Active Voice: Obesity in America – Don’t Believe Everything You Read

By Russell R. Pate, Ph.D., FACSM

Viewpoints presented in SMB commentaries reflect opinions of the authors and do not necessarily reflect positions or policies of ACSM.

Russell R. Pate, Ph.D., FACSM, is professor and director of the Children’s Physical Activity Research Group and a faculty member in the Department of Exercise Science, Arnold School of Public Health, the University of South Carolina, Columbia, SC. During his long career at USC, he has held several administrative positions including department chair and vice provost for health sciences. Russ is a past president of ACSM. In 2013, he received ACSM’s Honor Award for his exceptional scientific achievements relating to physical activity interventions for children and adolescents. Dr. Pate has published more than 270 scholarly articles and his research has been supported by the National Institutes of Health, the U.S. Centers for Disease Control and Prevention, the American Heart Association and others. Currently, he chairs the Coordinating Committee of the U.S. National Physical Activity Plan.

Unless you’ve been living under a rock for the last decade, you are almost certainly aware that the United States is in the midst of an “obesity epidemic.” You are probably concerned about this issue, probably believe it is an important public health challenge, and probably believe that our society needs to make some profound changes in order to solve this problem. But have you stopped to ask yourself why you believe whatever you believe about obesity in America? Have you thought about where you accessed the information that prompted you to adopt your beliefs?

A recently released government report and the accompanying news coverage provide an interesting case study in how information about obesity is communicated to the public by the mass media. In the February 26, 2014 issue of JAMA, Cynthia Ogden and colleagues with the National Center for Health Statistics, reported on the latest national survey of obesity rates in the U.S. Following is the statement that was published as the Conclusion and Relevance section of the abstract: “Overall, there have been no significant changes in obesity prevalence in youth or adults between 2003-2004 and 2011-2012. Obesity prevalence remains high and thus it is important to continue surveillance.” Interestingly, the following headline was published by The New York Times in its front page coverage of the Ogden report on February 25, 2014: “Obesity Rate for Young Children Plummets 43% in a Decade.” Hmmmmm.

So before going further, let me say that I am both a fan and subscriber of The New York Times. That said, I find The Times’ coverage of the latest obesity statistics to be at least disappointing and at worst troubling. Is The Times’ headline technically accurate? Yes, it is. As reported in the JAMA article, for 2-to-5-year-olds the prevalence of obesity in 2003-4 was 13.9% and in 2011-12 it was 8.4%, and that difference was found to be statistically significant. But does the headline send an accurate message about obesity in America? The same JAMA article also reported that, in those 60 years of age and up, the obesity rate increased from 31.0% in 2003-4 to 35.4%, a statistically significant increase of 14%.

Why did a decrease in the prevalence rate of 5.5% in preschool-age children make the front page of The New York Times, whereas the increased prevalence of 4.4% in those over 60 went essentially unmentioned? Though the changes were not statistically significant for most age groups, why was it largely overlooked that absolute obesity rates increased in every age group from 12 years and up? I guess that only the editors of The New York Times can explain that. But I suspect the decision to “cherry-pick” the only positive finding in the survey was fundamentally about attracting readers. There are more cynical interpretations, but I won’t go there.

My research group has been working with preschools and preschool-age children for over a decade, and I have participated in developing several sets of policy recommendations aimed at preventing obesity in young children. So I will be thrilled if it turns out that we have made real progress in preventing obesity in young children. But the evidence suggests that, considering the entire population, very limited progress has been made. We can legitimately celebrate the positive developments that come along, but I hope the media don’t declare victory until the data are forthcoming to support such a declaration.