Obesity: How Big a Problem?

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Science  29 May 1998:
Vol. 280, Issue 5368, pp. 1364-1367
DOI: 10.1126/science.280.5368.1364

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Numerous studies have linked being overweight to increased risk for heart disease, diabetes, and cancer; moreover, according to the Institute of Medicine, fat people in the United States are costing citizens more than $70 billion annually both in direct health care costs and in indirect costs such as lost productivity. But recently many obesity experts have come to believe that these alarms have been overstated, partly because many studies don't account for confounding factors associated with obesity, such as a sedentary lifestyle, that may be even more dangerous. They also note that there is scant proof that losing weight actually improves longevity, especially in people who are otherwise healthy. As a result, they say that not everyone needs to shed his or her extra pounds, but that the decision should be made individually, based on each person's risks, which depend not only on weight but also on age, distribution of body fat, family history of disease, and current health problems such as high blood pressure. Needless to say, this revisionism has stirred plenty of controversy, as other experts maintain that obesity is the driver for health risks including high lipid levels, high blood pressure, and high blood sugar.