Two years ago, Cleveland Clinic stopped hiring smokers. Recently, Doctor Delos "Toby" Cosgrove, the CEO of the Clinic, announced that if he could get away with it, he would stop hiring obese people. He noted that our national fat problem has huge costs, both medical and economic.

Jim Plagakis, RPh

What makes pharmacy run? The scent of profit, or the chance to make a difference as a healthcare professional? If we keep going like this, "Too much, I'm lovin' it" will overload the prescription mill. Universal access to healthcare will mean fat people too. Thousands of obese people, uninsurable today, will get full coverage, and expensive prescriptions for obesity-related illnesses will clog the tube. Obesity may become a millstone on an already overloaded system.

Overweight and obese people constitute a majority in the United States. There is a growing fat-acceptance campaign. Fat pride. Books are published claiming that obese is beautiful. Take Fat!So?, written by Marilyn Wann. Ms. Wann and others are pushing hard against the idea that obesity is unhealthy. They project the idea that fat is healthy and beautiful. This is revisionist propaganda. Overweight, fat, and obese = harmful. Period.

Fat-pride proponents claim people can be healthy at any size. This is not a productive argument in any conversation about healthy lifestyles in the 21st century. Adults can choose for themselves, but any group or book or video that glorifies obesity to children is a disgrace. Obesity has been an increasing epidemiological nightmare for years. It is getting to be a crisis. Our culture needs to take action. Perpetuating a myth that obesity is healthy is morally unacceptable.

Peggy Howell is the public relations director of an outfit called the National Association to Advance Fat Acceptance. She said, "We believe that fat people can eat healthy food and add movement to their lives and be healthy." Peggy Sue, girl, it's called diet and exercise. Keep it up and you won't be fat anymore.

We are bipolar about this. Profit sits on one side. On the other is the health professional. Linda Bacon (Health at Every Size) says we should refrain from giving a clear and direct message that there is something wrong with being fat. Sorry, Linda, there is something wrong. It is simply not healthy. Obesity is often a death sentence. Can you look your patient in the eye and somehow, gently, tell Brenda that 5' 2" and 300 pounds is going to kill her? She may miss her daughter's wedding.

In the past, Big Insurance deemed thousands and thousands of obese people uninsurable. Big insurance is not stupid. Brenda becomes a walking drugstore cash cow at the drive-through when she gets prescription coverage. I can envision the author of Fat!So? sending a handful of prescriptions through the drive-through tube. The manager starts salivating. He gets cross when the pharmacist counsels on her weight.

Fat!So? author Wann is self-employed and uninsurable right now. She recently said this about what she termed a humane and health-enhancing medical-care system: "We're all in this life raft together."

JIM PLAGAKIS is a community pharmacist in Galveston, Texas. You can e-mail him atjpgakis@hotmail.com
and cc us at drugtopics@advanstar.com
. You can also check out his Web site at http://jimplagakis.com/.