Mixed Messages on Obesity – What to Believe??

Most obesity researchers are intelligent, skillful professionals, dedicated to public health and medical research. We can also be drama queens.

In a 10-day span, August 6-15, scientists and health officials informed the American public that:

• After increasing for decades, obesity among low-income preschool children is decreasing in 18 states (yay!)
• Obesity among adults is now stable in 49 out of 50 states (yay!)
• Stable or not, obesity among adults is twice as high as it was 35 years ago (boo!)
• Obesity is killing 3 times as many people as we thought (what???)

Recap – obesity is less of a problem except it’s such a major problem that it’s actually more of a problem. You can see why the public might be scratching their heads. Presidential candidates don’t flip-flop this much.

Last month’s flurry of mixed messages doesn’t even include other controversies this year. In January, investigators at the National Center for Health Statistics and NIH reported that being overweight is associated with lower mortality among adults. Other studies suggested that obesity can even be beneficial among adults with cardiovascular or renal disease. Yet the American Medical Association declared obesity a “disease” 6 months later. These mixed messages can naturally leave people wondering: Is obesity a problem or not??

We hear mixed messages because we as a society love both the simple and the dramatic. We enjoy unambiguous, 140-character snapshots that obscure the complexity of results (which aren’t always as contradictory as they sound). We’re addicted to controversy; and we overreact to anything that defies conventional wisdom.

A dangerous side effect of our addiction is that we often ignore uncomplicated truths. Some of the most indisputable facts about obesity go ignored even when they’re major public health concerns. Take, for example, the dangers of severe obesity and why we should still be concerned about even non-severe obesity in children.

Obesity, like most conditions, comes in varying degrees. As an adult, having a body mass index (BMI) of 30-35 represents Grade 1 obesity, whereas a BMI of 35-40 is Grade 2, and 40+ is Grade 3. (Definitions differ for children.) The facts about Grade 2-3 obesity are as unambiguous as you will ever find:

• Thirty-five years ago, 1 in 70 adults in the U.S. had Grade 3 obesity. Now 1 in 16 do.
• Grade 2-3 obesity is now more common in men and women than any cancer except prostate cancer.
• Even skeptics agree that Grade 2-3 obesity is a major health risk. The same investigators who reported that overweight is associated with lower mortality reported that Grade 2-3 obesity increases the risk of mortality by 30%.

Furthermore, adolescents who have non-severe obesity are 16 times as likely to have severe (Grade 3) obesity by their early 30s. The picture is even bleaker for girls – if a teenage girl is obese, there is a 51% chance she’ll be severely obese by her early 30s and face all the health risks that go with it.

Honestly, I get confused by the mixed messages that different studies produce. There is a lot we still don’t know. That’s why, in the midst of a rollercoaster of obesity-related news, we need to keep an eye on the least controversial message: Severe obesity is, without a doubt, a serious, long-term health risk for today’s children.

That only took 90 characters.

(This blog was published on September 10, 2013, for the Michael & Susan Dell Center for Healthy Living)

I am an Assistant Professor at the University of Texas School of Public Health, where I specialize in childhood obesity policy research and systems science. My research has been featured in the New York Times, Los Angeles Times, NPR, CNN, FOX News, Wall Street Journal, and several other media outlets.

You can follow me on Twitter at @DanTaber47, where I often tweet about obesity news, school nutrition, public transit, systems science, and occasionally random topics like Seattle sports, marathon training, or my latest off-the-beaten-path vacation destination (coming in July 2014 – Kyrgyzstan!!)

1. Levi J et al., 2013. F as in Fat: How Obesity Threatens America’s Future. Trust for America’s Health.
2. The NS, Suchindran C, North KE, Popkin BM, Gordon-Larsen P, Association of Adolescent Obesity With Risk of Severe Obesity in Adulthood, JAMA, November 10, 2010—Vol 304, No. 18
3. Flegal KM et al., Prevalence of Obesity and Trends in the Distribution of Body Mass Index Among US Adults, 1999-2010, JAMA, February 1, 2012—Vol 307, No. 5


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