Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Charging passengers by the pound is unfair

Arya M. Sharma, MD
Physician
June 1, 2013
359 Shares
Share
Tweet
Share

obese airplanes

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

The logical argument of course is that 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 for 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 (assuming that these actually exist in cabs);

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;

5. Ball games: For occupying an extra seat and obstructing the view.

Why not add all of these to the list of things that obese people are already paying more for like health and life insurance, oversized clothing, bigger cars and sturdier home furniture?

That will certainly teach them to finally see the light and begin shedding those pounds.

But wait – did anyone mention that obesity rates are already markedly higher in poor income neighbourhoods, and that 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 that body size is a matter of choice and responsibility.  Unfortunately, for most this is not the case.

Let me state it clearly: 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 that obesity is far less under individual control than generally assumed is further evident from the fact that fewer than one in 20 individuals embarking on a weight loss attempt are likely to keep any of 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 a “pay as you weigh” policy, such as people starving themselves and abusing diuretics, laxatives and anorexic agents (including tobacco) to lose weight prior to boarding a flight. Such unhealthy weight-control practices are already widespread amongst competitive athletes who participate in sports that involve weight categories (e.g., boxers and wrestlers). 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 increase health risks, such as stroke n and hypoglycaemic shock, for example.

A single emergency landing because of a diabetic patient skipping breakfast before weighing in for a flight would by far outweigh any potential savings to the airline (not to mention the inconvenience to other passengers).

Ultimately, however, it is a matter of fairness.

If airlines wish to treat their passengers like cargo, then a pay-as-you-weigh policy may appear justifiable.  But if an airline sees itself as providing a service, namely, transporting human passengers, then the average price of a ticket (and the average size of a seat) 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.

Arya M. Sharma is a professor of medicine, University of Alberta, scientific director, Canadian Obesity Network. and an expert advisor, Evidence Network.  He blogs at Dr. Sharma’s Obesity Notes.

Prev

MKSAP: 78-year-old woman is evaluated for incontinence

June 1, 2013 Kevin 1
…
Next

What I look for in an EMR: Think of a good story

June 1, 2013 Kevin 1
…

Tagged as: Obesity

Post navigation

< Previous Post
MKSAP: 78-year-old woman is evaluated for incontinence
Next Post >
What I look for in an EMR: Think of a good story

More by Arya M. Sharma, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Simply knowing about health risks does not change behavior

    Arya M. Sharma, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Why weight loss advice may be unethical

    Arya M. Sharma, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Obesity is a sign of good health in some cultures

    Arya M. Sharma, MD

More in Physician

  • The Iranian diaspora’s fight for liberty: Overcoming challenges in the largest women’s rights movement of our century

    Montreh Tavakkoli, MD
  • The harmful effects of shaming patients for self-education

    Maryanna Barrett, MD
  • The power of self-appreciation: Why physicians need to start acknowledging their own contributions

    Wendy Schofer, MD
  • Skydiving and surgery: How one doctor translates high-stress training to saving lives

    Alexandra Kharazi, MD
  • Don’t be caught off guard: Read your malpractice policy today

    Aaron Morgenstein, MD & Laura Fortner, MD
  • The dark side of medicine: an urgent call to action against greed

    Don Gaede, MD
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • The psychoanalytic hammer: lessons in listening and patient-centered care

      Greg Smith, MD | Conditions
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • The Titanic sinking: a metaphor for the impending collapse of medicine

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD & Shreekant Vasudhev, MD | Physician
  • Recent Posts

    • The Iranian diaspora’s fight for liberty: Overcoming challenges in the largest women’s rights movement of our century

      Montreh Tavakkoli, MD | Physician
    • Surviving clinical rounds: tips and tales from a pediatric hematologist-oncologist [PODCAST]

      The Podcast by KevinMD | Podcast
    • The harmful effects of shaming patients for self-education

      Maryanna Barrett, MD | Physician
    • The power of self-appreciation: Why physicians need to start acknowledging their own contributions

      Wendy Schofer, MD | Physician
    • The endless waves of chronic illness

      Michele Luckenbaugh | Conditions
    • Skydiving and surgery: How one doctor translates high-stress training to saving lives

      Alexandra Kharazi, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 49 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Abortion Is Not Murder in the Eyes of the Law
  • Introducing Allergenic Foods Early Tied to a Reduction in Later Allergies
  • Isotretinoin REMS Still Needed, But Its Burden Could Be Reduced, FDA Staff Says
  • Children Do Well With Fewer Opiates After Surgery
  • High Out-of-Pocket Costs Tied to Less Follow-Up After Initial Mammography

Meeting Coverage

  • Children Do Well With Fewer Opiates After Surgery
  • Advances in Diagnosis and Management of Severe Cutaneous Adverse Reactions
  • Orismilast Clears Skin in Moderate-to-Severe Psoriasis
  • New Combinations Promising in Advanced Urothelial Carcinoma
  • No Survival Benefit With CRT Versus Chemo for Locally Advanced Endometrial Cancer
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • The psychoanalytic hammer: lessons in listening and patient-centered care

      Greg Smith, MD | Conditions
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • The Titanic sinking: a metaphor for the impending collapse of medicine

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD & Shreekant Vasudhev, MD | Physician
  • Recent Posts

    • The Iranian diaspora’s fight for liberty: Overcoming challenges in the largest women’s rights movement of our century

      Montreh Tavakkoli, MD | Physician
    • Surviving clinical rounds: tips and tales from a pediatric hematologist-oncologist [PODCAST]

      The Podcast by KevinMD | Podcast
    • The harmful effects of shaming patients for self-education

      Maryanna Barrett, MD | Physician
    • The power of self-appreciation: Why physicians need to start acknowledging their own contributions

      Wendy Schofer, MD | Physician
    • The endless waves of chronic illness

      Michele Luckenbaugh | Conditions
    • Skydiving and surgery: How one doctor translates high-stress training to saving lives

      Alexandra Kharazi, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Charging passengers by the pound is unfair
49 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...