Little Help From the Law

Many of the daily battles some fat people face do not lend themselves to the courtroom, however ó from plane seats that are too narrow to strangers who spout cruel taunts to doctors who refuse to believe that many diets only backfire. And then there are the insurers.

"The hardest thing to live with as a fat person is that you can't get health insurance," said Ms. Berg of the Council on Size and Weight Discrimination. "When people call me up and say, `My H.M.O. kicked me out; what should I do?' I have nothing to tell them. Nothing."

A person's weight does influence many health insurers, and a significantly overweight applicant can be turned down, said Janet Trautwein, director of federal policy for the National Association of Health Underwriters. "It's not an appearance thing," she said. "It's just strictly a health status factor, and it's used in combination with other factors like, `Do you smoke, have high blood pressure, high cholesterol or diabetes?' "

In some states, she said, insurers may charge higher premiums for overweight members.

Elizabeth Fisher, a programmer in Baton Rouge, La., decided not to let one such moment of daily difficulty go by. She was buying a new car, and found that the one she wanted, a Honda Odyssey minivan, did not make a seat belt big enough for her; nor would Honda offer an extender, as many other companies do.

This summer, Ms. Fisher petitioned the National Highway Traffic Safety Administration to require carmakers to offer the option of longer seat belts on new vehicles and seat-belt extenders on existing ones. Her fight had such resonance that it has gained national publicity.

"This issue is much larger than one fat woman who can't buckle her seat belt," said Ms. Fisher, who is expecting a decision soon from the agency. "There are millions of people in the United States who weigh more than 215 pounds, the current upper weight limit required for seat belts by N.H.T.S.A. And because fat is more prevalent in certain racial and ethnic populations, more common in women than in men, and more common in older people than young, denying fat people the protection of being included within the limits of federal seat-belt regulations disproportionately affects these disadvantaged groups."