Obesity myths? Fat chance

Posted: May 05, 2005 12:00 AM

?Some Extra Heft May Be Helpful.? That New York Times headline summarizes the tasty tale the media have fed you based on a new study that says the spare tire around your waist may actually give you more mileage in life. Moreover, declared the report, annual U.S. deaths from overweight and obesity are merely 25,814, while the Centers for Disease Control and Prevention (CDC) estimate for deaths from "poor diet and physical inactivity" is 365,000 ? 14 times higher.

But consume this fat fantasy at your own risk, for the figures published by Katherine Flegal and colleagues in the Journal of the American Medical Association (JAMA) utterly contradict decades of previous research the media ignored in their feeding frenzy.

Flegal is with the National Center for Health Statistics (NCHS), a branch of the CDC. Her study claims the current measurement for ?overweight,? a Body Mass Index of 25-30, is actually the healthiest category. In comparison, it said, the CDC?s healthy weight category of 20-25 BMI is relatively risky. Smug commentators went wild attacking ?the food police,? while the food and beverage front group Center for Consumer Freedom practically gloated itself to death with an obese $600,000 newspaper advertising blitz declaring ?Americans have been force-fed a steady diet of obesity myths.?

Really? Herewith a sampling of studies from America?s top medical journals, all of which are in addition to the six the CDC relied on for its 365,000 figure.

  • A 1998 New England Journal of Medicine (NEJM) study of 300,000 men and women found the ?minimal risk? to be a BMI of 19.0 to 21.9. ?I'm sorry to tell you,? lead author Dr. June Stevens of the University of North Carolina told reporters, ?but it?s the very lean weight that is associated with the best survival rate.?
  • The next year the largest obesity study ever, comprising over a million men and women and also appearing in the NEJM, put the optimum BMI for longevity at ?23.5 to 24.9 in men and 22.0 to 23.4 in women.?
  • In 2003 JAMA reported ?The optimal BMI is approximately 23 to 25 for whites and 23 to 30 for blacks.?
  • An analysis published last December in the NEJM by Harvard?s Dr. Frank Hu and colleagues of 116,000 women evaluated over a 24-year period found ?the lowest mortality was among women with a BMI of less than 23.?

These all dovetail with findings that in every species from worms to monkeys, calorie restriction increases longevity. The leanest animals also look and act younger. In the only calorie restriction analysis of people, ?The results clearly suggest that humans react to such a nutritional regimen similarly to other vertebrates.? If Flegal?s findings were valid, they would stand biology on its head.

Flegal told me one aspect of her analysis that might make it superior to previous ones is that it relied on nationwide data, yet so did the 2003 JAMA study. But whatever the explanation for Flegal?s findings, should we base national health priorities and individual actions not on the rule but the exception?

There are also many disturbing considerations that Flegal?s team didn?t look at. One is that so many in the overweight and obese population are children and adolescents. How can we know the long-term effects of type 2 diabetes or permanently enlarged hearts when they afflict butterball 10-year-olds?

Nor did Flegal?s group consider non-fatal illness or health-care costs. But the Rand Corporation found a direct connection between obesity and disability, and a just-released study shows that a mere 27.5 BMI (the middle of Flegal?s ?healthiest? category) can triple the need for knee surgery. Is that 1,800-calorie Ultimate Colossal Burger from Ruby Tuesday really worth titanium joints?

Further, ?Expenditures for medical conditions caused by being overweight or obese accounted ?for 9.1 percent of total annual U.S. medical expenditures in 1998 and may be as high as $78.5 billion ($92.6 billion in 2002 dollars)? according to the journal Health Affairs. It noted, ?Medicare and Medicaid finance approximately half of these costs.?

Strange how something that?s good for you can be so costly. But believe what you will as the Grim Reaper bears down on you while you try desperately to waddle away.

Michael Fumento (mfumento at pobox.com) is author of (mfumento at pobox.com) is author of The Fat of the Land: The Obesity Epidemic and How Overweight Americans Can Help Themselves, a fellow at Hudson Institute, and a nationally syndicated columnist with Scripps Howard News Service.The Obesity Epidemic and How Overweight Americans Can Help Themselves