The accuracy of the following statements is not only personally important to your health, but it may be politically important to your freedom.
Which of the statements you believe is also likely to affect such intimate issues as your body image and how you choose to feed your family.
-
Obesity and inactivity kill 400,000 Americans a year, making them the second leading cause of preventable death in the U.S., next only to smoking.
-
Obesity and inactivity kill 26,000 Americans a year, making them less lethal than relatively unknown diseases such as nephritis and septicemia.
The first statement creates panic; the second, concern. Without diminishing the desirability of a healthy diet and exercise, which reaction do the facts really support: a public panic with calls for political intervention, or a reason why individuals should reconsider reaching for that second doughnut?
Don’t look to the Centers for Disease Control for guidance. The CDC seems determined to create confusion, not clarity on the statistics. Over the past year, the CDC has provided numbers that support both statements, contradictory though they be.
In March 2004, a study co-authored by CDC director Dr. Julie Gerberding claimed that, in 2000, obesity and physical inactivity killed 400,000 Americans; that is, obesity caused more than 16 percent of all deaths in the U.S. The CBS headline, “Americans Eat Themselves To Death,” was typical of media coverage. Time/ABC News convened a Summit on Obesity.
Political reaction was equally alarmist. Surgeon General Richard Carmona declared, “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.”
Using words like “epidemic,” policy makers rushed to debate on everything from “fat taxes” on junk food to the regulation of fast-food advertising, from Medicare covering obesity-related surgeries to banning sodas from schools.
Some voices advised skepticism. Steve Milloy, in his FOX “Junk Science” column of March 12, 2004, pointed out that “the CDC produced its estimates with a statistical ruse called ‘attributable risk’ – the fearmongers’ method of choice for alarming the public with large body counts. Attributable risk could be the poster child for the saying, ‘garbage in, garbage out’.” In other words, science accurately views obesity as a contributing factor in death – or, even more loosely, as a correlation – not as a causative one.
Meanwhile, the Center for Consumer Freedom – a self-described “nonprofit organization dedicated to protecting consumer choices and promoting common sense” – called attention to severe methodological and mathematical flaws in the CDC study.
On Nov. 23 the Wall Street Journal reported that, according to an internal CDC investigation, the “widely quoted” study on obesity contained “statistical errors” that inflated the death toll by “tens of thousands” – specifically, by 80,000 or 20 percent. In November, the CBS headline (and others) changed to “Obesity Study Overstated Effects.” But the 400,000 figure seemed cemented into government policy and public awareness. It is difficult to unring an alarm bell.
Then, on April 19, the Houston Chronicle reported that the CDC “estimated today that packing on too many pounds accounts for 25,814 deaths a year…As recently as January, the CDC came up with an estimate 14 times higher.” No wonder, the CCF concluded “CDC stands for Center for Damage Control."
CCF takes an extreme view: it argues that CDC’s super-sized statistics were politically motivated and self-consciously false. (Others boomerang the same charges of dishonesty back at the CCF.)
If true, however, the CCF’s accusations would place some CDC officials in the same category as Eric T. Poehlman, a top obesity researcher who did work at the University of Vermont. On March 18, the Boston Globe reported Poehlman had “fabricated data in 17 applications for federal grants to make his work seem more promising, helping him win nearly $3 million in government funding.” Poehlman acknowledged making up “research results from 1992 to 2002, including findings published in medical journals that overstated the effect of menopause on women’s health.”
Apart from the profit (or funding) motive, political bias may be playing a role at the CDC and with other obesity research. In January 1998, the editors of the New England Journal of Medicine cast a skeptical eye on the “300,000 deaths” from obesity per year figure and warned against a growing trend; namely, that “the medical campaign against obesity may have to do with a tendency to medicalize behavior we do not approve of.”
Medicalized behavior is behavior that government deems proper to control. If the food going into your mouth is an addiction or an epidemic, then your diet ceases to be a personal choice and becomes an issue of public safety. The lunch you pack for your children becomes a matter of public policy.
Accordingly, which of the two opening statements you chose to believe is not the only ‘weighty’ question. It is quickly followed by “what political importance should be attached to statistics about fat?”
I believe people are responsible for their own weight and their own food choices. Government intervention is a wrong and a dangerous option, on several grounds. Just one of them: individuals should be assuming, not relinquishing personal control over their own health. We should down-size government’s interest in what we eat and right-size the statistics it’s feeding us.
May 4, 2005
