Monday, January 28, 2013

Anti-Bullying Programs Do Not Apply to the Obese

A few days ago, some scumbag senior researcher and retired president of the Hastings Center, Daniel Callahan, came up with an incredibly stupid idea: to save money on treating obese people, we need to shame them into compliance.  It has been all over the news.
In a controversial article, Daniel Callahan, the 82-year-old president emeritus of The Hastings Center a New York think-tank specializing in health policy ethics, calls for increased stigmatization of obese people to try spur weight-loss across America.
Personally, I don't know any group more stigmatized, ostracized and shamed than the obese.  The societal pressure on obese people, and particularly women, is enormous.  Sure is doing a lot of good, idnit?  From the Daily Mail
Dr Yoni Freedhoff, an assistant professor at the University of Ottawa and an author on obesity, told MailOnline: 'The one thing that’s not lacking in society is the stigmatization of people with obesity.

'If guilt and shame were sufficient to fuel long term weight management, the world would be a very skinny place indeed. Obesity is multi-factorial and driven by the world in which we live.'

Peggy Elam, a Nashville clinical psychologist specializing in eating disorders and a publisher of 'healthy body image' books said Callahan's views were 'horrifying'

'This kind of bullying has a tremendous impact on peoples lives. We've seen in the past decade or two a rise in the hospitalization of children under 12 with eating disorders. On a humanitarian level it is shocking he is encouraging such bullying.'
I happen to be reading a book by pediatric endocrinologist Robert Lustig: "Fat Chance".  If you're not familiar with his name or the book, you might possibly have heard of his video about sugar called, "The Bitter Truth".  Lustig himself says he never would have imagined that a 90 minute biochemistry lecture would get viewed at all on YouTube.  He assumed some family members might watch it.  Instead, it has gotten 3.2 million views.  Clearly there's a lot of people who are finding the mainstream dietary advice is not working for them and are looking into alternative hypotheses. 

I should interject here that while everyone has heard the term "obesity epidemic", there are questions about the whole concept that I'd like answers to.  Have they defined down the threshold for obesity?  That is, are weights that were considered "just overweight" a generation ago considered obese today?  If you look at pictures from 50s and 60s, where members of the general public are photographed, they don't look that different from today.  Of course, that's just a sample and may not depict a real cross-section of people.

Let's say that for now I'm willing to go with the idea that there might be more obesity today than a generation or two ago. Lustig says not only are more children obese, more infants are obese; even lab and food animals are more obese.  All of this is world wide.  He talks about seeing infants with fatty liver disease - previously almost unheard of.  His book, or at least the first quarter of it, is intense in biochemistry.  It's probably not a secret that he believes the root cause seems to be the uniquely damaging simple sugar fructose - probably in combination with other ingredients that excite different hormonal pathways in the body.  Glucose is used by every cell in the body, and if your diet doesn't include any, enough glucose to run your body is made in your liver from proteins.  Fructose, on the other hand, can be metabolized in only one organ: your liver.  In addition to being found in fruits, fructose is half the molecule of table sugar (sucrose) and is also found in corn syrup.  And, of course, the new industrial sweetener, HFCS - high fructose corn syrup.  (While sucrose is pretty much 50/50 glucose and fructose, HFCS is about 55/45 fructose to glucose).  There's a lot of buzz about how bad HFCS is for us, but I don't really see it as being all that different from sucrose.  It's just 5% different.

Just like the control debate, the wrong questions are being asked.  How about some successful treatments instead of just deciding to shame people.  Questions like: "is there really an obesity problem?" and "why do simple calories in vs. out models fail so dismally?"  Are there people who overeat because of emotional problems, stress, or other non-hormonal/non-chemical reasons?  Sure.  For a problem as big as they're claiming obesity is, and a long term success rate for treating obesity as low as it is, I'll bet real money that it has nothing to do with controllable behaviors that one could be shamed into complying with. 
(candid shot of your humble correspondent at the beach)


  1. I have been declared borderline obese by my reserve unit, and it is based on my BMI. I weight 160 lbs, am 65.5 inches tall, and have a 32 inch waist. The BMI works out to 28.5 percent body fat, but it doesn't take muscle into account, and is a very inaccurate scale. Using the BMI as a standard has allowed critics to declare most adults borderline obese, even the physically active, and panic about an epidemic that doesn't exsist to enact controls on behavior which are more about control, and revenue generation than about health.

    1. I have a special distaste for BMI. It takes the same information as the old height/weight tables of the '50s, but now it's somehow more scientific since you use metric units and divide two numbers. Wow.

      The guys who wrote the original BMI paper said not to use BMI on muscular, fit people - which I'll bet you are - because it will give false results. But nobody pays attention to the authors.

  2. They've been using the same bullying techniques on smokers for years, and recently, on gun owners as well.
    Nothing new.

  3. Probably has nothing to do with the fact that the majority of parents out there are too busy in their lifestyle to cook a healthy meal for their child. Throw in the video games and a mixture of FDA preservatives and WHA-LA! Instant obesity cocktail. I am a firm believer that all the garbage in foods these days are not helping with the issue. Parents of these children are another issue as well. My heart and prayers go to these children as it will only be a matter of time before they snap and either lash out or fall into a depression that leads to suicide.

    Private Pyle in Full Metal Jacket comes to mind.

    In Liberty,

    1. I'm thinking the majority of parents with young kids couldn't cook a healthy meal even if they wanted to. They never learned how to cook from scratch. If it's more advanced than opening a package, they're lost.

      Which is really sad.

  4. I think that just as with art, we know obesity when we see it. It's definition may/may not reside within a mathematical formula - but occasionally so.

    Just this morning on campus i found myself wondering about the likelihood of obesity - it seemed that if someone were walking about while consuming food or drink the overwhelming likelihood was that they were obese. I've noticed the same thing watching drivers at red light intersections - eating or drinking while driving - very likely to be obese.

    Just my observation.

  5. Obesity is genetic. If you see someone at a red light eating and they are obese this is not a science based "aha" moment. One of my sons had to gain weight to enter the Army, he was 5'9" and 115 lbs. Today he is 27 out of the army and he is 5'9" and 115 lbs. He eats everything in sight. He can consume 4 tacos and a 32 oz cola from Taco Bell in the time it takes me to eat one taco. I have a sister in law who weighs over 350 lbs. Her sister is obese, here children are obese and she tries to lose weight and the best she can achieve is a yoyo weight over time. Go to fast food outlets near a high school at lunch time and you will see skinny girls and boys eating fast food. The very same food some like to blame for obesity. Is it making them skinny and the fat people obese? Is that even possible? In fact the answer is so much easier to understand; you get the propensity to be obese from your parents and if you have those genes you cannot effectively fight it. If you don't have those genes you probably couldn't become obese no matter what you eat.