The stupid explodes: obesity now a disability

[Tatyana]

Having said that, IMO, I think bignickel has a valid point that Marketing Departments during Taubes' period of interest followed consumer demand, and medical advice does shape consumer preferences.

The extent to which genuine advice was distorted by media is difficult to evaluate. The amount of time and effort involved, and establishing an objective metric that would withstand peer review... feels like PhD worthy work to me.

I used to read a few journals religiously as they were available to me, BMJ and the Lancet.

We also have New Scientist in the laboratory.

I have always found it quite interesting to read an article in the BMJ, then reading the simplified (but still scientifically valid) version in New Scientist, and then reading the (often wrong) interpretation in the Metro.

It isn't very interesting to read a story about how there is a marginal improvement and life extension in terminal cancer that will cost £ 100 000 for six months, but stating 'NHS denies cancer treatment' is a head line that sucks people in.

Most people read really rubbish sources of information.

It is worrying when people think that facts and proper information are 'boring and stupid', which has even been illustrated in this thread.

I despair at the dumbing down of society.

 

[blutoski]

I used to read a few journals religiously as they were available to me, BMJ and the Lancet.

We also have New Scientist in the laboratory.

I have always found it quite interesting to read an article in the BMJ, then reading the simplified (but still scientifically valid) version in New Scientist, and then reading the (often wrong) interpretation in the Metro.

It isn't very interesting to read a story about how there is a marginal improvement and life extension in terminal cancer that will cost £ 100 000 for six months, but stating 'NHS denies cancer treatment' is a head line that sucks people in.

Most people read really rubbish sources of information.

Oh, I agree... I see it every day... but not sure how to close the circle and quantify the damage.

It is worrying when people think that facts and proper information are 'boring and stupid', which has even been illustrated in this thread.

I despair at the dumbing down of society.

I'm just as worried about the people who perform misguided research, though. This is one of the paradoxes of Skepticism: a lot of antiscience is very knowledgeable. Shermer verified this hypothesis back in the 1980s and it troubled me then as much as it troubles me today. Then came the whole Pauling fiasco. I have become convinced that this is a problem, too.

For example: antivaxxers not only have more education than the general public, but in particular are much more likely to have a natural science or applied science (eg: engineering, nursing) degree.

This is what has led me to treat personal reading of scientific papers to be essentially 'educational' but not 'problem solving' or 'thesis/belief testing' and to leave expert evaluation to, well, experts. To put this another way, the more I read on a subject, the more I realize I don't know much about it. My MSc in Research Medicine does not give me a good enough grasp of obesity epidemiology or physiology to challenge such an established consensus. If I dedicated a year of weekends to dietetics, I would be 6% of the way to my Registered Dietician friend's level of competence. It is not only more efficient use of my time to refer to her expertise on this subject matter, but it's more likely to result in the correct answer as well.

When I was doing research into fiction writing (hoping to launch a 3rd career someday) I came across a trope: [Omnidisciplinary Scientist]. There's a cartoon that captures my thoughts pretty succinctly.

 

[bit_pattern]

... and we'll discuss a valid comparison. Until then, not even close.
Good. My distress at being overweight got me to make a change. Maybe more people should follow in my footsteps and quite pretending that their are disabled.
Thanks for your support.

I find it interesting that you chastise someone else's comparison for being invalid then in the very next sentence go on to compare your own anecdotal experience of being overweight with that of someone who is so obese they are, for all intents and purposes, disabled. Losing 12 kgs is not comparable with the experience of someone who needs to lose 50-100 kgs and who is so obese that they can't physically do things like walk 2 miles (because, like you know, that's what disabled actually means). So while I applaud your efforts in losing a small amount of weight, please don't piss on the roof and tell us it's raining.

 

[Checkmite]

http://www.theage.com.au/victoria/h...onash-childrens-hospital-20141228-12c9et.html

Public health experts are calling for the new Monash Children's Hospital to exclude fast food outlets and say the Royal Children's Hospital should dump its contract with McDonald's because it is creating a "healthy halo effect" that sends the wrong message to families.

Give me a break. There isn't a single fool in the world who saw a McDonald's in a hospital food court and concluded "Hey, that must mean McDonald's food is perfectly healthy!", let alone an epidemic of families doing it. Unless families in Australia are pathetically and hopelessly stupid in general (except for the Smart People Who Know Better, like the people who are calling for an intercession on behalf of all the confused idiot-families who don't).

 

[bit_pattern]

Give me a break. There isn't a single fool in the world who saw a McDonald's in a hospital food court and concluded "Hey, that must mean McDonald's food is perfectly healthy!"

You've asked them all then, have you?

Ever heard of the Halo Effect?

 

[bit_pattern]

Oh. Look. Your feelings contradicted by actual data. What a surprise!

http://pediatrics.aappublications.org/content/118/6/2290

ABSTRACT

OBJECTIVES. The objectives of this study were (1) to determine fast food restaurant prevalence in hospitals with pediatric residencies and (2) to evaluate how hospital environment affects purchase and perception of fast food.

METHODS. We first surveyed pediatric residency programs regarding fast food restaurants in their hospitals to determine the prevalence of fast food restaurants in these hospitals. We then surveyed adults with children after pediatric outpatient visits at 3 hospitals: hospital M with an on-site McDonald’s restaurant, hospital R without McDonald’s on site but with McDonald’s branding, and hospital X with neither on-site McDonald’s nor branding. We sought to determine attitudes toward, consumption of, and influences on purchase of fast food and McDonald’s food.

RESULTS. Fifty-nine of 200 hospitals with pediatric residencies had fast food restaurants. A total of 386 outpatient surveys were analyzed. Fast food consumption on the survey day was most common among hospital M respondents (56%; hospital R: 29%; hospital X: 33%), as was the purchase of McDonald’s food (hospital M: 53%; hospital R: 14%; hospital X: 22%). McDonald’s accounted for 95% of fast food consumed by hospital M respondents, and 83% of them bought their food at the on-site McDonald’s. Using logistic regression analysis, hospital M respondents were 4 times more likely than respondents at the other hospitals to have purchased McDonald’s food on the survey day. Visitors to hospitals M and R were more likely than those at hospital X to believe that McDonald’s supported the hospital financially. Respondents at hospital M rated McDonald’s food healthier than did respondents at the other hospitals.

CONCLUSIONS. Fast food restaurants are fairly common in hospitals that sponsor pediatric residency programs. A McDonald’s restaurant in a children’s hospital was associated with significantly increased purchase of McDonald’s food by outpatients, belief that the McDonald’s Corporation supported the hospital financially, and higher rating of the healthiness of McDonald’s food.

 

[blutoski]

Oh. Look. Your feelings contradicted by actual data. What a surprise!

http://pediatrics.aappublications.org/content/118/6/2290

And that's an example of where I'm focusing my attention. There is no reason to assume these people are 'stupid' because they are affected by the Halo Effect. It just means they're human.

Part of being a skeptic is learning about these non-cognitive effects. We have a literal blind spot in our eye. Knowing this does not make it go away. We're not stupid because of our retinal blind spot - just human.

By the same token, we're not stupid because we have other phenomena like Halo Effect. It affects every one of us in ways that we're literally unaware - that's how it works.


Over the last thirty years, I've been aware of a lot of advancement in our understanding of cognitive illusions like this because of my involvement in Skepticism. Guess who else has been paying attention: Marketers. They are practitioners of "the science of getting people to eat more food"; they've advancing their craft, and it has produced better results.

Paco Underhill has a few nonfiction books based on his research that are good reading. Note: not specifically focused on food, but general retail strategies for increasing sales by using environmental psychology.

 

[qayak]

You've asked them all then, have you?

Ever heard of the Halo Effect?

Yup. It's the same reason coke and pepsi sponsor kids sports days. They convince parents that kids are fat not because of the product but because if lack of activity. Then they sponsor a sports day and offer their product for sale. More people buy more of the product because they see coke and pepsi as being concerned for children.

 

[phiwum]

Not equivalent at all. Sport is at least a positive pursuit. Sitting on your fanny eating isn't.

So, whether someone is disabled or not depends on whether their condition is caused by a positive pursuit?

Mighty fine line you cut there.

 

[qayak]

So, whether someone is disabled or not depends on whether their condition is caused by a positive pursuit?

Mighty fine line you cut there.

Makes me wonder on which side of the line someone who got fat eating "healthy" food as opposed to "crap" food would fall. Weren't they involved in a "positive" pursuit?

 

[blutoski]

Makes me wonder on which side of the line someone who got fat eating "healthy" food as opposed to "crap" food would fall. Weren't they involved in a "positive" pursuit?

This is another reason I try to clarify what a person means when they say they're 'dieting' or 'on a diet'. Often, what they mean is they have changed their food palette, not that they are reducing their eating.

I have seen quite a few people go full vegetarian and develop worse health outcomes, I suspect entirely because of the subsequent weight gain. One friend was going through a cup of peanut butter a day. She felt that since it was home-made in a food processor from organic peanuts, she could just eat as much as she wanted.

The Mediterranean Diet is another one where I had clients baffled by their weight gain. But I can completely understand how it happened: I could eat olives or nuts all day.

 

[The Atheist]

So, whether someone is disabled or not depends on whether their condition is caused by a positive pursuit?

Mighty fine line you cut there.

Mea culpa. I didn't think I'd need to be so pedantic as to point out what I meant, but here goes:

British Journal of Sports Medicine:

Owing to the high risk of overweight adolescents becoming obese adults, the engagement of children and adolescents in physical activity and sport is a fundamental goal of obesity prevention.

Web MD:

A new study shows that teens who play on three or more sports teams are up to 39% less likely to be obese.

Otago University:

A simple intervention designed to maximise opportunities for physical
activity during extra-curricular time at school and during leisure time through the provision of community based Activity Co-ordinators significantly ncreased participation in physical activity and slowed excessive weight gain in primary school aged children.

American Academy of Pediatrics:

Regular physical activity is important in weight reduction and improving insulin sensitivity in youth with type 2 diabetes. ...

Regular physical activity is also beneficial psychologically for all youth regardless of weight. It is associated with an increase in self-esteem and self-concept and a decrease in anxiety and depression.

Let me know if you need more, there's plenty out there.

 

[The Atheist]

Related: http://www.internationalskeptics.com/forums/showthread.php?t=286986

 

[blutoski]

There's a cartoon that captures my thoughts pretty succinctly.

Found the original. Credit where credit is due: [Real vs Movie Scientist]

 

[mijopaalmc]

Mea culpa. I didn't think I'd need to be so pedantic as to point out what I meant, but here goes:

British Journal of Sports Medicine:



Web MD:



Otago University:



American Academy of Pediatrics:



Let me know if you need more, there's plenty out there.

None of that data actually supports the idea that obesity is not disabling.

 

[blutoski]

None of that data actually supports the idea that obesity is not disabling.

I think The Atheist was trying to support the claim that exercise is 'positive' behavior. This would be a premise to support the argument that if a person is disabled due to exercise, they should be treated differently than a person who is disabled from becoming morbidly obese, even if they meet every other criteria for disabled status.

This is actually an old ethics debate, not limited to obesity. The most common example I have come across in ethics textbooks is: does the guy who drank himself into cirrhosis of the liver deserve a liver transplant?

Others: Does the smoker who got lung cancer deserve a lung transplant? Does the patient who got HIV via IV drug use deserve the same protection from discrimination as a mother of three who got HIV from tainted blood during surgery after getting hit by a car?

Some are easier to resolve than others, and the critical element is that we need to be able to estimate agency. There is no scientific unit of agency, so some ethicists argue that we shouldn't arbitrarily assign agency estimates, that we should assume no agency for things that research shows are very difficult to overcome through willpower. Other ethicists disagree.

 

[jimbob]

I think The Atheist was trying to support the claim that exercise is 'positive' behavior. This would be a premise to support the argument that if a person is disabled due to exercise, they should be treated differently than a person who is disabled from becoming morbidly obese, even if they meet every other criteria for disabled status.

This is actually an old ethics debate, not limited to obesity. The most common example I have come across in ethics textbooks is: does the guy who drank himself into cirrhosis of the liver deserve a liver transplant?
Others: Does the smoker who got lung cancer deserve a lung transplant? Does the patient who got HIV via IV drug use deserve the same protection from discrimination as a mother of three who got HIV from tainted blood during surgery after getting hit by a car?

Some are easier to resolve than others, and the critical element is that we need to be able to estimate agency. There is no scientific unit of agency, so some ethicists argue that we shouldn't arbitrarily assign agency estimates, that we should assume no agency for things that research shows are very difficult to overcome through willpower. Other ethicists disagree.

There was a famous case in the UK when George Best had a liver transplant.

It didn't give him much extra time

 

[blutoski]

There was a famous case in the UK when George Best had a liver transplant.

It didn't give him much extra time

Possibly, but that's statistically neutral for almost all of these ethical case studies.

Alcoholics actually have the same survival rate and life expectancy post-transplant as non-alcoholics with similar health issues. The debate is whether they should lose their place in the prioritization of liver transplants strictly because of how they got there, all other risk factors being equal. To wit: the debate is entirely about ethics of blameworthiness and agency and so on.

 

[jimbob]

Possibly, but that's statistically neutral for almost all of these ethical case studies.

Alcoholics actually have the same survival rate and life expectancy post-transplant as non-alcoholics with similar health issues. The debate is whether they should lose their place in the prioritization of liver transplants strictly because of how they got there, all other risk factors being equal. To wit: the debate is entirely about ethics of blameworthiness and agency and so on.

Thank you - as a complete layperson, I'd have thought that there'd be populations where the risk factor would have vanished with the replacement of the diseased (ETA: Damaged) liver, and ones (like non-reformed alcoholics) and probably some infectious diseases where the risk factor would damage the replacement liver.

 

[blutoski]

Thank you - as a complete layperson, I'd have thought that there'd be populations where the risk factor would have vanished with the replacement of the diseased (ETA: Damaged) liver, and ones (like non-reformed alcoholics) and probably some infectious diseases where the risk factor would damage the replacement liver.

There is, and these risk factors are inputs for establishing a patient's position on the waiting list. An alcoholic will probably already be placed into a lower priority due to these additional health risks, so the debate is about whether they should be put even lower on the waitlist, or be denied access to the waitlist entirely, because of how the liver was damaged.