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Incarceration Exacerbates Obesity in America

by Keith Sanders

Incarceration poses many health risks. Violence, inadequate medical care, as well as physical and emotional trauma, all take a sometimes deadly toll inside American jails and prisons. Yet one often overlooked problem incarcerated Americans encounter is obesity. Health experts have raised the alarm for several decades about rising obesity rates in the non-incarcerated population. Now a new study published on June 16, 2022, says chronic obesity is becoming the norm in America’s carceral system, too.

The study’s author, Stanford University Law School Associate Professor Rabia Belt, set out to assess the relationship between obesity and incarceration, with the goal of posing new approaches to the rising health and financial costs of chronic obesity in prisons and jails. She begins with the medical definition of “obese”: a body mass index (BMI) of 30 or higher. That’s a 5-foot-9-inch man who weighs 203 pounds. Or a 5-foot-4-inch woman weighing 174 pounds.

Far from a matter of weak willpower, obesity is a disability, one afflicting approximately 43% of Americans in 2017–2018, according to the latest data. Another 31% were “overweight,” with a BMI of 25–29.9. People of color, women and the poor are most likely to be obese.

The social and health factors contributing to obesity are well known: improper diet, lack of exercise and inadequate access to good nutrition, to name just a few. But for American prisoners, those factors are baked into the entire carceral system. As a result, according to the federal Department of Justice’s Bureau of Justice Statistics, “about three-quarters of the over two million people incarcerated in the United States are overweight or obese.”

Belt’s research found that most prisoners are already fat when entering prison. The condition is then exacerbated because of lousy prison food — or as she puts it, “problems stem[ming] from industrialization, budget-cutting, and ideological sentiments that deem nutritious food too decadent for incarcerated people.”

Because prisoners lack access to nutritional food in their daily rations, they rely heavily on expensive commissary items, which also offer limited variety. Moreover, prisoners often turn to the least healthy commissary food “as a substitute for absent therapeutic or rehabilitative services, as a coping mechanism, or as a way to alleviate boredom,” Belt noted.

Changing how the carceral system addresses chronic obesity is a daunting task. Prison reform advocates and critics of mass incarceration rarely, if ever, focus on nutrition. But Belt argues that such a shift in advocacy is necessary to combat America’s obesity epidemic behind bars. Although legal avenues exist, most notably under the Rehabilitation Act and the Americans with Disabilities Act (ADA), lawsuits require a showing that prison officials intend to discriminate against disabled obese prisoners. But obesity is generally considered a result of negligent treatment, not evidence of discriminatory intent, putting it outside the scope of ADA claims.

Belt believes that incorporating obesity’s negative impact into the larger framework of injustice can facilitate more activism for change. Injustice as a social cause does not usually emphasize the needs of disabled prisoners, leaving that to medical professionals. But “if we center people who become disabled … because of a marginalized identity such as poverty or race … then this is a subcommunity that we actually would want to shrink over time,” Belt said. More attention and advocacy on carceral injustice that includes obesity is the way forward.

Source: “The Fat Prisoners’ Dilemma: Slow Violence, Intersectionality, and a Disability Rights Framework for the Future”; Georgetown Law Journal, Vol. 110, No. 4, 786 (2022). 

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