Diabetes to Blame for Obesity Deaths
Weight Alone Doesn't Increase Risk, Study Shows
The new findings are not likely to end the medical debate about whether obesity is a direct or indirect cause of early death.
The issue made headlines a year ago last spring, when CDC researchers reported that the risk of obesity-related death was much lower than had been previously believed.
Researchers also reported no increase in death risk among people who were overweight but not obese.
The report was widely criticized, and a reanalysis of the same data by researchers from the Harvard School of Public Health showed a strong association between obesity and early mortality.
Just last month, two new studies were published which seemed to further confuse the issue.
In one, researchers from the Mayo Clinic concluded that obesity, as measured by BMI, was a poor predictor of death from heart diseaseheart disease.
The other, conducted by researchers from the National Cancer Institute, suggested that being even slightly overweight in middle age is a risk factor for early death.
Cardiologist Richard A. Stein, MD, says the new study may give physicians a more nuanced understanding of the role of obesity and obesity-related conditions like diabetesdiabetes in early death.
Stein is director of cardiology at Beth Israel Medical Center in New York City. He is also a spokesman for the American Heart Association.
"It has become a mantra in the U.S. that being overweight will kill you," he tells WebMD. "This study suggests that it is not obesity per se, but the company it keeps that is to blame."
The distinction is important, he says, because even if someone can't manage to lose weight they can take steps to keep obesity-related diseases under control.
"Telling an overweight person that they either need to lose weight or they will die is the wrong message," he says. "There is increasing evidence that aggressively treating diabetes and other risk factors that go along with obesity, like cholesterol and high blood pressurehigh blood pressure, is even more important than losing weight."
But JoAnn Manson, MD, of the Harvard School of Public Health in Boston, doesn't buy the idea that diabetes alone is responsible for the increased risk of early death in people who are obese. Manson led the team which reanalyzed the CDC data.
She tells WebMD that there is plenty of good evidence implicating obesity in death from cardiovascular disease and several types of cancer, as well as diabetes.
"There are clearly pathways through which obesity increases the risk of death that do not involve type 2 diabetes," she says.