So, it’s no surprise that overweight and mild obesity do not increase mortality. Thanks to the cutting edge of biomedical advance, we can often forestall death but high tech medicine is not remotely as useful for cultivating health and vitality. What it shows, among countries around the world, is that we are living longer, but sicker. The Global Burden of Disease Study, recently published in The Lancet and sponsored by the World Health Organization, the World Bank, and the Bill and Melinda Gates Foundation, is widely acknowledged as one of the most comprehensive epidemiologic assessments in history. The first, obvious limitation of this study is that it examined mortality (death) but not morbidity (illness). In this case, those studies merely looked at the population-level association between the body-mass-index, itself a rather crude measure of body fat, which is what really matters, and death rate. But in many important ways, it is very crude.Ī meta-analysis is never any better than the studies it is aggregating. Iconoclasts who get lots of attention just by refuting the conventional wisdom, and who are occasionally and importantly right, but far more often wrong- are often rather absurd, and scare the hell out of me.Īs for the meta-analysis, a study designed to pool the results of other studies, it is in some ways complex and in some ways quite sophisticated.
Treating any one study as if its findings annihilate the gradual, hard-earned accumulation of evidence over decades is absurd, and scares the hell out of me. We’ll get into the details of the meta-anlysis shortly, but first I’d like to say: treating science like a Ping-Pong ball is what’s absurd, and what scares the hell out of me. Campos as if a third tablet on the summit of Mount Sinai.
This study- debunked for important deficiencies by many leading scientists around the country, and with important limitations acknowledged by its own authors- was treated by Prof. In this instance, the Op-Ed was reacting to a meta-analysis, published this week in JAMA, and itself the subject of extensive media attention, indicating that mortality rates go up as obesity gets severe, but that mild obesity and overweight are actually associated with lower overall mortality than so-called “healthy” weight. Campos is the author of a book entitled “The Obesity Myth,” and has established something of a cottage industry for some time contending that the fuss we make about epidemic obesity is all some government-manufactured conspiracy theory, or a confabulation serving the interests of the weight loss-pharmaceutical complex. According to a widely circulated Op-Ed in yesterday’s NY Times by Paul Campos, a law professor at the University of Colorado with whom I don’t believe I have ever managed to agree on anything, our “fear” of fat- namely epidemic obesity- is, in a word, absurd.
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