The Obesity Myth

Matt_Simpson

Megan McArdles blogs an interview with Paul Campos, author of The Obesity Myth. I'll let anyone who is interest read the whole thing, but here's some interesting excerpts:

I mean, there's no better established empirical proposition in medical science that we don't know how to make people thinner. But apparently this proposition is too disturbing to consider, even though it's about as well established as that cigarettes cause lung cancer. So all these proposals about improving public health by making people thinner are completely crazy. They are as non-sensical as anything being proposed by public officials in our culture right now, which is saying something.

It's conceivable that through some massive policy interventions you might be able to reduce the population's average BMI from 27 to 25 or something like that. But what would be the point? There aren't any health differences to speak of for people between BMIs of about 20 and 35, so undertaking the public health equivalent of the Apollo program to reduce the populace's average BMI by a unit or two (and again I will emphasize that we don't actually know if we could do even that) is an incredible waste of public health resources

and

Megan: An economist recently pointed out that we don't encourage people to move to the country, even though rural people live more than three years longer than urban people, and the diffefence in their healthy life expectancy is even more outsized. Nor do we encourage people to find Jesus or get married. We target "unhealthy" behaviors that are already stigmatized.

Paul: Right, as Mary Douglas the anthropologist has pointed out, we focus on risks not on the basis of "rational" cost-benefit analysis, but because of the symbolic work focusing on those risks does -- most particularly signalling disapproval of certain groups and behaviors. In this culture fatness is a metaphor for poverty, lack of self-control, and other stuff that freaks out the new Puritans all across the ideological spectrum, which is why the war on fat is so ferocious -- it appeals very strongly to both the right and the left, for related if different reasons.

Megan McArdles blogs an interview with Paul Campos, author of The Obesity Myth. I'll let anyone who is interest read the whole thing, but here's some interesting excerpts:

I mean, there's no better established empirical proposition in medical science that we don't know how to make people thinner. But apparently this proposition is too disturbing to consider, even though it's about as well established as that cigarettes cause lung cancer. So all these proposals about improving public health by making people thinner are completely crazy. They are as non-sensical as anything being proposed by public officials in our culture right now, which is saying something.

It's conceivable that through some massive policy interventions you might be able to reduce the population's average BMI from 27 to 25 or something like that. But what would be the point? There aren't any health differences to speak of for people between BMIs of about 20 and 35, so undertaking the public health equivalent of the Apollo program to reduce the populace's average BMI by a unit or two (and again I will emphasize that we don't actually know if we could do even that) is an incredible waste of public health resources

and

Megan: An economist recently pointed out that we don't encourage people to move to the country, even though rural people live more than three years longer than urban people, and the diffefence in their healthy life expectancy is even more outsized. Nor do we encourage people to find Jesus or get married. We target "unhealthy" behaviors that are already stigmatized.

Paul: Right, as Mary Douglas the anthropologist has pointed out, we focus on risks not on the basis of "rational" cost-benefit analysis, but because of the symbolic work focusing on those risks does -- most particularly signalling disapproval of certain groups and behaviors. In this culture fatness is a metaphor for poverty, lack of self-control, and other stuff that freaks out the new Puritans all across the ideological spectrum, which is why the war on fat is so ferocious -- it appeals very strongly to both the right and the left, for related if different reasons.

Let's consider, though, why humans can become fat. The body stores energy in the form of fat for later conversion to sugars in the event of insufficient sugars to keep the body functioning.

You know that mammals cannot convert fat to sugar no matter what, right? (OK, there's some limited evidence that glyoxylate cycle enzymes might be present in mammals, but even if they are active, what doesn't seem terribly likely, the primary way to utilize fatty acids is definitely beta oxidation, which burns them for ATP).

To me this suggests that outright starvation is, evolutionarily speaking, a far greater threat than lack of access to particular essential comestibles.

There's an argument that pre-agricultural food had a lot higher micronutrient to calorie ratio, so micronutrients were unlikely to be lacking even on very restricted diet. Modern food is supposedly selected for high calorie content.

Historically being thin was not attractive, especially for women, as evidenced by human art that has long shown women with at least some significant fat stores as the most attractive.

As far as I can tell most art shows women of healthy weight as attractive, very rarely overweight or obese kind.

Probably nothing, although it's a worthy goal to push the elimination of weight as a status signal because even a partial success would result in a lot less suffering for billions of people.

Why would we want to eliminate a status signal that's so easy to manipulate for smart people?

In the mean time, at least LW readers can eliminate from themselves false beliefs that anything but extreme obesity, or extreme skinniness, has anything more than a marginal health effect.

Metabolic syndrome seems real enough. Even if being moderately overweight wasn't a health risk, it seems likely that someone moderately overweight is much more likely to become morbidly obese than someone with healthy weight. And far more people suffer from obesity-related diseases now than ever - so even if it's mostly the extreme cases, if anti-fat interventions can get them to just moderately overweight it's obviously worth it.

You know that mammals cannot convert fat to sugar no matter what, right? (OK, there's some limited evidence that glyoxylate cycle enzymes might be present in mammals, but even if they are active, what doesn't seem terribly likely, the primary way to utilize fatty acids is definitely beta oxidation, which burns them for ATP).

I was unaware of this. I am woefully ignorant of many aspects of biochemistry, so this was described as I recall the process being described. If fat isn't converted back to sugars, I think it doesn't affect the argument too much be... (read more)

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The Obesity Myth

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The Obesity Myth

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