Is it Fair to Ban Obese Employees?

May 11th, 2012 by Andrea Bennett

A Texas medical center says unhealthy employees set a bad example.

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The Responsibility Project

Most people will probably agree that medical centers should do everything they can to promote healthy living. But refusing to hire anyone over a certain body mass index? That could be crossing the line from simply promoting a healthy lifestyle to downright discrimination.

According to The Houstonian, Citizens Medical Center, a health-care facility in southeastern Texas, is refusing to hire any person who has a body mass index over 35. Officials say the measure is meant to promote healthy living so that employees can set an example for patients. In an editorial about the practice, Houstonian Editor-in-Chief Stephen Green says that the practice claims to free patients from the distraction of unhealthy-looking healthcare professionals, but argues that the move is ill advised. “The center’s reasoning is so that they can push healthy lifestyles onto their patients. The logic doesn’t make sense. Patients won’t look at their nurses and have a sudden epiphany about a healthy lifestyle. This is much in the same way that going to the gym and seeing beefed-up personal trainers doesn’t aid in behavioral change.”

Suzanne Lucas of CBS puts the new requirement in perspective: A body mass index of 35 is a person who weighs 210 pounds at 5’5”. Perhaps this new rule would be healthy, she maintains, if the center were also excluding people with a BMI below 18.5 (110 pounds for the same 5’5” person), because that’s also considered unhealthy. But “It’s only the fat people who are getting excluded,” she says.

Green says that the fundamental flaw in this logic is that it makes the assumption that obese people make other people get fat. “On the flip side, non-obese persons do not cause obese people to get thinner,” he says. And it hurts people who were grandfathered into the system, he says, though no employees have been fired. Who wants to be the lone obese person in a medical center aggressively offering to help them diet?

As it turns out, a recent study insists that measuring BMI might not even be the most accurate way to test for a healthy body weight, anyway. In a study published in the journal PLoS One, Dr. Eric Braverman, president of the NYC nonprofit Path Foundation, which supports brain research, says that BMI significantly underestimates the number of people who are obese. Braverman and Dr. Nirav Shah, New York State’s Commissioner of Health, maintain that BMI measurements don’t take into account how weight is distributed in the body, according to Time’s HealthLand blog.

Where do you stand? Should potential employees be subject to BMI calculations, or judged on the basis of their qualifications? And if obese health care professionals set a bad example, should medical centers cut out underweight employees, too?