Dear Media: No More Irresponsible Obesity Headlines, Please. Love, Jennifer

“Is it true I have a higher chance of dying if I lose weight?” my patient asked me. Why would she ask such a question? Does she really think it’s healthier to be overweight? No, she simply read the morning news headlines. The baffling headline in question was referencing a study that concluded that people who are overweight were less likely to die than those who were normal weight or underweight (as determined by body mass index, or BMI). Also of note, people who were severely obese were much more likely to die when compared to those other groups. Here it is, all your problems solved: You are actually healthier if you’re overweight!

News on obesity never ceases to capture the attention of Americans. Why are we overweight? What can we do about it, what can our government do? How can our tax dollars work to shrink this obesity epidemic? (What can help us lose our weight as easily as we’ve lost our 401Ks?) These are good questions to be asking. And we ask them a lot.

We discuss this with our peers and our co-workers to no end. We are deeply concerned about this, whether for our health, our looks, our self esteem, or our concern for the health of our country. Unless you’ve been living under a rock, you know that obesity is, in short, really freaking bad for your health.

So why, knowing this, does the study my patient was reading about conclude that being overweight protects against death, the ultimate finality? Well, we do know that unintentional weight loss in older adults is predictive of mortality – perhaps a bit of excess weight is protective for this reason. The authors of the study are also careful to note that they are not discussing co-morbidities, i.e., any other disease or condition that could affect quality of life while we’re still here, roaming the Earth.

Okay, so far, all this information is well and good. What kills me (pun intended) is the type of media coverage such a study generates. Take this headline, brought to you by Newsday, for example: “It Wouldn’t Kill You to Lose a Few Pounds – Or Would It?” Way to take harmless information and turn it into a public health issue. My guess is that this is the headline my patient happened across, right before our meeting about weight loss.

The New York Times initial coverage of this article was rather clear that being too obese was not a good thing. A subsequent article regarding the same study was not as clear, and what I would consider potentially damaging. The second article in question is essentially urging people to throw out their diets (bad idea: just ask these monkeys) and scales and embrace themselves as is. It gets a few brownie points for urging people to engage in regular exercise, but this information is placed in context of the overweight and mortality study, which is, after all, not the best motivator for people struggling with weight loss.

Psychologists who specialize in health are very familiar with what’s called the Health Belief Model. Basically, this theory states that people ask themselves a few questions before deciding to engage in a preventive behavior, a sort of risk-benefit analysis. They ask themselves if they are susceptible to a serious condition, about barriers to engaging in healthy behavior, and about how beneficial they perceive the behavior to be. It is easy to see why overweight people who engage in this very logical line of thinking would throw out the possibility of changing their diet or physical activity habits when presented with the limited information discussed in the articles above.

A protective association between obesity and tuberculosis (TB) was also recently reported on. (Previous link brought to you by the New York Times; click here for an example of less responsible reporting.) The study results are quite interesting, suggesting a connection between fatty tissue and immunity in some people, but I can already hear my patients’ thoughts (riddled with my own sarcastic undertones): “Sure, I’m at risk for diabetes, heart disease, cancer, and sleep apnea, but what the hell? No TB!”

Certainly, these protective associations may exist between different variables and being overweight on occasion, and this is interesting from a scientific standpoint. The thing that concerns me is that the lay reader is less likely to be a scientist, and more likely to be a person who has read or clicked on X headline because they themselves are overweight or obese, and thus have a personal interest in excess weight not killing them (“You mean it won’t kill me? Hallelujah! Let’s go to our favorite Brazilian steakhouse every night this year!”).

To be fair, these articles are not really attempting to communicate my ridiculous quotations. However it is my fear as a clinician that coverage of this type, geared toward the lay public, is one more contributory factor to an overweight, weight-obsessed society that is showing no signs of improvement. I know from experience that it is incredibly hard to sway people to change their daily behavior for the betterment of their health. My patients know from experience that it is incredibly difficult to lose weight, and their daily struggle with this can be compromised by unclear and inconsistent messages regarding overweight, obesity, and health. Considering the fact that obesity, still on the rise, is one of the largest health crises our nation faces today, I think we need to get on the same team here.

Photo by Nick J Webb

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