Is The Obesity Epidemic Overstated?

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Main Category: Obesity / Weight Loss / Fitness
Also Included In: Nutrition / Diet;  Eating Disorders;  Public Health
Article Date: 06 Feb 2008 - 0:00 PDT

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The debate over whether or not we are actually too obese continues in a recent article published in BMJ.

Researchers Patrick Basham and John Luik maintain that current scientific evidence is too uncertain to conclude that obesity is an epidemic. In the United States, the average population increase in weight over the past 42 years is 10.9 kg, or 0.26 kg per year. However, there have been no significant changes reported in obesity or overweight prevalence among US adults or in overweight prevalence among children between 1999-2000 and 2001-2002.

Arguing that obesity is exaggerated, Basham and Luik state that evidence regarding the link between body mass index (BMI) and death is not consistent with the category bands for normal, overweight, and obese. Supporting this claim, they refer to the study responsible for obesity and overweight categories and note that risk of death for men with a BMI of 19-21 was equal to that of obese or overweight men with a BMI of 29-31 - normal BMI is from 18.5 to 25. The authors also cite studies that have shown very small differences between death rates and BMI.

Further, the authors remark that the relationship between obesity and risks of certain diseases is not clear - life expectancy continues to increase even though the current levels of overweight and obesity are supposedly atypical. In addition, the authors propose that in the interests of health, professionals may have both overstated risks of overweight and obesity and exaggerated the community's ability to avoid and treat the conditions on a population-wide basis. They conclude that this deliberate exaggeration does a disservice for science and medical policy that is based on evidence.

On the other side of the debate are Robert Jeffery and Nancy Sherwood who support the notion that obesity is a scientifically-supported serious health problem. They refer to evidence that has shown an increase in obesity among 6-11 year-old Americans from 6.5% in 1976-80 to 19% in 2003-4. Similarly, among 12-17 year old Americans, 5% were obese in 1976-80 compared to 17% in 2003-4. In addition, they expect the number of overweight and obese children in Europe to increase at a rate of 1.3 million per year by 2010.

Jeffery and Sherwood argue that research has supported a serious and well-established relationship between obesity and risks of health conditions such as hypertension, diabetes, heart disease, and certain forms of cancer.

It has also been established in economic and epidemiological studies that obesity is related to a significant share of current healthcare costs and is likely to increase. The authors point to other studies that suggest a possible fall in US life expectancy in the 21st century.

To conclude, Jeffery and Sherwood believe that the declaration of obesity as an epidemic is a "more prudent scientific and policy choice." They acknowledge the research showing obesity as a major global health problem and state that a rise in obesity coupled with ineffectual treatment will most likely result in a poor public health outcome unless researchers are projecting incorrectly or more effective public health measures are introduced.

Is the Obesity Epidemic Exaggerated?
Patrick Basham, John Luik, R W Jeffery, N E Sherwood
BMJ, Volume 336, pp 244-5, February 2, 2008
doi:10.1136/bmj.39458.495127.AD

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Written by: Peter M Crosta, MA
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