Obesity Claims Overstated, Consumer Advocate Tells FDA

Published August 1, 2004

Obesity is a genuine problem in America, but our national debate on the subject has become nothing short of hysterical. And around every corner is a hidden agenda.

Some pharmaceutical interests, such as the American Obesity Association, are promoting an alarmist view of the problem in order to justify increased government support and promotion of new obesity drugs.

Animal rights groups, like the deceptively named “Physicians Committee for Responsible Medicine,” like to inflame the public’s fears about the dangers of obesity in order to disparage consumption of beef, chicken, pork, milk, cheese, and other nutritious foods that come from animals.

And then there are radical nutrition activist groups like the Center for Science in the Public Interest (CSPI), which never met a tasty food it couldn’t carp about. The leaders of these groups seldom pass up a chance to announce a desire to tax foods they don’t like out of ordinary Americans’ reach. CSPI has recklessly tried to characterize certain foods as being as risky as tobacco, in deliberate scare campaigns.

Trial lawyers, in turn, are attempting to turn America’s love of good food into their next cash cow. And some activists and academics have proposed zoning restrictions and other draconian regulations on restaurants.

Better Science Needed

The nation would surely be better served by a serious and scientific approach to addressing obesity. As the Food and Drug Administration builds a framework for messages to the public about weight reduction, it is important to avoid inadvertently exaggerating or misrepresenting the problem. And steering clear of needless hyperbole can be as simple as checking your facts and figures.

The three most commonly cited statistics associated with the obesity epidemic are (1) that obesity causes 300,000 American deaths per year; (2) that 61 percent of Americans are overweight or obese; and (3) that the economic cost of American obesity is $117 billion a year. All three are seriously flawed.

Obesity Mortality Overstated

Let’s start with the common belief that 300,000 U.S. deaths each year are attributable to excess weight. The truth is, “the data linking overweight and death … are limited, fragmented, and often ambiguous.” That’s from an editorial by the respected New England Journal of Medicine in January 1998 questioning the increasingly frantic rhetoric about obesity as a public health problem.

Speaking specifically about the 300,000 number, the New England Journal editorial continued: “[T]hat figure is by no means well established. Not only is it derived from weak or incomplete data, but it is also called into question by the methodological difficulties of determining which of the many factors contribute to premature death.”

It turns out that in order to allege that 300,000 Americans die each year from obesity, you would have to claim that everyone who dies while overweight dies because of that excess weight.

Alleged Health Costs Unsupported

Many in government and the mass media have blindly accepted the claim that obesity costs Americans $117 billion per year, believing the figure came from the Surgeon General. But the original source is a single study published in the March 1998 issue of the journal Obesity Research.

The Obesity Research study has serious limitations, as the authors themselves admit. “We are still uncertain about the actual amount of health utilization associated with overweight and obesity,” they wrote, explaining that “height and weight are not included in many of the primary data sources.”

Furthermore, the authors of the study defined obesity incorrectly, writing, “The current estimate of the cost of obesity defines obesity as a BMI [body mass index] greater than or equal to 29.” Obesity is actually defined as a BMI greater than or equal to 30. Thus the Obesity Research study erroneously included the economic cost of individuals with a BMI between 29 and 30. That’s more than 10 million Americans.

Finally, the authors acknowledged that even if some data flaws were corrected, their methodology would still result in double- or even triple-counting of obesity-related costs. They write, “Our model assumes that coronary heart disease, hypertension, and diabetes occur independently. However, we know that there is some interdependence among these disease states, especially in obese patients.” They go on to admit, “calculating the cost of obesity as it related to these diseases independently would inflate the cost estimate.”

Flawed Obesity Definition

Are 61 percent of Americans really overweight or obese? Overweight and obesity are diagnosed by using the body mass index (BMI), a deeply flawed standard. According to the Centers for Disease Control and Prevention, “Overweight may or may not be due to increases in body fat. It may also be due to an increase in lean muscle. For example, professional athletes may be very lean and muscular, with very little body fat, yet they may weigh more than others of the same height. While they may qualify as ‘overweight’ due to their large muscle mass, they are not necessarily ‘over fat,’ regardless of BMI.” This language is taken from the CDC’s Web site. It’s that agency’s official position.

Using the BMI standard, our very fit President, George W. Bush, is officially overweight. And the incredibly fit [Arnold Schwarzenegger] is considered obese.

The group of Americans presently “overweight” includes svelte movie stars such as Will Smith and Brad Pitt. Also “overweight” were Michael Jordan and Cal Ripken Jr. at the height of their athletic powers. And slugger Barry Bonds is “obese.”

So how does all of this affect what the FDA should do in going forward?

First, we caution the FDA against using the “$117 billion” number at all, or relying heavily on the “300,000 death” figure. Second, we suggest any mention of the “61 percent” number should include a prominent disclaimer noting that the body mass index standard is imperfect at best.

Lastly, I encourage the FDA and members of its panel on obesity to be on the lookout for hidden agendas, because they are around every corner.

David Martosko is director of research for the Center for Consumer Freedom (http://www.consumerfreedom.com). This article is based on his testimony to the federal Food and Drug Administration on October 23, 2003 regarding obesity in Americans. His remarks can be read in their entirety at http://www.consumerfreedom.com/article_detail.cfm?article_id=128.