Ralph Reiland (“Cultural Revolutions,” August) find himself in the same camp as the AIDS activists in insisting that political philosophy dictate physiology. The AIDS activists say “AIDS is everyone’s disease” because they can’t stand the idea of a virus disproportionately affecting them. Reiland pooh-poohs mountains of evidence of obesity’s harmfulness (heavily documented in my book The Fat of the Land) because he’s afraid it will be used to implement public policy he doesn’t care for.

For more than a century, insurance actuaries have noted that, on the whole, the fatter you are, the more often you’ll be sick and the sooner you’ll die. They adjusted their premiums accordingly. And in recent decades, epidemiologists have quantified what the actuaries have always known. The new government standard considers unhealthy a body mass index (BMI) of 25 or above. (BiMI is your weight in pounds multiplied by 705, divided by your height in inches and again by your height in inches.) Studies in the United States and throughout the world have shown BMIs above 25 to correlate with premature heart attacks, stroke, cancer, diabetes, myriad other illnesses, and overall premature death. Over half of Americans have a BMI above 25.

Consider the three largest American obesity studies of the 1990’s. The largest, released in January and comprising over 300,000 men and women, found that longest life was associated with the leanest bodies, specifically with a BMI between 19 and 22. Thirty- to 44-year-old men averaging six feet tall who were just 39 pounds overweight (a BMI of 25.3) increased their relative chance of death by 50 percent. The second-largest study, of female nurses, found a slight correlation between premature death and higher BMIs at less than 25, and the correlation increased appreciably at 25. The third-largest, of Harvard male alumni, found that the thinnest one-fifth lived the longest. Their average BMI was 22.5.

William Castelli, former director of the longest-running study of men’s health, the Framingham Heart Study, put it bluntly: “The lower your weight, the better off you are.” (Obviously this excludes starvation or anorexia, but this would be a BMI of well below 17.)

If Reiland had bothered to read my book instead of just attacking it, he would know that it deals with the lone source he cites to make his case, Glenn A. Gaesser, at great length. Gaesser, who is the first to admit that his findings are out of sync with those of the top obesity researchers in the country, is a major proponent of the “fat but fit” philosophy. But while it’s true that a 350-pound woman who walks a mile a day is better off than one who doesn’t, there is no substitute for weight loss.

This was shown in a study published in the December 27, 1995, Journal of the American Medical Association. One group of men pursued a moderate nine month weight loss regimen, eventually losing an average of 21 pounds; another group remained obese but engaged in regular aerobic exercise. In nearly even,’ measured risk factor for heart disease, the benefits of weight loss outweighed those of exercise.

But what of those obese persons who proclaim on the basis of a few blood tests that they are in fine health? Gaesser writes of “Lucy” who, though 206 pounds at only five feet, five inches, “has excellent levels of cholesterol, blood sugar, and blood pressure.”

The trouble is that Lucy is only 30. Give a few medical tests to a four-pack-a-day smoker at the same age and you can expect her to pass with flying colors, too. Just as almost nobody dies of lung cancer at 30, almost nobody dies from obesity at such a young age. It’s only after menopause, which usually takes place around the late 40’s or early 50’s, that a woman’s risk of dying of heart disease starts to go up. Let’s see how Lucy is doing when she’s up to 300 pounds at age 50. We might have to visit her at the cemetery.

Even Gaesser admits that excess weight is deadly. He states, for example, that abdominal fat appears to be responsible for “such killers as heart disease, cancer, and diabetes.” But anyone who’s extremely fat carries a large portion of it in the abdominal area; men in general can) most of their fat in the abdominal area, and so do many post-menopausal women. Gaesser is essentially saying that bullets are harmless—so long as they don’t strike you.

The evidence is incontrovertible. More fat equals shorter life and more illness. There’s plenty of room to argue about what should be done to curtail the obesity epidemic, but it is very real and very deadly.

        —Michael Fumento
Arlington, VA