[PHNUTR-L] UNC nutrition researchers dispute claims that obesity problem is exaggerated

[Kathrynne Holden, MS, RD]

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Public release date: 31-Jan-2006
http://www.eurekalert.org/pub_releases/2006-01/uonc-unr013106.php

Contact: Deb Saine
deborah_saine at unc.edu
919-962-8415
University of North Carolina at Chapel Hill

UNC nutrition researchers dispute claims that obesity problem is exaggerated

Two University of North Carolina at Chapel Hill researchers disagree 
with a prominent Colorado attorney's contention that talk of a national 
and global epidemic of obesity is exaggerated.

Writing in the February 2006 issue of the International Journal of 
Epidemiology, University of Colorado law professor Paul Campos says that 
the "current rhetoric about an obesity-driven health crisis is being 
driven more by cultural and political factors than by any threat 
increasing body weight may pose to public health."

UNC-Chapel Hill nutrition researchers Drs. June Stevens and Barry Popkin 
think that while he makes a few reasonable points, mainly he is just 
plain wrong.

Campos and colleagues present and discuss four "claims" that they 
consider untrue. Those claims are that:

     * Almost all countries are experiencing an obesity epidemic.
     * Mortality rates increase with increasing degrees of overweight as 
measured by body mass index.
     * The data linking overweight and obesity to adverse health 
outcomes are well established and incontrovertible.
     * Significant long-term weight loss is a practical goal and will 
improve health.

"So what if the so-called 'obesity epidemic' is largely an illusion?" 
Campos wrote.

"What if higher than average weight turns out to have neither much 
medical nor moral significance?

"The answers to these questions, all of which we believe are strongly 
suggested by the epidemiological literature, go far beyond the issues of 
body mass and health," he said. "The current scientific evidence should 
prompt health professionals and policy-makers to consider whether it 
makes sense to treat body weight as a barometer of public health. It 
should also make us pause to consider how propagating the idea of an 
'obesity epidemic' furthers the political and economic interests of 
certain groups, while doing immense damage to those whom it blames and 
stigmatizes."

Stevens and Popkin, both nutrition professors at UNC-Chapel Hill, beg to 
differ.

"There is very strong evidence to indicate that...the incidence of 
obesity is increasing in just about all of the countries in which we 
have information," Stevens wrote. "... Definitions of 'epidemic' are not 
confined to infectious diseases but rather rest on a health phenomenon 
'clearly in excess of normal expectancy.'"

She and most other health professionals see the upward shift in weight 
of most people of between about 6.5 pounds and 11 pounds as significant 
and say that it would be healthier if populations as a whole moved in 
the direction of preventing weight gain.

"Results differ depending on the population studied and the methods 
used, but the vast majority of studies show...an association between 
body mass index and mortality," Stevens said. "...Many studies in 
experimental animals have shown that those kept slender live longer than 
heavier animals. Recently, a study...examined the question of weight 
loss and mortality in an animal model. They showed that rats that were 
kept lean throughout their lives had the lowest mortality, and rats 
maintained at an obese weight had highest mortality."

Animals that were obese and then made to lose weight had mortality 
comparable to the consistently lean rats, she said. Mortality among rats 
that lost weight was slightly higher but significantly lower than the 
consistently obese animals.

While no one would say that significant weight loss is an easy goal, 
that does not make it impractical, Stevens wrote. "...There is ample 
evidence to support that adoption of a lifestyle that reduces excess 
weight by means of a healthy diet and increased physical activity will 
improve health."

Two keys points to keep in mind, she said, were that the global 
population is getting heavier and that being obese causes serious health 
consequences.

"...Obesity remains an exceptionally important preventable cause of 
disease and death," Stevens wrote. "Finally, after many years of 
inattention the scientific community has turned its considerable 
resources to obesity. The vast majority of researchers and practitioners 
champion this move, not because it will increase their personal fortune 
but because it offers the opportunity to make important improvements in 
human health."

Popkin and Dr. Soowon Kim, a fellow in the University of California at 
San Francisco's family and community medicine department, conducted a 
wide-ranging review of the scientific literature. They wrote that any 
such review "produces overwhelming evidence of the global obesity 
pandemic and the strong adverse consequences of obesity."

Among the health consequences they cite as arising at least in part from 
overweight and obesity are hypertension, cholesterol problems, insulin 
resistance, cancers of the colon, breast, esophagus, endometrium and 
kidney, type 2 diabetes, coronary heart disease, stroke, gallbladder 
disease, osteoarthritis and psychological issues.

"Overweight persons ... also retire earlier, go at younger ages into 
nursing homes, have higher absenteeism rates and are more likely to be 
disabled," Kim and Popkin wrote. "...It is often the poor, people with 
lower socioeconomic status and some socially disadvantaged racial/ethnic 
groups that disproportionately suffer from the obesity epidemic, both 
adults and children alike," the two wrote. "When the alarming increase 
in weight nationally and globally is ignored, these already marginalized 
and stigmatized subgroups, socially and health-wise, will suffer even 
greater from obesity-related morbidity and mortality.

"We feel that treating a real health problem as non-existing is equally 
irresponsible as blaming the victims only."
-- 
Kathrynne Holden, MS, RD < fivestar at nutritionucanlivewith.com >
"Ask the Parkinson Dietitian"  http://www.parkinson.org/
"Eat well, stay well with Parkinson's disease"
"Parkinson's disease: Guidelines for Medical Nutrition Therapy"
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