University Class Requirement For Students Of Body Mass Index (BMI) Over 30
Recent news coverage of Lincoln University in Pennsylvania and its policy requiring students with a BMI over 30 to take a three credit fitness course raised some challenging questions.
Under the headline “Colleges too Fat to Graduate Rule Under Fire”, Elizabeth Landau, CNN reporter, describes the way in which the policy has affected some students including a freshman who is quoted as saying she thought “it was a great idea” and that many of her classmates don’t find it offensive. However, another student wrote an editorial in the student newspaper and indignantly wrote “I didn’t come to Lincoln to be told my weight is not in acceptable range.”
The educators and school policy makers point out that the historically black college must do more to combat the serious health problem of obesity and diabetes, which disproportionately affects African-Americans. Currently approximately 80% of African-American women are overweight or obese and this contributes greatly to the high rates of diabetes and early mortality.
On the one hand, we find a historically black university generating a policy aimed at addressing the most threatening social and health problem that its students face. On the other hand, the policy involves an obligatory class to be taught in fitness for only those students whose body mass index is over 30. Some of the students object to what they see as discriminatory treatment and they don’t like being singled out in such a stark fashion for their weight problem.
A number of specific questions are raised by this story. One of them is a question of what roll universities and, for that matter, high schools, middle schools, grammar schools and nursery schools, should play in combating this deadly epidemic of obesity striking our young people. Clearly this is a classic public health problem that is going to be much more easily addressed through prevention efforts than through sweeping treatment efforts aimed at correcting the obesity that is well established in the adult population. Efforts by public entities and educational institutions should be lauded if only because they indicate a level of understanding of a global and sweeping health problem that will adversely affect the students more so than virtually any other educational, health, social or other public problem. Yet policies that may be instituted to combat the problem will potentially run afoul of our sensibilities about what is a personal or private concern and what is a discriminatory policy based on a person’s physical characteristics.
Another question raised by this story is whether a fitness class, which meets three hours a week, will have any success in reducing the chance of obesity among its students? I would argue that such classes are indeed part of the necessary effort, but they must begin at far earlier ages, probably in the kindergarten level and continue through university ages. As a physician treating obesity, I would also say that offering treatments, in this case a fitness class, to a group of people makes some practical sense, but why offer it only to those students who already have a body mass index over 30 when, statistically, 80% of the students risk becoming obese later in their lifetimes. One could argue that the more important target group is the group with a body mass index of 22-29 or, realistically, just everyone.
What are publicly funded universities to do about this pandemic of diabetes, obesity and the many attendant health problems such as sleep apnea, hypertension, early heart disease, blindness, renal failure, amputations and decreased life expectancy? In the absence of some sweeping local state and federal policy, the usual patchwork of solutions emerges from many different institutions in many different corners of the country. Only through discussion of all of these different ideas and the conflicts they raise, will solutions to the greatest health problem of our time emerge.