The federal health nannies worry we're too fat. So the surgeon general this week issued a "call to action" against overweight and obesity. "Thin is in" no longer is the slogan of a hip lifestyle — it's government policy.
But "thin" also describes the science and rationale behind the federal offensive against the American paunch.
Surgeon General David Satcher claims 61 percent of adults and 13 percent of children and adolescents were overweight in 1999.
These estimates are derived through suspect research (telephone surveys without data verification) and an arbitrary definition of "overweight" based on "body mass index." The BMI, a ratio of weight to height, is problematic because it does not consider body type or state of health.
"We are already seeing the tragic results from these trends. Approximately 300,000 deaths a year are currently associated with overweight and obesity," asserts Satcher.
But anyone familiar with such a "body count" will instantly recognize it as unadulterated junk science.
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 [studies with] serious methodologic flaws. Many studies fail to consider confounding variables, which are extremely difficult to assess and control … Thus, although some claim that every year 300,000 deaths … are caused by obesity, that figure is by no means well established."
Satcher subtly blends overweight and obesity to link both with increased risk of heart disease, diabetes, cancer, breathing problems, arthritis, reproductive complications, depression, and social, academic and job discrimination.
These claims are also somewhat overstated or wrongly simplified.
Being obese is associated with serious health problems, including heart disease, hypertension, diabetes, and muscoloskeletal problems. But the evidence supposedly linking mild-to-moderate overweight with increased health problems is murky, based only on flaky statistics.
Weight loss may also be oversold.
Patients with hypertension and diabetes unquestionably benefit from weight loss — even as little as 10 to 15 percent. But it's not clear that weight loss benefits people mildly or moderately overweight, and otherwise healthy. Some studies statistically link weight loss with a higher death rate.
Childhood obesity is another alarm bell sounded by Satcher. A study reporting "an epidemic increase in childhood overweight" in this week's Journal of the American Medical Association coincided conveniently with the call to action. "Urgency is warranted in responding to this epidemic," the federally funded researchers concluded.
It's not clear, though, that an "epidemic" can be inferred from a statistical analysis of very limited data about the height and weight of rapidly growing 4- to 12-year-olds. More importantly, the researchers did not report any "epidemic" of health problems among the children studied.
Satcher asserts (without supporting scientific reference) that "overweight children and adolescents are more likely to become overweight or obese adults." This claim, however, is challenged by a recent study in the British Medical Journal that studied a group of children from birth in 1947 to age 50.
The researchers reported, "Little tracking from childhood overweight to adulthood obesity was found … No excess adult health risk from childhood or teenage overweight was found. Being thin in childhood offered no protection against adult fatness, and the thinnest children tended to have the highest adult risk at every level of adult obesity."
Why is our fat in the fire?
In search of a reason to be, public health bureaucrats have taken on an activist mantle, "medicalizing" unpopular or politically incorrect behavior such as overeating, eating the "wrong" foods, smoking, alcohol consumption, not exercising, and even gun ownership.
The government survey used to develop obesity data is called the "Behavioral Risk Factor Surveillance System." Your behavior is being watched by bureaucrats who don't approve.
The irony in the "call to action" is rich.
Health and Human Services Secretary Tommy Thompson in his statement called upon "each one of us as an individual … to confront this new epidemic." But Thompson's own ample BMI gives his beckoning a "do as we say, not as we do" flavor.
Certainly moderation in food and drink, plenty of exercise and other "healthy" habits will help you reach your genetic potential for health. Bodyweight, though, is probably not worth stressing over — particularly if it results in bizarre diets, diet drugs, anorexia, and bulimia.
Steven Milloy is the publisher of JunkScience.com, an adjunct scholar at the Cato Institute and the author of Junk Science Judo: Self-defense Against Health Scares and Scams (Cato Institute, 2001).
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