It isn't just that
they were fudging the numbers, it is the scope of the fudging that
is so breathtaking. For the last few years Americans have been
subjected to an incessant barrage of warnings about the risks of
dying from being fat. The most dramatic of these came last year in a
study from the US Centers for Disease Control that suggested that
some 400,000 lives were lost each year due to obesity and that
obesity related mortality would soon overtake tobacco as the leading
cause of death in the US.
But in a study released this week by the
CDC and published in the Journal of the American Medical Association
("Excess Deaths Associated with Underweight, Overweight, and
Obesity"), the public health community has finally owned up to their
massive fib by acknowledging that the number of deaths due to
obesity in the US is closer to 26,000 not 400,000 as previously
reported. This means that if these numbers are correct -- which is
questionable -- then obesity goes from being the leading or second
leading cause of death to perhaps the seventh leading source of
premature mortality.
Apart from this huge downward revision in
the numbers of people supposedly dying from fat, there are several
things in this study which signal the end of any legitimate linkage
between obesity and premature death. First, for the merely
overweight with BMI's from 25-30 there is no excess mortality. In
fact, being overweight was "associated with a slight reduction in
mortality relative to the normal weight category." Being overweight
not only does not lead to premature death, something that dozens of
other studies from around the world have been saying for the last 30
years, but it also carries less risk from premature death than being
"normal" weight. In other words the overweight=early death
"fact" proclaimed by the public health community is simply not
true.
Second, for individuals aged 25-59 the
risks of premature death from being underweight are substantially
greater than those of being overweight and they are also slightly
greater than those of being obese. For those aged 60-69 the risk of
dying from being underweight is much higher than from being even
significantly obese, that is with a BMI > 35. Again, the total
number of premature deaths due to obesity is 25, 814, while the
mortality attributable to being underweight is 37, 746. If anything
this points to an epidemic of not fat but thin caused
death.
Third, the increased mortality risks from
obesity were concentrated in a small sub-section of the population,
the morbidly obese (BMI>35), who comprise only 8% of Americans.
Yet the obesity hysteria of the public health establishment
consistently tells us that 65% of Americans are overweight and
headed to an early death.
Fourth even the 25,814 deaths per year
from obesity needs to be taken not just with a grain of salt but
with enough to keep Chicago's streets ice-free for an
entire winter. That's because the results are in many cases not
statistically significant, though the authors don't mention this.
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. And even this is built on a shaky foundation as the
authors note that "Other factors associated with body weight, such
as physical activity, body composition, visceral adiposity, physical
fitness, or dietary intake, might be responsible for some or all of
the apparent associations of weight with mortality." So there it is
-- there may in fact be no link between obesity and death. Early
deaths might instead be due to diets, body type or lack of physical
activity.
All of this raises the question of why
the numbers have been so badly wrong. The CDC tells us that this is
tricky, technical stuff and estimates are always that -- estimates.
Of course the 400,000 deaths per year that has been the foundation
of the obesity epidemic was never an estimate -- it was always a
"fact". Part of the reason is that the 400,000 number was based, as
the authors admit, not on actual weights and heights -- but
estimates. And even in those surveys which supposedly used actual
weights and heights about 30% of the participants never showed up to
be measured.
The real answer, however, is to be found
in a companion article also published in JAMA. It notes that despite
the fact that Americans have supposedly gotten fatter, the
prevalence of high cholesterol level, and high blood pressure -- in
short the risk factors for cardiovascular disease -- have declined.
Even the prevalence of diabetes, the authors note, remained stable.
So given that the prevalence of cardiovascular disease risk factors
has declined and the rate of diabetes has stayed stable, it is
impossible for so-called obesity-related deaths to increase.
In a world without junk science, results
like these would mark the end of the supposed obesity epidemic that
is killing us by the thousands. Unfortunately the public health
community is already busily discounting the CDC's numbers and
telling us that whatever the science says, fat kills. Don't count on
it.
The author is a health policy writer
living in Canada.
