The New Republic Online recently posted an article by indefatigable crank Paul Campos, author of The Obesity Myth and a longtime patron saint of fringe-dwellers who are not only eager to be convinced that being fat is innocuous (if not a veritable cause for celebration), but view weight loss and its glorification — especially by public figures — as an unqualified act of aggression toward the large.
Campos — a passable demagogue who is completely full of shit and, as is always the case with cranky columnists, is grossly guilty of engaging in the very distortions he accuses his targets of applying — reiterates the same talking points he’s been milking for at least a half-dozen years. These comprise three basic assertions:
1. The BMI doesn’t work for professional athletes.
2. Diets don’t work, the diet industry is in it for money, and yo-yo dieting is dangerous.
3. It’s lifestyle factors, not size per se, that lead to the health problems associated with obesity.
Numbers one and two are red herrings. The fact that the BMI is an imperfect measure of adiposity (albeit a far better one that Paul “quit abusing statistics while I treat extreme outliers as the norm” Campos says it is) does not dispel the health consequences of excess fat. Similarly, putting scare quotes around terms like obese and overweight has no clinical value. And even though Weight Watchers is indeed in it for the money, this doesn’t mean that diet programs aren’t addressing a genuine medical need (the existence of obviously ineffective grow-your-wanker and overnight-hair-growth pills hardly implies that erectile dysfunction and male pattern baldness are not documented issues).
Campos also loves to paint the fact that most people who set out to lose weight soon regain it as evidence that they can’t — and moreover, shouldn’t — try to lose weight in the first place. But the fact that people so often regain lost weight is almost invariably tied to their slipping back into old habits. Losing weight may be simple in theory but it’s a bitch in practice. Habits tied to emotional payoffs and deeply ingrained routines usually die very slowly and stubbornly, if at all. People who try to give up drinking and drugs often relapse serially, but you won’t hear anyone positing that some folks simply need a certain amount of ethanol or heroin in their systems to function normally. What Campos avoids mentioning is that people who don’t merely “diet” but change their lifestyles around and take up exercise in addition to changing what and how they eat are in fact extremely successful at managing their weight in the long term. Just go to a marathon and listen to the anecdotes. Apparently, Campos either thinks that this is a coincidence or believes that these people are just a few snack cakes away from their “natural” grande sizes.
It is with regard to number three, however, that Campos really rockets off the rails. To wit:
“there’s virtually no evidence that being fat, in and of itself, is at all bad for you. In other words, while lifestyle is a good predictor of health, weight isn’t: A moderately active fat person is likely to be far healthier than someone who is svelte but sedentary.”
Notice how he neatly conflates interpersonal and intrapersonal risk factors, a solecism those without formal backgrounds in epidemiology should know to avoid; his use of “in other words” here is completely inane. Leaving aside the fact that the fraction of obese Americans who are genuinely physically active is unknown but surely small (most Americans, period, don’t get much exercise), claiming that a fat active person is healthier than a thin sedentary one says nothing about the fat person’s increased risks compared to those he or she would face at a lower weight, all else being equal. Most national-class distance runners could beat over 99% of entrants in a road 5K race on a training regimen of 10 miles a week, but would be nowhere near their best times under such conditions. I suspect that Campos is not deluded here, as he may be in other areas, but is simply lying.
Campos is also blatantly dishonest in his attempt to downplay the importance of relative risk in obesity studies. When he says “researchers fail to point out that, in practical terms, the differences in risk they are measuring are usually so small as to be trivial,” he sure as hell isn’t talking about the studies that have been the most revealing about the perils of being overweight, which involve huge numbers of people followed for long periods of time for adverse outcomes that are extremely common in both the overweight and the non-overweight. If Campos thinks the Harvard Nurses’ Health Study — which has tracked some 116,000 women for over 30 years — is too small-time to reveal anything, than he might as well place no faith whatsoever in biostatistics or modern medicine as whole. The rest of his column is similarly pockmarked with examples of cherry-picking and chicanery that are evident to anyone with a health-care research background, but sufficiently slick-sounding to keep fat activists, ever an accommodating bunch, awash in their own grim denial.
One more thing. Campos writes:
“Indeed, subject to exceptions for the most extreme cases, it’s not at all clear that being overweight is an independent health risk of any kind…”
It says something that Campos consistently does admit that extremely overweight people undeniably face size-related health problems while maintaining that being “just” fat is quite likely good for you. Unless one adopts the novel stance that health woes tied to excess weight statistically behave in accordance with some sort of step function, to simultaneously claim that being fat is either harmless or good but being really fat is bad smacks of the cries from the equally befriggered “I believe in microevolution, but not macroevolution” crowd.
Anyway, this is nothing but a long-winded preface to my main point, which is that someone calling himself or herself “sullydog” did a masterful job of fisking Campos’ piece item by item in the comments below the article, far more succinctly and with better focus than anyone I’ve seen. sullydog not only points out Campos’ basic errors (overweight is, in fact, an established independent risk factor for various adverse conditions), but, more importantly, highlights the specific ways in which Campos systematically distorts the truth. Guys like him will always have new material to malign, so it’s important to establish that the guy basically is either incapable of rational analysis or too lost in his own rectally generated smokeshow to care.
This is always such an emotionally charged issue — one in which so many people have a personal investment — that almost no one can examine it rationally; the greater message is never regarded solely in medical terms. There is plainly a tremendous psychosocial component, wherein fat people shield themselves behind unrelated matters as a means of vigoruously maintaining denial. It’s common to hear fat people express gratitude for not being anorexic, often smugly. But one never hears someone with an underactive thyroid bragging about how they don’t sweat a ton at night or walk around with that goofy bug-eyed look, and people with Laron dwarfism don’t cackle about not having a head the size of a jet engine like Andre the Giant and other exemplars of hyperpituitarism.
Go to Big Fat Blog and look at all of the commenters who are openly opposed to even looking at the comments after Campos’ article; most are clearly incapable of separating the issue of how fat people are regarded in terms of attractiveness from the medical realities, and a few have even hatched conspiracy theories proposing that the knowledgable “anti-fat” commenters are paid diet-industry mouthpieces (a standard they conspicuously never apply to manifestly pro-fat people with an obvious and hilarious lack of objectivity, like their favorite food-pushing nurse at Tech Central Station; the ability of wingnuts of all kinds to apply double standards never fails to amaze me).
The fact that anorexia is deadly in no way ameliorates the health problems associated with obesity and vice-versa. The fact that some people are more prone to gaining weight than others doesn’t mean they won’t suffer the consequences of excess weight or can’t maintain a relatively low body-fat percentage by getting active. The fact that women experience a disproportionate level of cultural pressure to be thin in no way means that being fat is not risky in irrevocably documented ways. If people view thumbing their noses at what they conisder a ludicrous stick-figure ideal as a personal triumph, that’s great. But this doesn’t neatly translate into weighing 275 pounds being a good thing either.
When it comes to weighty issues, Paul Campos — who writes ably and clearly about numerous other issues, by the way — is a perseverating harpy, a shill for a misguided movement who makes things up as he goes along. So it was gratifying to see his manipulations and distortions exploded by those with both more knowledge and more objectivity than he will ever know. There’s no reason the truth should take a back seat to the wailings of a few people who don’t want their feelings hurt. And the truth, unfortunately, is that America is breeding a generation of young diabetics while fools like Campos continue advocating for those curiously rare individuals who consume low-fat diets, get plenty of exercise, reduce their risk factors for various comorbidities of obesity, and still remain genuinely fat.