Paul Campos article marauded by the locals

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.

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  1. #1 by joan on January 9, 2007 - 6:11 pm

    I never understood why some see it as negative that Weight Watchers is in it to make money. They provide a service, after all. How to maintain a healthy weight is not obvious or easy for everyone. Some NEED a service to give than an idea of what kind of meals to make and what portions.
    I know plenty of intelligent people who didn’t know, for instance:
    -salads aren’t always low calorie (dressings at least)
    -a portion of chicken or anything isn’t necessarily what your favorite restaurant gives you
    -being at the gym for 30 minutes does not always equate to 30 minutes of exercise…waits for machines, chatting cuts down on time
    …and so on. My friends who tried Weight Watchers say they learned how to change their lifestyles without going crazy.
    I’d disagree that most fat people are in denial though…or at least not the vast majority of the heavy people I know. There are excuses but they do admit they should make time to exercise (at all or more often), they should eat less (but love eating too much), or that simply they should try harder but that it’s not a priority.

  2. #2 by Kevin Beck on January 9, 2007 - 6:35 pm

    Hi, “Joan.” I don’t believe you’ve visited us before. Welcome to an ongoing nightmare of shitty editorials and even worse comments.
    I don’t think that most overweight people are in denial by any means, but the BFB types who rally around Campos are a special breed. That guy is to America’s corpulent as Pat Robertson is to its churchgoers.
    I accept that the long-term success rates of groups like Weight Watchers aren’t great, but the thing Campos gets wrong is that this somehow lends validity to the idea that some people are “meant” to be fat. The fraction of people who will never be marathoner-lean is considerable, but the number with clinical glandular disorders keeping them heavy is almost vanishingly small. The commenters on BFB seem to think that practically every overweight child should be worked up for Prader-Willi syndrome, even if the kid is known to sit on his ass and eat high-energy foods all the time. This is akin to suggesting a 60-year-old diabetic hypertensive smoker showing up in the ER with crushing substernal chest pain radiating to the left axilla be evaluated first for a dislocated shoulder.
    God decreed that I should be insane, but He also made it more or less impossible for me to be fat. I nevertheless understand how very easy it is to be heavy in this country without “overeating” in any Bacchanalian sense. This only underscores, though, how wrong Campos is with his pseudodeterministic bullshit. Genetics determine people’s innate propensity for weight gain, but behavior is hardly a trivial component of gene expression, and it makes little sense for people struggling to stay below 3,000 calories a day and make time to exercise to crow about how it’s possible to be fit and fat.

  3. #3 by JKB on January 10, 2007 - 1:22 pm

    TNR comments are consistently the most entertaining, although the best are when the commenters feast on the carcases of liberal neocon authors.
    Read sully’s review, but it’s only interesting in the sense of stylistic fisking — what fool is going to take anything presented in the TNR at face value anyway?
    Campos has a few I( would say) valid points:
    1. BMI is not a good indicator and a different vernacular should be developed that is more medical or sciencey when discussing obesity and health. You have a social classification tool being used for medical diagnosis. People should be aware and their hair should stand up when BMI enters into discussion.
    2. Obesity research tends to get heavily funded not by the government but by business interests. This makes their research suspect, and voices in my head are telling me to beware. Since I expunged God from my head years ago, the voices must be media inspired paranoia. So, if the government really thought it was a danger, it would dedicate more resources — but since it’s not dedicating resources or brainpower to preventing the development of type 2 diabetes, it must think it’s more cost effective to treat it afterwards. Or maybe it’s better for the economy. Whatever. I’m sure they know best and are honest brokers when it comes to their concerns for the general public. To think that business interests and lobbyists may be whispering sweet nothings into the ears of the gov to focus research and results would be delusional paranoia.
    But he does say this:

    So what should we do about fat in the United States? The short answer is: nothing. The longer answer is that we should refocus our attention from people’s waistlines to their levels of activity.

    Which doesn’t make much sense. If you do nothing you remain sedentary.
    So yeah, overall, it seems that the words fat and obese have not kept up with the times and economy, but the alternative is scary as well — people on calorie restricted diets living to a 100 would be freaking ecological catastrophe. And they’d be self-rightously obnoxious geezers to boot (a lagniappe in Doc’s parlance).

  4. #4 by Shelley Batts on January 10, 2007 - 2:27 pm

    Kevin, excellent post and very funny as usual. I absolutely love it when you take the BFBers to task. I visit their website occasionally for a laugh or groan, but in a ‘look at at trainwreck’ kind of way. In all seriousness though, the ideas they proport are an extremely dangerous kind of denial. I honestly wouldnt care if it was just them, but then, I assume some of these people are parents who make food choices for their children. And of course, rising medical costs/insurance costs affect us all. I wonder if there’s a blog out there that purports that smoking is healthy too, and that all this nasty legislation against smoking in bars and public places is due to some huge conspiracy.

  5. #5 by Brian on January 10, 2007 - 2:34 pm

    The charge that the “diet” industry makes a buck off our concern about obesity is doubly foolish when we reflect on the financial interests of fast food and packaged food purveyors in obscuring the risks of obesity.

  6. #6 by Kevin Beck on January 10, 2007 - 2:57 pm

    JKB — I suspect that if Medicare were to vanish tomorrow, the goverment’s concern over how to manage obesity would be right up there with its fundamental desire to keep America’s citizens and natural resources safe from industrial toxins produced by Big Industry, particularly oil and sugar.
    The Harvard School of Public Health is a huge locus of obesity research and doesn’t rely on government breastfeeding (or any external support) for sustenance. One of its principals, Meir Stampfer, pointed out to me that there have been instances in which research funded in part by diet interests failed to result in the conclusions the diet industry would have hoped for. What the CDC, H&HS, etc. do with research findings is another matter. But Uncle Sam is smart enough to realize that just like everyone but BFB and Paul Campos understands, the costs of overweight and obesity are exorbitant. This is why there are so many “get active” advisories and initiatives on federal Web sites; it’s not because anyone gives a shit what we all look like, even if those snooty Europeans can’t help but notice how loud, boorish and ponderous we tend to look as a group when debarking from plans at places like Heathrow and Charles de Gaulle.
    Shelley — I’m hardly someone with his pulse on the mind of society in general, since I think most people are idiots and don’t much care what the consensus about anything is. But ten years ago I was telling my friends, “You wait, soon so many people will be fat that there will be a huge movement afoot underscored by a ‘wait, obesity isn’t unhealthy after all’ idea.” And I was right. I realize that BFBers are the fringe de la fringe when it comes to how deluded they are, but I’m still morbidly fascinated by how thorough they are about deluding themselves so as to assuage cognitive dissonance. And as far as I’m concered, if they’re going to be assholes about it and sic each other on often low-key and well-meaning bloggers, doctors and scientists as if non-FAs are the ones in the wrong, and post it on the Web for all to see, then I can’t feel especially sorry for them, or at least am to yammer-happy myself to overlook their output.

  7. #7 by SkookumPlanet on January 10, 2007 - 7:36 pm

    Well, you hooked me.

    I suspect that Campos is not deluded here, as he may be in other areas, but is simply lying.

    You are being much too generous to Campos and his ilk. In actuality, they voluntarily create a structure in which everything they say is a lie. Despite how able and honest Campos is otherwise, I give him no pass. Plenty of people are really nice most of the time but have some small area or trigger that turns them physically dangerous to others. If they choose to ignore that, and injure people, society locks them up. It’s called personal responsibility.
    While the point-by-point factual refutation is necessary, the deceit at the core of, well, one must assume at the core of denialists’ lives, is clear when analyzing the behavior/column/oeuvre in its social context. Having seen much of such public crap, I’ll wager most of the following items apply to Campos “weight writing” without having looked at any of his other material on fat or knowing anything about him personally.
    1. Denialist/mouthpieces rarely express, usually pro forma, recognition of the damage possible if they are wrong. Mostly that’s never acknowledged or overtly rationalized away. It’s an ethical imperative to not publicly lie if it has direct, damaging consequences for individuals who accept your lie as true. He’d have to be a complete idiot not to understand overweight people will use his lies as justification for not dealing with this difficult issue. Conceive of this as practicing medicine without a license. And also Campos’s DIY mini-Tobacco Institute.
    Protestations that people make their own decisions removes all doubt about the speakers amorality. That’s an argument to lie about everything. After all, juries also make their own decisions. As do FBI agents. And emergency room physicians. And social workers. And…
    2. If you use a public media presence to argue fundamentally against the public health community’s standard prescription on an issue, you have an ethical duty to err on the side of accuracy. In other words, no weak arguments, don’t ignore counter evidence, etc. The burden is solely on you. Given such, going directly to the public using political and rhetorical devices to make your case places you permanently into the gutter.
    3. One can look at the certainty with which denialists posit their arguments no matter how precarious their critique may be. In the field of public health this is an especially egregious transgression. This certainty amounts to lying. This is done because qualification and ambiguity are enemies of media visibility. Witness the rise of shout-down “analysis” political media and conservative talk radio.
    4. Here’s a handy rule of thumb for differentiating real debate from pseudo-debate, the latter having been very skillfully transplanted into the former in our national political discussion by Right-Wing psychomarketers.
    In a truth-seeking debate one takes in an opponent’s critique and attempts to integrate it, so it’s weaknesses and strengths can be discussed. In a public, pseudo-debate, every word is about winning and the truth is immaterial. Denialist’s rhetoric usually has big, never-addressed holes in logic and demonstrates profound disinterest in the pursuit of truth. It also routinely omits salient and/or obvious issues that are negative to the position defended. A classic, bountiful example of all three are Exxon’s global-warming skeptic guns-for-hire.
    5. Another analytical trick is to simply shift such methods into some field, like science, that demands adherence to reality and facts. Let’s say Campos had to write every word in every column under penalty of federal perjury and so risk losing his house, his livelihood, his childrens’ college funds, and his freedom. Would he write different columns?
    6. Carefully note even the implication that those attacked, if their professional ethics, like biomedical researchers, require neutrality, are in cahoots with commercial interests or dishonest for ulterior motives. Unfortunately, media columnist isn’t one of those professions. “Pharma shill” is a good example. Another angle on this is to look for logic that needs some massive number of graduate-trained professionals to suffer mass stupidity and fail at basics tasks in their profession. Here it’s biomedical researchers and clinicians not capable of comprehending research reports on weight and health.
    It matters not whether this would legally qualify as slander if directed at a specific individual in such group targets, although that’s also a handy-dandy analytical tool. It’s intent is slander. Campos is claiming something extraordinary so he needs some extraordinary proof, way beyond a few illustrative points. In an article this long he might be able to cover that evidence, but only if that’s its only content. He might as well claim public health professionals suffer hysterical dyslexia every time they consults the relevant literature.
    The list of little tests above is suggestive and demonstrative, hardly exhaustive. There’s a technical term for those who repeatedly fail them — lying scumbag.
    .
    I want to emphasize I’m not defending anything the medical establishment says about the weight issue. There may be ample room for criticism of the field. I’m simply pointing out one can think through the moral responsibilities inherent in certain social functions and roles, and run a tally on how individuals, such as Campos, measure up to their obligations. Then the bioscience content of his writing only need be related to tangentially. I wish there was more analysis in this vein, because it’s absence give these professional liars a gigantic psychopolitical edge and it’s presence puts them revealingly on the moral defensive. It’s the methods Campos chooses that reveal his absence of a soul.
    Those who approach the public-issues sphere like this, the Right Wing media franchisees for example, are soul mates to those, to stay with a weight metaphor, that perpetrate pro-anorexia websites. Twin denizens of the deep.
    Campos appears to have simply discovered a bit of uncolonized media space, seen the opportunity, and is exploiting it. Ultimately, morally disabled people like him deserve our sympathy and support. We should offer it to those involved in media if they agree to shut up.
    .
    .
    P.S. sullydog’s work is great. I did something similar on Wikipedia in summer ’05 with a creationist. By one count I found 93 lies in a bit more than 200 words. Yes, I admit, easy target. I gave in to temptation. The guy’s nom de net got into my head and the only way to purge it was this exorcism. He called himself “Truthteller”. My “air quotes” by the way, to the nth degree.
    P.P.S. And a very late note. JKB’s saying “people on calorie restricted diets living to a 100 would be freaking ecological catastrophe” suggests JKB is assuming biomed research won’t lead to people living on calorie-overdose diets to be 100, the last sixty years of that as resource-sucking diabetics. This is just to highlight that assumptions and predictions in unintended social consequences is a very tricky business. How far in advance was this obesity colic predicted?
    I’ve got a sizable comment to the comments on THR which may or may not get finished and posted there in reasonable time. Have to run so hope I didn’t leave a yawning mistake above.

  8. #8 by JKB on January 10, 2007 - 9:17 pm

    And a very late note. JKB’s saying “people on calorie restricted diets living to a 100 would be freaking ecological catastrophe” suggests JKB is assuming biomed research won’t lead to people living on calorie-overdose diets to be 100, the last sixty years of that as resource-sucking diabetics. This is just to highlight that assumptions and predictions in unintended social consequences is a very tricky business. How far in advance was this obesity colic predicted?

    Actually I was being sarcastic.
    Doc and the boys know that I tend to go overboard on the medical establishment being ethically challenged. See, I don’t think it’s as lucrative to heal, as it is to treat.
    Is it feasible that overweight people could reach to 100+? Absolutely, given the economics of using people as a life support systems for uberclass bank accounts. Would these obese 100 year olds be active, productive and lucid? Do we care as long as they have cash?
    I don’t know for a fact that these people would be bred for the purpose of feeding the economy, but I think it’s a good bet. I don’t know for a fact that the sun will rise tomorrow either, but I plan for it based on observation.
    My friendly jab was mainly at the thought of Beck living to a ripe and bitter 100. We Americans consume way above the global norm and I don’t know that the planet could support either overweight or underweight(?) Americans living to 100.
    Besides, what will we do with the old, flabby bodies when we move the consciousness to our new custom cloned bodies on the 95th birthday? That’s another ecological disaster.

  9. #9 by Kevin Beck on January 10, 2007 - 9:38 pm

    “…’ll wager most of the following items apply to Campos “weight writing” without having looked at any of his other material on fat or knowing anything about him personally.”
    I don’t know Campos personally, but I became acquainted with him on a distance-running message board before I was aware he was a newspaper columnist. One contention of his in particular sticks in my mind: his claim that running a 23-minute 5K as a ninth-grade male requires an unusual amount of talent. Now, this number may mean little to you, and “unusual amount of talent” is an arbitrary metric, but trust me when I say that this is a wildly ignorant statement, one I chalked up at the time to basic projection (Campos was a prone-to-chubbiness midpacker or back-of-the-packer).
    Later, when he was just getting going with The Obesity Myth and mentioning it every fifteen minutes, I mixed it up with him over a number of his specific medical claims, the bulk of which he had no answer for, such as reconciling “morbidly obese people do get sick” with “obesity per se isn’t harmful” and his reluctance to factor smokers and cancer patients out of low-BMI groups when assessing mortality despite railing against just this kind of crap in other areas.
    Campos is sharp enough to scan medical literature and present himself to the average reader in a manner that suggests he has a handle on everything, but when he is pressed for justification of his creative reformulation of data, it immediately becomes obvious that he both distorts and plain misunderstands key biostatistical principles, a habit into which the TNR piece offers a glimpse. He reached a point in our arguments at which one his basic defense was “You may be a fine runner, but you’re out of your element on this”; later, after finding out I’d taken graduate-level course work in this stuff and our discussions grew more heated, this became “not bad for a med-school dropout.” This de facto throwing in of the towel didn’t keep him from finishing his steaming heap of a book, of course.
    He repeatedly stressed to skeptics that a simple Google search couldn’t possibly compete with the hours and hours of research he’d done for his book. But he was wrong, because when someone known to have an axe to grind is mucking around in medical literature looking for evidence to support a preformed conclusion, even a cursory Web search is superfluous; you know the “research” in question is meaningless.
    But while the man is a liar, as you say, his target audience couldn’t care less. When facts fail miserably, all advocacy is valid advocacy. The evil diet-industry-funded mass media suddenly becomes an ally when it publishes trash like Campos’. Now the Big Fat Bloggers are braying about a new diet drug for dogs and how it’s all a ploy for the manufacturer to get humans to take it while skirting the FDA. God bless them, but those people’s brains are in ruins.
    So Campos’ background and established attitude to some extent do inform my assessment of his obesity drivel, but the latter fails any objective stand-alone sniff test.

  10. #10 by Doc Bushwell on January 10, 2007 - 10:17 pm

    JKB: Besides, what will we do with the old, flabby bodies when we move the consciousness to our new custom cloned bodies on the 95th birthday?

    Time to fire up the Soylent Green factories!

  11. #11 by SkookumPlanet on January 11, 2007 - 2:20 am

    JKB
    I thought you might be but using my highly-honed rhetorical analytical skills I convinced myself you were serious. I’ll feel fortunate if that’s my only mistake.
    And I can’t argue with your idea it’s more lucrative to treat than to heal. All the more reason to keep as much ethical tradition as possible in our medical professionals.
    Your point about eco-footprints is also solid. My real concern there is the Chinese commercial mind, one of the best arguments for the U.S. electorate to leave it’s hyper-extended adolescence and join the actual adult intermulticodependnet world the other nations’ citizens function in. Our long infatuation with distorting reality for internal political gain will, a century from now, look to be as faddish and brain-dead as our current infatuation with SUVs. Of course, by then it will be too late.
    My keen observational mind also failed to register the dates on the TNR comments until after I’d basically finished writing for there, so I doubt I’ll post. I’ve got a recurrent hiccup in my neural circuits about this particular oversight.
    Kevin
    One of the commenters there mentioned Campos was an attorney, which ground me to a halt for awhile. If so, all the more reason he should know better. In 8th grade I ran cross-country to be in shape for basketball season. My calves are genetically adverse and I’ve fortunately repressed all memories of, uh, it was, uh . . . running! That’s it!
    I’d like to mention to everyone involved here that while this was a distraction, it was also a lot of fun reading good writing, following bright minds, and rising to the challenge and participating myself. Thanks.

  12. #12 by Erechtheides on January 11, 2007 - 9:56 am

    I’m new here, so forgive me if this has all been covered before; I know it’s an ongoing topic.
    I’m absolutely not defending this ridiculous person, but I can see one genuine point of connection between the social and medical issues he conflates.
    I’m a woman in my mid-20s, and with one exception (about which more in a moment) I’ve been 5’7.5″ and 135-145 lbs since high school. I have a large frame, with broad hips and shoulders.
    And I cannot tell you how many times in my life I have been called fat, especially as an adolescent. This may be the root of some of people’s confusion. I’m not obese by any medical standard that I know of, but any female in this country who doesn’t look like Lara Flynn Boyle is, for all intents and purposes, fat as far as her peers are concerned.
    Anyway, for a year or so in my wayward youth, due to a combination of a busy social life (dancing 4 nights a week or so) and relative poverty (one meal a day- two at absolute maximum), I fell in line with our society’s ideal. Yes, for a brief, shining moment, I weighed a glorious 110 lbs.
    And you know what? I looked- and felt- like absolute crap. Just completely horrible.
    So while it’s obvious that this guy is at best deluded and logic-free, and at worst glaringly dishonest (and most probably all of the above), I don’t think that the medical and the social can be completely separated in the mind of anyone who exists both as an organism and as a social being. This is true even in less emotionally freighted issues than obesity, but it’s most easily seen in such a case.
    There is clearly a rational, safe place between emaciation and obesity. But those who fall within that range will still be considered fat by the majority of media-consumers in this country.
    Don’t know what it means, and it certainly doesn’t make Campos any more correct in his specious arguments, but I felt it needed to be said.

  13. #13 by Erechtheides on January 11, 2007 - 10:00 am

    P.S.
    JKB – What on earth is a “liberal neocon?”

  14. #14 by JKB on January 11, 2007 - 10:44 am

    I assume that you don’t habituate at TNR. It used to be a liberal, relatively intellectual magazine before Martin Peretz got his grubbies on it.
    Read the first four or so paragraphs of the Wikipedia link I provided and it’ll explain what a liberal neocon is.
    I would have stopped reading TNR years ago but for the commenters that descend, knives sharpened, to fillet Martin and some of the other boobs there. Some of the commenters are wicked clever, particularly when dealing with the aforementioned liberal neocons.
    Like Shelly says above: A trainwreck is hard to ignore. And TNR is a runaway train barreling toward the inevitable.
    To Shelly:

    And of course, rising medical costs/insurance costs affect us all. I wonder if there’s a blog out there that purports that smoking is healthy too, and that all this nasty legislation against smoking in bars and public places is due to some huge conspiracy.

    Beck makes mention of TCS. Please do spend some time there if you want to see a full on, frontal assault by the ridiculous on the sublime.

  15. #15 by Erechtheides on January 11, 2007 - 11:25 am

    JKB – You assumed correctly. Thank you for the link. People like Peretz make my brain hurt.

  16. #16 by JK (not JKB) on January 11, 2007 - 11:33 am

    “In a truth-seeking debate one takes in an opponent’s critique and attempts to integrate it, so it’s weaknesses and strengths can be discussed.”
    Go on then:
    http://scholar.google.com/scholar?q=medicalization
    Where do you get off telling people how they should live their lives? I’m sure that many overweight people rationalize away risks, but in many cases that would seem to be a fair enough response to public health busy bodies. I have no problem with a decent education system and provision of information to anyone who wants it. I strongly object to being told what I should do with my body, what risks I should take and how I should relate to my own mortality.
    Submission to medical authority is usually therapeutic, but it needs to be voluntary. Humane medicine should do its best to support people living as long, as comfortably and as well as possible given the choices they make.

  17. #17 by Kevin Beck on January 11, 2007 - 3:54 pm

    “Where do you get off telling people how they should live their lives?”
    Well, I could make this really simple and ask for an example of a behavioral imperative proposed by SkookumPlanet. But that would be boring, so…
    Is the Surgeon General’s Office listing the known health risks of smoking equivalent to the government breaking into people’s houses and confiscating their cigarettes?
    “I’m sure that many overweight people rationalize away risks, but in many cases that would seem to be a fair enough response to public health busy bodies.”
    So if I’m a smoker and I’m sick and tired of the increasing number of anti-smoking ads and public bans on lighting up, it’s fair for me to decide as a result that the link between smoking and heart disease doesn’t exist? Sounds to me like the antithesis of minding one’s own business, if you think about it.
    “I have no problem with a decent education system and provision of information to anyone who wants it. I strongly object to being told what I should do with my body, what risks I should take and how I should relate to my own mortality.”
    Again, where do you see evidence of being coerced into anything? There’s a McDonald’s and five of its sister establishments in practically every shopping center in every U.S. town with over 10,000 people. Ads for yummy, potentially fattening foods appear every 10 minutes on virtually every television channel. No one has ever limited your dietary choices by dint of law if you are not incaracerated and living in the United States. (OK, I can’t set up a Hibachi in a movie theater, but you get the idea.)
    “Submission to medical authority is usually therapeutic, but it needs to be voluntary. Humane medicine should do its best to support people living as long, as comfortably and as well as possible given the choices they make.”
    Do doctors routinely turn away or ridicule COPD or lung CA patients with smoking histories?

  18. #18 by SkookumPlanet on January 11, 2007 - 9:30 pm

    JK
    I meant to address the methods people like Campos use to make their arguments and suggest some focus off the argument content. [Encouraging obsessive focus on details is one of their techniques.] It’s a method to make their dishonesty and manipulation part of the conversation, which in turn opens the door to moral assessment and providing the public a bit of media literacy.
    Those final two elements are important. The Far Right has successfully created a reality in much of the public’s mind that they are morally ascendant and their opponents the reverse. It’s an entirely media-driven construct, realized through a highly amoral methodology — they’re willing to lie about anything. Advocating the public be given a few tools to see this themselves is my primary writing goal at SciBlogs.
    I don’t understand where I was telling people how to live their lives, other than what I just said. Certainly I implied Campos could pursue a less destructive career.
    But as far as me, or anyone, telling you what you should do with your body, I can add three related items to those Kevin listed.
    First, an assumption behind your points leads me to infer you’re missing something. Most people don’t see it. The assumption is the public health sector is the only persuasive message carrier. What you barely see is a huge industry, populated by some of the brightest minds in our country — psychologists, communication Phds, etc — which [figuratively] know more about you than you do. It’s spent tens of billions of dollars and 50+ years figuring out how to get you to do what they want whether you want to or not. By necessity this industry as become increasingly focused on doing this subconsciously and on using the increasingly sophisticated scientific understanding of how human brains process information. Neuroscience appears to be on the brink of its golden age. One thing being revealed is much of what we perceive about our own brains is an illusion.
    The industry rents these skills and knowledge out to completely legal efforts that, by their nature, have not a single communal interest [other than a desire for living customers] hindering their pursuit of separating people and institutions from their cash. Nothing wrong with that, it’s just a fact.
    Thinking about this industry as simply the advertising you consciously recognize in your life is uninformed and naive to the utmost. For example, cigarette companies are experimenting with turning architecture into non-verbal, invisible advertising. All of us now inhabit a virtually 100% manipulated environment where highly competitive, high-stakes, big-money players use decades of research and application results with their survival depending on the results. What goes out into this environment from public health sources is nearly microscopic.
    Second, arguments for motorcycle helmet laws, and the laws, might vanish if we could single out the true, lifetime costs of treating the resultant head injuries and find an insurer who could devise a business strategy out of it. We’d probably have to demand a year’s insurance up front, the bonding and implantation of RFID tags into riders and bikes, publicly branding and allowing only covered bikes, etc. to insure their insured status. My intuition is that then only the very wealthiest Americans could afford to ride. The lifetime cost of a severe head injury can go above a million dollars, no problem.
    Motorcycles cause a lot of head injuries. In case you’ve never heard the old homily, ER personnel call motorcycles, donorcycles.
    Third, we don’t let people do whatever they want with their bodies if in doing so they create large social costs and disruptions. Being a typhoid carrier is an example. I remember years ago reading a press story about the last person in world to be vaccinated for smallpox, clearly not the absolute last person, but it’s the idea. He had to be physically detained and vaccinated. He had refused based on religion.
    This isn’t an easy question. Does the single remaining reservoir of smallpox on Earth have the right to not do anything about it? As a group, we attempt calculate out the incalculable cost that smallpox has wrought, project that into the future, and remove the threat. It’s not much different than not allowing paranoid schizophrenics to run screaming through the streets with fully loaded semi-automatic weapons.
    Where society draws the line, and what actions it can take in response, is the debating point. Disallowing anyone, or group, to publicly call someone or their actions stupid and self-destructive would produce a bizarre society unlike anything most people would choose to live in.
    I suspect you would feel differently if an IQ 80, manic-depressive typhoid carrier, who refused treatment for both conditions, during a wild manic bout infected and thereby killed your child.
    That person will eventually repeat the performance.
    .
    Finally, I’m uncertain of the connection between your Google link and the sentence of mine you quoted. My best interpretation is it’s to suggest I don’t get the concept or in some way am an apologist for the medical establishment concerning somatization, medicalization, etc. You are making another assumption, one that reveals a huge hole in your thinking processes.
    Your knowledge about my personal medical history sums up to zero. If your link began a debate in which you went after me in that guise, I’d let you construct the largest “Big Med/Big Pharma/clueless about such” caricature of me as you can possibly conceive of.
    At the exactly right moment, I’d simply give you an abstract of my medical history, and exactly what I’ve done about it and the biomedical research I follow and know about, some biomedical history, how the biomedical “establishment” functions and the details of patient advocacy I’ve been involved with. That would include items like me witnessing the origin and national spread of derogatory terminology used to somatisize an illness, and explaining the detailed mechanics of how it happened.
    As there are over 25 years to cover, this would take quite awhile. In the process I would be cutting you up into pieces so small none left would be large enough to even whisper, “I was wrong.”

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