The deadly truth about ‘healthy obesity’
CHICAGO — Here’s a cold dose of reality for people telling themselves that their extra pounds aren’t harming them: Contrary to 2013 research linking extra weight to a lowered risk of mortality, there’s really no such thing as “healthy obesity.”
In January of that year, the Journal of the American Medical Association published a survey of research that found people with a body mass index of 25 to 30 — considered overweight — have a 6 percent lower risk of death than people whose BMI is in the “normal” range of 18.5 to 25.
As you can imagine, warnings not to take that data as a license to overeat were roundly ignored and spurred by sensationalist news headlines that surely led countless New Year’s dieters to belly up to the table.
Findings published as a letter in this month’s Journal of the American College of Cardiology debunked the myth of “healthy obesity” by citing a 20-year study of individuals who at the beginning of the research period were obese but otherwise in good health.
Over the two decades, these people’s health degenerated. In the end, 51 percent of them were unhealthy and were almost eight times as likely to arrive at unhealthy obesity as the healthy, non-obese adults.
Joshua A. Bell, the study’s lead author, told The New York Times’ Well blog: “’Healthy obesity’ is quite a misleading term. It sounds safe, but we know that it’s only healthy in a relative sense. The healthy obese become unhealthy and progress into the highest risk group. This is a real challenge to the idea that the obese can be healthy in the long term.”
Sadly, it’s not enough of a challenge that it’ll make a dent in the country’s apathy toward a state of health that the American Society of Clinical Oncology recently said could soon overcome tobacco as the leading preventable cause of cancer in the U.S.
The identity politics around the issue always keep obesity just outside its proper realm of epidemic-level public health crisis. The clashes pit individual liberties vs. nanny statism, and personal nutritional responsibility vs. predatory junk food marketing. We have endless debates over evolving attitude about what is “beautiful.”
Alarming statistics about the number of adults, minorities, women, children and babies who are overweight or morbidly obese have failed to ignite interest that could lead to significant change. The same goes for evidence linking obesity to death.
Data released in August 2013 in the American Journal of Public Health suggested that obesity’s death toll on Americans is more than three times previous estimates and is associated with nearly one in five U.S. deaths. Using the Centers for Disease Control and Prevention’s (CDC) number of 2.5 million mortalities in 2010, that comes to about half a million people annually.
But no one pays attention.
Is obesity too pedestrian? It doesn’t have the fictionalized TV-movie-of-the-week horror that helped get the American medical establishment to take special precautions against Ebola. Just for argument’s sake, let’s note that according to the CDC, 8,429 people have died from Ebola during the 2014 outbreak. Only two people have perished from Ebola in the United States.
This isn’t an irresponsible comparison. Obesity has been found to be socially transmissible — that is, friends, family, co-workers, peers and classmates influence individuals to eat or overeat certain foods in myriad ways.
Research has found that every person who isn’t obese has a 2 percent chance of becoming obese within a year because of their sedentary lifestyle and access to unhealthy foods. But it has been estimated that this number rises by 0.5 percent for every obese person they socialize with, meaning that knowing just four obese people can double a person’s risk of becoming obese.
While experts have proposed ideas to define obesity as a disease or a federally protected disability falling under the Americans with Disabilities Act, nothing has yet to “take,” even as a national discussion issue.
Perhaps we just don’t have enough concrete numbers to scare people into paying attention to the ravages of obesity.
For that we’ll need a movement to get the CDC to list obesity as an official cause of death and articulate clear guidelines for the medical establishment to start attributing morbidity to it.
If dread of a sick old age doesn’t get people’s attention about the risks of obesity, maybe fear of death will.
Esther Cepeda’s email address is email@example.com. Follow her on Twitter, @estherjcepeda.
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