A friend of mine forwarded me a news story about a university in Pennsylvania that has instituted mandatory physical education classes for all students whose BMI (Body Mass Index) ranks above 30. As a condition for graduation, any incoming college freshman with a BMI over 30, which classifies as obese, has to drop their BMI below 30 or face the possibility of being denied their diploma.

Needless to say, this policy has received a healthy amount of criticism. The debate centers on the issue of the ethical and legal right of forcing overweight people to exercise. Personally, I love the idea of extending education beyond simple biology or ancient roman history, but clearly not everyone feels the same way.

Those who oppose this policy argue that using BMI to stratify people into obesity is terribly shortsighted. They argue that BMI is a poor measure of obesity, as BMI is simply a relationship between height and weight. As a result, virtually every professional bodybuilder would rank as obese according to their BMI. While this is true, the percentage of the male population walking around standing 5’10″, weighing 210 lbs and having only 10% body fat is a small, small minority (standing 5’10″ and weighing 210 lbs would put someone’s BMI ~30). So while the linebackers on the school’s football team might have a legitimate gripe with this policy, I think that using a BMI cut-off of 30, while somewhat crude, is an acceptable way to assess global obesity.

The real issue at hand though is freedom of choice. Do we, as a society, have the right to force people who are over-fat to exercise? Although I work in health and fitness, my personal view is: no, we don’t. People are allowed to make choices, however “right or wrong” many of us may feel about it.

However, while I don’t necessarily agree that we should force over-fat people to diet or exercise, the reality is that having a BMI over 30, compared to one in the “healthy” range of 18-25, results in an additional $1400/year in extra medical spending per patient (according to US data). If we assume a comparable financial burden for an obese Canadian, this adds a layer of complexity to the issue here in Canada.

Given that Canada provides universal health care (funded by everyone’s tax dollars), and obesity is a largely preventable condition, obesity no longer becomes “just an individual choice”. This isn’t to suggest losing excess body fat is easy, because it’s not; however, significant weight loss is attainable for everyone.

As with any preventable health condition, the choices of a few become a burden to many. Current estimates place the obesity rate in Canada around 23%. Therefore, out of a population of 35 million, about 8 million Canadians are obese. Run some quick math, and Canadians are shelling out an additional $11 billion each year on a preventable disease. This seems like a travesty.

Cigarettes, another huge cost to tax payers and another largely preventable cause of disease, have been saddled with significant taxes as of late. Clearly this has been done in an effort to make cigarette smokers more financially responsible for dealing with the economic burden they impose on society. But how come we are loathe to take similar steps in taxing junk food or fast food? Would a junk food tax not help defray a portion of the massive health care costs associated with obesity?

I think we can all agree that something needs to be done. Whether by creating  “disincentives” through taxation or by way of offering incentives encouraging people to manage their weight.

Personally, I’m a strong proponent of tax credits for gym memberships, personal training or visits to nutritionists. I realize there’s no easy solution to the obesity epidemic; however, by encouraging people to take an interest in their health and offering a yearly cash incentive to do so, we might make some headway into this massive problem.

Improving the health of our nation, plus saving everyone a few dollars – now that’s a policy that just makes sense!

What about you? Got any thoughts on strategies to encourage proper weight management.

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