In late April, the Centers for Disease Control (CDC) released newly revised estimates of weight-related mortality in the United States, casting doubt on whether the country faces an obesity crisis at all. The agency’s new numbers also suggest it’s healthier to be slightly overweight than underweight.
In March 2004, the CDC and U.S. Department of Health and Human Services announced at a news conference that 400,000 Americans died from obesity-related causes in 2000, making obesity the second-leading cause of death in the U.S., just behind tobacco.
The 400,000 figure combined deaths of persons who are overweight, with a body mass index (BMI) of 25-30, and those who are obese, with a BMI of 30 or more. The CDC estimated there were 300,000 obesity-related deaths in 1990.
The March 2004 study counted every death of an overweight or obese person as an obesity-related death … even if the person was killed in a car accident.
Now, in an article published in the May issue of the Journal of the American Medical Association, the CDC has radically revised its obesity-related mortality numbers, making important statistical adjustments for confounding factors.
The CDC now estimates there were 111,909 deaths associated with obesity (a BMI of 30 or more) in 2000. That’s just one-quarter the number of obesity-related deaths the agency first reported. And of those, 82,066–nearly three-quarters–were deaths of extremely obese persons, those with a BMI of 35 or more.
The news for overweight Americans gets better. According to the CDC news release, “Being overweight (BMI of 25-29.9) was not associated with excess mortality. The study found that 87,000 fewer deaths than expected were associated with being overweight.”
Overweight persons fared much better in the CDC study than underweight persons (a BMI of below 19), who the CDC estimates experienced 33,746 “excess deaths.”
According to the BMI, persons who are 5 feet, 5 inches are extremely obese if they weigh 240 pounds or more; obese if they weigh 180 pounds or more; overweight if they weigh 150 pounds or more; normal if they weigh 114 pounds or more; and underweight if they weigh less than 114 pounds.
If the current CDC estimates are correct, deaths related to extreme obesity rank below those related to alcohol. In a Journal of the American Medical Association article published last year, the CDC identified the leading causes of death among Americans at 435,000 for tobacco, 85,000 for alcohol, 75,000 for microbial agents, 55,000 for toxic agents, 43,000 for motor vehicle crashes, 29,000 for firearms incidents, 20,000 for sexual behaviors, and 17,000 for illicit use of drugs.
Risk Factors Reassessed
In a fact sheet posted on its Web site on May 11, the CDC notes one of its researchers, Edward Gregg, found “large decreases in many of the cardiovascular disease risk factors known to be associated with early deaths in all U.S. adults ages 20-74, regardless of their BMI. The exception was diabetes. The prevalence of total (diagnosed and undiagnosed) diabetes increased by 55 percent over the past 40 years, likely the result of the dramatic increase in obesity during this time period.”
Gregg also noted elevated cholesterol and blood pressure readings fell almost 50 percent in all adults in the United States between the ages of 20 and 74 during the past 40 years; that reductions in the number of persons with elevated cholesterol “were more substantial among obese people compared to lean individuals”; and that elevated blood pressure levels were similarly reduced among both lean and obese persons.
The CDC conceded in its fact sheet that more needs to be known about the health risks of being overweight. “The CDC is undertaking an agency-wide effort to conduct research activities and programs to improve our understanding of all the ways that obesity can affect health, as well as identify strategies to prevent obesity-related health problems,” the fact sheet states, noting “[t]he prevalence of overweight and obesity has increased substantially over the past several decades.”
Obesity Lawsuits Remain
A CDC spokesman told the New York Times obesity would remain a public health priority for the CDC. “We would really be remiss if we didn’t continue to mount a full-court press,” the spokesman said.
According to an email sent to health care industry and litigation experts by Professor John Banzhaf of George Washington University law school, one of the architects of tobacco litigation and an early proponent of obesity litigation, the CDC’s new data “will not affect fat law suits against the food industry and others.
“A primary purpose of these fat law suits is to pressure the industry to continue to make changes aimed at reducing overeating, and therefore obesity,” Banzhaf wrote. He noted, “the [fast-food] companies will continue to feel the pressure, and will continue to respond despite today’s new statistics.”
Media Coverage Changing
In an April 26 interview with the Wall Street Journal, however, Burger King CEO Greg Brenneman denied he feels any such pressure. “You should be able to come to Burger King and get a healthy, low-calorie, low-fat meal,”said Brenneman, who has lost between 25 and 30 pounds eating Burger King salads. “Beyond that, I don’t think it’s my job to tell Americans what they should eat. We might as well go back to communism.”
The Center for Consumer Freedom (CCF) was an early critic of the methodology behind the CDC’s initial estimate. CCF notes on its Web site, “[W]e have said, time and again, that draconian food policies shouldn’t be based on flawed science. The CDC’s wildly mistaken obesity mortality figure, which was announced with great fanfare, has fueled hysteria from the school snack bar to the courtroom. Now the media is starting to come around to this position.”
But Boston Globe columnist Ellen Goodman isn’t so sure. “Is it possible that we are headed to a marginally more sane approach to weight?” she asked. “Did I hear someone say ‘Fat chance?'”
Attorney Maureen Martin ([email protected]) is a senior fellow of The Heartland Institute.
For more information …
The CDC’s BMI calculator can be consulted at http://www.cdc.gov/nccdphp/dnpa/bmi/calc-bmi.htm.