Debunking the Death Statistics
Hi, everyone. It’s Ali from Ok2BeFat. And it’s time for another episode of the Fat Activism Basics.
In this video I will be discussing weight and weight loss. I will also be using the words “obesity” and “overweight” in the context of discussing and quoting scientific studies, even though these are not words I would normally use.
This is the Debunking of the Death Statistics.
Since death statistics are commonly used as a tool to frighten fat people and to discriminate against them, it’s important to take a close look to make sure that this information was arrived at in a way that makes sense and scientifically rigorous.
Spoiler — These stats don’t meet those standards. At all.
The most commonly used number for the amount of deaths by fat is 300,000 people per year in the United States.
Where did this number come from?
When the pharmaceutical company Wyeth was in hearings with the FDA to get approval for their new diet drug in the 1990s, they used the 300,000 deaths per year figure 7 different times in those hearings.
Fen phen had deadly side effects, something the company already knew at the time but that they had hidden from the FDA. Instead they sold the FDA on a risk-benefit analysis that alleged that the benefits of even a tiny amount of weight loss were higher than the risks of a diet pill.
The benefit being saving those ubiquitous 300,000 people from fat death.
Where did Wyeth get this figure from? No one at the company seemed to know. We know quite a bit about the internal workings of Wyeth regarding the approval and sale of fen phen due to the enormous civil lawsuits brought by the people harmed by this diet drug and the families of those who died as a result of taking it.
The entire fiasco is covered by Alicia Mundy in her book Dispensing with the Truth.
An internal Wyeth company memo discovered during the civil trial referred to the 300,000 number as having “never been substantiated”.
The original source for the figure appears to be a study from 1993 by McGinnis and Foege who proposed a 300,000 death figure “due to poor diet and physical inactivity”, without ever once mentioning body size. This figure was immediately misused by the media and other research articles as 300,000 deaths by fatness, when the original study said nothing of the sort.
McGinnis and Foege tried repeatedly to correct the misuse of their study. In 1998, they published a letter stating that “the figures… applied broadly to the combined effects of various dietary factors and activity patterns…” They also tried to draw attention to the fact that they had explicitly noted in their study that it would be difficult to sort out the contribution of any single factor, such as body size.
The abstract to their study notes that the numbers cited in the study should be viewed as approximate. It also says that social and economic status and access to medical care are also important contributors to mortality, but that they were not able to quantify the impacts of those factors for this study.
In 1999, David Allison published a study defending the 300,000 number as THE number of annually dead fat people. You may remember him from my previous video, BMI part 3 — he’s the guy who told Scientific American that his dire warnings about fatness were just “back of the envelope” scenarios and were never meant “to be portrayed as precise”.
And hey, this may be related — In 2005, Allison reported that he had received funding from 148 drug and diet industry sponsors.
It’s weird how that always happens.
Paul Campos thoroughly examines and debunks the 1999 Allison study in The Obesity Myth.
In his critique of Allison’s study, Glenn Gaesser has pointed out that because studies have repeatedly shown that there is no link between a higher BMI and death in people over 65, that those people should be excluded from any claims about death due to fatness.
78 percent of the 2.3 million annual deaths in America are people over the age of 65. So that leaves about 500,000 deaths in people under 65 that might be related to fatness.
Excluding all other forms of death — accidents, the flu, homicide and suicide, pollution, et cetera — 60% of all deaths in people under 65 would have to be caused by fatness.
This is a flatly ridiculous and unbelievable claim.
Allison’s study from 1999 is pretty clear about how they arrived at their numbers.
“Our calculations assume that all (controlling for age, sex, and smoking) excess mortality in obese people is due to their adiposity.”
Allison and his co-authors did not investigate anything about fat people. They didn’t even mention the harms caused by dieting, medical discrimination, social stigma, diet drugs or anything else that is commonplace among fat people, much less try to control for those factors.
They discovered that fat people die from being fat by just assuming it.
Get hit by a car while fat? Well, it’s not the car that killed you! It’s the FAT.
This is appallingly bad and not even worthy of the title of scientific study.
In 2004, the Centers for Disease Control embarrassed itself with a similarly shoddy study. In March of 2004, the CDC released a report at a huge news conference stating that fatness kills 400,000 Americans a year. They claimed that fatness was about to become the number one reason of preventable death in America, which resulted in screaming media coverage that fatness was a self imposed death sentence.
In May of 2004, however, Science magazine dug into the statistics, reporting that there was doubt about these numbers, including from people who worked at the CDC. According to the article, those researchers “dismiss this prediction, saying the underlying data are weak. They argue that the paper’s compatibility with a new anti-obesity theme in government public health pronouncements — rather than sound analysis — propelled it into print.”
And in November of 2004, the Wall Street Journal published a front page story about the errors in the CDC’s study. The reporting noted that the study “inflated the impact of obesity on the annual death toll by tens of thousands due to statistical errors … Dr. Pechacek (a scientist at the CDC) wrote to colleagues that he had warned two of the paper’s authors, as well as another senior scientist. (He said) ‘I would never clear this paper if I had been given the opportunity to provide a formal review’.”
I’m just going to quote a little more from the Wall Street Journal article, because it’s genuinely astonishing how blatant these hucksters are.
“Dr. Gerberding (the director of the CDC) in an interview yesterday, acknowledged that there had been human errors in the study’s calculations, but said they don’t diminish the threat that obesity causes to public health. “The bottom line is that obesity is a leading cause of death,” Dr. Gerberding said. “This paper in and of itself is a very minor contributor to our knowledge of obesity.”
It doesn’t seem very minor, when people are still citing the CDC’s support for fake death statistics as a reason for why it’s ok to harm and discriminate against fat people.
Seeing as the Centers for Disease Control is a major part of the public health wing of the American government, and as such, helps set public health policy for not only the United States but around the world — the fact that they ignored their own scientists to put out made up numbers that only exist to help the weight loss industry — that seems like a major issue and big deal to me.
And in January of 2005, the CDC admitted that its study was wrong and that the 400,000 annual deaths figure had been exaggerated due to mathematical errors.
The massive revising downward of estimated deaths from fatness did not receive the same coverage as the wildly inflated numbers, and have not in any way made the same impact as the original study. The statistics were essentially retracted but their impact remains.
As of March 2018, according to the Journal of American Medicine website, the original, fake CDC numbers have been cited 2,846 times, while the correction has only been cited 326 times.
That seems fairly major.
Is it a coincidence that the director of the CDC, Dr. Gerberding, orchestrated a splashy press conference with faked up death statistics just days before she was scheduled to appear before Congress to ask for more money for her agency?
A study that she prepared herself, in a field that she had no expertise in, that did an end run around her own in-house scientists?
Doesn’t seem like a coincidence to me.
And of course, even after the CDC had to retract their wildly overblown so-called study, they still published a statement that said, as quoted in Health at Every Size by Linda Bacon-
“Despite the recent controversy in the media about how many deaths are related to obesity in the United States, the simple fact remains: obesity can be deadly.”
Translation — let’s not let the facts get in the way of a good con.
Remember what Harriet Brown said in Body of Truth —
“I’ve been told by numerous researchers that the easiest way to get a study funded now is to include the word ‘obesity’ in the proposal. Even better, cite ‘childhood obesity’.”
And now it seems like a great time to introduce the concept of regulatory capture, as developed by University of Chicago economist George Stigler.
Regulatory capture is when the government agencies that are supposed to regulate industries actually serve the interests of those industries rather than the public interest.
Under capitalism, the government tends towards regulatory capture, just like how under capitalism, industries tend to form monopolies to maximize profit.
The history of the Food and Drug Administration is a history of regulatory capture, of a government agency that is supposed to be working for the good of public health, instead being hollowed out and repurposed to serve the interests of the pharmaceutical industry.
When the Republicans took over the House in 1994, they were out for the FDA’s blood. Under Newt Gingrich’s tenure as Speaker of the House, many of the FDA’s activities were privatized. Gingrich would even personally intervene in FDA decisions, pushing for the approval of drugs owned by companies who had contributed to his foundation.
In 1991, the FDA had drawn up a list of 111 ingredients used in non-prescription diet ads and declared them ineffective or unsafe. This would have been quite a blow for the weight loss and supplements industry, but don’t worry. Republicans took care of it.
In 1994, the Dietary Supplements Health and Education Act made it almost impossible for the FDA to continue regulating these products. This law was pushed through by Senator Orrin Hatch, a Republican Senator from Utah, where the herbal supplement industry is huge.
Instead of the manufacturers having to prove that their supplements are safe, now the FDA has to bear the burden of paying for an investigation to prove that these products are unsafe.
Alicia Mundy says in Dispensing with the Truth-
“Officials now spoke of the pharmaceutical industry, not the American public, as ‘our clients’. Pharmaceuticals were playing hardball like doctors at the FDA had never seen before, backed by Congress. The FDA had to accede to the new culture, or its budget would be decimated.”
Republicans even attempted to get rid of the FDA completely in 1994. While they were not successful in that attempt, the FDA’s budget has been cut again and again, while the balance is made up by “user fees” which are paid by the drug companies to the FDA for drug approval.
Add in the revolving door of officials at the FDA who leave the agency for lucrative jobs with the drug companies they are supposed to be overseeing, and you can see that the agency is ripe for exploitation by the very industry it is supposed to be regulating.
Multiply and repeat this same tactic over the other government agencies that are supposed to be advocating for public health, and you can see how we are getting fake numbers from the Centers for Disease Control, and changes in BMI standards that only benefit the weight loss industry from the National Institutes of Health.
And that’s the end of our review of the death statistics.
Please see the notes for a list of the sources I consulted for this series.
All my love and thanks to all the fat activists around the world — past, present and future — who are doing such amazing and fantastic work.
And thank you to all my supporters on Patreon, especially these lovely people — you make it all possible, and I love you for that!!
You can support my work on Patreon at patreon.com slash Ok2BeFat or you can make a one time donation at ko-fi.com slash Bad Fatty Ali
See you again soon!
-Public Health Profiteering by James T. Bennett & Thomas J. DiLorenzo
-Dispensing with the Truth by Alicia Mundy
-The Fat Studies Reader, edited by Esther Rothblum and Sondra Solovay; “Prescription for Harm- Diet Industry Influence, Public Health Policy, and the ‘Obesity Epidemic’.” by Pat Lyons.
-“Actual causes of death in the United States” by McGinnis JM, Foege WH.
Journal of the American Medical Association, 1993 Nov 10
-“Methods of Calculating Deaths Attributable to Obesity” by Katherine M. Flegal, Barry I. Graubard, David F. Williamson; American Journal of Epidemiology, Volume 160, Issue 4, 15 August 2004, Pages 331–338 http://aje.oxfordjournals.org/content/160/4/331.long#ref-5
-The Obesity Myth by Paul Campos
-“CDC Study Overstated Obesity as a Cause of Death”, Wall Street Journal, by Betsy McKay, Nov. 23, 2004
“Obesity: An Overblown Epidemic?”, Scientific American, by W. Wayt Gibbs on December 1, 2006
“Annual Deaths Attributable to Obesity in the United States”; Journal of the American Medical Association, October 27, 1999
David B. Allison, PhD; Kevin R. Fontaine, PhD; JoAnn E. Manson, MD, DrPH; et al
“Regulatory and academic capture”, The Washington Post, By Will Baude, May 18, 2014
Newt Gingrich: Capitol Crimes and Misdemeanors
By John K. Wilson
Losing It- America’s Obsession with Weight and the Industry that Feeds on It by Laura Fraser
“Stupid Pills: The Politics of Fraudulent Dietary Supplements”, The New York Times, by Timothy Egan, February 6, 2015
“Actual Causes of Death in the United States, 2000”; Journal of the American Medical Association; March 10, 2004
Ali H. Mokdad, PhD; James S. Marks, MD, MPH; Donna F. Stroup, PhD, MSc; Julie L. Gerberding, MD, MPH
“Correction: Actual Causes of Death in the United States, 2000”; Journal of the American Medical Association; January 19, 2005
Ali H. Mokdad, PhD; James S. Marks, MD, MPH; Donna F. Stroup, PhD, MSc; Julie L. Gerberding, MD, MPH
Health at Every Size by Linda Bacon PhD