Do you have to meet some criteria during the checkup or just make sure you get it?

In the article it says:
If you're deemed fit, you're exempt. But if you flunk the BMI exam, it's shape up or pay up. Obese workers will be required to see a doctor and will have to show proof of their attempt to lose weight.

So.. yeah. You pay if you fail the exam. The criteria is that BMI OVER 35 is obese... Medically accepted, BMI over 30 is "obese."

Great. Unless they also charge the fee to people with low BMI who have high blood pressure, or smoke, or have a family history of cancer, it's straight up ignorant anti-fat bigotry.

disgusting. i agree with kris that it's a little better if they charge other people who qualify as unhealthy as well, but even still it is a disgrace. why why why are fat people treated with such disdain and made to feel that we deserve any discrimination we are subjected to? if we are fat, that means we are too lazy to get up and do something about it. as if there aren't thousands - maybe millions - of fat people who have tried diet after diet and failed every time, who work out daily and are healthy but never skinny, who eat in moderation just like tons of thin people, but always stay the same weight. come on! this is pure greed!

Smokers pay more. When they whine we turn our heads and don't listen.

You're just paying for the risk, it's not personal, it's a business.

I'm sorry your feelings are hurt, but the reality of it is that you cost more, you take up too much space and your gluttony is killing you. It's also costing a fortune.

According to the article, you have to have a BMI below 35 in order to keep from paying the $25 fee (BMI of 30 and above is considered obese). So a woman and man of 5'8" would have to weigh 230lb to be considered too fat.

A quote:
"He said employees with a BMI of 35 or higher cost the state 40 percent more than those with a BMI under 35."
BMI is just another number that makes us feel bad about ourselves. How the hell do height and weight (without body type) help determine if someone is healthy or not? It's so stupid.

Although as a woman living in the U.S., I have deep seeded body issues and occasionally "fat hate," people can be fit and fat. Just because someone has a BMI of 35 does not automatically mean they have diabetes and hypertension and high blood pressure, cholesterol, and glucose levels.

I just figured out if I gained 5 lbs, I would be considered overweight. Fucking BMI.

If smokers pay more, then the obese should pay more. It's a lifestyle problem. Family history or other genetic indicators are a completely unfair means to assess insurance rates. The potential for abuse here is if the BMI limit becomes unfair. 35 BMI seems very reasonable.

How the all get rich: AKA How they are killing us:

U.S. government subsidizes corn and has tariffs on sugar, therefore, High-Fructose Corn Syrup is used in most processed foods and drinks of the U.S. High-Fructose corn Syrup has been linked to the growing waistlines in the U.S.
Now enter the diet and health industry. There are new diets out almost every month (Atkins, Zone, Weightwatchers, Jenny Craig, Nutrisystem, etc.). A new fitness gimick (thighmaster, bowflex, p90x).
Also enter advertisements full of skinny boob-a-licious women and ripped men.
So we are made to think we are unhealthy and that our bodies are gross, and that diets can fix them. But diets don’t work, and the government subsidizes the one thing that we SHOULDN’T consume.
And then they charge us for being good consumers.

It makes perfect sense.

Obesity is mostly genetic, not a "lifestyle problem". This is completely wrong - I just hope it's not a test case for more such programs elsewhere.

Not to mention that the BMI is a ridiculously one-dimensional measure of anything.

All sorts of nasty products are advertised in an attempt to get them into our bodies. Yet nothing is forced upon us. Eating right and substantial exercise are proven to lead to better health. There's no conspiracy, just poor attitudes about physical health and a populace indifferent to obnoxious advertising.

I view this like someone with a bad driving record forced to pay more for insurance.

How is obesity a mostly genetic problem? There a genetic predispositions that cause many to have a less efficient metabolism than others, but how it being physically obese a product of genetics? We are all born with different gifts and different obstacles to overcome. Someone's genetics does not define there life, just as having red hair does not make one have a fiery temper.

I'd have no problem with this if the language didn't leave it so open ended. As it is, it's too much of a slippery slope. Also, BMI is an outdated and just crappy way to measure health.

We charge smokers more for insurance already. This is just a logical progression in a society where obesity has become endemic and the results are showing. The simple truth is that obesity, by and large, is an imperfect measurement, but it has its merits.

No, it's not a perfect gauge for diseases like diabetes or increased risk of heart attack, but it's a solid predictor in those cases. It's also a good indicator of the likeliness of joint damage/wear and tear. Insurance companies don't just pay for diabetes meds, they pay for things like surgeries to fix one's hip or knee.

As for obesity being a mostly genetic problem, that's a really, really weak answer. Given the fact that our predecessors had lower obesity rates and the time frame it takes to affect genetic change on a national scale the idea that genetics is the primary contributor is a flawed premise.

Does genetics matter? Of course. But obesity is still primarily a lifestyle issue, in the same way that many heart problems are. And obesity does have negative effects aside from the monolithic fears of heart attack. Carrying excess weight on one's body has negative long-term health effects in the areas of joint health, has been shown to contribute to things like sleep apnea, and can compound existing problems.

The truth is that our ideas of a healthy lifestyle have changed, and along with that our health as a whole has changed. I know I've been sedentary at times, and a slim waistline is no barometer of triglycerides sometimes, but I've definitely had to change my attitude towards fitness as time has passed. What I thought was sufficient really wasn't, and I was forced to ramp up my exercise routine in order to maintain the kind of health I want.

If we can't give those with obesity additional charges for insurance how can we charge those who smoke cigarettes? It wouldn't be logical.

"mostly genetic"

Thats an overstatement. Excess calories paired with little physical activity is the primary cause of obesity.

Also, body composition by fat (skinfold) should be used instead of BMI.

BMI is oversimplified and ignores things such as age, muscles and gender.

Re: Genetics

I think people need to be careful when defending with the "It's genetics, I can't help it" defense. Some people are predisposed to cancer. "Hey, I can't help it if I've got lung cancer. It's not the two packs of cigarettes a day - it's my genetics."

"It's not my fault I drink a six-pack when I wake up, down a mickey at work, and then have another six-pack when I get home." The problem is, if you bust out the genetics defense, then damn near every ill-advised lifestyle choice which may result in poor health can simply have any personal responsibility written right out of it.

While I find the use of such a defense in the aforementioned cases to be of relative inconsequence to *my* existence, I let you ponder this, what happens if they successfully identity a rape or serial killer gene? Think about that, for a moment. I know they've been doing studies on it. Have been for quite some time. And I did not like where some of those studies were leading in terms of possible future legal defenses. Granted, it's a big stretch. But there's a lot of people out there convinced that there are obese genes, gay genes, cancer and alocholism genes, perhaps rightly, perhaps wrongly. But all they need to do is convince one person out of twelve behind a bench; and all of a sudden genetics runs rampshod over personal responsibility. Then, all of a sudden, "Couldn't help it, your honor - she was asking for it." becomes "Couldn't help it your honor - it's genetic."

Just a thought. Proceed.

On a personal note, I would certainly hope that they would rely on a battery of tests, rather than a simple BMI index. Because there are just so many issues with that little gem it's not funny.

Actually, as a second note regarding "I've tried hundreds of different diets and never lost weight, but there's nothing wrong with what I'm doing, so there's got to be something wrong with the diets"

I swear I've heard a similar phrase before.
Let's play some word substitution.

"I've dated hundreds of different women, and none of my relationships worked, but there's nothing wrong with me, so there's got to be something wrong with women."

There's a common denominator in both these sentences. Hint: It isn't the word "women" or "diets".

Just a few random thoughts.
I get them from time to time. They're very rare.

The BMI metric is pure bigotry.

...nurses will check for diabetes and hypertension and measure blood pressure, cholesterol, glucose levels and Body Mass Index (BMI).

If you check for hypertension, blood pressure, cholesterol, and glucose levels, the BMI gives you almost no medically relevant information. (Obesity is associated with many health problems, and almost all of those problems are *indicated* by the other metrics.)

Why psychoanalyze or overthink this? Fat people are usually unnattractive, with little if any sex appeal. We just don't like them!

Ignoring the obesity question for a moment, I find myself wondering how much leeway an insurance program should be given for requiring treatment. My cholesterol has recently (finally) crept into the "high risk" levels, and my physician prescribed Lipitor. I don't want to take Lipitor, so instead I've started taking Omega-3's and adjusted my diet (which isn't all that unhealthy anyway). I'll have my cholesterol levels re-checked in a couple months to see what's happened.

But should my physician -- really, my insurer -- be allowed to require that I follow my physician's prescriptions? Should they be allowed to "fine" me (either tacitly or explicitly)? It's not a simple ethical question, and I'm quite troubled by the precedent being set by the State of Alabama here.

i think many people here are not seeing that this is also a class issue. the south happens to be one of the most impoverished areas in our nation. people living paycheck to paycheck are naturally going to want things to be cheap, including food. unfortunately, as someone else realized above, the cheapest food in this nation is riddled with high fructose corn syrup, trans-fat and highly processed. all of these are a recipe for poor health.

on the exercise front, most poor people cannot afford to join a gym, and some lack a safe area outside in which to exercise.

also, i think the comparison to smoking is disingenuous. maybe it is true that smoking and obesity are both choices-- but smokers aren't subject to public mockery and humiliation, smokers don't have to deal with spiteful ignorance from people claiming only to be "concerned for their health". smoking continues to be portrayed as glamorous and cool, and i seriously doubt smokers are faced with the same level of vitriol that the obese are.

obesity is definitely something to be concerned about, but i'm not sure if this is the right way to encourage healthful choices.

This issue I'm on the fence about. I would be okay with it if they'd just get rid of the BMI indicator and relied only on the information that is actually relevant to someone's health: cholesterol, blood pressure, etc. I do think it's a good way to start this country down the road of preventative medicine, but perhaps a better way would be to give people who are not unhealthy incentives instead of punishing those who are unhealthy. Of course with *only* a 30% obesity rate, that would cost the state of Alabama more money so I doubt they'd do that...

Dear me. The point of this country's obsession with health and fatness driven home by the web ad I saw just underneath this post: glycemic impact diet: are you heavy or healthy? :-P

Dondo, while you're right about the tests for cholesterol and diabetes giving a majority of the information necessary to really understand someone's health from a life-in-danger perspective you ignore the slew of other issues that obesity either contributes to or compounds, specifically in the realm of ligament, tendon, cartilage, and bone health, a very serious set of problems that can cost an insurance company a lot of money.

If obesity doesn't have any negative effects at all then yes, this rule makes no sense, but medical evidence is really, really clear in this regard that even if obesity won't give you a heart attack the odds are good it will at least be a contributing factor to SOMETHING. Given that with proper diet and exercise many obese people can alleviate these issues to some degree it makes sense to ask those in this category to pay more or cut back, in the same way we charge smokers.

The BMI metric is nowhere near perfect, but it is a simple mass-versus-height calculation that can be indicative in some cases.

And I'll echo Bunner's sentiments in the "I tried hundreds of diets and exercise plans, and none of them worked". It's not impossible to lose weight and become more fit, and while some workouts and diets are fads that do very little and others require a comfortable middle class existence to be effective that doesn't mean there aren't effective solutions out there.

http://kateharding.net/bmi-illustrated/

So, if someone has a lot of muscle mass and therefore a higher BMI, they have to pay more.

If someone is deemed "overweight" or "obese" by the BMI and "healthy" by their doctor, they have to pay more.

My two best friends who are physically very large people, yet are vegetarians and go on frequent ONE HUNDRED MILE bike rides, would have to pay more.

Oh yeah, terribly fair, not biased at all. /sarcasm

Alabama doesn't seem to charge smokers more. In general, yes, but the company offers a flat fee, and is going to increase it based on fatphobia.

It's one thing when you have an actuary analyzing many factors to determine an appropriate price, as they do for individual health care and other insurances like for driving, but if you have them ignoring things like family history, and just increasing prices based on BMI (which is highly inaccurate), it's straight and out fatphobia.

I'm really disappointed to see the fat-hating here. So, I'm fat, that doesn't mean I'm lazy or a bad person, there are plenty of skinny people who make worse lifestyle choices than me, but wouldn't be charged extra because they keep the weight off, through a naturally high metabolism, or whatever. Referring to obesity as a lifestyle choice is inaccurate, it just means that I like to eat through a bag of Doritos more than a normal person, and I have more trouble squeezing an hour at the gym into my schedule. That's not a lifestyle, and it doesn't give you the right to judge me.

As an Alabama resident, this doesn't surprise me all that much. We're a poor state desperately in need of revenue, but this is pushing it.

It'd be much better to educate people on healthy ways to modify their diet then punish them for their ignorance.

Yikes, this is my home state.

I go back on forth on this particular topic. Yes, being obese is a health issue and one that should be taken seriously. I have no problem with those who take up others' space on planes being charged for an extra ticket, or for those who are larger in size to not be allowed on roller coasters for safety reasons.

This, however, reeks of slippery slope. (And yes, I think it's slippery that smokers are charged more as well.)

I suppose as long as it stays in the realm of the "is", I'm okay with it. By that, I mean that there is a clear definition of what is "fat" and what is a "smoker". If Sally IS a smoker, then fine. But where do they draw the line? If Sally smoked for thirty years and quit two months ago, is she still a "smoker"? If Bob is at a high risk for prostate cancer, does he count as a health threat? If Nancy is an alcoholic who's been on the wagon for three years without a drink, is that a hazard?

All health risks. And like others have said, the BMI isn't a clear measurement of health and "appropriate" fatness, whatever the heck that is.

Actually, nightingale, most every choice we make is a "lifestyle choice". A peculiar love for coffee (or in my case iced tea), an aversion to running, enjoying the internet more than most, all of these are, in fact, lifestyle choices.

That said, someone's choice is fine as long as it only affects them. Whether or not I would do what one person does is not in and of itself judgement, in the same way that I would never sky-dive due to severe altophobia. However, some groups do have a vested interest in one's health, including family, friends, and yes, insurance companies.

I was unaware that Alabama didn't charge smokers more, and as I said previously it's illogical to charge for one thing and not the other.

Again, insurance companies do have a right to take health into account, and weight is a part of health. Not just in regards to one's heart or arteries but also their joints, bones, and so many other things. That's not "fat hate", it's logical. An insurance company puts a stake in your health, so obviously they should be interested in how healthy one is.

I didn't see anyone here calling overweight Americans "bad people". But that doesn't mean that we should allow rampant misinformation to spread, either ("it's mostly genetic", "diets can't work based on statistics", etc.).

I think this has another angle which is the way insurance companies are working to begin policies like this. Health insurance in this country is pathetic and it leads to companies trying to cut costs in ways that discriminate against its employee. Obese employees are the easiest target right now but trust me, it will get worse.

I hate sizism and fatphobia so much! This is blatant discrimination!

Given the dramatic rise and timespan of America's obesity trajectory common sense and the internal logic of evolution dictate that the main cause can't be genetics.
Simply put, too many people too quickly have become obese in America for us to scientifically blame it on "genes".

So, for the sake of a dignified debate that must be grounded in sound science, can we please, please retire the notion that all, or the majority of obesity in the US is mainly due to "genetics"?

Genetics are not the issue, societally speaking. It may be for the individual commenter, but in general, politically speaking, genetics are not relevant in the debate about obesity.

It's simply not scientifically viable to assume that such a large part of the population has undergone a seemingly spontaneous genetic mutation, resulting in the obesity levels we see now.

Acknowledging that does not mean open season for "fat hating". On the contrary. We must be able to discuss with honesty, courage and dignity.

But I can't freakin' abide science twisted for a moral purpose, however noble it may be - in this case to remove any undue moral stigma of being obese.

Well, I think the overall problem is the way the health insurance/health care system works. And yes, I guess it is discriminatory, but it's far from the only example. Obese people have to pay more, so do smokers, and people who have pre-existing conditions often can't get insurance at all. If you want to gripe about the health care system in America, there is a lot to gripe about, but you gotta think bigger.

Happy to be a healthy, fat Canadian with universal health care when I hear about ridiculousness like this from south of the border.

A cash grab like this at the peril of people's health care is morally repulsive and people who support it should be ashamed of themselves. The health of EVERYONE - addicts, the mentally ill, smokers, fatties, pill-popping Type A personalities, whoever - is important and beyond a price tag.

Smokers have to pay more for life insurance, men have to pay more for car insurance... like it or not, it's all about who's statistically at more of a risk for costing the insurance company money. Obesity causes more health problems, whether genetic or not in origin.

Overweight and obesity disproportionately affect people living in low-income communities in the US. It's really easy for people to point out that eating fruit and veg and lean meats are great for you but, they are hardly available at a price in which the majority of people on a fixed income can afford them. And if you want them organic, forget about it completely.

"smokers aren't subject to public mockery and humiliation, smokers don't have to deal with spiteful ignorance from people claiming only to be "concerned for their health"."

Uh...clearly you're not a smoker. Strangers feel comfortable approaching smokers in public to lecture them about the ills of smoking and yell at them for being "stinky", and family members can be frighteningly judgmental upon discovering that one smokes. Fat bashing may be worse, but you'd be surprised at how some people treat smokers.

Some quotes from the article...

1) Beginning in 2010, Alabama, which has the second highest obesity rate in the country, will start charging all of its employees an extra $25 per month for health insurance. (Currently, single workers pay nothing; family plans cost $180 a month.)

2) The $25-per-month fee is not the only way Alabama hopes to discourage bad health decisions by state employees, said the program's creator, William Ashmore, executive director of the Alabama State Employees' Insurance Board. Alabama already charges smokers a monthly $25 insurance fee.

3) employees with a BMI of 35 or higher cost the state 40 percent more than those with a BMI under 35

4) critics say it's just not going to work. "There's the thought that obese people are weak-willed, and if we charge them more they won't be as fat," Stern said. "This assumes they have control over what's involved, and often they don't."

1-3 aside, I agree with #4

I'd like to echo the people who pointed out the classism in this. It used to be that the rich were fatter, because they got more leisure time and more access to rich food, while the poor had to do more physical work and eat whatever they could come by. Now the rich can afford gyms, personal trainers, nutritionists, and healthy food, while poor people work long hours in sedentary jobs and have fifteen minutes to grab lunch.

For a quick comparison, look at the price of a health-food bar versus a candy bar.

As a few others have mentioned, the States badly needs universal health care. It's been shown time and again that private insurance companies will make any excuse they can not to do what they're being paid to do -- and that's even for those who can afford to pay them.

I just don't see any compelling argument against this policy. The parallel with smokers is absolutely and perfectly established: an unhealthy lifestyle issue. The links between obesity and health problems are unbelievably well-established. The links between lifestyle and obesity are also well-established. There's simply nothing missing here. I'm sure some people are more genetically predisposed to being addicted to cigarettes as well, but we still hold them accountable for that risk. Furthermore, if anyone can explain to me how a (mostly) genetic issue has somehow magically appeared in the last thirty years, I'll change sides. And finally, the anecdotes of hard-working, healthy-living obese people are largely irrelevant. While it's great that they are healthy, and somewhat unfortunate for them to get caught up in the high-risk bracket (I'd be happy to see a similar deduction for an active lifestyle, if that were possible), insurance is based on statistics. My grandpa smoked ten cigars a day and lived to be 95, but it doesn't make smoking any less dangerous.

Well, thanks for using up all my Sanity Watchers points, people. Where do you all get your "facts" about "just how things are," from fucking Cosmo?? This crap is ridiculous.

I don't care if it's a business, health insurance should not be charging people for HAVING RISK FACTORS. Although the risk factors associated with BMI are murky and poorly constrained AT BEST (yeah, please learn to statistics, folks), that's what we're talking about here - slightly higher RISKS for things. We're not talking about every fat person having a heart attack tomorrow. A small percentage of the population actually has heart attacks; translate that and you get the probability that the average person will have a heart attack in his or her lifetime. If twice the percentage of fat people have heart attacks as the heart-attack percentage in the average population, guess what: two times a small number is still A SMALL NUMBER! So they have double the small risk, but most fat people? STILL DON'T HAVE HEART ATTACKS.

And yup, sorry if you don't like it because your magazines promise you otherwise, but ~70-80% of your body shape and size is inherited; the rest of the variation observed is environmental. Of all the environmental factors, you only have control over a small number, so your ability to change the size and shape of your body is overall pretty small. In very short time periods it's possible to cause larger changes, because it takes time for the body to reequilibrate. But if we're talking long term, it's basically impossible, because your body maintains a status quo. And don't start in with the "it's simple thermodynamics" crap, because clearly, no one with a basic textbook understanding of biomechanics or bioenergetics would ever say that. Biology isn't simple, for fuck's sake.

davenj, eva, and lots of others here: clearly you do not know what the fuck you are talking about. Study after study has FAILED TO SHOW that fat people eat or exercise differently or in different quantities than thin people. Study after study has FAILED TO SHOW that any diet works to keep a large amount of weight off a person's body for 5 years or longer for more than 5% of the population. There is NO CONCLUSIVE EVIDENCE that being fat is dangerous for joints or tendons or any of that crap. The "estimates" of how much obesity "costs" the health industry are spurious bullshit that don't mean anything. As a population, you know who costs everyone with health insurance the most money? People who live the longest, not people who are sickest. (And it just so happens that people with "overweight" BMIs live the longest, so hey, I guess you can hate away at them for being so damn healthy.) YOU ARE JUST EATING UP WHAT THE DIET INDUSTRY FEEDS YOU (haha food analogy, isn't it funny). Most of the information reported in the news on this subject is completely misrepresentative of ACTUAL DATA. But hey, don't let factual information get in the way of your fat-hating or anything. That'd be a buzzkill.

Back to the subject at hand. The "It's wrong to charge more for genetic risk factors!! but for fatties it's okay because they take up space and people/women shouldn't take up space and because i don't want to fuck a fat woman and women only matter if they're fuckable" shit just doesn't hold water, and all your yelling and screaming about how much you hate fatties won't change that. Fatness: genetic. Genetically fat populations: associated with some risk FACTORS. Other genetic populations: associated with some risk factors. (For instance, Jews like myself: 4x higher risk than the general population of having autoimmune diseases like the one I have. Lucky me for being born!)

This is just based on hatred. Fat people are being stigmatized and blamed for everything wrong with society right now. The diet industry has been really successful at convincing everyone of that and they're making fabulous profits from it. But these things people say all the time about How It Is For Fatties are just things that are repeated so everyone can feel superior, not because they are actually TRUE. It's just more moralizing about people's bodies. And this new law if plain old bigotry.

"Unbelievably well established??" My ass, jeff. Have you actually looked at those data? And fyi, the increase in size of the population is SMALL, it STOPPED at least a decade ago, and BMI increases with height (it's a really crappy indicator of anything) and we got taller as a population. This HUGE EPIDEMIC is basically a tiny shift.

Also, FWIW, the classism argument sounds nice, but the correlation between body size and socio-economic status might have more to do with slight variations in ethnic populations than anything else. Recent results of studies looking at what different populations actually eat suggest the poor just eat less than rich people, and everyone is eating less than we used to.

As someone who grew up poor, I have to call bullshit on this classism argument. The poor don't know to eat spinach? The poor think McDonald's is good for you? We aren't stupid. We know, and have known for decades, that eating fried chicken, Big Macs, and Super stuffed burritos are bad for you.

If anything a middle class income affords more opportunity for gym memberships & personal trainers but lets not call poor people stupid.

A lot obesity is about personal responsibility & daily choices. I've seen this in my family, friends, and in my own choices. Nobody's mama raised them thinking it was ok to eat McDonald's 5 times a week. And even vegetarians have to face the fact that as we age we must consume less food than we did when we were younger. Metabolism slows with age & that's just an unfortunate fact of life.

I think AL's policy is a good one. Surely the only thing good to come out of that state.

ily, Lynne. You said everything I was thinking but couldn't articulate.

I think I'll let Wikipedia speak for me a bit (bearing in mind that every sentence on a high-traffic Wikipedia page is carefully annotated):

Obesity is one of the leading preventable causes of death.[17] Mortality risk varies with BMI. The lowest risk is found at a BMI of 22-24 kg/m2 and increases with changes in either direction.[18] A BMI of over 32 is associated with a doubling of risk of death[19] and obesity is estimated to cause an excess 111,909 to 365,000 death per year in the United States.[20][3] Obesity on average reduces ones life expectancy by 6-7 years.[21][3] For subjects with severe obesity (BMIs >40) life expectancy is reduced by 20 years in men and 5 years in women.[22]...Most researchers agree that a combination of excessive calorie consumption and a sedentary lifestyle are the primary causes of obesity.[40] In a minority of cases, increased food consumption can be attributed to genetic, medical, or psychiatric illness, but in general the rising prevalence of obesity is attributed to the availability of an easily accessible and palatable diet,[41] car culture, and mechanized manufacturing

Oh, and here's that "small increase"
http://en.wikipedia.org/wiki/Image:Bmi30chart.png

(BMI is not perfect but is overwhelmingly accepted by scientists as a reasonably accurate estimate of body fat in most people).

I'm sorry you find the truth offensive. I would never use it as an excuse to be "hateful" or "bigoted" to a fat person. I couldn't care less if a person is fat, other than I may find myself less attracted to them physically. But this is the mirror of every situation where the facts of the matter don't line up behind preconceived ideology, and as such, I consider such positions to be much like creationism, global warming denial, or the insistence on abstinence education.

This is absurd.

I wouldn't be obese for another 60 pounds according to Alabama.

I cannot comprehend carrying my 60 pound seven year old child on my back for an entire day. 60 pounds is half a human being, your heart isn't ready for that, your lungs certainly aren't, your kidneys...

Oh, please stop arguing that obesity isn't a problem. No one CARES how you look.

If you are MORBIDLY OBESE that means you are DYING. Stop being so fucking arrogant about it. You're spending your life arguing about your choice to use food as a slow burn suicide.

I'm sorry, it's pathological, and it would be cruel for me to sit here and nod and pretend like you aren't killing yourself.

If you want some help I want you to have it, but it's not a looks issue, it's not a feminist issue. It's smoking. It's the exact same issue. We didn't know before that smoking was bad, now we know. We didn't realize how deadly trans fats, huge quantities and HFCS is, now we know. There's no turning back.

So stop defending what can't be defended.

Are you people seriously defending policing other people's food intake in the way of fees that go to the added profits of a corporation?

It makes me ill that so many people have just bought into the idea that ANY class of people should be subjected to open ridicule and unfair treatment.

oops, I linked to the wrong graph. Anyways, nobody will follow the link so I'll just put the conclusions here:

In the period of 1971-2000, obesity rates in the United States increased from 14.5% to 30.9%.[44] During the same time period, an increase occurred in the average amount of calories consumed. For women, the average increase was 335 calories per day (1542 calories in 1971 and 1877 calories in 2004), while for men the average increase was 168 calories per day (2450 calories in 1971 and 2618 calories in 2004).

Lynne, I read through this entire thread and nobody said anything remotely like "It's wrong to charge more for genetic risk factors!! but for fatties it's okay because they take up space and people/women shouldn't take up space and because i don't want to fuck a fat woman and women only matter if they're fuckable," unless it got deleted in moderation. Certainly, none of the people you addressed said anything like that.

I'm not taking a side here, but putting words in people's mouths doesn't help.

"Are you people seriously defending policing other people's food intake in the way of fees that go to the added profits of a corporation?"

Not an entirely true argument but, yeah. Okay. I'm a shareholder and I'd like my pension to be there... so as a shareholder in a corporation I'd personally like to see it show a profit.

Good old fashioned free market.

"It makes me ill that so many people have just bought into the idea that ANY class of people should be subjected to open ridicule and unfair treatment."

Oh fer fuck's sake, try being a Republican in Los Angeles, that'll get you ridiculed. It's not ridicule, it's a spreadsheet and good business.

"Are you people seriously defending policing other people's food intake in the way of fees that go to the added profits of a corporation?"

Not an entirely true argument but, yeah. Okay. I'm a shareholder and I'd like my pension to be there... so as a shareholder in a corporation I'd personally like to see it show a profit.

Good old fashioned free market.

"It makes me ill that so many people have just bought into the idea that ANY class of people should be subjected to open ridicule and unfair treatment."

Oh fer fuck's sake, try being a Republican in Los Angeles, that'll get you ridiculed. It's not ridicule, it's a spreadsheet and good business.

Jessica said, "I'm sorry your feelings are hurt, but the reality of it is that you cost more, you take up too much space and your gluttony is killing you. It's also costing a fortune."

This is completely offensive. To assume that all people who struggle with obesity are gluttons is callow ignorance. Yes, we should all try to eat healthily and work out, but there are plenty of obese people who DO and still can't lose the weight. Further, many people are simply not privileged enough (for reasons of economic class, or perhaps just because their jobs require long and strenuous hours) to make the healthy lifestyle choices you take for granted. These people should not be humiliated at their workplace by having their weight problem thrown in their faces.

P.S. My dad struggles with obesity, and he is one of the most hardest working and selfless men I know. It hurts me to think he might have encounter in the world the sort of insensitivity you're brandishing here.

"Jessica", if you are going to fall back on the free-market line then consider how it applies to the unpunished choice of the consumer to purchase and enjoy whichever food they desire.

Capitalism doesn't justify the poor treatment of human beings.

Also, consider citing your sources when speaking of matters of health. You'll find, with some reading past the usual news outlets, that many of the anti-obesity health claims are unfounded.

I don't see a problem with charging extra for obese (since being obese is an increased health risk) people IF and only if the following criteria would be enacted

*Same increase for people who smoke or don't wear seatbelts, whatever is an increased risk
*Use body fat % or other reasonable health test- according to BMI only, very muscular people who are in good shape could be considered "overweight"
*Cover gym membership
*Provide (covered) compassionate, private counseling for healthy living.

Or maybe we can scrap insurance all together since there's no fucking reason that people in this country shouldn't be able to get the health care they need!

Obesity being genetic probably isn't the best argument to pull out when talking about insurance, because insurance takes family history into account. I'm going to be paying out the rear for insurance, because both of my parents died of genetic cancers. Insurance companies use family history to calculate how much money they might have to pay out for you, so if obesity is mostly genetic, that's one more little family history insurance hike check mark.

The way we store fat and our hormones and etc. is very likely linked to genes...but that won't stop insurance companies from charging you for it.

I'm not looking forward to trying to getting a new policy after I get too old to be covered by my current one...

I'm so sick of this argument. Can we just have universal healthcare already, so we can stop dealing with evil corporations who want to squeeze money out of everyone? Can we focus governmental concern trolling on food companies producing dangerously unhealthy food and forcing it into educational institutions? Is there a way to work on making fresh food affordable? And can we talk about the value of healthy food and exercise without demonizing teh fatties for their perceived transgressions?

I'd like that.

For all those who claim that the sole or main cause of obesity is personal choices, maybe you can help me out here.

Seven months ago, I weighed 130 pounds, with a BMI of 21 - an accepted "normal" weight for a woman of my height. I have gained 30 pounds in the past seven months due to excess calories. But I don't eat them! I deliberately restrict my caloric intake to somewhere between 600-800 calories a day - I eat almost nothing. The calories that are making me gain weight come from the dextrose in the dialysate solution I use for my dialysis. I am on peritoneal dialysis and do five exchanges a day. Each exchange gives me the dextrose load equivalent of eating a candy bar, so my daily dialysis routine is like eating five candy bars worth of sugar a day.

I exercise, but I am not physically capable of exercising vigorously for the three to five hours a day it would take to burn off all these calories. Kidney failure saps your energy and your stamina woefully. I do every bit that I can, almost every day of the week, but it's not enough. In fact, I seem to be able to do less and less as time goes on, rather than more and more.

So tell me, those of you who think this is a lifestyle choice, what am I supposed to do? I can't eat less; I'm already in a nutritional danger zone because of how little I eat. I can't exercise more; my body gives out. (I get dizzy and have to stop exercising entirely - doctor's orders.) If I give up dialysis, I die. What's a person supposed to do to get thin again?

Please:

according to BMI only, very muscular people who are in good shape could be considered "overweight"

I really hope you're the last person in this thread to make this strawman argument. It's utterly irrelevant. To quote the WHO guidelines on appropriate use of BMI:

... body mass index (BMI), the ratio of weight to the square of height, is a good indicator of variability in energy reserves in individuals with a sedentary lifestyle, but not in athletes; ...

Stop bringing up the argument about athletes being considered obese. It's pointless and just proves you don't know the first thing about what the BMI is used for.

Regarding health care costs, I read about an interesting study in the Netherlands that found that healthy people cost more money to the health care system than either smokers OR the obese. Why is that? Because they live longer. Morbid, yes. But the argument that fat people cost the system more isn't as valid as people think it is.

It's a good thing this isn't a feminist site, or I might expect that the people here would examine this issue from a feminist perspective.

(That was sarcasm, by the way.)

"Can we just have universal healthcare already, so we can stop dealing with evil corporations who want to squeeze money out of everyone?"

Places with universal healthcare are having the same arguments. In Great Britain, you can be denied certain funded treatments (such as fertility treatment) if you are obese or a smoker.

I agree with Ithika. No one is going to mistake an athlete with low body fat with someone of the same weight and a less muscular physique. Plus, if you are not training 12 or more hours a week it is unlikely to be an issue.

Many people are fooling themselves with how much of their body mass is muscle. It is very common for casual runners training for marathons to gain 5 or 10 pounds of fat. They tend to assume the weight gain is muscle since they are running 60 or more miles a week, but it is usually fat put on because they mistakenly assume that they can eat anything they want and burn the calories with the added mileage.

That's for athletes running one to three hours five times a week. For people who take a 45 minute walk every evening and lift light weights a few times a week, the BMI is not going to be skewed by muscle mass.

Pretty much everyone else in the fatosphere thinks this is such a fatphobic site that they don't even want to bother arguing with people here, but for some reason I'm in the mood today. The ignorance, it hurts.

Maybe I should have quoted more specifically, sorry, but it felt good to rant against everyone checking squares off the fatphobic bingo card last night. Someone upthread (don't feel like finding it) said that they just aren't attracted to fat people (bingo!), and that we just don't like them. Someone else said that fat people take up too much space. It was up there.

I don't have the energy to try to patiently explain everything to people who probably don't want to learn, and I shouldn't have to. It's interesting that someone responded (I think to my rant) by saying that I'm just killing myself. Do you think I'm fat? Heeheehee you know it's true, anyone who would stick up for fatties must be fat herself!

You can't have this discussion without SOMEONE bringing up whether or not they find people attractive, and almost always that goes the direction of women's bodies. Although the stigma against fat men is definitely there as well, in the media and magazines and public discourse this conversation is overwhelmingly about women's bodies, their acceptability, their attractiveness, and how much space they take up. The issue is pretty inseparable from feminism, actually.

Anyway, like I said, I don't have the energy to hunt down all the great resources out there, so I'll just link to a bunch of JFS articles that were recent enough they're still on the front page of the site. I don't always agree with all of Sandy's politics (she's pretty libertarian) but her synthesis of statistics and studies from major medical journals is very accessible and far more balanced than what you get from the news.

On exercise.

On obesity risk factors.

On the rise in obesity.

On what people actually eat.

More on exercise.

AgnesScottie, I'm really disappointed to hear some companies in some places are jacking up their premiums for other inherited risk factors. I think this is downright unethical. Same with smokers. Same with bungee jumpers. Paying into insurance means that everyone pays an average amount for their healthcare, and those that don't need any healthcare don't get their money's worth, and those who end up needing it get more back than they paid in. It protects everyone from being unlucky. If you hate it so much because you don't need expensive health care and don't want to be paying for those unhealthy people who do, why are you buying insurance AT ALL??

The moralistic language about body size and health is also really problematic. You are under no moral obligation to be healthy, whether or not you pay into insurance. Being healthier does not make you more virtuous - mostly it just makes you luckier. And if you fall ill it doesn't mean you're a lazy fuck failure. Illness happens. And to all the people screaming "If you're obese you're gonna diiiiiiiie!!!!" (which no one has said here yet, but it sure gets said a lot), hate to break it to you, but we are ALL going to die. No matter how hard you work to be puritanically virtuous by depriving yourself of food and enjoyment.

By the way, I consider Sandy's articles, which are directly from medical journals, to be a little more reliable than Wikipedia, fwiw. But the first graph you linked to is a little deceiving if you look at the bell curve in one of Sandy's posts. I linked to it.

And BMI IS a load of horseshit. Not only does it not distinguish between different types of body material (which yes, is important), but the height scales as a square with weight. Weight is related to volume, it should be scaled with the cube of a length, not the square. The effect is that if your proportions stay the same but you get taller, your BMI will increase. Thus, taller people have higher BMIs than shorter people. Likewise, it doesn't consider differently-shaped bodies - thin women with large breasts have much higher BMIs than those with smaller breasts. Breasts are fatty tissue, of course, but for many women they don't appreciably change size if you gain or lose weight (on me they're the only thing that changes, on the other hand. Makes buying clothes fun). BMI is fundamentally flawed as a measure for pretty much anything.

And if dietary and exercise habits for all weight and height populations are statistically the same, and the variance in body shape and size is overwhelmingly controlled by inheritance, and long-term attempts to change that body's shape and/or size are statistically impossible, you know what? Yeah, the genetics argument is relevant. Critically important, in fact. Overlooking it is downright lazy.

wow. a few thoughts.

a#1, it's really wild how, almost immediately, there came up a comment about fat folks taking up more space. that's just poor form. if you think this is a good policy, that's one thing. if you think you have a right to the 6 cubic feet that woman on the train is taking up that you don't take up, you're breathing my air. cough it the fuck up.

#2, it's so full of shit to argue that healthy food is expensive; it's really not. dry beans, rice and greens is going to cost you a shitload less than mickey d's in the long run. it does take more effort to get good food in poor neighborhoods, though (shit, the c-town by my house doesn't even carry produce) and there are community-based efforts (like the people's grocery in oakland) to combat this, but the fact stands that it's easier to find fresh produce in manhattan than in the bronx. there may be other factors, but studies show that lower-income people in the us are more prone to weight gain [http://www.biomedcentral.com/1471-2458/8/112]. so, this is using an economic incentive to punish the poor - which isn't really a great long-term strategy. (okay, i guess that was two or three points)

#3, re: insurance companies are just doing the free market boogie. i don't know if y'all noticed, but we're in a health care crisis right now because insurance companies have been skimming off from patients and from service providers. i have three friends who, in the past month, have racked up $50,000 (kidney operation), $150,000 (kidney operation when the guy thought he was covered, but they sent his check back because they upped the rate $9 and didn't tell him) and a whole lot (she just got diagnosed with sarcoma and has to get on emergency medicaid) of debt. and all three of those folks are college-educated. my mom also used to work in hospitals. she took a voluntary pay cut every year for the last five years to keep her hospital from closing because resources are drying up and it's not because people aren't getting sick anymore. bottom line: this policy isn't going to help deliver any better care to anyone, it's just going to help line the pockets of insurance execs. it doesn't cost me $300/mo for the lowest level of insurance i can get because person x likes fried food - it costs me that much because person ceo likes bonuses for jacking up rates and cutting back coverage. don't hate on the (overwhelmingly lower-income) overweight folks because the (gym-membership-holding) rich mofos are stealing our money and endangering our nation's health.

#4, bmi has been increasing and hasn't leveled off. however, as mentioned in passing before, there is variance between different backgrounds. according to the cdc, in 1960-'62, 13.3% of americans were "obese"... '88-'94: 23.3%... '99-'02: 31.1%... among other things, bmi is completely stupid (and i mean this in the most sincere way) in terms of judging an individual's health or risk factors. i'm few pounds shy of "overweight" and that's just because muscle is heavy and i work out every day. and that's the truth. i train martial arts 3-4 days a week, lift 3 days a week and do calisthenics 4 days a week. it may be effective for measuring population data, but for determining individual insurance rates, it's just inaccurate.

what bmi does show, though, across populations, is that poor people and people of color have higher bmi's that wealthier people and white people. and i'll bet that poor people have other risk factors as well (exposure to infectious disease due to lack of community medical coverage, poor air quality, lack of access to nutrient-rich foods, more aggressive marketing of tobacco and alcohol products, the list goes on)

should we tax the poor for being poor?

i guess the question becomes - what is our goal, here? is it to reduce the bottom line of insurance providers (mind you, they're not considering a commensurate drop in rates for "normal" bmi people or non-smokers, so this just means higher profits for insurers)? or is it to actually improve the health of our nation? if it's the latter, then this is definitely not an effective approach and may very well serve to exacerbate health problems across our population (what excuse do we have for having tuberculosis bursts in this day and age?)

the only redeeming thing i saw in this story was that they are offering discounted gym memberships, etc. to folks showing higher bmis.

Bullcrap. When are people going to understand that some people can be frickin' vegetarians and still be "overweight." And, as others mentioned, their weight standards would probably be ridiculous.

I hear conservatives constantly bitching about how the government's trying to "regulate" and dictate everything, including what we eat, by taxing soda and banning trans fats and public smoking. But then I wouldn't put it past them to support something like this.

"Pretty much everyone else in the fatosphere thinks this is such a fatphobic site that they don't even want to bother arguing with people here.": Girl, please. I'm a proud feminist fatty. Or, as I like to call it, pudgy. I completely agree with your arguments. And I'd like to add that the bogus science-journalism establishment - well, and the scientific establishment - doesn't help things by constantly connecting the fallacious "fat=unhealthy," or "fat causes poor health," or "fat=lazy, depressed, and unkempt," in everyone's minds.

P.S. Please disregard the male asshole trolls above. Their opinions are for entertainment purposes only and do not reflect the beliefs of Feministing.com or its affiliates.

Correlation is not causation.

It is well known that a high degree of body fat *correlates* with an increased risk of diabetes. But NO ONE HAS ANY IDEA WHICH CAUSES WHICH. It is *just* as plausible that when your pancreas starts to fail, it causes your body to convert more sugar to fat, since blood sugar is a poison when it's too high and converting it to fat would get it out of the blood and make it safer. (Insulin is involved in the *metabolism* of sugar, but to the best of my knowledge is not responsible for the conversion of sugar to fat.)

So perhaps fat diabetics aren't diabetic because they're fat, but are fat because they're diabetic. Certainly, my diabetic mom can go on an 800-calorie a day diet, lose no weight whatsoever, and repeatedly have low blood sugar reactions that are much more dangerous for her health than being overweight would be.

Also, thin people who do not work out have repeatedly been proven to have poorer health outcomes than fat people who do. *Exercise* is actually what gives you good health, not being fat or thin. But you can't tell if someone exercises based on how fat or thin they are, let alone their BMI.

So this is scientifically unsound and simply bigotry. Being fat does not cause bad health the way being a smoker does; it can be an *indicator* of poor health, but treating an indicator of poor health as if it were the cause of poor health is like forbidding umbrellas so that it won't rain.

I don't really mind getting a discount (and this isn't a fee for some, it's a fee for all with a discount for some) for being in shape, considering I spend hours each week staying that way. However, I do agree that BMI is a stupid measure of fitness.

While I don't doubt there is obviously a genetic component to obesity (or lack thereof), so what? If you think there aren't hardships and expenses in life because of your genes (or for that matter, other factors outside your control), you are living in a fantasy dream world and I'd like to join you.

I (and many) could argue that we pay an "ugly tax" because we don't get the discounts and advantages offered to the very attractive of the world. When my arthritis put me on disability, then kept me from being able to buy insurance, that cost a lot more than $25. You're lucky that all you have to pay is a fee.

My genes for alcoholism caused me a lot of suffering, and cost my whole family a lot of money. That's life. I had no control over (or knowledge of) my genetic tendency to addiction. I did have the ability to take responsibility and fight back, though, and I did.

Did someone above really insist that smokers aren't subject to ridicule and meddling from others? REALLY? Maybe it's just because I live in California, but that's ludicrous. I work with a couple - he's a smoker, she's fat. She's had major health problems lately, and got warned in the hospital of her extremely high risk of heart attack. He just gets yelled at to quit smoking all the time, always has. When she gets advice (usually she asks, sometimes unfortunately others bring it up which I agree is lame), everyone is positive and polite. No one calls her stupid, or tells her how much money she's wasting on food. All the abuse is reserved for the smoker. Which is about 1/1000th of the stigma and cruelty you'll get as an addict.

If I ran the world, no one would be singled out. Unfortunately profit-craving insurance companies didn't go to a Montessori school, so they'll do evil things. On the whole, I have to consider their refusal to cover sick people and denial of coverage to honest policyholders to be a lot more distressing than this.

/not a man

Lynne. You and I are talking about two different things. You may argue that AN INDIVIDUAL's size is determined 80 % by genetics. And that may be so, and I'm not disagreeing with you there.

But, crucially, the same argument is not viable for explaining a huge change in an entire population.

By irretrievable logic, the effect of genes take awhile to play out in a population - at least a couple of generations, because the genes need to be passed on, through natural selection and crowd out other, competing genes and so forth. We do agree on that much, right?

So how do you explain that within ONE generation such a huge shift has been made?

Did everybody's genes all of a sudden get a lot heavier? Massive scale, spontaneous genetic mutation geared towards being heavier? I'm sorry, but within the framework of evolution (which I assume we're all working in here), that is SIMPLY NOT AN ANSWER.

If you see a big, massive change in a population within one or two generations, you have to look at environmental factors, and one, just one of them, would be behavior.

This is one of the core points of evolution.

Personally I think we should look at class, and privilege and race and society and ALL of the many crucial intersections that other commentators have pointed out. And we should combat idiotic fat-hating everywhere we see it.

BUT to claim that genetics are the most satisfying explanation is simply not correct! And it's debasing a scientific point to suit a moral one, which is not helping us in making progress.

What a crock. I am a scrawny distance runner, which makes people assume I am healthy, but in fact my innards are a mess. I have high blood pressure, gastrointestinal reflux, and a 10x risk of blood clots as compared to someone without my crappy genetics.

Furthermore, I feel I should point out that while the running made me thinner, I've always been thin, even when I was a pizza-gobbling time-crunched lazypants undergrad. And one of my running friends, who runs almost as much as me, is fat. He was fat before he started running, and while he lost some weight, he hit a new set point and has been there for months. It would be silly to charge him extra for insurance and not me. I'm the one with actual conditions.

Alara,

that's a great point and goes far beyond diabetes. if one has a chronic joint problem, that will necessarily impede one's capacity to push a workout as far as another individual. there's also a poster upthread who's on dialysis and that changes one's body type. it's a really dangerous road to tread no doubt and, if anything, we need more affordable healthcare, not more barriers to healthcare.

allegra,

glad to hear that you're a feministing-loving pudgy feminist... this is not the first story where the comments have been full of people shaming folks larger than themselves and i fear that this is silencing a very important point of view. beyond that, there's absolutely nothing radical or revolutionary about voicing one's internalized self-hate of one's body and directing it at people who are less fit/ thin/ lucky/ healthy.

Lynn,

interesting about height being squared... that's a really, really good point. and i wonder if the increase in BMI over time has been hand-in-hand with our (unnaturally) rising heights as more and more hormones and other products have made it into our diets. so, it would make sense that rising bmis would be influenced by a general uptrend in height as well. hmmnnn...

i'm certain a fair amount of it, though, has to do with the more sedentary life that we have now compared to a few decades ago, as well as an explosion of easily-available, cheap and highly-marketed fried food.

there are a whole matrix of things that contribute to our changing shapes... but, no matter what you believe, be it problematic metrics, diet, exercise, genetics, etc., the solution definitely does not lie in punishing people for their body mass indexes.

If we didn't live in a fat-phobic culture, all the points about health risks and increased cost would be valid. But we do live in a fat-phobic culture. To pretend that actions like the state of Alabama has taken are not rooted in fat-phobia is disingenuous. If this were truly about charging more to people who cost more, people with extremely low BMI would also have a health tax since BMI below a certain point has as large a risk associated with it as BMI above a certain point.

@ShifterCat: For a quick comparison, look at the price of a health-food bar versus a candy bar.

Check out the caloric content, too. Health food bars are just glorified candy bars, but not as yummy.

@Lynne BMI increases with height

No, it doesn't. BMI is W/H^2. Height is in the bottom, so BMI decreases with increased height. In fact, due to the square, BMI decreases quickly with height.

In addition, BMI correlates well to direct measures of fat percentage.

Mei Z, Grummer-Strawn LM, Pietrobelli A, Goulding A, Goran MI, Dietz WH. Validity of body mass index compared with other body-composition screening indexes for the assessment of body fatness in children and adolescents. American Journal of Clinical Nutrition 2002;7597–985.

Garrow JS and Webster J. Quetelet's index (W/H2) as a measure of fatness. International Journal of Obesity 1985;9:147–153.

Frumious,
you missed the point...
height is a function of size, though it's a linear (one-dimensional) measurement.
height, as it fits into the BMI equation is squared (to the second power, ie, two dimensions)... however, humans are three-dimensional. the point lynne was making was that, for an accurate measurement, BMI would have to account for that third dimension, which it does not.

as one gets taller, the proportion between height and weight becomes more and more off. a real BMI would measure weight/volume (a cubic measurement). however, it measures weight/height^2 (a square measurement).

does that make more sense?

here's a nice article on the problems associated with using BMI to judge an individual's health (and it treats the area/volume issue):
http://www.theopavlidis.com/HealthIssues/bmi_0.htm

If everyone in a culture's behavior changes in order to cause a drastic change in a certain type of health effect, then it stops being the fault of the individual, and you have to start looking for systems at work.

I, too, agree that genetics does not explain why Americans are more overweight. But the fact that so *many* Americans are more overweight *cannot* be explained by "Americans are just lazy slobs" unless you are the kind of moron who every generation, opines that kids nowadays suck and things were so much better in the good ol' days.

For example, is it possible that higher American weights are due to lower American smoking? We know that smoking inhibits appetite and causes weight loss, and we know Americans have stopped smoking in record quantities.

Or, is it possible that fewer Americans work in cities, where good public transportation and poor parking solutions force most people to walk at least a few blocks every day to get to work, and more are working in suburban office parks where they can park their car practically at the door and get no exercise?

Could it have something to do with American children being actively discouraged from going out and playing without adult supervision, because of overblown fear of pedophiles, at the same time as the rise of female participation in the workforce makes it harder to have a parent free to watch the kids play outside?

Has our diet changed? Corn subsidies result in high-fructose corn syrup being vastly cheaper than cane sugar, so everything with sweeteners is sweetened that way. Is it worse for us than cane sugar?

Did mandatory overtime, longer hours and longer commute times deprive more and more Americans of time to cook healthy meals? You can make a cheap meal of beans and rice if you have an hour to cook, but if you have no time at all there's probably a Mickey D's on a corner near you...

All these factors contribute to making people fatter. Poor people are more likely to be fat, NOT because they are lazy and stupid -- far from it! -- but because the way our work lives are structured, even most of the poor do jobs that don't burn a lot of calories, but they have to work longer and longer hours at those jobs to make ends meet. The harder you work, the less free time you have, and without free time you can't make homemade healthy food or find time to exercise. Pre-processed, quick-to-make food becomes very important to people who are crunched for time, and *that* will make you fatter than healthy home cooking. It's the opposite of our stereotype. People get fat because they're *not* lazy. Lack of sleep can make you fat, too, come to think of it.

So no individual American should *ever* be blamed for being fat, even if fatness was inherently a bad thing (which it's not; it is often a *marker* of bad things, but it is not always the *cause* of bad things.) We need social change, not skinny people going "tsk tsk." Because, realistically, most skinny people aren't actually doing anything much to stay skinny; their genes and individual variations in their lifestyle have insulated them so far against the factors making the rest of America fat.

I, too, agree that genetics does not explain why Americans are more overweight. But the fact that so *many* Americans are more overweight *cannot* be explained by "Americans are just lazy slobs" unless you are the kind of moron who every generation, opines that kids nowadays suck and things were so much better in the good ol' days.

don't forget about the biscuits!

Random thought:

I wish people wouldn't label non-trolls trolls. There's a difference between trolls and people who express viewpoints you find distasteful. Trolls are adolescent boys who get their jollies by purposefully trying to piss you off. Key word: purposefully. They're not out to argue, or to share their views. They don't even want to change your mind. They just want to piss you off and laugh about it.

Labeling non-trolls trolls, then, is both inaccurate and a really cheap dismissal. Because if the person isn't a troll, you've just made an ad hominem argument, and if the person is a troll, he already knows it.

Further, many people are simply not privileged enough (for reasons of economic class, or perhaps just because their jobs require long and strenuous hours) to make the healthy lifestyle choices you take for granted.

If we didn't live in a fat-phobic culture, all the points about health risks and increased cost would be valid. But we do live in a fat-phobic culture. To pretend that actions like the state of Alabama has taken are not rooted in fat-phobia is disingenuous.

It doesn't cost you anything to move. It doesn't cost you anything to pushups, situps, or jog around your neighborhood.

Some people in here just don't get it. This isn't a "beautiful people vs. ugly people" issue, and being obese is certainly NOT genetic in most cases. Look at the obesity trends over the past 30+ years compared to before. Now, look at the average time people typically spend outside, the amount of fat/sugar content in our food, the percentage of Americans who eat prepackaged food and eat snacks in place of meals or eat right before bed, etc. Meat consumption has exponentinally risen in recent years and continues to rise. The obesity and diseases tied to too much meat in one's diet has gone up accordingly.

Obesity is costly because of the health problems that stem from it, which are well known and documented. I am very well aware of how are culture impresses the beautiful look on both men and women. Being a feminist blog, many of you are jumping to this conclusion. You need to revisit your judgement. There is big, and there's obese. The former one can't usually control, the latter, yes.

Jessica, while coming off brash, is correct.

It doesn't cost you anything to move. It doesn't cost you anything to pushups, situps, or jog around your neighborhood.

Oh, it most certainly does.

What if your neighborhood is not safe after dark and you ride 2 hours on a bus to work in the morning at 6 am and 2 hours back to return at 8 pm and then you have to make dinner for your kids so it's 9 pm by the time you're done with your day? When were you supposed to have safe time to jog around your neighborhood, or the energy to do pushups or situps? (Which, in fact, aren't particularly helpful anyway.)

The health problems that are known to be associated with obesity are *not* in fact known to be *caused* by it. They're correlated with it. Which means, we don't know if being fat causes the disease, or having the disease makes you fat, or something else both makes you fat and gives you a disease.

Americans eat too much pre-processed junky food because we don't have *time* to make healthy meals. We don't exercise because we don't have *time*. We work too much. We sleep too little. Not getting 9 hours of sleep a night contributes more to obesity than eating meat per se does. We consume foods that will help us stay awake, not foods that will help us stay healthy. We travel too far for our jobs in our cars. We work too many hours. We have too much high-fructose corn syrup in the foods we buy. The portion sizes we are sold are too large (many studies have shown higher portion sizes lead to overeating.)

If you are not obese, you're lucky. Your combination of genes, the activities you enjoy, your particular job and its location, the food that's to your taste and in your budget, all of that contributes to whether or not you are fat. Your genes are only a very small part of that, but the environmental stressors pretty much all Americans suffer to some degree or other interact with *most* human genes to cause fatness.

Alara-

First of all - if one is traveling two hours to work at a low-paying job they should consider moving. If their neighborhood isn't safe they should try on their day off. I don't know, I can't answer for every what-if, but I'll tell you this: every time I glance in a McDonald's or stop at one in the city to use a restroom, it is filled with people who obviously shouldn't be there.

I understand that not everybody is in an ideal situation. However, there ARE factors we CAN control. Where we work and where we live is one of them. Also, it is what we consume. There are many meals made from fresh vegetables that can be made for the entire week and the leftovers heated up. There are ready-to-eat salads. There are lots of food choices out there, and the price difference is not as big as some will lead you to believe. If one is that busy at work and home then they likely are getting enough exercise during the day, they're just not eating right.

I just don't buy the idea that obese people have no other choice. I've seen friends of mine lose over 200 lbs just by walking and eating dry turkey sandwiches. I've seen friends of mine bloat up from alcohol and drug use, and then lose it again.

Your body is something you control. I believe in social welfare and feel compassion like you do, but obesity, in most cases, is something that is easily avoidable by making simple life choices. In the case of the poor, see above. You see the people going in and out of the 24 hour McDonalds, it's all people who look like they don't need to eat or ones that are getting there.

Wow, Derek. Your privilege is showing. I'll tell ya, last year I was working 40 hours a week at Starbucks, doing a 25 hour internship, taking 9 credit hours of graduate courses, one of which required an extra 20 hours of research per week. When I had time to eat, it was a taco from Taco Bell, or pastries from work. I drank a shitload of coffee and diet soda, and was lucky if I got 4 hours of sleep per night. I still did my best to make time for my family and my boyfriend who lived on the other side of the country. Tell me when I had time to make myself a salad. I was paying for grad school out of pocket on $8/hour. Tell me when I money to purchase prepackaged health food. I ate what was available to get through the day, and I sure as hell did not cut into the precious sleep time that I had to do some jumping jacks. Lucky for me, my mother and father are skinny, so you'd never know my looking at me that I ate crap and never exercised.

People who live 2 hours from work and don't make enough money should move? Are you going to help them find an apartment or take out a loan to purchase a home closer by? If they live in an unsafe neighborhood they should take the only time they have not at work to bust their ass jogging? It is a truly bizarre moralism that we as Americans have cooked up. If you take a moment to have any pleasure, you're a bad person, unless of course, you're perfect. Why should fat people not be able to have a burger and fries and coke or shake from McDonalds? Because they are fat? So, a skinny person belongs in McDonalds, but a fat person does not? That shows very much that your concern is with appearances and not health. No one belongs in a fast food restaurant as it relates to health. However, why should it be alright for me to have cupcakes and not spend every free moment of daylight doing pushups just because I'm 115 lbs?

It is moralism, plain and simple, and it's not even based in practicality. Being fat is not bad in and of itself, and being obese is not an immoral state of being either.

Holy crap. It's strange to see so many people who obviously (or hopefully) are feminists and supporters of this site, SO incredibly biased against others who are fat. Being fat is like having blue eyes, being short, African-American, deaf, etc. It happens, and no, most times you can't help it. I do yoga, pilates, eat a veggie diet and still... I AM FAT. does that mean that i should pay more for insurance if I am actually living healthier than my skinny counterparts? That's called discrimination.

Someone commented earlier stating that healthier foods (aka trader joes/whole foods/organic foods on the whole) aren't more expensive than run-of-the-mill market brands. That's bullshit. It's a total class issue, people who make more can afford better diets and etc. People who cannot afford to buy organic have to purchase the alternative, which may be less healthy. Or maybe these hypothetical people are on food stamps, OR just simply cannot afford to spend the money or don't have the time.

I don't believe you can call yourself a feminist, or believe in feminism and still think it is okay to discriminate against ANYONE for something as ridiculous as their appearance.

Ok, since this has been brought up several times:

Being vegetarian does not automatically make one's eating habits healthy. You can still eat unhealthy food (fettucini alfredo and Cheetos, anyone?). Or, even if you're vegan, you can still eat all healthy food, but eat too much of it.