Medical Anthropology (ANG 6737)

A few weeks ago, we discussed a paper published in 2005 showing that people who are defined as overweight (BMI of 25-<30) actually have the lowest risk of mortality. Today, a new paper sheds more light on the association between BMI and mortality by looking at specific causes of death.

It turns out that people who are officially defined as overweight have a lower overall risk of mortality because they are less likely to die from diseases like Alzheimer’s, infections, and lung disease. At the same time, being overweight (but not obese) does not appear significantly to increase the risk of dying from cancer or heart disease.

In a New York Times story about this paper, several observers echoed some of our discussion in class:

Some who studied the relation between weight and health said the nation might want to reconsider what are ideal weights.

“If we use the criteria of mortality, then the term ‘overweight’ is a misnomer,” said Daniel McGee, professor of statistics at Florida State University.

“I believe the data,” said Dr. Elizabeth Barrett-Connor, a professor of family and preventive medicine at the University of California, San Diego. A body mass index of 25 to 30, the so-called overweight range, “may be optimal,” she said.

But as some of you suggested in class, mortality isn’t the only relevant outcome. Others argue that people who are overweight are more likely to develop heart disease, diabetes, and other conditions even if they are not more likely to die prematurely as a result.

On that note, another paper in today’s issue of JAMA examined self-reports of disability among people of varying weights at two points in time. They show that people defined as obese (BMI ? 30) are more likely to be disabled and that the disability gap between people in the obese and normal-weight categories has increased over time. But this finding appears to hold only for the obese category. People with BMIs in the range of 25-30—officially overweight—do not report higher levels of disability.

Causes of Death Are Linked to a Person’s Weight – New York Times

Via the Well blog at the New York Times, I just learned about the Illustrated BMI Categories Project on Flickr. As of today, the Flickr photoset includes photographs of 80 women, along with their height, weight, and BMI category, based on CDC guidelines (I haven’t verified the BMI calculations). Do the CDC categories fit your idea of who is overweight or obese? And what do you make of the fact that only women are featured in the photos?

Be sure to check out the comments on the original post at the Well blog, too. They give you a good sense of how people react to controversy over the meaning of BMI.

Yesterday we discussed the question that Wayt Gibbs posed in a recent issue of Scientific American: Is obesity an overblown epidemic? This question is also the focus of a three-part debate that took place last week in the Los Angeles Times. The LA Times pits Kelly D. Brownell, a professor of psychology and public health at Yale, against Paul F. Campos, a professor of law at the University of Colorado. Campos is featured in the Gibbs article you read, too.

This debate has also played out recently in the scholarly literature. For example, see the series of point and counterpoint articles in the February 2006 issue of the International Journal of Epidemiology. What do you make of this debate?

In class yesterday, you worked through the ways that medical anthropologists from different theoretical perspectives might approach the study of obesity. Some of you took on the role of ecological or evolutionary anthropologists; others became critical medical anthropologists; still others applied an interpretive perspective.

A recent story on NPR provides a perfect follow-up to our discussion. The story deals with the causes and consequences of dietary change on the Greek island of Crete over the last 60 years. There’s a lot to chew on (so to speak). What strikes you most about the story? How do the major theoretical perspectives we discussed apply to this case?