Figures Don’t Lie but Liars Do Figure
Or Dr. Ben Carson Has No Excuses--
NHANES, a part of the Center for Disease Control, surveys the U.S. population annually for information about our weight. In 2013 theyreported that 35% of adults are obese. Few question the methodology of this survey which is based largely on self-reported responses :http://www.bls.gov/osmr/pdf/ec140020.pdf
This data is analyzed using a BMI formula that classifies a 5’6” woman weighing 185 pounds as only overweight—not obese.
Dieticians are taught to use another measure known as the Hamwi Formula: at 5’ tall a female is 100 pounds, add 5 pounds for each inch beyond; for men: 106 pounds and 6 pounds per inch.
Two years ago Meredith Luce RD MS LN and I hired a statistician to convert the official data to the Hamwi Formula. The conversion raises the number to 55% obese from 35%. Which is correct? Maybe neither now that we know that waistline measurement—not overall weight-- is the critical indicator of obesity-related health issues. No surprise that in 2008 Japan passed the Metabo Law requiring annual waistline measurement. Max for females is 31.5” and 35.4” for males. Our diabetes experts are more generous: 35” max for females and 40” for males.
1- The CDC uses a statistical method called Raking to weight BRFSS survey data to adjust the survey data for proportions of age, race and ethnicity, gender, geographic region, marital status, education level, home ownership and other known characteristics of a population sample. It allows the introduction of more demographic variables suggested by the BRFSS expert panel. Because we do not have access to this extra information, as a result we were not able to make the appropriate adjustments to the data. For this reason, the above table is not directly comparable to CDC figures and is likely to include biases that could not be properly adjusted for.
2- Height and weight and gender data were pulled from the CDC’s website and converted into the HAMWI formula. We don’t have wrist measurements so I assumed an equal distribution of large and small frame.
People were then categorized as:
• Under-weight (five pounds or less than ideal HAMWI weight
• Normal-weight (plus or minus five pounds from ideal HAMWI weight
• Overweight (between 5 and 30 pounds over HAMWI ideal weight)
• Obese (more than 30 pounds overweight)
The Business
Wellness is now a $3 trillion industry worldwide. Beginning in the 60s with Weight Watchers, followed by Health Clubs, we have been easily led to consume simplistic body advice. Blaming fast food and insufficient exercise seemed to explain our failure. Today this is a tired story so we have started to nibble at the actual advice we have been fed; now the experts are criticizing 50 years of nutrient manipulations. The July 2014 TIME cover story kicked off the revisionism angle about the low fat rampage that began in the 70s. Sold as the way to avoid a heart attack, itsreal purpose was to increase consumption since fat at 9 calories per gram is more than twice as “fattening” as protein and carbohydrates. We gave up fat and satiety to eat MORE tasteless food.
Now even SELF magazine, the bible of the young Wellness crowd, has on its October cover : The End of Dieting? When 95% of dieters regain the “lost” weight or gain even more, it is a good time to re-merchandize dieting. The Big Three—WW, Jenny Craig, Nutri-Systems-- are losingsales and say this is a repeat of the early 90s when people stopped dieting.
But the still the media refuses to publicize what is now obvious:
“the eat healthy/exercise more” directive is flawed. The simple math of calories in/calories out is wrong. And these dual oversimplifications have led to our current obese state AND orthorexia; leptin resistance; and visceral fat from chronic cortisol overload.
Why the media resistance? Embarrassment; food advertising; failure to understand that their thin bodies are different from obese ones ( Are identical twins the same when one is seven months pregnant and the other not?); disbelief that research shows that exercise is NOT a weight loss solution once you are weighty( and also that today’s Millennial generation with their “go for the burn” exercise habit will have early arthritis—the data on the Military proves this point); and the always available easy phone-in article on the next new Power Food or Juice Cleanse.
Multiple businesses have feasted on American bodies for a long time. Food execs sometimes drop their guard and say they can’t believe they haven’t reached the limits of the American stomach! ( Don’t know how sensitive is yours, but a photo of a BIG stomach removed from one of Meredith’s patients during surgery is available.)
So what to do? Fortunately innovation will soon change the game. All the FDA approved obesity devices from the past year are designed to make our big stomachs feel small and thus limit consumption. The new Double Balloon Device is easy. The most promising is the Full Sense Device which can be inserted using only local anesthesia in a ten minute procedure. This makes a root canal seem like major surgery. A clinic to fix every stretched out stomach is coming soon to your neighborhood.
A few years ago an opinion piece by a well-known Economist was published in the New York Times with the recommendation that dieticians, diet experts, doctors (Hello Dr. Oz!); and assorted Wellness Gurus should move over and let Economists solve our obesity problem. Now imaginethat Americans begin to Close Their Mouths Sooner and Open Them Less Often. The economic repercussions will be huge, affecting not just food and fitness and water and diet but also containers and garbage and energy and the environment. We Americans hate less is more, but the success of Marie Kondo’s book may indicate a change. For someone of my vintage and perspective and stomach capacity, Americans typically consume about twice the quantity needed. Not calories, but quantity. And no one seems to understand the difference unless they have had stomach surgery and are left with an organ the size of a two-year old’s.
Some relevant links:
. Weight Loss and Adrenal Stress (click here).
. More Reasons to Whittle Your Middle (click here).
. The Facts on Leptin (click here).
. Metabolic adaptation in calorie restriction (click here).
. Exercising but Gaining Weight (click here).
. Debunking the Hunter-Gatherer Workout (click here).
. Why Some People Won't Be Fit Despite Exercise (click here).
. The Invention That Could End Obesity (click here).
. The New York Times reports that Americans Are Finally Eating Less (click here). This is why Coca Cola (click here) is concerned.