other severe respiratory issues, heart disease, stroke, etc.  They chose to smoke thus bringing on those disabilities themselves.  The same could be said about alcoholics and drug addicts.  No easy answer!

Any condition brought on by choice shouldn't be considered the same way, imho ( * AS in it shouldn't be considered the same way as a disability benefit.). Smoking is another choice with known consquences/risk factors. Those that are willing to take the risk should consider that. The consquences that surface are something that could've been avoided for free.  Perhaps if they started before the known risk factors, the tabacco companies should pay those customers disability because of the addiction.  Nothing beyond that should be paid to them by anybody.  ( AS in paid to them as a disability check. ) However, obesity is sometimes not the person's fault, which is very rare.  If they were born with diabetes from their parents, or born with some condition.  They should qualify for some assistance.  But general obesity from overeating or lack of self control, no. ( * Obviously. )

 As humans nobody should be denied treatment for healthcare. Healthcare isn't something that should be used to punish people for their actions or choices. It's fine if you believe others should suffer the consquences for their choices/mistakes. That's your view.

um...no.  that's not my view.  it's yours.  ( There is a difference between being given a disablity benefit/check and being given treatment. )

As slight offshoot to the original topic.... How far should we go to accommodate the increasing number of very obese people in existence?  Disable people have to be catered for in terms of access ramps and so forth.    Having seen some (admittedly US) innovations such as extra-large toilet seats and reinforced hospital beds I was left wondering what this achieves.  Is making the life of obese people more comfortable a compassionate move or is it admitting defeat?  ..... or should we keep the toilet seats small and keep charging the excess on airlines as an incentive for everyone to slim down?

Original Post by trustwomen:

Original Post by pgeorgian:

yep.  the deserving/undeserving question really has to be set aside, or the whole thing starts to fall apart.  not that those distinctions aren't made every day in practice, but in theory at least, they can't be part of the equation.

wait - did i just said the exact opposite of what you did?

Yes, you just said the exact opposite of what I said. In theory there is nothing wrong with claiming that those who can work should work and "incentivizing" them to do so by not giving them free money.

In practice, if they still don't work, they will use up far more public money in ways that you can't prevent them from doing (health care, incarceration).

The same economic argument to be made for universal health care (namely, get people treated earlier and you don't have the huge expense as they all turn up at the emergency room, so you save money) can be made for social safety net dollars (give people affordable housing, cash subsidies, etc. and they won't spend their time in the hospital or in jail just to get three hots and a cot).

yeah.  we're not really saying the opposite things: you're talking legislative and policy theory, and i'm talking philosophical theory.  the point is, neither one can really be put into practice.

Original Post by enchantingimage:

Original Post by pgeorgian:

Original Post by enchantingimage:

Original Post by kladdrn:

Well, what about smokers?  Many receive disability becouse they need oxygen, have other severe respiratory issues, heart disease, stroke, etc.  They chose to smoke thus bringing on those disabilities themselves.  The same could be said about alcoholics and drug addicts.  No easy answer!

Any condition brought on by choice shouldn't be considered the same way, imho ( * AS in it shouldn't be considered the same way as a disability benefit.). Smoking is another choice with known consquences/risk factors. Those that are willing to take the risk should consider that. The consquences that surface are something that could've been avoided for free.  Perhaps if they started before the known risk factors, the tabacco companies should pay those customers disability because of the addiction.  Nothing beyond that should be paid to them by anybody.  ( AS in paid to them as a disability check. ) However, obesity is sometimes not the person's fault, which is very rare.  If they were born with diabetes from their parents, or born with some condition.  They should qualify for some assistance.  But general obesity from overeating or lack of self control, no. ( * Obviously. )

 As humans nobody should be denied treatment for healthcare. Healthcare isn't something that should be used to punish people for their actions or choices. It's fine if you believe others should suffer the consquences for their choices/mistakes. That's your view.

um...no.  that's not my view.  it's yours.  ( There is a difference between being given a disablity benefit/check and being given treatment. )

 

ah - so you advocate health care but no other benefits?  you need to read trust's posts #12 and 20.  universal health care is just one piece of the puzzle; it can't and doesn't function in a vacuum.

Original Post by gi-jane:

As slight offshoot to the original topic.... How far should we go to accommodate the increasing number of very obese people in existence?  Disable people have to be catered for in terms of access ramps and so forth.    Having seen some (admittedly US) innovations such as extra-large toilet seats and reinforced hospital beds I was left wondering what this achieves.  Is making the life of obese people more comfortable a compassionate move or is it admitting defeat?  ..... or should we keep the toilet seats small and keep charging the excess on airlines as an incentive for everyone to slim down?

I think the accommodations should be mostly done by the obese people themselves -  public toilet seats should remain as they are, keep charging the extra seat (unless the plane isn't full, in which case don't charge it). I don't thing that acknowledging disability is the same as changing all these things around. Hospital beds are an exception, though-  the health care system needs ot be able to deal with the very large. Beds, crane lifts, scales, stretchers, larger surgical instruments, etc. are necessary.

NO.

Original Post by pgeorgian:

ah - so you advocate health care but no other benefits?  you need to read trust's posts #12 and 20.  universal health care is just one piece of the puzzle; it can't and doesn't function in a vacuum.

Exactly. The difference between getting "treatment" and getting a cheque exists only in the abstract; both are public dollars. I, for one, am not willing to spend MORE total public dollars on social services just because I want to feel virtuous about denying cheques to the "undeserving". I know it sounds counterintuitive, but really, if you deny people the means to survive, they don't just fade away into obscurity. They survive in other, more expensive ways, and they wind up sucking up more of our money, either by their medical treatment or their incarceration.

re: #30

those are tough questions.  i believe that structural oppression should be addressed just as other oppressions should, but i do wonder...when it comes to obesity, i think the structural changes that need to happen are on a different level. 

i believe that prevention and accomodation have to happen in parallel.  if the morbidly obese can't function in the world, that doesn't serve anyone.

very tough questions.

Original Post by gi-jane:

As slight offshoot to the original topic.... How far should we go to accommodate the increasing number of very obese people in existence?  Disable people have to be catered for in terms of access ramps and so forth.    Having seen some (admittedly US) innovations such as extra-large toilet seats and reinforced hospital beds I was left wondering what this achieves.  Is making the life of obese people more comfortable a compassionate move or is it admitting defeat?  ..... or should we keep the toilet seats small and keep charging the excess on airlines as an incentive for everyone to slim down?

What about a compromise? Having reinforced hospital beds available is absolutely a necessity, but there is no reason for every bed to be reinforced.

There is no easy solution to the airline question, though. I haven't been on an international flight in 10 years, but at least here in the good ol' US of A our airlines have been squeezing us coach passengers into smaller and smaller seats over the years. I could see myself supporting charging extra for people who take up two seats if the seats were reasonably sized to begin with, but they aren't. It isn't just a problem for the obese - tall people can't fit either, either because their legs don't fit or because even at a healthy BMI they are still too big! There are enormous economic incentives for airlines to do this. Add in the horror stories about overflowing toilets, young children being kicked off flights for crying, or passengers being stuck on planes (on the runway!) with no access to food or water for hours, and I really don't expect our airlines to treat people humanely without some sort of legal mandate.

Original Post by theholla:

However, I believe it is problematic to treat individuals as responsible for their own obesity. No one wants to be obese. Obesity isn't becoming more accepted, yet obesity rates continue to rise. The sad truth is that we still don't understand how to treat obesity. 

Is it these people's fault that they are obese, any more than someone who is insulin resistant due to PCOS? Should we hold obese children, or individuals who have been obese since childhood accountable for their size? The fact remains that some individuals will have a much harder time controlling their weight than others, and should not be stigmatized as having moral problems such as low self control.

I will not consider myself morally superior to someone just because I am thinner than them.

 "I believe it is problematic to treat individuals as responsible for their own obesity'

If the individual isn't responsible for their own weight, who is? Society? MacDonalds? No one else controls what anyone puts in their body ... what happend to personal accoutability.

"The sad truth is that we still don't understand how to treat obesity. "

The only person that can 'treat' obesity, is the obese person themselves - there is ALOT of information and resources available for those who choose to address their obesity. It's not a mystery.

"Should we hold obese children, or individuals who have been obese since childhood accountable for their size?"

Children, no - they rely on their parents to feed them nutritionally sound food.

Once they are adults though, why would they not be responsible? If someone is raised in an abusive family, and then grows up and abuses their own children we hold them accountable for their behavior. As an adult we have the ability to make our own decisions and know the difference between wrong and right - and we also have the ability to know the difference between fast foods/poor quailty foods and healthy wholesome foods. Just because it's hard to change behavior/lifestyle doesn't mean we shouldn't be accountable and responsible for it. (note: we are talking about being obese to the point where a person is physically disabled, not to the average person who is 30 or 40 lbs overweight. Not many overweight childeren are that obese until they become adults )

"should not be stigmatized as having moral problems such as low self control."

Holding someone responsible is a long way from considering yourself morally superior - the two are not necessarly related. Some people have issues with food, some with smoking, some with exercise, some with relationships, some with animals .... etc - just because my challenges aren't the same doesn't mean that I think myself better than someone who is obese. That doesn't mean that I think the obese person isn't responsible for their situation. We are all responsible for whatever area we have challenges with, it doesn't mean that anyone is better than anyone else. Low self control is not only NOT a moral problem, but it's also NOT the reason for obesity.

the airline question is an interesting one.  the fact is, air travel used to be a luxury.  seats were big, booze was free, and people dressed up like it was a social event.  but as air travel has come to be seen as a right rather than a privilege, and as airlines have gone further to be competitive and attract a wider market, they've had to make concessions.  you want $99 round trip to disneyland, and kids fly free?  okay.  but you can't expect to be treated like royalty.

Okay....

As someone who lives on disability, and has since I was 18 I wanted to say that it seems like people are coming off like we're all living with the government giving out big bucks.

It's not even enough to live on. I get 700$ a month, that is not even enough to pay rent on a decent place and keep the electricty on. Therefore I have to live with someone. They make it impossible to get off of it also, if I decided to try to work they would take away my money and healthcare the moment they knew. There is no time in between to see if it's possible.

So if a person was to try to go back to the work force, they lose all the disabilty right off the bat, so if it turns out they just can't work after all, they're set back to fighting tooth and nail to get the disability payments back.

I respect those who dont want to pay endlessly into the system for people who could work, but it's really not that simple. and to be fair I'm tired of people thinking I'm a leech because I get disability, because this is not a good way to live and if I could go off it and get a job I would, I'm certaintly not sitting here sipping wine and eating lobster using the system.

Would you take an axe and chop your left leg off so that you can get all the benefits that a disability badge brings?.........

No of course you wouldn't, well not unless your nuts.

So unless you can produce a Dr's note proving that you have an illness with which one of the side effects is weight gain then I say No it should not be classed as a disability.

Original Post by sybil878:

Original Post by theholla:

However, I believe it is problematic to treat individuals as responsible for their own obesity. No one wants to be obese. Obesity isn't becoming more accepted, yet obesity rates continue to rise. The sad truth is that we still don't understand how to treat obesity. 

Is it these people's fault that they are obese, any more than someone who is insulin resistant due to PCOS? Should we hold obese children, or individuals who have been obese since childhood accountable for their size? The fact remains that some individuals will have a much harder time controlling their weight than others, and should not be stigmatized as having moral problems such as low self control.

I will not consider myself morally superior to someone just because I am thinner than them.

 "I believe it is problematic to treat individuals as responsible for their own obesity'

If the individual isn't responsible for their own weight, who is? Society? MacDonalds? No one else controls what anyone puts in their body ... what happend to personal accoutability.

_____

I do see obesity as a systemic problem that begins in childhood, and don't think that personal accountability is a useful concept for addressing the obesity epidemic. It needs to be treated on a societal level. For example, I used to work as a middle school teacher in an extremely poor urban area. 85% of our students lived below the federal poverty level. 99% of the students were African American. Because of the extreme poverty, all students received free breakfast and lunch through the school. What were they served? Breakfast was a sugary yogurt, plus a sugary muffin, made with white flour of course. The fresh fruit they served was so nasty that none of the students ever ate it. Lunch was a fatty cut of meat that was either breaded and fried or swimming in a sodium-loaded sauce. It was served with white bread, and the veggies were so nasty that no one ever ate them either. "Juices" were often loaded with corn syrup. I saw a hell of a lot more fat kids in that school than I did when I was teaching in the suburbs.

 

"The sad truth is that we still don't understand how to treat obesity. "

The only person that can 'treat' obesity, is the obese person themselves - there is ALOT of information and resources available for those who choose to address their obesity. It's not a mystery.

_____

If we know so much about treating obesity, than why did the Institute of Medicine report that typically over two-thirds of weight lost by an individual will be regained within one year and almost all within five years? I don't see that as particularly successful. I am not saying that people can't lose weight. Many do (myself included). Some even keep it off. I'm just saying that we have a lot more to learn.

 

"Should we hold obese children, or individuals who have been obese since childhood accountable for their size?"

Children, no - they rely on their parents to feed them nutritionally sound food.

Once they are adults though, why would they not be responsible? If someone is raised in an abusive family, and then grows up and abuses their own children we hold them accountable for their behavior. As an adult we have the ability to make our own decisions and know the difference between wrong and right - and we also have the ability to know the difference between fast foods/poor quailty foods and healthy wholesome foods. Just because it's hard to change behavior/lifestyle doesn't mean we shouldn't be accountable and responsible for it. (note: we are talking about being obese to the point where a person is physically disabled, not to the average person who is 30 or 40 lbs overweight. Not many overweight childeren are that obese until they become adults )

_____

I don't disagree with you here. This is a tough question, and I am not that up on the science behind it. What I do know is that being obese in childhood is statistically a very good predictor of being obese as an adult. So are other factors that you can't really hold an adult responsible for, such as socioeconomic status or whether they were breast fed or not.

I was trying to respond to the posters (#2, #3, #7, #10, etc) who were trying to draw a distinction between people who were obese (or disabled) for medical issues like hypothyroidism and those who are obese "by choice." There are a lot of factors that contribute to obesity, and I just think it is foolish and not that useful to try to distinguish between who chooses to be obese and who doesn't.

 

"should not be stigmatized as having moral problems such as low self control."

Holding someone responsible is a long way from considering yourself morally superior - the two are not necessarly related. Some people have issues with food, some with smoking, some with exercise, some with relationships, some with animals .... etc - just because my challenges aren't the same doesn't mean that I think myself better than someone who is obese. That doesn't mean that I think the obese person isn't responsible for their situation. We are all responsible for whatever area we have challenges with, it doesn't mean that anyone is better than anyone else. Low self control is not only NOT a moral problem, but it's also NOT the reason for obesity.

_____

I do agree with you here. 

I believe that our bodies and our health are gifts, and it is no one's responsibility but your own to take care of yourself to the best of your ability, whatever that may be. 

However, there are quite a few people who do think they are better than someone who is obese, and that it does come down to simple self control. I think a lot of people justify discriminating against the obese for this reason. Personally, I am far more impressed by the discipline of someone who was 400 pounds and lost 100 pounds than a couch potato who has easily maintained a BMI of 22 their entire life.

edited to (hopefully) make it more readable...

Original Post by theholla:

However, there are quite a few people who do think they are better than someone who is obese, and that it does come down to simple self control. I think a lot of people justify discriminating against the obese for this reason. Personally, I am far more impressed by the discipline of someone who was 400 pounds and lost 100 pounds than a couch potato who has easily maintained a BMI of 22 their entire life.

but you don't feel superior.