A friend - who is actually moments away from becoming a doctor - recently sent me a study that concludes that being fat (evaluated based on BMI) will kill you in the sense that fat people live for fewer years. The study is an amalgamation of the data of 50+ studies conducted over the last few decades and admittedly, this study does a good job normalizing the data and accounting for things like smoking and other factors that would inappropriately skew the data.
If you want to look for yourself, it’s impressive title is Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. A blog article summarizing and supporting the data and drawing some quesitonable conclusions that I’m not going to comment on can be found at Denialism Blog.
My friend who sent it to me sent it to me with a quick one liner insisting that I better just deal with the fact that being “obese” means dying early. He wrote: “obesity = morbidity and mortality. deal with it.”
I’d be delighted to know what you think about the study and what you think about the following email that I wrote him in reply:
“Needless to say, I found the study you referred me to very interesting and I really appreciate you sending it along. I recognize that the data say that fat people live fewer years than thin people given the nature of the data collected, but that doesn’t mean that being obese will kill you. I noticed two things for which the studies this one conglomerated didn’t account.
“The first was the normalizing effect of good nutrition and regular exercise on the mortality rates of people at a whole range of BMIs. I recognize that many fat people have poor dietary habits and more sedentary lifestyles, but numerous studies demonstrate the way that introducing nutrition and exercise (and demonstrating that no significant weight loss occurs in the people with BMIs exceeding 25) into the lives of people at all BMIs normalizes death rates. This isn’t an isolated demonstration but occurs in numerous scientific and medical studies. For a good summary of those, I’d recommend Glenn Gaesser’s book, Big Fat Lies. In any case, this study didn’t account for the fact that all those conclusions resulting from the data at hand still don’t include the important point (not that it could have, being an amalgamation of past studies) that those correlations (not causations) do effectively vanish when good nutrition and regular exercise (w/out weight loss) are introduced into all people being evaluated (and in fact, when numerous diseases are present across the spectrum of people at varying BMIs it’s the fat people that live longer with them).
“The second issue was prejudice in the medical community against fat people. It is well documented that fat people often cease seeking medical care because they find doctors treat them poorly and focus solely on their weight rather than other issues. Take diabetics for instance. Many doctors tell diabetics to lose weight rather than tell them to eat more healthfully and get more regular exercise. Studies show that over 70% of type-2 diabetics who improve their nutrition and begin regular exercise actually stop needing to take their medications (these results hold for things like hypertension and other issues). However, doctors aren’t communicating those values as much as telling people to lose weight, weighing patients, berating them for their weight and ultimately resulting in far less fat people getting regular medical attention - especially ones with problems. The second issue relates to insurance. As you surely know, numerous fat people are denied insurance, which means that far fewer of them are getting adequate medical care even when they do feel comfortable going to see doctors. The morbidity statistics in these studies don’t account for this difference in medical care - again, not that this amalgamative study could have, but the point is that without normalizing other factors, the conclusions are far from definitive.”
Thoughts on this study or debate?
