Critics deride obesity science

By Rosie Mestel, Los Angeles Times
August 3, 2004

In the midst of the federally declared obesity epidemic, Paul Campos is savoring a plate of seared ahi tuna in ginger-garlic marinade, a neat mound of white rice and a bed of gently sauteed spinach accompanied by sourdough bread and real butter.

He looks slim enough — but is quick to point out that at 5-foot-8 and 165 pounds, he is officially "overweight" according to the National Institutes of Health, the World Health Organization and a slew of scientists and doctors.

Does he care? Not a bit. He snorts at the notion of a fat "crisis," that a little spare tire could be hurting him. He sips away at his full-calorie Bavarian beer and mulls the offerings on the dessert menu.

"Junk science," he says. "That's the real epidemic."

Campos and a minority of other scholars and researchers are challenging the science behind ever-more-shrill pronouncements on the hazards of heft. They want to stop the obesity feeding frenzy.

Fat chance.

Two-thirds of Americans are now deemed overweight, with half of those classified as obese, according to the government. In March, the U.S. Centers for Disease Control and Prevention declared that obesity was killing at least 400,000 Americans a year, almost as many as the 435,000-person death toll from tobacco.

Obesity skeptics say this is the latest in a long string of exaggerations.

"There's this tremendous cultural hysteria about this issue which is really not justified at all by the scientific and medical literature," said Campos, a University of Colorado law professor and author of "The Obesity Myth." "P.T. Barnum — wherever he now may be — must be furious with the notion that he can't get in on this thing."

Campos and others contend study after study — including those of 1.8 million Norwegians and 115,195 Massachusetts nurses — have found that people who are overweight have a lower risk of death than those who are lean. Some studies (such as one of 9,228 middle-aged and elderly Israeli men) have reported that people who intentionally lose weight die sooner than those who stay fat.

Mainstream obesity researchers object strenuously to this analysis, and say the skeptics are quibbling, misreading the data or cherry-picking medical facts.

They say that hundreds of studies show beyond reasonable doubt that there is a link between obesity and unhealthy conditions such as high blood pressure, diabetes, heart disease and certain cancers, as well as a higher overall risk of death.

"There are hundreds of people who've spent their careers studying obesity," said James Hill, director of the center for human nutrition at the University of Colorado, Denver. "And if there's one thing everyone agrees on, it's that obesity has negative health consequences."

Plumpness status is measured using an estimate of body fat called body mass index — a person's weight in pounds multiplied by 703, divided by the square of one's height in inches. People are classed as obese if their BMI is 30 or above — a cutoff chosen because studies suggest that health risks are significantly heightened beyond this point. They are overweight if they have a BMI of 25 or above.

It would seem reasonable that scientists and doctors could at least agree on the basics — such as whether the nation as a whole was really ballooning in size. But even this point is up for debate.

The perceived national obesity crisis is actually a problem for a narrow group of people, said Jeffrey Friedman, an obesity geneticist at Rockefeller University. Targeting the entire population with an exercise-and-eat-less public health campaign won't solve the problem.

Obesity skeptics say that there is ample evidence that overweight and obese people live longer than the thin.

For example, a 1984 population study of Norwegians reported people who were moderately overweight (with a BMI of 26 to 28) and even obese (with a BMI of 34 to 36) lived longer on average than the ideally lean (with a BMI of 18 to 20).

Even with this abyss of disagreement there are some areas where both sides agree. Diets work very poorly: Most people can lose only about 10 percent of their body weight, and most tend to gain back their weight over time.

Exercise improves health, no matter what you weigh.

Steven Blair, president of the Cooper Institute, a nonprofit research and education foundation in Dallas, thinks that exercise is by far the most important factor in long-term health. He has been monitoring thousands of men and women for decades — and showed that a person's performance on a treadmill test at the study's start was a better predictor of a person's later health than was body weight.

"It's better to be fat and fit than be lean and unfit," he said.

 

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