Goofus and Gallant of the Day

 

(Larger version here.)

Gallant writes about a new study suggesting there may be a viral cause of fat in some people. Gallant reports on the study, mentions previous research that pointed to a similar conclusion, and includes this quote from one of the lead researchers:

“We’re not saying that a virus is the only cause of obesity, but this study provides stronger evidence that some obesity cases may involve viral infections,” Pasarica says in a news release. “We would ultimately like to identify the underlying factors that predispose some obese people to [the effects of] this virus and eventually find a way to treat it.”

Then Gallant steps away from the story, because that’s pretty much all there is to it.

Goofus writes about the same study, using bad puns (“the buffet of reasons for why Americans are getting fatter”); barely speaks to the researchers actually involved in it (or chooses not to print anything they may have said, save one tiny quote); and then turns to “outside experts” for quotes like this:

“The cause for obesity in everyone is the same,” said Dr. Samuel Klein, director of the Center for Human Nutrition at the Washington University School of Medicine in St. Louis. “You eat more calories than you burn up; You can’t get away from that basic law of physics.”

and this:

“We don’t want obese people to feel that it’s all their fault because it is not all their fault … but clearly the buck finally lies with the person,” Klein said.

Goofus doesn’t ask the good doctor Klein what percentage of fault lies with the person, or what a person might do to atone for getting fat, given the long-term failure rate of deliberate weight loss. Nor does Goofus ask Dr. Klein if he’s considered all the variables that might affect the “calories in/calories out” paradigm in a live human being. Goofus is only interested in making the point that fat people should continue to feel guilty about being fat.

Gallant discusses the new scientific research and leaves any opinions about fat people out of it.

Boys and girls, do you want to be like Goofus or Gallant?

29 thoughts on “Goofus and Gallant of the Day

  1. If I’d had my thinking cap on this morning while browsing CNN I would have stopped reading this article after the first sentence. Buffet of reasons? Piling more on the plate? On what planet does that count as professional medical journalism?? Ugghh.

    I’m actually shocked that WebMD’s coverage was so even handed. I think that’s the first time I’ve read something on there that didn’t try to scare me into losing weight. (And yes, that includes the times I’ve researched maladies such as carpal tunnel or bronchitis) So I guess that’s good?

    And I’m really glad to see that “Dr” Klein is an “outside expert.” My first brief read through led me to believe he was the one behind this study and that was kind of upsetting to me. I find the idea interesting, at least on an exploratory level. I don’t love the idea of a “fat vaccine”…it actually kind of gives me the creeps, but if there is a virus that is changing people’s natural weights I think that’s important to understand.

    I just hope the research and whatever comes from it can be used for good and not for evil….

  2. I love that, if there is some credence to the viral theory, which I think is really interesting stuff, that it is STILL fat people’s fault.

    Tell me, is it my fault for erupting into chicken pox when I catch chicken pox? What other virus has a voluntary component like this?

  3. As someone with a medical and science background at the graduate school level I’ll answer the question you pose:

    Goofus doesn’t ask the good doctor Klein what percentage of fault lies with the person, or what a person might do to atone for getting fat, given the long-term failure rate of deliberate weight loss.

    They can’t ascertain this because there have been no human trials at this point. The research was actually first published in 1997 regarding chickens in India.

    Nor does Goofus ask Dr. Klein if he’s considered all the variables that might affect the “calories in/calories out” paradigm in a live human being.

    The study at hand doesn’t discuss live human beings, so Dr. Klien is focusing on the outdated belief that food in an bomb incenerator is processed the same in the human body. No calories are a dead science and an inaccurate measure of daily intake.

    Goofus is only interested in making the point that fat people should continue to feel guilty about being fat.

    I don’ t think the point was to shame anyone. Clearly there are numerous scientific studies that show overwhelmingly that being obese and overweight are negative factors in a person’s overall health.

    It would be a shame to discard the established results of other studies, because a trial in animals says it’s all a virus’s fault.

    At the end of the day… he’s right to a degree. I am prediabetic, have insulin resistence and metabolic syndrome. I’m heavy and I don’t process certain foods correctly. But that doesn’t mean that any of us with similar conditions should simply discard or hide from the fact that we need to eat healthier, drink more water, get exercise and proper sleep.

    Do I feel guilty about being heavy? No… No I don’t. And even if I did have some of my weight gain from a virus, it wouldn’t stop me from working out days a week, drinking plenty of water and eating only whole natural foods.

    My heart attack isn’t going to listen to excuses… neither should any of us.

    Much Love,

    Connor

  4. Connor, have you read this post of Kate’s? (If that link doesn’t work, there’s a link to it in the bar at the top, called: “Don’t you realise fat is unhealthy?”) You might find it interesting.

  5. Clearly there are numerous scientific studies that show overwhelmingly that being obese and overweight are negative factors in a person’s overall health.

    I haven’t seen any studies that convince me that fat causes ill health. I have seen studies that convince me that unhealthy behavior can cause fat (and also ill health, of course). I think there’s a massive cognitive bias being promoted here, and a miscarriage of logic and reasoning that wouldn’t be tolerated if it weren’t backed up by powerful industries.

    You show me the study that shows blood pressure, blood sugar, and cholesterol instantly improving in post-liposuction patients, and I’ll believe those things are caused by fat. Otherwise, what have you proven? Only that doing unhealthy things is bad for your health, and that some unhealthy behaviors also cause fat in some people. (I’m still waiting for the study that will show that many of the ill health effects correlated with fat actually come from dieting. Seems to be tough to get that study funded. For some reason.)

    It would be a shame to discard the established results of other studies, because a trial in animals says it’s all a virus’s fault.

    With all due respect, Doc, if you’re reading Kate as saying “I’ve just decided it’s okay to stop exercising and eat ten million donuts! I never considered this before but now fat is a virus!” then you have trouble beyond the use of the italics tag.

  6. I just love those catchy headlines. I saw one this morning that said “Belly Fat Kills”! I guess I better be more vigilant about my belly, I wouldn’t want unnecessary casualties.

    Connor, what’s frustrating to most of us is that doing what you suggest (always a good thing) doesn’t guarantee weight loss. Or if it does cause weight loss it may not put most of us into an “acceptable” BMI. As for a heart attack, my mother was 41 about 5’7″ and weighed probably about 130 lbs when she had hers. Many, many people have heart attacks for many, many reasons. And, interestingly, if you do have a heart attack, you are more likely to survive 5 years after than your thinner brethren. Go figure!

  7. Connor, have you read Kate’s “Don’t you realize fat is unhealthy?” essay linked at the top, or some of her other entries on this issue, or the underlying research she is referring to in them? It’s good stuff and I think calls into question some of the supposedly self-evident truths and “overwhelming evidence” you cite about how bad it is for you to be overweight.

    I agree with you that working out, drinking lots of water, and eating a variety of healthy foods are great things, though, and I don’t think the original post constitutes “excuses,” or an attempt to make them, in any way. That is really far beside the point IMO.

  8. All kinds of thin, barely middle-aged people have heart attacks. How fat were Dana Carvey and David Letterman when they had their quadruple bypasses? Not bloody very. I have a friend whose pencil-thin father had an MI in his early 40s. My friend, who’s male and built exactly like his father, had some heart trouble at a similar age. Meanwhile, nobody in my family, no matter how fat they were, has ever had a heart attack before their 80s. Genetics, genetics, genetics.

    Oh, and HAES does NOT mean “flop on the couch and eat donuts and guzzle Pepsi forever.” No one with half a brain would advocate doing so if one cares about health. It DOES acknowledge that you can eat a perfectly decent, moderately-portioned diet and be a moderate exerciser and still be fat, but derive significant health benefits from doing so nonetheless. Some fat people will lose significant weight from improving their diet and exercise habits; most won’t. Nobody wants to acknowledge this, at least nobody in the paid media. That is why we’re here.

  9. And even if I did have some of my weight gain from a virus, it wouldn’t stop me from working out days a week, drinking plenty of water and eating only whole natural foods.

    Right. And what if you’re still fat once you’re doing all this? Then does your fat body still count as unhealthy?

    As Fillyjonk points out, the conventional wisdom about fat and health relies on some major correlation-causation confusion.

  10. Why do Connor and Goofus both assume that fat people everywhere are going to start feeding their faces and spending more time on the couch just because of this study? I agree with Connor that the article is not necessarily about shame — but I think it is about *blame*. Connor says he doesn’t feel guilty about being at, but he still seems to feel it’s his fault. And this is someone with a “medical and science background at the graduate school level” who theoretically should read stories like this a little more critically than the average reader. Even the person at CNN.com who writes the “Story Highlights” felt compelled to identify the “Bottom line cause of all obesity: Eating more calories than you burn”.

  11. My father is one of six kids. The only one in the family who’s thin, really thin, is him. He’s always been that way, no matter what he
    eats. The rest of his sibling are all chubby, likely would be considered “obese” on the charts. Guess which one of them suffered a major heart attack at the age of 51? Right, my skinny dad.

    Now he survived, thank God, but he does have a tendancy to lecture me about my husband’s weight. Times like that I’m forced to point out that my fat husband’s heart always seems to be in perfect condition, unlike the heart of my skinny dad, which has seen better days.

  12. Not quite sure what I did to make my post come out looking so strange, but whatever it was, I’ll try not to do it again! Sorry.

  13. Connor, being prediabetic, I suggest you check out yesterday’s New York Times article on surviving with diabetes (any anyone else that is interested).

    …the common assumption that Type 2 diabetes is simply a consequence of being fat. And that losing weight will help cure it.

    Obesity does increase the risk of developing diabetes, but the disease involves more than being obese. Only 5 percent to 10 percent of obese people have diabetes, and many with diabetes are not obese. To a large extent, Type 2 diabetes is genetically determined — if one identical twin has it, the other has an 80 percent chance of having it too…as Mr. Smith has learned, most who lose weight are not cured of the disease. He lost 40 pounds but still has diabetes.

    “Everybody in the act of losing weight will have a pretty dramatic improvement pretty quickly,” said Dr. C. Ronald Kahn… Blood sugar levels drop precipitously and the disease seems to be under control… Once weight is lost, he added, and people stabilize at a lower weight, their diabetes may remain

    As one person with a ” medical and science background at the graduate school level” to another, I really hope you find it useful.

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  15. Was the fault placing Dr. Klein involved in the study, or had he just read it? Had he even read it, or had he just scanned a synopsis of the results or even just heard about them? Goofus somehow failed to bring this to light as well.

  16. Thanks for the article suggestion, Nella. Here’s the link if anyone else wants to check it out: http://www.nytimes.com/2007/08/20/health/20diabetes.html

    I’m shocked by the blame being put on patients in this article in this for being unaware that diabetics should be treated for high cholesterol and high blood pressure.

    It eventually includes doctors in the blaming (as it should!), but it starts out with stuff like “But in focusing entirely on blood sugar, Mr. Smith ended up neglecting the most important treatment for saving lives — lowering the cholesterol level… He also was missing a second treatment that protects diabetes patients from heart attacks — controlling blood pressure. Mr. Smith assumed everything would be taken care of if he could just lower his blood sugar level….Yet, largely because of a misunderstanding of the proper treatment, most patients are not doing even close to what they should to protect themselves. “

  17. It must be said, though, that although the article reads at times like a sales pitch for statins, at least it avoids the usual fat-bashing in articles like this one, by stating flat-out that type 2 diabetes has a strong genetic origin, that you can’t “eat yourself” into diabetes or diet yourself out of it, and that even fat people who lose weight don’t necessarily get their diabetes into permanent remission. And the author? Of course, Gina Kolata.

  18. I want to be the person who eats deep fried twinkies and doesn’t give a shit about big pharma, the healthcare industry, or any type of for-profit science.

  19. I do believe the lesson to be learned from this one is something along the lines of “weight and body shape are complex issues”. Complex issues have complex causes. So, one person may *look* “fat” (and let’s not forget, this is a purely subjective judgement on the part of the person observing) and still be healthy, due to the way their body is put together. Another person may be predisposed to carry extra adipose tissue (and still be healthy) due to various genetic factors (for example, two X chromosomes in the sex-determination pair). A third person may well have a slower metabolism than others, while a fourth could be affected by the virual factor which increases the size of the adipose cells themselves. A fifth person is suffering the effects of disordered eating, be it through binge and purge cycles, chronic overeating or just the various neuroses which even the sanest person can form after a multitude of efforts to “diet”. A sixth may have a chronic aversion to exercise of even the mildest variety, for reasons which could include things such as a chronic fatigue disorder, long-term depression, or just the after-effects of twelve years of childhood “physical education” classes.

    So there’s six different causes off the top of my head for why various people could look fat. Six different reasons for a problem, and it’s not even counting on the combinations and permutations of those reasons alone. Yet the only “treatment” offered for any and all of these is restricting food, increasing exercise, and surgery to ensure food is restricted further. Talk about “one size fits all” with a vengeance. Now, add in a number of diagnostic measurements which have been discredited repeatedly (BMI, pinch test, height/weight charts), several diagnostic measures which are prone to misdiagnosis or misuse (blood pressure, thyroid levels, insulin levels) and a complete lack of consensus as to what constitutes “unhealthy” and what would be “healthy”, and I see something which is most definitely not good medicine. Tell me again why I’m supposed to believe conventional wisdom on this matter… I keep forgetting.

  20. Thanks for providing the link, LadyGrey. I’m not quite that savvy.

    I don’t think diabetics should be blamed for being ignorant of heart disease risks. I’m not sure if the author intended for that tone or if it is a side effect of the NYT-style.

    What I have experienced is that most clinicians blame bad blood lipids in diabetics on the patient, not on the care. That needs to stop. Demanding every one lose weight is not proper medical care or even sound scientific thinking.

  21. I have a family history of Diabetes. I am very fat. And I have a pituitary tumor. So I get frequent blood tests. The latest test came back with a fasting blood sugar that was a bit high–scaring the pants off of me. My Endo said to go on a low-carb diet to control blood sugar levels. Then he pissed me off. He said that I would “lose 10 to 15 pounds” and that the weight loss would help control my blood sugar.

    His assumption that I would automatically lose weight was infuriating. Despite having a doctor/patient relationship that (I thought) was built on mutual respect and trust, his comment revealed that he believed I was fat because I ATE TOO MUCH.

    After I described the years of near-starvation diets (including low-carb!) that resulted in WEIGHT GAIN. (And not later–I mean that I never lost a single pound. I just felt like crap and continued to gain weight. And I won’t even tell you what my previous doctors told me.)

    After I mysteriously lost 30 pounds when my tumor went into remission.

    After I discussed WITH HIM the likelihood that I would never be able to lose the weight!?!

    Of course, I didn’t actually tell him how upset I was. Momma raised me to respect authori-tai. And now I’m kicking myself.

  22. Is it me or is fatness the frontier of doctors withdrawing from the I’m the all powerful doc. you are the sick patient who gives up all your power in exchange for no responsibility.
    Similar to the teachers that said, don’t teach your kids how to read, we’ll do it only for them to complain lately we are not your children’s parents!

    Professionals at some point seem to get carried away with it all in a grab for power and influence always end up having to backtrack when they begin to feel overwhelmed. I think that a lot of this ‘obesity crisis’ has been triggered by this. If so they could have the decency to have an open discussion about it, so we all know where we stand.
    The problem is they appear to be in two minds, it’s hard to let go, in some ways responsibility=equals status. Something has to give.

  23. Meg: You are badass.

    Shade: Funny that your doctor said to go on a low-carb (=low sugar) diet to control blood sugar, but then claimed that it was the resulting weight loss that would actually help your blood glucose levels. To borrow an analogy from J. Eric Oliver, that’s like saying that yellow teeth cause tobacco addiction.

  24. Wriggles, I agree with you about the power dynamic, to an extent. But your comment just reminded me of something…

    When I was an editor, I would often get angry at the author whose book I was working on for submitting a manuscript that, uh, needed to be edited. At both the copy editing and substantive editing levels, I would find SO MANY FUCKING PROBLEMS that seemed like sheer sloppiness to me, and after I’d been working for a few hours, I’d have to get up and walk away, because I was so infuriated that this person got a book contract in the first place. (And this was at a small press, so most of these mss had not gone through the filter of agents, and my job as editor was actually to edit.)

    That? Was a terrible attitude. I mean, those errors and logical inconsistencies and superfluous chapters and point of view shifts and pacing issues gave me a job to do. I should have been grateful for them. But precisely because my whole job was to look for that stuff, A) I could see it really clearly, and B) I felt like it was the most important thing in the world. Those things aren’t true of any writer (including me), who’s looking at his or her manuscript in a big-picture way and is very close to it. I knew that. But I would still end up yelling at piles of paper (rarely at the authors in person), “WHAT THE FUCK IS WRONG WITH YOU?”

    So I wonder if it’s a little like that. Like, doctors are so focused on illnesses, they A) lose sight of the big picture and B) inflate the importance of their own particular knowledge and where it fits in to a whole healthy life?

    And that’s without getting into the assumptions they make. (Shade, your story kills me.) This is kind of a dumb analogy, but in keeping with the editorial theme… when I was in college, I once turned in a paper where I used “affect” for “effect” or vice versa. I absolutely knew the difference and prided myself on being a stickler for such things, but as it happened, I made a typo and didn’t catch it when I proofread.

    Instead of simply correcting it, the professor wrote, “Look up the difference” in the margin. I felt sick when I read that. Humiliated beyond belief. (Yes, that’s how much of a nerd I am.) The professor just assumed that I was ignorant, not that I’d made a mistake, and I couldn’t stand it. Obviously, I still remember that ten years later, and I don’t remember any other single comment I ever got on a paper, good or bad.

    I’m sure there are many college students who don’t know the difference between “affect” and “effect.” (In fact, having tutored in a college writing center, I’m positive of it.) But I wasn’t one of them. And the professor’s choice not to give me the benefit of the doubt really stuck with me — obviously.

    So maybe it’s kind of like that. It’s the fact that so many doctors don’t see us as individuals who might have gotten sick for any number of reasons — they see us as part of a group of People who Don’t Know any Better. Which is humiliating and alienating.

    I deliberately never took another class with that professor. What do people who can’t afford to switch doctors do?

  25. Kate, I totally hear you on the editing analogy, having been an editor and a writer myself. I think it’s a great analogy–when I’ve copyedited long books in the past, especially those with stylistic errors (like, didn’t follow AMA style or what have you) part of my brain screamed “IT’S YOUR FIELD! LOOK UP THE STANDARDS!” But of course, when I write a paper for school now, making sure it conforms to MLA standards is the last thing I think of, and if I had, you know, a professional editor to catch it for me, I don’t know that I would try that hard. It’s hard to remember to switch hats when you’re in the midst of a difficult project or tedious task.

    All doctors have been patients at some point in their lives. Some doctors are fat; some doctors have chronic conditions; some have had emergency surgery. I wonder if, when we find a very compassionate doctor, we have found someone who can mentally switch hats–who can remember what it’s like to be the patient in such a scenario. Dr Jane Q HIppocrates may tell 20 patients a week to do X, and she may get frustrated by the 21st time. But if she’s compassionate, Dr JQH will remember that for any given patient, it is the first time she’s recommended X, and that every patient is different, even if some conditions are shared between them.

  26. I’m going to go with Gallant of course. The body is way too compex for that comment from the nutrtionist (Isn’t meme roth a nutrtionist too? *Rolls eyes*) to be accurate.
    My new blog is centered around the whole thing. I took that old message that refutes the biochemsitry behind it (Posted at your shakesville blog [I said I got it from you. :p]), and I quoted that doctor too.

    Thanks for another well-written, intelligent blog that refutes the overly expressed, and overly simplifed faux science that is being thrown at us.

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