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And this is what they call the “obesity paradox”

7th November 2007

And this is what they call the “obesity paradox”

posted in Fat Bias, Health/Nutrition |

October 16, 2007:


Sandy Swzarc reports on “one of the largest, longest and most expensive randomized controlled diet clinical trials in the history of our country” - the Women’s Health Initiative (WHI) Dietary Modification Trial. See her posts here and here. The study showed:

There were no significant differences in the incidences of breast cancer, colon cancer, heart attacks or strokes, or weight changes, among those who ate a restrictive “healthy” diet and the control group (29,294 women) who ate whatever they pleased.

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October 31, 2007:

The “largest ever study” of the links between lifestyle and cancer put together by the World Cancer Research Fund to produce what is billed as the most comprehensive analysis of the relationship between diet and cancer. Amongst its findings:

Evidence shows that vegetables, fruits and other foods containing dietary fibre (such as wholegrains and pulses) may protect against a range of cancers including mouth, stomach and bowel cancer. They also help to protect against weight gain and obesity.

Eating a diet rich in fruit and vegetables can help to prevent weight gain, which is linked to cancer.

Guess which study generated the most media attention?

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November 7, 2007:

In a paper published today in the Journal of the American Medical Association, researchers from the Centers for Disease Control and Prevention and the National Cancer Institute report:

The higher death rate in obese people, as might be expected, was almost entirely driven by a higher death rate from heart disease.

Which, as a March, 2007 study reveals, is “largely determined by parents rather than lifestyle… there was no clear association between parental longevity and BMI.”

Back to the most recent study.

Researchers, led by Katherine Flegal, of the Centers for Disease Control and Prevention, found that:

…contrary to expectations, the obese did not have an increased risk of dying from cancer. They were slightly more likely than people of normal weights to die of a handful of cancers that are thought to be related to excess weight — cancers of the colon, breast, esophagus, uterus, ovary, kidney and pancreas. Yet they had a lower risk of dying from other cancers, including lung cancer. In the end, the increases and decreases in cancer risks balanced out.

Gina Kolata elaborates on the study’s additional findings in The New York Times.

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A paradox, indeed.

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There are currently 10 responses to “And this is what they call the “obesity paradox””

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  1. 1 On November 7th, 2007, wellroundedtype2No Gravatar said:

    Thanks for the tip to the Gina Kolata article.
    This certainly underminds the “be as thin as you can” hypothesis.
    Sometimes it seems like the tide is turning, and other times, it’s like there is no way for the evidence to permeate.

    posted on November 7th, 2007 at 1:40 am

  2. 2 On November 7th, 2007, lilacsigilNo Gravatar said:

    Of course, then there’s people like me who get cancer which causes me to gain 55kg (121lb) - and wasn’t diagnosed for 18 month because doctors, (most) friends and family all thought I was just being fat and lazy! I’ve always wondered if the sub-par healthcare I received is something that shortens overweight people’s lifespans, rather than the weight itself.

    posted on November 7th, 2007 at 1:55 am

  3. 3 On November 7th, 2007, AshleyNo Gravatar said:

    That’s interesting.

    posted on November 7th, 2007 at 2:11 am

  4. 4 On November 7th, 2007, RachelNo Gravatar said:
    Lilacsigil - I’m sorry to hear about the lapse in diagnosis. You should really submit your story to the Fat Prejudice in Health Care site at http://fathealth.wordpress.com

    posted on November 7th, 2007 at 2:30 am

  5. 5 On November 7th, 2007, LindaNo Gravatar said:

    The last story is a nice bit of cherry-picking. Yes, obese people had an “averaged-out” risk of cancer, but, if you read the whole story, a bigger mortality risk due to diabetes and heart disease. This is not an argument for “health at every size,” but health at a slightly larger sized than we have been traditionally told to be. If the size is too big, it’s a health hazard.

    posted on November 7th, 2007 at 6:04 am

  6. 6 On November 7th, 2007, RachelNo Gravatar said:
    Linda - None of the other articles above even touched on diabetes, and I drew out the reference on heart disease in the latter. So, no, I’m not cherry picking - I’m emphasizing the contradicting information in each study in regards to cancer.

    The only doctor, Dr. JoAnn Manson, to mention an increased susceptibility related to obesity and diabetes is coincidentally the only doctor mentioned in the article who seemed to pooh pooh the study’s findings that a body mass index of 25 to 30, the so-called overweight range, may be “optimal.” And the Harvard studies she cites have been shown to be suspect.

    I could devote an entirely different post to all the studies that show an obesity paradox in regards to diabetes.

    posted on November 7th, 2007 at 10:02 am

  7. 7 On November 7th, 2007, FillyjonkNo Gravatar said:

    Linda, if obese people have a higher risk of dying from diabetes or heart disease (not that Rachel mentioned heart disease and the problematic causality of that above in a way that was totally obvious to everyone, or anything), but “normal”-weight people had a higher risk of dying from Alzheimer’s, Parkinson’s, infections, and lung disease, then why are you saying that “if the size is too big, it

    posted on November 7th, 2007 at 10:29 am

  8. 8 On November 7th, 2007, Kate HardingNo Gravatar said:

    Or, shit, why not

    posted on November 7th, 2007 at 5:30 pm

  9. 9 On November 8th, 2007, JollyRogerNo Gravatar said:

    Up till about 100 years ago, weight was considered a sign of health.

    Take your pick-the last 100 years of ever-changing scientific opinion, or thousands of years of human observations. I’m thinking the lessons of history are the more reliable ones.

    posted on November 8th, 2007 at 2:26 am

  10. 10 On May 15th, 2008, Top Chef: Eat some humble pie » The-F-Word.org said:

    [...] evidence to support the claims - this is yet another example of that niggling thing they call the “obesity paradox.” But one thing is clear here and that is the inherent class assumptions and contradictions: A [...]

    posted on May 15th, 2008 at 11:35 am

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