Medicine: Gauging the Fat of the Land

“Obesity is a killer. It is a killer just as smoking is,” says Dr. Jules Hirsch, chairman of a 14-member panel of doctors and nutritionists assembled last week by the National Institutes of Health. Hirsch warns that the public tends to regard obesity as “something more involved with appearance than with health.” But his panel, after reviewing mountains of research, concluded that being overweight presents “a very pervasive health hazard in many systems of the body.”

According to the panel, the hazards become significant at 20% or more above the “desirable weight,” as determined by averaging the values shown on the 1983 Metropolitan Life Insurance tables. By these standards, some 34 million American adults, or about 1 out of 5 people over age 19, are obese. Of these, 11 million qualify as “severely obese,” exceeding their desirable weights by 40% or more.

Studies have shown that obese people have three times the normal incidence of high blood pressure and diabetes, an increased risk of heart disease, a shorter life-span, and an unusually high risk of developing respiratory disorders, arthritis and certain types of cancer. A severely obese woman, for example, has five times the normal risk of developing cancer of the uterine lining and a heightened risk of breast and cervical cancers. Men who are significantly overweight have an increased chance of developing malignancies of the colon, rectum and prostate.

According to Hirsch, a professor at Rockefeller University, relatively small amounts of excess flab–“even 5 lbs.,” he says–can be dangerous, particularly to people already at risk for hypertension and diabetes. Oddly enough, the distribution of fat on the body seems to influence health. Studies have shown that people who carry their excess fat as a potbelly or “spare tire” are more apt to suffer from heart disease, stroke and diabetes than those who carry the same amount of flab around their hips and thighs. Why this is so remains a mystery.

Although the information reviewed by the panel has been previously reported, its message is a dramatic one, says Dr. George Blackburn, a leading nutritionist at Harvard’s Deaconess hospital. “Now we can stop fiddle- faddling around and see this for what it is,” he says. “Obesity is a disease.” Also significant, says Blackburn, is the panel’s concern with lesser degrees of overweight. In the past, he says, warnings have focused mainly on the 11 million Americans who are severely obese.

While the panel made no recommendations for follow-up action by the Government, Hirsch and other obesity experts say they would welcome a federal effort to educate the public about the risks of being overweight, similar perhaps to the Government’s ad campaign against smoking. What next? It may not be too farfetched to imagine a warning label on refrigerator doors and candy- bar wrappers: THE SURGEON GENERAL HAS DETERMINED THAT OBESITY IS DANGEROUS TO YOUR HEALTH.