From an AP story:
The Centers for Disease Control and Prevention estimated today that packing on too many pounds accounts for 25,814 deaths a year in the United States. As recently as January, the CDC came up with an estimate 14 times higher: 365,000 deaths.
The new analysis found that obesity … being extremely overweight … is indisputably lethal. But like several recent smaller studies, it found that people who are modestly overweight actually have a lower risk of death than those of normal weight.
Biostatistician Mary Grace Kovar, a consultant for the University of Chicago’s National Opinion Research Center in Washington, said “normal” may be set too low for today’s population.
Keep in mind that the 365,000 number was itself a retreat from the CDC’s recent figure of 400,000 deaths a year. Don’t worry, though… the fact that they overestimated fat deaths by 1400% isn’t going to make them do anything crazy like revise the publicity materials based on false figures.
CDC Director Dr. Julie Gerberding said because of the uncertainty in calculating the health effects of being overweight, the CDC is not going to use the brand-new figure of 25,814 in its public awareness campaigns and is not going to scale back its fight against obesity.
I’ll be interested to see if this new study accounted for the effects of yo-yo dieting as a separate cause from merely being overweight; if they didn’t, then even the new figure of 25,814 may be an exaggeration. And given the near-universal failure of diets to turn fat people into “normal” people over the long term, I think that describing being fat as a “preventable” condition is dubious.
“This analysis is far more sophisticated,” said Kovar, who was not involved in the new study. “They are very careful and are not overstating their case.”
A related study, also in Wednesday’s JAMA, found that overweight Americans are healthier than ever, thanks to better maintenance of blood pressure and cholesterol levels. Diabetes is on the rise among people in all weight categories, however.
I think that last paragraph relates to an important point: Fat people who are concerned about their health are better off using moderate exercise and improved diets to work on reducing blood pressure and “bad” cholesterol, and not paying attention to what the scales say. Unlike trying to lose weight, this is an approach that can be successfully applied by most fat people over the long run.
It’s stunning how irresponsible the CDC has been throughout the “fat is the new smoking!” saga. On the bright side, I’m surprised and pleased that the CDC is releasing this new data, rather than finding ways to cover it up.
Thanks to Paul of Big Fat Blog for the tip.
I must say I find your supposedly feminist perspective here to be somewhat bemusing. Unless you can demonstrate that being overwieght is a consequence of genetics (which it may in part be) then you have to accept that it is primarily due to bad diet and a lack of exercise. If it is genetic then perhaps you can quote me a reference. But while I have greqt deal of respect for Andrea Dworkin’s writing to argue that her(or any one else) being overwieght is her right because society regards thinness as sexually desirable is to put the cart before the horse. It’s the same as saying that anorexia is all right because it’s a response to sexism.
Being overwieght has more effects upon your body than just heart disease and whether or not your have a high cholesterol level your heart still has to work harder the more overwieght you are. The other problems associated with being overweight include e.g diabetes, arthritis, higher risk of several cancers(from high fat intake) etc.
Perhaps you should contrast the numbers of overweight people in the US with other parts of the world. I believe that the US has a much higher proportion of overwieght people. Is this because of feminism or McDonalds?
I have to wonder, what goes through someone’s mind to write something like this?
It appears that you thought something like this: “Gee, here’s a bunch of new people. I don’t know them, they don’t know me. So I think the very first words I say to them should be incredibly condescending; from my very first sentence I should take on the attitude of a bemused adult lecturing some dim five-year-olds, and faux-slyly suggest that maybe they don’t know feminism from a hole in the ground.”
What on earth makes you think this is a good first impression for you to make? Have you really found that sort of thing to be a good way to begin productive exchanges?
People worth talking to approach dialog in ways that are likely to be productive. You, on the other hand, appear to approach dialog with an attitude of dry mockery (or should that be “mokare?”). So why should I waste time arguing with you?
Now, if you’re really smart, you’ll say something like “okay, I didn’t mean to start off on the wrong foot. I can see how what I wrote could be taken as insulting in tone, and I apologize for that; let’s start over.”
That’s what you’ll say if you’re smart. And, frankly, that would surprise me a little. But it won’t surprise me if you respond by refusing to give an inch, and instead being even more condescending and snide than you were in your first post.
Go ahead. Please. Surprise me.
Saw this over on BFB yesterday and was astounded that they’d actually admit a mistake of this magnitude. I also thought it was interesting that the AP article includes a statement that validates Campos’ assertion (from “The Obesity Myth”) that the lowest mortality rates are among people currently considered “moderately overweight.”
They admit to the mistake, but simultaniously they won’t acknowledge it. These kind of figures make a mockery of nearly the entire anti-fat movement. Its absurd to continue an anti-fat campaign with these new numbers. They’ve admited the mistake, but are they making ammends? Nope. They are just choosing not to acknowledge the new data in marketing materials. This would be like a car maker discovering that their flashy new convertable doesn’t actually come with an engine, but continuing to air the sexy commercials of the car zipping through exotic locations. They’ve admitted that the Emperor has no clothes, but they really rather liked the thought of magical garments only special people can see, so they intend to go around naked and continue to pretending.
Really, this is just stunning. When I heard this, I first thought it was just a flashback to January when they admited their last mistake (which I thought was a flashback to last year when the mistake was first pointed out to the CDC). A 1400% exaggeration is unfathomable. When I read it, my first response was something on the order of “Daaaaaaaaamn.”
And yet, the first response is to to say “Yeah, but fat people are really really unhealthy and you all eat too much and boo McDonald’s.” The smoking gun has been revealed, the house of cards knocked over, the insert additional cliche here, and I expect we’ll now all get to watch how little changes. It never mattered that fat was unhealthy. Just that some people don’t care to look at it.
Bingo. Especially when you read their response, which is essentially that accepting this study would require them to change their ways and darn it, they don’t want to.
For those interested, read Paul Campos’s The Weighting Game in the New Republic, and article from over two years ago (Jan. ’03) that makes the exact point that the CDC is only now beginning to respond to. Don’t know if it’s available to non-subscribers, so this is the main point:
Sorry, it was subscriber only, I think, but it is also posted on pages 3-9 of this PDF.
I don’t know if it’s the same study, but Gina Kolata has an article in the Times about a study showing that being overweight actually has lower risk of death than being of “normal” weight and that any risk of death from obesity is limited to the most extremely obese, about 8% of the population.
Oh, and a quote of the reactions from the article:
Yes, folks, we can’t believe a vigorously-researched, peer-reviewed study in JAMA because it involves fat people.
The Times article was really interesting and, I think, will validate what many of us actually observe — i.e., thin people who drop dead at a relatively young age and overweight people who live to be quite old with no seriously debilitating health problems. Even the way we calculate the average number of people who are overweight is problematic, because there are clearly some people who are really overweight, and for whom weight might be an independent risk factor (the Times article calculated this as 8% of the population) but for most other people, moderately excess weight is not the main issue (with the possible exception of diabetes, not something to be taken lightly). Instead, the weight gain is most likely a more visible symptom of what ails many people, skinny or fat: bad diet, no exercise, and so on.
So based on what might be clear health risks to a few people, the many are badgered into near hysteria because of what might be unrealistic assessments of what is a normal weight. On the other hand, the article also made clear that there may be potential health effects of being moderately overweight that are being masked because of medical intervention — in other words, the weight might be an issue, but it’s treatable.
My dad is a pathologist, and I can remember him saying since at least the 1970s that the vast majority of the post mortems he ever did on people who just dropped dead at relatively young ages were done on thin or “normal weight” people.
This is something those directly involved in medicine have known for years and years. It’s criminal on the part of the medical establishment, IMO, that at this point in time we are still having to have these discussions.
JoAnn Mason, eh? Funny, I just brought her up in a different topic on fat right here at Alas. During the FDA hearings on Redux (a weight loss drug which went on to inflict heart disease on millions of people), Dr. Mason testified and acknowledged that the drugs were risky and potentially fatal in some and only produced an average weight loss of 7 lbs. In her slight defense, she did not realize just how risky, (albeit because she was busy helping rush approval of the drug cocktail before sufficent research could be done.)
Granting that the drug could kill and produced a nominal affect in weight loss, she still urged its approval on the basis that even such minor weight loss and such dangerous risks were outweighed by how impossibly deadly being fat was. Discovering that her premise is completely false puts her testimony (and indeed her entire profession) in an entirely new light. She’s got a lot of reason to refuse to believe the new data.
The entire hysteria over fat is shown to have no statistical basis? Well never mind that. We mustn’t lose sight of the epidemic we keep insisting is upon us. Fear morbid obesity! Can’t let the fact that its not really morbid at all get us off message.
Brian, I agree with you mostly, but I would add that there are a subset of people for whom weight really is a health issue, and a disproportionate share of these people are poor. As with the “mentally ill” the “fat” people most likely to avail themselves of help are those who are least likely to suffer from its worst consequences. In some cases, failure to get help is clearly the result of few resources and reduced access to care. I don’t want to accentuate my disagreement with you, but I’d hate to see an overreaction in the opposite direction that will inevitably turn into a justification for doing nothing to help this group of people. Alas, I fear that one of the reasons that health care types have been so alarmist is simply to get any funding at all to help anyone. This has become something of a modus operandi in alot of health related areas (think breast cancer). It’s like Y2K hysteria: if you don’t overdo it, you risk not being taken seriously at all.
I went and looked at the original JAMA article and it highlights and confirms previous findings that were not reported in the AP article. In 2000, severely overweight people (BMI>30) had 111,000 excess deaths compared to those in the normal weight range (25>BMI>20). This is high but not near the 350k-400k figures previously cited by the CDC. Those who were only slightly to moderately overweight (30>BMI>25) actually had 86k fewer deaths than those in the normal category. Adding these amounts leads to the 25K figure in the AP articles.
To me, this says that there is an intrinsic danger to weight itself outside of eating behavior and fitness but that individuals have to be severally overweight for this to be true (they also note that the vast majority of the 111K excess deaths were from people with BMI’s greater than 35). I think an appropriate message is to stress the importance of healthy eating and exercise for everyone and only focus on weight loss for those who are extremely overweight.
Except weight loss is a treatment which doesn’t work. Even if the “epidemic” is a quarter of what its been made out to be, that severely changes the justification. We also don’t know (and frankly, I don’t know how this could be done) if they controlled for the effects of yo-yo dieting. This has been shown to be a risk factor on its own (even for people who eventually maintain a “healthy” weight), but its also something the virtually everyone in the 35+ range will have a great deal of experience with. Continuing to advocate for a treatment with a lengthy track record of failure and whose failure may be a significant part of the observed risks is just not a good idea.
Its hardly comprable to “Y2K hysteria” to say that new approaches are needed. You suggest that I risk not being taken seriously because I’m “overdoing it”. So why are you advocating for a policy which his consistantly been shown to overreach, and overreach quite dramatically. They tell us weight loss works. It doesn’t. They say fat people are at grave risk, they aren’t. They insist on revising guidelines to increase those labeled as fat, but we now see those are the people with the least risk of all. When, exactly, do the fat attackers have to worry about “overdoing it”? Every time their suggestions have faced even the most mild scrutiny, it has failed to live up to its claims. We need a new approach.
All people need to be treated with dignity, meaning not being lectured about their weight. All people should be encouraged to eat a moderate diet and have moderate activity levels and to enjoy health at every size. It does no one any good to draw a line and decide who gets to be okay and who doesn’t. That’s what we’ve been doing, and it doesn’t work. The line always bleeds. First you focus on the people you deem “extremely” fat, but how long before things drift to those “at risk” of being “extremely fat”. How long before we expand those labeled “at risk” to include those deemed “pre-at risk”? I’d say not very long. Not because I’m cynic, but because we’ve been there already. Treatments which have never been shown to do anything to make people healthier, much less any thinner, have no place and no one should be shamed into accepting a system of failure. We need to change our approaches to encourage healthy living in a weight neutral perspective. People who are quite fat need support for that, without an obsessive and provenly counterproductive obsession with weight. Some may lose weight. Some may not. But we will all be better for it once we stop thinking a system which fails nearly 99 times out of 100 is somehow the way to go. Its doing all fat people a disservice, and I hardly think it wrong to say so.
Brian, I am not advocating for current approaches to weight loss. If I were to advocate for anything it would be along the following lines: take vending machines out of schools, build bike trails and playgrounds and plan more green space and fields, make mass transit more feasible, encourage community development of better food stores, etc. These require community acceptance and public funds. If the attitude is, well, who cares about weight, it doesn’t matter anyway, then there’s one less reason to care about these things. The problem with vesting so much power in medical types is that, of course, they start looking for medical resolution of what is for the most part an issue of non-medical lifestyle even if it has medical consequences (which it can, especially over the course of time and especially for people who are very overweight).
Current methods of weight loss do not work, and I agree, Brian, that it is a terrible disservice. I would just point out, though, that your at risk, or pre-at-risk analogy is exactly what we have tried to do with breast cancer through HER-2 screening in women with family history. I would argue that while it does assign a label to those women as pre-at-risk, it also affords them the opportunity to take measures that might save their lives. In a certain portion of the obese population there are people who eat well, exercise as much as possible and still get no reduction in weight or the other factors that put them at risk of cardio and metabolic diseases. I believe that the day is approaching that we can treat them medically through genetic screening (once genes are identified) and subsequent therapy (that will actually work, not just telling them to do what they are already doing while pretending that they are lying about their eating and exercise).
As for the CDC, I personally think they deserve alot of credit for going back and redesigning/reanylizing their studies and trying to get it right. They have long recognized that BMI is not the best way to go, but the other measures are either too expensive (such as CT scanning) or too phrenology-like (waist to hip ratios etc). I know alot of people think they have a hidden agenda, but this new release seems to me like they are headed on the right track to try to get a much better understanding of what the problem is (or if there really is one).
Ampersand
I havent responded to your original criticism until now because I got confused between this and the later post on this subject( and in fact thought that my original post had been lost). Your right it did sound condescending.
But now, I’m not bemused but quite horrified by the nature of the discussion taking place here. Much of what’s being expressed appears to me to be nothing more than self-justification based upon a series of news articles that misrepresented the original study.
Obesity is epidemic in indigenous communities (for instance) and there is much evidence that this is directly related to the epidemics of diabetes and heart disease that contribute to radical reductions in life expectancy in those communities. There is nothing special about indigenous communities beyond poverty, despair and cheap processed food.
While the study in question makes it clear that being overwieght (BMI
Obesity is epidemic in indigenous communities (for instance) and there is much evidence that this is directly related to the epidemics of diabetes and heart disease that contribute to radical reductions in life expectancy in those communities.
Diabetes, heart disease, and obesity are all caused by poor diet and inactivity. It’s no surprise that you’d find all three in indigenous communities where starchy, fatty food is the most affordable thing to eat. That is not at all the same as the CDC’s admission that slight ‘overweight’ appears to have lower mortality rates than ‘normal weight.’
Actually, bean, I’m finding this quite enlightening. I’ve got a number of books and articles of fatness that I keep on hand so I can respond should anyone ever make a specific criticism of fat people. (which rarely happens, of course) Its good to know that any contradicatory information won’t mean a darn thing to them. It’ll probably save me some time.
And the fat kills crowd marches on. Little inconveniences about fat not killing are hardly going to take them off message.
I honestly can’t help but be confused about the motivation for being so insistent and negative. To me I’d yet again have to state that I see it as an individual issue, cause and effect varying. I’m definitely chubby currently. Since having Sydney, I wear either a size 16/18 or XL, but haven’t graduated into ‘Women’s Clothing’. I think I’m the most at risk person in our group of friends, with regards to weight issues, but not because I’m the biggest (that’s just simply not the case), but instead due to the genetics that predispose me to certain weight related issues (primarily diabetes, thyroid and galbladder). Loss of weight might help somewhat, but definitively speaking, the thing that helps the most is healthy eating mixed with moderate activity. That doesn’t guaruntee me weightloss, however.
I remain confused, however, why folks like Kyan feel it necessary to attempt to preach, offer misleading or erroneous facts, and in general treat the issue with such blanketing generalities. What’s in it for you, Kyan, and why is it that you are bemused, befuddled and horrified that people aren’t willing to continue buying into the your line of thought? Personally I find your attitude far more unhealthy for heavy people than their weight – can you guess why that is?
Pray tell what ‘misleading and erroneous facts I’ve offered?
Hmmm somehow I crossed threads. The commentary you made on the other weight related thread. Brian said it best, you focused soley on weight instead of health and ‘reported’ the statistics in a dishonest manner.
Again though, what have you to gain by all of this? Where is the catch for you?
Even the 111,909 figure isn’t statistically reliable. http://www.techcentralstation.com/042205D.html
“For example, in the 25-59 year old group the confidence interval for increased risk for the obese with BMI’s up to 35 is 0.84-1.72, meaning that we can’t be confident that even for this group there is any increased risk of early death. The same is true for those with BMI’s up to 30. Moreover, the RR figure — the Relative Risk for dying from obesity – is, in the authors’ words, “in the range of 1-2.” This means that there is at the very best a very weak association — notice, not a causal connection — between obesity and death.”
Besides, even if there are health risks of being obese there are health benefits of being obese too that would be lost if people lost weight. The obese are less likely to have osteoperosis, bone fractures (which are deadly for the elderly) and various pulmonary diseases. Even if obesity is tied into heart disease, hypertension or diabetes (three of the main diseases associated with obesity) a high fiber diet and regular exercise should be enough to cut the risks from these diseases drastically. I was reading Gaesser’s book and he found that a healthy diet and regular exercise cut diabetes rates by 50% and hypertension rates by about 90% within a month.
“…Much of what’s being expressed appears to me to be nothing more than self-justification…”
Really, kya ? I was just thinking the same thing about you, and how you’re using this thread to justify your own shitty attitudes regarding fat people. WHAT a coinkydink !!
Sorry, Amp. I know you can’t put out the fires of condescension with the gasoline of condescension, but I had I just couldn’t resist.
Kim, you wicked, wicked… uh, basement-dweller. A Size 18 ?! For shame !! Jane Seymour and that *Friends* babe took off lots of weight after having kids !! Why can’t you ?!
Got anything nice I can borrow ? :p