The despair of “obesity battlers”

A few tweets I made this morning after seeing this lamentation on Radio NZ’s website:

This is an idea I’ve had rattling around in my head for a while – the constant messages and stigma focused on fat people (right from the get-go, depersonalizing us by talking about “obesity” as an amorphous, scary phenomenon) aren’t science any more. They’re religion.

Perhaps I’m too cynical, but making a headline by quitting and parrotting the usual demonizing lines – the Obesity Monster will destroy us all, the Obesity Monster is ruining our health system – and then mentioning “oh, by the way I have a book out soon” rings far too hollow to me.

For more information about Health at Every Size, I cannot recommend enough checking out Dr Linda Bacon’s website. Also:

I know this runs counter to so many ideas which are so deeply embedded in our society and media. We’re constantly reminded to associate physical size with health, and health with moral virtue. We’re meant to believe that weightloss is just this easy and that the only reason 95% of diets don’t work is because of personal failure and weakness.

But when we step away from the framing of “obesity” as a modern-day Nothing and remember we’re talking about people who happen to be fat, the whole facade starts to crumble. We can see that there’s a difference between having a certain body shape and having an actual defined health issue (like diabetes – which doesn’t only affect fat people – or high blood pressure – which doesn’t affect all fat people – or PCOS – which can cause weight gain but isn’t caused by being fat).

That’s crucial to being able to do something about those conditions instead of ignoring all the evidence that diets don’t work and fat stigma harms people far more than being fat does. That’s evidently something Dr Robyn Toomath wasn’t able to do. So, frankly, good riddance to her.

QOTD: Beware that latest “diet breakthrough”

A must-read article at io9:

I Fooled Millions Into Thinking Chocolate Helps Weight Loss. Here’s How.

Other than those fibs, the study was 100 percent authentic. My colleagues and I recruited actual human subjects in Germany. We ran an actual clinical trial, with subjects randomly assigned to different diet regimes. And the statistically significant benefits of chocolate that we reported are based on the actual data. It was, in fact, a fairly typical study for the field of diet research. Which is to say: It was terrible science. The results are meaningless, and the health claims that the media blasted out to millions of people around the world are utterly unfounded.

Here’s how we did it.

The story of how they got their study published and turned into blaring, inaccurate, weight-loss-promoting headlines across the world make for fascinating and worrying reading.

But it’s not just about the reporting. There’s a hugely important message about weight-loss “science”:

I know what you’re thinking. The study did show accelerated weight loss in the chocolate group—shouldn’t we trust it? Isn’t that how science works?

Here’s a dirty little science secret: If you measure a large number of things about a small number of people, you are almost guaranteed to get a “statistically significant” result. Our study included 18 different measurements—weight, cholesterol, sodium, blood protein levels, sleep quality, well-being, etc.—from 15 people. (One subject was dropped.) That study design is a recipe for false positives.

So why should you care? People who are desperate for reliable information face a bewildering array of diet guidance—salt is bad, salt is good, protein is good, protein is bad, fat is bad, fat is good—that changes like the weather. But science will figure it out, right? Now that we’re calling obesity an epidemic, funding will flow to the best scientists and all of this noise will die down, leaving us with clear answers to the causes and treatments.

Or maybe not. Even the well-funded, serious research into weight-loss science is confusing and inconclusive, laments Peter Attia, a surgeon who cofounded a nonprofit called the Nutrition Science Initiative. For example, the Women’s Health Initiative—one of the largest of its kind—yielded few clear insights about diet and health. “The results were just confusing,” says Attia. “They spent $1 billion and couldn’t even prove that a low-fat diet is better or worse.”

The ironic thing about Attia’s “lament” is that the lack of clear evidence about diet and health didn’t stop him cofounding an organisation whose website cries out for proper research and funding – but still assumes that the “dramatic rise in obesity” in the US is a “crisis” and not a blip caused by changing the definition of “obesity” in the 90s.

The authors of this terrible study did it deliberately to make a point about bad science and bad science reporting. There are plenty of others out there doing it for a far worse reason: the ridiculous amount of money there is to be made from promoting health anxiety and fat panic.

The personal impact of fat-hatred

I woke up yesterday looking forward to a relaxing fourth-day-of-a-long-weekend.

And one of the first things I saw on Twitter was an article which panickedly declared that

 

And I could go through all the same arguments which rapidly lose me Twitter followers: about the fact that classifications about what constitutes “overweight or obese” are almost entirely unscientific, about the fact this research was done by a “global management consulting firm”, about the incredibly influence and resources of the weightloss industry, about the fact that being overweight, obese, or even deathfat does not put you at higher risk of dying, about the fact that fat is incurable.

But that information’s already out there and if people are refusing to look at it, they’re not going to change their minds. So, I present a personal Twitter whinge-fest about how this kind of unscientific scaremongering affects me, personally.

And in the context of all that, some facts: it has been proven that doctors and nurses are biased against fat people. It’s proven that fat people fear medical discrimination so much they’ll avoid getting important checkups. And inflating healthcare costs actually aren’t the fault of fat people.

Maybe, if we’re really worried about the ~costs of obesity~, instead of promoting more diets (and medications, and surgical procedures) that don’t work and more bullying disguised as “get active” programmes, we could get the medical profession to treat fat people with basic dignity, respect, and proper practice. Might cut those costs a little, you think?

QOTD: Linda Bacon on bariatric surgery

Content note: surgery, complications, fat-hate

Because completely coincidentally, a number of surgeons who perform bariatric surgery (“stomach stapling” to your unmedical layperson) are suddenly in the media clamouring for public funding of their “craft”:

People are misled about the extent and severity of the health risks associated with being fat and told that bariatric surgery is a solution. It’s not. It would be more appropriately labeled high-risk disease-inducing cosmetic surgery than a health-enhancing procedure. And unlike a diet, you usually can’t abandon it when you realize you made a mistake.

Linda Bacon, Health at Every Size (pdf)

Junkfood Science have an excellent series of posts on the realities of weight-loss surgery, linked on their homepage; here’s their post about the real risks of weight-loss surgery vs. the risks of dying from fatness.

QOTD: Diets don’t work

From Anne G Mirer, MPH:

Even with outcomes for which weight loss could be beneficial, the benefit will be temporary if and when the weight comes back. Quickly or slowly it will come back for all but a very few. The best most people can expect for their pain and suffering is to be about five to ten pounds lighter, and those are the minority for whom the treatment succeeds. It doesn’t matter how big a problem you think obesity is, and it doesn’t matter whether or not you’re right about it, because we do not have any tool that will make obesity go away.

Read the whole post – it might be eye-opening.