'Fat Police' Brutality

The Centers for Disease Control and Prevention reported this week "the prevalence of obesity in the U.S. continued to grow in 1999, representing a serious public health threat to millions of Americans." 

Obesity rose 6 percent from 1998 to 1999, according to CDC. Obesity is defined as a body mass index — a ratio of weight to height — of 30 or higher. A BMI of 30 usually indicates an individual is about 30 pounds overweight. 

"The continuing epidemic of obesity is a critical public health problem," said CDC director Dr. Jeffrey Koplan. "As a nation we need to respond as vigorously to this epidemic as we do to an infectious disease epidemic, " he warned. "As obesity rates continue to grow at epidemic proportions ... the net effect will be dramatic increases in related chronic health conditions such as diabetes and cardiovascular disease in the future," Koplan predicted. 

Because no "epidemic" lacks a body count, CDC also claimed, "Overweight and physical inactivity account for more than 300,000 premature deaths each year in the U.S." 

CDC also suggested approaches "to control the obesity epidemic" to physicians, employers, schools, parents and urban policymakers. 

The "fat police" have landed. 

There is no doubt that many are obese. Nor is there doubt obese individuals have greater rates of health problems. But while obesity isn't desirable, should it be likened to epidemics of malaria, typhus, cholera, smallpox and the plague? Or is this just a case of "fat police brutality?" 

CDC's report is scientifically flaky and misleading, and promotes a disturbing agenda. 

Height and weight data were collected by telephone interviews of nearly 150,000 randomly selected individuals. This methodology is inherently suspect as CDC's researchers relied solely on the self-reports of the interviewees. 

No data collected — not even a sample — were ever verified for accuracy. 

CDC previously admitted "overweight participants in self-reported studies tend to underestimate their weight and all participants tend to overestimate their height." In other words, the data tend to be inaccurate. CDC researchers generously interpret this error as indicating the true rates of obesity are "likely underestimated." A less generous interpretation is true rates of obesity and fluctuations are not well known. 

One of the report's researchers revealed the number of individuals surveyed has steadily increased: 124,085 in 1996; 135,582 in 1997; and 147,672 in 1998. What is the impact of more and more people essentially "lying" about their heights and weights? 

Worse than the science is the downplaying of data not fueling CDC's agenda. CDC also developed data on "overweight" individuals — those with BMIs between 25 to 29.9. The prevalence of "overweight" individuals reportedly is unchanged since last year and only increased 10 percent since 1991. 

But the CDC didn't even mention that data in its media release or report, published in the October 4 edition of the Journal of the American Medical Association 

Then there's CDC's nonsensical claim that "overweight and physical inactivity" account for 300,000 premature deaths each year. 

As the New England Journal of Medicine recently editorialized, "the data linking overweight and death ... are limited, fragmentary, and often ambiguous. Most of the evidence is either indirect or derived from observational epidemiologic studies, many of which have serious methodologic flaws. Many studies fail to consider confounding variables, which are extremely difficult to assess and control for in this type of study. For example, mortality among obese people may be misleadingly high because overweight people are more likely to be sedentary and of low socioeconomic status ... although some claim that every year 300,000 deaths in the U.S. are caused by obesity, that figure is by no means well established. Not only is it derived from weak or incomplete data, but it is also called into question by the methodologic difficulties of determining which of many factors contribute to premature death." 

Why is the CDC so willing to play fast and loose with the facts? The answer is bureaucratic entropy coupled with the agenda of some to control behavior. 

Government agencies tend to expand in terms of mission, budget and authority. But public health professionals have largely succeeded in eliminating the significant threats to U.S. public health, chiefly infectious disease. 

In search of an ongoing raison d'etre, public health bureaucrats have taken on an activist mantle, "medicalizing" unpopular or politically incorrect behavior such as overeating, eating the "wrong" foods, alcohol consumption, smoking, not exercising and even gun ownership. CDC's own survey is called the "Behavioral Risk Factor Surveillance System." Your behavior is being watched by disapproving bureaucrats. 

Some public health professionals are concerned government nanny-ism will backfire. Two years ago, the feds changed the definition of "overweight" so that 37 million more Americans became "overweight" literally overnight. Former Surgeon General and weight-loss advocate C. Everett Koop criticized the guidelines, saying, "I worry that people will say, 'This goes too far. I quit.' It is like someone in a race saying, 'They moved the finish line.'" 

In a 1974 New England Journal of Medicine essay, Dr. Faith T. Hill of the University of California-Davis wrote, "The emphasis on healthy lifestyles, although salutary in many ways, has a very dark side to it and has led to the increasing peril of a tyranny of health in the United States ... We must beware of developing a zealotry about health, in which we take ourselves too seriously and believe that we know enough to dictate human behavior, penalize people for disagreeing with us, and even deny people charity, empathy, and understanding because they act in a way of which we disapprove." 

"Tyranny of health?" Sounds eerily similar to what Thomas Jefferson wrote in the Declaration of Independence: "The history of the present King of Great Britain is a history of repeated injuries and usurpations, all having in direct object the establishment of an absolute Tyranny over these States." 

— Steven Milloy is a biostatistician, lawyer, adjunct scholar at the Cato Institute and publisher of Junkscience.com.