How would you feel if your employer was thinking about making you reduce your waistline as a way to reduce the company's bottom line?
Some advocates for the rights of overweight people say that may be what is happening as debate over a broad public health approach to the obesity epidemic in this country comes face to face with a recession that is forcing companies to look at bottom lines.
The U.S. Centers for Disease Control and Prevention unveiled a free Web site application last week called LEANWorks designed to motivate employers to start healthy living programs and weight loss measures for their employees.
Yet, a keystone to the LEANWorks program, the "obesity cost calculator" for companies to estimate how much their obese and overweight employees cost them each year, has started a debate between some public health experts and size discrimination activists.
"They are my employer. They are paying for my time to work for them. They are not my owner. They do not have a right to my personal information such as my height, my weight or my BMI," said Peggy Howell, member and public relations director of the National Association to Advance Fat Acceptance.
The obesity cost calculator lets employers enter their employees' age, gender and Body Mass Index numbers and get an estimate of how much their obese and overweight employees cost in insurance and missed work days each year.
While some public health officials see this as a growing trend and the cost assessment as a necessary stick and carrot to get preventive programs off the ground, some size advocates say the calculator is fuel for needless size discrimination.
"We believe that this kind of practice would be discriminatory to all sorts of people, particularly to women and minority women because of the difference of body makeup and body composition," said Howell, who cited government statistics that a greater proportion of overweight people are female and of certain ethnicities.
For example, 23 percent of white men and 26 percent of white women are obese in the United States while 32 percent of black men and 39 percent of black women are obese.
"And, you cannot tell by looking at a person's physical appearance whether or not they are healthy," she said.
Joanne Ikeda, nutritionist emeritus at the University of California at Berkeley and member of NAAFA, supported the claim that not all obese people are necessarily unhealthy.
"I think we need to distinguish between the metabolically healthy obese person and the metabolic unhealthy obese person," Ikeda said. "There has been no attempt to look at the difference in terms of the physical fitness of people who are not meant to be a large size and their poor exercise and eating habits as opposed to the obese people whose genetics engineered them to be big people, and they are otherwise healthy."
Ikeda pointed to numbers from the National Health and Nutritional Examination Survey that showed while 68 percent of obese adults are metabolically unhealthy, 24 percent of normal-weight adults are also metabolically unhealthy.
Ikeda said she thought the focus on obesity alone unfairly targets people of size for being costly.
"For employers having a choice of spending money on a health promotion programs versus letting go or not hiring any more of them, which do you think an employer is going to choose?" Ikeda said.
But the engineers of the LEANWorks program said they disagree.