You can’t find a better example of denialism and spin than Big Fat Blog and its acolytes, and they’ve lived up to their usual standards in grousing about the media coverage of this study as well as the comments from the study’s researchers. With their keenly selective interpretation of reported findings, their twisting of what the study reveals and suggests, their putting words in people’s mouths, and above all their basic and thematic la-la-la-la-I can’t HEEEEEAAAR yoooooooooou! approach to modern medicine, they’ve nicely covered all of their usual terrority.
BFB links to an AP article about the Duke study of 16,000 people (the findings of which were first presented in 2003, but is for some reason reported in the article as a “2005 study”) which found that overweight and obese patients who suffered heart attacks had better post-MI survival rates than people of normal or below-average weight. Since excess weight is an established risk factor for coronary disease, the reseachers naturally want to know the reasons for this surprising finding. (I have not read the full study text, but I assume the researchers controlled for smoking and other lifestyle factors.)
BFB, of course, is having none of it. They categorically trust the data pointing to higher survival rates in the heavy, but of course don’t trust any of the researchers’ speculation as to why this occurred that doesn’t imply that being fat is the best thing you can do for yourself. On the Duke site it’s noted that the study’s overweight and obese were younger and were treated more aggressively, factors which might certainly contribute to better survival. But the BFB commentator ignores this, instead harping on the fact that one of the docs quoted in the AP article doesn’t go into detail about the risks of being overweight.
This is misguided for a number of obvious reasons: It’s not as if this information hasn’t been made widely available, the point of the article was not to revisit all of obesity’s dangers but to actually point out what can be viewed as good news for hefty cardiac patients, and it’s not as if the BFB crew accepts the first thing about known links between excess flab and heart disease, diabetes, some cancers, joint problems, gallbladder disease and more.
You can check out the range of whines on the BFB site itself; if nothing else, the guy who does all or most of the writing their is a world-class bellyacher.
Imagine that a study demonstrated that STD patients who had huge amounts of unprotected sex with strangers had less pervasive and painful symptoms than those who had fewer partners and usually used barrier contraception. Would this be an argument for screwing bareback and willy-nilly? In BFB-land, where throwing on blinders and helping others adjust theirs is a sine qua non, perhaps it might.
Posted by jeffk on July 13, 2007 at 6:52 pm
Not a doctor, but I would venture to guess that non-overweight patients who have heart attacks have a different cause for them – causes that are probably more serious than a weight-related heart attack.
Posted by Frenchdoc on July 13, 2007 at 10:57 pm
Not to mention the usual correlation / causation confusion.
Posted by Kevin Beck on July 14, 2007 at 12:35 am
In a 2006 study, researchers attempted to clarify this apparent paradox and found that obese and overweight patients had higher survival rates than normal-weight patients in the first six months post-MI, but a higher risk of recurrent MIs in the long term. They hypothesize that the younger average age in the heavier subset helps explain the relative hardiness of these people.
Leaving aside clinical considerations, what’s really striking is that the BFBers simultaneously harbor complete scorn for medical research that points toward weight-driven health problems and complete endorsement of the few studies suggesting otherwise. People who only trust science as a whole when it makes them happy are, to put it mildly, in no position to form reasonable arguments.
Posted by Obdulantist on July 14, 2007 at 10:27 am
Don’t have any expertise in weight studies, but I remember hearing an extended interview a couple years back with a senior researcher in this area saying that there is genuine uncertainty about whether being moderately overweight (BMI 25-30) is a problem.
Anyone know more about that?
Posted by yolio on July 14, 2007 at 1:25 pm
I never saw BFB before, but I checked out your link. I have to say that I disagree with your attitude towards them. The criticisms I saw over there were pretty sophisticated. There are a lot of weird and irrational attitudes about fatness that shows up in the media coverage of the science and in the science writing itself. I don’t agree that pointing out this craziness is the same as advocating an unhealthy lifestyle.
Posted by Kevin Beck on July 14, 2007 at 1:41 pm
“There are a lot of weird and irrational attitudes about fatness that shows up in the media coverage of the science and in the science writing itself.”
I’m inclined to agree with you regarding the media coverage, but not so inclined to agree about the science writing, at least that appearing in medical journals.
Nevertheless, the uphill battles fat people face in terms of popular culture and stereotypes are an entirely separate issue from the medical realities of being markedly overweight. There’s nothing “sophisticated” about the post I linked to or in the comments that follow that I can see (and I wish you had given examples); erecting and attacking crude straw men, tossing out red herrings, inventing quotes out of whole cloth, and deploying ham-handed sarcasm are not high on the list of solid argumentative strategies.
As I noted above, these people are happy to embrace research, and only that research, that appears to support them. Aside from that they think doctors who mention “overweight” and “risk” in the same sentence are shitheads. I feel bad for some of them, but most are willfuly blind and many are idiots. They’re no different from creationists who yammer about radioisotope dating being faulty but would sure as hell rally behind it if these methods had dated the Shroud of Turin to around 33 CE rather than revealing it to be a medieval forgery.
Posted by Trinifar on July 14, 2007 at 9:16 pm
As I noted above, these people are happy to embrace research, and only that research, that appears to support them.
That’s a nearly universal truth. The amazing thing is that some people change some of their views some of the time. The more personal the view, the harder it is to change it I think.
Posted by Trinifar on July 14, 2007 at 9:16 pm
As I noted above, these people are happy to embrace research, and only that research, that appears to support them.
That’s a nearly universal truth. The amazing thing is that some people change some of their views some of the time. The more personal the view, the harder it is to change it I think.
Posted by Kevin Beck on July 14, 2007 at 9:56 pm
Obdulantist:
The data linking increased adiposity with a higher incidence and severity of certain morbid conditions are unequivocal. People with type II diabetes in particular experience an exacerbation of their symptoms whe they get heavier, and fatter people are also more likely to wind up diabetic. Then there’s heart disease, connective-tissue problems, gout, some kinds of cancer, pregnancy complications, and more. Do a search on this blog for “heavy hitters” and you’ll find a five-part series I wrote here a year ago that includes a lot of factoids and links.
It’s true that the BMI is not infallible, that some people are never going to be rail-thin, that thin people also get the same illnesses fat ones do, that fat people may be unfairly judged, and so on. However, these things don’t negate the established health risks of being fat.
The most common absurdity among BFBers is their hammering away at arguments no one is making and conflating the above issues with the pertinent ones. It adds nothing to claim that a fat person who walks three miles a day is probably going to live an HIV-positive smoker with bronchogenic carcinoma and a BMI of 19. They either don’t understand the difference between intrapersonal variation and interpersonal variation or don’t care to (or both). They also deflect a lot of valid criticism by dismissing it as “fat hate.” They seem to think that thin people are scared by the idea of getting fat themselves or fat people accepting themselves that way, that formerly fat people are deluded, and that fat people tryingto lose weight are sellouts or victims of the diet industry’s marketing; this conveniently defines fat people who plan to stay that way as the only people with useful perspectives on the whole matter.
I don’t really care if people delude themselves, but the nastiness the BFBers expect to get away with whe ripping doctors, journalists, actresses and everyone else and their potential influence on younger fat people is grating. I’d be willing ot bet that most BFBers are young and can therefore sit there and talk about how healthy they are in spite of their size; a bunch of 30-year-old smokers could form on online yammer pit and behave the same way with equal conviction.
Anyway, the attitudes you see there are no more representative of a typical heavy person than Ken Ham or Tim LaHaye speak for people who believe in a god of some sort. It’s damned easy to get fat in the U.S., and one area inwhich I agree with some of the BFBers is that focusing on activity, on moving around, is far more important than making weight loss a primary goal, because not only do diets that omit exercise inevitably fail, but ample exercise usually drives body size toward taking care of itself.
Posted by Obdulantist on July 15, 2007 at 1:33 am
Kevin Beck. Much thanks for that. I have had a quick look at the ‘Heavy Hitters’ series, and will do a proper read through that info next weekend, and might have a question or two for you then. Apart from anything else, there is a real personal stake in this as I am starting to develop a middle age spread (BMI creeping towards 30, although I do have a stocky build to start with and have always been at the high end of the BMI index).
What are your views on the fructose/sucrose/glucose debate?
http://scienceblogs.com/terrasig/2007/07/the_dark_side_of_fructose.php
Posted by Kate on July 17, 2007 at 3:11 am
I’m sorry, but you’re no better than they are, from what I can tell. You trust the Duke study results, but are looking for reasons to explain away the MI study results.
It’s the nature of epidemiology research. It shows correlations with some degree of accuracy, but leaves endless room for interpretation of causation and confounding variables.
So having a deeply critical mindset when reading the “Discussion” section of an epidemiological study is not anti-science, it’s a smart thing to do. But you should do it for studies you both agree with and don’t agree with. Otherwise you’re just creating a confirmation bias. They need to do this, and so do you.
The controversies in the epidemiology of obesity are very real. It’s an extremely complicated and problematic area, and eliding these controversies is not in any way defending science. If you want a simple “good” or “bad” answer, it’s not going to make you happy, and you probably shouldn’t be doing science.
Posted by Kevin Beck on July 17, 2007 at 11:34 am
“I’m sorry, but you’re no better than they are, from what I can tell. You trust the Duke study results, but are looking for reasons to explain away the MI study results.”
I think you got that backward. Also, I’m not questioning the findings of the Duke team, I’m questioning the claim that these findings imply that being fat is, in and of itself, helpful in the manner the BFBers think it is. When something runs counter to a consnesus, it’s absolutely necessary to figure out why, which is not the same thing as finding a way to “elide” it.
A few people there seem to have a hint of a medical background, but the blogger himself doesn’t and he’s proven his inability to understand basic biostats over the years. And when it suits him, he trusts unquestioningly the same lay media he appears to hate the rest of the time.
But it doesn’t matter, because I don’t trust any one study to tell me anything about a multiufaceted health issue; I do place trust in the fact that a huge number of studies tend to confirm the stated health risks of being overweight. I am duly skeptical of any one of them, not just regarding weighty matters but regarding anything, but it’s hard to ignore something that seems to be confirmed repeatedly, doesn’t it?
If I flip a coin three times and it comes up heads each time, I don’t assume it’s loaded. If I get 30 heads in a row, I for all intents and purposes know that something’s rigged.
You say that I’m “no better than they are” in terms of bias. That means you equivocate my trusting the 99 in 100 (let’s say) studies that support my basic position with the BFBers’ denying the 99 in 100 that contradict their position, which is silly. Extraordinary claims require extraordinary evidence, right?
I don’t have an emotional investment in believing or not believing any of these results, while the BFBers obviously do. (It’s worth noting, though, that pro-fatters often accuse thinner interlocutors as being “threatened” in exactly the same way Bible-boppers accuse atheists as being “angry” at something they don’t even think is real.) This alone doesn’t mean I’m always going to be objective or correct or that the BFBers are always wrong to complain, but it’s a factor.
Your last paragraph reeks of your own confirmation bias, as it implies you think I want an easy answer, or think that obesity makes absolutely every health problem worse, or what have you. Why wouldn’t I, or anyone, want being fat to be totally benign? Think of all the lives and money spared. So, while I heartily agree with the point you’re making about sound science, and am in fact glad that not every commenter here reflexively hops aboard the “Yeah, screw the fatsos!” bandwagon, I don’t believe that it applies to what I’ve said here, as I’m not advocating for dismissing anything suggesting a protective effect of obesity out of hand.
Posted by Kevin Beck on July 17, 2007 at 11:34 am
“I’m sorry, but you’re no better than they are, from what I can tell. You trust the Duke study results, but are looking for reasons to explain away the MI study results.”
I think you got that backward. Also, I’m not questioning the findings of the Duke team, I’m questioning the claim that these findings imply that being fat is, in and of itself, helpful in the manner the BFBers think it is. When something runs counter to a consnesus, it’s absolutely necessary to figure out why, which is not the same thing as finding a way to “elide” it.
A few people there seem to have a hint of a medical background, but the blogger himself doesn’t and he’s proven his inability to understand basic biostats over the years. And when it suits him, he trusts unquestioningly the same lay media he appears to hate the rest of the time.
But it doesn’t matter, because I don’t trust any one study to tell me anything about a multiufaceted health issue; I do place trust in the fact that a huge number of studies tend to confirm the stated health risks of being overweight. I am duly skeptical of any one of them, not just regarding weighty matters but regarding anything, but it’s hard to ignore something that seems to be confirmed repeatedly, doesn’t it?
If I flip a coin three times and it comes up heads each time, I don’t assume it’s loaded. If I get 30 heads in a row, I for all intents and purposes know that something’s rigged.
You say that I’m “no better than they are” in terms of bias. That means you equivocate my trusting the 99 in 100 (let’s say) studies that support my basic position with the BFBers’ denying the 99 in 100 that contradict their position, which is silly. Extraordinary claims require extraordinary evidence, right?
I don’t have an emotional investment in believing or not believing any of these results, while the BFBers obviously do. (It’s worth noting, though, that pro-fatters often accuse thinner interlocutors as being “threatened” in exactly the same way Bible-boppers accuse atheists as being “angry” at something they don’t even think is real.) This alone doesn’t mean I’m always going to be objective or correct or that the BFBers are always wrong to complain, but it’s a factor.
Your last paragraph reeks of your own confirmation bias, as it implies you think I want an easy answer, or think that obesity makes absolutely every health problem worse, or what have you. Why wouldn’t I, or anyone, want being fat to be totally benign? Think of all the lives and money spared. So, while I heartily agree with the point you’re making about sound science, and am in fact glad that not every commenter here reflexively hops aboard the “Yeah, screw the fatsos!” bandwagon, I don’t believe that it applies to what I’ve said here, as I’m not advocating for dismissing anything suggesting a protective effect of obesity out of hand.
Posted by Lint on July 17, 2007 at 3:36 pm
Studies have shown that weighing 500 pounds increases your risk of being stuck in a river for 12 hours if you experience chest pains while inner tubing.
http://wcco.com/topstories/local_story_198075508.html
Posted by Obdulantist on July 21, 2007 at 1:38 am
Kevin, I have just read through your ‘Heavy Hitters’ series and it is good, informative stuff, including the many links. The apparently strong protective effect against female breast cancer of a BMI above 27.5 (at age 18) is an interesting finding.
Thanks for that.
So I guess I have no more excuses for not losing a few kilos then? Science can be a hard mistress.
[Starts pumping up tyres on woefully under-used bicycle. BMI
Posted by Obdulantist on July 21, 2007 at 1:42 am
It appears a chunk of my comment was chopped off the end. Should read:
[Starts pumping up tyres on woefully under-used bicycle. BMI less than 25 here I come. First thing tomorrow. No, really, I promise. Just as soon as I finish this last slab of chocolate cake. Or maybe Monday, start of a new week and all that. Aaaarrrggh!]