5 ms·

Of course "overweight" has as-good or better long term health outcomes so... Meh? https://academic.oup.com/ije/article/35/1/55/849914 https://academic.oup.com/

Of course "overweight" has as-good or better long term health outcomes so... Meh? https://academic.oup.com/ije/article/35/1/55/849914 https://academic.oup.com/ije/article/35/1/55/849914

dj-wonk 9y ago
Thanks for sharing; this line of thinking is too often overlooked. From the abstract: > National and international health organizations have focused increasingly on a perceived obesity epidemic said to pose drastic threats to public health. Indeed, some medical experts have gone so far as to predict that growing body mass will halt and perhaps even reverse the millennia-long trend of rising human life expectancy.1 In response to such concerns public health agencies across the world have sprung into action, searching for policies or incentives to mitigate the alleged ‘disease’ of obesity. > Yet even as the volume of alarm grows louder, a growing number of researchers, drawn from a broad array of academic disciplines, are calling these claims into question. The authors of this article come from this latter group. In our view the available scientific data neither support alarmist claims about obesity nor justify diverting scarce resources away from far more pressing public health issues. This article evaluates four central claims made by those who are calling for intensifying the war on fat: that obesity is an epidemic; that overweight and obesity are major contributors to mortality; that higher than average adiposity is pathological and a primary direct cause of disease; and that significant long-term weight loss is both medically beneficial and a practical goal. Given the limited scientific evidence for any of these claims, we suggest that the current rhetoric about an obesity-driven health crisis is being driven more by cultural and political factors than by any threat increasing body weight may pose to public health.
SeeDave 9y ago
Not very "meh" IMO as obesity, and especially childhood obesity, is a national security issue. https://www.usnews.com/opinion/blogs/policy-dose/articles/2016-04-05/obesity-is-a-national-security-threat https://www.usnews.com/opinion/blogs/policy-dose/articles/20...
Bartweiss 9y ago
This is an interesting paper, particularly the sections on how Americans have gained weight. "Obesity is up!" is much less informative than specifying which populations have gained how much like this does. That said, the section on health outcomes is not hugely compelling. The "normal weight has worse outcomes" studies (particularly the famous NEJM one) have a significant set of problems. NEJM simply didn't use the same bucketing as common parlance, so bucketed comparisons (as opposed to BMI ones) are basically meaningless. More broadly, these studies are generally correlational, which produces serious issues regarding patients suffering from diseases. Eating disorders have very high mortality and often cause low weights, while conditions like cancer and neurodegenerative disease often cause both mortality and low weight. Without correcting for that, you're actually noticing trends like "late stage cancer patients are both skinny and sick". I'll have to go and dig up references, but I thought the current state of research suggested that among otherwise-healthy patients, especially men in middle age or older, health outcomes noticeably worsened beyond the middle of the overweight category?
- Avshalom 9y ago
  I mean I don't know what's come out in the last months, that's just the famous one because it's such a large group but you can go poke around Wikipedia all the smaller studies seem to go back and forth though so if there is a negative effect it's probably a weak correlation or a weak effect https://en.wikipedia.org/w/index.php?title=Body_mass_index&ictd%5Bmaster%5D=vid%7Ebf66b9f4-81bf-4b84-a086-ea695ef9d0e7&ictd%5Bil726%5D=rlt%7E1441195210%7Eland%7E2_4755_seo_b8085c8cba90fd4c39b7aca234576e4a#Variation_in_relationship_to_health https://en.wikipedia.org/w/index.php?title=Body_mass_index&i...
Nomentatus 9y ago
Too old by more than half. 2005. The discussion has moved on since. For more recent articles, I went to pubmed.com and entered "obesity longevity review." Four quick highlights: "Although a recent meta-analysis suggests that overweight individuals have significantly lower overall mortality than normal-weight individuals, these data are likely to be an artifact produced by serious methodological problems, especially confounding by smoking, reverse causation due to existing chronic disease, and nonspecific loss of lean mass and function in the frail elderly." https://www.ncbi.nlm.nih.gov/pubmed/24628815 https://www.ncbi.nlm.nih.gov/pubmed/24628815 "Utilizing novel models of visceral obesity, numerous studies have demonstrated that the relationship between visceral fat and longevity is causal while the accrual of subcutaneous fat does not appear to play an important role in the etiology of disease risk." https://www.ncbi.nlm.nih.gov/pubmed/23764746 https://www.ncbi.nlm.nih.gov/pubmed/23764746 Mexico: "Obesity and overweight have a strong effect on the incidence of T2D;this, combined with the large impact of diabetes on adult mortality, generates increases in mortality that translate into losses of 2 to 3 years of life expectancy at age 50." https://www.ncbi.nlm.nih.gov/pubmed/26172231 https://www.ncbi.nlm.nih.gov/pubmed/26172231 Trend: https://www.ncbi.nlm.nih.gov/pubmed/24913899 https://www.ncbi.nlm.nih.gov/pubmed/24913899

Of course "overweight" has as-good or better long term health outcomes so... Meh? https://academic.oup.com/ije/article/35/1/55/849914 https://academic.oup.com/ije/article/35/1/55/849914

dj-wonk 9y ago

Thanks for sharing; this line of thinking is too often overlooked. From the abstract: > National and international health organizations have focused increasingly on a perceived obesity epidemic said to pose drastic threats to public health. Indeed, some medical experts have gone so far as to predict that growing body mass will halt and perhaps even reverse the millennia-long trend of rising human life expectancy.1 In response to such concerns public health agencies across the world have sprung into action, searching for policies or incentives to mitigate the alleged ‘disease’ of obesity. > Yet even as the volume of alarm grows louder, a growing number of researchers, drawn from a broad array of academic disciplines, are calling these claims into question. The authors of this article come from this latter group. In our view the available scientific data neither support alarmist claims about obesity nor justify diverting scarce resources away from far more pressing public health issues. This article evaluates four central claims made by those who are calling for intensifying the war on fat: that obesity is an epidemic; that overweight and obesity are major contributors to mortality; that higher than average adiposity is pathological and a primary direct cause of disease; and that significant long-term weight loss is both medically beneficial and a practical goal. Given the limited scientific evidence for any of these claims, we suggest that the current rhetoric about an obesity-driven health crisis is being driven more by cultural and political factors than by any threat increasing body weight may pose to public health.

SeeDave 9y ago

Not very "meh" IMO as obesity, and especially childhood obesity, is a national security issue. https://www.usnews.com/opinion/blogs/policy-dose/articles/2016-04-05/obesity-is-a-national-security-threat https://www.usnews.com/opinion/blogs/policy-dose/articles/20...

Bartweiss 9y ago

This is an interesting paper, particularly the sections on how Americans have gained weight. "Obesity is up!" is much less informative than specifying which populations have gained how much like this does. That said, the section on health outcomes is not hugely compelling. The "normal weight has worse outcomes" studies (particularly the famous NEJM one) have a significant set of problems. NEJM simply didn't use the same bucketing as common parlance, so bucketed comparisons (as opposed to BMI ones) are basically meaningless. More broadly, these studies are generally correlational, which produces serious issues regarding patients suffering from diseases. Eating disorders have very high mortality and often cause low weights, while conditions like cancer and neurodegenerative disease often cause both mortality and low weight. Without correcting for that, you're actually noticing trends like "late stage cancer patients are both skinny and sick". I'll have to go and dig up references, but I thought the current state of research suggested that among otherwise-healthy patients, especially men in middle age or older, health outcomes noticeably worsened beyond the middle of the overweight category?

Avshalom 9y ago
I mean I don't know what's come out in the last months, that's just the famous one because it's such a large group but you can go poke around Wikipedia all the smaller studies seem to go back and forth though so if there is a negative effect it's probably a weak correlation or a weak effect https://en.wikipedia.org/w/index.php?title=Body_mass_index&ictd%5Bmaster%5D=vid%7Ebf66b9f4-81bf-4b84-a086-ea695ef9d0e7&ictd%5Bil726%5D=rlt%7E1441195210%7Eland%7E2_4755_seo_b8085c8cba90fd4c39b7aca234576e4a#Variation_in_relationship_to_health https://en.wikipedia.org/w/index.php?title=Body_mass_index&i...

Nomentatus 9y ago

Too old by more than half. 2005. The discussion has moved on since. For more recent articles, I went to pubmed.com and entered "obesity longevity review." Four quick highlights: "Although a recent meta-analysis suggests that overweight individuals have significantly lower overall mortality than normal-weight individuals, these data are likely to be an artifact produced by serious methodological problems, especially confounding by smoking, reverse causation due to existing chronic disease, and nonspecific loss of lean mass and function in the frail elderly." https://www.ncbi.nlm.nih.gov/pubmed/24628815 https://www.ncbi.nlm.nih.gov/pubmed/24628815 "Utilizing novel models of visceral obesity, numerous studies have demonstrated that the relationship between visceral fat and longevity is causal while the accrual of subcutaneous fat does not appear to play an important role in the etiology of disease risk." https://www.ncbi.nlm.nih.gov/pubmed/23764746 https://www.ncbi.nlm.nih.gov/pubmed/23764746 Mexico: "Obesity and overweight have a strong effect on the incidence of T2D;this, combined with the large impact of diabetes on adult mortality, generates increases in mortality that translate into losses of 2 to 3 years of life expectancy at age 50." https://www.ncbi.nlm.nih.gov/pubmed/26172231 https://www.ncbi.nlm.nih.gov/pubmed/26172231 Trend: https://www.ncbi.nlm.nih.gov/pubmed/24913899 https://www.ncbi.nlm.nih.gov/pubmed/24913899