Right on the front page of every newspaper and news outlet today was “Overweight People Live Longer." Two-thirds of Americans are overweight or obese, and they are generally aware excess fat on the body is not healthy. So when word of a study like the recent one on body mass index (BMI) categories and mortality starts spreading through the news outlets, everyone listens, and many take the conclusions to be fact. Sadly this kind of news coverage does a disservice to an already overweight and misguided public, allowing them to believe that their excess body fat won’t harm them and influence many to maintain or add some pounds. I wonder how much more breast cancer and how many needless deaths this information will cause.
This was a meta-analysis, pooling data from different studies that analyzed death from all causes with consideration of various BMI categories (normal weight: 18.5 – 24.9; overweight: 25.0 – 29.9; obesity: 30 or greater). The researchers found a small (6 percent) reduction in the risk of all-cause mortality for overweight compared to normal weight individuals, and an 18% increase in risk for obese compared to normal weight individuals.1
Does that mean almost every study on fitness, and the benefits of dietary excellence in the last 40 years was wrong? So, should we nutritarians pack on some extra pounds, exercise less, eat some cheese doodles and lounge on the couch watching more TV, so we can live longer? Hah, and the moon is made of green cheese too. This paper found an association here between lower BMI and a slight decrease in mortality rate, but for a variety of reasons, this is bad science and should never have been reported.
This study is essentially worthless because it did not exclude people with chronic disease recorded at baseline. Sick people become thinner. It is well known that illnesses cause a lower body weight. The American diet is so disease-causing and weight-promoting that almost all relatively healthy people become overweight, leaving mostly the chronically ill and those with occult illnesses (not yet diagnosed) at a normal or near normal weight.
A number of medical conditions may cause unintentional weight loss, including depression, anxiety, alcoholism, drug addiction, autoimmune diseases, occult cancer and digestive disorders. What proportion of the normal weight group had one or more of these conditions? The study did not say, but the list below suggests that it’s a large proportion of those in the normal weight category. The fact is, the American diet is so fattening and unhealthy that if someone is eating the American diet and is not overweight, they most likely have something wrong with them. Below is a list of conditions that cause weight loss, and the estimated prevalence of these conditions in the general population:
- Alcoholism – 12.5%.2
- Anxiety disorders - 18%.3
- Asthma - 7.7%.4
- Autoimmune Disorders – 7.6-9.4% 5
- Celiac disease – 1%.6
- COPD – 5.1%.4
- Depression – 8%.7
- Drug addiction – 2.6%.8
- Irritable Bowel Syndrome – 10%.9
Depression, Anxiety and Alcoholism alone could account for the findings in this study and affect about 20 percent of the population. Plus the study did not consider subclinical disease, in other words medical problems that have not yet been diagnosed. For example, there are many with some hidden cancer, not yet diagnosed (called occult cancer) that keeps them thin. Studies like this always underestimate the impact of overweight and obesity on premature mortality.
Plus, the only measured outcome was all-cause mortality. We still see increasing mortality from diabetes and heart disease as weight increases and the increased mortality in the normal weight group was from more unusual causes. We also know that the overweight live a lower quality life – with heart disease, arthritis, or another lifestyle-related disease or disability. Excess weight is known to increase the risk of type 2 diabetes, heart disease, stroke, elevated blood pressure and cholesterol, liver disease, gallbladder disease, sleep apnea, arthritis, and impotence and infertility.10 Let’s not ignore all that.
In the end, what we can conclude from this study is that many researchers are confused about health and nutrition and because of that their work can just add more confusion. With the majority of Americans significantly overweight many must be rejoicing in line at those fast food joints after hearing this today. So please don’t skip the gym and head out to Drunkin Doughnuts tonight for some deep fried flour and sugar with artificial colorings and flavorings. There is no getting around, you are what you eat.
Image credits (Flickr): amarette, ActiveSteve, permanently scatterbrained, Matt Ryall
1. Flegal KM, Kit BK, Orpana H, et al: Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA 2013;309:71-82.
2. Hasin DS, Stinson FS, Ogburn E, et al: Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry 2007;64:830-842.
3. National Institute of Mental Health: Anxiety Disorders. http://www.nimh.nih.gov/health/publications/anxiety-disorders/complete-index.shtml. Accessed January 3, 2013.
4. Akinbami LJ, Moorman JE, Bailey C, et al: Trends in asthma prevalence, health care use, and mortality in the United States, 2001-2010. NCHS Data Brief 2012:1-8.
5. Cooper GS, Bynum ML, Somers EC: Recent insights in the epidemiology of autoimmune diseases: improved prevalence estimates and understanding of clustering of diseases. J Autoimmun 2009;33:197-207.
6. Talluri SK, Besur S, Talluri J: Abstract #74: A Population-Based Survey of Celiac Disease in the United States. In 2012 National Conference on Health Statistics; 2012.
7. Centers for Disease Control and Prevention: FastStats. Depression [http://www.cdc.gov/nchs/fastats/depression.htm]
8. Compton WM, Thomas YF, Stinson FS, et al: Prevalence, correlates, disability, and comorbidity of DSM-IV drug abuse and dependence in the United States: results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry 2007;64:566-576.
9. El-Serag HB: Impact of irritable bowel syndrome: prevalence and effect on health-related quality of life. Rev Gastroenterol Disord 2003;3 Suppl 2:S3-11.
10. U.S. Centers for Disease Control and Prevention: Overweight and Obesity Causes and Consequences. [http://www.cdc.gov/obesity/adult/causes/index.html]