Is Obesity the Problem or Just a Symptom?

IS OBESITY THE PROBLEM OR JUST A SYMPTOM?

"I'd kill myself if I was as fat as Marilyn Monroe." Elizabeth Hurley

A lot of misinformation has been distributed about obesity, much of it confusing and some of it questionable. As a result, many people think obesity is a disease, and an "epidemic" of a disease, at that. In fact, it is NOT a disease (it is one of many symptoms of a complex problem) and it most certainly is not an epidemic. The reason so many (65%) Americans are classed as overweight or obese is because the Centers for Disease Control (CDC) employs a crackpot formula to assess healthy versus non-healthy weight classifications.

If there is an epidemic, it's one of bad science and attendant public ignorance as to what constitutes fitness and good health versus the nature and causes of obesity. I think there is an epidemic absence of good sense. The American people do not accept sufficient responsibility for learning how to live well. Consequently, they rely way too much on a sickness-based health care system and way too little on their own initiatives to stay well and get "weller." The latter is something they should pursue daily via the practice of lifestyles consistent with known wellness principles for optimal functioning and high life satisfaction.

The bad science is seen in the fact that the CDC's body mass index (BMI) factors weight only in relation to height, which is far less significant than percentage of body fat and overall fitness. Complicit in this foolishness are the pharmaceutical companies, the diet pill industry and weight-loss emporiums, which would like to see everyone labeled obese. It's good for business!

Is obesity the cause of any kind of epidemic? No-it's a symptom. No more. Is obesity the CAUSE of higher cancer rates and more diabetes, heart disease and a greater incidence of morbidity and mortality? Of course not. It is a symptom - a symptom of the fact that we do not live wellness lifestyles. We eat too much and exercise too little. Instead of height and weight, we would be better off if the CDC measured calories consumed versus calories burned.

There are many villains in the non-epidemic of obesity in America, which should be called the crisis in too little wellness - or something like that. Government policies subsidize the wrong things (e.g., cheap corn which facilitates cheap additives in junk foodstuffs) for the wrong reasons (lobbyists from big industries pour funds into the campaign coffers of members of Congress who in turn write legislation favorable to these industries). Major gains could follow from reversing current subsidies that help agribusiness to subsidies that help poor families buy more fruits and vegetables instead of currently affordable but highly processed, low-nutrient foodstuffs. At present, poor people can't afford a healthy diet - and few think they have time or much opportunity, support and capacity for serious daily exercise. One food scientist recently calculated that a consumer could obtain seven hundred calories from a grab bag of Fritos chips, but it that it would be "hard to match that price-to-calorie ration with broccoli, squash, and greens." (Source: "Fat Politics': Healthy Skepticism on Obesity," NY Times, November 4, 2005.)

I hope I have convinced you that obesity is not the problem but rather a symptom of a larger challenge, that of persuading, supporting and rewarding citizens for staying well by living healthfully and, in the process, enjoying life more. Alas, this will be a tough sell, in good measure because we do not have the leadership in Washington to lead a sea change in attitudes from symptoms to underlying causes and overarching solutions. All of which reminds me of something George Bernard Shaw said about obesity: "No diet will remove all the fat from your body because the brain is entirely fat. Without a brain, you might look good, but all you could do is run for public office."

HEALTHY SKEPTICISM ABOUT OBESITY

At 6 feet, three inches and 170 pounds, my BMI (body mass index) is 21.24, which puts me in the normal range. But, I exercise at least two hours daily and compete in road races and triathlons throughout the year. Not everyone lives like this -- What about normal, sensible people who have a life, responsibilities, a job and leisure interests? What are their chances of maintaining a healthy weight, based on official government charts? Want to find out how YOU score and be rated? (No, I did not mean "berated.")

Go to http://www.consumerfreedom.com/games.cfm and fill in the blanks. Most people will discover that they are classified in the overweight (like 5:11, 191 pound George W. Bush) or obese (like 5:7, 201 pound Tom Cruise) categories. This fact and a number of recent books, articles and even an organized backlash by food marketers against the Centers for Disease Control and Prevention (CDCP) and consumer advocates like the Center for Science in the Public Interest (CSPI) have sparked a movement to debunk the idea that Americans are anywhere near as fat as they have been made out to be.

What's the deal? Is there a myth about obesity or not? To paraphrase an old (1944) Louis Jordan tune "Is You Is Or Is You Ain't My Baby," let me ask "Is we is or is we ain't as fat as they say we are?"

It depends. It depends on whom you ask, what standards you choose to apply and what you mean by "fat" or "obese."

Consider this: Using BMI standards, the following athlete celebrities (besides Tom Cruise and other normal-looking actor celebrities, such as Matt Damon, Will Smith and Bruce Willis.) all are obese (BMI of 30 or more).

* Mark McGuire (@ 6'5" and 250 pounds, a BMI of 30).

* Matt LeBlanc (@ 5'11" and 218 pounds, a BMI of 30).

* Donovan McNabb (@ 6'3" and 240 pounds, a BMI of 30).

* Steve McNair (@ 6'2" and 235 pounds, a BMI of 30).

* Dwayne Johnson (@ 6'5" and 275 pounds, a BMI of 33).

* Sammy Sosa (@ 6'0" and 220 pounds, a BMI of 30).

* Sylvester Stallone (@ 5'9" and 228 pounds, a BMI of 34).

* Mike Tyson (@ 5'111/2 and 218-235 pounds, a BMI of 30-32).

While you might not recognize every one of these athlete celebrities, you probably have seen pictures of enough of them to know that these folks do not fit the image of obese people. What's more, they are or have been among the best athletes of their time. While it is likely that many Americans, no doubt more than ever before, are indeed obese (think Oprah Winfrey when not on a diet or in training to attempt one of her seven-hour marathons), most are not even close to what you or I would call fat. As emphasized, all the above listed professional athletes were in extraordinary physical condition at the weights shown after their respective heights. The fact that CDCP BMI standards would classify them as obese simply demonstrates how ridiculous it is to have only height and weight, not muscle mass calculations, as the basis for determinations of fit or fat.

Thus, the CDCP claim that 65 percent of Americans today are overweight or obese should be viewed with a bit of skepticism if not outright disdain. More on this can be seen in an excellent article published in the New York Times ("Fat Politics': Healthy Skepticism on Obesity," NY Times, November 4, 2005) and in a book by J. Eric Oliver entitled "Fat Politics: The Real Story Behind America's Obesity Epidemic" (Oxford University Press, 2005). The latter shows that while "Pima Indians living in southern Arizona today are among the heaviest people in the world," they are fitter than most Americans (Even the average squaw tops 200 pounds.)

Bottom line: Don't focus on weight as much as fitness. For that, muscle mass needs to be taken into account, which is not done in current BMI assessments.

Be well. Always look on the bright side of life.

Donald B. Ardell, Ph.D. is the author of High Level Wellness: An Alternative to Doctors, Drugs and Disease (Rodale, 1977, Bantam 1979 and Ten Speed Press 1986). Since 1984, he has produced the quarterly ARDELL WELLNESS REPORT (68 editions in print), a weekly electronic newsletter (261 in circulation) and essays at the website SeekWellness.com - http://www.seekwellness.com/wellness. He also ran for mayor of Tampa as "the oldest, fittest, fastest and prettiest of all the candidates" on a "well city" platform based on four themes: functional, free, fit and fun. In 2004, he won his age group in both the duathlon national championship (8/8, Alphraetta, GA) and the national triathlon championship (9/18, Shreveport, LA). Don can be reached at (727) 824-5645 or via e-mail at donardell@knology.net