Saturday, May 22, 2004
The Obesity Contrarian
Today the World Health Organization decided to initiate a global campaign against obesity. Is this a good idea?
Until recently, increased average weight was beneficial for health -- undernourishment was a much more pressing concern than obesity from a public health perspective. This may still be the case in most countries today. In rich countries, however, undernourishment is no longer as severe, while obesity rates have risen. The US has seen major increases in obesity for 40 years, with the bulk of the increase occurring in the last two decades. In March, the US Centers for Disease Control and Prevention released a report claiming that some 400,000 deaths per year were associated with obesity. Surely such carnage should put obesity near the top of our public health concerns.
Or maybe not. Paul Campos, for one, isn't buying it, as indicated by the title of his recent book, The Obesity Myth. An edited excerpt appeared last month in The Guardian, and is available on-line here.
Campos suggests that the standard measure of obesity, the Body Mass Index (BMI), is itself quite flawed. The index is computed by taking your weight measured in kilograms and dividing it by the square of your height measured in meters. A BMI of 25 or more is generally interpreted as signalling an "overweight" condition, while BMIs of 30 or above are generally interpreted to signal "obesity". But as Campos points out, this crude measure leads to absurd results in individual cases: "According to the public health establishment's current BMI definitions, Brad Pitt, Michael Jordan and Mel Gibson are all 'overweight', while Russell Crowe, George Clooney and baseball star Sammy Sosa are all 'obese'." Campos also argues that the scientific evidence does not support the contention that a BMI above 25 is bad for one's health -- though those who are quite obese, with BMI's in the mid-30s and above, are at increased health risk. There is much more to Campos's critique, including a look at those parties (medical and pharmaceutical industries) that would seem to have a pecuniary interest in hyping the dangers of obesity, and the class origins of America's current anti-fat crusade: "The disgust the thin upper classes feel for the fat lower classes has nothing to do with mortality statistics and everything to do with feelings of moral superiority." I highly recommend The Guardian excerpt for those who would like to develop a fuller understanding of Campos's position.