Katherine Flegal, PhD: The Obesity Wars and the Politicization of Science

The External Medicine Podcast

In this interview, Mitch Belkin and Daniel Belkin speak with Katherine Flegal about the relationship between BMI and excess mortality. Dr. Flegal's publication of two papers in JAMA led to substantial controversy among obesity researchers. They discuss the data regarding the U-shaped mortality curve, the history of BMI, as well as the politicization of science.

Who is Katherine Flegal?

Katherine Flegal is an epidemiologist and former senior scientist at the CDC's National Center for Health Statistics. She is one of the most cited scientists in the field of obesity epidemiology. After receiving a bachelor's from UC Berkley, a PhD from Cornell, and an MPH from Pittsburgh, she worked in the biostatistics department of University of Michigan prior to working at the CDC in the National Center for Health Statistics.

Dr. Flegal worked on the National Health and Nutrition Examination Survey (NHANES), which is a comprehensive data set of nationally representative cross-sectional data from the US that combines interviews, physical exams, and laboratory tests along with demographic, socioeconomic, and dietary data. Her 2005 analysis of the NHANES data set and her 2013 meta-analysis demonstrated that people who are “overweight” (defined as a BMI between 25 and 30) have significantly lower all cause mortality compared to people who are “normal weight” (BMI 18.5 - 24.9). In addition, her publications showed no significant difference in mortality between people who have a BMI of 30-35 and people who are normal weight.

References

The Obesity Wars and the Education of a Researcher: A Personal Account (Progress in Cardiovascular Diseases, 2021)

Excess deaths associated with underweight, overweight, and obesity (JAMA, 2005)

Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index CategoriesA Systematic Review and Meta-analysis (JAMA, 2013)
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What is the External Medicine Podcast?
The External Medicine Podcast explores some of the most exciting ideas in medicine. Co-hosted by Daniel Belkin, MD, and Mitch Belkin, MD.
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