Opportunities & Exposures: Health
Living Large
Radley Balko
12/01/2005

Judging from today’s headlines, one might think that most Americans are pudgy, couch-ridden and on the verge of catastrophic illness. Our poor eating habits and slothful lifestyles have served as grist for many an in-depth report, multipart series and conferences such as the Time-ABC News Obesity Summit held last year in Williamsburg, Va. For years, the government and media have told us we are in the midst of an obesity crisis, and that our excess weight unnecessarily kills some 400,000 of us every year.

Here is some good news we don’t often hear: Last year, life expectancy in America reached an all-time high. Death rates among all age groups have been in decline for decades. That is true across all races and both sexes. In fact, the life expectancy gap between black and white is narrowing, even though African-Americans are fattening at a greater clip than white Americans. The two diseases most linked to obesity—heart disease and cancer—are in rapid decline, steadily dropping since the early 1990s. In fact, deaths from nine of the 10 types of cancer most associated with obesity are down over the last 15 years. Deaths from heart disease have declined in every state in the nation. Deaths from stroke are down, too. The biggest increases in mortality are coming from diseases that almost always set in at old age, such as Alzheimer’s and Parkinson’s.

Granted, much of this good news is attributable to advances in medical technology. But so what? If the fattening of America is really the health threat it is made out to be—Surgeon General Richard Carmona recently said it is a bigger threat than terrorism—after 30 years of putting on weight, we should at least be seeing the front end of this coming calamity. It simply isn’t happening.

What is worse, we have been misled about the real threat posed by obesity. Recently, after a wave of criticism from skeptics, the National Institutes of Health commissioned a review of that 400,000 deaths-by-obesity figure. Its findings: The number of deaths attributable to obesity each year is closer to 100,000. Furthermore, the new study found some modest protective effects to carrying a few extra pounds (an apt description of the average American, who is 8 to 10 pounds heavier than he was a generation ago). Subtract the number of lives saved by being mildly overweight, and the number of net deaths due to excess weight is closer to about 26,000—15 times lower than what the government has been telling us.

The Real Heavy
What is troubling is that the original figure was cited ad nauseam by politicians, public health activists and the media in an effort to get government into the business of regulating what we eat. Even accepting the premise that such regulation is a necessary intrusion into our private habits (and I don’t), this new data raises a troubling thought: If there are health benefits to being slightly overweight, and if the average American is slightly overweight, these efforts aimed at getting us to drop excess pounds may actually be doing more harm than good.

The University of Colorado’s Paul Campos, author of The Obesity Myth, makes a compelling case that it is our obsession with weight and incessant yo-yo dieting that is responsible for higher mortality rates in some obese people, not the weight itself. Black women, for example, do not have the same increases in mortality at higher weights as white women do. Campos believes this is because black women have healthier attitudes about weight: They don’t diet as frequently, and rarely suffer from eating disorders. If Campos is right, government efforts aimed at getting us to diet are not merely intrusive, they could well be deadly.

There is probably some truth to the argument that extreme obesity can be a drain on taxpayers (via Medicare and Medicaid costs), not to mention to non-obese payers on the same health care plan. Such arguments, however, are an invitation to government policing of just about any “bad habit” one might imagine. Any risky behavior could cost taxpayers money. The solution is not to regulate fat; rather it is to return some semblance of personal responsibility to the health care system.

We should also keep some perspective. Obesity is an affliction of prosperity. Not only has our economy managed to feed all of its citizens, our chief worry right now seems to be that our poor and middle class have too much to eat. And in the proper historical context, it’s not such a bad problem to have.

Radley Balko is a policy analyst at the Cato  Institute in Washington, D.C.