Bias, Stigma or Reality?

In addition to our own thoughts and ideas regarding wellness, we know there are many others out there with very similar—and very different opinions.

The Mayo Clinic has just released an article quoting a study that finds evidence of what they call an “obesity stigma.” The Mayo Clinic states up front that this is a sensitive topic (and it is), and that it is not their intent in reviewing this study to offend anyone. Nor is it our’s.

The study, reported in the July 2008 “International Journal of Obesity,” was conducted with the objective of creating a tool that would measure and compare bias: Bias regarding obesity, homosexuality and Muslims. Why these targets? We don’t know. Maybe because they are all documented targets of discrimination. But, look at them, they did. It’s also worth noting that the study acknowledges the words “bias” and “prejudice” for purposes of its findings are interchangeable.

The findings: The strongest prejudice was against obesity, followed by bias against homosexuals, and then against Muslims. It’s worth noting that while there are laws in place to protect against and discourage discrimination against race, gender, sexual orientation and religion, there are no laws in place (yet) to discourage or punish bias against obesity.

Here’s a fact. We are all, as individuals, paying higher health insurance premiums, and we are all paying for Medicare and Medicaid benefits that treat a huge percentage of preventable chronic illness. And, we know that:

• Approximately 40 percent of deaths in the U.S. are caused by behavior patterns that could be modified.
• Almost one-half of all Americans report having a chronic illness—and those illnesses account for 75 percent of our national spending on health care—and that about 80 percent of all chronic disease is caused by three preventable health behaviors—physical inactivity, poor nutrition and overeating, and smoking.

It is well documented that employers pay a premium in health insurance and disability benefits for obese and overweight employees. Annual medical expenses for employees range from $114 for normal-weight individuals to $573 for overweight individuals to $620 for the obese. A Cornell University study (Dec. 2007) reported that obesity-related sick days cost employers $4.3 billion a year in 2004 dollars.

Here’s the question. We know behaviors can be modified and changed. We know healthy choices can replace unhealthy choices, and we know almost all of us can find ways to become more physically active and improve our dietary behavior.

So, is this issue really about bias—or lifestyle choice—and the answer to that question leads to another—who pays (and who should pay), and more to the point, how will this play out for all of us in the months and years ahead?