In 2005, the American Dietetic Association claimed “we have stopped the epidemic of obesity” (1). It was no doubt an exciting and bold announcement, but six years later Americans find themselves still in the midst of a “war on obesity.” One might wonder when this “epidemic” even began and why it has returned. In 1998, the government changed Body Mass Index (BMI) definitions and “thirty-five million Americans went to sleepone night at a government-approvedweight and woke up ‘overweight’ the next morning” (1). This put people like Tom Cruise in the obese category, labeled Kobe Bryant as overweight, and even George W. Bush, considered the most fit president in U.S. history, became overweight when the BMI was lowered from 27.8 for men and 27.3 for women to 25 for both genders (1). This leads many to ask if the link between obesity and increased risk for poor health outcomes is sound or if over time America’s scientists, media and government have blown obesity out of proportion. While not dismissing the relationship between individuals with high BMIs and risk for poor health outcomes, there are equally strong arguments that BMI does not correlate directly to well-being; obese individuals can still be healthy and at times healthier than those with lower BMI’s when fitness is a factor.
Studies concerning the relationship between high BMI and health outcomes generally conclude in favor of there being a link between the two. Amy Berrington de Gonzalez wrote about this relationship, claiming obesity to be associated with “increased all-cause mortality” (2). Gonzalez states further however that the precise relationship between BMI and all-cause mortality remains uncertain.While Gonzalez and many others accept the fact BMI’s affect on all-cause mortality remains uncertain, there are others such as Paul Campos who believe all-cause mortality is certainly not caused by obesity. Campos argues obesity is “being driven more by cultural and political factors than by any threat increasing body weight may pose to public health” (3). Campos also notes how risks of thinness rarely gain media attention, suggesting “body build rather than fatness may be the source of risks associated with high BMI” (3).
Alternative opinions regarding obesity and its relation to health may not be as widely received but still address very interesting arguments, suggesting obesity need not be taken quite as seriously as some scientists, media, and political leaders believe. Epidemiologist Steven Blair has argued this point for years in his “fitness versus fatness” movement, explaining that it is more important to be “fit” than “not fat” (1). While Gonzalez and scientists similar to her argue those with higher BMIs are more susceptible to health risks and death, Blair agrees with research that states “Active obese individuals actually have lower morbidity and mortality than normal weight individuals who are sedentary,” as health risks associated with obesity are largely controlled if a person is physically active and fit (1). Although not as prevalent, alternative opinion pieces are still high in number and can be found in well-known resources such as The Harvard Health Policy Review stating, “[a] fit man carrying 50 pounds of body fat had a death rate less than one-half that of an unfit man with only 25 pounds of body fat.” (1).
It is difficult to pick a side, especially since there are strong points to both arguments. On one hand, you hear constantly in the media how big of a problem obesity is, but is this simply, as Campos states, “being driven…by cultural and political factors” (3)? On the other hand, it is hard to trust BMI standard when it has been argued as inaccurate across different populations, with potential to be “horrible as an individual gauge” (1). Although I am fairly moderate on several issues, I veer more on the side of scientists like Blair on this obesity debate, as I agree health needs are specific and different for every individual and BMI is not the best measure for this. Additionally, I have seen in my own life how fitness overrides “fatness.” As a cross country runner all through high school, there were several times I was warming up for a race and spotted both male and female runners whose bodies were not built like the typical runner one might imagine: they were not as lean and quite possibly, based on the changed BMI guidelines, fell in the overweight to obese category. At almost every race I ran though, without fail there were girls with those bigger body types who placed before me and boys with those bigger body types who placed before male runners on my team, runners who I would initially label as seemingly more in shape and less likely to be in risk of health problems. This illustrates the points made in research like Blair’s; low BMI values do not always represent healthy people and high BMI values do not always represent increased risk of morbidity and mortality.
It is crucial that no matter what stance one takes on obesity, he still does all he can to be both physically active and remain in good if not optimal nutritional status. Although I agree it is more important to be “fit” than “not fat,” this does not equate to doing away with proper eating and weight maintenance. Americans, whether they are in science, media, government or simply out in the general public, must be careful about this. As Jeffrey Friedman once said in The New York Times, “Before calling it an epidemic, people really need to understand what the numbers do and [do not] say.” (1). Become educated on the issue, decide what to believe, and make individualized changes that promote one’s personal optimal health.