This morning [May 8] brings us more news of a kind of growth America could do without: the "epidemic" of overweight and obesity. This time it was highlighted by a gathering of 1200 experts at the latest Centers for Disease Control and Prevention "Weight of the Nation" conference in Washington yesterday. Melissa Healey, "42% of American adults will be obese by 2030, study says; Though the rate of the last 30 years has slowed, it's far from leveling off, and it's going to get expensive, say experts at the Weight of the Nation conference in Washington," Los Angeles Times, May 8, 2012.
There's more below regarding how those experts define "overweight" and "obesity," how you can find yourself on their continuum, their projections regarding where our scales will tip in 2030, the causes, best strategies for cure, and long-term costs -- in our individual health and sense of well-being, the nation's public health, the costs to business of accommodation, and the multi-hundred-billion-dollar increase in the nation's healthcare costs.
But first . . .
As Joan Rivers used to say, "Can we talk?"
Because we have an accompanying problem associated with obesity, and that's how we talk about it -- to each other, to ourselves, and especially to those suffering from this condition.
It was illustrated in Iowa City recently with what turns out to be standard practice at a local bar catering to University of Iowa students, both under-age and legal.
Jordan Ramos, a third-year UI undergrad, paid the cover charge to enter the Union Bar the evening of March 3, 2012, and subsequently, and wanted to dance on a platform with the other girls. On both occasions she was forbidden to do so by employees on the grounds that she "was not pretty enough" (from photos, she has a pretty face by my standards) and was pregnant. (Somewhat overweight, she was not pregnant.)
Rosa Parks, pictured here with Dr. Martin Luther King in 1955, wanted to sit on the Montgomery buses wherever she chose. On December 1 of that year she refused a bus driver's order that she get up and give her seat to a white person. It was a major milestone in what became the civil rights movement, and eventually, with President Lyndon Johnson's leadership, a series of civil rights laws in 1964 and 1965.
Rosa Parks refused to be stereotyped, to know, and stay in, "her place." She wanted to sit, not stand.
Jordan Ramos also did not want to be stereotyped or kept in her place. Just as Rosa Parks didn't want to be forced to stand because of her appearance, Jordan Ramos didn't want to be forced to sit because of her appearance. She wanted to dance, not start a revolution. But she soon came to echo Emma Goldman's feeling that, once a revolution is requesting her membership, "If I can't dance, I don't want to be part of your revolution."
It wasn't quite a revolution, but it has been a series of demonstrations by students of all shapes, sizes and ages, protesting the policies of Union Bar owner George Wittgraf, and their execution by his employees. See, e.g., Emily Schettler, "Student: Bar Discriminates by Weight; Union Owner Says He Hadn't Heard About Situation, but He Wouldn't Condone Such Behavior," Iowa City Press-Citizen, April 28, 2012, p. A1; Logan Edwards, "Rally Will Accuse Union Bar of Size Bias," The Daily Iowan, April 30, 2012, p. A1; Emily Schlettler, "Bar owner wants to apologize; Protest over alleged discrimination at Union Bar planned for Friday," Iowa City Press-Citizen, May 1, 2012, p. A1; Editorial, "Let's Redirect All This Energy, Indignation," Iowa City Press-Citizen, May 3, 2012, p. A7; Mitchell Schmidt, "Union Bar Dance Platform Will be Torn Down; City Officials: Platform is a Safety Hazard and Doesn't Meet City Code," Iowa City Press-Citizen, May 3, 2012, p. A1; Alesha L. Crews, "Group uses gathering to bring attention to sizeism; UI student wants to shift attention away from bar incident to bigger issue," Iowa City Press-Citizen, May 5, 2012; Luke Voelz, "Rally Condemns Size Bias; Around 30 People Participated in Friday's Rally," The Daily Iowan, May 7, 2012, p. A1.
On May 3 the Press-Citizen trivialized Ms. Ramos concerns in an editorial headlined, "Let's Redirect All This Energy, Indignation," Iowa City Press-Citizen, May 3, 2012, p. A7. First, the editorial gives a half-hearted nod in her direction: "all establishments in the Iowa City area should be providing equal access and equal service for all their customers, regardless of external appearance."
Why? Because "even when that's not required by law, it's still just good business."
Good business?! Well, yes. But that's not really what this controversy is about. Ms. Ramos was not complaining about Wittgraf's failure to maximize his profits, his failure to recognize what is "good business." It was his failure to recognize what is good sense, his failure to treat all persons with dignity and respect, when and whether it will increase his profits or not.
It's not good business to have policies that create hostile demonstrations in front of your bar, anymore than it was good business for the Montgomery bus company to bring on a bus boycott. But Ms. Ramos is no more concerned about the business of the Union Bar than Rosa Parks was concerned about the business of the Montgomery buses.
The editorial continues with,
Ramos has been focusing her time, energy, passion and organizational skills on a goal unworthy of them: being able to dance on a platform overlooking the dance floor at The Union Bar. . . .What the Press-Citizen's usually sensitive and insightful Editorial Board missed on this one, I think, is that this controversy was, at base, no more about dancing on platforms in bars than Rosa Park's controversy was, at base, about sitting on buses. As UI grad student Mara Determan was quoted as observing, it was about "the root causes of prejudice against women" the "objectification of women." As Ramos said, "No wonder women feel they have to put on so much makeup and lose so much weight in order to feel valued in society." Luke Voelz, Daily Iowan, above. For an earlier blog entry addressing what we all lose out on when judging women by such standards, in that case a spectacular singing voice, see "Susan Boyle as General Semantics Lesson," April 20, 2009.
Because neither the state's civil rights law nor the city's civil rights ordinance includes body size as a protected category, there's little the Human Rights Commission could have done about the situation even if the commissioners had wanted to. And if Ramos had been complaining about something more significant -- if, say, a bar refused to serve her because of her size, or denied her a job, or paid her less than skinnier employees -- then we, along with many others in the community, would be more open to supporting her attempts to move forward with a civil rights claim.
But . . . [such] Commissions shouldn't be in the business of making sure more people of all shapes and sizes have equal opportunity to break their face after . . . falling off a beer-soaked bar platform. . . .
Now that everyone in The Union Bar has been consigned to the dance floor only, we hope that Ramos -- along with the people inspired by her -- will find a cause more worthy of all their indignation and creative energy.
Notwithstanding Wittgraf's protestations that it "has never been our policy" to discriminate based on size, from news reports it appears Ramos' experience was the result of an overt policy, not an aberration. (Picking up on the Press-Citizen's editorial approach, he was quoted as saying, "We can't be mean to people. It's bad business.") Ramos said "others have told her about their own experiences of discrimination at the Union based on size, race and sexual orientation." "Austin Fell . . . said he witnessed the discrimination firsthand when he worked as a bouncer at the bar . . .. [H]e was told by owners to 'keep the fat and ugly girls away from the stage . . ..' Others who worked there told Fall, 'We usually let girls dance on the bar if they're skinny, but if they're fat, we just don't want that image.' . . . [O]ver the course of one month, he said he probably told about 20 'heavy-set' girls that they couldn't dance on the platform . . .." Emily Schettler, Press-Citizen, May 1, above.
It's as if these folks are still taking their ethical values from the obnoxious cigarette commercial aimed at women in the 1950s and '60s: "Cigarettes are like women. The best ones are thin and rich. Silva Thins are thin and rich."
How the experts define "overweight" and "obesity," how you can find yourself on their continuum, their projections regarding where our scales will tip in 2030, the causes, best strategies for cure, and long-term costs -- in our individual health and sense of well-being, the nation's public health, the costs to business of accommodation, and the multi-hundred-billion-dollar increase in the nation's healthcare costsGovernor Mike Huckabee, questioned regarding his conservative credentials, responded: "I'm a conservative. I'm just not angry about it."
Similarly, one can be concerned about the "obesity epidemic" and its consequences without disparaging others regarding their body type and size -- regardless of whether they're trying to do something about it or not. See Perry Beeman, "Iowa, U.S. Expected to Pack On the Pounds," Des Moines Register, May 8, 2012.
Jordan Ramos is the first to acknowledge this. She's fully capable of distinguishing between the range of problems associated with obesity and non-discriminatory human decency: "I'm not condoning obesity. That was never my intention. I just . . . don't think anybody's size should impact the way they are treated." Emily Schettler, Press-Citizen, May 1, above. "She said some people misinterpreted her story and thought she was trying to promote obesity, which she is not. She said she is trying to raise awareness about discrimination based on size. 'We are all humans and we all deserve to be treated equally and nobody should be denied access or the right to do things because of their outward appearance,' Ramos said." Alesha L. Crews, Press-Citizen, May 5, above.
If data regarding Americans' overweight and obesity is to be useful we need to define our terms. That has been done, and the definitions involve something called Body Mass Index or BMI. Don't worry about the math. Just use the calculator provided by the NIH's National Heart Lung and Blood Institute. (The actual metric formula is weight in kilograms divided by the square of height in meters. The calculator speaks feet, inches and pounds.)
Once you get that BMI number from the calculator, here are the categories:
Underweight = <18.5
Normal weight = 18.5–24.9
Overweight = 25–29.9
Obesity = BMI of 30 or greater (>40 = "severely, or super obese")
By these standards, today 36% of adult Americans are obese -- a number that is projected to increase to 42% by 2030. (If past trends were to continue it would be over 50%. The severely obese are expected to increase from 5% to 11% of the population.) These trends are hard to turn around, but the experts at Monday's conference point to such things as "more effective weight-loss drugs, public health campaigns to encourage exercise and more-healthful eating, or workplace health promotion policies" (such as the UI's "LiveWell" program). As with nicotine addiction and alcoholism, one of the most cost-effective approaches is to prevent obesity in young children: 77% of obese children become obese adults; only 7% of non-obese children have the problem as they grow older.
Experts acknowledge the insuperable political hurdles: "For weight gain to be averted — let alone reversed — policymakers would have to move beyond politically palatable initiatives such as removing sugary sodas from schools . . .. Very likely, junk food would have to be taxed to discourage consumption, and advertising for those products would have to be prohibited . . ." said one.
Overweight and obesity contribute to many diseases and disabilities, including arthritis, cancer, diabetes, heart disease. The costs of treatment are a significant part of our nation's healthcare bill. Estimates are that the additional costs from the additional number of obese persons between now and 2030 could be as much as 550 billion (over one-half trillion) dollars. There are also added costs for public and private employers in addition to health insurance costs, from the increased number of sick days to the redesign of airline and theater seats, wheelchairs, and buildings. ("U.S. hospitals are ripping out wall-mounted toilets and replacing them with floor models to better support obese patients. The Federal Transit Administration wants buses to be tested for the impact of heavier riders on steering and braking. Cars are burning nearly a billion gallons of gasoline more a year than if passengers weighed what they did in 1960." Sharon Begley, "As America's waistline expands, costs soar," Reuters, April 30, 2012.
(The above is drawn, in part, from Melissa Healey, "42% of American adults will be obese by 2030, study says; Though the rate of the last 30 years has slowed, it's far from leveling off, and it's going to get expensive, say experts at the Weight of the Nation conference in Washington," Los Angeles Times, May 8, 2012.) For Iowa statistics see Iowa Department of Public Health, "Obesity in Iowa: A Statewide Epidemic," undated (with 2006-07 data).
There are few among us who would not be better off for ourselves, and our nation, if we ate better, exercised more, and shed a few pounds. I am one of the fortunate ones who has never had to struggle with obesity. I have sympathy for those who do. But neither am I of "normal weight" by the standards of the BMI chart, being more in the low to mid-range of the "overweight" category, weighing every morning, graphing the results alongside my goal for the week.
We need to talk about obesity. We need to do what we can to improve the public policies that support public health rather than diminish it. But when we are "speaking of obesity" we need to recognize the human need to do so in a way that respects the feelings of those with a problem. While we try to promote sensitivity, and the elimination of racism, antisemitism, sexism, homophobia, and discrimination or ridicule of those with disabilities or special needs, we need to add a similar respect for the feelings of those who suffer in a society in which all too many apparently still believe that "the best women are thin and rich."