Is America Ready For An Obese President?

Millions of Americans find New Jersey's frank and opinionated Republican Governor Chris Christie a welcome voice on the political scene. No slave to diplomacy, but giving evidence of genuine concern about people, Christie is considered a leading contender, one might even say, the biggest contender, for the 2016 Republican presidential nomination.

But at a height of 5'11" (180 cm) and a weight estimated at 350 pounds (160 kilos), is Christie's morbid obesity a disqualifying factor for the nation's highest office?

No Heavy-Set Presidents Since Taft

There is precedent for Americans electing an obese politician to the Presidency. William Howard Taft, the twenty-seventh President of the United States and later the tenth Chief Justice of the Supreme Court of the United States, carried 30 of the then-46 states in the presidential election of 1908, despite carrying 335 pounds on his also-5'11" frame.

Americans of the era equated size with strength, and Taft's size was considered to be a positive attribute, perhaps compensating for the fact that he also had bad teeth and wore his hair in a comb-over. Taft lived for 22 years after the 1908 election, eventually succumbing to arteriosclerotic heart disease at the age of 73.

So with 100 years of improvement in medical technology, is Chris Christie less likely to serve his term in office than Taft?

Christie Not Leaving Health Concerns to Chance

Unknown to Christie's critics in February 2013, even while CNN commentator Dr. Eleanor (Connie) Mariano, a Democrat, was pronouncing Christie unfit for office, Christie had recently undergone lapband surgery to reduce the size of his stomach so he was less likely to be hungry, or at least less able to overeat. In early May, citing previous failed weight loss efforts, Christie reported that he had lost approximately 40 pounds (18 kilos) in 10 weeks. Prior to Christie's May news conference, not even the governor's closest associates had known that he had had the surgery or even that he had been considering it. Just a week before the surgery, Christie had been made light of his weight by munching a doughnut on the David Letterman show. But as the governor became noticeably smaller, a public announcement was in order.

Christie belittled the public's fascination with his weight, but told a group of reporters that the matter had taken on new urgency after he passed the age of 50, and "You know, people in public life have the same concerns that people in private life have,” he said, adding,

Some political commentators recognize that Christie's struggles with his weight make him a more believable, sympathetic character. But is morbid obesity really a potential death sentence.

The Real Health Effects Of Morbid Obesity

Morbid obesity, defined as having a body mass index (BMI) of 35 or higher (Christie's BMI was approximately 50), is almost universally considered to a risk factor for diabetes, high blood pressure, heart attack, stroke, atherosclerosis, cancer, and complications after surgery. The fact that Christie's obesity is self-evident seems to suggest that voters are entitled to answers about his state of health, public findings of his cardiovascular stress test results, for example. But is morbid obesity itself a symptom or a disease?

Extreme Overweight Very Dangerous During Surgery

There is no doubt that being extremely overweight is a serious risk factor during major surgery. Many of the heaviest candidates for gastric bypass or lap band surgery, people who weigh 400, 500, and even 600 pounds or more (200 to 300 kilos and up) are at serious risk of death due to unpredictable effects of anesthetics and anticoagulants. Doctors will seldom perform elective surgery on morbidly obese patients.

We have no idea how heavy Chris Christie will be in 2016, but were he to become President and then to need surgery without losing lots of weight, there would be a substantial probability that the Vice-President would succeed him to office. But is morbid obesity also in itself a risk factor in heart disease and stroke as we are commonly told it is?

Surprising Relationships Between Extreme Weight and the Risk of Cardiovascular Disease

If you were to chart a graph of the relationship between body mass index and chances of survival after congestive heart failure (CHF) when the left ventricle is still functioning, you'd find a completely unexpected relationship:

• 55% of CHF patients who are markedly underweight, with a BMI of 20 or lower, die in 1 year or less.
• 38% of "slightly underweight" CHF patients (BMI 20-25) die in 1 year or less.
• 26% of "slightly overweight" CHF patients (BMI 26-30) die in 1 year or less.
• 25% of "overweight" CHF patients (BMI 31-35) die in 1 year or less.
• 17% of "obese" CHF patients (BMI 36-40) die in 1 year or less.
• 18% of "morbidly obese" CHF patients (BMI 41-45) die in 1 year or less.
• 25% of "super-obese" CHF patients (BMI over 45) die in 1 year or less.

Extreme obesity, such as Chris Christie's obesity before his lap band surgery, is associated with higher risk of death from heart disease--but even the extremely obese fair better than those who are underweight. Similar relationships are found between obesity and survival rates for many forms of cancer and many kinds of infections. 

But doesn't obesity cause many health problems?

Without getting into lots of detail here, it's closer to the truth to say that obesity is a symptom of the underlying disease process that results in cancer, diabetes, heart disease, and many other conditions we all are conditioned to blame on fat. Insulin resistance and inflammation, which cause these conditions, increase the storage of fat as they create other symptoms.

Even if the only benefit is that he will not become the second US President famous for breaking chairs and having to have a custom-made bathtub installed in the White House.

If you are campaigning for the highest office in the land, just about any question is a fair question. But it's also fair to expect the public to be open minded about the answer.