Paul Campos, law professor, Rocky Mountain News columnist and author of The Obesity Myth
(issued in paperback as The Diet Myth), has an excellent column in today's RMN uncovering the astonishing errors in the September 2007 Scientific American article "Can Fat Be Fit?"
The SA article by Paul Raeburn uses the same-old "killer obesity" rhetoric -- and interviews with prominent "obesity" researchers -- to discount a well-respected Centers for Disease Control researcher's study disproving claims that "obesity" kills hundreds of thousands of people a year. As Campos points out, key points Raeburn or his "expert" interviewees make are simply not true, as Raeburn might have discovered had he actually read Katherine Flegal's study, published in the April 20, 2005 issue of the Journal of the American Medical Association, or interviewed Flegal herself.
Instead, Raeburn (and Scientific American) reported the "obesity experts" (read: "people who make money related to the perspective that fatness is inherently pathological and must be 'treated'" and/or researched extensively) claims without verifiying them or offering the object(s) of their criticism an opportunity to respond.
Campos writes:
According to Meir Stampfer and Walter Willett [Harvard University professors quoted in Raeburn's article], Flegal and her colleagues should be ignored, because their study contains an egregious mistake....The authors' mistake, [Stampfer] says, was to include smokers and chronically ill people among the lean subjects in their study.
...A competent journalist would have called at least one of the paper's authors, and would have discovered Stampfer's criticism was completely false. Flegal and her colleagues did control for smoking and pre-existing illness -- they said so in their paper, and the supplemental data showing that doing so made no difference to their conclusions were published on the Centers for Disease Control and Prevention's web site at the same time as the paper itself, as Stampfer and Willett are perfectly well aware. (Raeburn never attempted to contact any of the various people whose work his article impugns.)
A competent journalist would have done the modest bit of research necessary to discover that the Flegal paper's conclusions are no different than those of countless other studies. The paper is particularly important because of its statistical rigor and the unusually high quality of its data, but to anyone familiar with the medical literature its conclusions are about as startling as the conclusion that cigarettes cause lung cancer. [Emphases mine.]
Read Campos's complete column here.
UPDATE 8/22/2007: After a colleague of Stampfer and Willett's posted a comment to this blog critical of Flegal (since deleted at his request after he learned his claims were erroneous), I thought it might be worthwhile to direct readers to the section of New York Times science writer Gina Kolata's recent book Rethinking Thin: The New Science of Weight Loss -- and the Myths and Realities of Dieting in which she reports on the reaction to Flegal's paper in the "obesity" research community.
This portion of the text appears in the chapter appropriately called "The Fat Wars." Emphases are mine.
Flegal's paper, written with her colleagues Williamson, Graubard, and Gail, was published less than a year later, on April 20, 2005, in the same journal, the Journal of the American Medical Association, that had published the two papers concluding that obesity and overweight were killing hundreds of thousands of people.
The firestorm began even before the paper appeared.
"I started getting e-mails," Flegal says. "People started circulating stuff about what was wrong with it." The critics were part of the obesity research and treatment community, Flegal noticed, not people who had no vested interest in a conclusion that obesity was a mortal danger. Statisticians who had no stake in the obesity panic praised the work. It is not as if no one had ever noticed such things before, but this was a meticulous analysis, by highly regarded researchers, and using the most recent and complete national data.
Kolata reports praise of Flegal et al's study by eminent scientists without a stake in the "obesity" wars. But, she says,
Researchers and organizations that had made a career out of sounding alarms about obesity and overweight were not assuaged. Flegal says she was most shocked by a direct attack by researchers at the Harvard School of Public Health, home of the nurses' study, which had been one that reported dire health risks from any excess weight. Shortly after her paper was published, the Harvard group held a seminar to refute it, making sure that newspaper reporters were not only invited to the meeting but able to watch it and listen in on a Webcast if they could not attend in person. It was an exercise in attack science.
Kolata reports the Harvard group's criticisms of the Flegal et al. study -- none of which were true, according to Flegal.
Those other studies that the Harvard group said contradicted her group's work had serious flaws. In fact, [study co-author David] Williamson added, not only were the Harvard group's data not representative of the American population, but they were not necessarily even representative of their own study populations. The same held for the data from the American Cancer Society, he said. The reason is that both studies excluded most of their subjects from their analysis, deciding that they should not be counted because they were sick, or because they were smokers, or for other other reason; one analysis of the nurses' study excluded nearly 90 percent of the deaths. "We have data sets that are truly nationally representative of the U.S. population," Williamson said. And, Flegal noted, their group used actual measured weights and heights, not self-reported ones as were used by the Harvard and the American Cancer Society investigators. That means Flegal's group probably had more accurate numbers, since people notoriously claim that they weigh less than they really do.
Barry Graubard, another of the Flegal et al. study authors, told Kolata he was used to scientific disagreements being resolved by
discussion and careful consideration of the data. He had just not appreciated the strong feelings people have when anyone questions whether being overweight is really bad for your health.
"This whole thing is a really strange mix of politics, science, and the personal way people view themselves and their condition," he says. "And there's an economic aspect, too. It's a very volatile mix of all these things. I think our paper was almost like a lens on this issue. It brought out the worst in everyone. I have never seen anything like this before. I was stunned by the whole reaction."
Flegal said she was stunned. Harvard researchers holding a seminar to refute her? It was unheard of in the nominally polite world of science. "I don't know what to say. I don't have a problem with people at a conference talking about their data, but I do have a problem with their talking about our data and saying we should have found the same things that they found." And why, she asked, were people so upset with her findings? "Isn't this good news? Isn't it good that people are not dying?"
Even the group's credentials came under attack, Williamson said. "Some went after us individually, which is okay, but it doesn't really advance public understanding. Some attacked our credentials because we are not physicians. Katherine and I have Ph.D.s in human nutrition, but one of the people who criticized our credentials is the head of a department of nutrition. Hopefully, he thinks nutrition is an important field." Mitchell Gail [the other co-author], Williamson added, got his M.D. degree from Harvard and also has a Ph.D. in statistics, as does Barry Graubard. "I've published papers with most of our critics, and our credentials didn't seem to be an issue then," Williamson says.
The Harvard group's seminar was not the end of their attack on the Flegal et al. study, Kolata reports. In July 2005 the group issued a press release claiming that Americans still believe "obesity" is a serious problem and "do not believe that scientific experts are overestimating the health risks of obesity."
Other "obesity" researchers "wrote editorials and letters urging action to combat" the Flegal et. al study, even encouraging physicians to write their local newspapers and share their experiences with fat patients -- all in the name of perpetuating the concept of "obesity" as a serious health problem.
Flegal says she had a real education in the politics of obesity.
"Everyone thinks they already know the answer," she says. "Anything that doesn't fit, they have to explain it away or ignore it. All these people who just know weight loss is good for you. It's just taken for granted regardless of the evidence." She was not naive about her findings, she said. "I expected people would get perturbed, but I really didn't expect the way they did it. All these erroneous so-called fact sheets. And these misinterpretations and making up things we'd said."
She saw the prevailing attitude in action: "It seems like some researchers say to themselves, 'If the data don't come out as strongly as we want, then let's just work on these data until they come out the way we want them to."
If any of this information is new to you, please read Rethinking Thin and Campos's The Obesity Myth or The Diet Myth. And add J. Eric Oliver's Fat Politics and Glenn Gaesser's Big Fat Lies: The Truth About Your Weight and Your Health to your reading list -- or, better yet, library -- as well.
