Smoking Out the Truth

On Tuesday, the Wall Street Journal’s Betsy McKay reported (subscription required) that obesity isn’t the national epidemic that the federal government had previously claimed.

Last March, researchers at the federal Centers for Disease Control and Prevention (CDC) published the results of a study that concluded obesity caused 400,000 deaths in 2000, a whopping increase of 100,000 deaths from just a decade before. That increase meant that obesity was about to overtake tobacco as the leading cause of preventable deaths. And it triggered a highly publicized educational campaign on the risks of being overweight.

McKay reported that mathematical errors by the CDC may have inflated the death toll by about 80,000 fatalities. If so, the increase in the number of deaths between 1990 and 2000 would amount to less than 10 percent. Revising the numbers downward (to reflect an accurate death toll), however, would still keep obesity as number two, with alcohol consumption a distant third.

The Journal story and CDC’s response were reported widely today. The stories described the internal investigation launched to determine how the errors were made, and how early warnings about the study’s flaws were ignored within the CDC.

Readers of the New York Times today, however, were treated not only to a detailed look at the flawed obesity study, but also a fascinating explanation of its political implications.

Veteran health reporter Gina Kolata wrote: “[B]eneath the dispute lies a truth about science and its uses in an age of limited resources.”

If obesity is a leading cause of death, more money should be spent to try to prevent it, and to treat it. Insurers should pay for diet programs or weight-loss surgery. If it is not so deadly, some fear, the impetus to pay for such things might vanish.

On the other hand, the more money that goes to fighting obesity, the less will be available for other programs, like antitobacco ones.

“The tobacco people are afraid that it’s a zero sum game,” said Dr. Eric Oliver, a political scientist at the University of Chicago who is writing a book on the politics of obesity. “If obesity gets declared Public Enemy No. 1, it’s going to come at their expense.”

Among the loudest critics of the CDC study are those whose research is tied to or supported by anti-smoking groups, Kolata notes:

“The kind of policies one would develop for something that is killing about as many people as tobacco or a quarter as many people as tobacco are very different,” said Dr. Stanton A. Glantz, professor of medicine and director of the Center for Tobacco Control Research and Education at the University of California, San Francisco.

Dr. Glantz estimates that the number of deaths from obesity to be more like 100,000 than 400,000. … “This is not some esoteric little detail over which there is huge uncertainty,” he said.

Unfortunately, Kolata fails to explain Dr. Glantz’ ties to the tobacco industry. According to its website, the Center for Tobacco Control and Research Education works closely with the Legacy Tobacco Documents Library, which is underwritten in part by the American Legacy Foundation. The foundation was established in 1999 as part of a settlement between 46 states, five territories and the tobacco industry and “develops national programs that address the health effects of tobacco use.”

Kolata owes it to her readers to fully disclose the connection and let readers decide for themselves any underlying motivations on the part of Dr. Glantz.

Despite that oversight, Kolata delivered a commendable report, deftly weaving together two subjects increasingly intertwined these days: Science and politics.

Susan Q. Stranahan

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Susan Q. Stranahan wrote for CJR.