Deseret Morning News, Saturday, March 25, 2006

Obesity may not be such a big crisis

Author addresses 'facts of fat,' 'cultural hysteria'

By Lois M. Collins
Deseret Morning News

America's "obesity epidemic" is more a case of moral panic than actual crisis, according to Paul J. Campos — the result of an arbitrary dividing line that doesn't categorize people by what's healthy for them but rather relies on formula.

And, he says, we've become so "super-sensitized to fatness that we see it everywhere."

It's not helpful, says Campos, author of "The Obesity Myth" and a professor at the University of Colorado School of Law. This week he addressed a group of law students at the University of Utah.

He's been giving and getting flak for his views on the subject, which have been published and broadcast nationally. He takes it in stride, with presentations that are comedic, the message serious. "Weight has been medicalized in an uncritical sort of way," the "facts" of obesity not backed by the science, he asserts.

"Ask your doctor if cultural hysteria is right for you," he suggests wryly.

Campos, who is of average size, agrees that Americans are getting heavier. But he's one of a growing number who believe the dire predictions of disease and illness that are sure to follow the weight gain are exaggerated. Instead of fixating on weight, Campos says, "we should be asking what actually increases people's health."

His list includes good genes — "humongously important, and I can't recommend it strongly enough" — not smoking and being physically active. When you are more active, you become healthier, regardless of whether your weight drops, he says.

And he notes that being female is better than being male, from a health perspective. " 'Ideal weight' men are at higher relative risk of whatever than 'morbidly obese' women."

That's not to say that being genuinely obese is not bad for you, Campos says. But the same case can't be made for the "tweeners" classed as overweight, he says, calling it "our phony claims to know way more than we do." Calling someone in the 25-29 body mass index range overweight "is completely bogus. Studies show no increased health risk overall. There's no empirical basis for it."

Instead, he says, the World Health Organization picked a number — 25 — and that became the standard.

The weight guidelines are based on a body mass index (BMI) calculation that considers height and weight, but can't differentiate lean muscle from fat, which is lighter. Standards that say someone with a BMI of 25 or greater is overweight pay no attention to what's healthy for an individual, Campos says, despite some studies that suggest the healthiest people are a little "overweight" based on BMI. If you just go by numbers, Campos says, George Clooney and President Bush are both pudgy, with Clooney bordering on obese.

Campos also suggests that relatively little is known about why we're heavier than previous generations, and better data on that "might be helpful." Perhaps it's as simple as the rise in the median age from 27 to 36.5.

Campos says that when the issue of weight is looked at politically, culturally and economically (who benefits financially from the weight loss push? he asks), and then the official pronouncements are compared to what well-devised studies show, the views don't match.

He gets challenged, he says, because he's not a doctor. But the real experts would be the obesity researchers, and "most of them are essentially funded by the weight-loss industry," which raises questions.

Reality shows that the health of the American people has never been better. They're living longer. Disease rates are down. So the question should be, "What actually increases people's health?" Campos says.

Ladene Larsen, health promotion bureau director in the Utah Health Department, says Campos ignores the fact that more people are moving from overweight to obese than are going from normal weight to overweight. It's not just a matter of where the line was placed, she says. And science clearly shows that "the higher we go up on the BMI chart, the more the probability of diabetes, osteoarthritis, stroke, heart disease. Those are well-documented, sound medical outcomes."

But she agrees the conversation should be reframed so that more emphasis is placed on healthy eating and exercise, which everyone agrees improve health. (And, she adds, lead to weight loss.) As for where that line is drawn, "I don't quibble before 30 BMI. But my concern is more people are going from 30 to 40.

"Unless some major changes are made in how we think about health and how to help each other stay healthy, (the trend to higher weight) is going to continue." The solution includes creating walkable environments where healthy choices are also easy choices, she says. She wants to see neighborhoods with sidewalks and schools with physical education class requirements, and work sites and schools that offer healthy foods.

"I can understand his need to say folks have overreacted. I think there is some of that. But I don't think we are reacting enough in the most useful way."

HOME