Researchers Dr Russell Keast and PhD student Jessica Stewart,
working with colleagues at the University of Adelaide, CSIRO, and
Massey University (New Zealand), found that slim people may have greater sensitivity to the taste of fat than overweight people. The results of their research are published
in the latest issue of the British Journal of Nutrition.

Tuesday, 09 March 2010
University of Melbourne

We know of five tastes that humans can detect – but this research shows that there
is a sixth; fat.

Deakin researchers Dr Russell Keast and PhD student Jessica Stewart,
working with colleagues at the University of Adelaide, CSIRO, and
Massey University (New Zealand), have found that humans can detect a
sixth taste – fat. They also found that people with a high sensitivity
to the taste of fat tended to eat less fatty foods and were less
likely to be overweight. The results of their research are published
in the latest issue of the British Journal of Nutrition.

“Our findings build on previous research in the United States that
used animal models to discover fat taste,” Dr Keast said.

“We know that the human tongue can detect five tastes – sweet, salt,
sour, bitter and umami (a taste for identifying protein rich foods).
Through our study we can conclude that humans have a sixth taste -
fat.”

The research team developed a screening procedure to test the ability
of people to taste a range of fatty acids commonly found in foods.

They found that people have a taste threshold for fat and that these
thresholds vary from person to person; some people have a high
sensitivity to the taste while others do not.

“Interestingly, we also found that those with a high sensitivity to
the taste of fat consumed less fatty foods and had lower BMIs than
those with lower sensitivity,” Dr Keast said.

“With fats being easily accessible and commonly consumed in diets
today, this suggests that our taste system may become desensitised to
the taste of fat over time, leaving some people more susceptible to
overeating fatty foods.

“We are now interested in understanding why some people are sensitive
and others are not, which we believe will lead to ways of helping
people lower their fat intakes and aide development of new low fat
foods and diets.”

ScienceDaily (Mar. 2, 2010) — Teens who spend more time watching television or using computers appear to have poorer relationships with their parents and peers, according to a report in the March issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Over the past 20 years, teens have used an ever-expanding array of screen-based tools for communication and entertainment, according to background information in the article. “The availability and attractiveness of screen time activities has provoked excitement about the opportunities afforded by these options, as well as concern about whether these displace other activities that are important for health and development,” the authors write. “One area of interest is how screen time may affect the quality of relationships with family and friends.”
Rosalina Richards, Ph.D., of the University of Otago, Dunedin, New Zealand, and colleagues studied 3,043 adolescents age 14 to 15 in 2004. The teens completed a confidential questionnaire about their free-time habits, as well as an assessment of their attachment to parents and peers.
Overall, the more time teens spent watching television or playing on a computer, the more likely they were to report low attachment to parents (in other words, difficulty forming a relationship or emotional bond). The risk of having low attachment to parents increased 4 percent for every hour spent viewing television and 5 percent for every hour spent playing on a computer. Conversely, teens who spend more time reading and doing homework reported a higher level of attachment to parents.
The researchers also assessed interview responses from 976 individuals who were age 15 years in 1987 to 1988. Among these teens, more time spent viewing television was associated with lower attachment to both parents and peers. For every additional hour of television, teens had a 13 percent increased risk of low attachment to their parents and a 24 percent increased risk of low attachment to peers. “Recommendations that children watch less television are sometimes met with the concern that being unable to discuss popular shows or characters may inhibit peer relationships,” the authors write. “The findings herein do not suggest that less television viewing is detrimental to adolescent friendships.”
There are several potential mechanisms underlying the relationship between increased screen time and poorer relationships, they note. For instance, teens who have televisions in their bedroom not only spent more time watching but also may share fewer meals with family members. “However, it is also possible that adolescents with poor attachment relationships with immediate friends and family use screen-based activities to facilitate new attachment figures such as online friendships or parasocial relationships with television characters or personalities,” the authors write.
“Given the importance of attachment to parents and peers in adolescent health and development, concern about high levels of screen time among adolescents is warranted,” they conclude. “With the rapid advance of screen-based options for entertainment, communication and education, ongoing research is needed to monitor the effect that these technologies have on social development and psychological and physical well-being among adolescents.”

Which comes first the obesity or the depression? Well, according to a meta-analysis of previously published studies in the March issue of Archives of General Psychiatry, obesity is associated with an increased risk of depression and depression is associated with an increased risk of obesity. Understanding the relationship between the two conditions over time could help improve prevention and intervention strategies. Floriana S. Luppino, M.D., of Leiden University Medical Center and GGZ Rivierduinen, Leiden, the Netherlands, and colleagues analyzed the results of 15 previously published studies involving nearly 60,000 participants that examined the relationship between depression and obesity over time.

ScienceDaily (Mar. 2, 2010) — Obesity appears to be associated with an increased risk of depression, and depression also appears associated with an increased risk of developing obesity, according to a meta-analysis of previously published studies in the March issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
“Both depression and obesity are widely spread problems with major public health implications,” the authors write as background information in the article. “Because of the high prevalence of both depression and obesity, and the fact that they both carry an increased risk for cardiovascular disease, a potential association between depression and obesity has been presumed and repeatedly been examined.” Understanding the relationship between the two conditions over time could help improve prevention and intervention strategies.
Floriana S. Luppino, M.D., of Leiden University Medical Center and GGZ Rivierduinen, Leiden, the Netherlands, and colleagues analyzed the results of 15 previously published studies involving 58,745 participants that examined the longitudinal (over time) relationship between depression and overweight or obesity.
“We found bidirectional associations between depression and obesity: obese persons had a 55 percent increased risk of developing depression over time, whereas depressed persons had a 58 percent increased risk of becoming obese,” the authors write. “The association between depression and obesity was stronger than the association between depression and overweight, which reflects a dose-response gradient.”
Sub-analyses demonstrated that the association between obesity and later depression was more pronounced among Americans than among Europeans, and stronger for diagnosed depressive disorder compared with depressive symptoms.
Evidence of a biological link between overweight, obesity and depression remains uncertain and complex, but several theories have been proposed, the authors note. Obesity may be considered an inflammatory state, and inflammation is associated with the risk of depression. Because thinness is considered a beauty ideal in both the United States and Europe, being overweight or obese may contribute to body dissatisfaction and low self-esteem that places individuals at risk for depression. Conversely, depression may increase weight over time through interference with the endocrine system or the adverse effects of antidepressant medication.
The findings are important for clinical practice, the authors note. “Because weight gain appears to be a late consequence of depression, care providers should be aware that within depressive patients weight should be monitored. In overweight or obese patients, mood should be monitored. This awareness could lead to prevention, early detection and co-treatment for the ones at risk, which could ultimately reduce the burden of both conditions,” they conclude.

As we all know by now, obesityincreases the chances of developing health problems in children, adolescents, and adults. Here is just more evidence to support that obesity is related to a heart disease risk. Dr.Asheley Skinner, a professor of pediatrics at the University of North Carolina School of Medicine, who was the first author of the study, asserts that people cannot delay to take action against obesity and argues that it is vital to intervene early in a child’s life. The study looked at the children’s weight and indicators of inflammation such as C-reactive protein, which has been shown to predict heart disease, stroke and death. This study is to be published in the journal Pediatrics.

Wall Street Journal
By SHIRLEY S. WANG

MARCH 1, 2010, 12:03 A.M. ET
Obese children as young as age 3 show signs of an inflammatory response that has been linked to heart disease later in life, researchers said, in a finding that is likely to further stoke concerns about childhood obesity.

The results suggest that obesity-related disease processes may start earlier than previously believed. Nearly 30% of obese 3-to-5-year-olds had elevated blood levels of C-reactive protein—a widely studied marker for inflammation—compared with 17% of healthy-weight kids of the same age. The disparities widened as children aged, according to the study, which is being published Monday in the journal Pediatrics.

“It’s really important to be concerned about childhood obesity and to even be concerned when they are quite young,” said Asheley Skinner, a professor of pediatrics at the University of North Carolina School of Medicine, who was the first author of the study. “We can’t wait until they’re adolescents or adults.”

In the U.S., 14% of 2-to-5-year-olds are considered overweight, or at the 85th percentile or greater of weight for height in their age group.

C-reactive protein, or CRP, has been shown to help predict risk of heart disease, stroke and death under certain conditions, according to the American Heart Association. Previous studies have found that overweight and obese adults show elevated levels of CRP, but less has been known about CRP in children.

The study examined three markers that measure different aspects of inflammation, including CRP, in more than 16,000 children nationwide between the ages of 1 and 17. By ages 15 to 17, CRP was elevated in about 60% of obese teens, compared with 18% of teens of healthy weight. The increase was even more pronounced for very obese kids, with nearly 43% of young children and 83% of teens showing CRP elevation.

A similar pattern of elevation was observed for the other two inflammatory markers, though one of the markers wasn’t elevated in obese children until the age of 6.

It isn’t known whether elevated CRP in young children will predict heart disease in adulthood. Such a study, which would involve following overweight and obese children until adulthood, hasn’t been done, Dr. Skinner said. But, she said there wasn’t any evidence to suggest that CRP response would be different in children than in adults; its response in the body is the same regardless of age. Inflammation is the body’s immune response to infection or injury.

The concern of finding CRP elevation in such young children is that its effects could be cumulative. Future research is needed to investigate whether that is the case, and also whether losing weight could reduce CRP response in kids, according to Dr. Skinner. This study was funded by the National Institutes of Health.

ScienceDaily (Feb. 28, 2010) — The anxiety that often accompanies a chronic illness can chip away at quality of life and make patients less likely to follow their treatment plan. But regular exercise can significantly reduce symptoms of anxiety, a new University of Georgia study shows.
In a study appearing in the Feb. 22 edition of the Archives of Internal Medicine, researchers analyzed the results of 40 randomized clinical trials involving nearly 3,000 patients with a variety of medical conditions. They found that, on average, patients who exercised regularly reported a 20 percent reduction in anxiety symptoms compared to those who did not exercise.
“Our findings add to the growing body of evidence that physical activities such as walking or weight lifting may turn out to be the best medicine that physicians can prescribe to help their patients feel less anxious,” said lead author Matthew Herring, a doctoral student in the department of kinesiology, part of the UGA College of Education.
Herring pointed out that while the role of exercise in alleviating symptoms of depression has been well studied, the impact of regular exercise on anxiety symptoms has received less attention. The number of people living with chronic medical conditions is likely to increase as the population ages, he added, underscoring the need for a low-cost, effective treatment.
The researchers limited their analysis to randomized controlled trials, which are the gold standard of clinical research, to ensure that only the highest quality data were used. The patients in the studies suffered from a variety of conditions, including heart disease, multiple sclerosis, cancer and chronic pain from arthritis. In 90 percent of the studies examined, the patients randomly assigned to exercise had fewer anxiety symptoms, such as feelings of worry, apprehension and nervousness, than the control group.
“We found that exercise seems to work with just about everybody under most situations,” said study co-author Pat O’Connor, professor and co-director of the UGA Exercise Psychology Laboratory. “Exercise even helps people who are not very anxious to begin with become more calm.”
Exercise sessions greater than 30 minutes were better at reducing anxiety than sessions of less than 30 minutes, the researchers found. But surprisingly, programs with a duration of between three and twelve weeks appear to be more effective at reducing anxiety than those lasting more than 12 weeks. The researchers noted that study participants were less likely to stick with the longer exercise programs, which suggests that better participation rates result in greater reductions in anxiety.
“Because not all study participants completed every exercise session, the effect of exercise on anxiety reported in our study may be underestimated,” said study co-author Rod Dishman, also a professor of kinesiology. “Regardless, our work supports the use of exercise to treat a variety of physical and mental health conditions, with less risk of adverse events than medication.”

It is not news that students live busy and sometimes unhealthy lifestyles. Having an irregular pattern of eating, drinking, sleeping, stress, and studying can make it difficult to stay healthy in college. Nicole Patience, a clinical dietitian at Temple Student Health Services, believes that there are not many weight loss plans designed for college students in particular, as the campus setting can be challenging. Melissa Napolitano of Temple’s Center for Obesity Research and Education says that a third of college students are overweight. Patience created a program called Onward to Weight Loss Success (OWLS) years ago and it teaches students about emotional eating, alcohol and weight gain, dining out, healthful cooking, and “mindful eating.”

Philadelphia Inquirer

February 22, 2010

Early in her college career, Kimberly Davidson fell into the typical campus lifestyle, a tailor-made prescription for weight gain: Study hard. Party. Watch TV. Eat junk food.

Davidson, 21, a junior at Temple University, had put on the so-called Freshman 15. Now she would like to lose about 30 pounds, which would place the 5-foot-9 social-work major at 140, well within the healthy weight range for her height.

She will join more than 20 other female Temple students in an 11-week weight-loss program that will aim to break ground and fine-tune methods that work best with the college crowd.

“There are very few weight-loss programs designed specifically for college students, and there isn’t a lot of data about the efficacy of the programs,” said Nicole Patience, a clinical dietitian at Temple Student Health Services.

The campus setting can be particularly challenging – with irregular sleep patterns, budget constraints, the stress of being away from home for the first time, and the prevalence of parties.

In addition, many Temple students work at least 20 hours a week, another stressor that could lead to poor eating habits.

“It’s a unique set of challenges,” Patience said, “compared to someone in the work world.”

Obesity is a problem of particular relevance because about a third of college students are overweight, said Melissa Napolitano of Temple’s Center for Obesity Research and Education, which will evaluate and monitor the program run by Patience.

Michelle Obama came to Philadelphia on Friday to promote her “Let’s Move” national campaign to lower childhood obesity.

Patience began her program – Onward to Weight Loss Success (OWLS) – 21/2 years ago after hearing from students how much they wished they could lose weight in a healthy way. This semester will be different in that the program will be monitored and evaluated by the obesity center.

In the program, students learn about such topics as emotional eating, alcohol and weight gain, dining out, healthful cooking, and “mindful eating” – being in the moment, so to speak, rather than being distracted in front of a TV. All the discussions are geared toward college students, their lifestyles, and their budgets.

Participants set goals and keep “food records” as part of the weekly one-hour meetings, Patience said.

The students will receive physicals before and after the program. Their weight loss, attitudes, moods, and body images also will be assessed.

Twenty-six students have signed up. Half will get the program immediately; the rest become a control group, then will get help in the next cycle.

To be eligible, students must exceed weight limits for their body mass index. A 5-foot-5 woman, for example, would have to weigh 150 pounds or more to be eligible.

Just how much weight they can expect to lose is uncertain. In the past, those in Patience’s program still living the college life have lost about a half-pound a week, compared with working-adult programs in which people shed one to two pounds a week, said Napolitano, an associate professor of kinesiology and public health at the obesity center.

Napolitano hopes the study will yield best weight-loss practices for students that can be rolled out to other campuses nationally.

“We want to get to people earlier,” she said, “before poor habits are established.”

Students will receive a $20 gift card for participating in the study, but Patience expects “internal motivation” – not the gift card – will keep them involved.

“One of my big motivations was just going there every week and seeing the other girls. We were each other’s motivations,” said Shuntelle Stephen, 23, who was in the program a year ago.

Stephen, who gained weight after taking steroids for asthma, lost 25 pounds in the program and has since lost 15 more by continuing to follow what she learned.

A public-health major, Stephen began going to the gym daily with her new friends. Information presented in the sessions also helped, she said. She learned, for example, that a margarita has about as many calories as 90 Gummy Bears.

Stephen, who has transferred to a New York state university, said she had entered the group a “very bad eater,” relying on frozen and fried foods. She exited eating more healthfully, enjoying fruits and vegetables, controlling portions, and having small meals or snacks regularly during the day rather than loading up once or twice.

Temple junior Kimberly Davidson has struggled with her weight since her senior year in high school. Lately, she has been biking more and buying fresh foods at the grocery store that recently opened near campus.

“I cook every day for myself. I’ve been doing a lot better,” she said.

She looked forward to beginning the group this week and getting a boost.

“I just kind of want to feel better and be in better shape,” said Davidson. “It’s something I’ve wanted to do for a long time. It will be good to have someone helping.”

ScienceDaily (Feb. 17, 2010) — Fat tissue in women with polycystic ovary syndrome produces an inadequate amount of the hormone that regulates how fats and glucose are processed, promoting increased insulin resistance and inflammation, glucose intolerance, and greater risk of diabetes and heart disease, according to a study conducted at the Center for Androgen-Related Research and Discovery at Cedars-Sinai Medical Center.
Polycystic ovary syndrome, or PCOS, is the most common hormonal disorder of women of childbearing age, affecting approximately 10 percent of women. It is the most common cause of infertility, and an important risk factor for early diabetes in women.
“We’re beginning to find that fat tissue behaves very differently in patients with PCOS than in other women,” said Ricardo Azziz, M.D.,M.P.H., director of the Center for Androgen-Related Research and Discovery, and principal investigator on the study. “Identifying the unusual behavior of this fat-produced hormone is an important step to better understanding the causes underlying the disorder, and may be helpful in developing treatments that will protect patients against developing heart disease and insulin resistance.”
Fat tissue is the body’s largest hormone-producing organ, secreting a large number of hormones that affect appetite, bowel function, brain function, and fat and sugar metabolism. One of these hormones is adiponectin, which in sufficient quantities encourages the proper action of insulin on fats and sugars and reduces inflammation. Women with PCOS produce a smaller amount of adiponectin than women who do not have the disease, in response to other fat-produced hormones, according to the research to be published in the February issue of Journal of Clinical Endocrinology and Metabolism.
While Polycystic Ovary Syndrome is often associated with obesity, women with the disorder are not necessarily more likely to be overweight. In fact, in the study, adiponectin was lacking in PCOS patients whose weight was considered to be in a healthy range, as well as in those patients who were overweight.
PCOS also can cause symptoms such as irregular ovulation and menstruation, infertility, excess male hormones, excess male-like hair growth (hirsutism), and polycystic ovaries. About two-thirds of women with PCOS have insulin resistance, an impairment in the effectiveness of the hormone insulin, which regulates the body’s utilization of fats and sugars, and which results in a higher risk for diabetes, metabolic syndrome, and cardiovascular disease. The causes of insulin resistance in PCOS patients remain unknown.

ScienceDaily (Feb. 18, 2010) — Obesity in general nearly doubles the risk of developing kidney stones, but the degree of obesity doesn’t appear to increase or decrease the risk one way or the other, a new study from Johns Hopkins shows.

“The common thinking was that as weight rises, kidney stone risk rises as well, but our study refutes that,” says study leader Brian R. Matlaga, assistant professor of urology at the Johns Hopkins University School of Medicine and director of stone diseases and ambulatory care at Hopkins’ James Buchanan Brady Urological Institute. “Whether someone is mildly obese or morbidly obese, the risk for getting kidney stones is the same.”

The findings are published in the February Journal of Urology.

Over the last decade, several epidemiological studies have shown a strong connection between obesity and kidney stone disease. However, as obesity continues to rise worldwide, Matlaga and his colleagues wondered whether different subcategories of obesity, ranging from mildly to morbidly obese, presented different risks.

To answer the question, the researchers used a national insurance claims database to identify 95,598 people who had completed a “health risk assessment” form with information about their body mass index (BMI), a measure of body fat calculated by dividing weight by height, and a general indicator of underweight, healthy weight, or overweight. The database, which spanned over a five-year period from 2002 to 2006, also had encoded information indicating whether these individuals had been diagnosed with kidney stone disease.

Using a definition of obesity as having a BMI greater than 30 kg/m2 (which, in English measurements, corresponds to a 5 foot tall person who weighs 153 pounds, or a 6 foot tall person who weighs 221 pounds), the researchers calculated the incidence of kidney stones in people who were non-obese and in those who were obese. Among the non-obese individuals, 2.6 percent were diagnosed during the study period with kidney stones, compared to 4.9 percent of the obese individuals. When the investigators arranged those in the obese group by their BMIs, ranging from above 30 kg/m2 to more than 50 kg/m2, they found that the increased risk remained constant, regardless of how heavy the individuals were.

Matlaga says that he and his colleagues aren’t sure why obese people are more at risk for kidney stones, though metabolic or endocrine factors unique to obesity are likely reasons, along with dietary factors such as a high-salt diet. The researchers plan to study these potential risk factors in subsequent studies.

ScienceDaily (Feb. 24, 2010) — The adverse affects of being overweight are not limited to physical function but also extend to neurological function, according to research in the latest issue of The Journals of Gerontology Series A: Biological and Medical Sciences.

The publication presents a collection of ten articles highlighting new findings related to obesity in older persons.

“One of the unanticipated consequences of improved medical management of cardiovascular disease is that many obese individuals reach old age,” saidJournal of Gerontology: Medical Sciences Editor Luigi Ferrucci, MD, PhD, of the National Institute on Aging. “We need a better understanding of the causes and consequences of obesity in older individuals — especially when obesity is associated with sarcopenia.”

A study headed by Anna Dahl, MS, of Sweden’s Jönköping University, found that individuals with higher midlife body mass index (BMI) scores had significantly lower general cognitive ability and significantly steeper decline than their thinner counterparts over time. These statistics were compiled from a study of Swedish twins that took place over the course of nearly 40 years, from 1963 to 2002; the results were the same for both men and women.

Other studies reported in the journal show that obesity appears particularly threatening in the presence of other health problems, such as poor muscle strength and depression.

Similarly, changes in weight also signify declines in overall health. A team of researchers led by Alice M. Arnold, PhD, of the University of Washington, Seattle, found that such fluctuations are significant indicators of future physical limitations and mortality in the elderly. Arnold and her colleagues used data from the Cardiovacscular Health Study, which included information from over 3,000 individuals aged 65 and older from 1992 to 1999. They discovered that a history of cyclically losing and gaining weight increased a person’s chance of having difficulty with activities of daily living — bathing, dressing, eating, etc. — by 28 percent.

The weight issue has been a delicate one for airlines trying to respond to concerns from both large passengers and those feeling crushed while sitting next to them. Film director Kevin Smith was recently kicked off a flight because of his size. He focused his anger on Southwest, but the incident put the spotlight on all airlines and their heavy passenger policies. Rick Seaney, CEO of Farecompare.com, an airfare comparison shopping site says that airlines do not want to get involved with this, and will avoid it at all costs. A third of the population is now obese, more than double the % obese of just 20 years ago, yet the size of an airplane seat has not changed very much. Brandon Macsata, executive director of the Association for Airline Passenger Rights, says that it is up to each airline to decide on policies for overweight passengers. Spokeswoman for JetBlue, Alison Croyle says that they address this problem as needed on a case by case basis.

2-17-2010

(CNN) — When film director Kevin Smith was recently kicked off a flight because of his size, he focused his anger on Southwest, but the incident put the spotlight on all airlines and their heavy passenger policies.

Smith said that he had no trouble buckling his seat belt and lowering his armrests on the flight Saturday and that his neighbors didn’t complain about him invading their space.

He said he suspected he may have been bumped by an airline employee who did not like his films.

Southwest has apologized to Smith — twice — but said he was not singled out to be removed.

“Our employees made the decision to remove Kevin after a quick judgment call that he might have needed more than one seat for his comfort and those seated next to him,” wrote Linda Rutherford, Southwest’s vice president of communications and strategic outreach, on the airline’s blog.

On his blog, Smith countered that all he wanted Southwest to do was admit that he wasn’t “too fat to fly” and that the incident “was all an unfortunate error” on the airline’s part. He expressed frustration that Southwest had not done so.

A related CNN.com story has generated thousands of comments from readers passionate about both sides of the issue.

“This whole thing has gotten so ridiculous. Southwest and all of the other airlines need to make bigger seats. Kevin Smith and the rest of America has become bigger and bigger, the airlines need to accommodate that, plain and simple,” wrote one poster.

But another summed up the frustration of otherair travelers.

“I did the fly-up-on-Monday-fly-home-on Friday thing for three years straight and nothing struck fear into the hearts of my fellow fliers more than seeing a ridiculously large person lumbering down the aisle as we were all boarding. Kudos to the airline for standing up for its passengers,” the poster wrote.

Who makes the decision?

The weight issue has been a delicate one for airlines trying to respond to concerns from both large passengers and those feeling crushed while sitting next to them.

“It’s embarrassing — airlines don’t want to touch this with a 20-foot pole,” said Rick Seaney, CEO of Farecompare.com, an airfare comparison shopping site. “[But] this is only going to get worse.”

A third of Americans are now classified as obese, according to the Journal of the American Medical Association, but the width of a coach airplane seat has changed little, remaining between 17 and 18 inches in most commercial planes.

The Federal Aviation Administration does not regulate seat width, but it does require passengers be able to sit belted and with both armrests down to comply with safety standards.

Ultimately, it is up to each airline to decide which passengers are too big to safely fly in one seat, said Brandon Macsata, executive director of the Association for Airline Passenger Rights. That means a gate agent, flight attendant or pilot can make that determination.

Macsata called the current guidelines arbitrary and said they are often unfair to women because they are typically larger in the hips, while men are often larger in the belly or in the chest.

He also urged people frustrated with fat passengers — the term preferred by his organization — to direct their anger at the airlines instead.

“It should not be about the size of the person’s butt sitting next to you, but rather the size of the seat that both of you are sitting in,” Macsata said.

“We’re crammed in like sardines, you don’t have to be a fat person to be uncomfortable sitting in those seats.”

A simple remedy would be for airlines to retrofit the first row of each plane with seats that are a bit roomier and reserve them for large fliers, who would pay more for booking them, Macsata said.

Addressing a ‘sensitive issue’

Airlines have adopted various policies to cope with the issue. Some are easier to find than others.

Southwest Airlines, for example, refunds the cost of an additional seat to “customers of size” after travel is completed if the flight doesn’t oversell. Southwest did not return phone calls asking for the number of people who have taken advantage of the refund policy.

Farecompare.com’s Seaney said there is little incentive for people to buy two seats. Many would rather pay for one ticket and take their chances that vacant seats will be available on their flight, rather than spend double and wait for a refund, he added.

United Airlines last year implemented a policy that requires obese passengers to buy a second seat, unless vacant seats are available on their flight — in which case they would be seated next to one for free.

American Airlines has a similar policy and encourages customers to address their seating needs when booking their flight.

JetBlue does not have a policy in place for customers who require an additional seat, but the airline addresses their needs on a case-by-case basis, spokeswoman Alison Croyle said in a statement.

“We understand this is a sensitive issue,” Croyle said. “If we can accommodate larger customers on the plane, we will do so at no additional charge.”

Delta did not return phone calls asking for details on its policy.

A few weeks ago, Air France announced that starting this month, it would refund the cost of a second coach seat purchased by heavier passengers if the economy cabin was not fully booked.

Still, industry observers said formal guidelines should be adopted to avoid incidents like the one involving Kevin Smith. Flight attendants, gate agents and pilots shouldn’t be made to act as “judges and juries” on weight issues, Seaney said.