Laurie Toby Edison

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Change We Don’t Believe In

Debbie says:

In a New Year when Haiti was devastated (yet again), this time by a huge earthquake, the Democrats threw away a sure thing (yet again), and the Supreme Court asserted that corporations are more important than you and I (yet again), it’s not too surprising that Michelle Obama’s choice of a new cause didn’t get too much pixel attention. But here at Body Impolitic, we feel compelled to notice that First Lady Obama is formally taking up the torch of the nonexistent “epidemic of childhood obesity.” Yes, yet again.

Calling obesity an epidemic and one of the greatest threats to America’s health and economy, first lady Michelle Obama said Wednesday that she would launch a major initiative next month to combat the problem in childhood.

2010: It’s just like 2009, except less original.

First things first: there is no epidemic of childhood obesity. Yes, I know you’ve read about it in hundreds of articles, seen it on dozens of billboards, had thousands of office or street-corner conversations about it. Nonetheless, the emperor (or perhaps the First Lady) has no clothes.

Here are the 2008 numbers, an 8,000-person study published in the highly respected Journal of the American Medical Association:

Results Because no statistically significant differences in the prevalence of high BMI for age were found between estimates for 2003-2004 and 2005-2006, data for the 4 years were combined to provide more stable estimates for the most recent time period. Overall, in 2003-2006, 11.3% (95% confidence interval [CI], 9.7%-12.9%) of children and adolescents aged 2 through 19 years were at or above the 97th percentile of the 2000 BMI-for-age growth charts, 16.3% (95% CI, 14.5%-18.1%) were at or above the 95th percentile, and 31.9% (95% CI, 29.4%-34.4%) were at or above the 85th percentile. Prevalence estimates varied by age and by racial/ethnic group. Analyses of the trends in high BMI for age showed no statistically significant trend over the 4 time periods (1999-2000, 2001-2002, 2003-2004, and 2005-2006) for either boys or girls (P values between .07 and .41).

If that’s too many numbers for you (it’s right on the edge of what I can follow), here’s the paper’s conclusion:

Conclusion: The prevalence of high BMI for age among children and adolescents showed no significant changes between 2003-2004 and 2005-2006 and no significant trends between 1999 and 2006.

Oh, and if this wasn’t enough, 1999-2000 is when they changed the growth charts to reflect BMI, a completely useless measurement:

But the growth charts underwent a significant change in 2000 which has made them even more controversial. The new charts, issued by the CDC in May 2000, were based on BMIs, rather than weights and heights. … What didn’t make the news and few parents may know is that the new BMI-based growth charts meant children’s percentile on the growth curves changed. With the new charts, nearly two-thirds of children were suddenly at higher percentiles, with greater discrepancies among shorter children.

So even if kids are too fat (which they aren’t; keep reading), it’s not an epidemic, because it’s not growing.

Second, and perhaps more important, if there was a childhood obesity epidemic, none of the standard plans to counteract it have the least effect.

The U.S. Preventive Service Task Force, which reviewed nearly 40 years of evidence on screening and interventions for childhood and adolescent overweight — some 6,900 studies and abstracts … concluded that there is no quality evidence to support that overweight or obesity in youth is related to health outcomes or predicts fitness, blood pressure, body composition or health risks. The USPSTF found insufficient evidence to recommend routine screening for overweight in children and adolescents as a means to improve health outcomes. It did, however, note potential harms of screening programs. According to the USPSTF Childhood Obesity Working Group, no scientific review has been able to find quality evidence that any program to reduce or prevent childhood obesity — no matter how well-intentioned, comprehensive, restrictive, intensive, long in duration, and tackling diet and activity in every possible way — has been effective, especially in any beneficial, sustained way. Nor has any program been able to demonstrate improved health outcomes or physiological measures, such as blood lipids (“cholesterol”), glucose tolerance, blood pressure or physical fitness. Nor has any diet or exercise intervention in children been shown to lead to better health outcomes in adulthood. Not only did the USPSTF find no evidence to support the effectiveness of counseling for healthy eating in young people, it also found no evidence to support low-fat diets in children and, instead, found growing evidence for harm.

(If you click the link to the findings, be warned that the abstract is *ahem* not representative of the study’s findings. See “The Faith Sentence.”)

In a nutshell: the First Lady has picked a mythical cause which, even if it were real, supports no evidence of a problem, and no approach to the non-problem that has ever shown the slightest effectiveness.

Just think about the things she could be focusing on.

I think I’ll send a somewhat politer version of this post to her in a private letter.

A million thanks to Sandy Szwarc at Junk Food Science, where all the facts I need are always in one place. And Lynn Kendall was first with the pointer.

10 Responses to “Change We Don’t Believe In”

  1. Stefanie Says:

    Thank you for this fantastic post. You hit it right on the head.

  2. Nancy Lebovitz Says:

    You may want to check out Diabetes Rising. I’ve only heard an interview with the author and read the amazon reviews, but it looks as though there’s something much weirder going on with diabetes than has hit the popular press– for example, that type 1 is up sharply, too, and no one knows why.

  3. Patsy Nevins Says:

    Great job, Debbie. Let’s once again concentrate on the imaginary problems caused by the size of people’s bodies, create problems for children with body image & food fears, while we ignore real issues. Michele is no different from most of those in public office of some kind; she has her nose driven so far up her own butt that she cannot see daylight & she believes what she sees & hears in the popular press, the lies disseminated by a $115 billion a year conglomerate of weight-related industries, & doesn’t bother to dig deeper & learn the truth. This is a really tough time to be a kid.

  4. Adrian Says:

    Aren’t those all percentile measurements? You say children are getting taller, and yet only ten percent are in the 90th percentile of height. That’s no better than it was during WW2 food rationing! Why aren’t those numbers improving?

  5. Lynne Murray Says:

    I blame corn.

    No, not really. Sometimes I have to laugh to keep from crying or from screaming when I read the news. But I needed to do more than make fun of the narrow-mindedness of this situation in order to stay calm.

    This was a “two-cat” post, in that I was only able to read it without screaming by petting two handy cats at once AND blaming corn.

    This week I’ve just decided to blame corn subsidies and Earl Butz for all the stupid attempts to pick a problem that doesn’t exist, scapegoat a group that’s already staggering under a burden of prejudice and pat oneself on the back for “doing something”

    This was a useful post for me though because it really brought home how we need to reframe this issue in ever simpler and more evocative terms, Repeatedly. Until we get the point across.

    Damn that corn! Next week I’ll blame the mass media for taking their sponsor’s money, kissing up to prejudice and fanning the flames of hysteria. So much easier than doing actual investigative reporting and standing up to speak the truth to power..

  6. Stef Says:

    Thank you for covering this. It’s really a fucking shame.

  7. Kerry Says:

    I think I will join you in writing a letter to the First Lady, perhaps if enough of us do we can bring her attention to the scientific facts and away from the media hype.

    And apologies for going almost completely off topic, but does anyone know what is going on with Junkfood Science? No new posts since October? Has Sandy given up the blog?

  8. Lynne Murray Says:

    I am SO pleased that NAAFA has sent a message to Michele Obama (the President’s mention of her taking up the anti-obesity banner caused me to emit a prolonged primal scream during the State of the Union speech). 1st paragraph and link below:

    NAAFA Challenges the First Lady

    For Immediate Release
    January 29, 2010

    Oakland, CA – First Lady Michele Obama has recently announced her intention to
    focus on childhood obesity prevention. NAAFA encourages the First Lady to
    consider all the research before taking action and supporting any program that
    may do more harm than good.

    http://groups.yahoo.com/group/naafanews/message/463

  9. Jane Says:

    Your statistical data is pretty weak. There has been a significant rise in obesity since the 1960′s in this country, and that rise is strongly linked to chronic health problems such as diabetes, especially for children. There are healthy people who are overweight, and not so healthy skinny people. But on average, being overweight takes away from your overall health. I live in a poor city and there are TONS of overweight kids with few places to play, minimal healthy options at the grocery store, disgusting free lunch offerings, and parents that are too poor and overworked (no – not contradictory) to go about fixing homemade meals every night – especially healthy ones that are probably pretty unfamiliar to them. While I agree that we have an unhealthy fixation on skinniness unto the point of death in this country, pretending that Americans aren’t getting heavier and that there aren’t negative consequences to weight is a delusion that helps no one.

  10. Debbie Says:

    Jane, we agree about minimal healthy options, unsatisfactory free lunch offerings, and parents that are too poor and overworked (certainly not contradictory). Otherwise, we differ. You might want to take a look at Kate Harding’s superb article on the topic in this week’s Salon.

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