EPISODE 1. Let's talk facts
Updated: Oct 19
Could everything we know about fatness be wrong? Join Sasha Borissenko as she talks to experts, officials, and more about the forces behind society’s obsession with ‘the o*esity epidemic’, the body mass index, and the power of interpreting data.
Release date: Sunday 6 August, 2023
In 1997 the World Health Organisation declared o*esity was a major health problem and a global pandemic.
Two years later, the WHO classified o*esity as a disease, describing it as “complex”, “serious”, “chronic”, and “incompletely understood”.
As a result, most people today have heard about the ‘o*esity epidemic’ and the usual way we measure it, Body Mass Index (BMI).
What’s less commonly understood is that both definitions - and the assumptions behind them - are regarded by many critics as highly suspect.
Chewing The Facts explores this debate in depth. The 10-part podcast series talks to a range of experts, including some who argue that our attempt to link fatness to poor health outcomes is scientifically unsound and serves only to stigmatise fat people, without solving the underlying problems which cause the diseases, such as poor access to nutritious food and good healthcare.
“It was the ‘ideal’ population mean. Now bear in mind that a Belgian mathematician 200 years ago meant a white person. And the people that were measured were principally European (men) and so that becomes problematic straight away, in that many women were not even included in that measure and certainly people of colour were not represented.”
The BMI, for instance, dates back to the 19th century when Belgian mathematician Lambert Adolphe Jacques Quetelet created a metric to identify the average man, by dividing a person’s weight in kilograms by their height in metres squared.
Otago University primary health care and general practice senior lecturer Dr Lesley Gray said the measure was never intended to be used in science today.
“It was the ‘ideal’ population mean. Now bear in mind that a Belgian mathematician 200 years ago meant a white person. And the people that were measured were principally European (men) and so that becomes problematic straight away, in that many women were not even included in that measure and certainly people of colour were not represented.”
Since the 1970s, BMI has been used to track population-level statistics, but it is used to extrapolate individuals’ health risks without making the appropriate additional diagnostic tests such as high blood pressure and insulin levels, she said.
Gray said o*esity was associated with diabetes, but not proven to be the cause.
She pointed to a 2016 study that addressed historical links between coffee and cancer. It found previous studies failed to adjust for people who smoked cigarettes, leading to confounding results.
“Chances are it wasn’t actually the coffee that was causing the cancer, it was more likely to be the cigarette.”
Grey said multiple studies reported higher risk and higher severity of H1Ni bird flu among fat people in 2009, but a systematic review and meta-analysis of the outbreak and BMI showed that after adjustment for medical bias against fat people receiving antiviral treatment, there was no increased risk of death for fat people.
This year, the American Medical Association released a policy criticising the use of body mass index...
To read the full article, click here.
Chewing the Facts - new episodes out every Sunday. Produced with the NZ Herald, with support from NZ On Air.
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RESEARCH AND SOURCES
- AMA adopts new policy clarifying role of BMI
- What's in a word? On weight stigma and terminology
- TOFI phenotype - its effect on the occurrence of diabetes
- Coffee and cancer: what the research really shows
- Resisting the problematisation of fatness in COVID-19: In pursuit of health justice
- Correlation between epicardial adipose tissue and body mass index in New Zealand ethnic populations.
- The bizarre and racist history of the BMI
- For researchers on obesity: historical review of extra body weight definitions
- Obesity and life underwriting
- The obesity research that blew up
- The Obesity Myth: Why America's Obsession with Weight is Hazardous to Your Health
- Is obesity a disease or a behaviour abnormality? Did the AMA get it right?
- Coffee consumption and incidence of lung cancer in the NIH-AARP diet and health study
- Do we need to think beyond BMI for estimating population-level health risks?
- The health risk of obesity - better metrics imperative.
- Coffee drinking and cancer risk: an umbrella review of meta-analyses of observational studies.