Fat Chances

Is overweight the new healthy?

Jacob Sullum | November 14, 2007

At five feet, nine inches tall and 175 pounds, I have a body mass index (BMI) of 25.9, which makes me "overweight." If I lost seven pounds, I'd have a BMI of 24.9, indicating what the government considers a "normal," "healthy" weight.

Yet that weight is not normal, since two-thirds of American adults exceed it. And judging from the latest research, it is not necessarily healthy either. According to a study recently published by The Journal of the American Medical Association (JAMA), people in the government-recommended BMI range of 18.5 to 24.9 are more likely to die from a variety of diseases than people with BMIs of 25 to 30.

The JAMA study updates research by Katherine Flegal of the National Center for Health Statistics and three other government-employed scientists, who two years ago scandalized the public health community by concluding that the annual death toll associated with excessive weight was far lower than the U.S. Centers for Disease Control and Prevention (CDC) had been claiming. The CDC later reduced its estimate from 365,000 deaths blamed on "poor diet and physical inactivity" to 112,000 "obesity-related deaths."

Looking at data from the National Health and Nutrition Examination Survey, Flegal and her colleagues found that people who qualified as "obese" (with BMIs of 30 or more) did indeed have a higher mortality rate than people in the "normal" range, as did those considered "underweight." But people who were merely "overweight" had the lowest mortality rate of all.

In their new study, Flegal et al. examine specific causes of death in each weight range and find that cardiovascular disease is by far the biggest contributor to "excess deaths" among the obese. Deaths from certain cancers and the combined category of "diabetes and kidney disease" also were significantly more common than in the "normal" group.

Although being merely "overweight" was associated with a higher death rate from diabetes and kidney disease, it "was not associated with mortality from cancer or cardiovascular disease." And since overweight people were significantly less likely to die from other causes, "the net result was that overweight was associated with significantly decreased all-cause mortality." Adjusting for smoking and pre-existing illness, both of which can be associated with lower weight, did not change the findings.

Standing alone, these data do not prove that plumpness is healthy or that thinness kills. But they do cast doubt on some of the more alarmist predictions made by "obesity epidemic" doomsayers.

"This could be the first generation of American children to lead shorter lives than their parents," warns Yale obesity expert Kelly Brownell, who urges a panoply of taxes and regulations aimed at averting that disaster. Yet there's no evidence that life spans are getting shorter in the U.S. In fact, as Flegal et al. note, death rates from cardiovascular disease continue to decline, while the association between obesity and cardiovascular disease seems to be getting weaker.

In response to the JAMA study, obesity researcher JoAnn Manson told The New York Times "health extends far beyond mortality rates." In particular, extra weight can make it harder to get around, discourage exercise (lack of which helps explain the association between obesity and cardiovascular disease), and contribute to problems such as sleep apnea and arthritis.

But such day-to-day impairment is much more obvious than the lurking, lethal risk of a few extra pounds that Manson has been warning people about for years. A 1995 New York Times headline inspired by one of Manson's studies warned that "Even Moderate Weight Gains Can Be Deadly." The story quoted Manson's prediction that "it won't be long before obesity surpasses cigarette smoking as a cause of death in this country."

It looks like both of those claims were wrong. That's good news not only for those of us who weigh more than the government says we should but for anyone who worries about the social engineers who have plans for making Americans thinner.

© Copyright 2007 by Creators Syndicate Inc.

Comments

M|11.14.07 @ 7:29AM|#

Yet that weight is not normal, since two-thirds of American adults exceed it.

Yo, I'm all about government is bad (no sarcasm here), but wouldn't that statement be true only if you substituted for "normal" some word like "average" or "common" or "typical"?

Doesn't the normalcy of 98.6 as the human body temperature persist even in a febrile community?

|11.14.07 @ 8:45AM|#

M - the point of that statement was that perhaps the BMI is too stringent with its requirements.

I'm 5-10, 175 and BMI calls me "overweight". What a load of shit science the whole thing is, really.

tijjer|11.14.07 @ 8:52AM|#

I think more informative than evaluating longevity based upon one's fit in one of four broad, somewhat arbitrary categories would be to just release projected (or observed) longevity based on the actual BMI.

For someone who is 5'9", both 125 lbs and 168 lbs are in the same category. This, to me, is kind of silly. It'd be nice to see the data at a BMI of 18, at 19, at 20, etc.

Episiarch|11.14.07 @ 9:06AM|#

I can't understand why anyone could think that BMI is even slightly legitimate. The only reason that comes to mind is that it provides a tool for authoritarian nanny-statists to use to control people.

And I'm saying this as somebody who could never be mistaken for fat, and am either just within the normal range or just barely into the overweight range because of muscle mass, so I'm not whining because BMI called me fat.

|11.14.07 @ 9:08AM|#

Hey, is there no adjustment for age? I'm 70 years old, many places give me a discount for age. At 6'3 1/2" and 205, my BMI is 25.9, (overweight). Am I gonna have to get AARP involved ? Call in the Americans with Disabilities Act people? Oh well, at my age it's good to get screwed again. I'll take anything at this point.

Episiarch|11.14.07 @ 9:18AM|#

Hey, is there no adjustment for age? I'm 70 years old

Silly rabbit, you can't be 70--people that old think the intarweb is a "series of tubes" and can't figure out how to use it.

|11.14.07 @ 9:45AM|#

Folks,

BMI's only one factor to consider when figuring out if you're overweight and by how much. Obviously body frame is a factor (people with bigger frames should be heavier). Body fat is another.

The quickest way to tell if you're fat, honestly, is by taking a good look at yourself. People at a healthy weight should have a lean (not skinny) look. If you have a gut, you need to lose weight. Simple as that.

For the record, 31, 5'6", 152 lb. Supposedly in the healthy range, but as a matter of fact still fatter than I'd like to be, which is to say I still have a gut. I have a small frame; by some calculations I should be about 128 lb, certainly no more than 140.

BMI isn't a Communist plot. Don't be silly, Episiarch.

Episiarch|11.14.07 @ 9:50AM|#

BMI isn't a Communist plot. Don't be silly, Episiarch.

Hmm, never said anything about Communists. I did notice that as soon as the BMI was adopted, 30 million Americans became "overweight" literally overnight, and immediately nanny-statists started using this as a call for controlling people's eating habits with government force.

That seems pretty convenient.

|11.14.07 @ 9:51AM|#

We don't like looking at you. Thank you.

Sincerely,

The Government

VM|11.14.07 @ 10:15AM|#

"I did notice that as soon as the BMI was adopted, 30 million Americans became "overweight" literally overnight"

not exactly accurate but good enough, what did happen in the late 90s was that the NIH changed the criteria (lowered from 30 to 27.5 or 25 or something like that).

The BMI was actually used in the 80s, but it became media mainstream in the 90s - and like all things that become media mainstream, it became misunderstood, twisted, blown completely out of proportion, and used for different people's agendas.

Eliminate the nanny state elements from the BMI, and it's (use of the BMI) no big deal. You need to determine what health risks you have, and you need to select your own health inputs. The BMI might be a helpful data point. That's up to you and your MD. Or just you.

But, on the bright side, having consensual sex as a teen makes good citizens. hier

(such studies generally seem to be silly)

|11.14.07 @ 10:25AM|#

Hmm, never said anything about Communists. I did notice that as soon as the BMI was adopted, 30 million Americans became "overweight" literally overnight, and immediately nanny-statists started using this as a call for controlling people's eating habits with government force.

Nanny-statists, communists, Al Qaeda, the Illuminati, whatever you want to call the phantom group that wants nothing more than to control your life for no reason.

W. Kone|11.14.07 @ 10:26AM|#

As a 6' 2" 40 year old male who has had to argue with the Army for the last 11 years about being "over weight" and in the last seven years for being "obese". I agree that what the government says is normal is not normal.

I have a BMI of 30.1, I'm 240 pounds which is over my "max allowed weight" of 207. The Army says I have a body fat content of 24.87% (I'm allowed 26%). I run four to five marathons a year, score between 250 and 280 on the Army Physical Fitness Test, I regularly do 12 mile road marches with 80+ pounds of equipment in less than four hours and do missions afterwards and I bike to work. But the Army says I'm fat and the government says I'm obese.

I'm told I need to get down to a "healthy" weight of 175 for my height. I have a guy in my unit that is 6'2" and 185. I carry half his mission load on marches because he can't. He's skin and bone. (he is also 19, and can't seem to get above 260 on the tests.) I don't think height/weight is a good determining factor for health. Kudos to Mr. Sullivan for exploring this.

Most people don't think they are overweight/obese, but are surprised to find that the government's BMI says they are.

|11.14.07 @ 10:30AM|#

I have been both painfully thin and obese at different points in my life.

At 5.7 and change, I've been everything from 135 to 235 in weight. If I could choose, I would put myself right at 165 as that was the weight at which I thought I looked the best; A flat stomach without looking malnourished. By BMI standards I would still be "overweight".

As Ottawa reader said, I, like many guys my height, am built a bit like a tank. I have a big chest so I need that extra twenty pounds or so to look right.
My question is, who are the people for whom the BMI is a good measure? I imagine they are a minority.

VM|11.14.07 @ 10:33AM|#

"but are surprised to find that the government's BMI says they are."

it's not the government's BMI. Jeez. The BMI might not be used well (for agendas, etc), and it might not be appropriate for you - there are other measures and ways to determine if you're obese.

Mellow out, dudes.

|11.14.07 @ 10:43AM|#

I'm precisely at the borderline between what the government considers overweight and obese -- a BMI of 29.9 or 30.0, depending on what day or time I weigh myself. A year ago I weighed the same as I do now, but due to daily strenuous workouts, perhaps 20 pounds of fat have been converted to muscle. Way different levels of health now versus then, but in the eyes of folks like HRC I need an intervention to get me to a "healthy" weight because of the costs they think I'll impose on the precious socialized medicine system they lust after.

Anyone think that the nanny-statist researchers in denial about what is average weight, and the politicians supporting them, ought to be given even more control over health care, since then they will feel justified in trying to control your level of health because the costs will affect the other taxpayers forced to pay for the consequences of your personal behavior?

|11.14.07 @ 10:49AM|#

Ah, more BMI scale fun. The thing is pure bunk, as W.Kone above explains.

If the BMI scale were to be taken seriously, a guy like Tom Platz would be told he needs gastric bypass surgery to overcome his crippling, er, obesity.

Height and weight by themselves are poor indicators of body composition, and the BMI scale in general fails to take into account the amount of a person's weight that comes from lean muscle mass.

|11.14.07 @ 10:50AM|#

Nanny-statists, communists, Al Qaeda, the Illuminati, whatever you want to call the phantom group that wants nothing more than to control your life for no reason.

Oh, they bloody well have a reason for wanting to control our lives, Danno. They think they're better able to run our lives than us. My mother-in-law, a nanny-statist elected official, is visting our house, and to keep the peace I decided to stay off the topic of politics. But last night she said something that I couldn't let go, and unloaded on her.

Do you seriously believe the shite you just spewed there, Dan T., or are you back to trolling? There really are people who want to control our lives, with the best of intentions and the worst results.

thoreau|11.14.07 @ 10:52AM|#

Obviously human weight is too complex of a matter to distill down to a single variable. However, a scale with 2 variables might be useful. Randian, I'm guessing that you're pretty muscular, given your job. So perhaps a scale that combines BMI with some variable that measures muscle vs. fat might be useful.

(And yes, I condemn the misuse of BMI to promote junk food taxes and whatnot.)

|11.14.07 @ 10:54AM|#

Dan T., you can be a big boy and admit that the BMI scale is arbitrary at best and capricious at worst, seeing as how it is being used to tell otherwise healthy, active people that they're not within some magically acceptable "ideal weight range," and that they therefore aren't good Americans.

How much do you weigh, Dan T.? I'll wager you a beer you've hardly ever done any physical exercise in your life, preferring instead to exercise your jaw muscles when you tell people how the benevolent federal government knows what's best for them.

|11.14.07 @ 10:56AM|#

Obviously human weight is too complex of a matter to distill down to a single variable.

Just as obviously, that fact is either unknown or unacknowledged by people coming up with things like the BMI.

VM|11.14.07 @ 10:57AM|#

exactly, Doktor T.

(especially your parenthetical)

thoreau|11.14.07 @ 11:02AM|#

The fact that a variable is insufficient to explain all the data does not mean that it is completely useless.

Quantitative tools can be useful, as long as you exercise some care in the application. (Or just exercise, and then you don't have to worry about BMI.)

|11.14.07 @ 11:31AM|#

BMI can be useful when combined with body fat percentages. I'm 5'9, 173, "overweight". I'm not a lard ass but I'll be honest in saying I could stand to loose a few extra pounds.

anneftx|11.14.07 @ 11:41AM|#

I'm always amused when the term 'mortality rate' is cited. With no disrespect for Mr. Sullum, I'd point out that heavy, obese, malnourished or underweight, smoker, heavy drinker or fatally ill, we all have the same mortality rate -- it is precisely 100%

As well, longevity is a spurious factor. If I die of sudden cardiac arrest at age 59 while enjoying an active, entertaining life, I'd generally prefer that to lingering to age 89 with limited mobility, pain and dementia.

As noted in earlier posts, when official BMI guesstimates were changed, a large portion of the population became overweight overnight. The same thing happened when smokers were deemed addicts. Suddenly 25% of the population was demonized and 'denormalized.' Children who are enrolled at too young an age are deemed 'hyperactive' and medicated. People who are occasionally 'blue' are medicated. People who experience sleeplessness during times of stress when their minds race are medicated. Please understand that I'm familiar with ongoing mental illness and do not intend to demean these conditions. They are serious and require medical attention.

Blood pressure and cholesterol goals have decreased incrementally over the past 10 years. I have nightmares about prohibitions on transfats, alcohol, and prepared or fast foods. As a nation we're abjured to avoid fried foods of any kind. Yet the recent hectoring about stunningly "unhealthy" foods at State Fairs never acknowledged the fact that these events occur but once each year. When else will you ever encounter a deep fried Snickers bar? One or two a year are hardly a death sentence.

My apologies for rambling on about such a variety of practices denounced by Aunties. I've been around long enough to see a seemingly never-ending trend to make people feel guilty about enjoying 'vices' and losing the simple pleasures of a fine meal, followed by a relaxing cigar or cigarette and a snifter of brandy.

Christ on a Cracker|11.14.07 @ 12:00PM|#

I am 6'4", 240 pounds = BMI of 29.2

OK, I can stand to loose a few. I think it's interesting I have to get down to 145# to have a BMI of 18.3 before being "underweight".

Why does the government want everyone to look like cancer patients?

Coc

ce|11.14.07 @ 12:21PM|#

I've never understood why they don't use body fat percentage over BMI.

You can lose fat and put on lots of muscle and watch your BMI get worse, but body fat percentage is a true measure of how much of which substances your body is made up of.

LarryA|11.14.07 @ 1:13PM|#

I've never understood why they don't use body fat percentage over BMI.

It's harder to calculate.

The nannies can get height and weight from records and bitch at all of us. They can do an article like this one and, because everyone knows their height and can guess their weight, include a calculation that has everyone comparing and talking about BMIs.

They'd have to convince each of us to get tested (involving getting naked and floating in a tank of water, if I remember correctly) before they could similarly abuse body fat percentage.

ce|11.14.07 @ 2:14PM|#

LarryA - You're right, it is harder to calculate, but not that much harder. I remember our high school gym teacher had a plastic caliper you could measure with. Maybe not as accurate as the tank, but still better than a BMI.

|11.14.07 @ 2:25PM|#

Their are three ways that I know of to do body fat, the water tank (most accurate), the Pinch Caliper not as accurate, and the "tape test".

The Pinch Caliper takes a bit of training and some skill to use right and wear can affect the caliper too.

the tape test is done by putting a tape about the neck and waist, running that through a chart and some simple math to come up with some pretty silly amounts of body fat. The army uses this method and "allows" a 40 year old to have a max body fat of 26% because the method is so off.

That one could be abused.

|11.14.07 @ 6:10PM|#

I always wonder how statistics are gathered. In gathering the underlying mortality statistics, did they use weight at the time of death? If so, don't many people get sick, lose weight, and then die? So their BMI at time of death is lower than before they becme ill from their terminal illness. Maybe adjustments are made, but how good are they?

|11.14.07 @ 10:14PM|#

For years I drove myself to distraction about my weight, or, more precisely, its distribution. After all that agony, I have just decided it is too much and I vowed never to think about it ever again. A waist is a terrible thing to mind.

Lou

Crilltog|11.15.07 @ 1:05PM|#

"people in the government-recommended BMI range of 18.5 to 24.9 are more likely to die from a variety of diseases than people with BMIs of 25 to 30."

Maybe that's why the government recommends it.