Friday, August 28, 2009

Guest Post - Weight as a Disability

A quick thought from my darling husband - Thomas - who I've spoken about with recurring frequency around these parts. Hope you enjoy his thoughts on an issue that came up at work and the discussion it spawned which he later shared with me, and now with you.

Okay, so the topic that your usual host asked me to talk about is 'Weight as a Disability' after we'd talked a bit about it.

First, let me cover how it came up. A while back the AMA was asked to review whether obesity should be counted as a disability. As is typical, it was the fluff reporting on the new channel that was on at lunchtime at work, and became our topic of conversation (our lunch conversations are not for the faint of heart, and have gotten us in trouble with bystanders on a few occasions). So Sam turns to me and says “That must really burn you up, what with all the weight you've lost.”

So I had to have an opinion now, as the weight loss 'expert'. I told a bit on Enzo's story as a good example of why it should be considered. Enzo was heavy enough he caused the floor to shake when he walked. BIG GUY. When I met him, he'd started Weight Watchers at his doctors recommendation. While he was working on his weight he was out twice on medical leave, once for each knee to have them replaced. Eventually his weight loss stalled out around 125 pounds lost. He and his doctor decided that it was necessary to get the gastric bypass surgery to get his weight under control fast enough to keep from damaging the knee replacements.

Over the time (about nine months to a year) that all of this occurred, Enzo and his doctor had to fill out the disability paperwork and get the approvals for the procedures and time off, and all the other items required to get things lined up three times.

I can see a wonderful argument that if obesity were counted as a disability, they could have lined all of the surgeries under a single disability and saved huge chunks of time filling out paperwork. That doesn't even take into account the advantages of having the last surgery (the bypass) requiring huge amount of effort to prove as 'necessary'.

Unfortunately, I can also see problems with 'if you just gain another 20 pounds, you'll qualify for the disability and then we can use the surgical solution' as a horrible abuse caused by labeling obesity as a disability. Not to mention the 'I can get Social Security Disability and not have to work if I just get heavy enough'. I have friends who are considering the bypass surgery as a replacement for changing lifestyles (I have a separate rant in my pocket about that), and can see them taking a ruling of disability as proof that that is the way to go.

So, in the end, no it didn't burn me up that it was being considered, but I do understand why the AMA did eventually returned the answer of 'No'. It's not that it may not in some cases be true, but that there's too much risk of abuse of the label, and many people can address their weight without the 'issue' being a 'disability'.


Summer said...

Since I'm in the travel business, I've been reading a lot of articles about another aspect of the obesity as disability debate. Specifically, the issue is what airlines should legally be allowed to do with travelers who are too large to fit into a single seat. If obesity is legally a disability, the airlines would HAVE to let obese travelers have two seats for the price of one ticket, otherwise they would be discriminating against the disabled. But if it isn't a legal disability, then it's up to the airline to determine their own rules and enforce them, to decide whether or not a larger traveler should be forced to purchase two seats, or to seat the traveler where he can have two seats for the price of one, or whether they'll just ignore it and let the traveler's seatmates deal with the inevitable overspill.

The traveling public would benefit from obesity being a disability: it would mean that travelers large and small would be able to enjoy their flights in as much comfort as is possible in economy coach. But for the airlines, which are all teetering on the verge of bankruptcy, being forced to give away seats they could have sold would be another nail in the coffin.

Anonymous said...

I'm on the fence about this.

Obesity as a disability seems like a big risk. Disabilities are things that usually cannot be fixed on a permanent level, meaning, being in a wheelchair or some other ailment.

Obesity can ALWAYS be treated and "cured" so I don't think it qualifies.

I am not a fan of the surgical responses to obesity, but that is my own issue.

Cammy@TippyToeDiet said...

So much to consider... The compassionate side of me sees the advantages for the obese in terms of medical care and public accommodation. The practical side of me sees a future in which, as you write, people intentionally gain weight to qualify for benefits. The truly pessimistic side of me sees parents feeding their overweight children even more unhealthy foods so that they can qualify for disability payments.

I hadn't really planned on doing much thinking today, but your post has my mind whirling. Let me see if I can fix that. :)

Happy weekend to you both!

Anonymous said...

Cammy... oh my. I hadn't even considered the people who use their children for SSI benefits. How sad.

This is a really great post. I personally never saw my weight as a disability. However, one of my relatives does. It is beyond frustrating.

Susan said...

I do not see weight as a disability but I do think that in some cases there is an underlying disability. A previous commenter said it can always be treated and cured. Alcoholism can be treated as well but it is considered a disability is diagnosed. Bulimia is also considered a disability. When you think of it this way you might need to look at obesity differently. Is there an underlying compulsion issue that needs to be treated? Behavioral therapy may be warranted. Yes I would say that a person can be taught healthy eating or go to WW or learn how to eat right but these underlying issues should also be considered. In many cases I think that insurance should step up and pony up the money for treatment. I have looked into medical treatment with a Dr that is not surgery but I am not sure I Have the money. I am doing the WW thing but the compulsive and behavioral pieces keep getting in the way.

On parents looking to "make" their child disabled to get SSI money that would only happen in few cases. In those cases Child services would step in. I have taught special ed for many years and there really has to be a case for SSI money to be awarded. I have 6 students right now and only 1 gets SSI and that is because of serious medical issues.

Kyra (@KyraTX) said...

I commend your colleague for starting the weight loss process off on his own rather than go straight to surgical options. He lost an amazing amount of weight.

S3XinthePantry said...

I can see both sides too. Certainly with a bariatric conditoin there are safety and other health issues - some of which are defined as a disability - it is a really difficult decision. I can't see refraining from naming something a disability becasue 'some people' may abuse it (i.e. your example - gain that extra 20 pounds). Because that does harm those who wouldn't abuse it and are living with the situation.

My first time here. You have a very informative blog!