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Higher BMI is healthier? NPR story makes well-documented ‘obesity paradox’ sound new

Rating

3 Star

Categories

Does Putting On A Few Pounds Help You Cheat Death?

Our Review Summary

BMIThis is a story looking at a data analysis of a large Danish health registry, in which researchers determined that the BMI (body-mass index) “associated with the lowest risk of death has increased … from 23.7, in the ‘normal’ weight category, to 27, which is deemed ‘overweight.'”

The story would have been much stronger if it had included that this type of finding is not new, and has been written about before and is known as the “obesity paradox.” This was an opportunity to rise above some of the criticisms leveled at journalists for simplified coverage on this topic.

 

Why This Matters

This matters because much of the world has been gaining weight in recent decades. How that might affect individuals’ likelihood of dying prematurely is important to many of us.

Criteria

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

While the benefits–increased survival–were discussed, they were quantified in a confusing way. For example, the story says that the risk of death for obese people, defined as having a BMI of at least 30, declined “to the point that it was on a par with some people of so-called ‘normal’ weight. So being fatter, at least a bit, may be healthier.”

It is hard to figure out what that means. It would have been more helpful if the story had quantified the death rates of the various groups discussed–that way readers would have a clearer sense of how likely it is that the extra weight will help you “cheat death.”

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The story did a good job describing why some people with low BMI might be at higher risk of dying– i.e., they may be suffering from cancer or another disease that could cause weight loss.

Does the story seem to grasp the quality of the evidence?

Satisfactory

We’re giving this rating a barely-passing Satisfactory. The story points out some limitations, but doesn’t get into the larger issue of this being an observational study.

And some of the language, including the headline, suggests that there could be a cause-and-effect relationship– something this type of study isn’t designed to prove.

It didn’t mention the many factors — beyond age, sex, smoking, cancer and heart disease — that could confound the relationship between BMI and mortality in this type of study. There was an extensive discussion of those factors the last time this type of research made the rounds, and the same concerns apply here.

Does the story commit disease-mongering?

Satisfactory

The story noted that the number of people who are overweight or obese has been increasing in many countries in recent decades–an assertion that can be backed up with data–and did not overstate the case.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

There were no apparent conflicts of interest. However, only one researcher was quoted, but nobody else independent of the work.

Does the story establish the true novelty of the approach?

Not Satisfactory

The biggest gap in this story is that it didn’t put this study in context with older studies raising the same issue. With no mention of past research, it makes it sound like a novel finding. But it’s not: On the JAMA study page, over on the right-hand side of the page are links to “related” research, including a large meta-analysis on the topic.

Does the story appear to rely solely or largely on a news release?

Satisfactory

The story does not appear to rely on a news release.

Total Score: 4 of 7 Satisfactory

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