Asymmetrical Information

Michael Fumento did an extensive analysis of the diet industry and obesity in his book, "The Fat of the Land."

I'll quote the following from an article he wrote responding to another one of Campos' famous rants:

"Using data culled from the famed Nurses' Health Study, comprising 115,000 women over a 16-year period, Manson and her colleagues found that women of average height (5'5") in the 162-80 pound category had sixty percent higher chance of dying during the study period as women in the leanest category. Yes the difference was statistically significant and yes, the the Centers for Disease Control and Prevention (CDC) indeed considers this category as "mildly to moderate overweight." "

He then attacks the claim that this research is funded by the diet industry.

"Yes, in the 19th century insurance actuaries observed a clear correlation between being overweight and dying sooner. The current Metropolitan Life Table puts optimum weight for a 5"5' woman of medium frame at 127-141 pounds, yet the average American woman of that height weighs well above 145 pounds."

Turns out Met Life's actuaries have been keeping very detailed records of who dies when for over 100 years.

Now unless someone tells me that Met Life is owned by Jenny Craig ...

The original Fumento article is here:
http://www.fumento.com/danger.html

Bob

From what I've read, although being overweight is bad for you, it isn't *as* bad for you as being sedentary and thin. An active fat person is less likely to die from a heart attack than a slothful skinny person.

There is some truth to that, but how many fat marathoners do you know? Fat is not only negatively correlated with activity; it prevents much activity, because you have to work your heart harder to haul around the extra weight, which makes people less likely to start excercising. As weight goes up, other systems start to be affected; the obese have trouble getting even a walking regimen going. That's why when you listen to fat people talk, many of them sound slightly out of breath even just sitting still. That's strain on the system -- and it's taken years of their lives.

My major complaint with most studies of this sort is that they compare just weight, without considerations of frame or muscle mass.

Let's see if we can all agree on some fundamentals:

Happy people tend to live longer than unhappy people (for example, unhappy people have ulcers and heart attacks and high blood pressure)

Unhappy people tend to find ways to make themselves happy. One way of doing this is by eating (other ways are alcohol or drugs for example)

If we can all agree on those two things then perhaps we can agree on some more, like lots of people are overweight due to genetics and lots of people are overweight and live amazingly long and happy lives.

Can we also agree that it's equally unhealthy to be underweight. Being underweight puts enoumous stresses on the kidneys and liver. In addition, you're less likely to win on Survivor.

So what it comes down to is what the hell do you care what some expert tells you is the right weight? Ask yourself, are you active, do you eat right? Do you have low blood pressure and a low heart rate? Do you smoke? Do you feel well? Do people you want to sleep with want, in turn, to sleep with you? Are you getting laid on a semi-regular basis? Are you happy?

I think the answers to these questions are much more relevent to whether you're going to live long than the Met Life actuarial table. More to the point, why should we care about the Met Life tables? We're all gonna die sometime anyway. It's how you live that's important.

The problem with the study which Fumento cites -- and with the data gathered by insurers -- is that they may well be counfounding several different variables. Sure, if you weigh four hundred pounds, never do anything more strenuous than lifting the TV remote, and regularly dine on a menu of Cheetos, Fritos, and Doritos, you're probably not going to be very healthy. By the same token, a skinny person who sits on the couch and eats lousy food might very well be unhealthy as well.

Without looking at the evidence myself, I suspect that Campos is exaggerating somewhat, and that the data do support the view that, all things being equal, one is better off not being terribly obese. Still, it's certainly not impossible that inactivity and diet, more than being overweight per se, cause health problems. That is, an active person who eats fairly well and is twenty pounds overweight might very well be better off than a skinny couch potato who doesn't eat well.

And it really is hard to disentagle all the factors. Take what is today pretty much accepted: the link between smoking and cancer. As I understand it, the epidemiological studies demonstrating that smoking caused cancer had really large numbers in them and considered a lot of possible factors. It really is fair to point out that obesity is often linked to poor diet and inactivity, which means that it's difficult to determine whether obesity is itself an independent cause of ill health, rather than being a neutral-in-itself result of unhealthy behaviors. That's why they do the regressions.

Furthermore, even if Jane is unmoved, I do think it's a data point that Koop's getting money from companies with an interest in promoting the perception that losing weight is necessary for health. Like Jane, I'm skeptical about lawyers who pontificate about scientific studies. But I'm also a bit skeptical about doctors who enter the world of public policy, which both Koop and Satcher have certainly done.

In any case, while this debate is undoubtedly interesting, I'm not sure it matters much for the average person. Most doctors -- even those who think that weight loss is vitally important -- agree that yo-yo dieting is a bad idea. Being slightly fat is better than constant gyrations, particularly since yo-yo dieters often end up fatter than ever. Which means that finding a sustainable lifestyle is more important than shedding every extra pound. Most doctors, when advising people who aren't morbidly obese to lose weight, advise them to exercise more and eat a bit better.

Campos agrees that being sedentary is bad. He thinks that getting regular exercise is a good idea. Likewise, he agrees that eating a diet consisting entirely of junk food is probably bad. Which means that, for an average person, eating better is a good idea.

Thus, Campos would advise most people to exercise more and eat better. Following Campos' advice, many will lose weight. Koop would probably consider the weight loss to be good in itself, while Campos would consider it to be a neutral side effect of behavior which is good in itself. Still, in terms of concrete actions, Campos doesn't really seem to disagree with Koop or Satcher that much. It's not as if he's advising everybody to bulk up to become Sumo wrestlers.

Still, in terms of concrete actions, Campos doesn't really seem to disagree with Koop or Satcher that much.

He certainly disagrees with the diet industry, which focuses entirely on intake.

A note in the german magazine "Der Spiegel" recently said that many studies in medicine and biology were based, are based and keep basing their work on false statistical methods. The use of these methods in engineering sciences is generally better, the article says, mentioning a study recently done in USA ( I don´t have the article in "Der Spiegel" in front of me, so I can´t quote correctly ).
It also says that many medical studies simply have come to wrong conclusions, as they cite statistical significance when there is none based on mathematic grounds.

As a matter of fact, as I have stated somewhere else here, a german fitness guru, Dr. Strunz, said in his book "For ever young" that with a BMI of 25-26 you have the BEST chance to become very old.

Just my 2 cents

Pedro

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