The obesity wars

[Todd Allen]

An article which paints a remarkably unflattering portrait of Walter Willett and the Harvard School of Public Health.

The obesity wars and the education of a researcher: A personal account

[Sibiriak]

Thanks.    Flegal got some pretty  vicious and arguably unfair push back on her shocking conclusion that " overweight [not obesity] was associated with significantly lower all-cause mortality. "    Not surprising, really.  Established public health policy was under attack.   And big money at stake. 

“Studies such as Flegal's [2013] are dangerous, Willett says, because they could confuse the public and doctors, and undermine public policies to curb rising obesity rates. ‘There is going to be some percentage of physicians who will not counsel an overweight patient because of this,’ he says. Worse, he says, these findings can be hijacked by powerful special-interest groups, such as the soft-drink and food lobbies, to influence policy-makers.”     

Debate raged on Flegal's  controversial work back in 2013, and now, eight years later, she seems to want to stir things up again, or at least  set the record straight from her perspective. 

Of course, the science has moved steadily on since then, as we have discussed here in various threads such as:

Relationship Between BMI and Disease, and Longevity

Optimal Weight for Longevity

Quote

[Gordo: ] As stated in a similar thread, there are a LOT of really low quality studies/analysis of BMI with regard to longevity.  These have been discussed in these forums many times.  The higher quality the study, in particular when they look at never smokers and do REALLY LONG follow up to ENSURE no one with disease impacted the analysis, they find the ideal BMI is between 20-22.

among healthy never smokers with exclusion of early follow-up, and 1.05 (1.04 to 1.07; I2=97%, n=198) among all participants. There was a J shaped dose-response relation in never smokers (Pnon-linearity <0.001), and the lowest risk was observed at BMI 23-24 in never smokers, 22-23 in healthy never smokers, and 20-22 in studies of never smokers with ≥20 years’ follow-up.

But how this changes for the elderly is still a bit of a mystery as far as I know, for example some here believe higher BMI may be beneficial after age 80 or so, frailty can be a serious risk factor for the elderly, and having "excess reserves" to burn if/when you are very sick could also save your life.

 

Edited June 21, 2021 by Sibiriak

[Todd Allen]

6 hours ago, Sibiriak said:

Flegal got some pretty  vicious and arguably unfair push back on her shocking conclusion that " overweight [not obesity] was associated with significantly lower all-cause mortality. "    Not surprising, really.  Established public health policy was under attack.   And big money at stake. 

What boggles my mind is the notion that observational studies attack, threaten or even mean anything at all.  They merely suggest statistical correlations.  In this case, it is quite possible that among the entire population studied longevity was best on average among the overweight as characterized by BMI.  But the result could be confounded by factors as discussed in the threads you have referenced such that the commonly held notion of getting fatter being generally detrimental to longevity is still true.

This article describes individuals and institutions supposedly devoted to science engaging in noxious ideological campaigning instead of thoughtful discussions of data, methods of analysis and potential confounders producing unexpected results.  To the degree the allegations are true it is a very sorry state of affairs.

[Ron Put]

9 hours ago, Sibiriak said:

Flegal got some pretty  vicious and arguably unfair push back on her shocking conclusion that " overweight [not obesity] was associated with significantly lower all-cause mortality. "    Not surprising, really.  Established public health policy was under attack.   And big money at stake. 

Hm, the big money is actually the food industry and Fiegal's research is used by them to spearhead a campaign to discredit its critics.

I read most of the article Todd linked and after doing a couple of more searches, my take is that Fiegal is creating a largely straw man argument and slaying it, to paint herself as the victim.

In her article, she does not address the research used against her findings. Instead, she essentially keeps presenting herself as the naive victim of a vindictive and powerful Goliath, branding the Harvard panels as witchhunts, and personally attacking the credentials and motives of those who disagree. Yet, she was invited to be on these panels and refused to accept.

A brief perusal of the talks appears to show a data-driven argument against her research and conclusions, which is a perfectly fine method of scientific discourse. She could have participated in the panels and defended her research and positions. Instead, she is going on the attack, claiming malicious intent on part of her detractors.

It is important to note that she was not censured in any way, no organized letter-writing campaigns were conducted to pressure journals to retract or banish her. Her studies received wide dissemination in the press, with a headline about the "Big Fat Lie" in the NY Times and her claims have been quoted widely, like this in AARP:

"A growing body of evidence points in this direction. In 2005, researchers at the Centers for Disease Control and Prevention looked at body mass index or BMI — an estimate of a person's body fat calculated by height and weight — and found that overweight people [with a BMI of 25 to 29.9] had less chance of dying than people with a normal BMI or a low BMI. For those over age 70 the evidence was even stronger. Says Katherine M. Flegal, CDC senior research scientist and lead author of the 2005 study, "The lower your BMI the worse your chances of survival."

My take is that she is reopening this to take advantage of the Left's circling the wagons around the CDC. Also, much has changed since 2013 and wokism is prevailing today, with a cottage industry of "peer review" "scientific" journals devoted to attacking claims that obesity is unhealthy as an example of "institutional" discrimination.

[Sibiriak]

11 hours ago, Ron Put said:

Hm, the big money is actually the food industry and Fiegal's research is used by them to spearhead a campaign to discredit its critics.

Yeah,  maybe I wasn't clear,   but that's what I was referring to, quoting Willett:  "these findings can be hijacked by powerful special-interest groups, such as the soft-drink and food lobbies, to influence policy-makers.”  

11 hours ago, Ron Put said:

and wokism is prevailing today,

I suppose some of the pernicious pro-obesity "body positivity" stuff would go under that category.

Edited June 22, 2021 by Sibiriak