I Don’t Have Any Evidence But…

Today I was on HuffPo Live to talk about childhood obesity.  I was on the panel with Autumn Whitefield-Madrano from The Beheld which is a blog that I like, two self-identified “childhood obesity experts” both of whom were fat children, are now thin adults and claim to help children lose weight professionally, and the guy who runs the weight loss camp that was featured on MTV’s “Fat Camp.”  You can see the full segment online.  It was frustrating because it was 3 against 1, so I wasn’t able to correct all of the misinformation – confusing correlation with causation, substituting anecdata for actual data etc. without inappropriately dominating the conversation, but I did the best that I could.

What I want to talk about is what happened when the cameras went off.  We continued to talk in the online chat room.  I suggested that they look at evidence  – Wei et. al, Matheson et. al, the Cooper Institute Longitudinal Studies that show that habits are a much better indicator of future health then body size.

I pointed out that University of Minnesota researchers found that “None of the behaviors being used by adolescents (in 1999) for weight-control purposes predicted weight loss (in 2006).  Of greater concern were the negative outcomes associated with dieting and the use of unhealthful weight-control behaviors, including significant weight gain.”

I mentioned that a study that tracked 15,000 participants and was published in the Journal of Paediatrics,  found that adolescents who were put on diets were significantly more likely to gain weight than those who were not.

Autumn was respectful and helped support me in getting space to talk when others were trying to steamroll me. None of the three self-identified childhood obesity experts  named a single study to refute what I was saying or support their position. One claimed to know the research (though never citing any) but said that they didn’t need all these scientific studies  and evidence because they have common sense. Ah the cult of “everybody knows.”

This is not limited to the person who said it – I hear it all the time. “Studies change but I know in my gut…” or “I don’t have research but just do a Google search on Obesity and read some of the news stories….” So our kids’ health is at stake and we are dealing with a whole profession of people who call themselves childhood obesity experts, and make money with promises of weight loss for kids, who not only don’t have evidence to support their methods, nor refute evidence that suggests that their work does more harm than good; but who, terrifyingly, don’t seem to think that matters.

I’m pretty sure “I don’t need evidence, I have common sense” is what they said to Galileo.

To provide clarity, let’s do a quick exercise inspired by reader Ericka:

A child needs their arm amputated.

Their first option is someone who amputated their own arm during a climbing accident and succeeded despite near impossible odds, and plans to do the amputation guided by common sense and his own experience.

Their second option is a doctor who went to medical school and studied the research and evidence that have come from hundreds of thousands of arm amputations,  has performed many such amputations using this information, and plans to use that same information to perform this kids’s surgery.

Who do you want treating this child?

One person’s experience is not extrapolatable to others.  The fact that someone was a fat kid and became a thin adult does NOT prove that everyone else can do it – or that anyone else can do it.  Just like the fact that I’m a 300 pound National Champion Dancer doesn’t prove that every 300 pound person can be a National Champion Dancer – that’s why we have studies. Every scientist knows that they could be wrong, but to suggest that common sense and personal experience are a substitute for information gleaned from a statistically significant sample size through a properly designed study is ludicrous, dangerous and, unfortunately, really profitable in the adolescent weight loss industry.

It would be bad enough if people who claim that they can help kids lose weight were just making fat kids into lab rats by testing out their unproven hypotheses on them, but what they are doing actually flies in the face of the evidence that does exist. Again, there are no studies that show that any weight loss interventions are successful in the long run.  There are studies that show that weight control attempts in kids leads to weight gain and eating disorders (in fact, hospitalizations for eating disorders in kids under 12 are up 119% in the last decade.  Kids.  Under.  Twelve.)

If we’re going to have a discussion about our experiences, then that is a valid discussion and is worth having and each of us is the best witness to our own experience – but let’s not confuse it with a discussion of how to approach kid’s healthcare.  If we are having a discussion about children’s health interventions then it has to be based on evidence – our kids deserve better than anecdata and somebody’s so-called common sense.

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Published in: on November 29, 2012 at 12:58 pm  Comments (29)  

29 CommentsLeave a comment

  1. This is slightly off the point that you’re making, but I feel more and more like science and evidence isn’t respected – on anything. People argue according to their gut instinct. The situation you’re describing is a perfect reflection of something that’s happening to me at work, where we need to make a decision. I have an armful of research. My colleague has gut instinct, but it’s gut instinct that chimes with what everybody else thinks, so they’re all reinforcing their own prejudices. It’s happening at a political level as well, where ideology trumps evidence.

    How do people who claim to be ‘experts’ who can’t back up their positions look at themselves in the mirror, much less go on television? Everyone’s a pundit!

    • People argue according to their ego. We are a society of “me” and “individualism” interspersed with our continuous feed of “live up to this modal” be it the new car, fancy clothes, “trophy” partner, and the sense of entitlement we have cultivated for ourselves and our families/friends/other.

      As such, our level of personal responsibility is next to null, our ability to make sound judgements and use logical reasoning is out the window so the end result is the consistent drone of “it’s all about me”.

      ~ I’m going to yell louder so you can hear that it’s all about me and anything you say to attempt to refute “all about me” will be hereby and forthwith ignored since it’s “all about me”. So, did you get that? Do you see me, hear me, know that I am so important? ~ end sarcasm

      Thankfully this doesn’t apply to everyone. But an unfortunate aspect of our world today. We’re so alone and lost that we’re becoming so hateful, mean and horrid to our fellow people in our desperate need to be loved and part of a bigger picture.

    • I think this is also part of the trend of anti-intellectualism in America, which has been growing stronger with each passing decade. I mean, just take a look at the “news” nowadays. Apparently fact-checking is no longer part of the job…

  2. It is so interesting to listen to other people’s inability to really hear what you are trying to say. I listened to the Huffpost segment and those other people just couldn’t hear what you said about weight. Overweight and unhealthy and obesity are so intertwined in American culture. It’s sad.
    I love your posts and your message! Thank you for being my spokeswoman!

  3. Thanks for doing what you do. Thanks for speaking out and for going up against the mainstream currents with grace and logic.

    • A thanks from me as well for being able to deal with people of that nature in an effective manner. Giving in to their hysteria just feeds their “I got under your skin” mentality. It was sadly amusing to watch the one “self identified obesity expert” start getting worked up and distraught when you would speak with calm reasoning, intellect and facts. Just gotta love those “experts”.

  4. Thank you for providing this helpful context in a debate so overtaken by self-appointed “experts” who misrepresent the research, or simply ignore it. The Everybody Knows school of thought is seductive if we’re looking for easy, simple, slap-it-on-anyone answers. But what a terrible disservice these people are doing, while promoting themselves. I consider myself a reasonably intelligent reader, but without the counterpoint of this research you discuss here, I’d probably accept some of their Common Sense nuggets as scientifically-based truths because it’s presented so forcefully (and with a nice chaser of shame and guilt for anyone who disagrees). But you’ve given me some much more useful ways to think about these issues, and to talk about them with my daughter. Thank you.

  5. One of my next-door neighbors’ four sons was a chubby pre-adolescent. I didn’t see him for a couple weeks. The next time I saw him, he was a rangy teenager I didn’t even recognize at first.

    Does that make him an expert on ‘solving’ childhood obesity?

    Nah, it just means he started growing up and his genes took after the thinner side of the family. And when he hits his late twenties or early thirties, chances are he’ll gain some weight at that point… because that’s what most human bodies do.

    But I’m guessing most of the ‘experts’ won’t believe my anecdata since it conflicts with their anecdata and they won’t listen to actual data.

    Ah, the wisdom of sticking fingers in ears and singing ‘lalalalalaaaa’ as loudly as you can!

    It worked out so well for the White Star Line a hundred years ago… until that ‘unsinkable’ ship rammed into an ice berg.

    • You are so right. Especially boys, they tend to put on weight for the growth spurt that comes later. Kids become adults from 18-25 and fill out to have adult bodies. We are not supposed to fit into our high school clothes as adults.

    • Yes, it’s not uncommon for kids to change body shape as they hit puberty without consciously doing anything differently. My sister and I basically switched places–I went from always being fairly thin to being chubby (I remember my arms and legs were not as thin as some of the other girls’, but up until puberty I always had a flat stomach). My sister went from always being chubby to being fairly thin.

      Ragen, I think one of my comments on this post (from 11/29) is stuck in the spam filter or something. Could you fish it out?

      • Yeah, I think a lot of this “I was a fat kid and then I got thin after puberty” is a case of “born on third, think they hit a triple” I found and approved the comment. Sorry about that!
        ~Ragen

        • Thanks, and agreed about “born on third, think they hit a triple”!

  6. I hope the evidence gets through the smoke and mirrors of the diet industry eventually . It feels like there are very few people who actually pay attention to what actual evidence suggests , unless it is saying what they want it to say. Right now it feels like what they want the evidence to be is we need to rid ourselves of the fat people. Off topic I tried Salsa Dancing and I love it , I am going back on Saturday … Thank you so much .Two months ago I would have seen the moves they were doing and been like I can’t do that ,but I really can :)

    • That’s completely awesome!!!!! You are an inspiration – happy Salsa Dancing :)

      ~Ragen

      ________________________________

  7. WOW! Great article! I’ll be using the arm situation later (maybe today). Thank you & keep up the good fight!

  8. I’m really beginning to see that being a fat adult isn’t the result of some failure of willpower and discipline on my part. I can look back and see the endless dieting cycles that have led to my weight creeping up to my all time high of 225. It all started when I put on a little weight around the age of 8 and my mother put me on diets and fat shamed me to the point where I felt like no matter what I did right, as long as I was fat, I was a failure as a human being.

    Putting children through all of that is just setting them up for a lifetime of confusion regarding how to eat. Being healthy and happy is far more rewarding than being thin. I’m one of the healthiest people I know and I’m also one of the fattest. People always comment on my near perfect blood pressure every time it’s taken (like that’s a shock or something).

    I feel a little cheated and angry about all of the time I’ve wasted around food and thinness and not being happy with my body. Freedom really is not giving a (bleep) about what other people think and doing what you feel is right for you.

    Thanks for being one of the voices that has helped me find mine.

  9. I recently came across* this video from 1990 and related to another moral panic, about music that is considered inappropriate for minors.

    The “best” part: at around 4:35, Representative Dixon asks if there’s any evidence that her intervention WON’T work, then asking why they need any evidence for her intervention (to label/ban “obscene” music (scare quotes because “obscene” is very subjective and her definition seems to be much broader than most people’s)).

    Does this remind anyone of how anti-childhood-obesity crusaders talk interventions ranging from banning junk food in schools to putting obese children in foster homes without any evidence that they work? In fact, for some of these interventions, there are studies showing that they DON’T work! People feel the need to Do Something, and if they don’t know of anything that will work, they’ll do something that they know will likely NOT work, just to feel like they’re Doing Something.

    *When I was looking up a song Mojo Nixon had done about the Hamlet Chicken Plant Disaster, after being reminded of it by the fire in Bangladesh–how many times does this have to happen?

  10. As always, thanks for the reasoned and super smart approach to this topic. I’m bookmarking this very blog post and having my Social Research Methods class read it next semester. I wish everyone could take such a class. ;) Hugs.

    P.S. Thanks for being willing to be in the limelight and face (and counter!) such pervasive, often willful ignorance.

  11. Hey, in case anyone is interested:
    If you’re looking for a smart answer when people start talking about their “common sense,” the books “Predictably Irrational” and “The Upside of Irrationality” by Dan Ariely, and “The Drunkard’s Walk” by Leonard Mlodinow, both use science and mathy-stuff to prove that people’s intuition usually doesn’t know crap, especially about controversial stuff. That’s pretty much their whole purpose. So it can be a way to shut people up that makes you feel really smart. I had to read “Drunkard’s Walk” and “Upside of Irrationality” for class last year, and they’re pretty good even on their own.

  12. hi
    …. i tuned in last night and watched as long as I could… i had to shut it off as soon as they started challenging you due to a lack of spare sanity points. I did hear one of the experts talk about a 16 y/o fat daughter who “had” to give herself diabetes since there is no family history of it on both sides of her family.
    I got to tell you that I have been thinking about this poor girl all day and I am sooooooooooooooooooo sad for her and the immense disappointment she must consider herself to be to her father who counsels fat kids for a living. Just one giant ugly disfunction al cluster-f*ck.

    Sadder still is that there could not be anyone on earth more qualified than you to mentor this young lady and equip her with the tools to navigate the fat hatred that must be all around her because of her father’s “profession” and simply because she is a 16y/o fat girl in our country. Who more qualified than you to help limit the number of years of pain and suffering that her father is dim-wittingly making worse with his erroneous belief system.

    My heart is heavy with all the unnecessary suffering and when this guy spoke about his daughter I just had to turn it off and mourn for this guys daughter and by extension reconnect with my own inner sorrow for all the unnecessary suffering I have endured.

    Thank you for all you do Ragen.

    • Yes, that comment about how the daughter must have done it to herself was horrible. What an ugly parent. Just ugly to treat his child in such a fashion. And publicly no less.

  13. Again, you make me laugh. Your example of the guy who cut off his own arm is great. May I use it? Im not a “trained” researcher as you are but I have experience in ‘trouble shooting’ in the electrial field. It has taught me to look for the cause. And that is what I did in my research to find ‘why’ am I fat. Until we know the why, we cannot accept the experiences of others as proof of how to be thin. (Yes, there is sarcasim in that statement.)

    • Glad you liked the example, please feel free to use it anytime. Thanks for the work the you are doing, you rock :)

      ~Ragen

      ________________________________

  14. I love the amputation analogy! I think a short course in the history of medicine would be really helpful for people who value a “common sense” approach over evidence-based medicine…

  15. In the UK now there is an idea to screen newborns for obesity risk (based on factors including parents weight, whether they smoke, socio-economic status, birthweight). Apparently the planned intervention is to “teach the parents about the dangers of overfeeding”. Not just putting adolescents on diets, but newborns on diets from birth, that may sound melodramatic to some, but that’s how I see it. I hope they have set aside funds for extra availability of eating disorder treatments in a few years time! My mother has been weight obsessed all her life and she monitored my weight and food intake from when I was a baby, she tells me I’d finish my bottle and cry for more but I’d had my allotted amount- her version of that is I was always a greedy, big eater. I gained a little puppy fat at 12 and she put me on a diet, I went from 9st to 7st 10 at 5ft 3 tall. I remember being hungry as a child, and when I look at pictures, I was a thin child until puberty. As soon as I rounded out, I was on restricted portions, she’d give me the smallest potato, the small portion of tuna etc. I’d be hungry and raid the fridge for cheese or go to the shop and buy chocolate bars.

    Fast forward 26 years and I am now approx 270lbs and still gaining no matter what I do. My daughter, who has a very similar bodyshape to me, had a similar puppy fat stage. My mother made several comments about how she needed to “get that tummy off”. When she said it in front of my daughter, I took my mother aside and said to her, please do not ever comment on her weight or size again. She listened, thank goodness. My daughter continues to eat what she wants of whatever foods she wants, including the “real food” meals I cook, and plenty of whatever she wants to spend her pocket money on, she lost the puppy fat naturally and is now 16 and a UK size 8-10. Whereas mybody seems to live in a state of constant fear of deprivation, no matter how much I feed it, it is never satisfied.

    So, what is my point- my point is that even for those who believe the whole “fat is bad” thing, these interventions can do nothing but harm. They make people fatter! So a handful of people manage to lose weight and keep it off, so what? And in the meantime, food scientists devote their lives to increasing the “hedonics”, “irresistability” and “craveability” of food, and yet those who are fat are supposedly solely responsible for their overreating (if indeed they are overreating).

  16. I am a nursing student in the UK so thanks for bringing this to my attention. We are told obesity is a “risk factor” for most illnesses but a lot of the time the real risk factor is a sedentary lifestyle & it’s never the only risk factor, but it’s always the one people focus on. The thing we have been taught in lectures is to not judge patients just because they don’t have the healthiest lifestyles, there are people of all shapes & sizes who don’t eat enough fruit & veg, don’t drink enough water, eat too much junk, smoke, don’t get enough exercise, drink too much alcohol, take drugs, don’t get enough sleep, don’t always follow health advice, work too many hours and do many more things that are “unhealthy”. Nobody has completely healthy lifestyles 100% of the time. The point is that as health professionals we treat people equally, nobody is undeserving of high quality health care!

    • Good to hear that there’s some pushback against too much focus on BMI!

  17. I was reading an article by a scientist talking about debating with anti-science people. He said the technique they use is to bombard you with sound-bites and anecdotes so that you cannot answer or give a complete picture of what you’re trying to say. So he decided to do the same – give them so much science, they couldn’t rebuff all of it and some of it would stick (in the audiences mind).

    I don’t think you should hesitate to dominate the conversation. The anti-fat industry (because that’s what it is) had been dominating the debate for far too long. You have lots of science on your side, USE IT. Give them the endless stream of evidence, anecdotes and information and watch them squirm and try to over-ride you.

    Now this is easy for me to say – I write science, I don’t speak it, but I did think it’s true that the anti people are not backwards in coming forwards, and we shouldn’t be either.

  18. Lovely comments from everyone. I put those book recs on my wishlist.


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