Afternoon InquisitionScienceSkepticism

AI: Friends and Your Health

Surfing the web for news this morning, I found this story in the New York Times. The item is related to the Framingham Heart Study, the nation’s most ambitious project to understand heart disease. Founded in 1948 by the National Heart Institute, the study has followed more than 15,000 Framingham, MA residents and their descendants, bringing them in every four years or so, for a comprehensive physical. Over the decades, the Framingham study has yielded a gold mine of information about risk factors for heart disease; it was instrumental, for instance, in identifying the positive role of “good” cholesterol.

Now, a pair of social scientists named Nicholas Christakis and James Fowler claim to have made yet another discovery using the Framingham data. Christakis and Fowler say, they have found some solid basis for a potentially powerful theory in epidemiology: that good behaviors — like quitting smoking or staying slender or being happy — pass from friend to friend almost as if they were contagious viruses. Apparently, in addition to genes, diet, etc., good health is also a product of your sheer proximity to other healthy people.

The data, they say, suggests we can influence one another’s health just by socializing.

Of course, according to their analysis, the same is true of bad behaviors — groups of friends appear to “infect” each other with obesity, unhappiness and smoking.

Do you see any holes in the analysis? What is the overall health level of your regular crew of friends? Do you think they, as a collective, “infect” you where health is concerned?

The Afternoon Inquisition (or AI) is a question posed to you, the Skepchick community. Look for it to appear daily at 3pm ET.

Sam Ogden

Sam Ogden is a writer, beach bum, and songwriter living in Houston, Texas, but he may be found scratching himself at many points across the globe. Follow him on Twitter @SamOgden

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139 Comments

  1. See any holes? Like what? That, like-minded people tend to stick with people that share ideas and lifestyles they they themselves share?

    That also explains why most of my friends are nuts, but I don’t need a scientific study to recognize that…

  2. @MiddleMan: I think it’s a little bit more than that. I saw this over at consumerist and a few people commented with the fact that, as soon as they got boyfriends who didn’t like gyms and ate horribly, their usual habits of going to the gym and eating decently went out the window.

    It’s not so much that people tend to stick with people that share their ideas and lifestyles, but rather that people tend to … adjust to the lifestyles of their friends.

    And I’d imagine it could go both ways – but the boyfriends’ laziness was probably stronger than the girlfriends’ normal habits of going to the gym and eating decently, so laziness won out.

  3. @marilove: Ok, that’s a good point, but in that case it it can also be that the laziness won out because of the girlfriend’s own inherent laziness. Otherwise, why would she be attracted to someone who differs in attitude?

    Or, am I just being too generalistic?

  4. Seems like a matter of an extra dimension. If we only had one point in time we couldn’t isolate the effect of “Make friends like me” from “Become more like my friends.”

    However, if we have time series data (which is the breakthrough in choosing Framingham) we can isolate the two components by looking at how a change in one member of a group of like friends propogates through the group.

  5. I don’t socialize much because I hate people. Or maybe I hate people because I don’t socialize much?

    Also, I think it makes some sense. Most of my friends are heavier than I am, so I’ve found myself eating more than I might otherwise have done because, well, I’m still smaller than they are. But then, when most of my friends were crazy-skinny college girls, I still ate my heart out because I knew I’d never be as skinny as they were no matter what I did, so I might as well enjoy my sandwiches.

  6. It sounds interesting, I’d have to see their paper and look over their mathematics before comming to any desicion for myself but it sounds plausable.

    I’m guessing but I suspect that they’ve used baysian statistics and conceptually it’s not that far away memes.

    @marilove: There are many studies that have been done in the UK to show that women have a postivie effect on their partner’s health. Married men have less mental & physical illness and live longer.

    Married women however, have higher levels of mental & physical illness than their singleton sisters and don’t live as long. It’s probably from all the running around looking after their husbands.

  7. @Sam Ogden: You’re right, I did jump in there without reading the article. But, we do tend to go toward people that reinforce personal attitudes, both positive and negative. Why is this such a surprise that smokers have smoker friends, or joggers work out together? These and other habits affect the mind, but some people never pick them up even in groups with these habits.

    This sounds a lot like Meme theory. I like the idea, but there’s too many factors that can affect and be affected by each individual in a culture that make such generalizations hard to equate to a social contagion.

    Unless we want to question if some people are naturally resistant to some ideas or habits, I still think it’s still a leap to say that we can “catch” obesity or such. Just my opinion…

  8. @Sam Ogden: I didn’t take it as a criticism, Sam. Nothing to be sorry about there.

    Just find that this is something that can be interpreted a number of ways. It’s hard to see what’s inside someone else’s head when what you have to go on is their actions and what your own head has in it. Too easy to judge things from a different point of view, as we see from my first post…

  9. This doesn’t seem surprising to me at all. We’ve already established that ideas propagate among social groups, and it only makes sense that you remain friends with people who you respect, and that your friends influence you.

    Given that, I don’t see why it’s surprising that ideas like quitting tobacco, going to the gym, etc. (or their opposites) would propagate in the same manner.

  10. I haven’t read the story-it was too long, and I don’t have the attention span. But, I’ve listened to SGU enough to realize:

    1) A single study proves nothing. Without followups, it can be difficult to deperate a signal from just noise.

    2) Without a hypothesis to test, its just data-mining. Its like an insurance company did a study in America comparing crashes to zodiac signs. They found one sign had a higher rate of incidence. However, a similar study was done in the UK, and a completely different sign was the worst driver.

    3)IMHO-no science behind this-people are going to be friends with others who share more qualities. I’m gay, skeptical, and a native Arkansan. Surprisingly, most of my FB friends are either gay, skeptical, or Arkansan. They didn’t make me these ways, these are things we share in common. While that’s not a perfect analogy, I hope you can pick up on the medaphor.

  11. @infinitemonkey:

    3)IMHO-no science behind this-people are going to be friends with others who share more qualities. I’m gay, skeptical, and a native Arkansan. Surprisingly, most of my FB friends are either gay, skeptical, or Arkansan. They didn’t make me these ways, these are things we share in common. While that’s not a perfect analogy, I hope you can pick up on the medaphor.

    That’s not the point of the study. MiddleMan already assumed that but he was corrected.

  12. The hypothesis is appoximately:
    The acquisition of a characteristic by an individual increases the likelihood of acquisition of that same characteristic among members of that individuals friend group.

    Whether that is precisely their hypothesis (it could certianly be phrased a number of ways) and what evidence they found for it is left to, as @russellsugden: rightly points out, the paper and the math therein.

  13. Peer pressure?

    Not always about the gateway drugs and the boze, sometimes it can be about being healthy or continueing your education.

    I agree with @infinitemonkey: ‘s first two points and also anyone out there who read it and went “well, duh.”

    As for the rest of the AI: Sort of… because I am doing Weight Watchers now all my coworkers are more aware of what they are eating… our office has become a points mecca and that is all well and good. It helps me stay on track knowing I am being watched. However, no matter how often they gush about American Idol, I will never watch it.

    I think there is a diff between habits as memes or things passed between friends, and personality traits or likes/dislikes. I hope that makes sense.

  14. Just a quick, important bit from a long article, in case you don’t have time to read it all:

    By the 1980s and 1990s, alarmed by the dangers of smoking among young Americans, health care workers began to do the same work on groupings of teenagers to discover exactly how each individual was influenced to pick up the habit. The language of contagion is part of pop culture today, thanks in part to the influence of Malcolm Gladwell’s best-selling book “The Tipping Point.” It’s now common to speak of social changes as epidemics (like the “obesity epidemic”) and to talk about “superconnectors” who are so promiscuously well linked that they exert an outsize influence in society, ushering trends into existence almost single-handedly.

    Yet the truth is, scientists have never successfully demonstrated that this is really how the world works. None of the case studies directly observed the contagion process in action.

    These guys are claiming they have observed the contagion process, using the Framingham data.

  15. @SKrap: There is this vendor I call sometimes and I’m alawys on hold for too long.

    They play Opera music. No, really. It’s horrible and grainy and the most painful hold music ever.

    Why anyone would choose OPERA as hold music, I do not know. Unless they like torturing people.

  16. If this is what I think it is, I’ve read about it on kateharding.net and it’s spurious as all hell. Iirc, it’s actually a computer simulation and the CONTAGIOUS OBESITY BOOGA BOOGA affected friends on opposite sides of the country but not spouses in the same house. And only affected men. By a pound. I’ll try and find the post.

  17. Again, I haven’t read the article, so it may have been covered, but I’m left with a few questions-mostly:

    If habits/physical characteristics can be passed from person to person like a virus, why are some people seemingly immune to them? EX: My office has a lot of overweight people, but we have a few people who go to the gym daily. I’ve worked here for 3 years, why aren’t some of them gaining weight? Why aren’t others losing? Are these people immune to the overweight virus?

  18. @marilove: Yeah, that was a little off the beaten path…

    Just to get back on your other post:

    @marilove:

    Too generalist. Because plenty of people are attracted to things that they don’t necessarily possess. He may have been awesome, otherwise.

    No, usually in that case they overlook that difference and try to see if they have the potential to accept the change in themselves. Some people opt out if they can’t or won’t, no matter how awesome the relationship may be.

  19. @eli54: Talk to me in five years, by which point 95% of diets fail. Yes, even if you call it a lifestyle change. Human bodies don’t conform to the laws of thermodynamics like that, there are too many other factors. And a huge component of weight is hereditary. (that study didn’t correct for relatives. Wtf?)

    Go forth unto the fatophere and read. kateharding.net, as I perviously linked, is a good place to start.

  20. @marilove: “Why anyone would choose OPERA as hold music, I do not know.”

    Because only f****** Wagner’s Ring cycle lasts long enough to still be playing when the average customer-service help-line call finally gets answered.

    That’s why.

    Can you tell I’m a Comcast customer?

    I didn’t say “bitter Comcast customer” because that’s redundant.

    (Oh, and “opera” is the plural of “opus,” which makes it a little less weird. Not a lot less, I agree. But a little.)

  21. @ekimbrough: This is why I forewent cable and got my high speed internet through AT&T. Though I have heard horror stories about AT&T, it has been good to me so far. I won’t touch their phone service with a ten foot pole but they were the only ones available in my area other than Comcast.

  22. As to the AI, I’ve heard of similar research done, and from an anecdotal respect, my sister had some significant influence on her husband and coworkers in regards to physical fitness (she runs marathons, so she’s really into that sort of thing).

    @infinitemonkey:
    In regards to the people in your office, how much do the fitter members socialize with the not so fit members? And if they do socialize a fair bit, are you sure there is absolutely NO influence? Influence on fitness decisions might be as much as significant weightloss (or weight gain) or as insignificant as the more overweight office workers avoiding that third donut.

    @Shiyiya:
    You may want to rethink that “95% of diets fail” statement: http://www.nytimes.com/1999/05/25/health/95-regain-lost-weight-or-do-they.html
    Most of the time common wisdom isn’t. It pays to be a bit skeptical of all claims especially frequently quoted statistics, unless you have a study (or a series of studies) to back them up.

  23. @ekimbrough: The thing about calling comcast that confuses the hell out of my is the recording of Shaq and Ben Stein greeting you. I mean, wat? But yeah it takes five years to get through the menus and another five to get through hold if their retarded pre-recorded tips don’t help and then all of the tech support reps are UTTERLY USELESS.

    I may be SLIGHTLY pissy about them, what with how our cable service goes down about once a week. MY INTERNETS!

  24. From the following site: http://www.libraryindex.com/pages/2749/Diet-Weight-Loss-Lore-Myths-Controversies-WHY-DIETS-FAIL.html

    The American Obesity Association (AOA) attributes this oft-cited statistic to Albert Stunkard of the University of Pennsylvania and a director emeritus of the AOA. Stun-kard put forth the 95% failure rate in an account of research he performed in 1959, which involved advising 100 overweight patients to diet, with no follow-up or support to increase their adherence to the diet.

    This article summary from JAMA states that diet adherence is low though it doesn’t site a statistic:
    http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&uid=15632335&cmd=showdetailview&indexed=google

    A rather quick but deep look into google has not turned up any significant studies that claim a 95 or greater failure rate for dieting. Most just seem to either assume that the 95% statement is true, or realize that the evidence is lacking and that this is just a common knowledge statement that is made with out corroborating evidence. I do await the articles, because I have no issue with being proven wrong on this, I just find that the statistic is a tad bit egregious in this particular case. Yes, failure rate is high, yes it is very bad to yo-yo diet, and yes I know that merely being considered overweight does not automatically mean a person is unhealthy. (I watched my sister run the Boston Marathon, and while a good 90+% were skinny rails there were the occasional person with a significant belly on them running this marathon, which means that these people not only have run other marathons before, and probably more than just one other marathon, but they did it fast enough to qualify for the Boston.)

  25. @marilove:
    Why anyone would choose OPERA as hold music, I do not know. Unless they like torturing people.

    Because the authors are long dead and no royalties need to be paid for using the music.

    With a recent change in royalty legislation in Belgium, we had to switch to royalty-free music as well, because our call-center would otherwise suddenly cost us an additional 30 Euro’s per phone line per month. That’s a shitload of money when there’s about 50 people there picking up phones …

    Switching to royalty-free music saved us a good 1500 Euros a month. The only downside is customers now have to listen to a lot of classical music if they are on hold …

  26. @MiddleMan:
    The fear of my current lazyness is apparently enough for my girlfriend to question the chances of our relationship.
    It doesn’t help that her previous boyfriend used to be pretty lazy too, and she essentially worked herself into a depression trying to get him out, and she (understandably) doesn’t want to do it again.

    I keep saying I’m not her ex-boyfriend (yet, and I hope to not become so soon :(), and that while lazyness is indeed infectious, I’m just as likely to pick up her cleanliness instead (which would be a good thing for both of us). I suppose though, that right now both of us are in a state of disorganisation we don’t want to be in forever. It’s just my opinion that we don’t have to break up in order to pull our lives together.

    Ii suppose I’m too much of an optimist to even acknowledge the potential for disaster.

    Anyway, to get back on topic, I can see how many things that have to do with your mental state might be infectious WRT your friends and others you spend a lot of time with. But infection isn’t always likely to occur, and on top of that the physical manifestations of the “infection” aren’t always likely to manifest themselves either. So while it sort of makes sense, there’s too many other variables which essentially make it an interesting tidbit but other than that pretty much useless as a predictive tool.

  27. @JamesFox: I agree and need to remember that line! A “social disease?” LOL

    @Kaylia_Marie: Exactly right. I think we focus too much on the negative manifestations of peer pressure without considering the positives of it. It does work both ways.

    Congrats on your WW efforts! Applause! I fully support you and your co-workers! Indeed, I’m proving that peer pressure can lead to positive results right now by starting to work out and diet – Others I work with are seeing the results and following my lead. (Not WW, just me. I have a stubborn streak that makes me effective at doing things once I’m set on doing them.)

    @InfiniteMonkey: Perhaps some in your office are “immune” in an analogical sense – maybe like an physical infection” that is sub-clinical, i.e. shows no effects?

    @shiyiya: 4AM? Ever heard of “sleep,” woman? I hear it’s good for the body and mind… Of course, if you have a partner with you, there are other options if you can’t sleep at 4AM… ;-)

  28. Being lazy is a choice, not an afliction. I think that’s an easy excuse. You are not a ‘lazy ‘person, you are just not motivated to get up and do something at any given moment. You don’t have to decide to change in some dramatic way, you can just decide not to be lazy this evening. Don’t nail yourself into a pigeon hole, other people will do that enough for you.

  29. @Shiyiya: The first one is interesting, and not an actual study, but it does speak ill of the weight loss programs available. the second one is more of what I was looking for, some scientific study that shows the efficacy (or inefficacy as the case seems to be) of dieting. I really like the third one though because it says what needs to be said and that the issue isn’t so much diet as it is dieting with the intent of losing weight. Changing eating and exercise habits may not result in weight loss but will result in significant health benefits. Dieting for the sake of losing weight appears to be ineffectual at best and hazardous to one’s health at worst. Thanks for the additional information.

  30. @eli54: “Staying slender is a matter of expending more calories than you take in; at least that’s been working for me.

    It’s … not that easy. And the assumption that it is is what causes a lot of problems and discrimination.

  31. @MiddleMan: “No, usually in that case they overlook that difference and try to see if they have the potential to accept the change in themselves. Some people opt out if they can’t or won’t, no matter how awesome the relationship may be.”

    I don’t know about that. Just because someone might be into eating fairly healthy food and going to the gym doesn’t necessarily mean they need their partner to be into it. Of course, I’m a super independant person and don’t tend to change my habits when I’m with someone (in fact, they tend to change their habits to MINE, because I’m a bit of a force).

    I’m a meat eater and I’ve dated several vegetarians. Wasn’t a big deal. I will not become a vegetarian any time soon.

  32. @killyosaur42: There’s all kinds more interesting stuff scattered around the internet, it’s pretty fascinating to look into. I’ve been reading a lot about it lately.

    @killyosaur42: I’m attempting to be sleeping on UK time, which in my timezone would be going to sleep at 14:00 and waking up at 00:00. Unfortunately my body seems determined to stick to no sleep schedule at all ever, whether it’s based on my own time zone are not. I had serious issues in high school.

    @marilove: Yeah. It’s fairly horrific. See: http://fathealth.wordpress.com/

  33. @Shiyiya: Dang, can’t view the link at work! (WordPress)

    But yeah, the constant, “Just eat less and exersize more and you’ll lose weight!!(*&!*$!!!” is so dangerous and causes a lot of people to give up, among other things. It’s bigotry, in my opinion: “Well if you weren’t lazy and had more self-control, you’d be slender!!”

    I’m sorry, but no. The women in my family are short and solid. Even when I didn’t have a car and walked miles upon miles a day and had a very active job in printing, I was never slender. I’m 5’2″ and was probably 145 at my “thinnest” — and I was damn healthy. I could probably lose a few pounds, especially now that I have a car and a desk job, but I’m not unhealthy according to all doc results, and I’m certainly not obese (even though BMI says I am!).

    People need to stop thinking of weight in such black and white terms.

  34. @marilove: Yeah, I’ve apparently just crossed the line into overweight. At 5’10” and 175lbs. With an hourglass figure. I’m kind of amazed at how not bothered I’ve managed to be about that, what with being a teenage female and all, and credit blogs like Shapely Prose with it. You may want to check out http://kateharding.net/bmi-illustrated/ when you’re where you can look at wordpress stuff, it’s pretty interesting to get a visual for the media horrorshow terms.

    But yeah, diet industry is total bullshit. Fat people are basically encouraged to acquire eating disorders as long as it makes them skinny. I’ve read that they actually think it’s a PROBLEM that latina and black women on average have higher self esteem as well as higher weights. A problem they want to fix. I despair for humanity when someone feeling good about themselves is a “problem”.

  35. BMI isn’t a meaningful measure of an individual, despite what the WII fit may tell you. Its a usefull population statistic, but for any nonstandard individual (height, bone structure, muscle mass, etc) it’s not indicative of anything in particular.

  36. @SKrap: Oh, I know that, but many people don’t, and many doctors don’t. I’ve heard horror stories.

    Just do a google search for “BMI calculator” — many major sites don’t even explain, “Hey, this is probably not accurate”.

  37. @marilove: Yeah, that’s what the stories on that fathealth wordpress blog I linked are about. People not getting treatment for serious conditions because all the doctors see is the number on the scale and assume everything is caused by it.

    And yeah. Like that. Urgh. That’s a pretty disgurting article they’re picking apart there :/

    Also, that’s why I’ve been hunting down linked so much and trying to hold up the hey-guys-fat-isn’t-evil end of the argument here – ti’s kind of disheartening to see it unquestioningly accepted on a skeptical blog! MUST EDUCATE. :P

  38. @Shiyiya: Besides, why do people automatically see “fat” and think “UNHEALTHY!” But automatically see “skinnY” and think “HEALTY!”

    I am far “fatter” than my mom, but I am also worlds healthier than her. I probably eat better than her too, and I have my own issues with not eating “right”. But she’s skinny not because she’s healthy, but because she is a drug addict. Yet if I were to ask a perfect stranger, “So, who do you think is healthier, based on looks alone?” they’d probably say, “Your mom” and if I pressed, they’d probably say, “Because you’re overweight, of course your unhealthy!”

  39. @marilove: Yeah, massively frustrating. Especially as beauty-ideal skinny is massively underweight and (for all but the tiniest minority of people with weird genes) unhealthy as fuck. And studies have shown that the overweight category is actually the healthiest. And that underweight is way unhealthier than overweight or obese and only barely less unhealthy than morbidly obese (study on mortality rates from heart disease, iirc. I shall have to hunt more. TOO MANY LINKS.)

    (also the phrase ‘your mom’ even use in a valid context amused me.)

    @marilove: I’m sorry, I’m contagious!

  40. Hi guys,

    Weight loss isn’t a “one solution fits all” game. As you have mentioned here, there are various “pieces” to the puzzle. I sympathize with those that struggle with their weight. My wife and one of my daughters are among those people.

    Example: I lose weight fairly easily by diet and exercise. My wife doesn’t – it’s a major struggle for her. Just because she’s female? Maybe. I don’t know the reason(s).

    You can’t entirely blame doctors for assuming that the average overweight patient just needs to exercise more and diet, considering how Americans have become carb consuming couch potatoes over the last 30 years. Like doctors like to say, “When you hear hoofbeats, first think horse, not zebra.”

  41. @QuestionAuthority: “Example: I lose weight fairly easily by diet and exercise. My wife doesn’t – it’s a major struggle for her. Just because she’s female? Maybe. I don’t know the reason(s).”

    Actually, this is a big thing. Men tend to lose faster when they diet and exersie. Women don’t.

    “You can’t entirely blame doctors for assuming that the average overweight patient just needs to exercise more and diet”

    Yes, you can. Doctors should know better. And many refuse to even LISTEN to people (especially women) and then insist that all their health problems are because they are “overweight” — even if they aren’t particularly overweight.

    Once a girl friend of mine went to the doc for a check-up. This girl is TINY. Not skinny, but tiny. Probably a size 6 at most. She was like half the size I was. Yet the doctor told her “she should lose weight becuase your BMI says you’re overweight.”

    What.

    Sorry, but that’s ignorance and yes, the doctor should be blamed.

    “considering how Americans have become carb consuming couch potatoes over the last 30 years. ”

    And that’s just stereotyping and assuming. Not what a doctor should be doing.

  42. I think those ‘ideal’ charts are unhealthy too. I dropped from 120lb to 112lb because I decided to eat only healthy foods (and I mean lots of healthy food, not a diet) for six months. Although I was still in the healthy weight bracket at 112lb (I’m 5’4”) I started to get severe migraines every couple of weeks. The doctor told me by loosing weight I’d messed with my hormone levels and that’s what was causing it. Now I’m back at 120lb and eating my extra cheese nachos and double chocolate muffins. I call them my ‘migraine medication’. ;)

  43. @QuestionAuthority: As I recall, the average American has gained less than ten pounds. I can’t find the statistic though. However, most of the things that go OMG LOOK HOW MUCH MORE WE WEIGH THAN X YEARS AGO? They don’t correct for fucking HEIGHT. We’ve gotten TALLER, too.

    Also, if there were a lot of ‘normal’ weight people who were on the high end, just a few pounds would knock them into overweight. Same goes for overweight into obese. And the weight gain starts at about the same time as the diet industry – hey, most people gain back more weight! (that one’s only a correlation, but still.)

    Oh, and BEING FAT ISN’T UNHEALTHY.

    Junk Food Science on various studies about the whole higher weight lower mortality thing:

    http://junkfoodscience.blogspot.com/2007/06/when-does-it-stop-becoming-paradox.html
    http://junkfoodscience.blogspot.com/2007/07/reading-in-dark-will-make-you-go-blind.html
    http://junkfoodscience.blogspot.com/2007/10/obesity-paradox-9-fat-on-brain.html
    http://junkfoodscience.blogspot.com/2006/12/obesity-paradox-2-how-can-it-be.html
    http://junkfoodscience.blogspot.com/2007/01/obesity-paradox-3.html

    And so on. And so forth. The entire Obesity Paradox series, really.

    (Losing weight is UNHEALTHY. As I previously linked, http://www.amptoons.com/blog/archives/2006/04/03/the-case-against-weight-loss-dieting/ )

  44. @Sarah: That, and were you happier eating super healthy and being super skinny? You’re likely happier now that you get to enjoy tasty food again. Moderation, you know?

    And this “OMG FATTY FOOD EVIL!!!!” attitude we have towards food is not healthy, and demonizing people who don’t eat 100% healthy all the time is dangerous.

    Food should be enjoyed!

  45. @QuestionAuthority: “You can’t entirely blame doctors for assuming that the average overweight patient just needs to exercise more and diet, ”

    Also, yeah, we can, since it’s pretty well known that “just exersizing and dieting” doesn’t mean a whole lot and doesn’t work for a LOT of peope. So doctrs who “assume” that that is all an “average patient” needs to do are horrible doctrs. Period.

    A doctor needs to take into account an individual, not use crappy science and stereotypes and bigotry toward heavy people to reach a medical conclusion.

  46. @Shiyiya: Read any comments on any blog ever (except here, though we aren’t exactly free from it either) when weight is even so much as mentioned, and you’ll get “Those fatty fatty fatty Americans eating fatty fatty fast food all the time! Those lazy fat people!” “Ewww! McDonald’s! Goood, why can’t you just eat better, you fatty!”

    It’s pretty horrific what people think of even slightly overweight and not skinny people by just looking at them.

    I’m really comfortable with my body and don’t have disordered eating, but you’d be surprised at what people have said to me, even when I was much thinner.

  47. @marilove: Oh, I know. I tend to avoid reading them because I just don’t have the sanity watchers points to deal with it.

    It’s pretty disgusting that the media calls even “normal”-weight people fat, constantly. Pretty poisonous messages for our children. (Hey, I should know – I grew up watching disney movies where all the women have improbably small waists and I’m STILL trying to beat through my head that actual people don’t work like that.)

  48. @marilove: ‘Moderation’ key word here with everything. I think people should forget about the weighing scales and just ask themselves ‘Can I walk up one /two flights of stairs without being out of breath?’
    You can be ‘fat’ and very fit and you can be ‘skinny’ and very unfit. Humans were not designed to be sedentary creatures. Most people won’t like that but I think its an easier judge and you don’t nee a doctor, scales or measuring tape to test yourself.

  49. @OneHandClapping: But doctors should be objective, and not base their medical decisions on stereotypes and assumptions. I’m basing this on all the studies linked above. Doctors are human and have biases like everyone else. They should just be better at recognizing them and not letting them get in the way of their job.

    Assuming that the “average American just needs to eat less and exercise more” is erroneous. Assuming that BMI is an indicator of someone’s health is erroneous. Thankfully my doctor is not like that, but if she were, I would choose a different doctor ASAP (and thankfully I have that ability; most people don’t).

  50. @Sarah: “‘Can I walk up one /two flights of stairs without being out of breath?’”

    This, of course, doesn’t take into account those with disabilities or actual medical conditions (PCOS is common in women and causes them to gain weight VERY VERY easily) that might account for them being unable to walk up a flight of stairs or that may account for them being overweight, but as a general rule, I do agree with you.

  51. I agree that doctors should be objective. If a doctor says to exercise more and eat less, before talking to a patient then yes, he is irresponsible and should be fired. Now if he has gotten the patient history, and it turns out that this particular person who appears overweight is indeed sedentary, then it is very likely that exercise and diet modification would improve their health. Notice I didn’t say that they would necessarily lose weight. Pounds do not equal health, but being physically active has been shown to stave off diseases linked to being overweight (diabetes and heart disease).

  52. @OneHandClapping: “and it turns out that this particular person who appears overweight is indeed sedentary”

    But as we’ve mentioned a million times, overweight doesn’t necessarily mean unhealthy. Would this same doctor say anything to an obviously underweight individual? My gut says most likely not, as appearances are really important in our society.

    There are SO MANY better factors out there than “overweight” to determine someone’s health. It can be a facet, but that’s it.

    I am a healthy person. My blood pressure, etc., are all well within healthy ranges. My hip-to-waist ratio (a much better indicator of health than BMI, but still not perfect) is well within the healthy range.

    Health disease doesn’t even run in my family.

    Now, crazy? Crazy runs in my family. I am far more concerned about my ability to stay sane than I am my ability to stay healthy. The women in my family are short, strong, and live long lives. They just tend to go coo-koo.

  53. @marilove: No argument there. My point(s) were that individuals vary widely on their ability to lose weight and that gender is just one variable.

    If your doctor isn’t listening to you, then you need another doctor. Personally, I prefer female doctors, as I have found by trial and error that women seem to listen to symptoms more carefully. I have recently changed just for that reason.

    @Shiyiya: That’s true to some extent. YMMV. OTOH, I started out at 225+ at 5′ 11″ and was too damned near to ‘manboobs’ for comfort. I have lost 25 lb and have about 15 more to go. I was definitely overweight and closing on obesity due to my sedentary job and eating habits. I do have a “husky” build with wide shoulders, so my ideal weight will be far different than someone with a lighter frame.

    My other half is definitely in scary territory and she has a history of heart disease and diabetes in her family. She also feels terrible about her weight and there is no doubt that she needs to lose a farly large amount to get into safe territory.

  54. @marilove: ‘Health disease doesn’t even run in my family.’

    Heart disease! I think the last person to die from a heart attack was my mom’s dad, and that was long before I was even born. Since then, it’s mostly lung disease (from smoking, which I do not do), one aunt who died from a heart condition she was born with, and old age.

  55. @marilove: My father-in-law has had two triple bypasses and is diabetic. Her weight issue is scaring both of us for that reason alone. She has a hard time climbing even one flight of stairs without wheezing, too.

    She was 5′ even and 100lbs when we married. She’s close to twice that now… :-(
    Her BMI is at about 35.

    (My wife is an RN/BSN, so she figures everything she can into her health decisons.)

  56. @OneHandClapping: The point being made was that doctor’s need to look at a patient’s actual health and family history and not basing everything they say on their weight.

    @marilove: I want health disease!

    But yeah, the biggest way that weight is an indicator of heath is if it changes rapidly and abnormally, in EITHER direction, which is an indicator that HEY SOMETHING IS WRONG HERE.

    Oh, and I’ve got crazy in the family too. My mom gave me ADD and clinical depression. Thanks, mom. (Oh, and genetic tendency to breast and colon cancer. Yay.)

    @QuestionAuthority: How do you know what would be ‘safe’ territory for her? There are people who do triathalons at 400 pounds. Health At Every Size and that.

  57. @QuestionAuthority: That’s quite a bit of weight gain, the kind that tends to have medical issues behind it unless she is literally sitting on a couch eating the fattiest things she can find all day, and if as you’ve said she’s an RN that seems unlikely.

    (or if she was starving herself when she was 100lbs, which I’ll assume is not the case.)

  58. @marilove:

    Which is why doctors (well, usually nurses do it before the doctor shows up) get vitals, which are key parts of identifying potential health problems. “Overweight” with great BP, heart rate, no history of heart disease and/or diabetes,and no medical problems? They may very well be healthy, and considered as much by their doctor. “Overweight” with high BP, overly rapid heart rate, history of heart disease/diabetes in their family, or other medical problems? Any one of these could be life threatening, and being overweight (maybe a body fat composition is a better standard than the silly BMI) has the very real possibility of exacerbating these symptoms.

  59. @Shiyiya:

    I totally agree. And maybe there ARE cases of doctors walking into a room with a patient and saying “WHOA! I prescribe diet and exercise for you as it is clear your problems stem from being overweight.” Those doctors should be fired.

    There are also very often cases where the person is overweight (by some standard) and the doctor does take vitals, history, and maybe even some tests before concluding that they need more exercise and change in diet.

  60. @QuestionAuthority: My BMI is a 33.6. I’m far from unhealthy, and I am NOT obese, no matter how much the BMI tells me I am.

    Clearly she has other factors she’s taking into account and not JUST BMI and weight alone, and that’s good! Also, I DO think going from 100 lbs. to nearly 200 is a huge jump, and likely causing her health problems. That is clearly unhealthy. I’ve gone from maybe 145 to 185, not a particularly huge jump.

    But I am 5’2″ and 185 lbs.

    If I were to tell someone that, without them seeing me, I’d get some nasty responses (and I have). They’d assume I was huge and a blubber butt.

    But then they SEE me, and they go, “You can’t be almost 200 lbs.!!!!!!” “Yep, it’s all in my tits and ass.” Like, all of it.

    I wear a size 14/16 depending on the clothing because of my butt (finding pants that fit are a pain, because if they fit over my hips/ass, they won’t fit around my waist properly…Old Navy jeans FTW!!).

    I could probalby (fairly) easily get down to a size 12, which I think is ideal for me as I’m getting older. The lowest I’ve EVER been was a size 10 (harder for me to get to now that I’m older) since I’ve become an adult.

    When I work out and lift weights, it’s even worse. I don’t lose much weight, so when I tell people how tall I am and how much I weigh, they assume I’m huge. But they don’t consider the fact that that it’s almost all muscle.

    My thighs and calves get HUGE when I work out.

  61. @OneHandClapping: Except many doctors don’t do that. They see a number and then say, “Lose weight.”

    Even my awesome doctor has done it, when I had a more active lifestyle and was going to the gym. “UM, I do work out. Look at these calves!”

    “Ooooh.”

    “Yeah, the women in my family are built like this. I’m not going to be able to get skinny, sorry.”

  62. @Shiyiya:

    There are people who do triathalons at 400 pounds. Health At Every Size and that.

    All right. I wasn’t going to say anything, because I know that weight is not necessarily an indicator of fitness. But come on. No one is doing real triathlons at 400 pounds. And if they are, they’re not doing them very well, and they’re not doing them without serious risks to their hearts and their bones.

    I’ve been involved in athletics my whole life, and the heavy people who are still considered fit, are never more than 25-50 pounds more than what is supposedly ideal for them. Staying truly fit is not going to let you get past that range.

    Now, of course the degree of health beyond that range should be measured on an individual basis, but we do know that extra weight brings a lot of health risks with it.

  63. @Sam Ogden: Er, for starters, there’s this thing called muscle and it weighs more than fat, so someone weight that much is not necessarily HUUUUUUUUUUUGE and unfit. And I linked SEVERAL studies saying that fat doesn’t affect heart health like that. And the studies, they show that the overweight and obese categories have lower mortality rates than ‘normal’ weight and WAY lower than underweight.

    I can’t find what I was talking about on the triathlon thing – I think the blog I was thinking of has been deleted, argh. http://www.bigfatblog.com/fat-girl-bike That talks about what I was thinking of, which I did miss the weight on – think I mixed it up with living400lbs. Point stands though.

    And will people read at least one of the many studies I’ve linked before they keep going FAT IS UNHEALTHYYYYYY at me? Or at least link one of their own? I’d appreciate it. >_< It's frustrating to watch people on a SKEPTICAL blog buy unquesitoningly into the media hype when I'm linking stuff that debunks it :/

  64. @marilove:

    No, it’s a point that is almost always ignored by bad doctors.

    I don’t doubt that there are bad doctors in the world, and I don’t doubt that neglec happens. But considering how sure a lot of commenters are in this thread that most heavy people are being written off immediately as just a case of “needs to lose weight”, I’d like to see some numbers that back up that claim.

  65. @OneHandClapping: I think it’s because people see “skinny “and automatically assume healthy, and see “fat/overweight” and automatically think unhealthy, and don’t go beyond that. Also, just because someone isn’t overweight and not underweight doesn’t mean they are healthier than an overweight person. Indeed, how many skinny-but-not-underweight people do you know that eat like crap, never exersize, and just have a decent metabolism? I know lots. Like my mom. Who I am worlds healthier than.

    It is IMPORTANT to bring up those factors, becuase otherwise people will just keep assuming that overweight = unhealthy.

    @Sam Ogden: “But considering how sure a lot of commenters are in this thread that most heavy people are being written off immediately as just a case of “needs to lose weight”, I’d like to see some numbers that back up that claim.”

    Have you read the many studies that were posted above?

  66. @Shiyiya:

    Overweight and obese have lower mortality rates than “normal” rates? Care to qualify that? I am wading through what you posted before, and so far what I see is high BMI = more likely to survive a heart attack. So are you saying that overall obese people have lower mortality rates? Because that’s what I see there when you say “Overweight and obese have LOWER mortality rates than “normal” weight.”

  67. @Shiyiya:

    And will people read at least one of the many studies I’ve linked before they keep going FAT IS UNHEALTHYYYYYY at me? Or at least link one of their own? I’d appreciate it. >_< It's frustrating to watch people on a SKEPTICAL blog buy unquesitoningly into the media hype when I'm linking stuff that debunks it :/

    This, so hard. And then when you bring up “but being underweight is even more unhealthy” they automatically say, “So? Being overweight has so many health risks!!”

    Again, people just brush aside everything, and go back to “overweight = unhealthy”. EVERY TIME..

  68. @Sam Ogden: “No, it’s a point that is almost always ignored by bad doctors.”

    Okay so why is it that almost every woman I have ever known has had to deal with size-ism when going to a doctor, even if otherwise their doctor is not an idiot or bad?

    People make a LOT of assumptions based on looks and nothing but looks, even otherwise intelligent people.

  69. @Shiyiya:

    The ONLY BMI category with higher mortality than underweight is morbidly obese, and not by much. Overweight and obese have LOWER mortality rates than “normal” weight.

    What does this mean? Everyone dies, whether you’re over weight, under weight, or somewhere in the middle.

    Plus, we have established that weight isn’t necessarily an indication of health. People in the “normal” range can be just as healthy or unhealthy as anyone else.

    If you’re talking about weight-related risk factors, I’d say you’re way off the trail. Risk factors are higher for over weight people than for those in the “normal” range.

  70. @marilove:

    Have you read the many studies that were posted above?

    No, I’m at work, and can’t get to most of the links. but if there’s one that show’s data, indicating that doctors tell most over weight people they are just too fat and need to lose weight as a sole diagnosis, without examining them for other problems, I’d be interested to see it.

  71. @OneHandClapping: Um, one of them was of very physically healthy army vets and followed deaths from all causes. Mortality rate meaning which ones died during the course of the study, not which ones died period. I AM aware that everyone dies. I know that wording is weird, I just can’t figure out a better way to put it.

    @Sam Ogden: Read the above, and how I’ve linked half a dozen studies backing up my points. Would you please stop insisting that overweight people are unhealthier if you can’t back it up with facts?

    The point is that yes, weight is not an indicator of health! There are lots of other factors! But if you insist on looking at weight as a factor, it does not work the way the general public has been lead to believe it does!

    I’m going to go watch an episode of Andromeda with my fiance now and hope that by the time I get back someone will either back up their claims or read my corroborating evidence. back in 45 minutes!

  72. @Shiyiya: I agree, as Rebecca often says ‘the plural of anecdote is not evidence’
    I wonder at what point before death are they weighing these people in the study. People tend loose a lot of weight if they are ill? It certainly seems to contradict the the common assumption but I didn’t see the study, link is blocked in work.

  73. So far the studies linked in this Junkfood Science blog are saying that there are some very strange benefits to being overweight. For instance, you are less likely to have a heart attack and die, when compared to someone of lower BMI. It doesn’t say that you are less likely to have a heart attack, just that you are more likely to live through it. I’ve tried to access some of the original reports, but many are subscription only.

    I am also skeptical of one person’s blog uncovering this vast skinny-wing conspiracy. The conclusions she reaches are her own, and she certainly adds more of her own opinion to the research than the research appears to support.

  74. @marilove:

    Okay so why is it that almost every woman I have ever known has had to deal with size-ism when going to a doctor, even if otherwise their doctor is not an idiot or bad?

    I don’t know, but I would suggest that a doctor who is making diagnoses based solely on that is a bad doctor.

    And look, if your doctor examines you and finds out what the real health problems you face are irrespective of your weight, and then still recommends you lose weight, I’d say he or she is doing a good job (prevention). Because even though you may not show signs of things like heart desease or diabetes, risks for those things do increase with extra weight.

  75. I can’t find it but Steven Novella used this study as a ‘science or fiction’ on SGU and he was pretty skeptical about it too. Although that’s an argument from authority that he wouldn’t approve of…

  76. Just my 2 cents.

    I weighed a healthy 134 for years. At 5’4 I figured that was fine. Then… the weight crept up and up and up until I was rocking the scale at 160. I cut back on meat, then I cut back on food in general, then I got divorced, had no money and ate verrrry little while not working out at all. Shocker but in a year I was back to 130. A bit of time, 134 again… where I stayed for another few years.

    May 2009, 134. August 2009, 142… hmmm. I cut out the candy, joined a gym, tried to eat healthy but…144.
    I went to my doctor. Afraid of the creep that ended at 160. I asked her “So, I was thinking about dropping a bit of weight…”

    She looks at me, glances at my chart: “Oh yes, at least 15 pounds, you should be at 130.”
    Me: How do I do that?
    Her: Join Weight Watchers and a gym
    ME:I am already at a gym and I walk 2 miles a day. I also hardly eat.
    Her: Weight Watchers, come back in six months, we’ll see how you are doing then.

    September: with Weight Watchers an some yo-yo numbers… 140 this morning.

    Am I healthy? Yes, I think so. Am I worried about gaining more weight. Yes. Am I even more worried because of my Dr’s attitude. Yep sure you bettcha.

    So… 130 is the goal but after eating less, eating healthy, and still working out… I am starting to get frustrated.

    /rant over.

  77. @marilove: She already has high BP and is on statins for it, too. She can’t climb stairs without wheezing. Her Dad has had two bypasses.

    She also looks severely out of proportion to her height. Most of her sisters (two out of three) have weight problems, too. She’s in frightening health territory…I appreciate that you have little health issue with your height and weight, but my wife clearly does… :-(

    Her only sister that doesn’t have a weight problem has kept it off by diet and hard workouts, as she used to run a dance studio and has kept herself in great shape ever since. She’ll probably outlive all of us. I wish I were half as dedicated as she is…

  78. @Shiyiya:

    Er, for starters, there’s this thing called muscle and it weighs more than fat, so someone weight that much is not necessarily HUUUUUUUUUUUGE and unfit.

    Err, for starters, this thread was about claims of a social contagion being measured in a set of data. I would ask that you try not to sound so smug and self-righteous when you’re actually off topic.

    And yeah, yeah, yeah. I know what muscle is. I have a little bit of it myself. And I know it’s heavier than fat. But someone that weighs 400 pounds isn’t going be 400 hundred pounds of muscle. And if they are, I’d wager they are going to have a whole other set of complications. Skeletal problems, and probably even mobility problems.

    And yeah, someone that weighs that much is not necessarily HUUUUUUUUUUUGE and unfit, but you know what? They probably are.

    You’re holding too tightly to the exceptions, which are indeed there, but the vast vast vast majority of people in the over 50 pounds above recommended weight range are unfit.

    Read the above, and how I’ve linked half a dozen studies backing up my points. Would you please stop insisting that overweight people are unhealthier if you can’t back it up with facts?

    Well, show me where I insisted that over weight people are unhealthier. Don’t think I ever said that.

    Being fit and being healthy are two different things. If you’re over weight, you’re not necessarily unhealthy, but the risk for other health problems is higher.

  79. First off, I’d like to sympathize with Marilove and Shiyaya for oversimplifications in the medical profession. Doctors often have a bad tendency to treat people as averages and not as individuals, and they are certainly right to point out that the range of healthiness does not fit neatly between two values of BMI.

    Additionally, there is a lot of warranted criticism about our society’s idolization of skinniness, which both of you are right to point out is quite often more damaging than being mildly above average weight.

    However, 95% of everything else you’re saying is utter nonsense, and props to Sam for actually calling Shiyaya out on this.

    @Shiyiya:

    I give the hell up. So much for skepticism. I’m not continuing this obviously fultile argument, thank you and goodnight.

    I think Shiyaya’s definition of skepticism is unfortunately limited to being skeptical where it suits her interests and getting incredibly angry with anyone who says otherwise. I have never in recent memory seen such callow, self-congratulatory, and boneheaded reductions of a topic to black and white terms, as I have reading through your posts. It parallels the doctors and public health perceptions that you rail against.

    Being skeptical does not mean accepting every single convincing blog entry you come across because it cites statistics. Being skeptical means critically examining the evidence for and against a claim, and then making a decision.

    Shiyaya says:

    Overweight and obese have LOWER mortality rates than “normal” weight.

    ….

    Source: Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies.” Lancet. 2009 Mar 28;373(9669):1083-96.

    “Collaborative analyses were undertaken of baseline BMI versus mortality in 57 prospective studies with 894 576 participants, mostly in western Europe and North America (61% [n=541 452] male, mean recruitment age 46 [SD 11] years, median recruitment year 1979 [IQR 1975-85], mean BMI 25 [SD 4] kg/m(2)). The analyses were adjusted for age, sex, smoking status, and study. To limit reverse causality, the first 5 years of follow-up were excluded…”

    FINDINGS: In both sexes, mortality was lowest at about 22.5-25 kg/m(2). Above this range, positive associations were recorded for several specific causes and inverse associations for none, the absolute excess risks for higher BMI and smoking were roughly additive, and each 5 kg/m(2) higher BMI was on average associated with about 30% higher overall mortality (hazard ratio per 5 kg/m(2) [HR] 1.29 [95% CI 1.27-1.32]): 40% for vascular mortality (HR 1.41 [1.37-1.45]); 60-120% for diabetic, renal, and hepatic mortality (HRs 2.16 [1.89-2.46], 1.59 [1.27-1.99], and 1.82 [1.59-2.09], respectively); 10% for neoplastic mortality (HR 1.10 [1.06-1.15]); and 20% for respiratory and for all other mortality (HRs 1.20 [1.07-1.34] and 1.20 [1.16-1.25], respectively).”

    Moving on…

    @Shiyiya:

    Yeah, [BMI’s] completely completely completely not any kind of indicator of health in any way shape or form

    “Although other anthropometric measures (eg, waist circumference, waist-to-hip ratio) could well add extra information to BMI, and BMI to them, BMI is in itself a strong predictor of overall mortality both above and below the apparent optimum of about 22.5-25 kg/m(2).”

    It is scientifically accurate to say that BMI is a strong predictor of health and of risk factors for a plethora of diseases and general health. Like anything in science, it is a tool, and one that should not be discounted because it is not always right all the time. The picture you’re presenting is that scientists everywhere are being mislead by their faulty BMI readings, when the shortcomings of BMI have been well-documented in the scientific community for over 20 years.

    More claims made by Shiyaya:

    “Oh, and healthy eating may not be all it’s cracked up to be”

    Please tell me how it is employing critical thinking to say that a specific low-fat diet given to only post-menopausal women that did not result in very much decrease in weight, breast cancer, and a few other diseases over the course of 8 years concludes anything negative about the benefits of eating fruits and vegetables, and not eating various unhealthy foods? Please read the many reviews of the study in JAMA, or the thousands of studies on the health benefits of eating plants.

    Moving on…

    “As I recall, the average American has gained less than ten pounds. I can’t find the statistic though. However, most of the things that go OMG LOOK HOW MUCH MORE WE WEIGH THAN X YEARS AGO? They don’t correct for fucking HEIGHT. We’ve gotten TALLER, too.”

    This is a pretty hilarious point, since data on increasing average weight in America absolutely does take into account the effects of height, and it does so because it is measured by obesity using body-mass index (note the height squared).

    http://www.cdc.gov/obesity/data/trends.html

    I could go on and on, but the point is really clear. Shiyaya, I think you have a lot of very reasonable apprehension towards weight stereotypes in the media, and towards applying averages onto individuals haphazardly. But eating neither too much or too little (and eating mostly plants) as well as regularly exercising are scientifically-supported, integral parts of avoiding several major diseases categories.

    These both make sense evolutionarily, too, as quite often our biggest risks nowadays stem from the fact that we are equipped to deal with an environment that is drastically different than the one we evolved in. A great example of this is the utter panic that we can feel while sitting at a desk in school taking a test. Our bodies are literally hindering our ability to take the test, because classically fear was associated with physical threats, not the non-physical threat of getting a bad grade. We needed quick muscle response, not clear-headed thinking. Likewise, our bodies evolved to continuously store fat because being overweight was impossible when we had to find our own food. Our bodies did not evolve to handle McDonalds — our bodies evolved to love the taste of sugar and fat /because/ it was scarce.

  80. Adding the that I missed so my post is actually readable:

    First off, I’d like to sympathize with Marilove and Shiyaya for oversimplifications in the medical profession. Doctors often have a bad tendency to treat people as averages and not as individuals, and they are certainly right to point out that the range of healthiness does not fit neatly between two values of BMI.

    Additionally, there is a lot of warranted criticism about our society’s idolization of skinniness, which both of you are right to point out is quite often more damaging than being mildly above average weight.

    However, 95% of everything else you’re saying is utter nonsense, and props to Sam for actually calling Shiyaya out on this.

    @Shiyiya:

    I give the hell up. So much for skepticism. I’m not continuing this obviously fultile argument, thank you and goodnight.

    I think Shiyaya’s definition of skepticism is unfortunately limited to being skeptical where it suits her interests and getting incredibly angry with anyone who says otherwise. I have never in recent memory seen such callow, self-congratulatory, and boneheaded reductions of a topic to black and white terms, as I have reading through your posts. It parallels the doctors and public health perceptions that you rail against.

    Being skeptical does not mean accepting every single convincing blog entry you come across because it cites statistics. Being skeptical means critically examining the evidence for and against a claim, and then making a decision.

    Shiyaya says:

    Overweight and obese have LOWER mortality rates than “normal” weight.

    ….

    Source: Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies.” Lancet. 2009 Mar 28;373(9669):1083-96.

    “Collaborative analyses were undertaken of baseline BMI versus mortality in 57 prospective studies with 894 576 participants, mostly in western Europe and North America (61% [n=541 452] male, mean recruitment age 46 [SD 11] years, median recruitment year 1979 [IQR 1975-85], mean BMI 25 [SD 4] kg/m(2)). The analyses were adjusted for age, sex, smoking status, and study. To limit reverse causality, the first 5 years of follow-up were excluded…”

    “FINDINGS: In both sexes, mortality was lowest at about 22.5-25 kg/m(2). Above this range, positive associations were recorded for several specific causes and inverse associations for none, the absolute excess risks for higher BMI and smoking were roughly additive, and each 5 kg/m(2) higher BMI was on average associated with about 30% higher overall mortality (hazard ratio per 5 kg/m(2) [HR] 1.29 [95% CI 1.27-1.32]): 40% for vascular mortality (HR 1.41 [1.37-1.45]); 60-120% for diabetic, renal, and hepatic mortality (HRs 2.16 [1.89-2.46], 1.59 [1.27-1.99], and 1.82 [1.59-2.09], respectively); 10% for neoplastic mortality (HR 1.10 [1.06-1.15]); and 20% for respiratory and for all other mortality (HRs 1.20 [1.07-1.34] and 1.20 [1.16-1.25], respectively).”

    Moving on…

    @Shiyiya:

    Yeah, [BMI’s] completely completely completely not any kind of indicator of health in any way shape or form

    “Although other anthropometric measures (eg, waist circumference, waist-to-hip ratio) could well add extra information to BMI, and BMI to them, BMI is in itself a strong predictor of overall mortality both above and below the apparent optimum of about 22.5-25 kg/m(2).”

    It is scientifically accurate to say that BMI is a strong predictor of health and of risk factors for a plethora of diseases and general health. Like anything in science, it is a tool, and one that should not be discounted because it is not always right all the time. The picture you’re presenting is that scientists everywhere are being mislead by their faulty BMI readings, when the shortcomings of BMI have been well-documented in the scientific community for over 20 years.

    More claims made by Shiyaya:

    “Oh, and healthy eating may not be all it’s cracked up to be”

    Please tell me how it is employing critical thinking to say that a specific low-fat diet given to only post-menopausal women that did not result in very much decrease in weight, breast cancer, and a few other diseases over the course of 8 years concludes anything negative about the benefits of eating fruits and vegetables, and not eating various unhealthy foods? Please read the many reviews of the study in JAMA, or the thousands of studies on the health benefits of eating plants.

    Moving on…

    “As I recall, the average American has gained less than ten pounds. I can’t find the statistic though. However, most of the things that go OMG LOOK HOW MUCH MORE WE WEIGH THAN X YEARS AGO? They don’t correct for fucking HEIGHT. We’ve gotten TALLER, too.”

    This is a pretty silly point, since data on increasing average weight in America absolutely does take into account the effects of height, and it does so because it is measured by obesity using body-mass index (note the height squared).

    http://www.cdc.gov/obesity/data/trends.html

    I could go on and on, but the point is really clear. Shiyaya, I think you have a lot of very reasonable apprehension towards weight stereotypes in the media, and towards applying averages onto individuals haphazardly. But eating neither too much or too little (and eating mostly plants) as well as regularly exercising are scientifically-supported, integral parts of avoiding several major diseases categories. And body fat percentages play a large role in the physiological mechanisms for these health risks.

    These both make sense evolutionarily, too, as quite often our biggest risks nowadays stem from the fact that we are equipped to deal with an environment that is drastically different than the one we evolved in. A great example of this is the utter panic that we can feel while sitting at a desk in school taking a test. Our bodies are literally hindering our ability to take the test, because classically fear was associated with physical threats, not the non-physical threat of getting a bad grade. We needed quick muscle response, not clear-headed thinking. Likewise, our bodies evolved to continuously store fat because being overweight was impossible when we had to find our own food. Our bodies did not evolve to handle McDonalds — our bodies evolved to love the taste of sugar and fat /because/ it was scarce.

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