Texas Hospital Bans Overweight Employees

In a move that has raised eyebrows among health care providers and prospective job applicants, Citizens' Medical Center in Victoria, TX has announced that there is one group it categorically won't hire to take care of its patients. And it's...the overweight?

The Texas Tribune lays out the facts:

The Citizens Medical Center policy, instituted a little more than a year ago, requires potential employees to have a body mass index of less than 35 — which is 210 pounds for someone who is 5-foot-5, and 245 pounds for someone who is 5-foot-10. It states that an employee’s physique “should fit with a representational image or specific mental projection of the job of a healthcare professional,” including an appearance “free from distraction” for hospital patients.

“The majority of our patients are over 65, and they have expectations that cannot be ignored in terms of personal appearance,” hospital chief executive David Brown said in an interview. “We have the ability as an employer to characterize our process and to have a policy that says what’s best for our business and for our patients.”[...]

Both the Texas Hospital Association and the American Hospital Association said that although they’ve seen more hospitals restricting employment for job candidates who smoke — Baylor Health Care System, for example, no longer hires employees who use tobacco — they hadn’t heard of any hospitals with weight or body mass limits.

The reasoning behind the new policy, as Buzzfeed describes it, is medically and logically suspect, even if the policy is legal:

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.[...]

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.