CardioExchange Archive

I am a creature of routine and order, and therefore don’t do very well with Southwest Airlines’ lack of seat assignment. Not so long ago, during a business trip to San Antonio, I was looking at my group C boarding pass and wondering if there would be any room for my carry-on luggage, or if I was going to have to sit in the last row of the airplane. As it turned out, both my fears became reality. Not the end of the world, but what came next was something I wasn’t prepared to handle.
The middle seat, or I should say, what was left of the middle seat, was the only one available. Two young, obese individuals each occupied about a fourth of my seat. I looked at the flight attendant who looked back at me, shrugging her shoulders and silently apologizing. I sat down and immediately felt my shoulders compressed; I literally could not move.
The plane took off. I knew I wasn’t going to be able to tolerate the feeling of confinement for the 4½-hour flight. I was already getting anxious, tachycardic, and I could feel my shirt drenched in sweat. The flight attendant saw my distressed face and asked me to stand with her at the back of the plane. She really prevented a panic attack. For almost the entire flight, I stood up in the back, chatting with the flight attendant. My row mates slept the entire time.
As a cardiovascular prevention specialist, I deal with obesity and counsel weight loss on a daily basis. But until that day, although I have always conceptualized obesity as a global epidemic, I was interacting with it as a one-person problem and not as an issue that can impact society in many ways. That day, my comfort and safety were jeopardized by the obesity problems of two individuals.
So my questions to you are the following: 

Should obese individuals be obligated to purchase two airplane seats instead of one?
Do you visualize obesity as a public health hazard, and, therefore, support a government role in implementing laws that might help halt the growing obesity epidemic? (e.g., regulating fast-food chains?)
As a physician, do you sometimes feel hesitant to bring up the obesity issue with your patients for fear of offending and consequently losing them? 

 
Editor’s note: Southwest Airlines’ articulation of their policy requiring the purchase of extra seats by customers of size addresses issues of individual sensitivity and public fairness.