Obesity Obsession
Friday, March 12, 2004
By Steven Milloy
�Obesity is catching up to tobacco as the leading cause of death in
America,� proclaimed Centers for Disease Control and Prevention chief
Julie Gerberding this week. �Americans need to understand that
overweight and obesity are literally killing us,� added Health and Human
Services Secretary Tommy Thompson.
While it�s not disputed that severe obesity (search) may shorten life,
the real killer in this case seems to be the CDC�s statistical
malpractice.
The excuse for the desperate health warning is a study in the March 10
issue of the Journal of the American Medical Association in which the
CDC claims that poor diet and physical inactivity caused 400,000 deaths
in 2000. That estimate supposedly represents a 33 percent increase from
the 1990 estimate and approaches the 435,000 deaths in 2000 supposedly
attributable to smoking.
Now it�s been said that there are two types of statistics ― the
kind you look up and the kind you make up. CDC�s body counts are
definitely the latter.
The CDC produced its estimates with a statistical ruse called
�attributable risk� ― the fearmongers� method of choice for
alarming the public with large body counts. Attributable risk (search)
could be the poster child for the saying, �garbage in, garbage out.�
Without getting lost in the depths of statistical formulas, the key
components of attributable risk calculations are statistical
correlations between potential causes and effects, like
overweight/obesity and premature death. But just because
overweight/obesity and premature death might have been statistically
correlated in some studies doesn�t mean that overweight/obesity has been
proven to cause premature death.
In the few studies that have reported correlations between
overweight/obesity and premature death, the vast majority of the
correlations are small, not statistically significant (that is, they may
be due to chance) and, in short, are unreliable. Reported correlations
between overweight/obesity with premature death don�t start to inspire
even minimal confidence until the obesity in question is extreme ―
cases where you only need common sense, not statistical hocus-pocus.
Recklessly plugging unreliable statistical correlations into the
attributable risk formula to produce sensational body counts can only be
described as junk science.
But you don�t need to take my word about the folly of the CDC�s
methodology.
As the New England Journal of Medicine editorialized in 1998, �Although
some claim that every year 300,000 deaths in the United States are
caused by obesity, that figure is by no means well established. Not only
is it derived from weak or incomplete data, but it is also called into
question by the methodologic difficulties of determining which of many
factors contribute to premature death.�
�Calculations of attributable risk are fraught with problems � [and can
produce] a nonsensical result,� noted the Journal.
And if all this is too technical, just ask yourself this question: Is it
really plausible that the death rate from overweight and obesity has
increased by 33 percent in the last 10 years?
Let�s not forget that despite all the hyperventilating about our health,
the CDC reported last month (with much less fanfare) that U.S. life
expectancy (search) ― the most objective measure of public health
― reached an all-time high of 77.4 years in 2002, up from about
75.2 in 1990.
So what gives? Why does the CDC insist on nagging us about our
waistlines? Two reasons come to mind.
First, the previously mentioned New England Journal of Medicine
editorial characterized the obesity obsession as an example of �a
tendency to medicalize behavior we do not approve of� ― that is,
politically incorrect activities like over-eating, not exercising,
smoking, drinking, and gun ownership.
Next, the public health establishment (search) is simply running out of
things to do. Preventing and controlling the spread of infectious
disease, the traditional and primary mission of public health
professionals, has largely been achieved. The relatively small number of
infectious disease deaths that still occur annually, excluding
AIDS-related deaths, decreased by 25 percent from 1990 to 2000,
according to the CDC.
In former President Dwight D. Eisenhower�s famous 1961 speech warning us
of a looming military-industrial complex (search), he also said, �The
prospect of domination of the nation's scholars by Federal employment,
project allocations, and the power of money is ever present and is
gravely to be regarded. Yet, in holding scientific research and
discovery in respect, as we should, we must also be alert to the equal
and opposite danger that public policy could itself become the captive
of a scientific-technological elite.�
Were Ike witnessing the health nannies� apparent desire to control our
behavior and bigger budgets, he might warn us of the looming �public
health-industrial complex.�
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