Obesity Danger May Have Been Overstated
- From: dog_dx@xxxxxxxxx
- Date: 19 Apr 2005 17:13:53 -0700
Article:
By CARLA K. JOHNSON, Associated Press Writer
CHICAGO - Being overweight is nowhere near as big a killer as the
government thought, ranking No. 7 instead of No. 2 among the nation's
leading preventable causes of death, according to a startling new
calculation from the CDC.
Researchers at the Centers for Disease Control and Prevention reported
that packing on too many pounds accounts for 25,814 deaths a year in
the United States. As recently as January, the CDC came up with an
estimate 14 times higher: 365,000 deaths.
The new analysis found that obesity - being extremely overweight -
is indisputably lethal. But like several recent smaller studies, it
found that people who are modestly overweight actually have a lower
risk of death than those of normal weight.
Biostatistician Mary Grace Kovar, a consultant for the University of
Chicago's National Opinion Research Center in Washington, said "normal"
may be set too low for today's population. Also, Americans classified
as overweight are eating better, exercising more and managing their
blood pressure better than they used to, she said.
The study - an analysis of mortality rates and body-mass index, or
BMI - was published in Wednesday's Journal of the American Medical
Association.
Last year, a CDC study listed the leading causes of preventable death
in order as tobacco; poor diet and inactivity, leading to excess
weight; alcohol; germs; toxins and pollutants; car crashes; guns; risky
sexual behavior; and illicit drugs.
Using the new estimate, excess weight would drop behind car crashes and
guns to seventh place - a ranking the CDC is unwilling to make
official, underscoring the controversy inside the agency over how to
calculate the health effects of obesity.
Last year, the CDC issued a study that attributed 400,000 deaths a year
to mostly weight-related causes and said excess weight would soon
overtake tobacco as the top U.S. killer. After scientists inside and
outside the agency questioned the figure, the CDC admitted making a
calculation error and lowered its estimate three months ago to 365,000.
The new study attributes 111,909 deaths to obesity, but then subtracts
the benefits of being modestly overweight, and arrives at the 25,814
figure.
CDC Director Dr. Julie Gerberding said because of the uncertainty in
calculating the health effects of being overweight, the CDC is not
going to use the new figure of 25,814 in its public awareness
campaigns. And it is not going to scale back its fight against obesity.
"There's absolutely no question that obesity is a major public health
concern of this country," she said. Gerberding said the CDC will work
to improve methods for calculating the consequences of obesity.
CDC spokesman Tom Skinner said the agency will probably start using a
range of estimates for obesity-linked deaths.
Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women's
Hospital in Boston, said she is not convinced the new estimate is
right.
"I think it's likely there has been a weakening of the mortality effect
due to improved treatments for obesity," she said. "But I think this
magnitude is surprising and requires corroboration."
The analysis was led by Katherine Flegal, a senior research scientist
with the CDC's National Center for Health Statistics. The study that
had to be corrected was conducted by a different arm of the CDC, the
Division of Adult and Community Health, and its authors included
Gerberding.
One major reason for the far lower number in this latest study is that
it used more recent data, researchers said.
"This analysis is far more sophisticated," said Kovar, who was not
involved in the new study. "They are very careful and are not
overstating their case."
A related study, also in Wednesday's JAMA, found that overweight
Americans are healthier than ever, thanks to better maintenance of
blood pressure and cholesterol levels. Diabetes is on the rise among
people in all weight categories, however.
Flegal said the two studies raise questions about what definitions to
use for obesity and "where to draw the line." Under current government
standards, a BMI, or weight-to-height measurement, of 25 or higher is
overweight; 30 and above is obese.
In recent years, the government has spent millions of dollars fighting
obesity and publicizing the message that two out of three American
adults are overweight or obese, and at higher risk for heart disease,
arthritis and diabetes.
Link to JAMA Vol. 293 No. 15, April 20, 2005 FULL STUDY W/CHARTS:
http://jama.ama-assn.org/cgi/content/full/293/15/1861
.
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