On Fatness & Health

Perhaps because I read Gary Schwitzer's blog and quality assessment project so avidly, I am somewhat down on the quality of much health journalism, in the West, at least.  But every now and then, I read a terrific article that renews my faith.  One such article, authored by Margaret Wente, appeared in the Globe and Mail, a Toronto-based publication.  The article takes an unusually (for media, I think) critical look at the epistemology of the fatness-health connections.  It is quite well-written, and while I do not endorse the entire article, I absolutely appreciate the critical tone of the writing and the arguments adduced therein.  The article models, in many ways, some of the best and most persuasive academic writings in the critical obesity scholarship.

Some excerpts:

Thin was always in. But now, the social and public-health message is that fat is not simply a sign of sloth. It kills. The obesity epidemic is the greatest health crisis of the age. According to various health statistics (which are never consistent), between 17 per cent and 25 per cent of Canadian adults are obese. Thirty-six per cent of the adult population is overweight, or maybe two-thirds. Whatever. It's a catastrophe.

But is it? A new study based on Statistics Canada population data reaches an exceedingly awkward conclusion: People who are overweight live longer than people who are classified as “normal” weight. Not only that, people who are classified as significantly overweight also live longer.

(For the record, thin was most assuredly not always "in."  Quite the contrary, in fact.  But it has been so for much of the 20th century, at least in the U.S.)

[ . . . ]

“Overweight may not be the problem we thought it was,” said David Feeny, a senior investigator at Kaiser Permanente Center for Health Research in Oregon, almost apologetically. “Overweight was protective.” He added that agencies such as Health Canada might want to rethink the way they classify people's weight.

It is remarkable to see an academic investigator working on obesity research publicly allow as such.  Perhaps there is hope.  Indeed, as Wente notes,

Is this study just a fluke? On the contrary. It confirms the findings of dozens of other large population studies that rarely get publicity. They all conclude that being overweight is not a problem, except at the extreme. In fact, a little extra padding is good for you.

Many of these studies are documented in Gard and Wright's fine book on the subject.  Last excerpt:

In 2005, another researcher, Katherine Flegel, of the U.S. Centers for Disease Control and Prevention, published another large study with similar findings. Prominent health experts were outraged, calling the research flawed. “There's not a lot of money in trying to debunk obesity, but a huge amount in making sure it stays a big problem,” Patrick Basham, a professor of health-care policy at Johns Hopkins University, told The Associated Press.

Indeed.  

Go read the whole thing.  Thoughts?

(h/t SDOH Listserv) 

Comments

[Marilyn Mann]

See also the recent review article in the Journal of the American College of Cardiology (JACC) on Obesity and Cardiovascular Disease. Overweight and obesity is a risk factor for CVD but among people with established CVD overweight and obesity is associated with a better prognosis (I'm simplifying; read the article for details).