Public Perception, Obesity and the Health of Politicians

 

By Jeffrey Kahn, PhD, MPH

 

The health status of elected officials is in the news again. Gov. Chris Christie of New Jersey is the latest name to be mentioned as a potential republican candidate for president, but along with the enthusiasm are murmurs about whether his weight is a liability.

 

As Eugene Robinson outlines in his recent op-ed in the Washington Post, obesity is bad for individual health as well as health care costs, and the negative effects are multiplied as the proportion of Americans who are obese increases to epidemic proportions.  However, leaping from those facts to assertions about whether the Governor is a “fit” candidate or how he ought to get serious about losing weight doesn’t do much to address the public health issues or enlighten the debate about fitness for high office.  And it begs the bigger questions. Discussion of the medical fitness of candidates is nothing new.  Dick Cheney’s longstanding challenges with heart disease raised concerns over the course of his political career, and controversy over disease past and present have dogged candidates from Richard Nixon to Thomas Eagleton to Paul Tsongas.  Gov. Christie’s case carries an added dimension in that whatever his known health issues may be, there are perceptions that someone clearly overweight is inherently less healthy than someone who appears more fit.  Looks can be deceiving, however–high blood pressure, dangerous cholesterol levels, or susceptibility to cancer are invisible.

 

So to what extent should voters consider candidates’ health information in deciding whom to support? How far should the media go in attempting to uncover current and past medical information, and how much information should candidates be asked or compelled to disclose?  What do challenges with weight have to do with fitness to serve in elected office, and what role can and should elected officials play in addressing public health concerns shared by a majority of the population?

 

There is an odd tension in American society between the near reverence for personal privacy and the expectation that the lives of public officials be open for almost limitless scrutiny. Can a candidate just say no to the media or rivals’ requests for medical history? Politicians have discovered that isn’t a good idea, having learned the lesson of one-time democratic vice presidential hopeful Thomas Eagleton. During the 1972 presidential campaign, it came out that Eagleton may have undergone electroshock therapy, a treatment for some mental illnesses. The disclosure was humiliating and effectively ended his political career. In today’s political environment, saying “no” is tantamount to admitting there is something to hide ,and many candidates have taken to releasing sometimes voluminous medical records in an effort to answer questions and thwart further digging. Gov. Christie has certainly realized that he cannot hide his weight, and in some respects that could redound to his advantage.  Many voters can identify with his struggles—he looks like them—and his financial and political successes speak volumes about erroneous generalizations and assumptions based on appearance. Robinson’s “unsolicited, nonpartisan, sincere advice” to “eat a salad and take a walk” makes light of the serious issues he raises in the column and diminishes the real difficulties involved in losing weight and keeping it off.

 

If Christie decides to run, we’ll have many months to watch his struggles with his weight.  And we should take a hard look at Gov. Christie’s public health record in the State he currently governs, including what, if anything, he is doing about the challenges of good nutrition and obesity in New Jersey.  But beyond that, it seems that what we really need to know as voters is whether a candidate is physically and psychologically fit to hold office, an assessment most people would be comfortable leaving to trained and unbiased professionals. Once a candidate is pronounced fit to serve any digging for further information starts to look more like reality TV or medical voyeurism than journalism.  The bigger point is that judging fitness based on girth is uninformed at best and discriminatory at worst.  None of us knows for certain what diseases may strike us or whether we’ll be hit by the proverbial bus the next time we step off the curb.  Diet and exercise are virtues everyone knows they should practice but are easier said than done, something to keep in mind as the media monitors whether Chris Christie gains or loses a pound, or an election.

 

Jeffrey Kahn is Deputy Director for Policy and Administration at the Johns Hopkins University Berman Institute of Bioethics.  He works in a variety of areas of bioethics, exploring the intersection of ethics and health/science policy, including research ethics, ethics and public health, and ethical issues in leading edge biomedical technologies.

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