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Obesity in the news

The big International Congress on Obesity going on this week in Stockholm is generating lots of news. Three studies being presented Tuesday make it clear how daunting the battle against overweight and obesity really is.

Consider these findings:

-- Community-based interventions to prevent obesity in children can work, but they work best in those under the age of 5. Researchers report that there is evidence of some success for such programs among primary schoolchildren but "very mixed effects" among adolescents, according to media materials. (For more on the success of intervention programs for schoolchildren, read this.)

-- Efforts to limit the marketing of unhealthful food and drink to children are underway in the U.S., Brazil and two-thirds of European countries, among other jurisdictions. But they're complicated by all kinds of issues, including unclear definitions of what's "unhealthful," the debate over whether the food industry's voluntary changes can be sufficient and the expanding field of venues through which those companies can reach children.

-- A man who is obese at age 20 is at double the risk of dying at any subsequent age through age 80 of a man who is not obese. That's from a Danish study that tracked more than 5,000 military conscripts from age 20 until age 80 -- the longest follow-up period of any such study. On top of that, the study found that "the chance of dying early increased by 10 percent for each BMI point above the threshold for a healthy weight and that this persisted throughout life, with the obese dying about eight years earlier than the non-obese," according to the news release. That argues strongly against the "health at every size" stance that says overweight and mortality are not directly linked.

And that's not all the obesity news. The debate over the utility and wisdom of a soda tax continued in this Hartford Courant op-ed feature, in which Yale professor Kelly Brownell maintains that it's the government's responsibility to protect citizens' health, in this case by imposing a soda tax, while Fergus Cullen of the Yankee Institute counters that the government has no business meddling with our dinner plates and that overweight is a matter of personal responsibility. Cullen further notes that if curbing obesity is really a matter of saving money, we should encourage all the soda drinking we can, as people of healthful weights tend to live longer and ultimately cost the government more money than a fat person's medical costs.

Want more? Join the debate reported in The New York Times about whether we're doing the right thing by focusing so narrowly on young people's obesity at the expense of anti-smoking campaigns.

I came back to all this news after spending 10 days in Italy eating pizza and gelato and drinking excellent wine with most meals and walking from historic site to art museum to music venue. I didn't gain an ounce. But I spent some of my time there thinking about how different cultures' approaches to eating might determine how overweight people are. I'll be writing about that in my "Eat, Drink and Be Healthy" column July 22.

As always, I welcome your thoughts on these and any other obesity-related matters. Now that I'm back in my office, I'll be tweeting regularly, too, so let's be in touch.

By Jennifer LaRue Huget  |  July 13, 2010; 7:00 AM ET
Categories:  Nutrition and Fitness , Obesity  
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Psychologists have noticed a common trait that interferes with people’s ability to change their minds. It’s called confirmation bias – the tendency for people to favor information that confirms their belief system. I thought of this when I saw the attack on Health at Every Size – one of the many examples of poor journalism in this article.
Huget refers to a small study that indicates earlier mortality for those at higher weights. But she doesn’t mention that about 40 studies have actually shown that “overweight” people live longer than those in the category deemed normal and advisory (and include millions of people, which is a bit more than the 5,000 in this study), compared to only a handful which suggest otherwise.
But that there is ambiguity in the research is not surprising. There are many issues that confound the relationship between weight and mortality. The Health at Every Size movement is certainly not claiming that everyone is at a weight that is healthy for them. We’re merely asking for a shift in focus – we can all benefit from improved health behaviors, regardless of where we are on the weight spectrum. We can make a strong argument for good nutrition on the basis of health alone; body bashing distracts us from the real concerns.
And let’s face it. No matter how authoritatively we expound on the dangers posed by high weights, America’s average weight is not declining. Instead of helping people get healthier, we’ve inadvertently supported rampant food and body preoccupation, damaging cycles of weight loss and regain, eating disorders, reduced self-esteem, weight discrimination, and poor health.
Here’s where we agree: improved nutrition is a good thing – for everyone. Let’s join together in advocating for that directly – and stop the damage that results from fear-mongering like this.

Linda Bacon, PhD, Professor, Researcher, and author of Health at Every Size (

Posted by: LindaBacon | July 13, 2010 11:12 AM | Report abuse

"That argues strongly against the "health at every size" stance that says overweight and mortality are not directly linked."

No, actually, it doesn't. This is just one more epidemiological study that shows that overweight and mortality are associated. It does not show causation. It can't -- that's not what these kinds of studies do.

The problem is that excess weight is usually associated with poor diet and lack of exercise. So unless you can account for those other factors, how can you even begin to claim that this "proves" that weight is the real culprit?

Even other health issues can be confounding issues. For example, someone is overweight and has asthma. Did the weight cause the asthma? Did the asthma cause the weight gain (ie, through difficulty exercising)? Are they both associated with some other underlying cause? Of course, asthmatics also have shorter life spans. If this person dies young, is it fair to say that his obesity caused his early death?

Personally, I think there are some pretty strong associations between obesity and lifespan, which together lead me to believe there might be a causal relationship -- at the very least at the high end of the weight scale (when you're that large, it puts an extra strain on your body, keeps you from exercising and being healthy, etc.). There are also some interesting lab studies that support that causal relationship (i.e., studies about how fat cells interact with the body vs. muscle cells -- really intriguing).

At the same time, though, I don't know that there's sufficient data to extrapolate back to folks who are at the lower range of the scale -- does 10-20 lbs really have any effect on mortality? The studies Linda Bacon refers to suggest otherwise. And there are interesting studies that might point the other way (i.e., bacteria colonizations that differ among obese and non-obese -- are the bacteria simply adapting to a different environment, or do the different bacteria changing their environment to be more hospitable?). I find this all really fascinating.

The only part that really annoys me, though, is when studies make (or are interpreted as making) sweeping findings that are not supported by the evidence. Like, say, large-scale epidemiological studies being construed to prove causation.

Posted by: laura33 | July 13, 2010 11:45 AM | Report abuse

Wondering if it all isn't a moot point. Do we really (honestly?) know any safe, effective, enduring ways to change peoples' weights, that don't involved radical preoccupation with the project? I don't think so, and I don't think the problem is psychological or characterological. I think weight is a lot more biological - and immutable - than our fat-phobic, fat-hating culture cares to admit. I also think this preoccupation with weight (the number) keeps a lot of the uppercrust where they want to be (incl. the financial gains of those who prey on, oops "treat", weight fears), and keeps the "riff-raff" out of a lot opportunities. Disaster capitalism at its most developed and ingrained.
I would like to do vast, hugely-funded public health studies on all the people who see weight as the enemy - and then get published writing essays on the problems they create for society.

Posted by: ya_ta_hey | July 13, 2010 12:25 PM | Report abuse

It's a culture shift. It's about healthy living and healthy eating. And,yes, we do know safe, effective, enduring ways to change people's weights: creating safe, walkable neighborhoods; ending food deserts; cooking classes; teaching parents how to food parent effectively (Ellyn Satter comes to mind); healthy school lunches; PE and recess in every school; safe places for children and adults to play and exercise; creating car-free ways to get around. Will changing our culture be easy? No, but it has happened before. Look at what America was like until the 1950s. We are killing ourselves with junk food and "labor saving devices". For our own nation's sake, the national security, and the strength of our people, we need to re-focus our priorities.

Posted by: queen522 | July 13, 2010 10:48 PM | Report abuse

My life experience is that most of the high energy, intellectually active, enthusiastic elderly people I know are realtively thin. Cultures with a large populations of active elderly people are typically cultures with a lower BMI and more active lifestyles. What else do you need to know? Stay active, stay fit, don't pile on the weight, and eat your fruits and vegetables.

Posted by: tiggertime1 | July 14, 2010 10:06 AM | Report abuse

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