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MAY 2008 STRONG GENETIC FACTOR FOUND IN WEIGHT GAIN More evidence that the prejudice shown against large people is just that: prejudice NEW SCIENTIST A team of Swedish researchers has found that humans determine their total number of fat cells in childhood. New cells spring up and old ones perish, but their numbers change little after adolescence. By measuring radiation absorbed after nuclear bomb tests in the 1950s and 60s, researchers found that our fat cells quickly regenerate. But obese people turn over far more fat cells than others, says Kirsty Spalding, a biologist at the Karolinska Institute in Stockholm. The difference could explain why people battle to keep weight off after a diet. "The take-home message is be careful what you feed your child," Spalding says. "Do everything you can to make sure you don't blow out your fat cell number when you are young." . . . We recycle about 10% of our fat cells each
year, and every 8 years, half our adipocytes have been replaced. After plugging those numbers into a mathematical model, her team found that obese people start building up their fat cells much faster and at a younger age - about two years old - than thin people. APRIL 2008 STUDY FINDS DISCRIMINATION AGAINST BIG PEOPLE RAMPANT ABC NEWS It's illegal to discriminate against someone because of race or gender, but our culture condones a bias against people who are overweight. There are no federal laws that prohibit discrimination on the basis of weight, and only Michigan has such a law, according to a new study from Yale University. As a result, the researchers contend, weight discrimination is spiraling upward. . . Weight discrimination "occurs in employment settings and daily interpersonal relationships virtually as often as race discrimination, and in some cases even more frequently than age or gender discrimination," the researchers report in the current issue of the International Journal of Obesity. Overweight women are twice as vulnerable as men, and discrimination strikes much earlier in their lives, the report states. "This is a form of bias that remains very socially acceptable in our culture," research scientist Rebecca Puhl, lead author of the study, said . . . Puhl, who has been studying weight discrimination for nine years, said our culture has made it clear that it's wrong to discriminate against someone because of race, color, creed, gender, age and so forth, but that it's OK to show someone the door because he or she is fat. "We send a message to citizens in our culture that this is something that is tolerated," she said. "We live in a culture where we obviously place a premium on fitness, and fitness has come to symbolize very important values in our culture, like hard work and discipline and ambition. Unfortunately, if a person is not thin, or is overweight or obese, then they must lack self-discipline, have poor willpower, etc., and as a result they get blamed and stigmatized.". . . "We know from hundreds of randomized clinically controlled trials that it's very difficult to sustain weight loss over time with our existing treatment methods. That has compelled a number of expert panels, like the National Institutes of Health, to conclude that we really can't expect you to lose more than 10 percent of your body weight and be able to keep that off.". . . The heart of the problem, Puhl said, is that obesity brings social stigmatism and stereotyping, and that can lead to depression, discrimination and binge eating, so the problem just gets worse. http://abcnews.go.com/print?id=4568813
JANUARY 2008 STUDY FINDS 77% OF DIFFERENCE IN TWINS' BODY MASS ARE GENETIC BBC - Becoming overweight as a child is more likely to be the result of your genes than your lifestyle, claims a study. University College London researchers examined more than 5,000 pairs of identical and non-identical twins. Their American Journal of Clinical Nutrition study found that differences in body mass index and waist size were 77% governed by genes. . . Identical twins have exactly the same genes, while non-identical twins are genetically different, like brother and sister. However, because they were born at the same time, and raised in the same household, they can be assumed to have roughly similar upbringing in terms of food http://news.bbc.co.uk/go/rss/-/1/hi/health/7230065.stm STUDY: NEARLY A QUARTER OF GENES CONTRIBUTE TO BODY WEIGHT SCIENTIFIC BLOGGING - Genetics Researchers from the Monell Chemical Senses Center have attempted to count the number of genes that contribute to obesity and body weight - and it isn't a pretty number. The findings suggest that over 6,000 genes, almost 25 percent of the genome, could help determine an individual's body weight. "Reports describing the discovery of a new 'obesity gene' have become common in the scientific literature and also the popular press," notes Monell behavioral geneticist Michael G. Tordoff, PhD, an author on the study. "Our results suggest that each newly discovered gene is just one of the many thousands that influence body weight, so a quick fix to the obesity problem is unlikely.". . . Tordoff comments, "It is interesting that there are 10 times more genes that increase body weight than decrease it, which might help explain why it is easier to gain weight than lose it." JUNE 2007 THE MYTH OF DIETING NY TIMES - The researchers concluded that 70 percent of the variation in peoples' weights may be accounted for by inheritance, a figure that means that weight is more strongly inherited than nearly any other condition, including mental illness, breast cancer or heart disease. The results did not mean that people are completely helpless to control their weight, Dr. Stunkard said. But, he said, it did mean that those who tend to be fat will have to constantly battle their genetic inheritance if they want to reach and maintain a significantly lower weight. The findings also provided evidence for a phenomenon that scientists like Dr. Hirsch and Dr. Leibel were certain was true - each person has a comfortable weight range to which the body gravitates. The range might span 10 or 20 pounds: someone might be able to weigh 120 to 140 pounds without too much effort. Going much above or much below the natural weight range is difficult, however; the body resists by increasing or decreasing the appetite and changing the metabolism to push the weight back to the range it seeks. http://www.nytimes.com/2007/05/08/health/08fat.html?ex=1182398400&en=229da81e2fdb565c&ei=5070 JANUARY 2007 SUBURBAN KIDS HEAVIER THAN URBAN ONES REUTERS - Using data from a national health survey, researchers found that teenagers living in sprawling suburbs were more than twice as likely to be overweight as teens in more compact urban areas. The findings echo those of a 2003 study by the same researchers that focused on U.S. adults. The researchers believe the same factors may be driving the link between suburban living and teenagers' weight -- the major one being reliance on cars. . . By contrast. . . people in cities are often forced to be active in their daily lives -- walking to stores and public transportation, carrying groceries up the stairs to their fifth-floor walk-up apartment. And while suburban dwellers may be able to go to the gym for some exercise, research suggests many lack the time. This is again, in part, due to spending so much time in cars, commuting to work or driving to far-away stores and schools. What's more, Ewing said, those cars have become "de facto snack shops" for many adults and kids, with the food often being fast food. In many spread-out suburbs in the U.S., fast food is the predominant dining option, Ewing noted. http://news.yahoo.com/s/nm/20061218/hl_nm/suburban_sprawl_dc STUDIES SHOW IT'S MORE THAN CALORIES ELIZABETH WEISE, USA TODAY - You are what your microbes eat. Two new studies show that there are different colonies of bacteria in the intestines of the obese than there are in the innards of the slim. The research, published in today's edition of the journal Nature, finds that the microbes in an overweight body are more efficient at extracting calories from food. "Not everyone sitting down to a bowl of cereal will necessarily absorb the same number of calories from it," says Jeffrey Gordon, lead author of the papers and a professor of medicine at Washington University in St. Louis. . . About two-thirds of adults, about 136 million Americans, are overweight or obese, the government says. These findings open up a new area of research, says Sam Klein, a study co-author and professor of gastroenterology at the university. "It's not just your brain and your body fat and your body organs involved in your energy balance equation," he says. "It may also be the bugs that are in your body as well.". . . When obese people lost weight, virtually all the bacteroidetes increased, while the firmicute group shrank, Gordon says. http://www.usatoday.com/news/health/2006-12-20-obesity_x.htm NY TIMES FINALLY DISCOVERS THAT THE BMI DOESN'T WORK [Although interestingly, the Times still doesn't notice that BMI absurdly uses a two-dimensional formula for a three dimensional object, i.e. you.] NY TIMES - A Belgian statistician and astronomer, Adolphe Quetelet, invented the index formula in the 1830s. But it wasn't until the 1980s that public health agencies adopted it as a way of identifying individuals at risk for heart attacks, hypertension, diabetes, stroke and some cancers. In 1998, two branches of the National Institutes of Health created new guidelines which divided people into categories: You were "normal" if your index rating was between 18.5 and 24.9; "overweight'' if it was 25 to 29.9; and "obese" if it was 30 or higher. After the change, many doctors and lay people were up in arms. By the revised standards, nearly 55 percent of the American adult population in 1998, was considered overweight or obese, according to the N.I.H. (Today, 66.3 percent of adults are overweight or obese, according to the Centers for Disease Control and Prevention.) The index also didn't distinguish between body fat and muscle mass, so athletes and bodybuilders like Arnold Schwarzenegger, whose rating was 33 when he was Mr. Universe, were technically obese. That struck some people as odd. Such discrepancies got experts wondering how accurately the index gauges health. Others questioned the reliability of the index because the figure doesn't take fitness into account. A low number can be deceptive. Sedentary men with a rating of less than 27 were at a greater risk for heart attacks, strokes, diabetes and certain cancers than fit men with a rating above 30, according to a study of 25,389 men conducted by the Cooper Aerobics Center in Dallas. . . A study published in the August 19 issue of the medical journal Lancet combined data from 40 studies involving about 250,000 people with heart disease. The researchers found that patients with a low rating in the normal rating had a higher risk of death than others in the normal rating. Overweight patients had better survival rates and fewer heart problems than those with a normal index number. "We concluded that B.M.I. might not be the best way to assess body fatness," said Dr. Francisco Lopez-Jimenez, the lead author and a cardiologist at the Mayo Clinic in Rochester, Minn. "The issue is that people with 'normal' weight based on B.M.I. may have a lot of fat, and we're labeling these people as completely healthy when they might not be." Yet, the index remains a widely accepted gauge of health, even though some tools are better predictors like say the hip-to-waist ratio in the case of heart attacks. Part of the reason is because it's simple to calculate and cheap. http://www.nytimes.com/2006/12/28/fashion/28Fitness.html?_r=1&oref=slogin NOVEMBER 2006 PHARMA PHRAUD TO GAIN FROM OBESITY OBSESSION;
http://bmj.com/cgi/content/full/332/7555/1412 BRITISH MEDICAL JOURNAL - New guidelines on obesity in the US may end up harming children, says an article in this week's BMJ. And an accompanying article goes on to question the financial links between the organization promoting these proposals and the pharmaceutical industry. If implemented, the proposals would see many more children classified as overweight or obese - and thus eligible for treatment with obesity drugs. The article outlines how an influential expert committee of the American Medical Association has "tentatively decided" to reclassify obesity definitions. This will result in healthy children being categorized as medically overweight or obese, says the author, and mean that approximately a quarter of toddlers and two fifths of children aged 6-11 in America will be classed as having the disease. Author of the articles is Ray Moynihan, who has previously written about drug companies promoting an increasing reliance on medications to the public. His report reveals that the US proposals have been greeted with alarm by some senior public health academics who have written to the committee. Dr Jenny O'Dea from the University of Sydney, for instance, warned that labeling children as overweight or obese can lead to stigmatization, eating problems, and avoidance of exercise. Mr Moynihan points out that one of the prime movers behind the proposed changes being considered by the expert committee is Dr William Dietz, a senior member of the International Obesity Task Force. In the second article Mr Moynihan reveals how the high profile and highly influential Task Force, which has close ties to the World Health Organization, was set up in the mid-1990s with the help of grants from three drug companies and continues to benefit from drug company sponsorship. Now merged with another international obesity forum, the Task Force gets two thirds of its funding from pharmaceutical giants Roche and Abbott. Roche makes the anti-obesity drug Xenical (orlistat), and Abbott makes the appetite suppressant Reductil (sibutramine hydrochloride). Over recent years, the article states, drug company sponsorship is likely to have amounted to "millions". The Task Force has responded to Mr Moynihan's questions about its funding, saying that it has made no secret of the grants it has received from drug companies and emphasising that an internal ethical scrutiny system ensures independence from sponsors. http://bmj.bmjjournals.com/content/vol332/issue7555/press_release.shtml From 1993 to 2003, the U.S. population grew by 12 percent but emergency room visits grew by 27 percent, from 90 million to 114 million. In that same period, however, 425 emergency departments closed, along with about 700 hospitals and nearly 200,000 beds. - Washington Post If a storyteller thinks enough of storytelling to regard it as a calling, unlike a historian he cannot turn from the sufferings of his characters. A storyteller, unlike the historian, must follow compassion wherever it leads him. He must be able to accompany his characters, even into smoke and fire, and bear witness to what they thought and felt even when they themselves no longer knew. - Norman Maclean, author of A River Runs Through It, who died this day in 1990. SCHOOLS' WEIGHT OBSESSION CAN HURT KIDS DONALD MACLEOD, GUARDIAN, UK - Screening the weight of four and 10-year-olds in schools could be psychologically harmful to children and result in some developing eating disorders, researchers from Loughborough University warned today. The government has proposed tests in schools in England to measure children's body mass index as part of a drive against childhood obesity, but the academics say the initiative could lead to overweight children being misinformed about the state of their health and being bullied. "If translated into policy and practice in schools, this latest measure will certain damage the health of some children," they warn. . . Schools in the UK are already carrying out lunchbox inspections and the Loughborough team is concerned that "panic" over childhood obesity will escalate into the degrading practice of "fat laps" - where children considered to be overweight are required to run around the school field during lunch breaks. The practice has been reported in Australian schools. http://education.guardian.co.uk/schools/story/0,,1802654,00.html?gusrc=rss SOCIAL BIGOTS AND HEAVY PEOPLE REBECCA M. PUHL AND KELLY BROWNELL IN WASHINGTON POST - With colleagues, we recently completed a study of more than 2,000 people enrolled in a weight loss program. . . . Participants told us that when they are stigmatized because of their weight they respond with such strategies as eating more food and just giving up on dieting. Eating more in response to discriminatory treatment was reported by 79 percent of the participants, and 75 percent refused to diet. A smaller number, 63 percent, said that they had at one time or another used dieting to cope with such discrimination, but dieting doesn't work very often. Other studies have shown that overweight girls and boys who are teased because of their weight are more likely to engage in unhealthy weight control and binge eating than are overweight youth who are not teased. It has also been shown that overweight young people avoid physical activities in which peer victimization frequently occurs. The data are quite clear: Stigmatizing overweight people contributes to unhealthy behavior that only adds to the problem of obesity. With two-thirds of American adults now overweight or obese, obesity is recognized as a pressing public health issue. Schools, health professionals and communities across the country are beginning to talk about what must be done to improve eating habits and encourage more physical activity. But these efforts, which are urgently needed, must expand to include the topic of weight stigma. Weight stigma is more than indirect experiences -- for example, feeling inadequate compared with the size-zero celebrities who are everywhere in our culture. Derogatory comments, job discrimination and even physical aggression were all reported by study participants. . . These stories reflect a viciousness long ago shunned in matters of race or gender. In the case of obesity, though, there is a perverse twist: The people inflicting the stigma are often convinced that they are actually helping the victim. Indelible harm is the more likely result. The sources of weight stigmatization reported in the study were surprising, with family members being the most frequent perpetrators at 72 percent and physicians following closely at 69 percent. . . 46 percent of respondents reported being stigmatized by nurses, 37 percent by dietitians or nutritionists, and 21 percent by mental health professionals. The obvious question is: If even the health-care system is unwelcoming, where can an obese person turn for help? [Rebecca M. Puhl is coordinator of community and weight stigma initiatives at the Rudd Center for Food Policy and Obesity at Yale University. Kelly Brownell is director of the center and a psychology professor at Yale] http://www.washingtonpost.com/wp-dyn/content/article/2006/11/01/AR2006110102969.html?nav=rss_opinion/columns THE PARIAH ECONOMY & SOCIAL
BIGOTRY AUGUST 2006 RESEARCH SHOWS WEIGHT LOSS PLATEAUS DESPITE DIET AND EXERCISE RESEARCH AUSTRALIA - Researchers frm Queensland University of Technology say that our bodies have a much easier time gaining weight then losing it Research confirming the human body is designed to strongly resist attempts to lose weight will be presented at an international gathering of obesity experts hosted by QUT. Queensland University of Technology appetite regulation and energy balance researcher Dr Neil King. . . said our bodies have strong mechanisms to defend attempts to lose weight but very weak mechanisms to prevent weight gain. Dr King's weight loss intervention studies demonstrate the "plateau effect", whereby weight loss from exercise and calorie restrictions stops at a certain point. He conducted two studies on weight loss following induced energy deficits in two different groups of overweight and obese people. http://www.researchaustralia.com.au/files/weight_loss_30.08.06.pdf
MEDICINE FINALLY DISCOVERS THAT BODY MASS INDEX IS WRONG REUTERS - Body Mass Index, the standard measure of obesity, is badly flawed and a more accurate gauge should be developed, according to doctors in the United States. Writing in Friday's Lancet medical journal, the researchers from the Mayo Clinic College of Medicine, Rochester, Minnesota, found that patients with a low BMI had a higher risk of death from heart disease than those with normal BMI. At the same time overweight patients had better survival rates and fewer heart problems than those with a normal BMI. This apparently perverse result, drawn from data from 40 studies covering 250,000 people with heart disease, did not suggest that obesity was not a health threat but rather that the 100-year-old BMI test was too blunt an instrument to be trusted. . . Maria Grazia Franzosi
from the Instituto Mario Negri in Milan, writing in the same
issue of the Lancet, noted that a 52-country study comparing
four different tests -- BMI, waist-to-hip ratio, waist measure
and hip measure -- found that waist-to-hip was the best predictor
of heart attack risk. "BMI can definitely be left aside
as a clinical and epidemiological measure of cardiovascular risk,"
she said. http://go.reuters.com/newsArticle.jhtml?type=healthNews&storyID=13231437&src=rss/healthNews BMI IS FAULTY MEASURE [Now that weight obsession is formal national policy, we ought to at least get some basic facts right, such as the body mass index. There are a number of problems with this simplistic measure such as its failure to distinguish between fat and muscle, but even more critical is that it is based on bad math. Looking for a site that would explain this, we oddly found one of the best descriptions on an electronic game site] BRYON HALL, FATAL GAMES - BMI is an acronym for Body Mass Index, and is used widely by hospitals, the healthcare field, fitness trainers, and a variety of occupations that seek to determine a healthy proportion of height and weight. BMI has been criticized widely because it does not take into account body build. Therefore, a fitness trainer may mistakenly tell their client that the client is slightly overweight according to their BMI, when in fact they are fit but merely have an athletic build. I knew this before I began using it with F.A.T.A.L. However, when I began extrapolating height and weight proportions to larger and smaller humanoids such as elves or giants, who were still generally meant to have a build at least similar to an average human, I got strange results. Unless I were also using the Cube-Square Law, I probably would not have noticed how BMI went askew. Proponents of BMI argue that BMI is suitable for a human range, but even this argument is false. . . The Cube-Square Law relates to the proportions of larger and smaller creatures. For example, as a creature increases proportionately in size, its surface area increases by a ratio of the difference in height squared, but the weight increases by the ratio of the difference cubed. When a muscle is increased twofold in all 3 dimensions, its volume and weight are cubed, but the muscular power is only multiplied by 4, since cross-sectional distance determines muscular strength, not volume and weight. For this article, the "square" part of the law is ignored, since strength will not be computed, but only weight. To calculate a proportional change in size, consider 6 variables: OH = Original Height in
inches For example, if an average male (OH = 70, W = 150) were to have his height doubled (NH = 140), then first determine that HR = 2 (since 140 / 70). Next, WR is determined by cubing HR, so WR = 8 (since 2 x 2 x 2 = 8). Finally, NW = (OW x WR), so NW = 1,200 (150 x 8). Therefore, if an average male stood nearly 12 feet tall, then he should weigh 1,200 pounds. Using the same method, if an average male had his height halved, then he would be 35 inches tall and weigh 19 pounds. But when BMI is calculated for these, the answers vary considerably. The average male mentioned above has a BMI of 21.58. The nearly 12-foot hypothetical person would have a BMI of 43.16. The hypothetical half-size or child-size person would have a BMI of 10.93. At this point, the problem should be obvious. As a measure, BMI results vary with height. BMI is still useful as a quick method for determining the proportion of height and weight with adult-sized humanoids who are or resemble humans, as long as accuracy is not critical. APRIL 2005. . . WEIGHT PREJUDICE ADDS TO DEPRESSION OF THE HEAVY BBC - Most overweight people said they felt discriminated against Two-thirds of overweight women say they feel that life is not worth living because of their size, a survey reveals. Of the 4,000 questioned for the National Slimming survey, only 1% were happy with their shape. Nine out of 10 felt depressed and eight out of 10 utter despair about their weight. The research for Slimming World found overweight men faced similar angst based on replies from 1,000 men. More than nine out of 10 of those questioned said they felt like "second class citizens" and seven out of 10 said they had been "pilloried and poked fun at". Overall, 98% said that society discriminated against overweight people. Many blamed the celebrity culture and pressure from the government to be slimmer for causing greater victimization of overweight people than ever before. Among the overweight women, half said they cut the size labels out of their clothes and over a third said they would have cosmetic surgery now or in the future. . . OVERWEIGHT WHO DIET SUCCESSFULLY DOUBLE RISK OF DEATH IAN SAMPLE, GUARDIAN - Overweight people who diet to reach a healthier weight are more likely to die young than those who remain fat, according to a study. The finding needs to be backed up by further research before sweeping changes are made to public health strategies, the authors warn, but it highlights how poorly the long-term health effects of dieting are understood. . . The study, which was carried out in Finland, followed 2,957 overweight or obese people who had been screened to ensure they had no underlying illnesses. . . Analysis of the data showed that those who wanted to lose weight and succeeded were significantly more likely to die young than those who stayed fat. "Healthy overweight or obese subjects who try to lose weight and succeed in doing so over a six-year period suffer from almost double the risk of dying during the next 18 years compared with subjects who do not try to lose weight and whose weight remains stable," said Dr Sorensen. Those who gained weight also had a greater risk of dying young. The researchers were unable to identify why the dieters were at a greater risk of dying younger, but believe it is caused by fat being lost from lean organs as well as other body tissues. "It seems as if the long-term effect of the weight loss is a general weakening of the body that leads to an increased risk of dying from several different causes," said Dr Sorensen. "The adverse effects of losing lean body mass may overrule the beneficial effects of losing fat mass when dieting," he added. The finding is supported by an earlier study by researchers at the US National Centre for Chronic Disease Prevention and Health Promotion in Atlanta. It followed 6,391 overweight or obese people for nine years and found that those who had no intention of losing weight and even gained weight were least at risk of dying young. If the latest study is confirmed, it emphasises the need to prevent people becoming overweight and obese, the authors say. STUDY FINDS THREE PERCENT CHANCE OF THROMBOSIS ON FLIGHTS [Why are there no class
actions against the airlines? Is it because the big lawyers all
fly first class with plenty of legroom?] THE SOCIOLOGY OF WEIGHT GINA KOLATA, NY TIMES - The idea of an epidemic, some critics say, is in the financial interest of weight loss centers, supplement makers, drug companies and purveyors of diet books and diet programs. And the alarm can also benefit many scientists, who get research grants to study the problem and who often serve as consultants to drug companies or run weight loss centers at their universities. A sense of crisis can also help government agencies get additional funds from Congress. "Obesity works across the board - that's a big part of it, and that's what's fascinating about it, " said Dr. Eric Oliver, a University of Chicago political scientist who is writing a book on the politics of obesity. "If you are on the political right, obesity is indicative of moral failure," he said. "If you are on the left, it means rampaging global capitalism.". . . In fact, epidemiologists say, while Americans are fatter than they used to be, they also are healthier by every measure than they were in the 1960's and 1970's, when the average body mass index was lower. In the ensuing years, even as the public has grown heavier -15 percent more, on average - heart disease rates have plummeted, cancer mortality has fallen, many fewer people smoke and death rates from auto accidents are down. People also live longer than back then, and when they do develop chronic illnesses, they tend to get them later in life. But such data may be at odds with the "cultural resonance" of obesity, according to Dr. Abigail Saguy, a sociologist at U.C.L.A. "People don't like fatness. They don't like it for aesthetic reasons, and they don't like it for moral reasons." Even the language used to describe obesity is judgmental, Dr. Saguy said. "Obesity is a health risk, like smoking, rather than a physical trait, like race," she said. "It assumes that people are to blame for their weight.". . . Dr. James Morone, a political science professor at Brown University, recalls that concerns about obesity were suddenly raised to the level of "crisis and obsession." For years, the surgeon general's office had been the great force behind the anti-tobacco campaign, Dr. Morone observed. "In 2001, the tobacco settlements were in place. We'd gotten all the cultural mileage out of blaming tobacco for our sins. The surgeon general's report gave us a new sin and it resonated, it had a sense of truth." Dr. Saguy, at U.C.L.A., takes a similar view. "Things we didn't think were possible before the anti-tobacco movement became possible afterward," she said. Companies could be held liable for selling a legal, but unhealthy product. Social pressures could change the image of smoking from glamorous to pitiable or even despicable. Now, she said, the overweight are pitiable or despicable. . . HE AIN'T HEAVY; HE'S MY REVISED LONGEVITY FIGURE THE GIGANTIC error in CDC obesity stats has been given less coverage than it should. We can't recall a similar public health statistic found to be so far wrong. Further, the original research, listing obesity as the number two cause of death, has undoubtedly spurred the misallocation of millions, if not billions, in public and private funds. Instead of worrying about blogs and who gets into White House news conferences, the media nannies would do better to examine the way the press covers health issues, how it routinely accepts data from questionable sources like drug companies without adequate investigation, and how it serves as a transmitter of mass hypochondria. It could also examine the public record better. For example, the JAMA story in question contains interesting information not mentioned in most stories, such as the fact that the effect of weight is significantly different depending on one's age. And it could examine the basis of most of these stories about weight: the mathematically absurd body mass index, in which humans are treated like paper cutouts when most of them have three dimensions. If, in high school math, you tried to compute the size of a cube the way we compute BMI - squaring things that should be cubed - you would flunk. And it shouldn't pretend there isn't a controversy when there is. For example Stephen Blair of the highly respected Cooper Institute has been arguing that fitness is much more important than weight but has gotten little press attention. Finally the media should read its own copy. If, as one story reported, the CDC had "found people who are modestly overweight actually have a lower risk of death than those of normal weight," then shouldn't the latter really be called underweight or perhaps even morbidly thin? This is a small but useful example of how in the media past assumptions survive new facts. CDC ADMITS HUGE ERROR IN WEIGHT
STUDY AP - The Centers for Disease Control and Prevention estimated today that packing on too many pounds accounts for 25,814 deaths a year in the United States. As recently as January, the CDC came up with an estimate 14 times higher: 365,000 deaths. The new analysis found that obesity — being extremely overweight — is indisputably lethal. But like several recent smaller studies, it found that people who are modestly overweight actually have a lower risk of death than those of normal weight. Biostatistician Mary Grace Kovar, a consultant for the University of Chicago's National Opinion Research Center in Washington, said "normal" may be set too low for today's population. Also, Americans classified as overweight are eating better, exercising more and managing their blood pressure better than they used to, she said. Based on the new calculation,
excess weight would drop from the second leading cause of preventable
death, after smoking, to seventh. It would fall behind car crashes
and guns on the list of killers. LOOKS, WEIGHT, HEIGHT MATTER
IN JOB PROMOTION FEDERAL RESERVE BANK OF ST. LOUIS - In a recent book, journalist Malcolm Gladwell reported the results of his survey of about one-half of the CEOs of Fortune 500 companies. He found that the average CEO is approximately 3 inches taller than the average American man, who stands 5-foot-9. Further, 30 percent of the CEOs are at least 6-foot-2; the corresponding percentage for American adult men overall is only 3.9 percent. . . A study by economists Daniel Hamermesh and Jeff Biddle uses survey data to examine the impact that appearance has on a person's earnings. In each survey, the interviewer who asked the questions also rated the respondents' physical appearance. Respondents were classified into one of the following groups: below average, average and above average. Hamermesh and Biddle found that . . . a person with below-average looks tended to earn 9 percent less per hour, and an above-average person tended to earn 5 percent more per hour than an average-looking person. For the median male in 1996 working full-time, the respective penalty and premium amounted to approximately $2,600 and $1,400 annually. The corresponding penalty and premium for the median female worker are $2,000 and $1,100. Occupations that require more interpersonal contact have higher percentages of above-average-looking employees. However, Hamermesh and Biddle showed that the plainness penalty and the beauty premium exist across all occupations. In a separate paper, Biddle and Hamermesh investigated the influence of beauty on the wages of lawyers, using data collected from the same law school for graduating classes of 1971-78 and 1981-88. The school has photographs of each entering class, which form the basis of the study. . . They found evidence of a beauty premium for attorneys that increases with age, at least for the 1971-78 classes. Five years after graduating, a male lawyer from these classes with a beauty rating of one rank above average had approximately 10 percent higher earnings than his counterpart with a rating of one rank below average. Fifteen years after graduation, the beauty premium increased to 12 percent. The beauty premium was smaller for the 1980s classes and might be attributed to tighter labor market conditions at the time of graduation. Economists Susan Averett and Sanders Korenman . . . showed that women who were obese according to their Body Mass Index in both 1981 and 1988 earned 17 percent lower wages on average than women within their recommended BMI range. . . When comparing by race, the authors found a wage penalty for obesity among white women but no significant penalty for black women. Among white men, they found a much lower wage penalty for obesity than for their white female counterparts. A small positive relationship was actually found between obese black men and wages. In a similar study, economist John Cawley found that the only group for which weight consistently lowered wages is white females. His results show that for a typical white woman weighing 64 pounds more than an otherwise-similar white female of average weight, the former's wage will be about 9 percent lower. Economists Nicola Persico, Andrew Postlewaite and Dan Silverman . . . found that for white men in the United States, a 1.8-percent increase in wages accompanies every additional inch of height. Men's wages as adults can be linked to their height at age 16. For a given adult height, Persico, Postlewaite and Silverman found that increasing height at age 16 by one inch increased adult wages by 2.6 percent, on average. STUDY FINDS HEAVY MOMS HAVE
HEAVY KIDS REUTERS - The children of overweight mothers are 15 times more likely to be obese by age 6 than children of lean mothers, U.S. researchers reported on Tuesday. The children start piling on the pounds at age 3, the team at The Children's Hospital of Philadelphia and the University of Pennsylvania found. . . [Dr. Robert Berkowitz] said his team is now examining the eating and exercise habits of the families they studied but said other studies clearly show genes play an important role. The dramatic spike in weight between ages 3 and 6 support this, he said. "This suggests that some genes controlling body weight may become active during this period," Berkowitz said. . . Berkowitz said certain children must carry a combination of genes that make them much more vulnerable to what he calls the "toxic" Western environment, where it is difficult to exercise and food abounds. He does not believe poor diet alone is to blame. "It doesn't appear to be the factor entirely because we know there are plenty of lean people who eat hamburgers," he said. "The lean group stays pretty lean but this high risk group really takes off."  CHART SHOWS CHANGE IN MENTIONS OF OBESITY IN BRITISH ARTICLES AND ADS (BLUE & RED) VS. MENTIONS OF POVERTY (YELLOW) SOCIAL ISSUES RESEARCH CENTER, UK - Amidst disoriented casting around for culprits and simple solutions, driven hard by media hype, it was refreshing to read in the Observer a thoughtful article by David Smith that for once dealt with some of the real issues underlying the rise in obesity - poverty and disadvantage. It has become fashionable to believe that in the modern Blairite Britain such features of British society are no longer with us - that we are all now 'middle class' and that the old social and economic distinctions that were once an intrinsic feature of our culture have been consigned to history. Not so, sadly, for the people of Glasgow's East End where life expectancy is around 60 and falling and where the average diet is about as unhealthy as it can get. Obesity is but one of the symptoms of the impoverishment that plagues their lives. For those directly concerned with stemming the declining health of the population, the middle-class food and health philosophies generated in Westminster seem almost obscenely irrelevant. A local GP, Dr Gerry Spence, for example, comments: "A lot of people are on benefits, living from week to week, relying on convenience foods and eating out of the chippy. Give people jobs and the ability to be masters of their own destinies and they will make healthy decisions about their lives. You bring employment into here and I guarantee the pubs will empty, the kids will stay at school and the place will flourish. You can't blame the people when they are victims of circumstances. It's not really a medical problem, it's something for the politicians to sort out. I hope the drop in life expectancy is a turning point and the politicians are called to account. They should hang their heads in shame." Bob Holman, who quit academia to work on projects in socially deprived areas, is similarly unimpressed with current initiatives to combat obesity. "This is not rocket science. Poor health is a well-known feature of deprivation. Mothers are not daft and they do know fat and crisps are bad for children but they can't afford the alternative. The government has to give them the means. Initiatives are not going to change anything unless you've got the cash in your pocket. If you buy a salad at Sainsbury's, it's still very expensive." The Observer article is, unfortunately, a rarity. Most journalists and editors seem to prefer to crank up the attacks on soft targets - the unlovable McDonald's or Coca Cola - rather than expose the dirt that has been swept under the carpet of many parts of urban Britain. The data show quite clearly that lower income families and those living in socially deprived neighborhoods are far more at risk from becoming obese than the middle and upper classes. A report from the National Statistics office notes: "Obesity is linked to social class, being more common among those in the routine or semi-routine occupational groups than the managerial and professional groups. The link is stronger among women. In 2001, 30 per cent of women in routine occupations were classified as obese compared with 16 per cent in higher managerial and professional occupations." Researchers at the Department of Social Medicine at Bristol University have also concluded that: "Social origins may have a long term impact on obesity. Whether this operates through the early establishment of behavioral patterns, such as diet and exercise, or through metabolic changes associated with early deprivation, is still to be determined." LAKSHMI CHAUDHRY, ALTERNET - We're at war and the enemy is obesity - or so warn the doctors. U.S. Surgeon General Richard Carmona has declared obesity "the terror within because it is every bit as devastating as terrorism." It allegedly affects nine million children and two out of three adults, and claims the lives of 400,000 Americans every year. It takes a brave man to speak out in favor of flab today - and that man is Paul Campos. The Obesity Wars are nothing but a big lie about fat, says the author of a provocative new book titled "The Obesity Myth: Why America's Obsession With Health is Hazardous to Your Health." Campos argues that Americans are in fact only a mere 15 pounds heavier than we were 20 years ago. What have become more stringent in that duration are public health standards for ideal weight, which now define the vast majority of us as "overweight" or "obese" - and that includes Hollywood icons like Brad Pitt and George Clooney. What's more, according to Campos, there is no documented relationship between weight loss and health. He claims that medical studies that link obesity to wide range of diseases, including heart disease and cancer, are misleading and often self-serving. The result is a cultural hysteria that uses a dangerous and pervasive myth to demonize all - especially poor people of color - who do not fit the shrinking standards of the ideal body weight. Campos talked to AlterNet from his office at the University of Colorado, Boulder. Q - Your central claim is that major epidemiological studies show little or no link between weight and health, be it risk for cancer or heart disease. That sounds kind of kooky to a lay person. A- For the vast majority of people in the United States, their weight does not give you any meaningful information about their likely overall health. You can look at the roughly 75 percent of the population that has a Body Mass Index (a measure of your weight relative to your height) between 18.5 and 32 or so. That entire range, which represents about 80 pounds for an average height woman (5 ft. 4 in.), you will not see any significant variation in terms of risk (of contracting a disease). Q - So you're saying that there is no difference in terms of overall health between someone who would be considered "obese" with a BMI of 32 and someone who has the "normal" BMI of 20. A - There are two points here. One is that for the vast majority of people, weight simply isn't going to tell you anything relevant about their health in and of itself. And second that among those groups that do show some meaningful correlations with health, we need to unpack the extent to which the weight is causal or merely a marker for other things, such as poor nutrition, socio-economic status, weight cycling brought on by dieting etc. If a person with a BMI of 32 has a significantly increased health risk but is far less likely to have health insurance than someone with a BMI of 25, what is really relevant here? The BMI or health insurance? Q - So you do make a distinction between weight and a healthy lifestyle. Eating well and exercising is important to good health but it is not necessarily connected to weight loss. A - Absolutely. The war on fat is based on the assumption that if people have a healthy lifestyle they'll be thin. Now we know that's not true. Now we don't know the extent to which it's not true - i.e. what percent of the population would be "overweight" or "obese" if they had a healthy lifestyle - but we know it's a very significant percent. WEIGHT EXPERT SAYS FAT PLAGUE OVERRATED GINA KOLATA, NY TIMES - Dr. Jeffrey Friedman, an obesity researcher at Rockefeller University, argues that contrary to popular opinion, national data do not show Americans growing uniformly fatter. Instead, he says, the statistics demonstrate clearly that while the very fat are getting fatter, thinner people have remained pretty much the same. . . Dr. Friedman said he was outraged by the acceptance of what he sees as a hurtful myth, one that encourages people to believe that if you are fat, it is your fault. The obesity arena "is so political, so rife with misinformation and disinformation," he said. Dr. Friedman points to careful statistical analyses of the changes in Americans' body weights from 1991 to today by Dr. Katherine Flegal of the National Center for Health Statistics. At the lower end of the weight distribution, nothing has changed, not even by a few pounds. As you move up the scale, a few additional pounds start to show up, but even at midrange, people today are just 6 or 7 pounds heavier than they were in 1991. Only with the massively obese, the very top of the distribution, is there a substantial increase in weight, about 25 to 30 pounds, Dr. Flegal reported. . . Over the years, Dr. Friedman says, he has watched the scientific data accumulate to show that body weight, in animals and humans, is not under conscious control. Body weight, he says, is genetically determined, as tightly regulated as height. Genes control not only how much you eat but also the metabolic rate at which you burn food. When it comes to eating, free will is an illusion. "People can exert a level of control over their weight within a 10-, perhaps a 15-pound range," Dr. Friedman said. But expecting an obese person to decide to simply eat less and exercise more to get below the obesity range, below the overweight range? It virtually never happens, he said. Any weight that is lost almost invariably comes right back. The same goes for gaining weight in general, Dr. Friedman argued. A person who has the genes to be thin is not going to get fat because portion sizes increase. It makes no scientific sense, he said. But isn't it true that we can decide to eat or not, choosing to skip dinner, say, or pass up dessert? Isn't that free will? Not really, Dr. Friedman said. The control mechanisms for body weight operate over months, even years, not day to day or meal to meal. MEDIA IGNORES HEALTH STORY THAT CONTRADICTS OBESITY THEORIES [The Atlanta Journal Constitution was the only paper to come up on Google for this story.] ATLANTA JOURNAL CONSTITUTION - The amount of body fat you carry around does not predict heart disease as well as its location does, a new study claims. The findings should call into question the practice of recommending bariatric surgery solely on obesity rather than other heart disease risk factors, Dr. Edward Harry Livingston, chairman of gastrointestinal and endocrine surgery at UT Southwestern Medical Center, said April 20 at the Experimental Biology 2004 meeting in Washington, D.C. . . In his analysis, he found death from heart disease did not increase in a totally linear fashion the fatter people became. And he found distribution of body fat, rather than overall weight, is a better predictor of heart disease risk, with fat on the abdomen more unhealthy than that on the thighs and hips. "One of the reasons we do these operations is there is a concern for early mortality attributed to obesity," Livingston explained. Traditional thinking has it that the heavier a person is, the more heart disease risk factors he or she has. WAR ON OBESITY AS A FORM OF DISCRIMINATION DINITIA SMITH, NY TIMES - Almost every day, it seems, there is another alarming study about the dangers of being fat or a new theory about its causes and cures. Just this week, VH1 announced a new reality show called "Flab to Fab," in which overweight women get a personal staff to whip them into shape. But a growing group of historians and cultural critics who study fat say this obsession is based less on science than on morality. Insidious attitudes about politics, sex, race or class are at the heart of the frenzy over obesity, these scholars say, a frenzy they see as comparable to the Salem witch trials, McCarthyism and even the eugenics movement. "We are in a moral panic about obesity," said Sander L. Gilman, distinguished professor of liberal arts, sciences and medicine at the University of Illinois in Chicago and the author of "Fat Boys: A Slim Book," published last month by the University of Nebraska Press. "People are saying, `Fat is the doom of Western civilization.'" ~~~ [Peter]Stearns, provost and professor of history at George Mason University, has written that plumpness was once associated with "good health in a time when many of the most troubling diseases were wasting diseases like tuberculosis." He traces the equation of obesity and moral deficiency to the late-19th and early-20th centuries. . . During World War I, Mr. Stearns writes, some popular magazines actually said that eating too much and gaining weight were unpatriotic, presumably because of concerns about food shortages. ~~~ Kathleen
LeBesco, associate professor of communication arts at Marymount
Manhattan College, also asserts that at the root of the current
slimness craze is an effort to stigmatize certain groups. She refers to a study by the Centers for Disease Control in which the highest proportions of overweight people are said to be African-American women and Mexican-American women. "Is it coincidence that representatives of these two stigmatized racial and ethnic groups, as well as women, are most likely to be obese?" Ms. LeBesco writes. WHAT'S WRONG WITH THE WAR ON OBESITY PAUL CAMPOS, GUARDIAN - The doctors and public health officials prosecuting the war on fat would have us believe that who is or isn't fat is a scientific question that can be answered by consulting something as crude as a body mass index chart. This, like so many other claims at the heart of the case against fat, is false. "Fat" is a cultural construct. According to the public health establishment's current BMI definitions, Brad Pitt, Michael Jordan and Mel Gibson are all "overweight", while Russell Crowe, George Clooney and baseball star Sammy Sosa are all "obese". According to America's fat police, if your BMI is over 25, then you are "overweight," full stop. Note also the radical difference between how our culture defines "fashionable" thinness for men and women. If Jennifer Aniston had the same BMI as her husband Brad Pitt, she would weigh approximately 55 lb more than she does. A 1999 study published in the Journal of the American Medical Association estimated that overweight lead to around 300,000 premature deaths per year in America alone. Meanwhile, the proportion of the population that maintains a dangerously high weight continues to climb: obesity in America has increased by more than 50% over the course of the past decade. If the authors of these studies are correct, America is facing a health crisis that, in the words of one anti-fat warrior, will make Aids look "like a bad case of the flu.". . . This, then, is the case against fat: America, we are told, is on the verge of eating itself to death. The core belief of those prosecuting this case is that the BMI tables testify to a strong, predictable relationship between increasing weight and increasing mortality. That, after all, is what most people assume when they read that medical and public health authorities have determined a BMI of 25 or above is hazardous to a person's health. This belief, however, is not supported by the available evidence. A 1996 project undertaken by scientists at the National Centre for Health Statistics and Cornell University analyzed the data from dozens of previous studies, involving a total of more than 600,000 subjects with up to a 30-year follow-up. Among non-smoking white men, the lowest mortality rate was found among those with a BMI between 23 and 29, which means that a large majority of the men who lived longest were "overweight" according to government guidelines. The mortality rate for white men in the supposedly ideal range of 19 to 21 was the same as that for those in the 29 to 31 range (most of whom would be defined now as "obese"). In regard to non-smoking white women, the study's conclusions were even more striking: the BMI range correlating with the lowest mortality rate was extremely broad, from around 18 to 32, meaning a woman of average height could weigh anywhere within an 80-pound range without seeing any statistically significant change in her risk of premature death. In almost all large-scale epidemiological studies, little or no correlation between weight and health can be found for a large majority of the population - and indeed what correlation does exist suggests that it is more dangerous to be just a few pounds "underweight" than dozens of pounds "overweight. . . Most Americans, and indeed most doctors, simply assume that the heavier you are, the more likely it is you will suffer from coronary artery disease - hence the various clichés about "artery-clogging" fast food and the like. Yet several studies have specifically investigated the question of whether a high percentage of body fat correlates with the incidence of coronary artery disease. Answer: no, it does not. Even massively obese men and women do not appear to be more prone to vascular disease than average. It is true that increasing weight is associated with high blood pressure and certain types of heart disease. But even here there is considerable evidence that this correlation is not necessarily a product of being fat, but rather of losing and then regaining weight. Obese patients who have been put on very low-calorie diets subsequently display much higher rates of congestive heart failure than equally fat people who did not attempt to lose weight in the first place. The biggest evidentiary problem for those who insist there is a strong causal link between increasing weight and heart disease is that deaths from heart disease have been plunging at precisely the same time that obesity rates have been skyrocketing. . . There are some groups of heavier individuals - usually those with BMI figures in the mid-30s and above - who do suffer from worse health than those of "ideal-weight". Yet this does not of itself prove that such people's problems are caused by their excess weight. There are many other factors that disproportionately affect the heaviest people in our society, and that also correlate with poor health: most notably a sedentary lifestyle, poor diet, dieting-induced weight fluctuation, diet drug use, poverty, access to and discrimination in health care, and social discrimination generally. None of these factors was taken into account in Annual Deaths Attributable To Obesity In The United States, the JAMA study responsible for the "fact" that fat kills 300,000 Americans a year. The case against fat proceeds on the assumption that if a fat person becomes thin, that person will acquire the health characteristics of people who were thin in the first place. Although this assumption may seem like simple common sense, it is, like many commonsensical assumptions, quite dubious. If a person who is physiologically inclined to be fat loses weight, this does not transform that person into someone who is physiologically inclined to be thin. To understand the implications of this distinction, consider that bald men die sooner, on average, than hirsute men, probably because bald men have higher levels of testosterone, which appear to lower life expectancy. Given this, surely no one would conclude that giving a bald man hair implants would improve his prospects for long life. No one has ever successfully conducted a study into the effects of long-term weight loss, and for a very simple reason: no one knows how to turn fat people into thin people. . . Over the past 20 years, scientists have gathered a wealth of evidence indicating that cardiovascular and metabolic fitness, and the activity levels that promote such fitness, are far more important predictors of both overall health and mortality risk than weight. Yet none of the studies most often cited for the proposition that fat kills makes any serious attempt to control for these variables. The most extensive work of this sort has been carried out by Steven Blair and his colleagues at Dallas's Cooper Institute, involving more than 70,000 people. What they have discovered is that, quite simply, when researchers take into account the activity levels and resulting fitness of the people being studied, body mass appears to have no relevance to health whatsoever. In Blair's studies, obese people who engage in at least moderate levels of physical activity have around one half the mortality rate of sedentary people who maintain supposedly ideal weight levels. Similarly, a 1999 Cooper Institute study involving 22,000 men found the highest death rate among sedentary men with waist measurements under 34 inches, while the lowest death rate was found among fit men with waist measurements of 40 inches or more. A 1995 Blair study found that improved fitness (ie, going from "unfit" to "fit"), with the latter requiring a level of exercise equivalent to going for a brisk half-hour walk four or five times per week, reduced subsequent mortality rates by 50%. As Blair himself puts it, Americans have "a misdirected obsession with weight and weight loss. The focus is all wrong. It's fitness that is the key." [From The Obesity Myth: Why America's Obsession With Weight Is Hazardous To Your Health, by Paul Cosmos, to be published next month in the US by Gotham Books] - ORDER FOUR PASSENGERS ON EVERY BIG JET TRIP SUFFERS THROMOBIS BRITISH MEDICAL JOURNAL - A report on the front page of The London Times today warns that around three to four passengers on every jumbo jet are likely to develop deep vein thrombosis. Researchers from New Zealand studied 878 people who took long-haul flights over a six-week period. Some of the passengers wore compression stockings or took aspirins to reduce the risks of DVT. The researchers identified four cases of pulmonary embolism and five of DVT, amounting to 1 per cent of the total. High-risk patients were deliberately excluded from the trial. The study is published in The Lancet today. EVEN SHORT FLIGHTS CAN BE DANGEROUS TO LEGS BRITISH MEDICAL JOURNAL - A study of people flying between Italy and London's Stansted airport has found that deep vein thrombosis is a threat on short flights, as blood clots develop in the first two to three hours of a flight. Previously it was thought that DVT was only linked to the cramped conditions on long-haul flights. Ultrasound tests were performed on 568 people making the short journey between the UK and Italy, and researchers found clots in 4.3 per cent of higher risk passengers (women on the pill or HRT, those who have had surgery recently, and mothers to be). Professor Gianni Belcaro, leading the study, advised all passengers to try to exercise, avoid alcohol, and drink lots of water. ARKANSAS TO GRADE KIDS ON OBESITY JUDITH GRAHAM, CHICAGO TRIBUNE - The state of Arkansas is tackling the rising problem of childhood obesity by testing all 447,000 of its schoolchildren in an ambitious program that has some parents up in arms and some educators warning of logistical problems. . . Arkansas' effort begins this school year with a program to calculate each schoolchild's "body mass index"--an indicator of body fat based on height and weight, adjusted for age and sex. Results will be sent to parents next spring, along with educational materials about health risks, in the form of health report cards. In the past several years, school districts in Pennsylvania, Florida, Massachusetts, Michigan and South Dakota have initiated limited programs to send out similar report cards--dubbed "fat letters" by critics--with mixed results. The reports also call parents' attention to pupils and students who are severely underweight. Some consider health report cards an important response to a nationwide epidemic of childhood obesity, likening them to past efforts to fight polio by targeting children in school. . . Others consider such reports a misguided approach that could expose children and teens to taunting or induce them to try dangerous diets while straining schools' stretched resources. "Call this what you want, it's going to be a form of labeling kids," said Nancy Rousseau, principal of Little Rock's Central High School. "To me, it's not the answer." In middle school, where children are exposed to intense peer pressure, "it's almost inevitable that they'll compare scores and teasing will occur," said Daniel Whitehorn, principal of Pulaski Heights Middle School in Little Rock, and the impact on overweight kids' self-esteem could be "devastating." School nurses already are overloaded with work, and many districts don't have sufficiently sensitive equipment to take accurate weight and height measurements, said Margo Bushmiaer, coordinator of health services for the Little Rock School District. . . Some experts on childhood obesity warn that health report cards can backfire if parents start nagging children about eating or put them on diets. "You're setting kids up to feel bad about how they are," and that could aggravate, not alleviate, weight problems, said Dr. Nancy Krebs, chairwoman of the American Academy of Pediatrics' Committee on Nutrition and an associate professor of medicine at the University of Colorado. According to research, trying to put children and teens on diets or control what they eat can "create disordered eating," she said. Schools should focus on nutrition and physical education, the nutritional content of school lunches, and what's sold in vending machines instead of weight-related measurements, Krebs said. LAURA GLADNEY-LEMON, WIRE TAP - When I was 16 I filled out a job application at a Jack in the Box. It was thrown away in front of my face, with the explanation that there is no way they could hire me, I would disgust the customers and make them lose their appetite because of my weight. When I was 18 a 7-11 clerk refused to sell me food telling me I was too fat to eat. When I contacted the manager the next day, she defended her employee saying they did have the right to refuse service. . . The most common retort I hear from those that defend fat hate is that is a "health" issue. This is a disputed fact, but for argument's sake let's accept being fat truly is a "health" issue for the moment. In addition to being fat, I smoked for seven years. Smoking definitely is a "health" issue. It is known that smoking causes cancer, emphysema, and other really nasty health problems. Not only that, my smoking actually directly affected everyone's health around me when I was smoking, as it is well known that second-hand smoke is a health hazard. On the other hand, my fat does not affect anyone else's health. My point is, that smoking is at least as big of a health risk as being fat, but interestingly, during my entire seven years as a smoker I never once had random people yell rude remarks at me about smoking, not to my face, not from cars, it just didn't happen. This happens to me because I am fat at least once a month. . . Also, what about all of the kids that made fun of me for being fat as a kid? Did they have my health on their mind? I very seriously doubt it. Fat hate and discrimination is real. With the old adage "if you want truth, ask a kid" in mind, these survey results ring especially loudly: "In one study, ten- and eleven-year-olds were shown drawings of children and asked how much they thought they would like them. Children's preferences, from most likeable to least likeable, were: (1) a normal child, (2) a child with leg braces and crutches, (3) a child in a wheelchair, (4) a child with a hand missing, (5) a child with a facial disfigurement, and, finally, (6) a fat child" I can remember feeling inferior because of my weight as early as pre-school. Family friends were telling my mom that she needed to put me on a diet a few weeks after I was born. SECOND OPINION WENDELL COX, HEARTLAND - It has always been difficult to make something out of nothing, but a new report linking America's growing obesity problem with urban sprawl (suburban living) sets a new record for political spin. The report (Measuring the Health Effects of Sprawl), released by Smart Growth America and the Surface Transportation Policy Project, purports to demonstrate that people living in more sprawling, suburban counties are fatter than people who live in more dense central cities. . . The Chicago area claims make my point. The researchers suggest that in less-sprawling counties, people walk more, which accounts for much of the doubtfully reported difference in weight. Using their formula, one can conclude that the average resident of less-sprawling Cook County walks approximately 20 minutes more per month (40 seconds per day) than residents in more sprawling Grundy County. Even with their microscopic research tools, the authors find little by way of health effects. The average resident of Cook County - the most urban in the Chicago area - is estimated to weigh 0.9 pounds less than the slothful ne'er-do-wells who inhabit the North Shore communities of Lake County. But it is Grundy County residents who really stand out, weighing in at 0.5 pounds more (8 ounces). The story is similar elsewhere around the nation. Boston-dominated Suffolk County residents can look down on their suburban neighbors, who weigh up to 1.7 pounds more. Or one can look at San Francisco, whose residents are a fit 2 pounds lighter than their counterparts in sprawling Marin County. When is the last time you saw a late-night cable television commercial for a weight-loss program claiming it could take off two pounds in a lifetime? So much for manipulating the inconsequential to feign significance. Centers for Disease Control data demonstrate that obesity has skyrocketed in the United States over the past 10 years. From 1991 to 2001, the obesity rate rose from 12.7 percent of the population to 20.5 percent in Illinois. By comparison, the report estimates the largest sprawl-related obesity difference among Chicago-area counties at 1.9 percentage points--one-quarter the Illinois increase over the past 10 years. Something else is going on. SHORT HOP PLANES FOUND DANGEROUS TO VEINS, TOO BRITISH MEDICAL JOURNAL - A survey carried out by the Aviation Health Institute has shown that even passengers taking short flights can be at risk from fatal deep vein thrombosis. According to the survey, almost one in five British DVT deaths happened after three hours or less of travel on a plane. The survey analyzed the cases of 544 British passengers who suffered a blood clot following airline travel during the past three years. Eighty-five of them died, of whom 14 were on short flights. The conditions on the flight, such as dry air, reduced oxygen levels, compression of veins and prolonged immobility, are thought to be more significant than the duration of the flight. Women on the Pill or taking HRT are especially at risk. American to Add Seats on Many Flights WEIGHT BUREAUCRATS PITTSBURGH POST GAZETTE - The
number of people worldwide who are officially regarded as overweight
or obese may increase by 600 million -- almost 50 per cent --
as scientists move to adopt a new definition of abnormal body
weight. BIG FAT MYTHS ABOUT OBESITY [While improving the quality of food offered kids in school is a worthy cause, it is being supported by some shaky theories and bad science. Among the problems are these: - The widely touted Body Mass Index only measures mass; it does not discriminate between fat and muscle; it assumes that everyone in the United States should be average despite broad genetic or physical development differences; and it is an unproven indicator of health or longevity and reflects the anorexic cultural bias of our society. - At the very least, the decline in exercise programs in our school system is as important in diet in contributing to great weight among students, yet it is getting only a fraction of the media attention. Further, there is the possibility that the lack of physical activity in today's bureaucratized education is a contributor to other problems such as hyperactivity. - The widely touted 300,000 deaths due to obesity is a faulty extrapolation from a computation that 300,000 heavy people die each year. What they die of is another matter. This is a highly complicated matter for which there is at least some good evidence that both lean people and heavier people who lose weight are more at risk. - At least part of the increase in average weight may have been due to the purported cure proposed to a recent generation of Americans: a high carbohydrate diet, which has been found to cause some of the very problems associated with weight including diabetes. - The high carb bias of recent years has also been a boon to one of the most powerful lobbies in the country: the sugar industry. Not only is sugar specifically associated with some of the problems often charged generally to weight - again such as diabetes - but has been found to have a drug-like ability to affect the working of the brain. - A good health program at schools would emphasize fitness and healthy eating, rather than a puritanical attack on children who - many for unalterable genetic reasons - do not fit our culture's stereotype of health. These kids have enough social problems with their weight - such as teasing from other children - without being harassed by adults and media as well. Instead of stigmatizing the young as "obese" or decrying the crisis, our emphasis should be at dealing with more specific problems such as sugar, high carbohydrates, lack of exercise at school, corporate hustling of the young, planning public space to encourage more exercise (such as building bikeways and designing communities where services are within walking distance) and finding appealing alternatives lying on a couch watching some model disguised as a reporter decrying the obesity crisis.] ARIZONA DEPARTMENT OF HEALTH SERVICES - The 1998 Arizona Behavioral Risk Factor Surveillance Survey found that almost 60% of all Arizonans do not "exercise" regularly. National studies of youth, such as the Centers for Disease Control and Prevention Youth Risk Behavior Survey, indicate exercise levels are decreasing, especially among teens. Among children and teens, lack of physical activity is considered to be the primary cause of the rising childhood obesity rates. . . [Our goal is to] increase the number of 4th - 8th grade youth in participating schools who accumulate 30 to 60 minutes of daily, moderate-intensity physical activity. AMONG THE LEGIONS of young people in every age group who fail to get enough exercise, the biggest decline in physical activity occurs when students reach high school, according to CDC's 1999 Youth Risk Behavior Survey. The report showed that more than one-third of high school students do not regularly participate in vigorous physical activity (at least three 20-minute sessions per week). And only one-half of high school students regularly engage in stretching and strengthening exercises. The survey also showed that physical activity declines sharply as students get closer to graduation, and that the amount of physical activity is lower among high school girls, particularly among African-American and Hispanic girls. ONCE CUSTOMARY for children at nearly every grade level, gym class, in recent years, has been steadily scaled back. Just during the past decade, the number of U.S. high school students attending daily physical education classes dropped from 42 to 29 percent. Currently, nearly half of all students and 75 percent of high school students do not attend any physical education classes, according to the National Association for Sport and Physical Education, the nation's largest organization for physical education teachers. Judith Young, executive director of NASPE, maintains that schools cut gym classes for lack of funding, but more often cuts result from time constraints that develop with the addition of new curriculum. "Standards-based reform has been detrimental to physical education," said Young. PAUL CAMPOS, NEWSDAY - Currently an estimated 120 million Americans are on some sort of diet. This also happens to be almost exactly the same number of Americans the government categorizes as either "overweight" or "obese." That is not a coincidence. Part of the problem is that there are many facts about America's war on fat that rarely find their way into the media. Various medical studies show that, for instance, people who intentionally restrict their caloric intake invariably end up, on average, weighing more than people of similar initial weight who don't. . . Americans get 20-percent fewer calories from fat than we did a generation ago - and yet we weigh, on average, 15 pounds more than we did in 1982,according to data from the United States Department of Agriculture and the National Institutes of Health. . . . . . Physical-activity levels are better predictors of health than body mass: As long-term studies at Dallas' Cooper Institute show, "overweight" active people are far healthier than thin sedentary ones and just as healthy as their thin active counterparts. We're a nation that makes a large percentage of its citizens feel terrible about their failure to conform to an absurdly thin cultural ideal. The weight-loss industry profits from encouraging these people to engage in behavior - obsessing about weight, in general, and dieting, in particular - that causes them to become much fatter than they would be otherwise. And the government exacerbates this neurotic situation by issuing increasingly hysterical pronouncements, demanding that Americans keep doing the very things that have been making them fat but to do them "right" this time. PAUL CAMPOS, NEW REPUBLIC - According to the government, you're "overweight" (that is, your weight becomes a significant health risk) if you have a BMI figure of 25 and "obese" (your weight becomes a major health risk) if your BMI is 30 or higher. A five-foot-four-inch woman is thus labeled "overweight" and "obese" at weights of 146 pounds and 175 pounds, respectively; a five-foot-ten-inch man crosses those thresholds at weights of 174 pounds and 210 pounds. Such claims have been given enormous publicity by, among other government officials, former Surgeons General C. Everett Koop--whose Shape Up America foundation has been a leading source for the claim that fat kills 300,000 Americans per year--and David Satcher, who in 1998 declared that America's young people are "seriously at risk of starting out obese and dooming themselves to the difficult task of overcoming a tough illness.". . . Yet, despite the intense campaign to place fat in the same category of public health hazards as smoking and drug abuse, there is in fact no medical basis for the government's BMI recommendations or the public health policies based on them. The most obvious flaw lies with the BMI itself, which is simply based on height and weight. . . . As The Wall Street Journal pointed out last July, taking the BMI charts seriously requires concluding that Brad Pitt, George Clooney, and Michael Jordan are all "overweight," and that Sylvester Stallone and baseball star Sammy Sosa are "obese." According to my calculations, fully three-quarters of National Football League running backs--speedy, chiseled athletes, all of whom, it's safe to say, could beat the world's fastest obesity researcher by a wide margin in a 100-yard dash--are "obese." Perhaps the most comprehensive survey of the literature regarding the health risks of different weight levels is a 1996 study by scientists at the National Center for Health Statistics and Cornell University. This survey analyzed data from dozens of previous studies involving more than 600,000 subjects. It concluded that, for nonsmoking men, the lowest mortality rate was found among those with BMI figures between 23 and 29, meaning that a large majority of the healthiest men in the survey would be considered "overweight" by current government standards. For nonsmoking women, the results were even more striking: The authors concluded that, for such women, the BMI range correlating with the lowest mortality rate is extremely broad, from about 18 to 32, meaning that a woman of average height can weigh anywhere within an 80-pound range without seeing any statistically meaningful change in her risk of premature death. . . . The most comprehensive work regarding the dangers of sedentary lifestyle has been done at the Cooper Institute in Dallas. . . Quite simply, when researchers factor in the activity levels of the people being studied, body mass appears to have no relevance to health whatsoever--even among people who are substantially "obese." It turns out that "obese" people who engage in moderate levels of physical activity have radically lower rates of premature death than sedentary people who maintain supposedly "ideal-weight" levels. For example, a 1999 Cooper Institute study found the highest death rate to be among sedentary men with waist measurements under 34 inches and the lowest death rate to be among physically fit men with waist measurements of 40 inches or more. And these results do not change when the researchers control for body-fat percentage, thus dispensing with the claim that such percentages, rather than body mass itself, are the crucial variables when measuring the health effects of weight. Fat people might be less healthy if they're fat because of a sedentary lifestyle. But, if they're fat and active, they have nothing to worry about. . . "Fitness" in Blair's work isn't defined by weight or body-fat percentage but rather by cardiovascular and aerobic endurance, as measured by treadmill stress tests. And he has found that people don't need to be marathon runners to garner the immense health benefits that follow from maintaining good fitness levels. Blair's research shows that to move into the fitness category that offers most of the health benefits of being active, people need merely to engage in some combination of daily activities equivalent to going for a brisk half-hour walk. To move into the top fitness category requires a bit more--the daily equivalent of jogging for perhaps 25 minutes or walking briskly for close to an hour. (Our true public health scandal has nothing to do with fat and everything to do with the fact that 80 percent of the population is so inactive that it doesn't even achieve the former modest fitness standard.) ARE THE SCALES WRONG? GUARDIAN, UK - The BMI, a method used worldwide to determine how healthy a person's weight is, is based on the relationship between an individual's height and weight. At a reading of 25 or above, you are overweight. But so, according to the calculations, is Mel Gibson. And at 30, you become obese; but so are Arnold Schwarzenegger, Jonah Lomu and Sylvester Stallone. The simplicity of the BMI makes it a godsend for looking at trends. But it is also something of a broad-brush tool. It takes no account of age, sex or race; it makes no allowance for your fitness. Most importantly, it does not measure how much fat you are carrying or how that fat is distributed. Professor Ian Macdonald, co-editor of the International Journal of Obesity, explains that the fat you need to worry about is abdominal fat. Fat above the hips puts a strain on your heart, putting you at risk. Below the hips, it is not such a problem. The system also fails to take into account the amount of fat you are carrying - hence the reason for the "obesity" of Jonah, Arnie and Sly. Dense, muscled physiques can weigh more than flabby, unfit ones, with the result that the superfit can end up being categorized as obese. So why don't doctors measure
a patient's body fat before pronouncing on their weight? Because
they have neither the time nor the resources, says Macdonald.
A study in the American Journal of Clinical Nutrition in 2000 found that healthy body-fat levels vary by age, gender and race. So a white man in his early 20s might have a healthy range of 8% to 21% body fat, while for a black woman aged between 60 and 79 the healthy range is between 23% and 35%. The BMI takes no notice of such distinctions: GPs in this country work to a measure designed for western Europeans, yet inner-city general practice lists are becoming increasingly multi-ethnic. Other parts of the world are thinking of altering their BMI charts to take account of their different physiques. . . A TIMELINE OF DIETARY GUIDELINES - FROM ATHENS TO ATKINS RECOVERED HISTORY [Now that the atrocious seating space provided passengers by airlines has come to public notice, the following are worth recalling] JOHN SWEENEY, OBSERVER, LONDON, January 14, 2001 - British airline companies ignored warnings for more than three decades about the deadly effects of blood clots on passengers during long-haul flights, The Observer can reveal. Despite being warned as long ago as 1968 by leading medical experts about the problems of so-called 'economy-class syndrome', the airlines played down the dangers and gave no advice to passengers on how to minimize the risks. Hundreds of people are feared to have died as a result . . . Three doctors working at a hospital near Heathrow - Yvonne Hart, D. J. Holdstock and William Lynn - wrote: 'Working in a hospital on the perimeter of London Airport we see a steady stream of illnesses which have developed in flight. The major manifestation of the illness may not occur until after disembarkation. We have seen several patients with thromboembolism presenting in this way, with a near-fatal outcome in one case.' Our investigation has uncovered a culture of deceit at some airlines which has been allowed to thrive due to complacency at the Department of Health and the Civil Aviation Authority. Today we reveal that airline company doctors have known about the risks of immobility since 1940 and the risks of immobility on long-haul flights since 1968 REUTERS, January 2001 - Japan's first survey of "economy class syndrome" found that 25 passengers have died of the condition at Tokyo's Narita airport in the past eight years, a figure likely to put pressure on airlines to tackle the issue. According to the study by a clinic at Narita airport, 100 to 150 passengers arriving in Tokyo on long-distance flights are treated each year for the problem, believed to be caused by immobility and cramped seating on long flights . . . The long hours in cramped conditions are believed to cause deep-vein thrombosis, or formation of blood clots, and it can be fatal if the clots circulate into the heart or the lungs. [Despite considerable anti-low carb media coverage, the diet still seems to work for some] REUTERS - In motivated people who are overweight and have type 2 diabetes, a low-carbohydrate diet with some caloric restriction has lasting benefits on body weight and blood sugar control, Swedish researchers report. Dr. Jorgen Vesti Nielsen and Dr. Eva A. Joensson previously reported that 16 obese patients with type 2 diabetes who followed a low carbohydrate diet achieved significantly better diabetes control and body weight over 6 months than did 15 patients who followed their usual diet. Follow-up data at 22 months for the low-carbohydrate group now show "stable improvement" of body weight and glucose control, the investigators report in the journal Nutrition and Metabolism. At the start of the study, the average body weight of the participants was 100.6 kg in the low-carbohydrate group. At 6 months, they were down to 89.2 kg, and by 22 months they were at 92.0 kg. . . . The low-carbohydrate and high-carbohydrate diet contained about the same amount of calories (1800 kcal for men and 1600 kcal for women), but the proportions of carbohydrates, protein, and fat were different: 20 percent, 30 percent, and 50 percent, respectively, for the low-carb diet versus 55-60 percent, 15 percent, and 25-30 percent, respectively, for the higher-carb control diet. . . When it comes to diet and diabetes, Nielsen acknowledges that "we know very little and patients should be informed about our lack of knowledge so they can make their own choices. And then they should get our full support in whatever they chose." www.nutritionandmetabolism.com/home FLY NOW, PAY DOUBLE [For some years now, your amply proportioned editor has been looking for a really big lawyer - say the size of Gerry Spence as opposed to Arhtur Kinoy - to file a public interest suit against the airlines for their gross discrimination against large people. The legal theory is that if one's size is not normal than it is a disability and should be treated that way under the law. If one's size is normal then airlines have no right to endanger life by not providing enough legroom for some of its passengers just because they do not fit its definition of average. Further, corporations as heavily subsidized as airlines should at least provide as much legroom as Amtrak.] MARIE BEAUDETTE, WASHINGTON TIMES - Southwest Airlines will start charging larger passengers for two seats on its 2,800 daily flights starting June 26. Top Stories The airline, which operates out of 58 U.S. cities and is the largest carrier at Baltimore-Washington International Airport, will begin charging "persons of size" for two seats if they think they may not fit comfortably in one. Ticket agents will not have weight and height requirements to follow when determining who can comfortably fit into one seat or who needs to purchase another ticket, said Southwest spokeswoman Christine Turneabe-Connelly. . . . Miriam Berg, president of the Council on Size and Weight Discrimination, questioned agents' ability to make the correct assessment. "Do they have scales to weigh people? Do they have tape measures to measure a person's girth?" she asked. "Do they discriminate the same way against basketball players who are 6 foot 5 inches and don't fit in their seats?" All people who are too large to fit in one seat, not just the obese, are included in the Southwest policy, Mrs. Turneabe-Connelly said. Miss Berg said she has had more complaints from large travelers about Southwest, which is the fourth-largest domestic airline based on passenger numbers, than any other airline. "They think they can get away with it because they think discriminating against people on the basis of weight will be acceptable to most of the population," she said. She blames the airlines for making seats too small to accommodate larger Americans. "The fact is that Americans are getting larger," she said. MARIE BEAUDETTE, WASHINGTON TIMES - Southwest Airlines insisted that it has long charged larger passengers for an extra seat, despite statements from airline officials a day earlier that it would begin doing so later this month . . . Miriam Berg, president of the Council on Size and Weight Discrimination, said she was interviewed 35 times yesterday about the policy. Miss Berg said the policy will backfire and passengers will take their business elsewhere. "When an airline sells you a ticket, they're selling you passage from point A to point B," she said. "Now that they're saying they're selling you inches of space, they've got to put that in their advertising." She said airlines seats should be able to accommodate the growing number of larger Americans. Southwest's seats are 18 3/4 inches wide. [SOUTHWEST SEATS are 18 1/2" wide. According to one analysis this makes them adequate for roughly 60% of American males. Your editor's shoulder width, for example, is roughly 4 inches wider than a SW Airline seat but still within the limits of 95% of American males. Then, of course, there is the grossly inadequate leg room. Put it all together, add the problem of occasional death owing to inadequate circulation, and you've got a real good class action suit] HERMAN MILLER FURNITURE COMPANY - People vary widely in all their dimensions. Improperly fitted chairs can cause discomfort and contribute to health problems . . . People vary considerably in shape as well as overall size. In addition to the 17 inches in height and 140 pounds in weight that separates a 1st-percentile female from a 99th-percentile male, there are gender-related differences in bone structure and weight distribution and infinite variations in limb lengths and body contours. Even among a group of people of the same gender, age, and stature, one finds significant variation in bodily proportions. Two men of the same standing height, for instance, can appear to be of very different heights when seated, and their seated elbow heights may vary by as much as three or four inches. Achieving a match between certain body dimensions and corresponding chair dimensions is crucial to the sitter's comfort and health. The wrong seat height can cause uncomfortable pressure on the backs of the thighs. . . . Most work chairs are designed on a "middle-out" model of anthropometrics intended to accommodate the middle 95 percent of the user population: from the 5th percentile female to the 95th percentile male. However, as British ergonomist Stephen Pheasant points out, there is no true 5th- or 95th-percentile person; someone who is at the 95th percentile for stature is likely to be at a different percentile on distribution curves for lower leg length or sitting elbow height. So a chair designed to accommodate the middle 95 percent on each of a succession of important dimensions could conceivably exclude a different 5 percent of users with each anthropometric constraint. The end result would be a chair that accommodates considerably less than 95 percent of its potential users. Compounding the problem is the fact that the anthropometric data used by chair designers do not necessarily reflect the total adult population that will be using their product. This makes it virtually impossible to determine the actual percentage of users that will be fit for any given dimension. Commonly accepted anthropometric tables are based on samples of military personnel which (due to entry and retention criteria for size, age, and physical condition) tend to exclude very large and very small persons. Analyzing our own random sample of the U.S. civilian population, we found that a chair designed for the 5th-percentile female to 95th-percentile male-as defined by standard anthropometric data published by the U.S. military would actually fit slightly less than 68 percent of the sample, even when considering only the four most crucial seating dimensions. HEAVY KIDS MORE APT TO BE DEPRESSED AND FRIENDLESS [This is one reason why the current obesity obsession may have unwanted side-effects, adding to the problems of an already difficult childhood.] BILL HUTCHINSON, DAILY NEWS - Fat jokes can be deadly. A pair of new studies say overweight teens are more apt to be depressed, friendless and suicidal than their skinnier peers - all because they get teased about being chubby. University of Minnesota researchers interviewed 4,746 kids in grades 7 to 12 and found that the waistline is often the bottom line in the schoolyard social scene. The study's author, Marla Eisenberg, said it was "alarming" how many overweight kids attempt suicide or think about killing themselves because of the ribbing they get. The findings, in the August issue of the Archives of Pediatrics & Adolescent Medicine, showed 26% of teens teased at school and at home said they considered suicide and 9% attempted it. The startling stats were "two to three times as high among those who were teased compared with those not teased," Eisenberg wrote. Girls take the teasing harder, with 36% saying it made them depressed compared with 19% of the boys. Meanwhile, another study found that hefty children often don't have many pals to lean on when they're down. The study by the University of Michigan and the University of Medicine and Dentistry of New Jersey surveyed 17,500 adolescents and found that the overweight kids had fewer friends than normal-weight kids. "Overweight adolescents were more likely to be socially isolated and to be peripheral to social networks than were normal-weight adolescents," the researchers wrote. |
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