The Obesity Myth: Why America's Obsession with Weight Is Hazardous to Your Health by Paul Campos
New York: Gotham Books, 2004

Review by Jennifer Sader

I had hoped that this book would be a voice of reason in the current hysteria over America's "Obesity Epidemic." The latest installment, Medicare deciding that obesity is a disease, seems particularly worrisome as experts predicted that this would result in an increase in weight-loss surgeries, a procedure that seems drastic and risky and has already increased exponentially since celebrities like Carnie Wilson have undergone dramatic and incredibly public transformations. Some recent headlines have even suggested that being fat is more dangerous than smoking.

Campos provides a fresh perspective and a sorely-needed critical eye on the current debate about weight and health. He examines the data used to make the case that excess weight is unhealthy and finds no link between being moderately overweight (defined as a BMI between 25 and 29.9) is associated with any risk. The federal government defines the ideal weight range as a BMI between 18.5 and 24.9 (for a 5'5" woman, this is a weight between 111 and 150 pounds). However, Campos's examination of the same data showed that for women, "the BMI range correlating with the lowest mortality rate was extremely broad, from around 18 to 32, meaning that a woman of average height could weigh anywhere within an 80-pound range without seeing any statistically significant change in her risk of premature death" (p. 12).

Campos discusses the weight-health link in great detail because for many of the most aggressive "solutions" proposed for overweight people—drastic diets, diet drugs and weight-loss surgery—the potential risks are weighed against the risks of being overweight. Campos suggests that both the benefits of these interventions and the risk associated with being overweight have been exaggerated. Actually, Campos says, "the epidemiological evidence suggests that it is more dangerous to be 5 pounds ‘underweight' than 75 pounds ‘overweight'" (p. 39).

Campos also provides a good introduction to statistical concepts, like the difference between correlational relationships and cause-and-effect relationships, that are important to understand for people who want to be critical consumers of medical and government studies. Correlation means that two characteristics show a pattern of relationship. It can mean that one factor causes the other, or they could both have the same cause, or there could be other confounding factors that the researchers have not been able to factor out. Campos suggests that overweight may be just a marker for a sedentary lifestyle, which has been proven to have a negative effect on health in randomized studies.

He also points out that much of the weight-loss research is being conducted by people who have ties to the weight-loss industry. The more proof they can furnish of the dangers facing an overweight population, the more grant money and other funding is available to this industry. Science is not as objective as most people think. The researcher can exaggerate the results or at least choose which points to emphasize to make a particular case fit the desired outcome.

In parts two and three of his book, "Fat Culture," and "Fat Politics," Campos examines Americans' strange relationships with food and weight through a number of recent popular culture references, including Bill Clinton's affair with Monica Lewinsky and the strange phenomenon of thin celebrities like Gwenyth Paltrow using "fat suits" for comedic effect in movies like "Shallow Hal." He uses these anecdotes to discuss the complicated interactions of weight, social class, ethnicity, and morality. Campos suggests that in many ways the predominant attitudes toward weight in America resemble those of an anorexic, and that in fact, "we have now reached a point where the cultural ideal for women's bodies is barely distinguishable from the bodies of women diagnosed with full-blown anorexia nervosa" (p. 48).

Though there is a lot of really good information and food for thought in this book, Campos's tone is almost shrieking at times and can be a turnoff. He seems to completely discount the idea that, statistical risk factors aside, some individual people may have good reasons for wanting to lose weight and might use healthy strategies to do so with success. Campos is at his best when he suggests that readers pursue fitness, which is an attainable goal with proven health benefits, instead of pursuing thinness: "If you want to achieve a healthy weight, stop wanting to lose weight and start wanting those things—an active life, good food, and the calm enjoyment of both—that, unlike weight loss, are unalloyed goods in and of themselves. If you can manage to do this, you may well lose weight in the process; but far more important, you will get to a place where the weight you lose has been lost precisely because you no longer care, at some deep level of self-acceptance, whether you've lost weight or not" (p. 245). This is advice worth following, though the author admits he has not been able to get to that point yet himself.

Jennifer Sader is a freelance writer, part-time doctoral student and recreational athlete. She has completed several sprint and international distance triathlons and three half-marathons. Her next goal is to do the Columbus Marathon. She is supported in all her endeavors by her wonderful husband of ten years, Jesse Squire, who inspired her to do her first competitive event, a 5K run, at the ripe old age of 20. Email Jennifer Sader: jensader@yahoo.com

Photo: András