Commentary

Living Large: We’ve Been Misled about the Real Threat Posed by the ‘Obesity Crisis’

This article appeared in Worth, December 2005.
Judging from today’s headlines, you’d think most of America is pudgy, couch-ridden, and on the verge of some catastrophic illness. Our poor eating habits and slothful lifestyle have served as grist for many an in-depth report, multi-part series, and conference like the Time-ABC News “Obesity Summit” held last summer. For years, the government and media have told us we’re in the midst of an “obesity crisis,” and that our excess weight unnecessarily kills some 400,000 of us every year.

Here’s the good news you don’t often hear: Last year, life expectancy in America reached an all-time high. Death rates among all age groups have been in decline for decades. That’s true across all races and both sexes. In fact, the life expectancy gap between black and white is narrowing, even though African-Americans are fattening at a greater clip than white Americans. The two diseases most linked to obesity — heart disease and cancer — are in rapid decline. Deaths from each have been steadily dropping since the early 1990s. In fact, deaths from nine of the ten types of cancer most associated with obesity are down over the last 15 years, not up. Deaths from heart disease have declined in every state in the nation. Deaths from stroke are down, too. The biggest increases in mortality are coming from diseases that inevitably set in at old age, such as Alzheimer’s and Parkinson’s.

In short, we are healthier than we’ve ever been. Granted, much of this good news is attributable to advances in medical technology. But so what? If the fattening of America is really the health threat it’s made out to be — Surgeon General Richard Carmona recently said it’s a bigger threat than terrorism — after thirty years of putting on weight, we should at least be seeing the front end of this coming calamity. It simply isn’t happening.

What’s worse, we’ve been misled about the real threat posed by obesity. Recently, after a wave of criticism from skeptics, the National Institutes of Health commissioned a review of that 400,000 deaths-by-obesity figure. Their findings: The number of deaths attributable to obesity each year is closer to 100,000. What’s more, the new study found some modest protective effects to carrying a few extra pounds (an apt description of the average American, who is 8 to 10 pounds heavier than he was a generation ago). Subtract the number of lives saved by mild overweight, and the number of net deaths due to excess weight is closer to about 26,000 — or 15 times lower than what the government has been telling us.

What’s troubling is that the original figure was cited ad nauseum by politicians, public health activists, and the media in an effort to get government into the business of regulating what we eat. Even accepting the premise that such regulation is a necessary intrusion into our private habits (and I don’t), this new data raises a troubling thought: If there are health benefits to being slightly overweight, and if the average American is slightly overweight, these efforts aimed at getting us to drop excess pounds may actually be doing more harm than good.

The University of Colorado’s Paul Campos, author of The Obesity Myth, makes a compelling case that it is our obsession with weight and incessant yo-yo dieting that’s responsible for higher mortality rates in some obese people, not the weight itself. Black women, for example, don’t have the same increases in mortality at higher weights than white women do. Campos believes this is because black women have healthier attitudes about weight — they don’t diet as frequently, and eating disorders are rare. If Campos is right, government efforts aimed at getting us to diet aren’t merely intrusive, they could well be deadly.

There’s probably some truth to the argument that extreme obesity can be a drain on taxpayers (via Medicare and Medicaid costs), not to mention to non-obese payers on the same health care plan. But such arguments are an invitation to government policing of just about any “bad habit” one might imagine. Any risky behavior could cost taxpayers money. The solution isn’t to regulate fat, it’s to return some semblance of personal responsibility to the health care system. We should be free to indulge our personal vices, but we shouldn’t expect others to subsidize them.

We should also keep some perspective. Obesity is an affliction of prosperity. Not only has our remarkable economy managed to feed all of its citizens, our chief worry right now seems to be that our poor and middle class have too much to eat. That’s a remarkable achievement. And in the proper historical context, it’s not such a bad problem to have.

Radley Balko is a policy analyst at the Cato Institute.