If you checked out the Web site for the recent Obesity Summit, you'd have noticed the quote the summit's organizers chose to set the tone for the three-day event. It's from U.S. Surgeon General Richard Carmona: "As we look to the future and where childhood obesity will be in 20 years ... it is every bit as threatening to us as is the terrorist threat we face today. It is the threat from within."
The U.S. government's spokesperson on medical issues says obesity is every bit as threatening as terrorism. Given that the war on terror has spawned the largest federal bureaucracy in the history of the United States, questionable trespasses on civil liberties, and is costing U.S. taxpayers tens of billions of dollars, that's an awfully scary thing for a high-ranking government official to say. And that conference organizers chose to place Mr. Carmona's quote front and centre ought to give some sort of indication of the starting point from which this debate kicked off.
First up to the podium at the summit was Time magazine president Eileen Naughton, who expounded on the numerous important, intelligent people from all walks of the diet, nutrition and medical fields that were in attendance, and who then complemented all of us conference attendees for our "shared sense of urgency." She implored us not to "turn our backs" on our children. She thanked ABC News, New Balance, Aetna, and the Milk Producers, then lauded praise on the Robert Wood Johnson Foundation for embarking on its crusade to "eradicate childhood obesity by 2015."
Time's science editor, Philip Elmer-DeWitt, also took the stage. Mr. Elmer-DeWitt showed the results of a Time poll on American attitudes toward obesity.
He even gave me a plug. "Our friends at the Cato Institute who emphasize personal responsibility will be happy to know," he said, "that almost 90% of Americans put the blame for obesity on individuals who are obese."
Unfortunately, a healthy majority of poll respondents also blame fast food companies, restaurants, marketers and advertisers, and food manufacturers. Fewer than half also blamed the government. Even more disturbing, 74% of respondents favoured government-mandated warning labels on high-fat, high-sugar foods; 61% believe restaurants should be forced to disclose calorie and fat content of every menu item; 56% favour a ban on advertising high-fat or high-sugar foods to kids; 41% favour a tax on fatty or sugary foods; and more than one in five actually favour legal limits on restaurant portion sizes.
That in mind, the keynote speaker was Tommy Thompson, currently President Bush's Secretary of Health and Human Services. Mr. Thompson is one deft politician.
In Time's news release touting Secretary Thompson as keynote speaker, Secretary Thompson supplied the get-tough quote "America is just too darned fat." His speech also churned out a copious number of meaty sound bites:
"We're on the verge of the tipping point when it comes to obesity... There are a billion overweight people in the world, and we have to do something about it."
Speaker after speaker reinforced the notion that obesity is a looming health crisis of catastrophic proportions. Attendees were told Americans have been getting fatter for the last quarter century, and that we're already seeing exploding health costs as the result of the many maladies associated with overweight. That obesity is a very public, very urgent problem was more a universal, inarguable premise than the subject of any real debate.
The summit seemed to centre not around whether or not obesity was a public or private matter, but around what collection of federal regulations, restrictions and lifestyle programs we ought to implement to fight it. In a concluding speech summarizing the conference, for example, Time's Ms. Naughton said there was "consensus" that obesity is a huge public health problem, but conceded that she personally was disappointed that "we didn't have an 'aha' moment, where we came to a consensus that we need to ban the marketing of sweets to children." The conference was inspired by ABC News anchor Peter Jennings' prime time special last December entitled, "How to Get Fat Without Really Trying," in which Mr. Jennings cited the tobacco example and pled for government action to fight obesity. At the summit, Mr. Jennings hosted a panel on advertising and marketing food to children.
But on the second day of the summit, ironically enough, a new study from the National Center for Health Statistics reported that cancer rates have been steadily dropping by about a half percentage point per year since 1990. Cancer deaths over the same period declined by about 1% per year. The obesity warriors often mention the fat-cancer link, but an increase in heart disease is even more frequently cited as reason for government intervention to stave off the coming crisis. Surely we should be seeing an increase in heart disease since 1990, a period over which we've all allegedly been growing thicker.
But the results there are even more striking. According to the American Heart Association, cardiovascular disease is down 16.5% since 1990. Coronary heart disease is down by nearly 25%. And incidence of stroke is down 10%. Critics might attribute these numbers to decreases in smoking, but the number of smokers in the United States dropped only from 25.4% to 22.1% from 1990 to 2001, perhaps enough to explain the drops, but certainly not enough to explain the drops and compensate for the increase in these diseases we should be seeing due to obesity.
About the only increase in obesity-related ill health we have in the last 25 years is in diabetes. But even the Center for Disease Control -- as big an alarmist on obesity as you'll find -- concedes on its Web site that part of that increase can be attributed to a change in survey methodology the agency implemented in 1997 and to an ageing population - and the elderly are the one age group least likely to be overweight.
The author Paul Campos points to similar data in his new book, The Obesity Myth. Campos argues that if you look at mortality rates, there's no statistically significant risk of premature death among the overweight until you find yourself among the very seriously obese. Campos was one of the few voices of dissent at the summit in Williamsburg, Virginia. But he was hardly taken seriously. He was a last-minute addition, and put on a panel called, "Media: Part of the Problem, or Part of the Solution?" -- an odd place to put him, considering that he isn't a journalist, and only a very small part of his book addresses the media (not to mention the strange name of the panel to begin with -- the media's job is to report, not to instigate problems or to provide solutions). He was ridiculed in the question-and-answer session, and when the panel concluded, Time science editor Philip Elmer-Dewitt took the stage and said, "I just want to say to Paul, we may disagree with everything you say, but we support your right to say it," a curious thing for the editor of a detached, objective newsweekly to say.
Though Mr. Campos may have been lonely among the nutrition activists in Williamsburg, he is finding some company in academia. Last week, the New York Times profiled Dr. Jeffrey Friedman of Rockefeller University. Prof. Friedman's thesis is every bit the apostasy Mr. Campos' is. Prof. Friedman carefully analyzed Americans' body weights from 1991 to 2004 and found most Americans aren't packing on the pounds, but are a mere six to seven pounds heavier now than they were then. Prof. Friedman concluded that only the very obese have gotten significantly heavier, a phenomenon that misleadingly skews the distribution curve to the right.
This isn't to say Mr. Campos and Prof. Friedman are right, or that the obesity warriors are wrong. But there certainly ought to be a debate. The way the issue is being framed by the media suggests there is universal agreement that our overindulgence portends a coming health care crisis, and that the only solution is to put restrictions on our options as food consumers, and to slap regulations on the companies that feed us.
As it stands, that obesity ought to be a matter of private concern and not public policy, that overweight may not be the dire condition some say it is, or that data suggesting we're all ballooning to plus sizes may be misleading, are points the media won't even take into consideration.