Lost in Obesity Statistics and Quibbles

Obesity statistics are back in the news and it reminds us of a comment at the first Obesity Society Advocacy Forum in 2009. After a Q&A session that got mired in quibbles about what we do and don’t know about obesity, Executive Director Jeff Levi of the Trust for America’s Health remarked, “good luck getting anything done with these guys.”

Now it’s not really as bad as all that. We’ve actually accomplished quite a bit in the last five years, but we do like to get stuck on our quibbles. Two favorite subjects for public debate are obesity rates and mortality attributable to obesity.

On the subject of obesity rates, the announcement of stabilizing childhood obesity rates in a sample of low-income preschoolers was still resonating last week. People continue to offer all kinds of explanations for this trend. Increased rates of breast-feeding is an explanation that stands out as most lacking factual support. It’s not that breast-feeding isn’t beneficial — clearly it offers both mother and child indisputable benefits. But obesity prevention isn’t one of those indisputable benefits. So claiming that breast-feeding must be the cause of better childhood obesity trends is a bit of fact-free wishful thinking.

Before childhood obesity rates could fade from the news, a new report from the Trust for America’s Health brought the news that obesity rates are stabilizing in adults, but at a very high rate. So you could take your pick of headlines. “Obesity rate levels off,” or “Obesity rates remain high,” or “U.S. sees rise in extreme obesity.” Each headline is true, but incomplete.

But the absolute favorite subject for debate and confusion is deaths attributable to obesity. The American Journal of Public Health published a study suggesting that one in five premature deaths may be attributable to obesity. This is a rate more than three times the 5% rate quoted by many other researchers. The last kerfuffle over this number came in 2004, when CDC slashed its estimates of obesity-related deaths amid a debate over methods.

To further stir the pot, a new commentary by Katherine Flegal has just been released online in the Journal Obesity. Flegal offers perspective on the observation she has published a number of times, that mild overweight is associated with a small mortality benefit. And inevitably, this observation gets twisted into a lie that obesity might be good for you. Expect a replay.

Former HHS Secretary Tommy Thompson casts all of this confusion aside with a very clear analysis of the importance of taking obesity and its treatment seriously:

If we are going to get a handle on healthcare costs, obesity is front and center. We simply must stop waiting for people to get sick and then spend infinitely more trying to make them well again. Covering obesity is a no-brainer, and we must begin behaving rationally if we are going to come to grips with rising health costs and a population that’s getting sicker.

Click here to read more in the Washington Post, here to read more from the Trust for America’s Health, here to read more from NBC News, here for the study in the American Journal of Public Health, and here for the Flegal article in Obesity.

madness + gaussian curve, photograph © retrofuturs Stéphane Massa-Bidal / flickr

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