The Death Toll Is Important, Except When It Isn't

While researching this week's column on obesity, I came across the CDC's list of "Frequently Asked Questions About Calculating Obesity-Related Risk," an amusing demonstration of how to back-pedal while pretending to move forward:

Why is CDC even involved in estimating how many people die of obesity?

As the nation's disease prevention agency, CDC is charged with protecting the nation's health. Seven of the 10 leading causes of death in the United States are chronic diseases, the top two being heart disease and cancer. So many chronic diseases are affected by obesity and mortality (deaths) is an important indicator of the severity of a public health problem….

Is CDC changing its estimate of obesity-related deaths?

Yes. We are no longer going to use the previous annual estimate of 365,000 deaths from poor nutrition and physical inactivity. Instead, CDC will state, "The latest study based on a nationally representative sample of U.S. adults estimates that about 112,000 deaths are associated with obesity each year in the United States."…

Does this study mean that obesity is less important than CDC once thought?

Not at all.

In short, obesity-related deaths are an important measure of how serious the problem is, but reducing the number by two-thirds does not make the problem any less serious.

Comments

[Phillip Conti]

I look forward to the day when everyone takes care of everyone else and no one takes care of themselves.

[CDC flunky]

sarcasm
But, if we can save just ONE life, then all the intrusive regulation we want to saddle you with will be worth it. Remember, sacrifices must be made, for the good of society.

[David]

I think all this nannyism comes from the same fallacy. "If you do a,b,& c, and avoid x,y,&z, then you won't ever die."

Couldn't they qualify it with a target age where the cause of death doesn't matter? Then they could say, "People who wash down deep-fried cigarettes with whiskey are less likely to reach 75." and it would at lease have some meaning.

If you believe the spins put on these studies, you would think we were all immortal except for our bad decisions.

[Mr. Nice Guy]

"As the nation's disease prevention agency, CDC is charged with protecting the nation's health."

This statement is fallacious. A public health agency's mission is to only provide INFORMATION to individuals so they can make informed decisions. And this information should be SCIENCE-BASED, not political.

But maybe I'm living in a dream world.

[nostradumbass]

The CDC sure did a lousy job of keeping me from getting a kidney infaction last summer. Bastards! And to think that my tax dollars fund such shoddy work!

[nostradumbass]

Not to mention the infection I had as well...

[Johnny Clarke]

Since automobile accidents are a preventable cause of death (a sure sign of bad health), shouldn't the CDC be in charge of auto safety measures, or is that going too far?

[R C Dean]

Mmmmm. Deep-fried cigarettes.

/Homer OFF/

[R C Dean]

The mission creep from disease prevention > protecting the nation's health > sticking their nose into things that are not diseases is a classic. I'm sure its studied and applauded by bureaucrats everywhere.

[dpotts]

Johnny-

And shrink the size of the NTSB??? Where's your common sense? Honestly, death is so much of a threat that they really ought to coombine all of these disparate agencies under one umbrella agency, so that they can all exchange information about death more efficiently, and serve society in a more effective way. The head of this new umbrella agency should be a new cabinet post as well. My fellow patriots, we can beat death if we all pull together and do our duty.

[fluffy]

That's a great idea, dpotts.

Since the natural name for such an umbrella agency would be the Department of Death, you'd probably make Rumsfeld jealous and he would start angling for a transfer.

[fluffy]

Oh wait, I left "Ba-dum-bump!" out of my last post.

Sorry.

[Ar Pharazon]

My fellow patriots, we can beat death if we all pull together and do our duty.

Couldn't have said it better myself.

To Valinor we go!

[David]

It's obvious that we need a Death Czar. Someone who could oversee and set policy to prevent all deaths everywhere.

[John]

"Center For Disease Control" Forgive me for thinking that perhaps their job should be doing things like plotting the spread of AIDS, and trying to make sure Avian Flu doesn't reach our shores and combating the envirowackos who want to stop the use of pesticides to control West Nile. You know, things that actually have to do with stopping the spread of disease!! Since when is obesity a disease? Three words, Fraud Waste and Abuse!!!

[Randolph Carter]

Is the head of the CDC a giant, flaming eye?

[Elendil]

To Valinor we go!

That might be a bad idea.

[mac]

Well, assuming that the 110K number is correct, and that 25% of americans are obese, and a 72 year lifespan, and a population of 380M, that gives you an 9% chance of dying because you are obese.

That's a pretty big number, as these things go, just about as bad as breast cancer and smoking, and Russian Roulette.

[Isaac Bartram]

Of course if you are a physician who wants to do something to help your obese patients, you will need to consider the fate of this guy.

http://www.fosters.com/apps/pbcs.dll/article?AID=/20050825/NEWS05/50825070

[Julie Louise Gerberding, M.D.,]

"Either you're with us, or you're with the Grim Reaper."

[Larry A]

The CDC could really perform a valuable public service if it could figure out what infects certain people with the urge to run other people's lives. And they could find all the test subjects they needed without even leaving the building.

Anyone volunteer to join me in the control group?

[TJIT]

All these do gooders trying to protect me from myself make me want to put my brainpan in a microwave oven.

Fight the power, deep fried twinkies, washed down with a beer for lunch today. After lunch relaxation will feature cigarette smoked while facing the sun with no sunscreen on:-)

[G. Reaper]

"Either you're with us, or you're with the Grim Reaper."
Alright, who is with me? How about some chess? Or a game of Battleship?

[ChicagoTom]

Isaac,

I had seen that story a day ago, and for the life of me I could not figure what it is that the doctor actually did wrong, much less warrant the involvement of the AG. Maybe he was "impolite" in telling a patient who had visited 7 times with obesity related symptoms that she was obese, but that's hardly reason to investigate the guy the way they have.

This guys problem seems to be that he cared too much.

[fluffy]

Congress will assert authority over that doctor's case based on the commerce clause, because, as any casual observer of American society could figure out in about a minute, our biggest national product is capital-R Respect, and by not providing this patient with the proper amount of it [despite her eating habits] the doctor was interfering in the broader national market for Respect in general.

Eventually the Feds will wise up and realize that they need to make Disrespect a controlled substance, and prohibit its possession or distribution. Our entire culture is at stake.

[Shelby]

Apparently it's a crime to accuse any particular person of being obese, though of course this is consistent with paying a national agency tens of millions of dollars to tell the country that it's obese.

I love how the question "why do you study obesity" leads to the answer that "the top two [leading causes of death are] heart disease and cancer". Obesity causes cancer! Who knew?

Personally I've always thought the leading cause of death was life.

[Eddy]

So does that make twinkies a disease vector? What's the pathogen? Is it only a matter of time before nail biting becomes a disease or is there not enough money in it?

[j harris]

In your article you seem to state that "poor nutrition and physical inactivity" equal obesity (by equating the numbers that die from each).

This is definitely not the case, so the number of deaths due to poor nutrition and physical inactivity will naturally be much higher than obesity (poor nutrition and physical inactivity include many more medical problems).

[Isaac Bartram]

The story reminded me of an elderly lady I knew who saw an ortho about her knees. The ortho said there was no point doing the surgery if she didn't lose weight first. She refused to go back to him. But at least she confined her rants to everyone who would listen to how rude and inconsiderate he was, she didn't go after his license.

[Isaac Bartram]

Is it only a matter of time before nail biting becomes a disease or is there not enough money in it?

As soon as they find the evil corporation that forces us to bite our nails.

[Anonymous Coward]

Speaking of Mr. Reaper, check out the Grim Reaper cartoons at http://www.loservillex.com/cartoons.html (scroll down).

[poco]

mac: Isn't it 280 million?

[Herman]

our biggest national product is capital-R Respect
So a tax scheme for respect would provide a great revenue stream....

[Jennifer]

Nail-biting may not be classified as a disease, but just wait and see what happens when the CDC learns that the majority of ingrown toenails are caused by improper cutting. Nail clippers and toenail scissors will become illegal, and the only way to prevent your toenails from ripping holes in your socks will be to go to an official government-licensed pedicurist. It'll cost $150 dollars a pop, but at least the poor or old people will be covered by Medicaid or Medicare. Nothing to worry about.

[Jennifer]

Nail-biting may not be classified as a disease, but just wait and see what happens when the CDC learns that the majority of ingrown toenails are caused by improper cutting. Nail clippers and toenail scissors will become illegal, and the only way to prevent your toenails from ripping holes in your socks will be to go to an official government-licensed pedicurist. It'll cost $150 a pop, but at least the poor or old people will be covered by Medicaid or Medicare. Nothing to worry about.

[fluffy]

You can't tax Respect.

In the classic Supreme Court decision Feelings Of Most Americans vs. Reality, when faced with the delicate question of balancing the compelling state interest in acknowledging reality with the compelling state interest in providing for the common Respect, Justice Stevens [writing for the majority] found that Respect trumps all other state interests.

This means that the state can no more tax the Respect economy than it can our churches.

[Isaac Bartram]

Nail clippers and toenail scissors will become illegal,...

But when nail clippers and toenail scissors are outlawed only.....

And the rest of us will have to bite our nails. Ah, unintended consequences.

[fluffy]

Perhaps the coming craze for toenail biting means that now is the time to invest in yoga studios.

[Jennifer]

If growing your own medicinal pot falls under the commerce clause, then so does biting your own toenails. So don't even THINK about trying it.

[Stevo Darkly]

Three words, Fraud Waste and Abuse!!!

Technically, that's four words.

[Rich Ard]

Technically, "that" is one word. "Fraud, Waste and Abuse" - those are four words.

[Amy Phillips]

Mac,
But even if the number is correct, it states that those deaths are *associated* with obesity, not *caused by* obesity. The way they derive that number is to correlate the weight of people who died with a list of diseases that they consider to be obesity-related. So, for example, the pro football player who died last weekend will likely be statistically classified as an obesity-related death because his BMI was over 30, despite the fact that his weight was mostly muscle, he ate a professionally prepared balanced diet, and he exercised for a living. Those numbers may tell us how many people with high BMIs died of certain diseases, but they tell us very little about to what degree being overweight will affect a person's lifespan.

[Stevo Darkly]

"Fraud, Waste and Abuse" - those are four words.

You're right. To be grammatically correct in referring to "wast, fraud and abuse," I should have said, "Technically, them's are four words."

[JK]

You obviously need to work harder at the doublethink Jacob:

"To know and not to know, to be conscious of complete truthfulness while telling carefully constructed lies, to hold simultaneously two opinions which cancelled out, knowing them to be contradictory and believing in both of them, to use logic against logic, to repudiate morality while laying claim to it, to believe that democracy was impossible and that the Party was the guardian of democracy, to forget whatever it was necessary to forget, then to draw it back into memory again at the moment when it was needed, and then promptly to forget it again: and above all, to apply the same process to the process itself. That was the ultimate subtlety: consciously to induce unconsciousness, and then, once again, to become unconscious of the act of hypnosis you had just performed. Even to understand the word 'doublethink' involved the use of doublethink."