A new government study has concluded that obesity causes about 112,000 deaths each year in the United States, far fewer than a previous, highly publicized estimate by another part of the same agency.
The new calculation was immediately seized upon by skeptics who argue that public health authorities have created undue alarm about obesity. Other experts and the researchers who conducted the new study, however, said obesity still is a major public health threat.
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"This certainly shouldn't be interpreted to mean obesity isn't a problem anymore," said Katherine M. Flegal of the National Center for Health Statistics in Hyattsville, who led the study in today's issue of the Journal of the American Medical Association. "Obesity certainly is still a problem."
Flegal attributed the difference in the estimates to the fact that her group used more recent and more complete data, and was able to account better for more variables, such as smoking, age and alcohol consumption. Flegal and her colleagues also speculated that improvements in medical care and lifestyles may have begun to reduce obesity's toll.
"People have been changing their diets in response to some of the public health activities around obesity, which has been having a positive effects on such factors as cholesterol levels," she said.
The number of Americans who are overweight has been steadily increasing. About two-thirds of Americans are overweight, including about one-third who are obese. Being overweight is believed to increase the risk for such health problems as heart disease, cancer and diabetes.
The federal Centers for Disease Control and Prevention in Atlanta estimated last year that being overweight caused about 400,000 deaths each year, making it the second leading cause of preventable death. The agency predicted obesity would soon overtake tobacco as the leading cause of preventable death, but it later acknowledged that estimate involved a statistical error and lowered it by about 80,000 deaths.
In the new study, Flegal and her colleagues used data collected in three periods between 1971 and 2000 by the large National Health and Nutrition Examination Surveys.
Based on measurements of height and weight and other information about health, lifestyle and mortality, the researchers estimated that in 2000 obesity caused 111,909 deaths.
Critics seized on the new findings as evidence of "scaremongering" by public health authorities.
"It's a scandal that the CDC's 400,000 deaths estimate didn't use this information, which was readily available on the agency's computers," wrote Richard Berman of the Center for Consumer Freedom, an advocacy group funded by the restaurant and food industries, in a letter to CDC Director Julie L. Gerberding. "The American public deserves to know where the CDC stands on this greatly reduced number and whether obesity is truly worse than the Black Death, as you have stated."
Flegal and her colleagues speculated that some of the difference in the two estimates may be the result of recent improvements in treating heart disease, a major cause of death among the obese.
In addition, Flegal noted that her study looked at mortality but not at the other negative effects of obesity.
Other health authorities said the findings should not undermine efforts to fight obesity.
"Obesity prevalence is increasing in adults and in the young, and we may not see that impact on cardiovascular disease and death until the next three to four decades," said Robert H. Eckel of the American Heart Association.
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