TCS Daily


400,000 Big Fat Reasons for Skepticism

By Radley Balko - December 2, 2004 12:00 AM

The Centers for Disease Control announced last week that the often-mentioned figure of 400,000 Americans dying each year due to overweight or obesity is based on a study that's plagued by methodological errors. The CDC estimates that the number may be off by 20%, but longtime critics of the figure (who until last week were largely ignored by the media) say it may actually be closer to four times the number of early deaths attributable to obesity.

The CDC's announcement represents a tidy anecdote for what's wrong with the obesity debate. The problem, put simply, is that hysteria sells. It sells research to grant writers, it sells executive summaries to media outlets, and it sells newspapers to the public. Anyone taking a close look at the 400,000 number could see some obvious flaws in its computation. In the New York Times, for example, the University of Chicago's Dr. Eric Oliver pointed out that there are only 2 million deaths each year in the United States, total. Since obesity has little effect on the mortality rates of people over 65, and 70% of annual deaths are among people over 65, in order for the 400,000 figure to be correct virtually every single death among people under 65 would have to have been caused by obesity.

There were other obvious problems, too. The JAMA study that came up with the number was a meta-study, which examined other studies dating back as early as the 1940s, then extrapolated the data to today's population. Obviously, several ailments that killed us sixty years ago are treatable and preventable today. Most remarkably, the study's researchers actually admitted that their calculations "assume that all excess mortality in obese people is due to their adiposity." That's an astounding concession. It means that every person in the study's data who was obese and died early was assumed to have died because of obesity. There are thousands of things that could cause an obese person to die early -- getting hit by a car or succumbing to cancer -- that aren't related to weight at all.

Despite these obvious flaws, as well as less obvious ones, the 400,000 figure was recited ad nauseum by government officials, nutrition activists, and the media. Researchers such as the University of Virginia's Glen Gaesser and Dr. Katherine Flegal have been criticizing the figure since it was published, yet were rarely consulted or quoted by media outlets, politicians, or government agencies. A Lexis search finds over 1,500 mentions of "obesity" and "400,000" in the last two years. And that's not including mentions of "obesity will soon overtake smoking as America's number-one killer," a statement widely perpetuated in the obesity debate that was also based on those alleged 400,000 deaths.

Dig a little more into America's health statistics and you'll find that despite our expanding waistlines and the devastation that's supposed to mean for our well-being, we've actually never been healthier. Heart disease, stroke, and cardiovascular disease are all down dramatically in the last 20 years. Mortality rates in nine of the ten types of cancer most associated with obesity have all dropped in the last 15 years. Overall cancer rates and deaths from cancer have dropped every year for the last ten years. We're living longer, too. In fact, while black men and black women have seen greater increases in obesity rates than their white counterparts over the last 15 years, they've also seen greater increases in life expectancy. The only ailment that's up in the last twenty years is diabetes, and that could be as attributable to an aging population, changes in the definition and collection methods of diabetes statistics, and increased awareness as to our love handles.

If all the obesity hype is true, we should at least be seeing the front end of this pending health care disaster by now. It simply isn't happening.

The most troubling thing about the 400,000 fiasco is the way nutrition activists and politicians relied on the number to call for drastic new laws and regulations aimed at getting obesity under control, but which also represented potentially severe restrictions on the food industry, and serious trespasses on consumer choice, personal freedom, and personal responsibility -- and how the media let them get away with it without an ounce of skepticism.

Radley Balko is a policy analyst with the Cato Institute.


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