Could it be that excess fat is not, by itself, a serious health risk for the vast majority of people who are overweight or obese--categories that in the U.S. include about six of every 10 adults? Is it possible that urging the overweight or mildly obese to cut calories and lose weight may actually do more harm than good?
Such notions defy conventional wisdom that excess adiposity kills more than 300,000 Americans a year and that the gradual fattening of nations since the 1980s presages coming epidemics of diabetes, cardiovascular disease, cancer and a host of other medical consequences. Indeed, just this past August a large study of retirees published in the New England Journal of Medicine by scientists at the National Cancer Institute (NCI) and the National Institutes of Health concluded that "excess body weight during midlife, including overweight, is associated with an increased risk of death." And in March 2005 that journal presented a "Special Report" by S. Jay Olshansky, David B. Allison and others who asserted that because of the obesity epidemic, "the steady rise in life expectancy during the past two centuries may soon come to an end." Articles about the special report by the New York Times, the Washington Post and many other news outlets emphasized its forecast that obesity may shave up to five years off average life spans in coming decades.
And yet a number of scholars have accused obesity experts, public health officials and the media of exaggerating the health effects of the epidemic of overweight and obesity. The charges appear in a recent flurry of scholarly books, including The Obesity Myth, by Paul F. Campos (Gotham Books, 2004); The Obesity Epidemic: Science, Morality and Ideology, by Michael Gard and Jan Wright (Routledge, 2005); Fat Politics: The Real Story behind Americas Obesity Epidemic, by J. Eric Oliver (Oxford University Press, 2005); and The Gospel of Food: Everything You Think You Know about Food Is Wrong, by Barry Glassner (Ecco/HarperCollins, 2007).
These critics, all academic researchers outside the medical community, do not dispute surveys that find the obese fraction of the population to have roughly doubled in the U.S. and many parts of Europe since 1980. And they acknowledge that obesity, especially in its extreme forms, does seem to be a factor in some illnesses and premature deaths.
They allege, however, that experts are blowing hot air when they warn that overweight and obesity are causing a massive, and worsening, health crisis. What is really going on, asserts Oliver, a political scientist at the University of Chicago, is that "a relatively small group of scientists and doctors, many directly funded by the weight-loss industry, have created an arbitrary and unscientific definition of overweight and obesity. They have inflated claims and distorted statistics on the consequences of our growing weights, and they have largely ignored the complicated health realities associated with being fat."
One of those complicated realities, concurs Campos, a professor of law at the University of Colorado at Boulder, is the widely accepted evidence that genetic differences account for 50 to 80 percent of the variation in fatness within a population. Because no safe and widely practical methods have been shown to induce long-term loss of more than about 5 percent of body weight, Campos says, "health authorities are giving people advice--maintain a body mass index in the 'healthy weight' range--that is literally impossible for many of them to follow." Body mass index, or BMI, is a weight-to-height ratio [see top box on opposite page for the definition of weight categories].
By exaggerating the risks of fat and the feasibility of weight loss, Campos and Oliver claim, the Centers for Disease Control and Prevention, the U.S. Department of Health and Human Services and the World Health Organization inadvertently perpetuate stigma, encourage unbalanced diets and, perhaps, even exacerbate weight gain. "The most perverse irony is that we may be creating a disease simply by labeling it as such," Campos states.