Yes, I once subscribed to the view that obesity was a character flaw. I did more than my share of fat shaming as a young man. These fat people need self-discipline, I thought. Just don't eat that extra doughnut!
Now I subscribe to a different view and personal responsibility is part of it. However, I've come to believe that the primary cause of the obesity epidemic is a problem with our food supply. The food industry learned that adding sugar and high fructose corn syrup to what they sell makes these products more "palatable" and increases sales. Fast and processed foods are the main culprits.
Unfortunately, eating healthy is expensive, which you already know if you shop at the "whole paycheck store."
As to whether you should coerce people into weight loss programs by threatening their benefits, the article states correctly:
"Unfortunately, diet and lifestyle interventions have restricted, often transient, benefits due to biological adaptations, that act to sustain high bodyweight. It is therefore important to ask whether requiring people to participate in weight-loss programmes, despite a high likelihood of failure, is acceptable from the point of view of an individual, provider, or society. "
I think if people had the financial incentive of knowing that their disability payments will be shut off if they refuse to participate in some type of weight loss program they would be MUCH more likely to stick with it.
"... if they refuse to participate in some type of weight loss program..."
Would they just have to participate or actually lose weight to keep their benefits? From what I read, the only consistently effective weight loss program for most people is surgery.
Nevertheless, I think you are on to something with this authoritarian approach. But why limit the benefits to Social Security/SSI beneficiaries. Obesity causes health problems which increase insurance premiums and cost the taxpayers money.
How about a program which requires federal and state government employees to maintain a normal BMI or lose their government health insurance or even their jobs? Wouldn't they be more likely to stick with a weight loss program when faced with loss of benefits or job? Think how much money this would save the taxpayers. Think of how healthy our government employees would become. Win Win!
Currently failure to follow prescribed treatment is a basis for both denying and ceasing benefits. That goes for any condition. It is never used though.
In response to 12:15; Eating healthy is not more expensive unless you insist on organics only, but it does take more TIME, which millions feel justifies buying salty, sugary, high fat prepackaged 'quick to fix' meals or fast foods. A head of lettuce costs less than a bag of lettuce; chicken, pork chops or ground meat cost less per pound than a big mac with cheese; apples and bananas cost less than a box of twinkies, and roasting real potatoes cost less than a big bag of chips. It's about choices. Claimants do not want to be dictated to by the entity who provides their entitlements. Just that simple. In response to 10:59: I agree 'failure to follow prescribed treatment' is rare, but I was advised it was due to the reality that it was because it is too cumbersome and difficult to prove intent in the eyes of ALJs. The few times I observed it being used, there was a whole lot more at play than just a medical condition, often requiring intervention by other agencies.
DDS does not do FTC decisions either. The only similar thing done is not allowing those cases in which the Listing requires that the condition persists despite following prescribed treatment for several months. If we did do FTC decisions we would have to prove the treatment was available and affordable, was not invasive and did not involve changing their lifestyle such as stopping smoking or presumably changing their dietary habits. Years ago people could be ceased if they did not cooperate with rehab services and if their condition was amenable to treatment and rehabilitation. (Also it woul have had to be a controlled referral when allowed) That all stopped after Reagan's exhortations for us to be meaner than junkyard dogs , its consequences and then the privatization of rehab services. Ticket to work led to less rehabilitation than ever before.
Sorry. I did not mean FTC. I meant failure to follow prescribed treatment for which we so not use an acronym presumably because we never make a decision on that basis.
I look at it like this: disabled but failure to follow prescribed treatment = remand. It's too hard to support. However, it would suggest that the claimants allegations aren't as severe as alleged,and diminishes their credibility.
@ 5:03...these programs are already creeping in. With my insurance, if I keep a BMI of less than 30 and get a regular check-up, I get a "rebate" on my health insurance cost. To some, this is like a discount, but others (correctly) see this as a way to charge obese people higher rates.
Additionally, as obesity is not a protected class, people can be fired for being obese.
Charles hopes this debate won't come here? It already did. When we got rid of the Listing for Obesity. Now obesity can be considered in combination with other impairments, but it is not of itself a disability. About time the world caught up with us..
Yes, I once subscribed to the view that obesity was a character flaw. I did more than my share of fat shaming as a young man. These fat people need self-discipline, I thought. Just don't eat that extra doughnut!
ReplyDeleteNow I subscribe to a different view and personal responsibility is part of it. However, I've come to believe that the primary cause of the obesity epidemic is a problem with our food supply. The food industry learned that adding sugar and high fructose corn syrup to what they sell makes these products more "palatable" and increases sales. Fast and processed foods are the main culprits.
Unfortunately, eating healthy is expensive, which you already know if you shop at the "whole paycheck store."
For more on this topic, I recommend:
Sugar: The Bitter Truth
As to whether you should coerce people into weight loss programs by threatening their benefits, the article states correctly:
"Unfortunately, diet and lifestyle interventions have restricted, often transient, benefits due to biological adaptations, that act to sustain high bodyweight. It is therefore important to ask whether requiring people to participate in weight-loss programmes, despite a high likelihood of failure, is acceptable from the point of view of an individual, provider, or society. "
I think if people had the financial incentive of knowing that their disability payments will be shut off if they refuse to participate in some type of weight loss program they would be MUCH more likely to stick with it.
ReplyDelete@1:45
ReplyDelete"... if they refuse to participate in some type of weight loss program..."
Would they just have to participate or actually lose weight to keep their benefits? From what I read, the only consistently effective weight loss program for most people is surgery.
Nevertheless, I think you are on to something with this authoritarian approach. But why limit the benefits to Social Security/SSI beneficiaries. Obesity causes health problems which increase insurance premiums and cost the taxpayers money.
How about a program which requires federal and state government employees to maintain a normal BMI or lose their government health insurance or even their jobs? Wouldn't they be more likely to stick with a weight loss program when faced with loss of benefits or job? Think how much money this would save the taxpayers. Think of how healthy our government employees would become. Win Win!
Currently failure to follow prescribed treatment is a basis for both denying and ceasing benefits. That goes for any condition. It is never used though.
ReplyDeleteIn response to 12:15; Eating healthy is not more expensive unless you insist on organics only, but it does take more TIME, which millions feel justifies buying salty, sugary, high fat prepackaged 'quick to fix' meals or fast foods. A head of lettuce costs less than a bag of lettuce; chicken, pork chops or ground meat cost less per pound than a big mac with cheese; apples and bananas cost less than a box of twinkies, and roasting real potatoes cost less than a big bag of chips. It's about choices. Claimants do not want to be dictated to by the entity who provides their entitlements. Just that simple.
ReplyDeleteIn response to 10:59: I agree 'failure to follow prescribed treatment' is rare, but I was advised it was due to the reality that it was because it is too cumbersome and difficult to prove intent in the eyes of ALJs. The few times I observed it being used, there was a whole lot more at play than just a medical condition, often requiring intervention by other agencies.
DDS does not do FTC decisions either. The only similar thing done is not allowing those cases in which the Listing requires that the condition persists despite following prescribed treatment for several months. If we did do FTC decisions we would have to prove the treatment was available and affordable, was not invasive and did not involve changing their lifestyle such as stopping smoking or presumably changing their dietary habits. Years ago people could be ceased if they did not cooperate with rehab services and if their condition was amenable to treatment and rehabilitation. (Also it woul have had to be a controlled referral when allowed)
ReplyDeleteThat all stopped after Reagan's exhortations for us to be meaner than junkyard dogs , its consequences and then the privatization of rehab services. Ticket to work led to less rehabilitation than ever before.
Sorry. I did not mean FTC. I meant failure to follow prescribed treatment for which we so not use an acronym presumably because we never make a decision on that basis.
ReplyDeleteI look at it like this: disabled but failure to follow prescribed treatment = remand. It's too hard to support. However, it would suggest that the claimants allegations aren't as severe as alleged,and diminishes their credibility.
ReplyDelete@ 5:03...these programs are already creeping in. With my insurance, if I keep a BMI of less than 30 and get a regular check-up, I get a "rebate" on my health insurance cost. To some, this is like a discount, but others (correctly) see this as a way to charge obese people higher rates.
ReplyDeleteAdditionally, as obesity is not a protected class, people can be fired for being obese.
Charles hopes this debate won't come here? It already did. When we got rid of the Listing for Obesity. Now obesity can be considered in combination with other impairments, but it is not of itself a disability. About time the world caught up with us..
ReplyDelete