Obesity in the Sky, Part 3

C seat

Recently, Childhood Obesity News discussed the rules made by airlines to accommodate obese passengers (or not). The rules are not uniform, and about all they agree on is the politically correct term, “passenger of size.” In exactly what way is an obese person inimical to the safety of other passengers? How does a person in the 400-pound range deal with the extremely tiny toilet facilities? Why don’t airplanes just have bigger seats?

For Forbes, Cecilia Rodriguez looked at some recent studies concerning the reasons for the rules, and the problems of adequate seat-belting:

Not only is the energy absorption capacity built into aircraft seats likely to be overwhelmed by the extra weight, but also the risk of injury is not confined to the hefty passenger. If seats collapse or seat belts fail, the ‘unrestrained motion of the passenger’ will endanger those seated next to him or her. Another study in Japan concluded that the proximity between passengers in economy class creates a higher likelihood that the heavier passenger would become a hazard by colliding with those sitting nearby.

Rodriguez outlines the notion formulated by a European airline, to create wider seats and charge extra fare, which is criticized by some because it would mean making the “normal” seats even slimmer. There is only so much room on a plane, and apparently a more radical redesign has not been contemplated.

Liz Weiss, writing for The Huffington Post, notes that many passengers feel embarrassed and discriminated against, no matter what the airlines do. The journalist also asks whether passengers who can’t fit into a single seat should be forced to pay for two? She writes:

The U.S. Federal Aviation Administration (FAA) requires that passengers are able to lower their armrests and sufficiently buckle and fasten their seatbelts. Some airlines provide passengers with belt extenders to elongate them, but not all carriers are this accommodating.

Adding insult to injury, the FAA does not allow passengers to buy and bring their own seat-belt extenders — even if the airline does not provide this item.

A contributor to The Economist, known as N.B., discovered that some airlines will let a passenger have an extra seat for free, if they bring a doctor’s note — and then wonders if this is fair. It costs the airline to give away a free seat, and makes every other passenger’s fare go up a little bit. Should we mind? Do we mind subsidizing the defibrillators that planes carry in case someone has a heart attack?

In Part 1 of this trilogy, we recounted the tragic story of Vilma Soltesz, an obese American who was unable to book a flight back to the U.S. and died in Hungary. And if a live 425-pound person can’t be allowed, imagine the whole separate web of issues surrounding the journey of an oversize coffin. Dr. Pretlow says:

The story of this lady’s death is pitiful, that food addiction can reach the point that transportation companies can’t accommodate the individual.

This highlights the basic conundrum: Is morbid obesity a medical condition that should be catered to and handled with kid gloves? Or are obese people as culpable as the passengers who used to smoke on airplanes because their addiction demanded it? But the airlines put non-smoking rules in place, and no amount of popular demand by nicotine addicts will ever succeed in reversing that decision. Dr. Pretlow asks:

If air travelers to a large extent have to give up their smoking addiction to be accommodated, shouldn’t obese travelers have to give up their food addiction to be accommodated? In other words, it might be argued that banning extreme obesity on airplanes is in the same category as banning smoking.

But there is a big difference, isn’t there? A smoker can agree not to smoke on a flight. Giving up the behavior for a few hours is sufficient to render the smoker acceptable. A food addict can agree to give up eating for a few hours (the length of a flight), but that in no way addresses the underlying issue: the seat is too small, and passengers in adjoining seats are cheated of the flying experience they paid for. A person can’t stop weighing 500 pounds, just to go from here to there.

Where does sheer logistical safety end, and where does discrimination start? Should there be a solid cutoff point of, say, 300 pounds, enforced across the board? But then what if one airline wants to be a pioneer and design their services around the 500-pound passenger? There are, of course, more questions that could be asked. What do Childhood Obesity News readers think?

Source: “The Pain of Overweight Airline Passengers,” Forbes, 05/29/12
Source: “Who Is Too Fat To Fly? Airlines Are Working It Out,” The Huffington Post, 11/10/12
Source: “How should airlines treat larger passengers?,” The Economist, 11/12/12
Image by busbeytheelder.

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Profiles: Kids Struggling with Weight

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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