Discrimination: Alive and Well
in the United States

SWLC understands the disturbing challenges faced by obese people in our society. We thought you might be interested in reading the following submission from our own Dr. Fox to Obesity Surgery, the official journal of the ASBS and the International Federation for the Surgery of Obesity.

An interesting note: as you lose weight, we believe you’ll be surprised by how differently people perceive and interact with you.

The last bastion of socially acceptable discrimination in the USA is the public and professional discrimination against the segment of society in which is found those citizens who are morbidly obese. In virtually every aspect of their lives, the super-obese people are treated as second-rate citizens.

There is, for example, discrimination in the workplace. In some areas of the country, almost 50% of the morbidly obese people are unemployed. This is not related to their lack of talent, experience or willingness to work; it occurs because employers and fellow employees see the morbidly obese as being less than properly motivated, of inadequate intelligence, physically unattractive or unable to perform the tasks that employment requires. In the workplace, when there is an opportunity for promotion, if a slender person applies for a position along with an obese person, almost inevitably the heavy person is bypassed for the upgrade. Every physician who deals with heavy patients has had them tell her/him about opportunities lost because of the obesity. Comments such as “If you weren’t so heavy, the sky would be the limit for you” or “If you’d just lose weight you could easily move up through the company,” are common.

Obese people suffer discrimination at the hands of the professionals with whom they deal. Some of the most serious offenders are physicians. It is common for heavy patients to be told that all of their medical problems would disappear if they would just learn to “push away from the table.” Because of their inability to lose weight, the physicians see the patients as noncompliant and slovenly, and are treated as such. The same tends to be true in dental offices as well as in situations where the heavy folk are dealing with other non-medical professionals.

Even in the public transportation system, heavy folk are discriminated against. Often the super-obese are disallowed on planes, buses and/or trains, and when they are accepted on public transportation, occasionally they are charged extra fees.

The American media are guilty of serious discrimination. Obese people are frequently subjected to derision and much negative humor is directed against them. The svelte appearance is always portrayed as being the most desirable.

A very distressing form of discrimination is perpetrated by the medical insurance providers. They often discriminate against obese people by refusing to provide medical care for that person’s primary medical difficulty: obesity. Often the rationale for failing to fund the therapy for obesity relates to the fact that, in the opinion of the insurers, obesity is self-induced. They feel they should not be asked to provide therapy for something that, as they see it, is caused by the patient. This, of course, is grossly inconsistent because the insurers will pay for the treatment of carcinoma of the lung, cirrhosis of the liver, drug abuse therapy, motor vehicle accidents, AIDS, and a host of other maladies that are directly related to patient choices.

Excessively heavy people are treated as second-rate citizens in social settings. They are laughed at or chided in restaurants and many other places. Often, they are treated as non-persons.

There are very few bright spots on the horizon relative to the disappearance of the discrimination against the obese segment of our society. What is needed is a clarion voice, an advocate with considerable influence to espouse the cause of the super-obese. What person or group might be willing to accept such a challenge is conjectural; but the American Society for Bariatric Surgery could reasonably be the catalyst for such action. The morbidly obese desperately need someone to champion their cause.

S. Ross Fox, MD
Seattle, Tacoma, WA, USA
Fax: (253) 472-9850

"Reproduced with permission from OBESITY SURGERY, 1995; 5: 352."