I knew this would happen...

Sigh.

People were a bit surprised by the recent results of a CDC study which adjusted the number of excess deaths due to being overweight down from 400k per year to 25k per year. This was due in part to the fact that the first study from which the 400k number was taken was from the results of surveys taken primarily during the 70's while the recent study took information from 3 surveys spanning a greater and more recent timeframe.

Another surprise was that being somewhat overweight produced less excess deaths relative to the normal BMI range. As such, it should thus be noted that being obese (BMI>30) resulted in over 100k excess deaths, so obesity is still a major problem.

But due to these two facts, I knew that media irresponsibility with reporting the findings and pundits crowing about being free from food anxiety and not being a slave to the gym would commence immediately. And it has.

Check out this Times article... note the headline of "Some Extra Heft May Be Helpful, New Study Says." Bullshit... the study does not conclude that. There's not a damn place in that study that suggests that "extra heft" is a good thing. Some folks in some of the articles I have read speculate about the positive effects that some extra weight might have on folks 70 or older, but there is nothing in there advocating for extra weight. What a crock of shit.

Or how about this one from USA Today: check out the caption next to the picture of “The CDC estimated that obesity accounts for more than 25,000 deaths a year.” Wrong, wrong, wrong… that number is the total combined of BMI 25-30 and BMI >30. The number due to the category of obese (BMI>30) alone is over 100k.

And then John Tierney from the Times op-ed page drops this load of crap. No John, the study does not say thin healthy people have a larger relative risk of excess death… the category you are referring to is for underweight people. Yes John, there are several industries that have a vested interest in one side of the obesity equation or the other, but the problem of obesity is not exactly washed away here as you seem so intent on portraying it. I will say that there are people who take diet and exercise to an extreme, but “hard bodies… die young?”… what a chode.

Lost amid all the furor of the study are things such as what the study says to keep in mind about the limitation or what questions it could not address: the rising levels of obesity in children, the overall increases in obesity around the world, the medical burden from obesity (some $93 billion), possible effects in the current study due to length of follow-up and (more important in my mind) weight stability, weight impact on specific conditions such as cardiovascular health and diabetes, controlling for body type and adipose distribution, controlling for exercise levels, and on and on. This is far from definitive.

The three items that struck me about the study that don’t seem to be getting the proper amount of attention:

1) BMI=25 appears to be coming out as a good number, which is right on the border of “normal” and “overweight.” The JAMA article notes the U-like distribution about this BMI value… perhaps our definitions should change somewhat.

2) It appears that there is a decreasing trend in excess deaths from the older surveys to the newer surveys in the overweight group… why? Is it due to better exercise in this group (which some studies have suggested to be more important than the moderate excess weight) or is it due to prolonging their lives through cholesterol medications and better mortality rates in stroke, cancer, and other illnesses. This begs the final point:

3) The study says nothing about quality of life… this is a biggie to me. Yeah, there might be some differences between normal and overweight in terms of excess deaths, but there is nothing on how fun those years are to live. If you are still goin’ but you have severe osteoarthritis from years of being overweight, are on chemo for a recurrence of cancer, and are having issues with other disease processes, then the differences in the excess deaths between normal and overweight don’t look so attractive anymore.

Anyway, my whole point that I wanted to make is about how pundits and the media in general are always getting carried away with this stuff, although I will say one thing in a slam against the CDC: what is up specifically combining the overweight and obese populations into one statistic?!? The 25k number that comes out totally obscures the major problems with obesity… the fact that they explicitly provided that relatively meaningless number shows that some folks in the CDC have a tin ear for how that number will sound and reverberate in the media.