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Obesity obeisance

By Greg McInerney.

Ireland is set to become Europe’s most obese country by 2030 according to figures presented last month by the World Health Organisation as part of their yet to be published Modelling Obesity Project. The proportion of obese Irish men is expected to increase from 26% to 48%, with the number of men classified as either overweight or obese rising from 74% to 89%. Obesity in women will jump from 23 percent to 57% while 85% of women will be classified as either overweight or obese by 2030.

Dr Joao Bredo of the WHO described the figures as painting a “bleak picture” for the continent. Professor Donal O’Shea, co-chair of the Royal College of Physicians of Ireland envisioned the scenario as “a much bigger health crisis than what cholera was back in the 1800s and HIV/AIDS was back in the 80s and 90s”. Minister for Health Leo Varadkar admitted that obesity has become a “major personal and public-health problem” and called for the issue to be treated “as seriously as we treated tobacco in the past.”

The consensus would appear certain. We are getting fatter, our ever-expanding waistlines are toxic to our health and, according to most scientists, politicians, medical practitioners, teachers and journalists, we are on the verge of a seismic, generation-defining medical epidemic caused primarily by our individual eating and exercise habits. Is this consensus, however, firmly supported by the available scientific and medical evidence as its proponents claim it to be? Is being fat really that detrimental to our health or are their moral, social and economic influences pushing us towards this consensus, rendering our understanding of obesity inaccurate at best, or worse still, enormously harmful to many people’s lives?

To begin to answer this question it is useful to consider the baseline unit of measurement for obesity that the World Health Organization and most medical researchers use: the Body Mass Index or “BMI”. Dating back to the early 19th century, the BMI is a simple mathematical formula that places people of different heights and weights on a single integrated scale. The index was never intended to be a measure of individual health yet despite this; it has formed the basis for almost every public policy and study on issues of weight and obesity written in the modern era.

The BMI index defines obesity in a completely arbitrary and unscientific fashion.  In the late 1990’s one of the world’s leading obesity experts, Professor Philip James, set up a body called the International Obesity Task Force (IOTF). The IOTF drafted the WHO report in the late 1990’s which would define rising obesity levels for the first time as a health “epidemic”. The evidence underpinning this report was comprised largely of data provided by US health insurance giant Met Life. Joel Guerin, an American author who reviewed Met Life’s data told the Guardian newspaper that ‘’it wasn’t based on any kind of scientific evidence at all.” The funding for the IOTF report came from large multi-national drug companies, hoping to broaden the market for potentially lucrative weight loss drugs. The report led to the “ideal”, “healthy” weight for an individual to drop by 15-20 pounds. Millions of people across the globe were now considered, overnight, newly overweight or obese, despite having never gained a single pound.

Not only has the BMI index been skewed to entirely unrealistic weight standards, the formula itself does not account for things like muscle mass and bone density. To put this into perspective, Chris Hemsworth, the actor who plays Thor in the popular ‘Avengers’ movie franchise and who was also voted the world’s sexiest man in 2014, is, according to the BMI index, overweight, bordering on obese. Irish rugby star Cian Healy fares worse, definitely obese according to his BMI.

An influential study published in Science magazine, it was estimated a reduction in calorie consumption, or an increase in energy use, of just 100 calories per day would prevent weight gain for most people, hardly the basis for an “epidemic”. Similarly, after reviewing data from around the world, Dr Michael Gard concludes in his recent book ‘End of the Obesity Epidemic’ that in fact obesity levels for both adults and children have levelled off or declined over the past 10-15 years.

Even if we were to accept the notion of an “epidemic” based on fundamentally-flawed statistics, surely the quotidian idea that being fat is bad for one’s health is beyond doubt? Not quite. A 2013 study published by The Journal of the American Medical Association, reviewed nearly three million subjects from more than a dozen countries in an attempt to determine the correlation between body mass and mortality risk. The study found that adults categorized as overweight, and most of those declared obese, actually had a lower risk of mortality than so-called thin or normal weight individuals. Average-height women, 5 feet 4 inches, who weigh between 108 and 145 pounds have a higher mortality risk than average-height women who weigh between 146 and 203 pounds. For average-height men, 5 feet 10 inches, those who weigh between 129 and 174 pounds have a higher mortality risk than those who weigh between 175 and 243 pounds.

Throughout the terrors of our recent obesity “epidemic”, life expectancy in western countries has risen, not fallen, despite the many life-threatening health conditions supposedly caused by obesity. The correlations between higher weight and greater health risk are thread-bare, only significant at the extremes, severely underweight or morbidly obese. Improvements in health as a result of increased aerobic exercise have been documented in people who actually gained weight during the process. Exercise and nutrition can also effectively reduce blood pressure entirely independent of weight loss. Among overweight and obese men and women, with and without type 2 diabetes, those who reported trying to lose weight (but failed) experienced a reduction in mortality rate that was the same as, or greater than, those who reported that they were successful at weight loss. In other words weight loss itself did not appear to be beneficial.

There’s almost no evidence that turning a fat individual into a slim individual improves their overall health. This is mostly due to the fact that despite claims of omnipresent miracle diets and exercise programs, sustained, long-term weight loss is something we currently, according to the evidence, do not know how to achieve. A former finance director of Weight Watchers, itself a billion dollar corporation, told investigative reporter Jacque Peretti that the brand was successful because “the 84% [who can’t keep the weight off] keep coming back. That’s where your business comes from.” The global market for “Weight Management Services” is expected to reach $650.9bn this year and huge corporate conglomerates control both the “healthy” and “unhealthy” markets. Nestle sells traditionally fattening foods but also owns US diet company Jenny Craig. Uniliver owns numerous ice-cream brands but also “healthy” meal replacement brand Slimfast. The current CEO of Weight Watchers used to be President of Kraft Foods Snacks and Confectionery division and before that, CEO of Cadbury America.

Do we even understand why people gain weight? The traditional view, known as the energy balance model, would be that of caloric surpluses or deficits, too many calories equals weight gain, too few calories equals weight loss. This too is a staple of public policy and information with regards to weight control. However a growing body of research is beginning to question the calorie as an indicator of food’s weight-producing qualities and the energy balance model in general. Disruption in sleep patterns is associated with increases in body fat, chronic stress alters hormone levels linked to weight-gain, even nutritional deprivation and stress experienced by our parents and grandparents could affect our weight according to the relatively new scientific field of epigenetics. Perhaps of greatest significance though could be our exposure to everyday, but harmful chemicals known as endocrine disruptors which may create biological pathways to obesity independent of caloric metabolism.

The greatest indictment of the energy balancy, calorie-centric model comes from the astonishing revelations of Dr. Michael Gard and Jan Wright’s 2005 book on the subject, ‘The Obesity Epidemic: Science and Ideology’. After reviewing hundreds of studies on eating and physical activity around the world, they found absolutely no evidence that food intake in industrialized countries has risen, or that activity levels among people have decreased since the 1980’s.

In fact they even found that some of the literature would indicate a reduction in individual’s consumption of food. The idea therefore that excess calories caused from individual overeating or lack of exercise are making us fat, an idea that underpins almost all governmental policies towards obesity, is simply not supported by the available evidence.

Individuals who are irrationally concerned or consumed with their weight beyond its actuality and impact on their health today are diagnosed with eating and/or body disorders yet governments, organisations and medical practitioners who view fatness in identically phobic terms are dictating our attitudes and public policies.

The obesity epidemic is not in fact an epidemic at all but rather a confluence of junk science, political and economic manipulation, and social anxiety. •