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Whatever happened to last year's breakout stars?
Disease: a disordered or incorrectly functioning organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity, or unfavorable environmental factors; illness; sickness; ailment.
“Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health,” according to both the Centers for Disease Control and the World Health Organization. “A crude population measure of obesity is the body mass index (BMI), a person’s weight (in kilograms) divided by the square of his or her height (in meters). A person with a BMI of 30 or more is generally considered obese. A person with a BMI equal to or more than 25 is considered overweight.”
So is obesity a disease?
All of a sudden, the American Medical Association thinks it is; the House of Delegates, the principal policy-making body of the AMA, recently voted to officially label obesity a disease. It is interesting to note that the “vote of the AMA House of Delegates went against the conclusions of the association’s Council on Science and Public Health, which had studied the issue over the last year,” according to the New York Times. “The council said that obesity should not be considered a disease mainly because the measure usually used to define obesity, the body mass index, is simplistic and flawed.”
The body mass index or BMI is categorized as follows:
Underweight BMI < 18.5
Normal or Ideal BMI 18.5 – < 25
Overweight BMI 25 – < 30
Obese – Grade 1 (or mild) BMI 30 – < 35
Obese – Grade 2 BMI 35 – < 40
Obese – Grade 3 (or morbid) BMI > 40
The BMI is indeed a poor measure of obesity. Because it does not take into account lean body mass such as muscle, it can overestimate obesity in certain ethnic groups while underestimating it in others. Many physically fit people, including actors and athletes with very low percentages of body fat, register as obese when judged solely by their BMI.
There are economic implications of the AMA’s decision. If everyone who has a BMI equal to or over 30 now has a disease, then doctors can get reimbursed to treat it as such. A disease that affects over one-third of the population will generate an expensive prescription to be filled. And everyone who is labeled “obese” will have a pre-existing condition, which can surely affect premiums.
But there is more at stake here than just the BMI or other obesity measures. Cardiologists are still grappling to understand a phenomenon known as the obesity paradox. In short, obesity is generally recognized as a risk factor for the development of cardiovascular disease. But many studies of patients with the disease have shown that the best survival rates occur not in the ideal body weight but in those groups that are either overweight or mildly obese—counter-intuitive, obviously, to the conventional wisdom. Dr. Carl Lavie, one of the first researchers to describe this phenomenon, has shown that the survival benefit is related to a greater percentage of body fat, not due to a misleading BMI.
And the paradox is growing. A recent meta-analysis of almost three million people around the world—one of the most comprehensive analyses to examine the relationship between mortality and BMI—found that the lowest mortality rates were not in the ideal BMI group. It was the overweight group that had the lowest mortality rate, with a statistically significant six percent reduction over the ideal group. In fact, the mortality rate of the ideal group was actually the same as the Grade 1 (or mildly obese) group. Grades 2 and 3 did show a significantly risk, but individuals in those groups represent a small fraction of the 67 percent of all Americans who are classified as either overweight or obese (though they are among the faster growing classifications). At some level of increasing weight, there is always going to be an increased risk of mortality, but where that boundary is is far from clear.
If, for argument’s sake, these study results are correct, what are the implications?
If we remove overweight and mildly obese persons from the classification of obesity (remember obesity is defined as an “abnormal or excessive fat accumulation that presents a risk to health”) there is no longer an obesity epidemic. But the incidence of diseases likes diabetes, arthritis, heart attacks, strokes, and certain cancers needs to be accounted for. Could an alternative hypothesis be that it is not simply the mass of food we ingest but the quality that makes the difference? That it is not absolute quantity but the value of what we eat which determines who we are? That it is consuming a diet based on fat and sugar substitutes, as well as too much prepared, processed, and preserved food-like substances that results in increased visceral adipose tissue (VAT) and other specific measures of fat deposition?
Perhaps the discussion about the foods we eat needs to be less about calories and more about content.
The star of “Beasts of the Southern Wild” charmed practically everyone at the Oscars, where she was the youngest best actress nominee ever; she went on to film a remake of “Annie” opposite Jamie Foxx and Cameron Diaz.
Carly Rae Jepsen
Jepsen, who had 2012’s song of the summer with “Call Me Maybe,” released the fifth and final single from her debut album in January 2013. She toured the U.S. in mid-2013 -- just as Daft Punk and Robin Thicke battled to succeed her as icons of the summer.
Honey Boo Boo
2012’s biggest reality star, the young pageant contestant Alana Thompson, had a quieter time this year, with a second season whose ratings were strong but whose buzz was a bit muted. America was, by now, accustomed to young Thompson, and outraged or scandalized reactions were reserved for other TLC programming, like “The Man With the 132-Pound Scrotum.”
Ocean missed out on the top Grammys for which he was nominated in early 2013; he bounced back quickly with featured appearances on albums by Kanye West, Jay Z and Beyoncé, and is at work on a new album. Things are looking up!
The “21 Jump Street” and “Magic Mike” star had a marginally less charmed 2013, with “White House Down” failing to connect with moviegoers and “Foxcatcher” delayed until next year. It may get worse before it gets better: His big 2014 sci-fi flick, “Jupiter Ascending,” looks … well, a little weird!
With their third album in 21 months hitting No. 1 immediately upon its fall 2013 release, the boy band that broke into America in 2012 would seem to be here to stay for a while. Still, they looked a bit nervous in their reaction shots during the Video Music Awards’ ‘N Sync reunion; maybe not this year, maybe not next, but eventually, the Justin of One Direction is going to break out. For now, though, things look good!
Lana Del Rey
The famously uncomfortable “Saturday Night Live” musical guest overcame endless mockery from 2012 to land her first top-10 hit in the summer of 2013 -- a remix of a year-old song, “Summertime Sadness.” As the co-writer of “Young and Beautiful,” the love theme from “The Great Gatsby,” Del Rey is such a front-runner for the best original song Oscar (last won by Adele) that there has been a direct-mail campaign to academy voters against her. The song was also played at the most romantic event of the year: Kanye West’s stadium marriage proposal to Kim Kardashian.
Wilson, who charmed fans of 2012’s “Pitch Perfect,” had a rockier 2013, with her sitcom “Super Fun Night” struggling creatively and in the ratings. Her next planned movies are both sequels, to “Kung Fu Panda” and -- hoping lightning will strike twice -- to “Pitch Perfect.”
Another 2012 music icon, Gotye won the record of the year trophy at the 2013 Grammys for “Somebody That I Used to Know.” He released no new singles in 2013, and has told the press he has been struggling to complete new material. Good luck, Gotye!
The golden boy of the 2012 Olympics, without feats of aquatic derring-do to distract the public this year, saw his always-tenuous persona completely shift from “amiable jock” into “utter dolt” with his E! reality series. Worst of all, the series was canceled.
In 2012, the young actress -- best known for her role in the indie “Winter’s Bone” and a supporting part in the “X-Men” franchise -- had marquee roles in the first “Hunger Games” film and in David O. Russell’s comedy “Silver Linings Playbook.” In 2013, she played to her strengths: After winning an Oscar, she starred in the second “Hunger Games” movie, on whose publicity tour she managed to charm everyone in America, and had another role in a David O. Russell comedy, “American Hustle,” for which she might just win ANOTHER Oscar. By 2014, she may end up running a major studio, or serving as president.
The breakout bikini model of 2012 made a repeat appearance on the cover of the Sports Illustrated swimsuit issue -- and got to do high-fashion spreads in Elle, Vogue and Vanity Fair. She was cast in a Cameron Diaz comedy, too. Some types of appeal are eternal!
E. L. James
The “50 Shades” novelist now gets to help share some input into a movie adaptation set for release in 2015. She probably never needs to work again! Isn’t that great? Isn’t that … just … great?
The “Gangnam Style” phenom performed at New Year’s 2013, but will spend New Year’s 2014 flipping channels to find his pistachio ad, his goofy antics having been outdone in the past year by “The Fox” singers Ylvis. Nothing meme can stay.
Pacific Standard is a bimonthly print and daily online magazine that highlights the best thinking in the social sciences, technology, health, and policy, and grounds those ideas in real stories—entertaining, accessible, urgent. We are of the West, but not strictly about the West.
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