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The Effects of Obesity on Mortality

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The Effects of Obesity on Mortality
Hung Vuong
HDCS 1300
November 14, 2013

Abstract This paper explores articles that conduct research on obesity and its effects on the health and longevity of the body. The articles vary in their interpretations of the data and arrive at different conclusions in certain areas. The University of Oxford’s research and Samuel H. Preston’s article focus on the Body Mass Index (BMI) to interpret data, while articles from the Scientific American and Paul Campos assert that the BMI has its limitations and that obesity is only part of a greater problem of lifestyle choice. This paper examines the articles in relation to each other to suggest that greater scrutiny into the subject of obesity should be taken to fully understand its effects on health and mortality.

The Effects of Obesity on Mortality Numerous studies have been conducted on obesity and its relation to mortality, however contradictory results appear because different studies lump data in different ways. In Crimmins, E. M. (2011) a person is of normal weight if he or she has a BMI between 18.50 and 24.99. A person with a BMI of 25 or more is considered overweight, while anyone with a BMI of 30 or more is considered obese. Obesity is further subdivided into Class 1 (30–34.99), Class 2 (35–39.99), and Class 3 (40 and above). While the University of Oxford (2009) argues that moderate obesity reduces lifespan, Reinagel (n.d.) introduces a new study which report findings that some people who are overweight may actually have a higher life expectancy than those who are considered normal or healthy weight. This paper examines two Block, W. & Cussen, M. (2000) articles in relation to three other articles to compare to what extent obesity affects longevity.
Literature Review In Block, W. & Cussen, M. (2000) Preston’s article points to the substantial increase in the prevalence and severity of obesity since 1980, and extrapolations of data show the trend will only increase. The severity of obesity is equated to smoking and has been reducing life expectancy among the U.S. population, and Preston argues that only ad campaigns such as the ones warning about the dangers of smoking, drunk driving, and HIV will shift the behavior of the American people towards a healthier lifestyle (Block, W. & Cussen, M. 2000). Block, W. & Cussen, M. (2000) featured an additional article by Paul Campos which attempts to refute the claims of obesity being deadly, arguing that obesity in and of itself is not the cause of hundreds of thousands of deaths a year. He goes on to say that lifestyle choice, not weight, is an indicator of health and longevity, and that moderately active fat people are far healthier than thin, sedentary individuals (Block, W. & Cussen, M. 2000). Campos goes on to state that the BMI is arbitrary and based solely on height and weight, therefore not a good indicator of healthy weight; he lists the example that according to the BMI, three-quarters of all running backs in the NFL, whose job is to run, would be considered obese (Block, W. & Cussen, M. 2000). In fact, for every study that shows being overweight has an increased health risk for people with a BMI between 20 and 25, which is currently one out of every three adult Americans, another study indicates lower overall health risk for them compared to “ideal weight” individuals (Block, W. & Cussen, M. 2000). The University of Oxford (2009) research found that moderate obesity, which is now common, reduces life expectancy by about 3 years, and that severe obesity, which is still uncommon, can shorten a person’s life by 10 years. This 10 year loss is equal to the effects of lifelong smoking. Among the 900,000 men and women in the study, mortality was lowest in those who had a BMI of 23 to 24 (University of Oxford, 2009). This data contradicts the claims put forth by Campos. Reinagel (n.d.) introduces some of the latest research using the BMI and it found that those who are overweight might actually have a greater longevity than those in the normal or healthy weight range, causing many people to question the reliability of the BMI. She goes on to state that this is likely due to grouping together all kinds of people disregarding age and health conditions (Reinagel, n.d.). One example that she says would skew perceptions is that people who are underweight due to advanced age or extreme illness would fall into the healthy weight category, but have a much shorter life expectancy than the actual average of a healthy person in that BMI group, thus causing data to be seen and interpreted differently (Reinagel, n.d.). Her claim is that not enough variables were controlled in that recent study.
Discussion
As can be seen from the articles so far, much of the findings contradict each other, with no clear idea where the healthiest weight group lies or to what extent the impact of obesity on longevity is compared to other factors such as smoking and a sedentary lifestyle. This statement is supported by the aforementioned discussion of other research. There may be a few possible theoretical explanations for these discrepancies.
Limitations of These Studies The discrepancies identified may result from a number of limitations found in the materials reviewed by Block, W. & Cussen, M. These limitations can result from demographics, issues of focus, and not taking into account other factors. Each of these limitations will be examined in further detail below.
Demographic Limitations First, one major limitation is the BMI itself. While it works for the general population, not everyone can be calculated accurately with the BMI, such as the NFL linemen mentioned earlier by Campos. Also, although the University of Oxford (2009) conducted a study on approximately 900,000 individuals over the course of 10 to 15 years, making it the largest study ever on obesity and mortality, the study was conducted in mostly Europe and North America. This means that there is no relevant data of other parts of the world to compare it to in order to see whether the effect of obesity on mortality applies universally. Reinagel (n.d.) earlier mentioned that because of the large number of people studied, many people of different age groups and conditions were lumped together, thus putting those who were suffering from severe sickness or were advanced in age, into certain weight categories and possibly affecting the results of the data.
Conflicting Areas of Focus In addition to certain limitations concerning demographics many studies had conflicting areas of focus, causing results of studies to be as they determined, but inevitably conflicting with other studies because though they are similar, they differ in certain aspects. For example Preston and the University of Oxford focused on the BMI and the assumption that obesity is analogous to a sedentary lifestyle and unhealthy diet, basically putting all three into one disease called obesity. Crimmins, E. M. (2011) and Campos stand on the basis that obesity is caused by a sedentary lifestyle with an unhealthy diet, and thus putting all three factors into different categories and causes of a shorter lifespan. By separating them or putting them all together, the data will come out very differently in research conducted with different mindsets.
Other Factors Outside of Obesity Another limitation of the research is that it was not controlled for many other variables. For example, the debilitating effects of crash diets and diet pills on the human body that can also contribute to a lower life expectancy (Block, W. & Cussen, M. 2000). These people are desperately trying to lose weight but essentially are shortening their lives with dangerous substances prescribed by a massive diet industry glamorizing being thin and muscular while making fat seem disgusting and shameful. Lifestyle choices are also not accounted for, so no distinctions are made between active and sedentary individuals who are overweight, or the ones who are thin yet do very little physical activity compared to those who are active and in the ideal weight group. If more distinctions were made, or more variables were controlled, then perhaps there would be more accurate data out there to compare with.

Conclusions and Future Study
In order to gain a complete understanding of obesity and its effect on mortality, it is necessary to conduct further studies that examine all aspects of a person’s lifestyle. Controlling for other variables so that lifestyle, age group, and other factors are similar for everyone in the study, research will show more accurate results of the effect of obesity, and only obesity, on fitness and to what extent it contributes to a shorter life expectancy. It is also important to consider whether obesity is a root cause, or if an unhealthy diet or lifestyle may be the primary factor that leads to obesity and thus, greater risk of a reduced mortality. Although much research has been conducted thus far, quite a bit of it contradicts other research because the studies are not being controlled for other variables. As obesity becomes more and more prevalent in society, it becomes increasingly important to provide accurate research on such a formidable impact to daily life.

References
Block, W. & Cussen, M. (2000). Does obesity cause a decline in life expectancy. In Bishop, P., Ezell, S., Greenwood, K., Hutchins, H., Norwood, M., Stewart, B., Waight, C. (Eds.), Human ecosystems and technological change (6th ed., pp. 592-603). Boston, MA: McGraw-Hill.
Crimmins, E. M. (2011). Explaining divergent levels of longevity in high-Income countries. Washington, D.C.: National Academies Press. NCBI. Retrieved November 12, 2013, from http://www.ncbi.nlm.nih.gov/books/NBK62367/
Reinagel, Monica. (n.d.). Can You Be Overweight and Still Be Healthy? Scientific American. Retrieved November 12, 2013, from http://www.scientificamerican.com/article.cfm?id=can-you-be-overweight-still-be-healthy
University of Oxford (2009). Moderate obesity takes years off life expectancy. ScienceDaily. Retrieved November 12, 2013, from http://www.sciencedaily.com/releases/2009/03/090319224823.htm

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