– Obesity: Epidemic or Myth?

Is Obesity’s mal-effects a myth or reality? Here is a contrarian take on how obesity can affect health!

Between 1976 and 1991 the prevalence of overweight and obesity in the United States increased by about 31 percent (Heini and Weinsier 1997), then between 1994 and 2000 it increased by another 24 percent (Flegal et al. 2002). This trend, according to a 2004 analysis, shows little sign of slowing down (Hedley et al. 2004). The fact that more of us are getting fatter all the time raises a significant public health concern. The Centers for Disease Control and Prevention (CDC) began calling the problem an epidemic in the beginning of this decade as the result of research that estimated 280,000 annual deaths as a consequence of obesity (Allison et al. 1999). Since then there has been a strong media campaign devoted to convincing Americans to lose weight. In 2003, Dr. Julie Gerberding, the director of the CDC, made a speech claiming that the health impact of obesity would be worse than the influenza epidemic of the early twentieth century or the black plague of the Middle Ages. In 2004 the campaign reached a fever pitch when a report was released that increased the estimate of obesity-related deaths to 400,000 (Mokdad et al. 2004). Finally, in March of this year, a report appeared in the New England Journal of Medicine that predicted a decline in life expectancy in the United States as a direct result of obesity (Olshansky, et al. 2005).

Despite the assertions that obesity is causing our society great harm, however, many scientists and activist groups have disputed the level of danger that it actually poses. Indeed, a recent analysis presented in the Journal of the American Medical Association (JAMA) by Katherine Flegal of the CDC and her colleagues calls the severity of the dangers of excess body fat into question, indicating that the number of overweight and obesity-related deaths is actually about 26,000—about one fifteenth the earlier estimate of 400,000 (Flegal et al. 2005).

There is little argument about the fact that, as a nation, more of us are fatter than ever before; the disagreement lies in the effect that this has on our health. The campaign to convince us to lose weight gained much of its momentum in 2004; not only were there high-profile public health initiatives devoted to stopping the obesity epidemic, but the idea had pervaded popular culture as well. Movies like Morgan Spurlock’s Super Size Me were the topic of many a discussion, and there were regular news reports about the dangers of too much fat.

During this campaign, however, there were some notable dissenters. Paul Ernsberger, a professor of nutrition at Case Western Reserve University, has been doing research since the 1980s that led him to assert that obesity is not the cause of ill health but rather the effect of sedentary living and poor nutrition, which are the actual causes. Another prominent researcher, Steven Blair, director of the Cooper Institute of Aerobics Research in Dallas, Texas, has been an author on several studies indicating that the risks associated with obesity can be significantly reduced if one engages in regular physical activity, even if weight loss is not present. According to Blair, weight loss should not be ignored but a greater focus should be placed on physical activity and good nutrition. Both Ernsberger and Blair indicated to me that they thought the new research by Flegal and her colleagues provides a more accurate picture of the mortality risk associated with obesity.

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