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Hangry Hippocrite: Is it Fair to Fine Fat People for Not Dieting?

June 23, 2011

Wow, that headline certainly caught my attention when I first saw it…which I suppose is the entire point, as it’s fairly sensationalized. And now I shall feature it on Hangry Hippocrite!

The article begins as such: “Just as American waistlines – like many in the Western world – continue to expand, so does the budget to meet the associated costs…Medicaid, the programme which provides healthcare for the poor, costs the US federal and state governments $339bn a year, a figure climbing 8% annually. It wants [in Arizona] to impose a $50 annual fine for overweight Medicaid recipients who don’t follow a strict health regime developed with their doctor. Those with children, and people overweight due to a medical condition, would be exempt. Smokers and diabetics who ignore their medical advice would also have to pay.”

Alright let me get one point out of the way: fining “fat people” for “not dieting” is extremely different than fining “overweight Medicaid recipients” for not “following a strict health regime developed with their doctor.” I take huge issue with the lack of definition that our media and society has about being HEALTHY which involves a combination of diet, exercise, and psychology and deals with the mind, body, and spirit.

Now, I am all for personal responsibility. But really, how is this the best solution they can come up with? One of the experts they cite in the article explained that the effect of the fine might not be an individual change in behavior, but an impetus for doctors to speak frankly and honestly with their overweight patients about their health: “A recent Harvard study said 61% don’t have time to talk to patients about weight loss, so this could have a more dramatic impact on the way doctors see their patients than on the behaviour itself.” Doesn’t this study imply therefore that these supposed “strict health regimes” that the doctors are prescribing actually aren’t so easy or definitive enough to follow and make an impact? Medicaid is “the United States health program for people and families with low incomes and resources” and the thought has not arisen “Oh, perhaps it is because these people do not have access or the resources to educate themselves on a healthier lifestyle, feed themselves and their families better quality nutritious foods, or join exercise programs that they suffer with these terrible health conditions?” Let’s fine them instead of helping them! Let’s punish them instead of giving them options!

Calm down, Hangry. It’s only a $50 annual fine and public humiliation! Let’s say that there is a specific regiment involved, that is agreed upon with a doctor, and you “choose” not to follow it. According to Monica Coury, assistant director at Arizona’s Medicaid program,

‘the aim is to change behaviour using a carrot and stick approach, in the same way that increasing cigarette taxes reduced smoking. “It’s undeniable that there is a link between obesity and the rising cost of healthcare in America, so we can’t be afraid to discuss this issue. It’s reaching a crisis level in the US and we continue to complain about the rising uncontrolled costs of care – and yet we don’t drill down and test some of these concepts. But if you are just an average person who is able to do something to address your weight issue, and your doctor believes you can do something about it and prescribes a regime for you and you choose not to follow it, your treatment [for heart problems in later life, for example] is costing more and we’re asking you to put something back to the system.” 

Fine, then my question is: how will this be measured? Is the doctor following you around with a clipboard, giving you a citation for every time you sit on the couch with a bag of potato chips instead of walking around the block munching a bunch of celery sticks?

Consider yourself Fined.

Consider yourself Fined.

The obesity epidemic is obviously very real and extremely frightening. The statistics are indisputably upsetting:

  • For every dollar spent on health care, 83 cents is spent on a patient who is overweight or obese
  • Annual health costs related to obesity in the US are as high as $168bn
  • 25.5% of Arizona residents are obese, which is about the US average

but I wish that more money and effort were being put into programs which actively combat and educate people who are overweight (like the school lunches program I previously highlighted or Let’s Move! or…huh, seems like we need more for adults no?) and provide resources to prevent or maintain weight-loss and healthy lifestyles, instead of punishing those who are already at that stage.

Why are we as a country consistently focused on REACTION rather than PREVENTION? And what do you think of this fine?

(Image courtesy of, a fantastic site you should definitely check out!)

4 Comments leave one →
  1. June 23, 2011 9:24 pm

    I am sorry but this is outrageous and beyond hypocritical! Yes, the rising cost of healthcare is directly related to growing obesity in this country but what are the true causes of that obesity? Here is a thought, instead of taxing the overweight victims of unhealthy America why don’t we look at the corn and soy subsidies that are make up 90% of food products in any run of the mill American grocery store? Hey how about we just stop those subsidies and other disgusting ArgiBusiness horrors instead? Or fine ad agencies that promote unhealthy un-diet worthy food? I guarantee you that revenue generated would be infinitely higher and would represent an actual step towards a healthier America. Check out Michael Polland in this podcast for a rational argument that my hangry hangry self simply cannot muster at the moment. (The Boris the Boar story by the peeps at Stone Barns is an added amazing bonus)

  2. Dave permalink
    June 23, 2011 9:58 pm

    Is it just a coincidence that this is taking place in Arizona, the state that decided the police could stop and search any person who appeared to be an immigrant, and if the proper papers were not produced, then arrest that person and put them in jail?

    Who really thinks a $50 [per year?] fine will actually keep a Dorito-lover from gobbling down their favorite snack in either the short or long term? Maybe the next Arizona step would be to help balance their out-of-control state budget by putting a “consumption tax” on every bag of Doritos, much like the very heavy taxes on packs of cigarettes [that simply cause eager smokers to smuggle cartons over various state lines from places with lower excise taxes].

    Hey, it also occurs to me that just like taxing packs of cigarettes, Arizona could help balance its state budget by “taxing” human trafficking smugglers on a “per capita” basis rather than expending all those precious police resources locking up poor people.

    Oh, but I forgot, Arizona has a solid Republican state government, and that means “read my lips, no new taxes”.

    Viva Doritos!

  3. June 24, 2011 3:32 pm

    Arizona was also the last state in our nation to accept Martin Luther King Jr. Day as a holiday, if that tells you anything about the state. Enough said.


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