Tag Archives: health risks

New Zealand Tells South African Chef, “You’re Too Fat to Live Here!”

I know I am not the first and I certainly hope I’m not to write about this story.  Because you know what?  This scares me right out of my sparkly, yet sensible shoes.  Last week, New Zealand immigration officials told South African chef Albert Buitenhuis that due to his weight of 286 pounds he has an “unacceptable standard of health” and faces expulsion from the country.  Despite the fact that Buitenhuis has actually lost weight since he was originally admitted to the country in 2007, he has lost his work visa because he failed to lose weight.

He needed to stop working immediately.  And because Albert was the primary applicant on the original work visa, his wife needed to stop working as well.

An immigration spokesperson has stated that Mr Buitenhuis’s application had been rejected because his obesity put him at “significant risk” of complications including diabetes, hypertension and heart disease.  The spokesman reportedly said:

“Unless it is in the extreme, obesity will not in itself cause an applicant to fail health screening requirements, but INZ’s medical assessors have to consider to what extent there might be indications of future high-cost and high-need demand for health services,”

It should be noted that Albert may also need a knee replacement which could cost the health system over $20,000.  However, it has also been reported that the fact that Mr. Buitenhuis’ BMI was over 35, originally triggered the rejection of his work visa renewal.

This story has hit international news outlets including the Daily Mail and the BBC.  So I am hopeful this won’t just slip into obscurity in the next day or two, and I am eager to hear how Albert’s appeal process proceeds.  Because I have to admit, I find this story terrifying and frustrating in the extreme.

Here are just a few points:

1.  Immigration officials arbitrarily choose to apply or not apply BMI statistics in regards to work visa renewal.  If the irrational or irregular application of body size regulations are enough to leave people traveling on a jet plane in the lurch, think of the effect it can have on people moving their entire lives from one country to another.  And as we’ve seen in regards to flying on airplanes, if fat people are unable to ascertain exactly how these regulations will apply to them they are more likely to avoid the situation altogether.

2.  It appears that the rules changed after Albert moved to New Zealand.  Albert and his wife set down roots, made friends, built a career and a life, and then the rug got pulled out from under them.  This should be a chilling tale for everyone interested in ever immigrating anywhere.

3.  It appears the New Zealand Immigration ministry are using BMI and health interchangeably.  There is ample evidence that as a health metric BMI is extremely problematic and unreliable.  There is significant evidence that people who have a BMI in the “ideal range” actually live shorter lives than those in the “overweight” range.  Furthermore, I have heard no indication that New Zealand’s Immigration ministry are using other, far more reliable health metrics in determining visa renewal status.  Are they taking into account issues like: stress level, sedentary lifestyle, tobacco use, levels of discrimination, lack of sleep, working third shift or driving a motorcycle, being older, or being male?  There’s also evidence that bald men are more likely to have heart disease and taller women are more likely to get cancer.  Why are they taking this one extremely unreliable metric (BMI) out of context and using it to determine immigration status?

4.  Is BMI used because it is a “cheap shot” both figuratively and literally?  Despite the many, many questions about the effectiveness of BMI as a health metric, there is no question that it is extremely easy to measure and verify.  And I wonder whether discrimination based on body size is cheap politically as well?  Immigration necessarily needs to limit the number of people who can enter and stay in a country.  And they need to make sure the limitations that are used are politically tenable.  Are fat people singled out and discriminated against simply because politically, they are easy targets?

I admit that I can’t claim to know everything that is going on in this case.  I will be watching with interest to see how it plays out.  But, in any case, I think this is further proof that we need to be ever vigilant of new ways that discrimination is heaped upon people of size.

Love,

The Fat Chick

UPDATE: Don’t miss this amazing post by Angela Meadows in Huff Po!  And don’t forget to like the story and comment if you have the sanity points to spare!

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Boy Scouts, BMI and Managing Risk

Would the BSOA deem Russell “too fat” to go to camp?

Yesterday, I read Ragen Chastain’s amazing post on the new policies implemented by the Boy Scouts of America regarding participation in events and BMI.  In order for any Boy Scout to participate in a “high adventure” activity which includes a duration of over 72 hours and being over 30 minutes drive from emergency medical services, his parents and doctors must fill out a group of forms including Part C which has a whole lot of questions about BMI.  In fact questions about height and weight are the first things listed on the form before listing any pre-existing conditions or other information about disease or wellness.  Any scout with a BMI over 40 will be forbidden from participating in these high adventure activities (including the Jamboree).  And according to the site:

The Jamboree Medical Staff will review all applicants with a BMI of 32.0–39.9 and consider jamboree participation based on  1) health history, 2) submitted health data, and 3) recommendation of the applicant’s personal health care provider. For applicants with a BMI >31.9, a recommendation of “no contraindications for participation” by the applicant’s personal health care provider does not necessarily guarantee full jamboree participation. The jamboree medical staff will have final determination of full jamboree participation.

The Boy Scouts of America (BSOA) site, lists these reasons for the new restrictions:

“Anyone who is obese and has multiple risk factors for cardiovascular/cardiopulmonary disease would be at much greater risk of an acute cardiovascular/cardiopulmonary event imposed on them by the environmental stresses of the Summit. Our goal is to prevent any serious health-related event from occurring, and ensuring that all of our participants and staff are “physically strong.”

And frankly, all of this sent me scrambling for my manuals and training information about exercise in children.  One question I had right away was, “Are they using data for all-cause mortality in adults and extrapolating that information for children?”  Because, the data I’ve reviewed indicate that mortality among exercising children and teens comes from different sources that that of adults.

According to the Youth Sports Safety Alliance, the number one cause of death among exercising young athletes is Sudden Cardiac Arrest (SCA).  During my fitness certification training, I learned that the number one cause for SCA is a heart defect called hypertrophic cardiomyopathy, a thickening of the heart muscle.  Hypertrophic cardiomyopathy and other heart conditions likely to lead to SCA are often virtually undetectable from a standard physical exam.  This is why many schools are starting to recommend and a few are beginning to require a EKG for participation in strenuous school sports.  When SCA occurs, death often follows.  Being close to a hospital only helps so much as mortality risk increases by 10 percent for every minute it takes to get to medical care.  This is why there is a greater focus on CPR and Automatic External Defibrillators for helping to protect student athletes these days.

I am not aware of any research indicating that SCA is more frequent among overweight or obese young athletes.  I am also unaware of any efforts on the part of the BSOA to ask that participants in high adventure activities be screened for hypertrophic cardiomyopathy or be given an EKG as part of the Part C form.  Now, I understand that an EKG can be expensive to administer and read, but if the concern is really about the safety of the participants, it would seem that this is a more important test than BMI.

Another important risk for kids and strenuous exercise is heat stroke.  And there is some research that indicates that heat illness is more frequent among overweight and obese football players than “normal weight” players.  But many experts stress that exertional heat illness is 100 percent preventable.  Most experts strongly recommend an acclimation process to help get student athletes ready for physical exertion.  The super punishing, first day of practice workouts in full pads and gear is now frowned upon.  I wonder if the Jamboree and other “high adventure” scouting activities really do enough to help scouts of all sizes acclimate to higher temperatures and altitudes or if they simply assume that as long as the kids are skinny, they will be safe.

Which makes me wonder.  Where is the data?  Show me the data that BMI has a serious impact on safety for children and youth who wish to participate in strenuous physical activity.  Do not simply show me studies from adults and extrapolate down to kids.  And if the health and safety of your scouts is of primary importance, why are you not requiring adequate screening for the leading cause of death among young exercisers?  Are you building adequate acclimation days to make the camp safe for participants?  Or again, are  you assuming skinny = safe and healthy?  And why are you making your most important event so strenuous that you have to worry so much about health and safety in the first place?

To borrow from a famous phrase from the film Jerry Maguire, “Show me the data!”

Love,

TFC

Like my posts?  You’ll love my stuff!

Buy my book: The Fat Chick Works Out! (Fitness that is Fun and Feasible for Folks of All Ages, Shapes Sizes and Abilities)–available in softcover and e-book versions

Buy my DVD: The Fat Chick Works Out! (A Safe, Easy and Fun Workout for Klutzes, Wimps and Absolute Beginners!)

Buy a book or a DVD for a friend and save $5!  Just enter FRIENDBLFT in the discount code box!

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or

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