TCS Daily


The Fat Lady Ain't Singing Yet

By John Luik - June 3, 2005 12:00 AM

Whatever else you might want to say about Centers for Disease Control Director Dr. Julie Gerberding, she is not a quitter. Ever since controversy erupted over the CDC's claims about the number of so-called obesity-related deaths published last year in a paper co-authored by Gerberding, she has been out in front of the mikes trying to defend both her claims about what she persists in calling America's "tragic and unacceptable" obesity epidemic and the integrity of the CDC itself. The problem is that every time she gets up to speak her take-away messages destroy a little bit more of both her standing as a scientist and the credibility of her institution.

For instance, when it finally became clear in April that the CDC's claims about hundreds of thousands of Americans dying from obesity were closer to science fiction than science, Gerberding told the media that the CDC was not going to publicize the new, correct number of 25, 814; nor was it going to scale back its fight against obesity.

Take away message: There is no scientific evidence of an obesity epidemic that is killing Americans but don't expect that to stop us from pretending that there is.

When that tack -- with its implicit hints of officially condoned misrepresentation -- didn't work terribly well, Gerberding came back with another news conference at which she claimed that whatever the numbers said, the obesity "epidemic" was far more serious than the 1918 influenza epidemic or the Black Death of the Middle Ages. "If you looked at any epidemic -- whether it's influenza or plague from the Middle Ages -- they are not as serious as the epidemic of obesity in terms of the health impact on our country and our society", opined Gerberding. Unfortunately, the good doctor's grasp of epidemic history is no more reliable than her obesity statistics.

Take the Black Death which blighted Europe from 1348-1350 and killed from one-third to one half of the population, or about 25 million people -- or roughly 1000 times the number of Americans supposedly dying from obesity according to Gerberding's own statistics. At its current rate the fat "epidemic" would have to run for another 1000 years before its death toll would equal the Black Death. Or take Gerberding's other example, the world-wide influenza epidemic of 1918-1919 where 675,000 people died in the US alone, along with about 25 million around the world. Once again, the obesity "epidemic" numbers simply don't add up.

Take away message: Once again I don't appear to know what I'm talking about. Real epidemics kill millions of people in a short time. The faux obesity epidemic is killing about 26,000 Americans at year at most. Trust me.

And then there's yesterday's CDC news conference where once again Gerberding is back on the obesity bandwagon in an effort to "clarify" -- for, what, the fourth or fifth time? -- the agency's position on obesity. What bothers Gerberding is that the statistics just aren't terribly helpful since they refuse to show that being overweight is a health hazard. That's one of those tricky problems of being a health promoter -- sometimes the facts just don't support your predetermined policies. Indeed, they show precisely the opposite. What worries Gerberding is that, thanks to the media scrutiny of the CDC and its claims, Americans are getting the heretical impression that being overweight might even lead to a longer life! And that just can't possibly be true.

Except that is what Gerberding's science says. "Overweight" according to the revised CDC paper, is "associated with a slight reduction in mortality relative to the normal weight category." But not once has Gerberding admitted in public what her study says: that for Americans aged 25-59 with BMI's up to 35 -- that include the obese -- the findings of increased risk of premature death from obesity were not statistically significant (confidence interval 0.84-1.72). Nor has she admitted at one of her news conferences that the study found that the Relative Risk (RR) for dying from obesity is "in the range of 1-2" a RR so low that most epidemiologists would dismiss the obesity- premature death connection as a statistical fluke rather than a scientific fact. In other words not only does being overweight protect from premature death, but the statistics don't even support the claim that the obese die prematurely.

Instead of finally coming clean about this, Gerberding said that she is "very sorry for the confusion that these scientific discussions have had." That in itself speaks volumes, since it isn't at all clear whether Gerberding is sorry for the fact that her science was wrong or sorry for the confusing effect that the wrong science has had on the public. Either way, if she were sorry for the confusion she would want to set the record straight by telling Americans plainly what her study says. Instead, she wants them to continue to believe in something that isn't true -- according to her own science. If she is sorry about anything it is that her sloppy science has been exposed and with it the justification for a massive government crusade against obesity.

What we are seeing now is no longer Dr. Gerberding scientist and head of what was once one of the world's premier health institutions, but Julie Gerberding as "true believer in the doctrine of fat kills", someone who has no scientific evidence to support her belief about the dangers of being overweight but who still clings to it by "faith". This is not to suggest that there is anything wrong with belief, it is merely to argue that we shouldn't have to base public policy about obesity on anyone's "faith". The CDC should not be a home to this kind of "faith-based" initiative.

So just where does Gerberding's latest news conference leave us?

Take away message: Despite our best efforts our study shows that only 25, 814, not 400,000 Americans die from obesity each year. But don't be fooled by those numbers. Obesity is still an epidemic that is killing thousands we just don't know how or who they are. Remember whatever the science says "It's not healthy to be overweight."

All clear now?

The author lives in Canada and is writing a book about public health.

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