Posted in Rants on March 6th, 2013 by Ed

(This is one of those extra-special read-it-all-before-bitching posts. Reading comprehension is important here.)

Matt Roth wrote a Baffler piece nearly a decade ago that stands as one of the best things I've ever read ("Living the Delayed Life with Amway"). Unfortunately it's not online, but it details the struggling freelancer's personal experience with Amway – the notorious "direct marketing" company that was the Next Big Thing in the 80s/90s and has been criticized for its cultishness and uncanny resemblance to a pyramid scheme. While the FTC has ruled that it is legitimate, as the majority of its revenue comes from the sale of products rather than from member fees, Roth makes a compelling point: if Amway isn't a scam, why does it feel so much like one?

This is an elegantly restated version of the Duck Test idiom ("If it walks like a duck…) Our perceptions are not always 100% correct but if something meets all of the criteria for being a scam, you're safer assuming it is than to assume the opposite.

The introductory analogy complete, this is the part of the post wherein I bring up the actual topic. If the recent surge in interest, academic and popular, in "fat studies" – research purporting to show that mainstream medicine's conclusion that obesity is unhealthy, or that obesity is even a condition, is wrong – is not basic science denialism along the lines of anti-vaccine theories, climate change denial, or "creation science", then why does it have all of the characteristics of denialism?

STOP. Here are some things I'm not talking about here: fat shaming, stigmas about weight, the media-driven obsession with thinness, or any other aspect of size/weight/appearance as a social phenomenon. Neither am I suggesting that people should/shouldn't lose weight, or gain weight, or anything else. My point is simply that the supposed evidence underlying the idea that the current medical consensus (obesity = bad for one's health) is wrong has all of the trappings of an argument that in another context would readily be identified as total bullshit.

First, it is based largely on a selective or distorted interpretation of evidence. Recently an article flew around the internet with eye-catching titles like "Overweight People Live Longer". It is based on a study published in the Journal of the AMA. The sole finding of the article is that BMI (Body Mass Index) has a small positive effect on lifespan, irrespective of cause of death (so the sample included, for example, people who died in accidents). But for the past 20 years, Fat Activists have been telling us that BMI is a load of crap. Why is BMI suddenly a valid measure of weight/health/obesity? Oh, because the results of the study are telling you what you want to hear. Cool.

Second, it makes wild assumptions backed by scant, shoddy evidence and ignores mountains of evidence to the contrary. The idea that people cannot lose weight, or cannot keep it off after it is lost, is supported by one or two dubious studies. The converse – that healthy weight loss is possible and can be maintained – is supported by decades of research. Why is the one study that supports your argument the only one worth considering?

Third, it borrows heavily from the climate denial/anti-vaccine movements in its belittling of "so-called experts". This recent Guardian (UK) column illustrates the point nicely. Did you know that doctors are not to be trusted? That they're just a bunch of know-it-alls whose opinions are no better than yours? Beware the "beady eye of a disapproving GP" who doles out the "type of medical finger-wagging (Academy of Medical Royal Colleges) advocates." The National Health Service has a plan to "pester patients about their weight in every encounter," which is not what doctors should do (in the opinion of people like the author who seem convinced that obesity is not inversely related to overall health and longevity).

Fourth, there's a conspiracy. From the same article:

AoMRC's proposals are not about health promotion, but contribute to a narrative of blame, punishment, prejudice, stigma and anti-fat scapegoating that is horribly familiar. The only thing that looks healthy in this context is the twinkle in the eye of the diet industry CEOs, who are laughing all the way to the bank.

Ah, yes. The diet pill industry, and the pharmaceutical industry in general. These are the same people who are pushing all those unnecessary polio vaccines on your kids for profit. Aside from the fact that this makes no sense – pharma would make money by encouraging doctors to keep patients obese/unhealthy so they'll be stuck on more meds, and certainly the trillion-dollar pharmaceutical industry can outgun the "diet industry CEOs" – why is the Fat Activist not equally skeptical of the role of the trillion dollar junk food industry? Surely it's in McDonald's interest to push the idea that eating garbage is not detrimental to health. I guess skepticism only works in one direction.

This is not to say that Fat Activists, as they self-label, make no valid arguments or, to reiterate, are not entirely correct about the social dimensions of obesity. But their overriding problem is that the attempt to uncouple obesity and health/well-being/longevity has the same goal as that of global warming deniers: to convince you that the vast majority of evidence, as well as the medical and scientific consensus, is wrong. The only way to make it look wrong is to engage in the same tired rhetorical tricks and logical fallacies that have underlain quackery and denialism for centuries. Something that bears such a striking resemblance to bullshit should be treated as such until conclusively proven otherwise.