At the beginning of this week The Academy of Medical Royal Colleges released the latest report entitled: “MEASURING UP: THE MEDICAL PROFESSION’S PRESCRIPTION FOR THE NATION’S OBESITY CRISIS” There are 10 key recommendations which it is believed are necessary if progress is to be made in tackling the obesity crisis in the UK. Unfortunately it trots all the same arguments which not only exaggerate the dangers of people being overweight/obese but also continue to proclaim that the problems will be solved by applying the approach which has manifestly failed to deliver the results expected. I will just deal a selection of the flaws contained in this report which apparently is supposed to represent the views of almost the entire medical profession. According to the report: “Obesity is one of the largest public health threats facing many of the wealthiest nations in the 21st century. Every day doctors treat people, young and old, who are facing the health consequences of being overweight or obese, such as high blood pressure, type 2 diabetes, heart disease, strokes, depression, and some major cancers. These illnesses are putting our nation’s health – and the budget of the NHS – under strain, and the contributions of overweight and obesity are growing.” It is simply not true that people who are overweight have serious health problems. There are several reliable and comprehensive studies which...Read More
Despite all the emphasis on BMI as an indicator of health status/risk of dying the fact remains that for any given body weight/BMI there is a wide variation in health because many others factors can come into play. A recent study conducted in the USA has analysed the impact of various demographic and behaviour-related factors likely to affect all-cause mortality. 3,617 men and women were monitored between 1986 and 2005 during which time there were 1,409 deaths. The results confirmed earlier findings that low income is a predictor of mortality when allowance is made for major health risk behaviour. By contrast, physical activity – even at relatively low levels – provided a protective effect against mortality. Those with little or no physical activity had a 60% higher mortality rate than those who were reasonably active. The risk of death was not associated with obesity or overweight. For those over 55 at the start of the investigation, mortality rates were significantly reduced for those who were overweight or obese(1). The levels of physical fitness for different BMI values were compared in 2603 men and women aged 60 years and over. 450 deaths were recorded over the 12-year follow-up period. The participants who died were older, less fit and had higher cardiovascular risks than those who survived. The results in Table 1 show that there is very little difference in the death...Read More
The official approach to obesity is based on the fact that there is an increased incidence of diabetes, heart attacks and certain cancers as the BMI increases. But there are many other causes of death and to obtain a comprehensive perspective we need to consider all the different diseases/conditions which contribute to ill-health and death. Katherine Flegal’s team, whose detailed work (BLOG 10) provided convincing evidence that those in the BMI “overweight” category had a lower death rate than those with a “normal” BMI has analysed the causes of death in the different BMI categories(1). The results are shown in Table 1. TABLE 1 RELATIONSHIP BETWEEN BMI AND EXCESS DEATHS (1000s) BMI Cause of death <18.5 18.5-25 25-30 >30 Coronary heart disease +3 0 -12 +6 Other cardiovascular +8 0 -5 +36 Lung cancer 0 0 -10 -7 Obesity related cancer 0 0 -3 +20 All other cancers +3 0 +3 +2 Diabetes/kidney disease 0 0 +15 +34 Chronic respiratory +16 0 -30 -6 Acute respiratory/infectious +8 0 -8 -3 Injury +2 0 -32 -13 Other causes +6 0 -52 +13 ALL +46 0 -134 +82 The findings for the “overweight” category confirm that there is an increase in the deaths from diabetes but that the reductions in deaths from a variety of other causes are...Read More
In 2005 the authoritative Journal of the American Medical Association published the results of a study conducted by Katherine Flegal and colleagues at the respected Center for Disease Control (CDC). This work is an analysis of data derived from the National Health and Nutrition Examination Survey (NHANES) conducted in the USA. It was started in the 1970s and has continued until the present day. Large numbers of people are involved. Participants report regularly to a centre where various measurements are taken by professional health workers to ensure that the quality of the data is absolutely first class. The normal BMI range has been taken as the benchmark and given a value of 1.00. The results are shown in Table 1. TABLE 1 CDC STUDY RELATIVE RISKS ALL-CAUSE MORTALITY BMI 25-59 Years 60-69 Years >70 Years <18.5 Underweight 1.38 2.30 1.69 18.5-25 Normal 1.00 1.00 1.00 25-30 Overweight 0.83 0.95 0.91 30-35 Obesity Class I 1.20 1.13 1.03 >35 Obesity Class II 1.83 1.63 1.17 These results show that risks of dying are slightly smaller in the ‘’Overweight’’ category than in the ‘’Normal’’ one. The risks of those in ‘’Obese (Class I)’’ are only marginally increased, especially those aged over 70 years(1). In Canada 11,326 men and women aged 25+ at the outset were monitored over a 12-year period commencing in 1994/1995 as part of the National Population...Read More
According to official government strategy published in 2008: “Britain is in the grip of an epidemic. Almost 2/3 of adults and 1/3 of children are either overweight or obese……These figures will rise to almost 9 in 10 adults and 2/3 of children by 2050.” “We are facing a public health problem that the experts have told us is comparable with climate change in both its scale and complexity” The rationale for this strategy is a report entitled “Tackling Obesities: Future Choices” prepared by Foresight which answers directly to the Government Chief Scientist and the Cabinet. This report definitely concludes that: “….being overweight or obese increases the risk of a wide range of chronic diseases principally type 2 diabetes, hypertension, cardiovascular disease including stroke as well as cancer “. This policy has been continued and re-affirmed by the present government. In his introduction to “Healthy Lives, Healthy People: A call to action on obesity in England” (13 October 2011) Andrew Lansley wrote; “Excess weight is a leading cause of type 2 diabetes, heart disease and cancer, adding costs to the NHS” “Overweight and obesity are a direct consequence of eating and drinking more calories and using up too few…..for most of us who are overweight and obese, eating and drinking less is the key to weight loss” “The Government….will ensure that local effort is supported by high quality...Read More
- 306. Opioids
- 305. A Comparison between the approaches to Type 2 Diabetes (T2D) by Dr David Unwin and Diabetes UK
- 304. Sulphonylureas increase cardiac deaths but are still recommended for use after Metformin in type two diabetics in Scotland.
- 303. Statins: Why it is crucial to have a comprehensive picture
- 302. The Conventional Treatment of Type 2 Diabetes (T2D)
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