The Obesity Paradox

[Commercial disclaimer: I am fat]

Contrary to popular belief, fat people can even ride motorbikes

Aren’t fat people awful? I mean they take up all that space and sweat so damn much. If the law says we can’t snuff out their existence in an orderly fashion then we should just tax the merry fuck out of them till they stop it. After all – fat people cost us BILLIONS in NHS costs every year, and it doesn’t seem fair that us thin folk should shoulder such a heavy burden.

I’m reminded of this by a story on the BBC (quelle surprise!) about the dangers of being overweight during pregancy. A typical story, you might think.

Bizarrely, the American Journal of Obstetrics and Gynaecology would appear to paint a more nuanced picture.

“Low weight and BMI at conception or delivery, as well as poor weight gain during pregnancy, are associated with low birth weight, prematurity, and maternal delivery complications”

As would the American Journal of Clinical Nutrition:

“Maternal thinness is a strong predictor of both preterm birth and fetal growth restriction”

Who are further backed up by America’s National Maternal and Infant Health Survey

“Low weight gain in pregnancy was associated with increased risk of preterm delivery, particularly if women were underweight or of average weight before pregnancy”

Further studies by the American Journal of Obstetrics and Gynaecology also found that:

“Women whose BMI declines between pregnancies are at increased risk for pre term birth”

And when you start to look away from the whole spitting-entire-people-out-of-your-vagina scene you will see a similar pattern emerging.

• “For every 5-U increase in BMI, the odds of risk-adjusted mortality was 10% lower“ Source: American Heart Journal
• “For all factors studied, except body mass index, we observed statistically significant linear trends for lower offspring examination 1 risk factor levels with increasing parental survival category.” Source: The Archives of Internal Medicine
• “Among men, risk of death from suicide is strongly inversely related to BMI” Source: The Archives of Internal Medicine
• “Obesity in critically ill patients is not associated with excess mortality” Source: Society of Critical Care
• “Overweight and obese stroke patients have a lower poststroke mortality rate than normal-weight and underweight patients” Source: The Journal of Neuroepidemiology
• “Overweight and obesity were associated with lower all-cause and cardiovascular mortality rates in patients with chronic heart failure and were not associated with increased mortality in any study” Source: The American Heart Journal
• “Compared to non-obese individuals, overweight and obese patients have similar or lower short- and long-term mortality rates” Source: University of Alberta
• “Obese/overweight women at risk for spontaneous preterm birth exhibit less uterine activity and less frequent spontaneous preterm birth before 35 weeks of gestation than normal/underweight women.” Source: The American College of Obstetricians and Gynecologists
• “Estimates for all-cause mortality, obesity-related causes of death, and other causes of death showed no statistically significant or systematic differences between BMI and other variables” Source: National Center for Health Statistics

Here’s how science works. You make an observation about the universe (“Ed Balls is a cunt”) then construct a hypothesis to explain that (“perhaps he is from a disadvantaged background?”) then create a test to see whether that hypothesis holds water (“did he go to a bad school?”) and then publish your conclusion (“No. He’s just a cunt”). Other scientists then test the rigour of your hypothesis and suggest alternatives and eventually some kind of workable agreement is reached until a new improved theory emerges later.

The great thing is that you only need one – as in a single – refutation of a theory to falsify it. As Einstein famously put it:

“No amount of experimentation can ever prove me right; a single experiment can prove me wrong.”

And yet, despite the slew of ‘null findings’ (findings that disprove a theory of correlation) the myth of obesity as a risk factor in health of itself remains unchallenged. There’s even a cardre of people writing fretful pieces trying to reconcile the ‘obesity paradox’.

Here’s a hint, Poindexter – there is no paradox. Just the facts.

It has become groupthink. The mythology is so intertwined in our culture that it is hard to see it shifting any time soon – whatever the evidence might inconveniently say. All the way down from Jamie Oliver who was happy to call people “fat scrubbers” and “white trash arseholes” for feeding their kids chips, down to the endless reams of Government advertising and to the constant low-level jibes that are directed at anyone with a belly.

There’s an unholy mix of interests promoting this guff. Hell – it’s got it’s own industry sector these days, fronted by a phalanx of charlatans, politicians, celebrity chefs, credulous dupes and self-satisfied, whippet-thin, permatanned nonentities with a product to hawk or a lifestyle to shill.

And if you think the problem is confined to the public health debate, think on the next time someone tells you that the science of climate change is “settled” or that a “consensus” is all the authority you need to send your economy back to the stone age.

HT to the massively informative and well-written Junkfood Science.