Q: Are the Health Risks of Obesity Exaggerated?

By Gaesser, Glenn A.; Fumento, Michael | Insight on the News, November 10, 1997 | Go to article overview

Q: Are the Health Risks of Obesity Exaggerated?


Gaesser, Glenn A., Fumento, Michael, Insight on the News


Yes: In fact, being a little heavier than average may actually be good for your health.

Of all our convictions about health, the belief that obesity itself is a killer has no rival when it comes to the gap between conventional wisdom and scientific evidence. Conventional wisdom tells us that obesity causes heart attack, that thin people live the longest, that weight loss invariably improves health. These beliefs are so firmly entrenched in our lipophobic mind-set that they seldom are questioned. They should be.

Despite assertions that obesity causes heart disease, the preponderance of autopsy and coronary angiography studies indicates that obesity is unrelated to cardiovascular disease. In fact, the largest of the angiographic studies -- more than 4,500 subjects, published in 1991 -- revealed that the fattest men and women had the cleanest arteries. The massive International Atherosclerosis Project (1960s) concluded after analysis of 23,000 sets of coronary vessels that there was no relationship between heart disease and body fat.

Furthermore, the "thin-is-healthier" studies frequently cited by health professionals and publicized by the media are far outnumbered (by about 3-to-1) by studies indicating body weight, aside from the extremes, to be rather neutral in terms of health. On the heavy side, "extreme" corresponds to more than 75 to 100 pounds above the so-called ideal weight. Only 8 percent of American adults fit this description -- and a number of them are quite healthy.

The health risks of moderate obesity have been greatly overstated, a conclusion emphasized in a 1996 report from the National Center for Health Statistics. After scrutinizing data from dozens of previously published studies, comprising a total of 356,747 men and 248,501 women (making it one of the most comprehensive analyses of the weight-mortality issue published to date), the researchers found that moderate obesity posed little, if any, threat to men and women, and that thin men, far from being paragons of longevity, had a risk of premature death equal to that of extreme obesity.

The "lose weight, live longer" axiom is similarly flawed: At least 80 percent of the relevant scientific evidence shows that weight loss actually increases the risk of an early demise. Because increased physical activity has been shown to have only positive effects on longevity, one need not be concerned about exercise-induced weight. However given the prevalence of dieting and diet-drug use during the last few decades, weight loss via these methods could rank as one of the leading contributing causes of premature death in America. Talk about irony.

Conventional wisdom on the purported evils of obesity is a direct legacy of the life-insurance industry, mainly MetLife, which, for the better part of this century, has furnished us with the ubiquitous height/weight tables. Indeed, the company asserts that the tables indicate the weights at which mortality is lowest -- or longevity highest.

So it would seem logical to assume that any weight outside the recommended range carries with it the risk of an early death. To the contrary, a close inspection of MetLife's actuarial source for its tables -- the 1979 Build Study -- reveals that the company's recommended weights do not accurately reflect the data on which they were based. To illustrate, consider a woman of average height, say 5 feet 4 inches. According to MetLife's tables, she should weigh between 114 and 151 pounds. But if she happens to be 40 or older, MetLife's actuarial source indicates that she could weigh close to 200 pounds without experiencing any increase in risk of premature death. In fact, for an average-height (5 feet 3 inches to 5 feet 6 inches) woman in her fifties, the weight at which she would have the lowest of all mortality rates would be -- and this may be hard to believe but is written in black and white on page 152 of the 1979 Build Study -- 185-194 pounds. …

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