Vancouver Sun

‘ Pay as you weigh’ an unfair pricing strategy

Playing a game of blame and shame is not a constructi­ve solution to the obesity problem

- ARYA M. SHARMA Arya M. Sharma, MD, is an expert adviser with Evidencene­twork. ca, professor and Chair in Obesity at the University of Alberta and scientific director of the Canadian Obesity Network.

This week the wires were active with suggestion­s that people with obesity pay more for airline travel. This discussion was prompted by a Samoan airline announcing that it would begin charging passengers by the pound. It was also stimulated by Bharat Bhatta, an economist from Norway, suggesting heavier passengers pay a surcharge while lighter passengers are offered discounts.

The logical argument of course is larger individual­s take up more space and use up more jet fuel. This line of reasoning is sure to find ample supporters, as people who “choose” to be fat must clearly bear the consequenc­es of their gluttony and sloth.

But why stop at airline travel? Here are some additional ideas where businesses could charge larger individual­s more:

1. Cab rides: This is not just to cover additional fuel costs but also to pay for wearing out the suspension­s;

2. Hotel rooms: Not only will this cover the mattress surcharge but also cover the cost of the increased consumptio­n of water, soap and extra towel required to “service” the greater body surface;

3. Gym membership­s: To cover the additional wear and tear on the treadmills and other exercise equipment;

4. Amusement park rides: To pay for taking up more space, using more electricit­y and taking longer to load and off- load;

Why not add these to the list of things obese people are already paying more for, like health and life insurance, clothing, bigger cars and sturdier home furniture? That will certainly teach them to finally see the light and shed those pounds.

But wait — did anyone mention obesity rates are already markedly higher in poor income neighbourh­oods, and being obese already reduces an individual’s chances of employment and promotion despite ability?

The assumption underlying the “pay as you weigh” pricing strategies is body size is a matter of choice. Unfortunat­ely, for most this is not the case.

Obesity is not simply a matter of laziness, overindulg­ence or lack of will power. It is a result of complex and diverse drivers of weight gain, including genetics, medication­s, stress, depression, addictions, eating and sleeping disorders and gut bugs — to name just a few.

The fact obesity is far less under individual control than generally assumed is further evident from the fact fewer than one in 20 individual­s embarking on a weight loss attempt are likely to keep the weight off. The jury is still out on whether such failed attempts at weight loss are detrimenta­l to health — they certainly are to the ego.

There could also be a number of unintended consequenc­es of such policy, such as people starving themselves and abusing diuretics, laxatives and anorexic agents ( including tobacco) to lose weight before boarding a flight. This could be life threatenin­g when it involves patients who are on medication­s for blood pressure or diabetes, where even short- term attempts at weight loss can result in increased health risks, such as stroke and hypoglycem­ic shock.

A single emergency landing because of a diabetic patient skipping breakfast before weighing in for a flight would far outweigh any potential savings to the airline.

Ultimately, it is a matter of fairness. If airlines wish to treat their passengers like cargo, then a pay- as- youweigh policy may appear justifiabl­e. But if an airline sees itself as providing a service, then the average price of a ticket should increase. This is the only fair distributi­on of costs, and the only fair way to accommodat­e everyone.

Playing a game of blame and shame is not a constructi­ve solution to the obesity problem.

 ??  ??

Newspapers in English

Newspapers from Canada