The "Texas Tribune" reports that Citizens Medical Center in Victoria, Texas won't hire anyone with a BMI above 35. CEO David Brown offers an odd explanation: "The majority of our patients are over 65, and they have expectations that cannot be ignored in terms of personal appearance." So, old people don't like fat people? Even if this were true, it doesn't seem to have much bearing on actual medical care.
The policy is apparently legal — Texas has no laws prohibiting weight discrimination in hiring (in fact, only the state of Michigan and six U.S. cities do). But criticism is unsurprisingly flying. Suzanne Lucas of CBS points out that the hospital could still get in legal trouble if anyone can show that its BMI requirements have "a disproportionate impact on a particular group" (she mentions African-American women, who tend to have higher BMI than the national average). She also is surely not alone in thinking the policy is bad PR: "Now if you Google 'Victoria Hospital Texas,' three references to the obesity policy show up on the the first page of hits. Is that what you want prospective patients, donors, and employees to know about you? Probably not."
But Citizens Medical Center isn't the first — or even most high profile — company to get involved in employees' weight. In 2010, Whole Foods instituted the Team Member Healthy Discount Program, which offered higher employee discounts to those with lower BMIs. The program drew a lot of criticism at the time — one customer told the "New York Daily News," "This is really stupid. They are judging people on how they look."
But while the controversy appears to have died down, the program remains in place. According to the company's 2011 annual report, "In fiscal year 2011, approximately 15,000 team members participated in biometric screenings, with nearly 8,300 receiving higher-level discount cards compared to approximately 7,000 team members at the end of fiscal year 2010." And a representative for the company confirmed to me that the program is ongoing as of this year.
Meanwhile, the BMI controversy no longer shows up on the first page of Google hits for Whole Foods (though a Slate story called, "The Dark Secrets of Whole Foods" does), or on the company's Wikipedia page. Insofar as the BMI discount was bad PR for the company, they appear to have outrun it, at least for now.
But Citizens Medical may run into a different problem. Though the hospital's CEO boldly states the regulation is about "appearance," he'd probably still run into trouble if he tried to pass it off as a way to monitor employee health. CBS's Lucas points out that "BMI is actually a poor predictor of health." Indeed, Whole Foods admitted as much in a "Healthy Heart" newsletter released in February: "Studies show that fat around the belly (abdominal fat) may be more of an indicator of heart disease risk than weight or BMI."
And a study released just this week found that BMI fails to accurately measure body fat. Study co-author Eric Braverman told NBC, "BMI doesn't tell you how much fat … you have. So without knowing how much fat you have, you can't really save people from illness." Since Citizens Medical is in the business of keeping people healthy, they ought to know that the connection between BMI and health is looking increasingly tenuous.