Director of Research, The Center for Consumer Freedom
FDA Public Meeting on Obesity
October 23, 2003
Good afternoon. My name is David Martosko and I am Director of Research at the Center for Consumer Freedom, a nonprofit coalition supported by restaurant operators, food companies, and concerned individuals, working together to promote personal responsibility and protect consumer choices. I appreciate the opportunity to speak today.
Obesity is a genuine problem in America, but our national debate on the subject has become nothing short of hysterical. And around every corner is a hidden agenda.
Pharmaceutical interests, like the American Obesity Association — which we heard from earlier today — promote an alarmist view of the problem, in order to justify increased government support and promotion of new obesity drugs.
Animal rights groups, like the deceptively named "Physicians Committee for Responsible Medicine" — whose president will speak shortly — like to inflame the public's obesity fears in order to disparage beef, chicken, pork, milk, cheese, and other nutritious foods that are not "animal-rights friendly."
And then there are radical nutrition activist groups like the Center for Science in the Public Interest (CSPI), which never met a tasty food it couldn't carp about, and whose leaders seldom pass up a chance to announce a desire to tax foods that they don't like out of ordinary Americans' reach. CSPI has recklessly tried to link food to tobacco, in deliberate scare campaigns.
Trial lawyers are attempting to turn America's love of good food into their next cash cow. And some activists and academics have proposed zoning restrictions and other draconian regulations on restaurants.
We believe that the nation would be better served by a serious and scientific approach to addressing obesity. As the Food and Drug Administration builds a framework for messages to the public about weight reduction, it is important to avoid inadvertently exaggerating or misrepresenting the problem. And steering clear of needless hyperbole can be as simple as checking your facts and figures.
The three most commonly-cited statistics associated with the obesity epidemic are 1) that obesity causes 300,000 American deaths per year; 2) that 61 percent of Americans are overweight or obese; and 3) that the economic cost of American obesity is $117 billion a year. The Federal Register notice of this very hearing cited two of these three numbers. And all three are seriously flawed.
Let's start with the common belief that each year 300,000 U.S. deaths are attributable to excess weight. The truth is that "the data linking overweight and death … are limited, fragmented and often ambiguous." That's from an editorial published by the respected New England Journal of Medicine in January 1998, questioning the increasingly frantic rhetoric about obesity as a public health problem.
Speaking specifically about the 300,000 number, the New England Journal editorial continues: "[T]hat figure is by no means well established. Not only is it derived from weak or incomplete data, but it is also called into question by the methodologic difficulties of determining which of the many factors contribute to premature death."
It turns out that in order to allege that 300,000 Americans die each year from obesity, you would have to claim that everyone who dies while overweight diesbecause of that excess weight. Even car accident fatalities count toward the total if the victim's Body Mass Index is too high.
Secondly, many in government and the mass media have blindly accepted the claim that obesity costs Americans $117 billion per year, believing that the figure came from the Surgeon General. But his original source was a single study published in the March 1998 issue of the journal Obesity Research.
The Obesity Research study has serious limitations, as the authors themselves admit. "We are still uncertain about the actual amount of health utilization associated with overweight and obesity," they wrote, explaining that "height and weight are not included in many of the primary data sources."
Furthermore, the authors of this study defined obesity incorrectly, writing: "The current estimate of the cost of obesity defines obesity as a BMI greater than or equal to 29." Obesity is actually defined as a BMI greater than or equal to 30. Thus the Obesity Research study erroneously included the economic cost of individuals with a BMI between 29 and 30. That's more than ten million Americans.
Finally, the authors acknowledged that even if some data flaws were corrected, their methodology would still result in double- or even triple-counting obesity-related costs. They write: "Our model assumes that coronary heart-disease, hypertension, and diabetes occur independently. However, we know that there is some interdependence among these disease states, especially in obese patients." They go on to admit that "calculating the cost of obesity as it related to these diseases independently would inflate the cost estimate."
Lastly, are 61 percent of Americans really overweight or obese? Overweight and obesity are diagnosed by using the Body Mass Index (BMI), a deeply flawed standard. According to the Centers for Disease Control and Prevention: "Overweight may or may not be due to increases in body fat. It may also be due to an increase in lean muscle. For example, professional athletes may be very lean and muscular, with very little body fat, yet they may weigh more than others of the same height. While they may qualify as 'overweight' due to their large muscle mass, they are not necessarily 'over fat,' regardless of BMI." This language is taken from the CDC's website. It's that agency's official position.
The CDC also notes: "Two people can have the same BMI, but a different percent body fat. A bodybuilder with a large muscle mass and a low percent body fat may have the same BMI as a person who has more body fat because BMI is calculated using weight and height only."
Using the BMI standard, our very fit President Bush is officially overweight. And the incredibly fit governor-elect of California is considered obese.
It's also worth noting that the definition of overweight used by the U.S. government was arbitrarily changed in 1998, following political pressure brought by the World Health Organization. The definition that we abandoned in 1998 had the virtue of distinguishing between men and women — something our current definition does not even attempt to do.
And the 1998 redefinition re-classified 39 million Americans as "overweight." They literally went to sleep one night at a government-approved weight, and woke up "overweight" the next morning, without gaining an ounce. That group of Americans includes presently "overweight" movie stars like Will Smith and Brad Pitt. Also "overweight" were Michael Jordan and Cal Ripken Jr., at the height of their athletic powers. And slugger Barry Bonds is "obese."
So how does all of this affect what the FDA should do going forward? First, we caution the FDA against using the "$117 billion" number at all, or relying heavily on the "300,000 deaths" figure. And second, we suggest that any mention of the "61 percent" number should include a prominent disclaimer noting that the Body Mass Index standard is imperfect at best.
Lastly, I encourage the FDA and members of this panel to be on the lookout for hidden agendas, because they are around every corner.
Thank you for the opportunity to speak today, and good afternoon.