Fat Chance

January 01, 2003  ·  Michael Fumento  ·  The New Republic  ·  Overweight and obesity

To the editors:

How unfortunate for Paul Campos that just as his article appeared studies in two major medical journals completely refute him ("Weighting Game," January 13). Both added to the mountain of scientific literature that a high body mass index (BMI) is with exceptions an excellent measurement of obesity and premature death. A Journal of the American Medical Association (JAMA) report found that white men ages 20 to 30 with a BMI greater than 45 lost 13 years of life compared with those with a BMI below 25 (the cutoff for the definition of "overweight"), while overweight women lost eight years. The Annals of Internal Medicine reported six to seven years of lost life for obese 40-year-old nonsmokers, approximately the same premature mortality found in normal-weight smokers.

Campos says a "careful survey of medical literature" supports him. Translation: He cherry-picked a few items and twisted them. For over a century, insurance actuaries have noted a clear correlation between fatness and early death. More recently, medical professionals have defined and explained that association. These include the 1995 Nurses’ Health Study of over 115,000 women and a 1998 study by Dr. June Stevens and her colleagues that tracked more than 300,000 men and women for twelve years. "It’s the very lean weight that is associated with the best survival rate," said Stevens.

A 1999 New England Journal of Medicine report on over one million people found those with a BMI below 25 lived longest, while white men with the highest BMIs were twice as likely to die during the study and overweight white women fared even worse.

Campos pretends the Harvard Alumni Study supports him, yet it states that "body weight and mortality were directly related," and the "lowest mortality was observed among men weighing, on average, 20% below the U.S. average for men of comparable age and height."

Never mind though, says Campos, because "even where there are clear correlations," association is not cause and effect. That’s sophistry and empirically false. Studies have repeatedly shown that obesity leads to congestive heart failure, coronary heart disease, stroke, cancer, high blood pressure, high blood cholesterol, Type 2 diabetes, and myriad other harmful conditions.

Campos’s "fat but fit" thesis was directly tested and refuted in a 1995 JAMA study, finding that, in every measured risk factor for heart disease but one, the benefits of weight loss outweighed those of exercise.

Like the very diet industry he deplores, Campos offers something for nothing. And like sirens of legend, his message kills.

Michael Fumento Senior Fellow Hudson Institute Washington, D.C.