Overweight: The New Normal

A study in the current Journal of the American Medical Association suggests that overweight people are not really overweight. Analyzing data from the National Health and Nutrition Examination Survey, researchers at the CDC and the National Cancer Institute found that mortality is lowest among people the government considers "overweight" and highest among the extremely obese. People of "normal" weight had a higher death rate than people who were a little fatter.

That is very different from the findings of earlier studies, one of which was described in a front-page New York Times story headlined "Even Moderate Weight Gains Can Be Deadly." The new study also differs sharply with previous estimates of premature deaths due to excessive weight. Other researchers at the CDC had put the number at 400,000 a year, which was later downgraded to 365,000 because of a calculation error. The new study ties about 112,000 deaths to obesity but finds that extra pounds in the "overweight" range prevent about 86,000 deaths a year, leaving a net loss of 26,000 or so--lower than the 34,000 deaths tied to being "underweight" (i.e., below "normal").

"Counting deaths is not an exact science," says the CDC's chief science officer. No kidding.

Since the alleged death toll of several hundred thousand has been repeatedly cited to justify a paternalistic crusade against overeating, I'd like to believe the new numbers are more accurate than the old ones. But I don't really know. The important point is that neither does the government, notwithstanding the confident pronouncements of public health officials.

Policy implications aside, the suggestion that health risks from excess weight don't show up until you're really, really fat should come as a relief to those of us who tend to toggle between "normal" and "overweight." Then again, the possibility that a few extra pounds are protective may force us to choose between health and vanity.

Comments

sage | April 20, 2005, 10:14am | #

When people tell you that your ass looks like two pigs fighting over a milk dud, you need to drop a few pounds, healthy or no.

too many steves | April 20, 2005, 10:16am | #

Dammit! This means that my enviable BMI of 23 yesterday is now putting me at a higher risk for premature death?!? Dammit!

Fortunately there is a cure and its name is "Eating and Drinking".

I think I'll sell the Weight Watchers stock and buy McDonalds.

joe | April 20, 2005, 10:25am | #

This isn't saying that being overweight, as most people would define it, is healthy. Just that the standards the government was using to define overweight were too stringent.

If your ass looks like two pigs fighting over a milk dud, you probably are courting health problems.

Ron Hardin | April 20, 2005, 10:26am | #

The new http://www.mypyramid.gov site to discover your personal diet recommendations doesn't work with Netscape 4.08, sentencing late-adopters to certain early death, a wholesome house-cleaning if you ask me.

Number 6 | April 20, 2005, 10:40am | #

The best part of the NYTimes story was the paragraph stating that being too skinny "increases the risk of death."

Last I heard, the risk of death was 100%.

Eryk Boston | April 20, 2005, 10:43am | #

Since the weight in question in government health statistics doesn't differentiate between fat weight and muscle weight I'd be willing to venture that the extra health gained by those with a few extra pounds applies mostly to those whose few extra pounds are in the form of muscle gained by regular exercise.

Rhywun | April 20, 2005, 10:43am | #

Doesn't work with Maxthon either.

Sandy | April 20, 2005, 10:44am | #

I would love to shadow the researchers (and even better, the bureacrats who implement the research recommendations) to see if they come close to the number of cups (!) of vegetables they recommend each week. I seriously doubt anybody but a handful of fanatics get anywhere close to those proportions in America -- or, since they downplay rice and bread, in the world.

Eryk Boston | April 20, 2005, 10:45am | #

Wow, 52 words in one sentence. The quality of my BS is improving.

Pigs is Pigs | April 20, 2005, 10:48am | #

See, this is what I love. You go on day after day, and Joe is Joe and then a day like today comes along and he is completely the guy with the answer.

Too many Steves - what's the source of your BMI? It it's eating well, then you're in no danger.

Ironchef | April 20, 2005, 10:54am | #

Pigs - check out the CDC website.

I somewhere that according to those calculations, Shaq is "obese", and Brad Pitt is "overweight".

The bigger problem is inactivity, regardless of weight. Active, fat people are much healthier than inactive, skinny people.

too many steves | April 20, 2005, 11:00am | #

A diet heavy on cheap whiskey and hand-rolled cigarettes. Oh, and genetics; I'm among the heavier males in my family.

js | April 20, 2005, 11:20am | #

The usual explanation for this type of data is skinny people with wasting diseases. But we just don't have enough information either way here.

And yea ... more people look like Brad Pitt or Shaq than like they have a few extra pounds ... right ... (actually most people don't look particularly overweight to me .. but come on ... you see more chubby people than Shaqs).

The government crusade to get people to eat healthy (or whatever they consider healthy) may be paternalistic but I question whether it can ever be *entirely* parternalistic since healthy eating can be helped by this or that factor but ultimately requires some significant personal willpower. Perhaps they intend to replace personal willpower with social (ie peer) pressure. Well it won't be without forseeable unintended consequences.

ChicagoTom | April 20, 2005, 12:03pm | #

Is there really a debate about the merits of being fit vs. being obese?

I think a paper that said "being obese is bad --- dont be obese." would have ben sufficient.

I think the conclusion was the best part :
"Underweight and obesity, particularly higher levels of obesity, were associated with increased mortality relative to the normal weight category."

Well no shit?!?! If you are underweight or obese you run a higher risk of dying but if you are normal (normal I guess is "average" weight and "slightly above average weight")

And let's not even get started talking about where the line between overweight and obese is drawn

*THIS* is a waste of money

NoStar | April 20, 2005, 12:06pm | #

If "your ass looks like two pigs fighting over a milk dud, you need to drop a few pounds, healthy or no", I would suggest you also have a serious dingle-berry problem. Buy some Wet-Wipes.

Lowdog | April 20, 2005, 12:10pm | #

js - what are you talking about? The government has been all about downplaying the role of personal responsibility for years by replacing it with social pressure. Where have you been?

Rick Barton | April 20, 2005, 12:25pm | #

Yeah, as js mentioned; 1) Dying folks often lose weight prior to their actual expiration. Also, 2)People tend to put on weight as they age. Did the study correct for these trends?

Of course, it's still hard to explain: "People of "normal" weight had a higher death rate than people who were a little fatter"., within the "thinner is better" paradigm unless it can be accounted for by trend #1.

It's my understanding that folks who are older than 100 have one medical parameter in common. More than their cholesterol levels, or anything else, folks that live to >100 have low insulin levels. And low insulin levels are associated with thinness. How often do you see really old plump people?

Rick Barton | April 20, 2005, 12:34pm | #

...Forgot to add: Doesn't it seem that most exceedingly old people are quite thin?

thoreau | April 20, 2005, 1:13pm | #

You know, I honestly have no idea what the ideal weight is. I'm not terribly shocked that the most recent recommendations are being called into question, especially given the hysteria that the recommendations have prompted.

So maybe the most recent recommendations are overly stringent. Or maybe they aren't.

One thing to keep in mind is that I don't think living to 100 is necessarily the goal to keep in mind when making such recommendations. Reducing the incidence of the diseases most directly linked to weight seems more reasonable.

Neil Lindsey | April 20, 2005, 1:51pm | #

It amazes me that this study made no apparent distinctions based on body composition; a muscular, active person will likely have a lower risk of health-related death than a fat, inactive person of the same weight.

Randolph Carter | April 20, 2005, 2:05pm | #

any model of the "ideal weight" is total crap. I am 6 foot 3 and have a large build. I play college football and rugby. According to the CDC, I should weigh 185 lbs. I'm about 100 lbs "overweight," but for some reason, I'm healthy and in good cardio shape. How could that be? The obesity problem is a great example of why gov't solutions usually don't work: there's no one-size-fits-all (haha) fix or standard for any problem, and when the feds try to use a blanket solution, it inevitably screws someone.

dhex | April 20, 2005, 2:17pm | #

so has anyone come up with an alternate to the BMI calculator that takes into consideration muscle mass or just general frame?

Randolph Carter | April 20, 2005, 2:26pm | #

Body fat percentage. It's the most reliable way to check how fit you are.

Tom Maguire | April 20, 2005, 3:05pm | #

The researchers are at least aware of the confounding issue caused by folks with wasting diseases showing up in the "Skinny but dead" category. From the third paragraph:

And being very thin, even though the thinness was longstanding and unlikely to stem from disease, caused a slight increase in the risk of death, the researchers said.

I like the suggestion above, that some of the "overweight" people are just jocks. BTW, First Fitness Maniac George Bush (6 ft, 190) cracks the "overweight" range.

independent worm | April 20, 2005, 3:21pm | #

"Last I heard, the risk of death was 100%."

True dat!! (sorry, just got back from looking at freevibe.com). Remember:

on a long enough timeline, the survival rate for everyone drops to zero.

Whenever i hear about somebody whose life was "saved" I think: no it wasn't. They just prolonged the wait until their inevitable death.

Alan | April 20, 2005, 3:22pm | #

This just goes to show that it's best to leave eternal verities to the Pope. When it come to health advice, today's dogma is tomorrow's heresy, so anybody who gets dogmatic about health is nuts. And anyway, how often do you see people over ninety who don't drool and wear diapers? Eat, play chess, and be merry.

Seamus | April 20, 2005, 3:43pm | #

"People in the twentieth century believed that cigarettes and red meat were unhealthy, the exact opposite of what we now know to be true."

Randolph Carter | April 20, 2005, 4:19pm | #

Is that from "Sleeper"?

Stevo Darkly | April 20, 2005, 5:28pm | #

Think so.

Rick Barton | April 21, 2005, 12:30am | #

"Fatness, Despite Fitness, Is Linked With Cardiovascular Risk Factors"

http://www.sciencedaily.com/releases/2005/04/050419105030.htm

Alan | April 21, 2005, 2:14am | #

"Life, despite fitness, is linked with fatal risk factors"

http://www.livewelldiehealthy.com

Rick, send your move!