Voice of Reason: Fact vs. Fiction on Obesity

At a June 2, 2005, press conference, Dr. Julie Gerberding, the director of the Centers for Disease Control and Prevention, issued a rare and curious apology. She apologized for the mixed messages and contradictory studies regarding the dangers of obesity, acknowledging that flawed data in several CDC studies had overstated the risks. We have all heard the news reports, such as that 400,000 Americans die annually from obesity and that fat kills more people than smoking. Amid the hue and cry, a small group of writers and researchers were questioning the numbers and assumptions.

Paul Campos, author of The Obesity Myth: Why America's Obsession with Weight Is Hazardous to Your Health, is among the most vocal critics of the CDC. Campos and others rightly sounded the alarm over bad science, and his book was prominently featured in a recent Scientific American cover article.

Campos believes that the efforts to portray fat as unhealthy and unacceptable are driven by junk science, hatred of fat people, and a profit-hungry dieting industry. Campos charges that "almost everything the government and the media [are] saying about weight and weight control [is] either grossly distorted or flatly untrue," and he even calls former Surgeon General David Satcher "unhinged" in his efforts to curb America's obesity.

It is certainly true, as Dr. Gerberding admitted, that various estimates of obesity's death toll were consistently overstated. While Campos and other critics gloat in vindication, it pays to be skeptical of the skeptics. The fact is that obesity is only the latest in a long list of public health threats that have been overstated by a sensationalist news media (and, to a lesser degree, by the medical community). The dire warnings and hype surrounding West Nile virus, ebola, flu, anthrax, Mad Cow disease, and even AIDS, to name just a few, all far outstripped any reasonable public health threat. Furthermore, the whole controversy may leave some with the impression that obesity is not a health threat, when in fact it clearly is. The CDC criticisms gloss over just how difficult and imprecise medical research can be. The public wants quick and easy answers, but real medical progress is often slow, expensive, and fraught with contradictory studies. In the end, science and medicine corrected itself.

CDC critics such as Campos adopt a crusading tone and blame the news media and medical journals for getting their facts wrong and presenting a biased viewpoint. So how does The Obesity Myth stack up?

Let's start with Campos's subtitle. Does America have an obsession with weight? Campos certainly seems to think so; he calls America "a nation of dieters." Yet, unlike the fictional Bridget Jones, studies and surveys find that while some Americans are dieting, a majority are not, and a surprising percentage—one-third to one-half—rarely or never diet. According to a 2002 survey published in USA Today, only one out of every five women said losing weight was a top priority. In 2000, a People magazine survey found only one-quarter had dieted at any point in the last year. Studies published in medical journals have found similar results. For a critic who repeatedly criticizes others for exaggerating numbers, Campos starts out on shaky ground. 

Campos compounds this factual error with a logical one by suggesting that "advising people to eat less and exercise more appears to have ended up making Americans a good deal fatter" (p. 33). He is mistaking correlation for causation, but the misunderstanding goes far deeper than that: Campos is assuming—incorrectly—that Americans have been following the advice to eat less and exercise more. In fact, studies have found that most Americans eat poorly and don't exercise regularly. This is an important and often overlooked point in the obesity debate.

Wrongly convinced that most Americans are dieting, Campos blames the "fat police" medical establishment and the media for causing low self-esteem in women. "Few Americans—and especially very few American women—are satisfied with the appearance of their bodies," Campos writes. The zealous skepticism with which he attacked the CDC's inflated numbers is absent when it comes to examining his own assumptions. In 1998 USA Weekend conducted one of the largest surveys ever taken of American youth, surveying over a quarter of a million students in grades 6 to 12. Among the results: 93 percent of teens feel good about themselves. A recent Gallup poll of more than five thousand adults found that 90 percent of Americans are confident in their looks. In 2000, the British Medical Association issued a report that concluded "The majority of young women (88 percent) say they are of average or above average self-confidence with only 12 percent saying they're not very confident." And a 2004 survey, "The Real Truth About Beauty: A Global Report" found that only ten percent of women were "somewhat or very dissatisfied" with their beauty. The facts show exactly the opposite of what Campos claims.

Many obesity skeptics denounce popular culture's obsession with thinness. While thin bodies are undeniably present in entertainment media, large bodies are just as present, from Oprah Winfrey to Roseanne Barr and Kirstie Alley, American Idol Ruben Studdard to Starr Jones and Queen Latifah. Bizarrely, Campos cites very thin actresses Kate Moss and Calista Flockhart as being the "cultural ideal." He offers no support for this claim (ideal according to whom?) and seems unaware that both Moss and Flockhart were continually and harshly criticized—not lauded—for their thin bodies.

The CDC critics, Campos among them, deserve credit for helping reign in the public's phantom fears of fat. But in the process they have perpetuated more myths than they have debunked. The latest chapter in the war on fat is a good lesson in the importance of being skeptical not only of others' assumptions and beliefs, but also our own.

Benjamin Radford wrote about exaggerated media claims in the March/April 2005 issue of Skeptical Inquirer, based on his book Media Mythmakers: How Journalists, Activists, and Advertisers Mislead Us.