"Rising obesity will cost U.S. health care $344 billion a year"
is the eye catching title of an article of USA TODAY, of November 16, 2009, where Nancy Hellmich writes that <a study released in July 2009 showed that obese Americans cost the country about $147 billion in weight-related medical bills in 2008, and that it will cost the USA about $344 billion in medical-related expenses by 2018>.
Let me open a parenthesis to see what they say about the cost of smokers.

The Berkeleyan, a newspaper for faculty and staff at the University of California, Berkeley, on September 16, 2008, reported that <the total cost of caring for people with health problems caused by cigarette smoking — counting all sources of medical payments — is about $72.7 billion per year, according to health economists at the University of California>.

Now, I am by no means a genius in calculation, but I think that any housewife would come up saying that a smoker costs to the country (almost) exactly one half than the obese. In fact, considering that nicotine curbs the appetite (see what happens to the waist-line of the majority of people who stop smoking), the US Treasury department should become a fan for smokers!

Let’s put aside the sarcasm and see what Nancy Hellmich states in the contest of the above article, when she puts together smoking and obesity: <Overall, the United States spends about $1.8 trillion a year in medical costs associated with chronic diseases such as diabetes, heart disease and cancer, and all three are linked to smoking and obesity, the nation’s two largest risk factors, according to the America’s Health Rankings report>.

Again, I am a failure with calculations, but isn’t it true that the sum of $147 billion plus $72.7 billion, respectively the costs of obesity and smoking, are very far from $1.8 trillion? Sorry, I slipped again into irony. Let’s get serious

Before introducing a countercurrent article, I would like to remind you the scaremongering campaign that has been going on about the epidemic of overweight and obesity which, for years, has been afflicting the United States and that, slowly but surely, is spreading though Europe. Already in January 2003, Dr. Richard Carmona, Surgeon General, called obesity the fastest growing cause of illness and death in the United States and said it deserved more attention than any other epidemic. On March 2006, he also stated: "Unless we do something about it, the magnitude of the dilemma will dwarf 9-11 or any other terrorist attempt".
Despite those alarming statements, the Journal of the American College of Cardiology (JACC) was not satisfied and, on January 1, 2007, put the cherry on the cake publishing a manuscript by Dr. Arthur Garson, in which it is said: <For the first time since the Civil War, American life expectancy is projected to decrease, owing to the diseases associated with obesity such as diabetes, ultimately causing cardiovascular death>. Garson also said: <It is abundantly clear that in short order, obesity will kill more people than smoking>.

I guess the smokers should be grateful to the Surgeon General and the American College of Cardiology for not having paralleled them to Al Qaeda’s followers, at par with the fat slobs!….

The article I hinted at above comes from Medscape CME (Continuing Medical Education). For the benefit of those not versed in medical matters, Medscape is a web site for physicians, which provides peer-reviewed medical journal articles. Its articles are <intended for primary care clinicians, cardiologists, nutritionists, and other specialists who care for patients … and its goals are to provide medical news to primary care clinicians and other healthcare professionals in order to enhance patient care>.

So much for the carte de visite of Medscape. Now the article that could be considered a scoop.
It was published on June 5, 2009 and it was titled "Obesity Paradox Probed in New Review", by Dr. Carl J. Lavie et al., of the Ochsner Medical Center, New Orleans, LA. . The review appeared in the May 26, 2009 issue of the same JACC that for years, along with the SG, has been persecuting the obese ‘terrorists’.

<According to Dr. Laurie Barclay, author of the Medscape’s scoop, Dr. Lavie said that:
• There is solid evidence to suggest that being overweight or obese may improve survival, not just in heart failure, but also in diseases like hypertension, coronary artery disease, and peripheral artery disease.
• While people who are obese do have more hypertension, five papers spanning almost 20 years also point to the fact that obese people with hypertension seem to have lower mortality and/or lower stroke risk, despite less effective blood-pressure control, than do normal-weight people.
• There is also literature to suggest that overweight and obese coronary heart disease patients have a lower risk for mortality compared with under- and normal-weight coronary heart disease patients who have undergone re-vascularization procedures.
• We know that fat cells do a lot of bad things, but it’s certainly conceivable that in advanced disease, the fat cell could have some beneficial effects.

Reasons for the obesity paradox, or the unexpectedly better prognosis of obese vs. nonobese patients with established cardiovascular diseases, are unclear>.

This revolutionary study, apparently, is not the first and only one, but, perhaps, it is the only one that has risen to the honors of the press. As a matter of fact, Dr. Lavie said: <When people were finding this in their data, five and six years ago, they probably had some trouble getting their papers published, because it didn’t make any sense>.

Personally, I suspect that those researchers, who in the past reached the same conclusions as Dr. Lavie, did not even try to publish their results because they were contrary to the ongoing propaganda, against the ongoing credo, and they did not want to endure the same criticism/ostracism and censorship that James E. Enstrom and Geoffrey C. Kabat had to go through when they published their countercurrent results on environmental tobacco smoke.


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