Cut The Fat, Ctd

A reader writes:

Campos is off-base. If changes in diet and exercise have benefits even if there is no weight loss, is that an argument against trying to achieve weight loss? Of course not.

One of the studies he cites about interventions to achieve weight loss clearly documented that the children did not decrease caloric intake. Is it a surprise that they did not lose weight? The increase in obesity rates is leveling off. So obesity is not a problem? Weight nomograms are arbitrary? No kidding, it is a nomogram. The issue is that more children are now overweight/obese by those nomograms than they were 20-30 years ago.

I have cared for multiple obese 19-25 year olds with type-2 diabetes and BMIs > 45. My gray-haired attendings at the county hospital where I trained used to say they had never seen that many before. The data back that up. Remember that even if these obese patients do not develop type-2 diabetes during their childhood, fat children usually grow up into fat adults ... who then get diabetes (there are data to support that). Walk through any medical ICU and count the percentage of patients with outright obesity, or extreme obesity. It is a stunning exercise. Especially when you consider that some of the thin patients are thin due to their underlying disease (cancer, cardiac cachexia).

Campos' hobbyhorse is pushing back against the anti-obesity crowd. Skepticism is good, and some pushback against "crisis" thinking and panic is probably a good idea. But the case for picking on the Obama's effort reduce childhood obesity – as if teaching good health habits is going to cause eating disorders and make people feel bad – is just weak.