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.

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 because the point is still to convert fat into energy later.

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

I can't find a handy reference, but I recall (from art history class) that women who were at least slightly overweight have long been portrayed as the ideal in art around the world. It may be necessary to consider that what's considered a healthy weight today may have looked slightly overweight (indicating good access to quality food, a signal of status) to artists in the past.

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

Because it's not easy to manipulate no matter how smart you are. If someone were so smart as to figure out a successful, lasting intervention, they'd be rich from selling the diet to the rest of us. Taking a page from Robin Hanson, there's a benefit to this similar to that of taxing the tall.

Because it's not easy to manipulate no matter how smart you are.

Fat is trivial to manipulate. I lost 27kg (BMI 30 to 22) without any effort with ECA (with non-junk diet and a light amounts of exercise, nothing unusual), it's stable for many years now. Just ask any bodybuilders for advice - they know how to do it, or read pubmed about ECA. The difficult part is not believing the popular culture's completely ineffective methods, once you do that losing your fat is trivial matter.

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