Friday, February 1, 2013

Is Obesity Prevalence a Myth?

Fans at Stadium Bar & Grill in Green Bay, Wisconsin on SuperBowl Sunday two years ago. I warrant that NONE of these fans would be 'obese' if the BMI was replaced!.

According to assorted health centers, institutes and sources, depending on which one you cite, up to 2 of every 3 Americans are “overweight” denoting a BMI or body mass index of 25 to 30. With one fell swoop the adoption of the insane BMI index created about 25 million additional “overweight” people, and "BMI inflation" led to 35 million by last year. Included in the new overweight population were football running backs and wideouts such as: Ray Rice of the Ravens, Danny Woodhead and Wes Welker of the Patriots, and Davon Best of the Dolphins. Of course, this exposes the BMI as absurd and inaccurate.

The effect? To possibly siphon many more citizens into the maw of the Medical Industrial Treatment Complex, including being hostage to weight loss regimens prescribed by docs, or drug prescriptions. Of course this modus operandi isn’t new. In medical arenas such as psychotherapy (with disorders determined by the Diagnostic and Statistics Manual) as well as cancer testing, millions and millions are herded into medical treatments they don’t need each year. This adds hundreds of billions of dollars in extra costs.

In the case of cancer testing, a recent Consumer Reports (‘Save Your Life – Cancer Screening is Oversold’, March, p. 28) we learn that only three cancer screening tests – for breast, cervical and colon cancer- are really worth their repeated costs. The others are not and frequently lead down a treatment path that can be harrowing as well as dangerous. (For example, a simple prostate biopsy risks hemorrhage, sepsis). The prostate cancer screening itself is also hostage to the numbers game, determined by PSA. This is why CR recommends men aged 50-74 speak with their doctors first about whether the benefits of the test outweigh the harm based on risk factors. Generally, given 96% of prostate cancers are slow growing,  a test every other year is more than adequate.

At the root of massive screening rejection is a new concept of cancer. As the article notes: “Cancer is different than once thought. Doctors used to view cancer as uniformly deadly, but researchers now understand that cancer cells can appear and even disappear on their own or never spread. Most screening tests don’t discriminate between the harmless and deadly kinds.”

When my PSA doubled over a year’s time, the first thing I did – as opposed to rushing into a biopsy – was to have it re-tested. Humans are liable to make errors after all. When the result was confirmed I then took the “free PSA” test to check that the doubling could really have been from cancer as opposed to benign prostate hypertrophy. (The free PSA measures the ratio of bound to free prostate specific antigen in the blood). Only after all 3 tests spelled “failure” did I march myself in to get a biopsy, and yes, the finding was adenocarcinoma in 5 lobes.

Back to the BMI and Americans being overweight. According to a new book by Paul Campos: ‘The Obesity Myth: Why America’s Obsession with Weight is Hazardous to Your Health’, the BMI has been largely responsible for fomenting an obesity hysteria. If that hyper-biased measure were removed and the earlier weight standards adopted, 35 million Americans currently falling under the umbrella of overweight would be normal weight. That is a significant amount. Adding heft to Campos’ thesis is a study appearing in The Journal of the American Medical Association that “found that all adults categorized as overweight and most of those categorized as obese have a lower mortality risk than so-called normal weight individuals” (‘Vindication for the Obesity Debunker’ in The Denver Post, Jan. 30, by Vincent Carroll)

Carroll in his DPost article acknowledges factors such as fitness and quality of life are often neglected in looking at BMI, but he adds:

“That’s true enough, except that BMI statistics are used all the time to beat Americans over the head with the idea that something like 7 in 10 of us weigh too much.”

Carroll then goes on to insist more Americans need to be aware of the JAMA findings, especially when they encounter the BMI driven morbidity persecutors and “fat” obsessives who, by their zeal, have probably forced more millions of young women into anorexia or bulemia than overweight people they’ve helped by their incessant preaching. Campos, for his part, doesn’t dismiss the danger of being seriously obese or the import of physical activity but he does insist the more extreme claims of the obesity alarmists are seriously overblown.

This is a view with which most sober observers can agree, as well as rational nutritionists. Certainly, if we want to see lower medical cost inflation in the U.S. – including for prescription drugs- then all out anti-fatness frenzy needs to be avoided and that includes the over the top tongue- wagging of the food police who demand we switch from brats to Brussels sprouts on Super Bowl Sunday..

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