The epidemiology of overweight and obesity: public health crisis or moral panic?
The epidemiology of overweight and obesity: public health crisis or moral panic?
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DOI：
10.1093/ije/dyi254
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发表时间：
2006-02-01
影响因子：
7.7
通讯作者：
Gaesser, G
中科院分区：
文献类型：
--
作者：
Campos, P;Saguy, A;Gaesser, G
国家和国际卫生组织越来越关注一种被认为对公众健康构成严重威胁的肥胖流行病。事实上，一些医学专家甚至预测，不断增长的体重将停止甚至逆转人类预期寿命持续了数千年的增长趋势。为了应对这些担忧，世界各地的公共卫生机构纷纷采取行动，寻找政策或激励措施来减轻所谓的肥胖“疾病”。然而，即使警报越来越响，越来越多来自广泛学科的研究人员也对这些说法提出了质疑。本文的作者来自后者。在我们看来，现有的科学数据既不支持关于肥胖的危言耸听的说法，也不证明从更紧迫的公共卫生问题上转移稀缺资源是合理的。本文评估了那些呼吁加强对脂肪战争的人提出的四个主要主张：肥胖是一种流行病；超重和肥胖是导致死亡的主要因素；高于平均水平的肥胖是病理性的，是疾病的主要直接原因；这种显著的长期减肥在医学上是有益的，也是一个实际的目标。鉴于这些说法的科学证据有限，我们认为，目前关于肥胖导致健康危机的言论更多地是由文化和政治因素驱动的，而不是体重增加可能对公众健康构成的威胁。
National and international health organizations have focused increasingly on a perceived obesity epidemic said to pose drastic threats to public health. Indeed, some medical experts have gone so far as to predict that growing body mass will halt and perhaps even reverse the millennia-long trend of rising human life expectancy. 1 In response to such concerns public health agencies across the world have sprung into action, searching for policies or incentives to mitigate the alleged ‘disease’of obesity. Yet even as the volume of alarm grows louder, a growing number of researchers, drawn from a broad array of academic disciplines, are calling these claims into question. The authors of this article come from this latter group. In our view the available scientific data neither support alarmist claims about obesity nor justify diverting scarce resources away from far more pressing public health issues. This article evaluates four central claims made by those who are calling for intensifying the war on fat: that obesity is an epidemic; that overweight and obesity are major contributors to mortality; that higher than average adiposity is pathological and a primary direct cause of disease; and that significant long-term weight loss is both medically beneficial and a practical goal. Given the limited scientific evidence for any of these claims, we suggest that the current rhetoric about an obesity-driven health crisis is being driven more by cultural and political factors than by any threat increasing body weight may pose to public health.