There is a huge disconnect between health factors that research suggests are most important, and health factors that get the most media and policy attention. A new RWJF working paper suggests that the press overemphasizes obesity to satisfy reader demands:
News reports on the "obesity epidemic" have exploded in recent years, eclipsing coverage of other health issues including smoking. … Anyone with a Body Mass Index (BMI, weight in kilos divided by height in meters squared) over 25 is deemed "overweight." … Almost 2/3 of the U.S. population today weighs "too much" today by these standards. Recently, several researchers have argued that, for the overwhelming majority of people, weight is a poor predictor of health and should be less of a public health focus. A recent study by scientists at the Center for Disease Control and Prevention (CDC) suggests that it is only after BMI reaches 35 that there is a meaningful increase in mortality, that people in the "overweight" category actually had the lowest rate of mortality. Still, such skeptical voices remain a minority perspective in public discussion of obesity. …
This paper exploited a unique sample of: 1) scientific articles on weight and health; 2) press releases on those studies; and 3) and news reports on those same studies … We found that … the news media’s tendency to report more heavily on the most alarmist and individual-blaming scientific studies, and not simply how they frame individual stories, partly explains how the news dramatize and individualize science. … These findings support the contention that scientists work as "parajournalists" writing their stories and especially the abstract with journalists in mind. They then frame their research via press releases and interviews with journalists. A reward structure in which, all things being equal, alarmist studies are more likely to be covered in the media may make scientists even more prone to presenting their findings in the most dramatic light possible.
The press/policy overemphasis of obesity is probably small compared to the overemphasis of medical care. In general it is very hard for the press and academic system to tell the public anything much different from what the public expects and wants to hear.
I think that the condemnation of fat is about aesthetics more than health concerns. Fat is ugly and so people want others to loose weight. I also think that aesthetics is why people turned in smoking, it stinks.
The methodology involves coding the articles based on thewords present in the text. This leads to the conclusion onpage 19 that
Our analyses suggest that the news media tend todramatize the risks of obesity by using, more than thescience on which they are reporting, words like"epidemic" and "war" and by blurring the lines betweenweight categories, giving an impression that thepopulation is heavier than it is.
However on the next page the authors note that
The 1999 JAMA issue and news reporting on that issueoverwhelmingly represented overwieght and obesity as acrisis, at 70% and 72% respectively. This framing wasless prevalent in the 2003 special issue and newsreporting on that issue, at 40% and 34%respectively. This does not mean that the 2003 articlestended to /counter/ claims that obesity was acrisis. Rather, compared to 1999, they were more likelyto take them for granted so that they did not need to bemade explicit.
What do I think this means? My understanding is that in 1999scientists wrote sentences like "Our treatment targets thecurrent epidemic of obesity...". In 2003 they wrote the samekind of thing in their first draft, but when it came to thestage of squeezing their articles to fit within the pagelimits, they thought "We can drop references to the epidemicbecause we are writing for our colleagues who read the 1999special issue and already know that their is an epidemic ofobesity.". So in 2003 the final version reads "Our treatmentfor obesity ...".
Meanwhile journalists are writing for a lay audience thatis only vaguely aware of the 1999 JAMA special issue onobesity and only vaguely aware that there is an epidemic. Sothe journalist knows that the JAMA authors took out the wordepidemic because /their/ audience didn't need it, and thejournalist correctly puts the missing word back in because/his/ audience needs it fully spelled out.
The methodology codes the actual texts of the articles, soit detects dramatization in the news papers, because thenews paper text contains the word "epidemic" when theoriginal article did not.
The article destroys its own methodology when it claims thatthe authors of the JAMA articles /meant/ "epidemic" but hadno need to actually use the word in their text to conveythis to their audience. The article says that you have toread between the lines but its methodology doesn't codebetween the lines.