sarahmichigan (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
sarahmichigan) wrote2005-03-29 03:08 pm
sarahmichigan) wrote2005-03-29 03:08 pm
The war on obesity is based on overblown rhetoric and not facts
More on food, body image, and exercise:
I mentioned in my last entry that dieting makes you FATTER. This article notes that dieting, especially when started early in life (before age 14), leads to weight GAIN not weight loss:
http://www.berkeley.edu/news/media/releases/2004/06/09_fatdi eting.shtml
To continue with what I've come to believe about food, body image, and exercise:
3. Yo-yo dieting and weight cycling is much more destructive than being moderately overweight.
There is mixed evidence that being fat leads to Type 2 diabetes, but good evidence that chronic dieting is a factor in developing diabetes. Much of our new "diabetes epidemic" is due to better diagnosis and not increased rates of diabetes. Over the course of the 1990s, the incidence of Type 2 diabetes incrased from 8.2 to 8.6 percent while the "obesity" rate rose by 61 percent.
There's no strong evidence that being overweight is a major risk factor for coronary heart disease, but much better evidence that chronic dieting is a factor in heart disease. People who are fat but have steady weights have much lower incidences of heart disease than thinner people who have cycled up and down in their weight. Furthermore, yo-yo dieting is linked to poor heart health:
http://www.med.umich.edu/opm/newspage/2003/yoyodiet.htm
Yo-yo dieting is also linked to poor immune system function and poor mental health:
http://www.msnbc.msn.com/id/5613222/
4. Physical activity level is much better correlated with health and mortality rates than how much you weigh.
-A study in Norway followed 1.8 million people for 10 years and found that the highest life expectancy was found among people with BMI figures between 26 and 28, all of whom are overweight according to current US goverment guidlelines. The lowest life expectancy was found among those who were about 5 pounds "underweight". Those with BMI's between 18 and 20 (currently defined as "ideal") had worse life expectancy rates than people who were 60 to 75 pounds "overweight."
-Another study at Cornell University found that the mortality rate for non-smoking white men in the supposedly ideal BMI range of 19 to 21 was the same as those with BMI's of 29 to 31.
-The data linking obesity to cancer deaths is really shaky. Adults with BMI's of 18.5 to 24.9 had a mortality rate from cancer of 4.5 deaths per 1,000 subjects while those with BMI's of 25 to 29.9 had a rate of 4.4 per 1,000. People who were 35 to 70 pounds "overweight" had a mortality rate of 5.1 per 1,000.
-Contrary to hysterical reports in the media, fat doesn't always, or even often, lead to cancer. At least nine studies have found an association between *increasing* weight and *lower* mortality from cancer of all types. An example, the landmark Seven Countries Study which followed 13,000 men for 40 years found that risk of dying from cancer decreases with increasing weight. The study itself says that "the risk of dying from cancer decreased with increasing relative weight".
-In other studies, the association between *less-than-average* weight and a *higher* overeall cancer mortality remains even when controlling for smoking and for "occult wasting" (i.e. weight loss brought on by a preexisting diesease). Other studies, like the one in the New England Journal of Medicine from 2003 which is often cited in linking fat to cancer, has rather ambiguous results, with only a slighty elevated risk among only the fattest of the subjects and no elevated risk for the moderately "overweight".
-An American Cancer Society Study in the early 1990s showed that weight loss was associated with higher mortality even after screening out smokers and all deaths that took place within a few years of an individual's entry into the study (to screen out people who were losing weight because they were sick with an incurable disease). A follow up to the study found that obese women were better off if they didn't lose weight. Healthy women who intentially lost weight over the span of a year or longer suffered an increased risk of premature death from cancer, heart disease and other causes that was up to 70 percent higher than that of healthy women who didn't intentionally lose weight. A 1999 report on men found similar results.
In conclusion, when you factor out activity levels, obesity itself isn't particularly well correlated with any health condition with the possible exception of putting extra strain on the joints. You're protected from certain conditions and diseases by being slightly HIGHER than average weight (i.e. BMI of 25-28 which is the high end of normal to "overweight"). People with a BMI of 25, which is at the high end of normal, have better mortality rates than those who are at the low end of normal. People who are in the "obese" range of BMI have better mortality rates than people who are 5 pounds underweight.
5. The majority of our dieting obsession is focused on looks and NOT on health.
In 1986, the National Institute for Health panel on obesity ignored nearly all of the data presented to it and declared obesity a health threat, despite presentations showing that people who gained weight as they aged reduced their risk of premature death and that obesity was not related to hardening of the arteries. In 1996 when the FDA held hearings on the weight loss drug fen-phen, they were relying on data from a small trial of the drug that was paid for in part by the drug's manufacturers. Long-term human studies show that almost all of the excess risk associated with obesity can be accounted for by the higher incidence of weight cycling (going up and down) in obese people, and that obese people with stable weights have very little excess risk.
When fen-phen was approved, it was already known that it was linked to fatal lung conditions in many people, but the average weight loss of 7 pounds from taking fen-phen was deemed worth the risk. Later, of course, fen-phen was recalled after dozens of people died or developed permanent heart and lung problems. I hope those people burn in hell.
Even very mainstream dieting organizations have policies that, when examined closely, show that the emphasis is on looks, not health.
For instance, at Weight Watchers, you establish a "range" that's ideal for you. For me, the first time, it was 108 pounds to 128 pounds. Their policies further said that if you were at least 5 pounds over the LOW end of that range, they would help you lose those last 5 pounds. So if I'd come in weighing 115 pounds, they would have helped me lose down to 108 pounds, actually LOWERING my life expectancy, statistically speaking. If they were really interested in health and not taking your money and exploiting your body image issues, they'd tell a 115 pound woman to go away, keep eating healthy, and get some counseling about her distorted body image.
6. Medical studies on inactivity are often misinterpreted to reinforce the idea that being of a higher-than-average weight, in and of itself, is unhealthy.
-"Consider... the claim that fat kills 300,000 Americans per year, and is thus the nation's second leading cause of premature death, trailing only cigarettes. (T)he evidence for this claim is so slim as to be practically nonexistent. (T)he supposed source for this claim was a 1993 medical study that made no such assertion. That study attributed around 300,000 extra deaths per year to sedentary lifestyle and poor dietary habits, not to weight, which was not even evaluated as a risk factor. Indeed the authors of the study, Michael McGinnis and William Foege, became so frustrated by the chronic incorrect citation of their data that in 1998 they published a letter in the New England Journal of Medicine objecting to the misuse of their study."
http://www.opinions3.com/junk_science_about_obesity.htm
-Glenn Gaesser (an obesity researcher) notes that numerous studies-- more than two dozen in the last 20 years alone-- have found that weight loss of this magnitude (10 to 30 pounds) leads to an *increased* risk of premature death, sometimes by an order of several hundred percent. By contrast, during this same time frame only around four studies have found that weight loss leads to *lower* mortality rates."
-Recently, it was noted that the CDC methodology for estimating the health effects of obesity is flawed: A reporter from the Wall STreet Journal originally broke the story about the obesity stats being arrived at incorrectly.
The CDC plans to revise its figures by 9 percent.
http://usgovinfo.about.com/od/healthcare/a/cdcbadstats.htm#
-For more on the debate about "can you be fat but still fit," check this out:
http://www.forbes.com/lifestyle/health/feeds/hscout/2004/09/07/hscout521087.html
The study found that exercise, regardless of weight loss, improved heart health, but exercise without weight loss didn't affect diabetes or blood sugar levels. My criticisms are as follows:
This is a study of correlation, and we can't be sure of causation. Gaining body muscle is associated with your body handling sugar and insulin better, so I would be really surprised if people who exercise but don't focus on weight loss don't also reduce their risk of developing diabetes.
From an abstract on the diabetes/obesity study linked above:
The multivariate-adjusted HRs were 1.15 (95% CI, 0.83-1.59) for normal-weight inactive, 3.68 (95% CI, 2.63-5.15) for overweight active, 4.16 (95% CI, 3.05-5.66) for overweight inactive. . .
The rates for "overweight" people weren't that much higher than people of "normal" weight, until you reached the "obese" category-- then it jumped up quite a bit.
I would not argue that being at a BMI of 35 or higher is healthy for you, but I think people are far too freaked out about being 10-15 pounds over their "ideal" weight.
I also wonder if the study separated out people who only did cardio work from people who did weight-training, since building muscle mass is associated with your body handling insulin and blood sugar better. I also wonder if a higher rate of yo-yo dieting among the bigger participants could be a factor they didn't control for. Many studies show that rapid weight cycling is a better indicator of developing certain health conditions (heart problems & high blood pressure, for instance) than being overweight but maintaining a steady weight.
Glenn Gaesser is skeptical that obesity in and of itself has a great deal of impact on diabetes, when you factor out activity level. He cited a study in one of his books in which two groups tried to get their diabetes or borderline diabetes under control. One group (A) focused on losing 10 percent of their body weight. Another group (B) learned how to make better food choices and were encouraged to exercise. Almost no one in the B group lost any weight, but both groups improved their blood sugar levels. Almost every in the A group gained back the weight, and lost the blood sugar benefits. Most of the people in the B group kept exercising and maintained their gains in that area.
A link to an article by Gaesser asserts that the medical risks of obesity are greatly exaggerated (not non-existent, though). He also notes what I've commented on previously, that there's good reason to believe that traditional calorie-counting dieting promotes weight GAIN. There's also a reference to the study I mentioned that showed that increased activity DID have a strong impact on blood sugar levels, independent of weight loss.
http://www.hhpr.org/currentissue/fall2003/gaesser.php
I mentioned in my last entry that dieting makes you FATTER. This article notes that dieting, especially when started early in life (before age 14), leads to weight GAIN not weight loss:
http://www.berkeley.edu/news/media/releases/2004/06/09_fatdi eting.shtml
To continue with what I've come to believe about food, body image, and exercise:
3. Yo-yo dieting and weight cycling is much more destructive than being moderately overweight.
There is mixed evidence that being fat leads to Type 2 diabetes, but good evidence that chronic dieting is a factor in developing diabetes. Much of our new "diabetes epidemic" is due to better diagnosis and not increased rates of diabetes. Over the course of the 1990s, the incidence of Type 2 diabetes incrased from 8.2 to 8.6 percent while the "obesity" rate rose by 61 percent.
There's no strong evidence that being overweight is a major risk factor for coronary heart disease, but much better evidence that chronic dieting is a factor in heart disease. People who are fat but have steady weights have much lower incidences of heart disease than thinner people who have cycled up and down in their weight. Furthermore, yo-yo dieting is linked to poor heart health:
http://www.med.umich.edu/opm/newspage/2003/yoyodiet.htm
Yo-yo dieting is also linked to poor immune system function and poor mental health:
http://www.msnbc.msn.com/id/5613222/
4. Physical activity level is much better correlated with health and mortality rates than how much you weigh.
-A study in Norway followed 1.8 million people for 10 years and found that the highest life expectancy was found among people with BMI figures between 26 and 28, all of whom are overweight according to current US goverment guidlelines. The lowest life expectancy was found among those who were about 5 pounds "underweight". Those with BMI's between 18 and 20 (currently defined as "ideal") had worse life expectancy rates than people who were 60 to 75 pounds "overweight."
-Another study at Cornell University found that the mortality rate for non-smoking white men in the supposedly ideal BMI range of 19 to 21 was the same as those with BMI's of 29 to 31.
-The data linking obesity to cancer deaths is really shaky. Adults with BMI's of 18.5 to 24.9 had a mortality rate from cancer of 4.5 deaths per 1,000 subjects while those with BMI's of 25 to 29.9 had a rate of 4.4 per 1,000. People who were 35 to 70 pounds "overweight" had a mortality rate of 5.1 per 1,000.
-Contrary to hysterical reports in the media, fat doesn't always, or even often, lead to cancer. At least nine studies have found an association between *increasing* weight and *lower* mortality from cancer of all types. An example, the landmark Seven Countries Study which followed 13,000 men for 40 years found that risk of dying from cancer decreases with increasing weight. The study itself says that "the risk of dying from cancer decreased with increasing relative weight".
-In other studies, the association between *less-than-average* weight and a *higher* overeall cancer mortality remains even when controlling for smoking and for "occult wasting" (i.e. weight loss brought on by a preexisting diesease). Other studies, like the one in the New England Journal of Medicine from 2003 which is often cited in linking fat to cancer, has rather ambiguous results, with only a slighty elevated risk among only the fattest of the subjects and no elevated risk for the moderately "overweight".
-An American Cancer Society Study in the early 1990s showed that weight loss was associated with higher mortality even after screening out smokers and all deaths that took place within a few years of an individual's entry into the study (to screen out people who were losing weight because they were sick with an incurable disease). A follow up to the study found that obese women were better off if they didn't lose weight. Healthy women who intentially lost weight over the span of a year or longer suffered an increased risk of premature death from cancer, heart disease and other causes that was up to 70 percent higher than that of healthy women who didn't intentionally lose weight. A 1999 report on men found similar results.
In conclusion, when you factor out activity levels, obesity itself isn't particularly well correlated with any health condition with the possible exception of putting extra strain on the joints. You're protected from certain conditions and diseases by being slightly HIGHER than average weight (i.e. BMI of 25-28 which is the high end of normal to "overweight"). People with a BMI of 25, which is at the high end of normal, have better mortality rates than those who are at the low end of normal. People who are in the "obese" range of BMI have better mortality rates than people who are 5 pounds underweight.
5. The majority of our dieting obsession is focused on looks and NOT on health.
In 1986, the National Institute for Health panel on obesity ignored nearly all of the data presented to it and declared obesity a health threat, despite presentations showing that people who gained weight as they aged reduced their risk of premature death and that obesity was not related to hardening of the arteries. In 1996 when the FDA held hearings on the weight loss drug fen-phen, they were relying on data from a small trial of the drug that was paid for in part by the drug's manufacturers. Long-term human studies show that almost all of the excess risk associated with obesity can be accounted for by the higher incidence of weight cycling (going up and down) in obese people, and that obese people with stable weights have very little excess risk.
When fen-phen was approved, it was already known that it was linked to fatal lung conditions in many people, but the average weight loss of 7 pounds from taking fen-phen was deemed worth the risk. Later, of course, fen-phen was recalled after dozens of people died or developed permanent heart and lung problems. I hope those people burn in hell.
Even very mainstream dieting organizations have policies that, when examined closely, show that the emphasis is on looks, not health.
For instance, at Weight Watchers, you establish a "range" that's ideal for you. For me, the first time, it was 108 pounds to 128 pounds. Their policies further said that if you were at least 5 pounds over the LOW end of that range, they would help you lose those last 5 pounds. So if I'd come in weighing 115 pounds, they would have helped me lose down to 108 pounds, actually LOWERING my life expectancy, statistically speaking. If they were really interested in health and not taking your money and exploiting your body image issues, they'd tell a 115 pound woman to go away, keep eating healthy, and get some counseling about her distorted body image.
6. Medical studies on inactivity are often misinterpreted to reinforce the idea that being of a higher-than-average weight, in and of itself, is unhealthy.
-"Consider... the claim that fat kills 300,000 Americans per year, and is thus the nation's second leading cause of premature death, trailing only cigarettes. (T)he evidence for this claim is so slim as to be practically nonexistent. (T)he supposed source for this claim was a 1993 medical study that made no such assertion. That study attributed around 300,000 extra deaths per year to sedentary lifestyle and poor dietary habits, not to weight, which was not even evaluated as a risk factor. Indeed the authors of the study, Michael McGinnis and William Foege, became so frustrated by the chronic incorrect citation of their data that in 1998 they published a letter in the New England Journal of Medicine objecting to the misuse of their study."
http://www.opinions3.com/junk_science_about_obesity.htm
-Glenn Gaesser (an obesity researcher) notes that numerous studies-- more than two dozen in the last 20 years alone-- have found that weight loss of this magnitude (10 to 30 pounds) leads to an *increased* risk of premature death, sometimes by an order of several hundred percent. By contrast, during this same time frame only around four studies have found that weight loss leads to *lower* mortality rates."
-Recently, it was noted that the CDC methodology for estimating the health effects of obesity is flawed: A reporter from the Wall STreet Journal originally broke the story about the obesity stats being arrived at incorrectly.
The CDC plans to revise its figures by 9 percent.
http://usgovinfo.about.com/od/healthcare/a/cdcbadstats.htm#
-For more on the debate about "can you be fat but still fit," check this out:
http://www.forbes.com/lifestyle/health/feeds/hscout/2004/09/07/hscout521087.html
The study found that exercise, regardless of weight loss, improved heart health, but exercise without weight loss didn't affect diabetes or blood sugar levels. My criticisms are as follows:
This is a study of correlation, and we can't be sure of causation. Gaining body muscle is associated with your body handling sugar and insulin better, so I would be really surprised if people who exercise but don't focus on weight loss don't also reduce their risk of developing diabetes.
From an abstract on the diabetes/obesity study linked above:
The multivariate-adjusted HRs were 1.15 (95% CI, 0.83-1.59) for normal-weight inactive, 3.68 (95% CI, 2.63-5.15) for overweight active, 4.16 (95% CI, 3.05-5.66) for overweight inactive. . .
The rates for "overweight" people weren't that much higher than people of "normal" weight, until you reached the "obese" category-- then it jumped up quite a bit.
I would not argue that being at a BMI of 35 or higher is healthy for you, but I think people are far too freaked out about being 10-15 pounds over their "ideal" weight.
I also wonder if the study separated out people who only did cardio work from people who did weight-training, since building muscle mass is associated with your body handling insulin and blood sugar better. I also wonder if a higher rate of yo-yo dieting among the bigger participants could be a factor they didn't control for. Many studies show that rapid weight cycling is a better indicator of developing certain health conditions (heart problems & high blood pressure, for instance) than being overweight but maintaining a steady weight.
Glenn Gaesser is skeptical that obesity in and of itself has a great deal of impact on diabetes, when you factor out activity level. He cited a study in one of his books in which two groups tried to get their diabetes or borderline diabetes under control. One group (A) focused on losing 10 percent of their body weight. Another group (B) learned how to make better food choices and were encouraged to exercise. Almost no one in the B group lost any weight, but both groups improved their blood sugar levels. Almost every in the A group gained back the weight, and lost the blood sugar benefits. Most of the people in the B group kept exercising and maintained their gains in that area.
A link to an article by Gaesser asserts that the medical risks of obesity are greatly exaggerated (not non-existent, though). He also notes what I've commented on previously, that there's good reason to believe that traditional calorie-counting dieting promotes weight GAIN. There's also a reference to the study I mentioned that showed that increased activity DID have a strong impact on blood sugar levels, independent of weight loss.
http://www.hhpr.org/currentissue/fall2003/gaesser.php