Obesity Crankery in the Washington Post

Why the Washington Post decided to devote space to libertarian crankery from the Pacific Research Institute, I’ll never know, but today’s op-ed from Sally Pipes on the evils of governmental interference in diet is a bit much.

The way I see it, obesity cranks recycle 3 arguments over and over. It usually goes: (1) BMIs don’t fit everyone (2) the stupid government has arbitrarily changed the definition of overweight to make more people fat and (3) exercise is all that matters anyway and overweight doesn’t hurt you.

First, we have BMI’s are inaccurate:

The standard metric for this measurement is a person’s body-mass index, or BMI — the ratio of one’s height to one’s weight. But at best, BMI is a rough tool that does not take into account an individual’s body type. A six-foot-two athlete who weighs 210 pounds would be classified as “obese” according to BMI charts — despite his 32-inch waistline, 17-inch biceps and his less than 6 percent actual body fat.

If you believe the BMI tables, most of the best players in the NBA and NFL are “overweight,” including superstar athletes Kobe Bryant and Tom Brady.

Many Hollywood heartthrobs also qualify as fatties — Brad Pitt, Matt Damon, Tom Cruise and George Clooney, to name a few.

Once you read this you know you’re going to see the standard idiotic attacks on science from someone defending the food industry or obesity itself. Why is BMI used? It is a indirect measure of adiposity. It is not perfect, and sadly, there is no perfect way to measure and track total body fat easily. BMI is an approximation, but on average a pretty good one.

Now, the obesity cranks love to throw out this red herring, usually it’s Arnold Schwarzenegger, but whatever. Is anyone really confused by this? Certainly I doubt that professional athletes and body builders are losing sleep because their BMIs aren’t ideal. BMI is an indicator for the average schmo and not professional athletes and body builders. No one is confused about this, and if anything it hurts their case as it suggests overweight statistics are being brought down by healthy athletic people. No one thinks the BMI is perfect, but until we develop a better indirect measure of adiposity that can be easily tracked in individuals (or an easy direct measure) we shouldn’t let the perfect ruin the good.

Next, this endless refrain from people who are full of it:

What’s more, the acceptable BMI continues to be ratcheted downward — transforming those who were considered perfectly healthy yesterday into “overweight” and “obese” today.

Before 1998, a “healthy” BMI was anything less than 27. Then, suddenly, the government changed the “healthy” number to anything less than 25. Overnight, more than 25 million people who were previously considered to be a healthy or normal weight were reclassified as overweight. Looked at another way, the government artificially manufactured an obesity crisis by moving the BMI goal posts.

The Govmint! The Govmint! It’s a conspiracy! For one her first statement is completely incorrect. Obesity has always been > 30, and still the number of obese has been increasing based on this threshold. Therefore it would be very difficult to manufacture an obesity crisis by keeping the BMI threshold for obesity the same!

Further, the “government” said anything less than 27 was healthy? Whom do you mean? The NIH? Or the CDC? Which “government” are you talking about? One group of government researchers convinced the government researchers in the CDC in 1998 to stop using 27 as a measurement of overweight so they would fit with everyone else who had always used 25. It’s no great conspiracy, they were sick of the definition being different across different evil government groups. Further this only changed the definition of overweight from the CDC, not obesity nor the definition for overweight being > 25 that many other gov’mint researchers had used for a long time.

Now, the third nonsense argument – that exercise is all that matters and overweight isn’t that bad – I’m not even going to go into extensively as I’ve harped on it so much already. Remember, it’s about primary vs. secondary prevention. Overweight and obesity get you by giving you diabetes, hypertension, and dyslipidemia. These conditions, however, can be largely controlled with drugs which will largely abrogate overweight/obesity’s effects on mortality. The goal though is primary prevention – preventing the co-morbidities in the from occurring at all. This is superior to secondary prevention – prevention of increased mortality through pharmaceuticals. The irony is the cranks are using the success of medicine at preventing harm from obesity to criticize medicine for trying to keep us healthy in the first place!

Instead I’ll just jump to a paragraph I found so cranky, I almost plotzed:

While we may not always like the choices others might make, it is essential that we all have the freedom to choose for ourselves. Once we accept the idea that the Nanny State should step in when it’s “for our own good,” we’ve taken a very big step down the road to something like the scene painted in George Orwell’s “1984” — when citizens wake each day to mandatory exercise classes on the Telescreen.

Holy persecution batman, I think we have ourselves a crank! That was pretty fast – usually I have to read more than one article from someone before they so perfectly fulfill the crank criteria. Pipes, however, has managed in record speed. Considering this is coming from the libertarians I guess I shouldn’t be surprised. But damn! That was some high-speed crankery.

What is most tragic about this article, however, is that she takes a study with an important holiday message about obesity, and only mentions it in passing, rather than describing its very relevant message to all of you eaters out there. She mentions in her first sentence, “it should come as no surprise that the average American gains about one pound between Thanksgiving and New Year’s, according to the National Institutes of Health. That pound a year really adds up over the decades.”

It really does add up, because the study showed that not only do you gain a pound a year over the holidays (and about 10% of people gain 5 pounds!), you don’t lose that weight throughout the year. The result is that for many people weight gain occurs in discrete steps of over-consumption rather than steady accumulation. It used to be the harvest feast was followed by a winter lull in food availability – no more. You get stuck with that extra turkey for life. There’s a holiday message of joy, and a suggestion for a New Year resolution. Aim low, and try to get rid of those pounds you just added. In the long run, it might make a big difference. Primary prevention people. Get on it!