Fears of a fat planet overblown, skeptics say

updated 12:44 p.m. ET March 4, 2008

LONDON - Go on, have another doughnut. According to some experts whose views are public health heresy, the jury is still out on how dangerous it is to be fat.

"The obesity epidemic has absolutely been exaggerated," said Dr. Vincent Marks, emeritus professor of clinical biochemistry at the University of Surrey.

Marks is among a minority of skeptics who doubt the severity of the obesity problem. They claim that the data about the dangers of obesity are mixed and there is little proof that being fat causes problems including high blood pressure, heart disease and cancer.

Such views contradict nearly everything doctors have been saying for years.

Being fat has long been blamed for conditions like diabetes, which can lead to heart, kidney and nerve diseases. There is also increasing evidence that certain cancers may be linked to weight gain.

"The evidence linking obesity to diabetes and cardiovascular disease is very strong," said Dr. James Hill, director of the Center for Human Nutrition at the University of Colorado. "Type two diabetes rarely happens in people who aren't obese."

Alarmist projections?
But obesity contrarians say that there's no data proving why being fat — in itself — would be dangerous. "There's no good causal connection," said Eric Oliver, author of Fat Politics and a political science professor at the University of Chicago.

Blaming obesity for diabetes and heart attacks, Oliver says, is like blaming lung cancer on bad breath rather than on smoking. Excess weight may actually be a red herring, Oliver says, since other factors like exercise, diet or genetic predispositions towards diseases are harder to measure than weight.

In addition to questioning the dangers of being fat, researchers like Marks also criticize oft-repeated alarmist projections about the rise in obesity — like the British government's warning that nearly half of Britain will be obese by 2050.

Those simply aren't based on good evidence, they say.

According to national health statistics released last month, from 1993 to 2006, "relatively little change" was noted in weight gain, with men and women gaining an average of about 9 pounds. In children, no significant gains were recorded.

The main problem, obesity skeptics say, is that too many people are considered fat, with the obese and overweight often lumped together.

"Being moderately plump is not a health disadvantage," Marks said. "Some overweight people may not look svelte, but they may be perfectly healthy."

As defined by the World Health Organization, anyone with a body mass index above 25 is overweight, and anyone above 30 is obese. Most experts agree the distinctions are imperfect and somewhat arbitrary.

Moreover, Marks and others point to research showing the benefits of a few extra pounds.

Obesity paradox
In 2005, Katherine Flegal of the United States' Centers for Disease Control and Prevention published a study in the Journal of the American Medical Association, finding that overweight people typically live longer than normal-weight people. More than a dozen other studies have come to the same conclusion.

Outrage ensued. Prominent health experts called the research flawed and worried that people would gleefully supersize their meals.

"I think some experts found it disturbing that we actually said that overweight people have a lower death risk," Flegal said. In other research, Flegal and colleagues found there to be almost no link between death rates and weight.

"The relationship between weight and disease and survival is very complex and we don't have a good handle on why some of these things are related and others are not," Flegal said. She suggested that being fat may help you survive some conditions, but not others.

Doctors have long struggled to explain the obesity paradox — the mystery that in certain conditions like heart attacks, fat patients often have better odds of surviving than thin people. Some experts hypothesize that fat peoples' hearts already work harder than those of thin people, thus giving them a natural edge when their bodies are stressed.

"We don't want people to think it's ok to be heavier," said Hill. "But not everybody who gains weight is going to get heart disease or diabetes," he said.

Some obesity skeptics question the motives of experts who make dire predictions about obesity.

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