Where does this loathing of fat come from? Charisse Goodman, author of The Invisible Woman, points out that "one of the most curious contradictions of weight obsession is that if a woman succumbs to it and keeps her weight unnaturally low by even the most desperate means, she is popularly considered in our culture to be an attractive person who 'cares about herself,' even if she risks her health in the process. On the other hand, a heavy woman who shuns this mania and refuses to waste her life fixated on her figure is characterized as unattractive and lacking in self-regard." In The Obesity Myth, law professor Paul Campos considers the darker side of our disgust with fat as he explores the idea that Americans worry that we've become too big for our own good. He writes, "Nor is it a coincidence that, amid America's whirlwind of overconsumption, with its attendant anxieties about our economic, cultural, and military voraciousness, our anorexic Puritans promise that we can maintain our virtue by refusing to surrender to the most literal of our gluttonous impulses." Could it be that our own desires and fears about losing control are displaced onto the body of a fat person? What other unconscious dynamics might be at play?
Even as we begin to acknowledge the unfair prejudice and discrimination against overweight people, the obvious question arises: given the preponderance of evidence that people falling into the overweight and obesity categories have a significantly higher rate of health problems, how can we responsibly ignore this information? While it's impossible to explore the complexity of obesity research fully, my hope is at least to raise the possibility that there's another side to this story. Despite the bombardment of antiobesity campaigns, a mountain of research suggests that the drastic claims that fat is killing us are more problematic than you might expect.
These findings surprised J. Eric Oliver, author of Fat Politics: The Real Story Behind America's Obesity Epidemic. With a background in statistics, he set out during a postdoctoral fellowship at Yale University to understand how the soaring rates of obesity and its catastrophic consequences could be handled politically. What he discovered surprised him: "Based on the statistics, most of the charges saying that obesity caused various diseases or that obesity caused thousands of deaths were simply not supported. Yet consistently, these pseudofindings were promulgated as fact." Paul Campos reports a similar experience: "When I began researching this topic five years ago, I assumed the fact that being 'overweight' was a serious health risk was so well established that this aspect of the subject was hardly worth discussing. Yet in the course of plowing through dozens of books, hundreds of articles in medical journals, and countless interviews with medical and scientific experts, I discovered that almost everything the government and media were saying about weight and weight control was either grossly distorted or completely untrue."
Consider the frequently cited statistic that 300,000 people die from obesity each year—which was based on a 1993 study by Michael McGinnis and William Foege, reported in the Journal of the American Medical Association (JAMA). What they actually found was that "dietary factors and activity patterns that are too sedentary" contributed to 300,000 deaths per year. Inaccurate reporting by media sources, and its use to validate health policies, led McGinnis and Foege to publish a letter in The New England Journal of Medicine saying that the results of their study had been misrepresented. The researchers explained that obesity, high blood pressure, heart disease, and cancer were side effects of dietary and activity patterns, but they hadn't concluded how many deaths actually resulted from each single factor.
In 2004, the Centers for Disease Control and Prevention (CDC) presented new research, claiming that 400,000 deaths per year were attributable to obesity; however, this study was debunked for its poor research methods, and in January 2005, the CDC lowered the death estimate to 365,000. In April 2005, lead researcher Katherine Flegal of the CDC published in JAMA findings that put the actual annual rate of deaths due to obesity at 25,814, and determined that being overweight—or even in the lower end of the obesity range—wasn't associated with excess mortality or a shorter life expectancy. Despite this good news, the 300,000-deaths-per-year statistic continues to be used to justify treatment of obesity, and Julie Gerberding, who was director of the CDC at that time, stated that the CDC didn't plan to use the much lower obesity mortality figure in its public-awareness campaign, nor did it plan to reduce its fight against obesity.
This scenario is an example of how the concepts of causation and correlation frequently get misused in scientific research. While the popular conviction is that obesity causes higher mortality and health problems, it's next to impossible to establish causality in large population-based studies. When, as often occurs, weight is associated with health problems and mortality, it's possible that other factors, such as a sedentary lifestyle and poor nutrition, lead to both higher weights and higher death rates. Consider the fact that bald men have higher death rates. Does that mean that offering a toupee will decrease mortality among these men? Of course not! Instead, it's higher testosterone levels that cause both baldness and heart disease. Likewise, weight loss in and of itself isn't a panacea for the great majority of health problems.