Unfair discrimination of overweight staff in Singapore hospitals

“If you are fat, how do you teach patients?” asks nurse Rajaletchumi Raja Singam. Discriminatory words like hers are not uncommon. In fact, subtle and invidious discrimination against people who are overweight happens at all levels of society, and they ruin people’s lives.

Professor Linda Bacon, who is a specialist in food and sustainability and an advocate for Health for Every Size movement, says that research supports that you can be both healthy and overweight.

In her book “Health at Every Size”, she says, "No obesity myth is more potent than the one that says obesity kills. It gives us permission to call our fear of fat a health concern, rather than naming it as the cultural oppression it is. That 'obesity kills' has been the backbone of the [U.S] federal public health campaign. Yet that is not supported by evidence examined by federal employees. Their research found that 'even severe obesity failed to show up as a statistically significant mortality risk' and suggested that overweight may actually be protective...The most comprehensive review, for instance, pooled data from 26 studies and concluded that overweight individuals were living slightly longer than those of normal weight."

Although the etymology of the word ‘obese’ means, “that has eaten itself fat”, that is not the truth; for people who are in the ‘obese’ category very often do not eat any differently from people in the ‘normal’ category.

In a culture where people are pre-occupied with food and weight and with the constant message going out (even from well meaning healthcare professionals) that you need to be trim to be fit, instead of emphasising on being healthy, there is a lot of bashing going on, right from the schools to the places of work.

Even the chief executive of Alexandra Health Group (the healthcare group which manages Alexandra Hospital and Khoo Teck Puat Hospital) Mr Liak Teng Lit, equated being trim to being healthy when he recently said that “(If you are overweight) you are going to fall sick”.

He says that he will use ‘weight’ as a key performance indicator (KPI) for the staff in the hospitals managed by him and that overweight staff will not be promoted.

This KPI adds further stress to the staff in the hospital (many of whom are women) who juggle shift work, family commitments and societal pressures.

I asked Association of Women for Action and Research (AWARE) if they had a view on the KPI set by Alexandra Health Group for their staff’s promotion. AWARE responded that in its view, this practice of the health-group is clearly discriminatory and unacceptable.

Ms Corinna Lim, the Executive Director of AWARE says, “If the hospitals wish to implement such an unusual policy, the onus is on them to substantiate and justify this.”

Ms Lim further asserted that the health-group have to show as a matter of fact that weight and body-shape generally affects work performance or poses a health-risk to the individual and their families, if the heslth-group insist on using body weight of staffs as a KPI.

“If so, are the hospitals applying similar considerations to individuals with other types of health risks such as smoking or who suffer from insomnia?” she asks.

This KPI she feels sets a very bad precedent not just for the health-care industry, but also for the country, for if it is accepted as a precedent, “then one can stretch it to every health care establishment in the country and to any other job where there is greater exposure to germs (e.g. cinemas, shopping centres, toilets).”

“What are the job specifications of hospital staff?” she asks. “Is it to promote healthy living or to take care of sick patients when they check in? Surely, what a patient is looking for is caring and competent staff, be they fat, thin or otherwise”, she adds.

‘Being trim equals being fit’ is a cultural idea that has been repeated so many times and has spread so swiftly that it has become part of our belief system. We are led to belief so strongly that being fat is killing us that we lose our open-mindedness and we see everything only through this lens.

The fact is, there are plenty of thin people who are making very bad health choices and don’t gain weight, as their bodies are genetically predisposed another way.

It is simply not true that everyone who is overweight has poor lifestyle habits.