Slim society's tolerance is wearing thin.
As more people over the last decade have tipped the scales toward obesity, normal weight folks have signed up for employee wellness programs that offer them lower premiums and other financial perks as a reward for their healthy weight -- and that indirectly penalize heavier workers. They've crafted policies, most unsuccessful, to compel individuals to lose weight. They've become vocal, sometimes vehemently so, in their support for "sin taxes" on junk food and soda. And they've increasingly attacked, with words or actions, the overweight and obese.
All the while, public service campaigns offer a steady drumbeat of vague lose-weight, get-healthy messages.
"Americans as a society are getting fed up with the matter of obesity. No doubt about it," said Douglas Metz, chief of health services for American Specialty Health, a San Diego-based company that offers wellness programs to employers. "Some pockets of society are taking positive action, and unfortunately others are taking negative action. That's what happens when a society hasn't figured out what the fix is."
Among those actions:
* A recent and ultimately unsuccessful plan at Lincoln University in Pennsylvania sought to take the body mass index of every enrolling student and require the obese to lose weight or take a fitness class before they could graduate.
* In Mississippi, legislators tried to pass a bill to let restaurants prohibit obese people from dining.
* In an interview with the New York Times last August, Toby Cosgrove, chief executive of the Cleveland Clinic, one of the nation's largest medical centers, provoked national outrage when he said that, if it were up to him, he would stop hiring the obese. He later apologized for his remarks.
* Last summer in Florida, animal rights activists at People for the Ethical Treatment of Animals (PETA) took aim at heavy women in a "Save the whales" billboard campaign that featured an overweight, bikini-clad woman. It read: "Lose the blubber. Go vegetarian." Angry reactions caused the organization to remove the signs.
Most efforts have ultimately met a quick demise or retraction, but not before leaving an impact. Employers and legislators are now getting in on the force-others-to-change bandwagon. And the 31-year-old National Assn. to Advance Fat Acceptance has seen its membership increase 20% each year for the last five years, according to co-chairman Jason Docherty.
Michael Kellner, a trim, 37-year-old public relations professional who lives in San Francisco, is among the disgusted: "I am completely and utterly frustrated with rising healthcare costs due to the deluge of fat Americans taxing the healthcare system. I'm in shape and have been all my life because I don't soothe myself with food all day." He's not alone in his opinion.
Los Angeles actor Jim Dailakis feels most frustrated with the fat issue when he travels. "I understand some people have issues that are uncontrollable. However, why is it that if I say anything about being stuck between two huge people on an airplane, I'm being politically incorrect? I work out religiously, watch what I eat and am very healthy. Yes, I'm fed up with it."
Frequent media reports of the toll obesity is taking on our nation's health fan the fury. A report by Emory University researchers projected last November that by 2018 the United States could expect to spend $344 billion on healthcare costs attributable to obesity. Obesity-related costs would account for 21% of healthcare spending, up from 9.1% today, said the report, sponsored in part by the United Health Foundation and the American Public Health Assn.
"If we as a nation don't get any fatter, then excess weight would cost the nation $198 billion in 2018," said Kenneth Thorpe, professor of health policy at Emory and the report's lead author. "Obesity is a leading driver in rising healthcare costs. Between 1990 and today, obesity rates have doubled, and obesity now accounts for one-third of the increase in our nation's healthcare costs."
The forecast is frightening, agreed Dr. Reed Tuckson, chief of medical affairs for the UnitedHealth Group.
"It portends a tsunami of preventable chronic illness, and it's overwhelming from an economic point of view." Obesity is linked to heart disease, stroke, cancer, respiratory disease, diabetes, hypertension, asthma, sleep apnea, arthritis, degenerative joint disease, gastric reflux and depression.
But sociologists believe more lies behind the anger than concern over healthcare costs.
"In our society, being heavy has become more of a stigma lately because we're struggling with other issues of consumption," says Abigail Saguy, associate professor of sociology at UCLA.