Obesity

The obesity wars continue. They are interesting. I read the recent JAMA article (April 20 issue) and as far as I can see it is well done (although I am not an expert in this particular area, I am a chronic disease epidemiologist). What the data seem to show is that the previous CDC definition of optimal weight, as measured by Body Mass Index and using risk of death as an outcome (rather than morbidity) should be redefined, moving slightly upward. The data still reveal considerable increased mortality (112,000 excess deaths) for the truly overweight (BMIs above 30).

So why is this interesting? Because of the smarmy politics. The Right wing didn't complain much about highlighting obesity when it was conceived of as a personal failing, a lack of will-power and discipline. Obese people eat too much. But then the public health started to call attention to the structural determinants of excess caloric intake (advertising, mass marketing of unhealthy foods, easy access and marketing to school children, etc.). When the tort system became involved (obesity lawsuits against fast food chains) the Right saw an opportunity and turned against the obesity meme. Public health never had its act together because the notion that there is some personal accountability involved in excess weight is a widely shared cultural notion (I am taking no position as to its truth or falsity here). In addition there were other interests involved. The anti-smoking portion of public health was dismayed to have cigarettes displaced as the number one killer and fiercely attacked the first (and faulty) CDC study. I think it is fair to say, too, that there was more than a little hype about the dangers of obesity. This made the "obesity epidemic" a prime (and easy) target for the Right.

Enter astroturf "non-profits" to take advantage of the confusion caused by the latest correction. Full-page ads appeared in major newspapers dismissing concerns about obesity and casting doubt on public health science. Today's WaPo has the story of one of these phony "consumer" groups, the Center for Consumer Freedom, which describes itself as a "nonprofit organization dedicated to protecting consumer choices and promoting common sense." Yeah, Right. Right as rain. Right. Very, very Right.

It turns out the Center for Consumer Freedom, which has been running full page adds warning readers of the "obesity myth," was born ten years ago (maiden name, Guest Choice Network) as the bastard offspring of Big Tobacco and the restaurant industry to fight anti-smoking bills in restaurants. As they started to lose that fight they shifted to mad cow disease and genetically modified foods. Now anti-anti-obesity is their cash cow (don't get mad, get cash). It has dumped $1.1 million into the lap of a real scumbag, 62 year old Richard Berman, a lobbyist who also runs the American Beverage Institute (fighting restrictions on alcohol use) and the Employment Policies Institute Foundation (fighting minimum wage).

Berman would love it for the bright lights to stop shining on the kitchens of his clients. That way we don't see what is going on. And of course, when you turn out the lights, the vermin start to scurry around to do their business. Like Richard Berman.