SCIENCE&HEALTH: Experts weigh both sides of issue

In a recent study examining different points of view regarding
the rise in obesity in the United States, two UCLA sociologists
concluded that the condition is not an epidemic, as widely reported
by scientists and the media.

Abigail Saguy, UCLA assistant professor of sociology, and
sociology graduate student Kevin Riley explained in their article,
“Weighing Both Sides,” that although there is a push by
certain groups to understand the obesity profusion as an epidemic,
it does not meet the requisites of the title.

“One way you could define (an epidemic disease) is that
it’s increasing exponentially, and that’s not the
case,” Saguy said.

“Weighing Both Sides,” which was published in the
2005 issue of the Journal of Health Politics, Policy and Law, goes
on to define the two camps on opposing ends of the obesity issue
““ those who are proponents of labeling obesity as a dangerous
health risk, and those who find that the recent discussions of
obesity’s peril are alarmist and exaggerated.

On the side decrying obesity are scientists, the media and
medical and insurance companies; this group tends to frame obesity
as a disease, according to the research paper.

The other side, what Saguy calls “fat acceptance
activism,” is comprised of those who frame obesity as a
natural characteristic, much like race, and is a popular
perspective in the food industry.

In the paper Saguy said that while fat acceptance activists
sometimes refer to obesity as a disease, they do so to disown the
idea that they are personally responsible for their condition, a
thought that may lead to moral judgments about their character.

Between these two groups, a “credibility struggle”
has emerged, and Saguy said the pathologizing of obesity by calling
it a disease has become a tool to add the credibility of medical
science to anti-fat activists’ argument.

“Scientists themselves play into the alarmism,”
Saguy said, also noting how “(the media) emphasizes the
individual responsibility of obesity … and they also dramatize
the risks of obesity.”

However, Judith Siegel, a professor of community health science
at UCLA’s School of Public Health, said that “not every
media article is accurate, but in general they seem fairly on
target.”

Saguy also said despite her research indicating that it is
undetermined what body mass index indicates the best point at which
to define obesity, many scientists are ready to make claims about
an individual’s health status based on their index level.

The body mass index is a measurement comparing one’s
height and weight to determine if an individual is obese. The
National Institute of Health recognizes an index number between 25
and 29 to be overweight, and a score of 30 or greater to be
obese.

“The research on (the level defining obesity) is very
unclear,” Saguy said, adding that mortality rates for people
with BMIs below 35 are not significantly different.

She argued that if obesity were defined as having a BMI of 35 or
higher, the point at which mortality increases, only six percent of
the population would be obese ““ thus further detracting from
classification as an epidemic.

Siegel, on the other hand, said she feels the BMI is a good way
of measuring obesity in conjunction with other methods, and that
“there is pretty much a consensus … (that) a person with
body mass index above 30 is obese.”

Saguy contends that some groups are motivated to group risks
associated with being obese or very obese with those of being
merely overweight. Medical insurance companies, for example, can be
reimbursed for certain costs by Medicare if obesity is viewed as a
disease.

Statistics showing a certain number of people to be overweight
by their BMI may be inaccurate, due to the inability of the body
mass index to determine an individual’s body fat
percentage.

A particularly lean, muscular person may have an index level
that indicates obesity, when it is not the case ““ this
misrepresentation is due to an inflated body mass relative to the
individual’s height.

Siegel said that this instance is negligible, however, only
describing a small number of cases.

“Weighing Both Sides” also found that media
reporting on obesity has quadrupled in the decade following 1994,
while the number of obesity articles have only tripled in medical
journals.

Many health professionals maintain belief in the dangers and the
definition of obesity, saying that the issue is dangerous enough
that it is not being overblown.

A World Health Organization consultation on obesity recognized
the public health problem as a “global epidemic” in
1997. The organization has even seen fit to coin the term
“globesity” to describe the international
phenomenon.

Siegel said that by her assessment, as well as those of the
medical community at large, obesity is indeed an epidemic, because
“rates of obesity have gone up so quickly in the last two
decades.”

She suggested one reason that Saguy’s conclusions about
obesity alarmism may be at odds with Siegel’s own is that the
definition of obesity changed in the mid-90s to be less
inclusive.

Older studies thus may have overrepresented the ubiquity of
obesity in the U.S., Spiegel said.

She also said that although debate over how much excess
mortality can be attributed to obesity exists, obesity has been
shown to have “malignant health effects” which are
corroborated by a 2003 study in the Journal of the American Medical
Association linking obesity to type II diabetes, cardiovascular
disease and other health conditions.

“It is a significant concern,” she said.