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Many people feel that if somebody is so obese that they occupy two seats, they should have to pay for two. In June 2002, Dallas-based Southwest Airlines began doing just that. Calling it a comfort and safety issue, Southwest began requiring passengers to purchase two tickets if they cannot fit in the 47.63-cm (18.75-in)-wide airplane seats. Other carriers, including Continental Airlines and American Airlines, have similar policies.
According to a recent report from the Centers for Disease Control, the average American gained 10 lb (4.5 kg) during the 1990s. The airline industry spent $275 million to burn 350 million more gallons of fuel in 2000 to carry the extra weight.
So DOC News asked:
Is obesity a cost of doing business that is shared by all customers, or should obese people pay more for their weight?
I don't think they should be charged more. It represents an unnecessary penalty for something that may or may not be in their control. It's like penalizing somebody who has diabetes or high blood pressure, as though there were an intrinsic cost of the disorder. I can understand from the raw economics that obviously it costs more to transport an obese person in an aircraft. Perhaps one way to balance the economics is to give them a lower luggage allowance or something. But I don't believe in penalizing them.
E. Dale Abel, MD Endocrinology Salt Lake City, Utah
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Of course not. It's discrimination. You're going to do a sliding scale based on size? Children don't pay any less on most airlines. I don't think it's a fair way to go.
Maria Wilson, PhD Research Hayward, Calif.
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Should people who are obese be charged more for more services? I guess that's a reasonable thing to do. We all get charged for extra services that we use, if we order more food in a restaurant or at the supermarket. If people use services to a greater extent, they should have to pay for it. Sounds like a reasonable approach.
Alan Rubin, MD Endocrinology San Francisco, Calif.
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That's a very tough call. Having been in the position of being wedged between people who are obese, and there is barely any seat left, there is a certain feeling that they need bigger seats. Yet as a scientist, and knowing full well that obesity is not always someone's fault from eating too much, my sympathies go out to them. It's tough.
As obesity is becoming much more prevalent, I'd like to see the burden go on to theaters and the airlines to have seats that accommodate larger people. I understand that would mean fewer [customers].
Susan Vannucci, PhD Research New York, N.Y.
I think it's a moot question. I don't think you could ever get that acted upon. There are too many overweight representatives and senators.
Cynthia Engle King, PA-C Physician Assistant Houston, Texas
TALK BACK: SMOKING BANS
Smoking or secondhand smoke caused the premature deaths of 438,000 people each year between 1997 and 2001, according to a June report from the Centers for Disease Control and Prevention. Smoking cost the nation about $92 billion in the form of lost productivity during those years, the report says, up about $10 billion from the annual losses for the years 1995–1999. On average, smoking reduces adult life expectancy by about 14 years.
Smokers have become accustomed to workplace policies that force them outside to light up. Some companies attempt to discourage off-duty smoking by raising health care insurance premiums for smokers. Still other employers have gone to the extreme of firing or barring the hire of workers who smoke even when off duty.
Weyco, a medical benefits provider based in Okemos, Mich., has banned employees from smoking on their own time. Workers are subject to random tests that detect whether or not they have smoked. They also have to agree to searches of briefcases, purses, and other property. Those who smoke face suspension, or even getting fired from their job.
Attempts to control employees' behavior in other areas of their lives may not be far behind. Proposed tactics include firing, suspending, or charging higher premiums to employees who are overweight, have high cholesterol, or participate in risky activities.
Many workers are legally protected from such off-the-job behavior surveillance. About 20 states have enacted legislation that bars companies from discriminating against employees for their lifestyle choices.
What do you think? Have smoking bans gone too far? Should employers have the right to dictate lifestyle decisions?
Send your comments to docnews{at}diabetes.org.
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