Now that the government says fat might not kill
so many of us after all, is it OK to be just a little
pudgy? Maybe, but before celebrating with a hot fudge
sundae, keep in mind the overriding message: Being
too overweight really is a serious health risk.
The new data, released by the government two weeks
ago, confirm that obesity can kill, even if the numbers
are squishy, said Dr. David Katz, a Yale University
obesity researcher. "Clearly it isn't a license to
gorge yourself."
Even so, the new report, drastically reducing the
number of annual obesity-linked deaths, was confusing
and quickly became a target for critics of "food police"
efforts by the government.
"At first I got a chuckle out of it thinking now
I don't have to work as hard, but then I thought,
how can something like that be possible?" said Lisa
Cusumano, a 40-year-old mother of five from suburban
Carol Stream who is trying to lose 60 pounds.
The report from Centers for
Disease
Control and Prevention scientists didn't challenge
the long-held view that being at least 50 pounds overweight
is risky. But it did suggest that being even as much
as 40 pounds overweight seems to protect people more
from an untimely death than being at a normal weight.
Experts say that seeming contradiction has appeared
in smaller health studies and again challenges the
usefulness of the body-mass index a formula
using height and weight to calculate how heavy a person
should be.
The Center for Consumer Freedom, a restaurant industry-backed
group, responded to the new data with full-page newspaper
ads proclaiming, "Americans have been force-fed a
steady diet of obesity myths by the 'food police,'
trial lawyers and even our own government."
University of Colorado law professor Paul Campos,
whose book "The Obesity Myth" argues that America's
fat obsession is unhealthy, says the new report confirms
that "there's a very wide range of body mass that
is compatible with good health."
The new estimate that obesity kills 25,814 Americans
yearly conflicts with much larger estimates from different
CDC scientists last year.
Newspaper editorials criticized the CDC; some have
even called for the resignation of agency chief Dr.
Julie Gerberding. She co-authored a report last year
suggesting obesity contributes to 400,000 deaths yearly
and her agency used that flawed data to warn that
obesity is becoming a top killer.
The CDC later admitted a calculation error.
Some experts say the new, much lower estimate of
nearly 26,000, published April 20 in the
Journal
of the American Medical Association, is likely
the most accurate. But Gerberding says the CDC won't
use it in its public health campaigns.
Instead, the agency likely will use a range of
obesity mortality estimates while continuing to emphasize
that being too fat contributes to costly health problems
even when it isn't deadly, CDC spokesman Tom Skinner
said.
The CDC "doesn't want to get fixed on a bottom-line
number" because the science behind calculating obesity-related
deaths is evolving, he said.
Dr. Robert Kushner, medical director of Wellness
Institute at Chicago's Northwestern Memorial Hospital,
said calculating death rates from a specific condition
is difficult, especially when people have multiple
ailments like diabetes, heart disease and obesity.
Also, Kushner said, focusing on death rates doesn't
address quality of life and the health problems that
often accompany being overweight and obese
conditions that make people feel lousy even if medication
can sometimes prolong life.
The April 20 report also prompted criticism for
relying on the body-mass index, the government's standard
measure of overweight and obesity.
Using that standard, anyone with a BMI of 25-29
is considered overweight, and a BMI of 30 and above
is obese. That means a 6-foot, 190-pound man is almost
in the overweight zone.
But the height-to-weight ratio doesn't consider
muscle mass, and recent calculations stirred controversy
by proclaiming that based on BMI, sizable numbers
of professional football players and even some basketball
stars are overweight.
"BMI has to be taken with a grain of salt," said
Dr. Samuel Klein, director of Washington University's
Center for Human Nutrition. "People who are more muscular
will have a higher BMI" but are not necessarily overweight.
Greg Penman, a business analyst from Naperville,
Ill., who weighs over 300 pounds, says the conflicting
reports haven't changed his determination to shed
fat.
Already 20 pounds lighter since joining Weight Watchers
in January, Penman said he's sick of not being able
to fit in normal-sized chairs and feeling out of breath.
He says the obesity flap is just the latest example
of "flip-flopping" medical studies.
"I tend to think I've become a little bit numb to
it," said Penman, 31.
A recent editorial in the New Jersey newspaper,
Asbury Park Press, offered a solution.
"How should we respond to these mixed signals? By
ignoring them and using common sense in our eating
and exercise habits," the editorial said.
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On the Net:
JAMA: http://jama.ama-assn.org
CDC: http://www.cdc.gov