NYTimes: The Fat Epidemic: He Says It's an Illusion

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>

> The Fat Epidemic: He Says It's an Illusion

> By GINA KOLATA

>

>

> Ask anyone: Americans are getting fatter and fatter. Advertising

> campaigns say they are. So do federal officials and the scientists they

> rely on.

>

> But Dr. Friedman, an obesity researcher at Rockefeller

> University, argues that contrary to popular opinion, national data do

> not show Americans growing uniformly fatter.

>

> Instead, he says, the statistics demonstrate clearly that while the

> very fat are getting fatter, thinner people have remained pretty much

> the same.

>

> Let it be said that Dr. Friedman, a Medical Institute

> investigator and the discoverer of the gene for leptin, a hormone

> released by fat cells, is not fat. He is tall and gangly, with the

> rumpled look of an academic scientist.

>

> As an obesity researcher, he might be expected to endorse the

> prevailing view that obesity in this country is out of control. But Dr.

> Friedman said he was outraged by the acceptance of what he sees as a

> hurtful myth, one that encourages people to believe that if you are

> fat, it is your fault.

>

> The obesity arena " is so political, so rife with misinformation and

> disinformation, " he said.

>

> Dr. Friedman points to careful statistical analyses of the changes in

> Americans' body weights from 1991 to today by Dr. Flegal of

> the National Center for Health Statistics. At the lower end of the

> weight distribution, nothing has changed, not even by a few pounds. As

> you move up the scale, a few additional pounds start to show up, but

> even at midrange, people today are just 6 or 7 pounds heavier than they

> were in 1991. Only with the massively obese, the very top of the

> distribution, is there a substantial increase in weight, about 25 to 30

> pounds, Dr. Flegal reported.

>

> As a result, the curve of body weight has been pulled slightly to the

> right, with more people shifting up a few pounds to cross the line that

> experts use to divide normal from obese. In 1991, 23 percent of

> Americans fell into the obese category; now 31 percent do, a more than

> 30 percent increase. But the average weight of the population has

> increased by just 7 to 10 pounds since 1991.

>

> Dr. Friedman gave an analogy: " Imagine the average I.Q. was 100 and

> that 5 percent of the population had an I.Q. of 140 or greater and were

> considered to be geniuses. Now let's say that education improves and

> the average I.Q. increases to 107 and 10 percent of the population has

> an I.Q. of above 140.

>

> " You could present the data in two ways, " he said. " You could say that

> the average I.Q. is up seven points or you could say that because of

> improved education the number of geniuses has doubled. "

>

> He added, " The whole obesity debate is equivalent to drawing

> conclusions about national education programs by saying that the number

> of geniuses has doubled. "

>

> Not everyone agrees.

>

> " It' s one thing to talk about statistics and another to talk about

> what's happening to individuals, " said Dr. n Nestle, a professor

> of nutrition, food studies and public health at New York University.

> " Everyone notices that there are more overweight people now. "

>

> Dr. Friedman, however, begs to differ. The statistics let scientists

> get beyond impressions and focus on the evidence.

>

> He is, in a way, an unexpected figure to insert himself into the

> highly charged politics of obesity. He left clinical medicine in 1980

> after discovering that his true passion was the laboratory. By 1981, he

> had begun his scientific career, and within a few years he was taking

> on what seemed like an impossibly onerous task, finding a gene whose

> absence made mice grow massively obese.

>

> He keeps mementos from those days. He still has the purchase order,

> from December 1986, for the first batch of mice he used for the

> experiment. Hanging on his office wall is a framed strip of white paper

> with black blotches, the data that on Sunday morning, May 8, 1994,

> revealed he had found the gene that he named leptin.

>

> " To me, those data are as beautiful as the Mona , " he said.

>

> Over the years, Dr. Friedman says, he has watched the scientific data

> accumulate to show that body weight, in animals and humans, is not

> under conscious control. Body weight, he says, is genetically

> determined, as tightly regulated as height. Genes control not only how

> much you eat but also the metabolic rate at which you burn food. When

> it comes to eating, free will is an illusion.

>

> " People can exert a level of control over their weight within a 10-,

> perhaps a 15-pound range, " Dr. Friedman said. But expecting an obese

> person to decide to simply eat less and exercise more to get below the

> obesity range, below the overweight range? It virtually never happens,

> he said. Any weight that is lost almost invariably comes right back.

>

> The same goes for gaining weight in general, Dr. Friedman argued. A

> person who has the genes to be thin is not going to get fat because

> portion sizes increase. It makes no scientific sense, he said.

>

> But isn't it true that we can decide to eat or not, choosing to skip

> dinner, say, or pass up dessert? Isn't that free will? Not really, Dr.

> Friedman said. The control mechanisms for body weight operate over

> months, even years, not day to day or meal to meal.

>

> " People live in the moment, " he said. " They lose weight over the short

> term and say that they have exercised willpower, " but over the long

> term, the body's intrinsic controls win out. And just as willpower

> cannot make fat people thin, a lack of it does not make thin people

> fat.

>

> No one, he says, can consciously calibrate their food intake as

> precisely as the body does naturally. Most people's weights remain

> steady, within about 10 pounds, year in and year out. But when people

> count calories, they typically err by about 10 percent. For someone who

> eats 750,000 calories in a year, that 10 percent error would add up to

> 75,000 calories, or about 25 pounds.

>

> Obesity, Dr. Friedman says, is a problem; fat people are derided and

> they have health risks like diabetes and heart disease. But it does no

> one any good to exaggerate the extent of obesity or to blame the obese

> for being fat.

>

> " Before calling it an epidemic, people really need to understand what

> the numbers do and don't say, " he said.

>

>