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54September/October 2015
CULTURE Obesity
Michael Smith replies to a recent article
in
Village
which misled about obesity
Obesity obeisance
obtuse obscenity
Source: Wikipedia
REPLY
September/October 2015 55
A
RECENT article in Village,
‘Obesity obeisance’ (June
) suggested Ireland
was in the manipulated
throes of a spurious fatness
‘epidemic’ contrived by industry mach-
ination, junk science and
twenty-first-century angst.
The article was an example of truthi-
ness, a righteous gloss on truthfulness
– minus the core ‘truth’ element; and
thankfully a number of Village readers
were enraged. Normally Village pub-
lishes nothing nutritional except
articles that vilify obesity and its
purveyors.
One of the points of journalism is,
where relevant, to draw attention to
the science; and not to succumb to
crackpot minority opinions
ungrounded in the scientific method.
Journalism can with ease distinguish
peer-reviewed science from junk sci-
ence; and denying an obesity epidemic
has little academic substance. It is not
journalism to publish the disproved
views of cancer/smoking link-deniers,
of creationists or of climate-change
deniers. Obesity deniers should draw
our opprobrium no less.
Interestingly a representative of the
ambassador of one of the great culi-
nary civilisations wrote to the
magazine letting it be known his excel-
lency would like to talk to the piece’s
author; and arrangements were made.
Why ambassadors do not make more
focused contact about real issues is
unclear.
The stakes are high. per cent of
Irish people are obese (ie with a body
mass index in excess of ), but Ireland
is actually set to become Europe’s most
obese country by , rivalled only
by Uzbekistan, according to figures
presented by the World Health
Organisation as part of their
Modelling Obesity Project.
The proportion of obese Irish men is
expected to increase from % to
%, with the number of men classi-
fied as either overweight or obese
rising from % to %. Obesity in
women will jump from % to %
with the number of women classified as
either overweight or obese rising from
% to % by . In the US for
reference currently two thirds of
women and three quarters of men are
overweight or obese, and the figures
there are rising.
Professor Donal O’Shea, co-chair of
the Royal College of Physicians of Ire-
land, sees all this as “a much bigger
health crisis than what cholera was
back in the s and HIV/AIDS was
back in the s and s”. Minister for
Health Leo Varadkar admits that obes-
ity has become a “major personal and
public-health problem”, and has called
for the issue to be treated “as seriously
as we treated tobacco in the past”.
The Village article questioned
whether being fat was really that detri-
mental to our health and suggested
there were moral, social and economic
influences (no less) rendering our
understanding of obesity (wait for it)
“inaccurate at best, or worse still,
enormously harmful to many people’s
lives”.
No such fear.
The article started by looking at the
baseline unit of measurement for obes-
ity that the World Health Organization
uses: the Body Mass Index or “BMI”, a
simple mathematical formula that
places people of different heights and
weights on a single integrated scale,
but one which, the piece notes, “was
never intended to be a measure of indi-
vidual health yet despite this it has
formed the basis for almost every
public policy and study on issues of
weight and obesity written in the
modern era”.
It is alleged a body called the Inter-
national Obesity Task Force (IOTF)
– scandalously funded by big drug
companies looking to sell weight-loss
drugs - drafted a report for the WHO
using data provided by US health insur-
ance giant Met Life. The report led to
the “ideal”, “healthy” weight for an
individual dropping by - pounds.
The BMI formula itself does not
account for things like muscle mass
and bone density. Rugby-player, Cian
Healy, according to the index (and the
article), registers as obese.
Certainly BMI is an unreliable indi-
cator for individuals but the point the
author missed is that it is not unrelia-
ble for populations: there is no reason
to think that, if a population’s BMI
rises, weight will fail to rise under any
of the other established indexes, such
as ‘the Body Shape Index’.
The author seems to miss the entire
point. Public policy is addressed to
populations not individuals.
BMI remains a useful gauge of how
society is progressing over time and of
how it is faring relative to other coun-
tries that use the same measure.
“Where BMI is really useful is for
measuring trends in large popula-
tions”, according to Dr David Haslam,
chairman of Britain’s National Obesity
Forum. The author’s mistake is basic.
In America, the author goes on, the
country thought of as leading the way
in weight gain and rising obesity levels,
the majority of people, according to a
study from the International Journal of
Obesity, have only experienced a mod-
erate weight gain of approximately
-Kg. That’s only an extra calories
a day in their diet, a Big Mac every two
months, he declares.
It’s not quite clear what he means. He
notably fails to say what time period he
is considering. No matter. His topic is
obesity. As already stated, in the US
currently two thirds of women and
three quarters of men are overweight
or obese. According to the Trust for
America’s Health, in , the US
obesity rate was percent. By it
almost doubled, with percent of
Americans considered obese. Five
years later, it was . percent.
Worse, a report by CDC in
Obesity’s
existence and
prevalence;
and the
increase
in that
prevalence,
are clear.
At least to
experts
“
56September/October 2015
CULTURE Obesity
estimated percent of Americans
would be obese by . America, the
science and the figures show, is obese
and getting obeser.
It therefore matters not, in proving
the scale of the obesity problem, that a
particular Journal over an unspecified
period noted the majority of people
only gained -kg, even if – presuma-
bly unbeknown to the author – it is
probable they will put on even more
weight over a further (perhaps even
specified) period.
The author proceeds to look at a
study published by The Journal of
the American Medical Association
which reviewed nearly three million
subjects from more than a dozen coun-
tries and found the ‘obesity paradox’
- that adults categorised as overweight,
and most of those declared obese actu-
ally had a lower risk of mortality than
so-called thin or normal weight
individuals.
For example for average-height men,
feet inches, those who weigh
between and pounds have a
higher mortality risk than those who
weigh between and pounds.
But the study was criticised by
Walter Willett of the Harvard School of
Public Health, who called it a “pile of
rubbish . . . No one should waste their
time reading it”. Soon after it was pub-
lished, the dean of Harvard Medical
School, Jeffrey Scott Flier, convened a
panel of experts to discuss it at Har-
vard. The panel members stated that it
contained several methodological
errors. For example, panelist Frank Hu
said that its selection criteria “ruled
out high-quality studies of million
people” and that these studies, com-
bined with those actually included in
the review, showed that the highest
survival rates are in people of normal
weight.
The author goes on: “throughout the
terrors of our recent obesity ‘epidemic’,
life expectancy in western countries
has risen, not fallen, despite the many
life-threatening health conditions sup-
posedly caused by obesity. The
correlations between higher weight
and greater health risk are threadbare,
only significant at the extremes,
severely underweight or morbidly
obese”.
This doesn’t even offer rudimentary
logical appeal. It is undermined com-
prehensively by the argument that life
expectancy would have risen even
more without the impediment of preva-
lent obesity.
But, he notes, in any event that
there’s almost no evidence that turning
a fat individual into a slim individual
improves overall health. He claims, in
argumentation likely to appeal to
right-on progressives, that this is
mostly due to the fact that - despite
claims of omnipresent miracle diets
and exercise programs - sustained,
long-term weight loss is something we
currently, according to the evidence,
do not know how to achieve.
A former finance director of Weight
Watchers, claimed the brand was
successful because “the % [who
can’t keep the weight off] keep coming
back. That’s where your business
comes from”.
That may be so. But it is a further
injunction against becoming obese and
in no way belies the dangers, or exist-
ence, of the epidemic. It does not help
him with his argument that obesity is
not a problem.
He notes that the global market for
“weight management services” is
expected to reach $.bn this year
and huge corporate conglomerates
control both the “healthy” and
“unhealthy” markets. Nestlé sells tra-
ditionally fattening foods but also
owns US diet company, Jenny Craig.
The current CEO of Weight Watchers
used to be, CEO of Cadbury America.
Again this suggests nothing but that
there are malign forces facilitating the
epidemic.
His final gambit is that there is a
growing body of research beginning to
question the calorie as an indicator of
food’s weight-producing propensity.
Harmful chemicals known as endo-
crine disruptors may create biological
pathways to obesity independent of
caloric metabolism.
This may go to the cause, but again it
does not go to the existence, of the
obesity epidemic.
In any event fashion, science (and
Jamie Oliver) are pointing to sugar as
the major source of contemporary
obesity. There are nine calories in one
cube (. oz) of granulated sugar. You’d
need to walk two minutes to burn nine
calories. But people rarely do.
As Michael Gibney, Professor of Food
and Health at UCD pointed out in a
recent Irish Times column the problem
of obesity (like it must be said, that of
climate change) is highly complex.
Even with a body of evidence from
several disciplines, the answers are
neither straightforward nor are they
necessarily known.
There is a clear need to integrate
what scientific evidence we have.
Because of its complexity, helping
people with obesity requires a multi-
pronged approach. What works for
those who are somewhat overweight
may not be appropriate for the very
obese. The causes of, and solutions to,
obesity are complex. Even for experts.
Obesity’s existence and prevalence;
and the increase in that prevalence, are
clear. At least to experts. •
The article was
an example of
truthiness -
truthfulness –
minus the core
‘truth’ element
“
September/October 2015 57
MARCH FOR
CHOICE
Choos
e
Your
Future
Village 220 x 285.indd 2 28/08/2015 16:42
