Wednesday, Jul 13, 2011

According to peer-reviewed studies in the Journal of the American Medical Association by U.S. CDC-sponsored medical researchers:

Excess Deaths/year (Underweight) [Generally at a later age] = 33,746
Excess Deaths/year (Fat) = Obese (111,909) + Overweight (−86,094) = 25,815
=> Excess Deaths/year (Underweight) > Excess Deaths/year (Fat) & "Overweight" is not all bad (−86,094) compared to "normal" weight.

We estimated relative risks of mortality associated with different levels of BMI [body mass index, calculated as weight in kilograms divided by the square of height in meters; underweight < 18.5, overweight 25 to < 30, obese >= 30 in the United States in 2000] from the nationally representative National Health and Nutrition Examination Surveys.

We found significantly increased all-cause mortality in the underweight and obese categories and significantly decreased all-cause mortality in the overweight category compared with normal weight.

Obesity (BMI >= 30) was associated with 111,909 excess deaths... and underweight with 33,746 excess deaths. Overweight was not associated with excess mortality: −86,094 deaths.

The more recent data from NHANES II and NHANES III suggest the possibility that improvements in medical care, particularly for cardiovascular disease, the leading cause of death among the obese, and its risk factors may have led to a decreased association of obesity with total mortality... Life expectancy [in the United States] increased from 73.7 years in 1980 to 75.4 years in 1990 to 77.0 years in 2000 and continues to increase.

Of the 111,909 estimated excess deaths associated with obesity the majority, 84,145 excess deaths, occurred in individuals younger than 70 years. In contrast, of the 33,746 estimated excess deaths associated with underweight, the majority, 26,666 excess deaths, occurred in individuals aged 70 years and older.

Excess Deaths Associated With Underweight, Overweight, and Obesity, Flegal et al, Journal of the American Medical Association, April 20, 2005, http://jama.ama-assn.org/content/293/15/1861.full.pdf.

Underweight was associated with significantly increased mortality from noncancer, non-CVD causes (23,455 excess deaths)... but not associated with cancer or CVD mortality. Overweight was associated with significantly decreased mortality from noncancer, non-CVD causes (−69 299 excess deaths) but not associated with cancer or CVD mortality. Obesity was associated with significantly increased CVD mortality (112,159 excess deaths) but not associated with cancer mortality or with noncancer, non-CVD mortality. In further analyses, overweight and obesity combined were associated with increased mortality from diabetes and kidney disease (61,248 excess deaths) and decreased mortality from other noncancer, non-CVD causes (−105,572 excess deaths).

Cause-Specific Excess Deaths Associated With Underweight, Overweight, and Obesity, Glegal et al, Journal of the American Medical Association, November, 2007, http://jama.ama-assn.org/content/298/17/2028.full.pdf.

It is important to go back to the 1995 World Health Organization report that helped establish the idea that a person is overweight with a BMI of 25. This document probably had more impact on determining how obesity was defined than anything else. And who wrote this important document? Most of it was drafted and written under the auspices of the International Obesity Task Force (IOTF). On the surface, the IOTF seems to be a credible association of scientists interested in obesity research and policy....

In reality, however, the IOTF is anything but an unbiased congress of scientists. The IOTF is an organization primarily funded by Hoffman-LaRoche (the maker of the weight-loss drug Xenical) and Abbott Laboratories (the maker of the weight-loss drug Meridia). Like other organizations financed primarily by drug companies that don the “neutral” mantle of science (including the American Obesity Association) the primary mission of the IOTF is to lobby governments and advance particular scientific agendas that coincide with the pharmaceutical industry’s goals. Indeed, the initial mission of the IOTF was to get the lower BMI standards imposed on the WHO report. Few realize that the effort to establish a world-wide standard for what is overweight and obese was sponsored primarily by a company that makes a weight-loss pill.

The IOTF's chair, British nutritionist Philip James, typifies this conflict of interest. James, a well-regarded scientist, also has many financial links to the pharmaceutical industry. He has been amply paid for conducting clinical trials of Sibutramine (Meridia) and Orlistat (Xenical). He also engages in regular promotional activities for Hoffman-La Roche and Knoll Pharmaceuticals, offering regular praise of their products in press releases.

It is difficult to find any major figure in the field of obesity research or past president of the North American Association for the Study of Obesity who does not have some type of financial tie to a pharmaceutical or weight-loss company...

Unlike the mostly thin doctors and academic health researchers... whom I interviewed for this book... when I ask fat activists... what they would do about the obesity epidemic, they give a relatively simple and straightforward answer. Rather than continuing this mad and pointless effort to either fight our biology or stifle the free market, the best way to get over our weight problem is to stop worrying so much about our weight... After all, the science... shows no clear evidence that excess fat is, by itself, harmful for most Americans.

Fat Politics: The Real Story behind America's Obesity Epidemic, J. Eric Oliver, 2005, http://www.amazon.com/Fat-Politics-Americas-Obesity-Epidemic/dp/0195169360.