CDC Makes an About-Face on Obesity Risks

Being overweight is nowhere near as big a killer as the

New studies revealed that obesity only causes about 112,000 deaths in the United States— a far cry from the 400,000 that the Center for Disease Control and Prevention (CDC) estimated last year.

The new findings plummet obesity to seventh, instead of second, on the list of the nation’s leading preventable causes of death. The news is bittersweet for African-Americans who have suffered disproportionately from the condition.

Last year, an alarming study conducted by the CDC’s Division of Adult and Community Health listed the leading causes of preventable death in order as tobacco; poor diet and inactivity leading to obesity; alcohol; germs; toxins and pollutants; car crashes; guns; risky sexual behavior; and illicit drugs.

In recent years, the government has spent millions of dollars fighting obesity and publicizing the message that two out of three American adults are overweight or obese, and at higher risk for heart disease, arthritis and diabetes. Researchers even warned that excess weight would soon overtake tobacco as the top U.S. killer.

But they were wrong, and Katherine Flegal, a senior research scientist with the CDC’s National Center for Health Statistics, told them so.

Using the new estimate, obesity would drop behind car crashes and guns to seventh place — a ranking the CDC is unwilling to make official, underscoring the controversy inside the agency over how to calculate the health effects of obesity.

The new study attributes only 111,909 deaths to obesity, but then subtracts the benefits of being modestly overweight, and arrives at the 25,814 figure.

Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women’s Hospital in Boston, said she is not convinced the new estimate is right. “I think it’s likely there has been a weakening of the mortality effect due to improved treatments for obesity,” she said. “But I think this magnitude is surprising and requires corroboration.”

CDC Director Dr. Julie Gerberding said because of the uncertainty in calculating the health effects of being overweight, the CDC will not use the figure of 25,814 in public campaigns. And it is not going to scale back its fight against obesity.

“There’s absolutely no question that obesity is a major public health concern of this country,” she said. Gerberding said the CDC will work to improve methods for calculating the consequences of obesity.

While the numbers of deaths from obesity may have decreased overall, one consequence—shorter life span—is of major concern for African-Americans. To date, the CDC reports that 67 percent of African-Americans are overweight and two-thirds of those are technically obese.

Under the guidance of biostatistician David Allison, researchers for the Journal of the American Medical Association recently reported that being obese at age 20 can take up to 20 years off your life.

“A 20-year-old obese White man lives 13 years less than men of normal weight,” said Allison. “The news is worse for obese Black men, who live 20 years less than their slimmer peers.”

The life-shortening effects of obesity were lower for 20-year-old obese White women, who live eight years less, and for obese Black women, who lost five years.

He found life expectancy for 20-year-olds with body-mass indexes of at least 45 is 13 years lower for White men and 20 years lower for Black men, compared with people of normal weight.

Under current government standards, a BMI (height-to-weight ration) of 25 or higher is overweight; 30 and above is obese. The ideal index is between 18 and 25. The study also found there were racial differences in how much body fat people had to have before life expectancy dropped.

In Blacks, life expectancy was not shortened in obese men with BMIs under 31 and in obese women under 37. But in Whites, lifespan reductions of about one year occurred in young people who were merely overweight-meaning those men with a BMI of about 25.5 and women with a BMI of about 27.5.

The numbers may change, depending on who you speak with.

According to Flegal, the contrasting studies raise questions about what definitions to use for obesity and “where to draw the line.”