On obesity

[Nils K Oeijord]

[ source: http://news.bbc.co.uk/2/hi/uk_news/magazine/7105630.stm
<http://news.bbc.co.uk/2/hi/uk_news/magazine/7105630.stm> ]

The truth about obesity
By Richard Vadon
BBC Radio 4's The Investigation

Britons are getting bigger and it's a crisis on the same level as
climate change, says the government. Within 15 years most of us will be
overweight, with our life expectancy cut by 13 years. Scary stuff, but
do all the facts about this "ticking time bomb" really add up?

It's headline grabbing-stuff. The obesity epidemic in Britain is now a
crisis on a scale with climate change, says Health Secretary Alan
Johnson.

It will lead to the first cut in life expectancy in the UK for 200
years. "Children are likely to die before their parents," says Dr Colin
Waine, chair of the National Obesity Forum.

There's just one problem with this claim - official forecasts show it's
not true. The government-commissioned Foresight report released last
month [see internet links, right] looked at the future trends of obesity
and found an increase will have surprisingly little impact on life
expectancy. In fact it predicted Britons will live significantly longer.
So what is the truth about the obesity epidemic?

The UK is certainly getting heavier. The weight of adults and children
is on the rise, with the annual health survey - conducted by the
National Centre for Social Research - showing a clear upwards trend.

"If you look at men they have become around half a stone heavier on
average than they were in 1993," says Heather Wardle, a senior
researcher at the centre.

This weight gain matters because it means more and more of us are
becoming overweight and unhealthy, argue anti-obesity campaigners.
Putting any weight on after your 21st birthday is even a risk, according
to last month's World Cancer report.

'Arbitrary' figures

No one denies extreme obesity is bad for you, but some are now standing
up to defend the overweight. Professor John Evans, from the School of
Sport and Exercise Sciences at Loughborough University, doesn't believe
the predictions.

"There is very little evidence to say that being overweight is a
signifier of a person or a population's health," he says.

This may sound like heresy but there is good science to back it up. Only
this month a study, led by Katherine Flegal of the USA Centre for
Disease Control, reported that those who are overweight had no higher
risk dying of cancer or heart disease and overall lived longer than
those of "normal" weight. You might be surprised at her finding but she
was not.

"There is actually a large amount of evidence that suggests that the
overweight live the longest," she says.

It's certainly not the public health message you normally hear.

For instance, a recent study by Cancer Research UK reported that 6,000
women a year get cancer because of obesity.

But look closer at the detail of the report and you find an unreported
story. This research also found the overweight are no more likely to die
of cancer than the slim.

"Overall there is no evidence of a strong increase in risk in being
overweight, but there is evidence of a significant increase for people
who are obese," says Doctor Gillian Reeves, who led the study.

'Built on sand'

One of the most alarming statistics about obesity is that a third of
children are now overweight. We are told that weight is now even a
problem among the youngest school children.

An estimated 25% of 5-year-olds are now overweight, according to the
government's Health Survey for England. That might be the statistic, but
some are still sceptical.

"Many of the teachers we talk to can't recognise the epidemic of obesity
that is always reported," says Mr Evans.

When you visit schools it's certainly hard to find these large numbers
of overweight kids. Doctor Linda Voss is the co-ordinator of the Early
Bird Study, which is looking at the links between childhood obesity and
diabetes. Put on the spot in a school even her expert eye failed to spot
these numbers of fat kids.

Like many experts, she thinks it's our view of normal that has changed.

"I think I failed to spot the overweight kids because we are so used to
seeing overweight kids these days," she says.

But another reason we can't see them could be because the figures are
misleading. The figures the government use are based on a 1990
benchmark. It put the weight and height measurements from different
surveys on a graph and decided that the top 15% of kids would be called
overweight and the top 5% obese. As our children have got heavier, more
and more have passed these benchmarks.

If you think the benchmarks seem rather arbitrary, the first to agree
with you is the man who came up with them.

Scare the public

"I've taken a graph and drawn a line on it," says Tim Cole, professor of
medical statistics at the Institute of Child Health.

"I'm not saying they are healthy and they are not. The idea that these
numbers are cast in stone is absolute nonsense. It is all built on
sand."

But the UK's way of calculating obese and overweight children isn't the
only one. If we adopted the international standard we would roughly cut
our figures for fat children in half.

Experts like Professor Cole say that whatever figures you use, the
underlying trend is going up. But critics say big scary statistics are a
good way to unsettle the public and justify government intervention.

At last month's annual conference of the National Obesity Forum there
was a vote of no confidence in the government policy on dealing with
Britain's weight problem.

Forum board member Tam Fry was one of those who spoke out against the
government. He has worked for a charity for years to publicise the risks
of obesity. Yet he is obese himself.

"Technically I am obese," he says. "But if you look at my size, my age,
my height and my body type, I am not outstandingly obese."

He is clear that he isn't blaming the government for his obesity, it was
just that his obesity isn't a problem.

The obesity statistics are full of people, who like Tam, are fine at
their weight. It's the small minority of very obese that are the
problem, not the two-thirds of us the government defines as overweight.