Fwd: [Naafa News] Don't Feed the Humans!
- Peggy <naafa_pr@...> wrote:
Don't Feed the Humans!
The medical establishment's ridiculous definition of "overweight" is
Paul Campos, The New Republic Published: Tuesday, November 27, 2007
The reaction of America's leading "obesity" experts to the latest
study on the issue demonstrates yet again that our current
definition of the word "overweight" makes no sense. Walter Willett
of the Harvard School of Public Health's fumed that the new findings
were "rubbish." His colleague JoAnn Manson found the study, authored
by Katherine Flegal and others, and published in the prestigious
Journal of the American Medical Association, "very puzzling." After
all, for "overweight" people to be healthier than "healthy weight"
people just doesn't seem logically or linguistically possible.
How did we get into this mess? First, the relevant definitions:
According to public health authorities in America and around the
world, people are "overweight" if they have a body mass index
between 25 and 30 (for a 5'4" woman this is between 145 and 173
pounds; a 5'10" man fits the category if he weighs between 174 and
A decade ago, when I began to study the relationship between weight
and health, I was struck by the almost total lack of medical
justification for labeling people in this weight range "overweight."
Since then, the situation has become considerably more absurd. It's
possible to have reasonable disagreements about the extent to
which "obesity" (defined as a BMI of 30 or higher) is an independent
contributor to ill-health and mortality risk. After all,
epidemiology is a crude science, and the correlations between ill
health and body weight among very fat people are inevitably open to
For example, suppose one follows two groups, each made up of 5,000
people, for ten years. People in the first group are at their
supposed "ideal weight" for their height, while people in the second
group are "obese." After a decade, twenty people in the first group
and thirty in the second have died of heart disease. Statistically,
this means the fat people had a 50% increased risk of dying from
heart disease than the thin people did. (This is typical of the
sorts of risk ratios associated with obesity, and an example of how
a handful of extra deaths, in the context of a tiny baseline risk,
makes for scary-sounding headlines about obesity "raising the risk
of a fatal heart attack by 50%.") Does that mean the ten extra heart
disease deaths were caused by fatness? Far from it. Perhaps the fat
people were, on average, poorer; more stressed; more prone to diet
and therefore to weight cycle; more likely to use diet drugs, many
of which have been linked to cardiovascular disease; more sedentary;
more discriminated against by the health care system and by society
in general; and so on. Long-term observational studies of this sort
can never control for more than a few of these sort of confounding
variables, making it difficult to determine the extent to which, if
at all, a particular correlation between a risk factor and a health
outcome is causal.
But all this involves a very different question from that at the
center of the controversy over whether being "overweight" is
unhealthy. Flegal's study has provided yet another rigorous
demonstration of the fact that, if anything, people in
the "overweight" category have, on average, better overall health
and lower mortality rates than people in the absurdly
mislabeled "healthy weight" category.
Flegal and her colleagues found that, for a whole range of diseases,
from Alzheimer's and Parkinson's to infectious illness and most of
the major respiratory ailments, "overweight" people face a lower
mortality risk than "healthy weight" persons. In addition, they
found no difference between the two groups in mortality risk from
heart disease or cancer (the nation's two biggest killers, and ones
that many people tend to associate with being overweight). Thus, the
relative mortality risk, and by extension the overall health,
of "overweight" Americans appears to be better than that of "healthy
In the context of America's war on fat, the fact that being
called "overweight" makes no medical or scientific sense is hardly a
trivial point. How do our anti-fat warriors deal with this
Three rationalizations are getting prominent play. First, obesity
researchers point out that while being overweight doesn't correlate
with increased health risk, being obese does, and "overweight"
people are closer to being "obese" than "healthy weight." "You
should not take heart in the idea that if you are only overweight
you are OK...because people gain weight as they age in this
country," said Robert Kushner, a professor of medicine at
Northwestern. The problem with this argument is that, statistically
speaking, people who are even slightly "underweight" face greatly
increased health risks. Consider two women of average height, who
weigh 110 and 150 pounds, respectively. The former "ideal weight"
woman is roughly ten pounds away from a lower weight level that
correlates with a doubling of her mortality risk, while the
latter "overweight" woman would have to gain more than 100 pounds to
move into a similar risk category. And while people generally gain
weight in middle age, they usually begin to lose weight once they've
reached retirement age--and nearly 80% of all deaths take place
among people 65 and older. (Indeed, high weight has almost no
correlation--or even a negative correlation--with mortality risk
among the elderly, while weight loss has a very strong positive
correlation, even when one controls for weight loss caused by
eventually fatal illnesses). Given these facts, it seems odd to
focus on the possibility of an "overweight" woman gaining 100 pounds
rather than a thin woman losing ten.
Second, researchers talk about "quality of life." After all, life
expectancy isn't everything. As Manson says, "health extends far
beyond mortality rates." According to a New York Times story, Manson
is concerned that excess weight makes it difficult for people to
move around, and therefore impairs their quality of life. That's
part of "the big picture in terms of health outcomes," Manson says.
The notion that an average-height woman who weighs between 146 and
175 pounds is going to find it difficult to move about is as good an
example as one could hope to find of what eating disorder experts
call "anorexic ideation." Here again, we see how an argument which
may make sense when talking about extremely fat people is
transferred onto people who are "fat" only in the sense that they
don't conform to a radical preference for extreme thinness--a
preference which is one of the key explanations for why we're
saddled with a scientifically bogus definition of what constitutes
a "healthy weight."
Finally, as a senior government scientist told me last
week, "There's this new argument going around that says overweight
people are living longer because they're going to the doctor more
often and are therefore getting better medical care." The scientist
emphasized that, in a culture where access to medical care is
closely linked to socio-economic status, and in which socio-economic
status is inversely related to increasing body mass, this argument
is, to put it politely, highly implausible.
Still, when the entire public health establishment has put its stamp
of approval on a definition, those who have staked their
professional reputations on the accuracy of that definition aren't
going to be deterred by something like, well, evidence. Predictably,
Willett, who has been perhaps the most prominent proponent of the
idea that people ought to try to maintain very low weights, was
outraged by the latest refutation of his theories: "It's just
ludicrous to say there is no increased risk of mortality from being
overweight," he told The Washington Post.
What's actually ludicrous is that Occam's razor has yet to be
employed to explain the "very puzzling" result that, once
again, "overweight" people have been found to enjoy better health
than "healthy weight" people. The definition of "overweight"
promulgated by Willett, Manson, and their colleagues makes no sense.
Many "puzzling" results cease to puzzle when one stops abusing the
Paul Campos is a professor of law at the University of Colorado-
Boulder. (Peggy's note: Paul is also on NAAFA's Advisory Board!)
NAAFA website: http://www.naafa.org
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