If you subscribe to the U.S. government’s current characterization of “obese,” then you’d better brace yourself because the fatty next door is going to outlive you.
The Journal of the American Medical Association published a report a while back that concluded that — by the government’s definition — the fatter you are, the longer you live. The study found, for example, that women who were 5 feet 4 inches between 108 and 145 pounds had a higher mortality rate than women who weighed 146 to 203 pounds at the same height. Similarly, men who were 5 foot 10 inches that weighed between 129 and 174 pounds had shorter longevity than those who weighed 175 and 243 pounds.
So by that account, skinny people should start carb-loading. Or, the U.S. government needs to reevaluate its parameters of how it defines obesity and healthiness.
Given that the Centers for Disease Control and Prevention (CDC) calculates 64% of women and 74% of men to be either overweight, obese or mega-obese, some adjustments need to be made about what factors determine overweightness and obesity. America is fat, but what makes them fat? And more importantly, is fatness the best way to measure one’s health and longevity?
Obesity is currently measured by our body mass index, a standard devised in the 1800s by some Belgian dude who knew a lot about science and people. BMI divides your weight in pounds by the product of your height in inches, multiplied by 703 (this is the conversation factor for all you non-metric users). Out pops your number, and the CDC determines where you fall on the scale of underweight to obese.
But even the CDC admits it may not be the best diagnostic tool for body fatness or healthiness:
“At an individual level, BMI can be used as a screening tool but is not diagnostic of the body fatness or health of an individual."
It even goes to admit that there are better ways to measure obesity, but we generally stick with using BMI because it’s cheaper and easier:
“Other methods to measure body fatness include skinfold thickness measurements (with calipers), underwater weighing, bioelectrical impedance, dual-energy X-ray absorptiometry (DXA), and isotope dilution. However, these methods are not always readily available, and they are either expensive or need highly trained personnel. Furthermore, many of these methods can be difficult to standardize across observers or machines, complicating comparisons across studies and time periods.”
Without proper examination of what makes the data the way they appear, we run the risk of fixating on the wrong things instead of effectively solving issues in health care around the world.
In 2008, the Japanese government imposed a waistline law in an effort to curb health care costs for a nation with one of the highest longevities but the lowest fertility rates. But doctors and experts have pointed out that belly girth probably isn’t the best indicator of one’s health. Doctors and researchers at Kitasato Institute Hospital in Tokyo found that one person’s waistline could vary 7.8 centimeters (3 inches) when measured by different people throughout the day.
Many companies in America have placed a fat penalty on employees, which has both employers and employees riled. Under the government’s understanding of obesity, charging higher premiums to overweight employees makes sense. But it doesn’t make sense if being overweight doesn’t necessarily mean you’re going to live longer or die faster.
There are many factors that contribute to a heavier person’s longevity — maybe you’re a pro CrossFit champ and has more muscle weight than the so-called average woman of 5 foot 4 inches at 145 pounds. Maybe the obese man lives a lifestyle with less exercise than he should get, but he’s less stressed (numerous studies have proved that stress speeds up ageing).
So companies should look beyond the scope of obesity before they slap more taxes on the Phyllis Vances of the world. And the government needs to invest more in technologies like personalized genomics that will improve the cost and accuracy in measuring our health.