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)