WASHINGTON, DC - New England Journal of Medicine (NEJM) editors Jerome Kassirer and Marcia Angell were commended today by The Advancement of Sound Science Coalition (TASSC) for their scientifically sound, but controversial stance concerning a recent study on obesity and mortality published in the January 1, 1998 NEJM. The editors came under heavy criticism from some in the public health community for saying in an accompanying editorial that obesity is overemphasized as a public health problem.
Kassirer and Angell were particularly criticized for stating "although some claim that every year 300,000 deaths in the United States are caused by obesity, that figure is by no means well established. Not only is it derived from weak or incomplete data, but it is also called into question by the methodologic difficulties of determining which of many factors contribute to premature death."
"Drs. Kassirer and Angell are right. ‘Body counts' such as the 300,000 figure are classic junk science," said Steven Milloy, a biostatistician and executive director of TASSC. "Anyone who has taken first-year medical statistics knows the formula for "attributable risk" -- how the 300,000 number is calculated -- is not designed to determine how many people die each year from specific factors.
Compounding the formula's design shortcomings are data that come from epidemiologic studies reporting weak and unreliable statistical associations, such as increases in risk of less than 100 percent according to the National Cancer Institute. The new obesity study reported 100 percent or greater increases in mortality only in those that were overweight by 100 pounds or more. This leaves the vast majority of the association between obesity and mortality uncertain.
Second, mortality is a complex event. It is rarely attributable to one factor alone, such as being overweight. For example, obese people also tend to be sedentary, have poor diets, and less active social lives -- all significant risk factors for mortality.
In contrast to artificial body counts based on the attributable risk formula, 150,000 people die every year from traumatic injury. But this toll is based on counting actual fatalities, not from misuse of statistics.
Kassirer and Angell were particularly courageous for stating "a second reason for the medical campaign against obesity may have to do with a tendency to medicalize behavior we do not approve of."
"It is for this reason the body count fallacy often is used today, " said Milloy. "From predicting 8 million deaths over the next 20 years from global warming, to 40,000 annual deaths from indoor radon to 15,000 annual deaths from particulate air pollution, some in the public health community are trying to change politically incorrect behavior by creating scientifically unfounded epidemics of sole-source deaths," said Milloy.
"I'm glad to see the NEJM editors stand up for sound science just like they did when they took on the personal injury lawyers in the silicone breast implant controversy," said Milloy. . TASSC is a not-for-profit organization of scientists, former public policy officials and private citizens interested in the use of sound science in public policy. TASSC is located at 1155 Connecticut Avenue, N.W., Suite 300, Washington, D.C. 20036. TASSC is also on the Internet at http://www.tassc.org and http://www.junkscience.com.
For more information contact: Steven J. Milloy, Executive Director, The Advancement of Sound Science Coalition, 1155 Connecticut Ave., N.W., Suite 300 Washington, D.C. 20036 Telephone: (202) 467-8586. Fax: (202) 467-0768 E-mail: milloy@cais.com
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