[HM2Viking]

I think that there is just a little bit of fat discrimination going on here.

As someone who has struggled with weight issues throughout life I think it is simplistic and wrong to say that lifestyle changes will fix everything. There are people who are heavier who are perfectly capable of running a 5 k or swimming 1500 yards with a BMI over 25.

Undoubtedly there are no easy answers but denying care to the overweight or smokers because of a "preexisting" condition will not lead to decreased health care costs. If anything it will lead to increased cost for society. (One of the strongest arguments for UHC is its emphasis on prevention oriented activities as an integral part of the health care system.) We need to make it easier for people to engage in prevention oriented activities not more difficult.

Why not offer tax breaks to employers for providing employee fitness centers on site?

Make gym membership dues fully deductible from taxes.

Make the 20 dollar health club discount a standard insurance plan item for all policies.

Support life long fitness in school phy ed programs and INCREASED phy ed time for kids.

The point of this is that we need to build systems that support healthy change. (Pointing finger and shaming people for being overweight gets in the way of change. Punishment suppresses behavior. Praise increases behavior.)

[BBFRN]

Originally Posted by HM2Viking

I think that there is just a little bit of fat discrimination going on here.

As someone who has struggled with weight issues throughout life I think it is simplistic and wrong to say that lifestyle changes will fix everything. There are people who are heavier who are perfectly capable of running a 5 k or swimming 1500 yards with a BMI over 25.

Undoubtedly there are no easy answers but denying care to the overweight or smokers because of a "preexisting" condition will not lead to decreased health care costs. If anything it will lead to increased cost for society. (One of the strongest arguments for UHC is its emphasis on prevention oriented activities as an integral part of the health care system.) We need to make it easier for people to engage in prevention oriented activities not more difficult.

Why not offer tax breaks to employers for providing employee fitness centers on site?

Make gym membership dues fully deductible from taxes.

Make the 20 dollar health club discount a standard insurance plan item for all policies.

Support life long fitness in school phy ed programs and INCREASED phy ed time for kids.

The point of this is that we need to build systems that support healthy change. (Pointing finger and shaming people for being overweight gets in the way of change. Punishment suppresses behavior. Praise increases behavior.)

Thank you- ITA!

[jeolsz]

Oh please, fat discrimination!. You know what got me to quit smoking and start running?.. It wasn't a group hug!.. It was the constant birage of ads on TV and people reminding me how I was going to die if I didn't quit.. I think the clincher was when my father died of lung cancer after years of smoking.. You have to be able to change your thinking and decide to change ..and it's different for everyone. Even if you set up an apartment in the middle of a health spa, unless you are motivated on a personal level to change, you will never put in the effort. All the free health spas in the world won't make people exersize if they haven't made up their minds to change their habits.

And you are right about the BMI however.. I see many runners who look like couch potatos beat the pants off of me. As Jack LaLaine puts it, "Exersize is king, diet is queen and together you have a kingdom" and also " Dying is easy.. it's living that's hard"

[HM2Viking]

I don't think that being judgemental or sanctimonious is helpful.

I am reacting to the sort of "blame the victim mentality" that is sometimes displayed towards victims of fill in the blank. My real point was that we need to look at the barriers to change and redesign the systems to reduce the barriers. I don't think that anyone denies the role of free will in making changes but we do need to design interventions based in the nursing process AND with an awareness of the 4 stages of change. If someone is in that precontemplation phase and is harped on by well meaning people I think that that can set up a dynamic that prevents progression to making changes.

Incentives + support by medical professionals facilitate change. Taking away one's benefits does not.

Is a very well put point.

Undoubtedly acting as a role model is important but I also think we do much more for people by inviting them to go for a walk rather than saying "you have got to lose weight." THe old saying of catching more flies with honey than vinegar is usually true.

[MoonRising]

My truck driver husband is considered overweight, not by 100lbs, but since he has began his career he has put on weight . And it is true that not all truck drivers are long haul but even local drivers drive for 11 or so hours a day and are able to get in and out of the truck more often than long haul drivers.

My husband does have to do mandatory physicals I believe annually. And at the last one they stated he was overweight but otherwise healthy. Its not that all truck drivers don't try to be healthy. He packs sandwiches, water (regular and flavored), granola bars, and for a treat one bag of 100 calorie chips. And for exercise we take walks on his days off. So, someone who is doing things to be healthy and is yet considered overweight, should be denied health insurance based solely on the number on the scale?

I think that I lived my life in an extremly unhealthy way more so when I was in nursing school doing my clinicals. No time to eat a good meal, rest, and 12 hour rotations. These things have been brought up many times on this board. So many jobs that don't fit the 9-5 work schedule in a cubicle/office are at greater risk for overweight workers. Certainly providing incentives, as someone mentioned above, would perhaps provide a better participation in weight loss. But also understand that not everyone is meant to be skinny.

[jeolsz]

Originally Posted by HM2Viking

I don't think that being judgemental or sanctimonious is helpful.

I do not believe I have been, and if I came across as such I apologize. However, when you change yourself in a positive way such I have in the past, it is kinda like finding religion.. You want to scream it out to anyone who can hear you.

Don't think working in an office all day is any healthier.. I have never seen so many pastey overweight people in my life. My point thruout this thread is, while many of us make excuses for our behavior and life style, playing the victim, it is my belief that we are all born with free will.. and while most bad behavior is learned,. it can be unlearned and changed.

[BBFRN]

Originally Posted by jeolsz

I do not believe I have been, and if I came across as such I apologize. However, when you change yourself in a positive way such I have in the past, it is kinda like finding religion.. You want to scream it out to anyone who can hear you.

Don't think working in an office all day is any healthier.. I have never seen so many pastey overweight people in my life. My point thruout this thread is, while many of us make excuses for our behavior and life style, playing the victim, it is my belief that we are all born with free will.. and while most bad behavior is learned,. it can be unlearned and changed.

No one made excuses or played victim here. You were offered some examples of the challenges that truck drivers face as a population (these are documented, researched facts that healthcare professionals can use in implementing individualized plans of care for this group), and chose to see them as excuses. These are very real barriers in self-care.

And in light of the fact that it took the death of your father (sorry for your loss, BTW) to cause you to change, what makes you think other people can just change at the drop of a hat without support?

Incentives + support by medical professionals facilitate change. Taking away one's benefits does not.

[HM2Viking]

Well Stated!

[TAB_RN]

Originally Posted by Baptized_By_Fire

No one made excuses or played victim here. You were offered some examples of the challenges that truck drivers face as a population (these are documented, researched facts that healthcare professionals can use in implementing individualized plans of care for this group), and chose to see them as excuses. These are very real barriers in self-care.

And in light of the fact that it took the death of your father (sorry for your loss, BTW) to cause you to change, what makes you think other people can just change at the drop of a hat without support?

Incentives + support by medical professionals facilitate change. Taking away one's benefits does not.

We live in such a excuse driven society. The 23 year old we are talking about is just an example of the obesity in America. We live in a non-active era. It is sad. This is not "fat discrimination", it is time for everyone to wake up. I work on a cardiac surgery floor. Our biggest culprits are smoking and obesity. It is sad to see people in their 40's dropping dead of heart disease and having heart catherizations done to place stents due to grossly clogged arteries.

I am not the "skinny" person you think I may be making these statements. I am merely an average person. I work out 3 - 5 times per week and believe me, it is a chore... but I do it, because I shouldn't feel tired while in only a few months I will turn 40. I do it because it is necessary. I smoked for 20+ years and stopped because I was really starting to feel the effects of smoking. It was the hardest thing I ever did... and my reward... I gained 20 lbs. I am saying that when somebody has the BMI of 40 - no matter how you look at that, it is incredibly hard on a 23 year old body. I can totally see why an insurance company wouldn't want to take that on. It isn't right, or maybe even morally correct, but I understand their financial standpoint. If insurance companies were very clear with what their requirements were before taking you on, then it probably wouldn't be such a shock. For example, with car insurance, if you are a crappy driver and a higher risk, insurance will cost you more. Maybe if health insurance companies charged more for the people that place their health in higher risk status, then people would work harder to stay healthy. I know, that in my case, I have to work harder than the average person to stay healthy. I wish I didn't have to, but I do.

[jeolsz]

Originally Posted by Baptized_By_Fire

No one made excuses or played victim here. You were offered some examples of the challenges that truck drivers face as a population (these are documented, researched facts that healthcare professionals can use in implementing individualized plans of care for this group), and chose to see them as excuses. These are very real barriers in self-care.

And in light of the fact that it took the death of your father (sorry for your loss, BTW) to cause you to change, what makes you think other people can just change at the drop of a hat without support?

Incentives + support by medical professionals facilitate change. Taking away one's benefits does not.

I beg to differ here..All the insentives and support will not help a person change, who chooses not to. I still see blaming one's work schedule and such as an excuse.. The sooner a person realizes that most everything in life is based on choice and not luck of the draw, the sooner change can start. Change is based on having a sense of control over a situation.

From your statements, I gather you must have an inability to change your own bad habits. I understand your frustration, as I have been there. I managed to stop smoking with out the support of any group and with my husband and friends still smoking all around me. While it may be nice to have support, inner strength and determination, and also realizing that you are in control is what eventually did it for me. If you haven't watched the biggest loser, you should.. these people show what motivation can do.