CHICAGO (AP) - Packing on the pounds is not nearly as deadly as
the government thought, according to a new calculation from the CDC
that found people who are modestly overweight actually have a lower
risk of death than those of normal weight.
The Centers for Disease Control and Prevention reported that
obesity 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.
According to the new calculation, obesity ranks No. 7 instead of
No. 2 among the nation's leading preventable causes of death.
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 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. Also, Americans
classified as overweight are eating better, exercising more and
managing their blood pressure better than they used to, she said.
The study - an analysis of mortality rates and body-mass index,
or BMI - was published in Wednesday's Journal of the American
Medical Association.
Last year, a CDC study listed the leading causes of preventable
death in order as tobacco; poor diet and inactivity, leading to
excess weight; alcohol; germs; toxins and pollutants; car crashes;
guns; risky sexual behavior; and illicit drugs.
Using the new estimate, excess weight would drop behind car
crashes and guns to seventh place - a ranking the CDC is unwilling
to make official, underscoring the controversy inside the agency
over how to calculate the health effects of obesity.
Last year, the CDC issued a study that attributed 400,000 deaths
a year to mostly weight-related causes and said excess weight would
soon overtake tobacco as the top U.S. killer. After scientists
inside and outside the agency questioned the figure, the CDC
admitted making a calculation error and lowered its estimate three
months ago to 365,000.
The new study attributes 111,909 deaths to obesity, but then
subtracts the benefits of being modestly overweight, and arrives at
the 25,814 figure.
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 new figure of 25,814 in its public awareness
campaigns. And it is not going to scale back its fight against
obesity.
"There's absolutely no question that obesity is a major public
health concern of this country," she said. Gerberding said the CDC
will work to improve methods for calculating the consequences of
obesity.
CDC spokesman Tom Skinner said the agency will probably start
using a range of estimates for obesity-linked deaths.
Dr. JoAnn Manson, chief of preventive medicine at Brigham and
Women's Hospital in Boston, said she is not convinced the new
estimate is right.
"I think it's likely there has been a weakening of the mortality
effect due to improved treatments for obesity," she said. "But I
think this magnitude is surprising and requires corroboration."
The analysis was led by Katherine Flegal, a senior research
scientist with the CDC's National Center for Health Statistics. The
study that had to be corrected was conducted by a different arm of
the CDC, the Division of Adult and Community Health, and its authors
included Gerberding.
One major reason for the far lower number in this latest study is
that it used more recent data, researchers said.
"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 because of better maintenance of
blood pressure and cholesterol levels. Diabetes is on the rise among
people in all weight categories, however.
Flegal said the two studies raise questions about what
definitions to use for obesity and "where to draw the line." Under
current government standards, a BMI, or weight-to-height
measurement, of 25 or higher is overweight; 30 and above is obese.
In recent years, the government has spent millions of dollars
fighting obesity and publicizing the message that two out of three
American adults are overweight or obese, and at higher risk for
heart disease, arthritis and diabetes.
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On the Net:
JAMA: http://www.ama-assn.org/
