nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
See here for more discussion.

Wednesday, March 16, 2011

Are Americans Getting Fatter Or Not?

Well, yes and no.  This is confusing.

My Just-Arrived-In-The-Mail issue of the New England Journal of Medicine has a commentary on what's going on with obesity in this country (not yet available online).

Consider the following quotations from that article:
"state-and national-level data from the 2009 Behavioral Risk Factor Surveillance System...showed increases between 2007 and 2009 in the reported prevalence of obesity among adults--a 1.1% increase nationally, or an additional 2.4 million or so obese adults."

"Results from the CDC's 2007-2008 National Health and Nutrition Examination Survey suggest that the prevalence of obesity among women (35.5%) and children 2 to 19 years of age (16.9%) has remained stable over the past 10 years and that the prevalence among men (32.2%) has not changed significantly since 2003."
You can see the confusion.  I've written before that maybe we've "peaked out" on weight gain in those who are susceptible, or that the obese are getting more obese, but those who are not susceptible are keeping weight gain in check...but it's just speculation. 

While the authors mention this, there are other likely explanations.  Some are methodological:  one set of results is from measurements (the second) and the other is from self-reporting (the first).  Self-reporting is frequently distorted, particularly if some opprobrium attaches to a positive self-assessment.  Some are congratulatory:  our efforts to reduce obesity are having some impact.  I don't believe it.

Apparently it's not in doubt that the obese are getting "up there."  The fraction of obese people who are grossly so--350 pounds and up--is growing.

We don't need to get distracted by seemingly contradictory data reporting.  The fact is, this is a critical public health problem and we don't have a good way to address it.  I've written that IMO, dietary laws are futile (here, here, and here).

From a preventive medicine specialist's perspective it's the most frustrating problem of all.  There's no pill to take (there are some, but I dispute the wisdom of these treatments), the surgeries work for only a while (same dispute with the wisdom).

And there ain't no vaccine.

Doc D

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