the HAES® files: Beyond Awareness

This is a brilliant piece written by a brilliant woman. How many people can come up with insights like this?

Weekend reads: MIT professor accused of fraud, biologist who retracted paper suspended, and more

Retraction Watch

Another busy week at Retraction Watch, featuring lots of snow at HQ and a trip to take part in a conference in Davis, California . Here’s what was happening elsewhere on the web:

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Statistics, Semantics and Parity

I am by no means a statistician, but I’ve worked as a medical writer and editor for long enough to know that the results of clinical trials rely heavily on statistics for their interpretation. There have been countless books written on this matter, and here’s a gem of an article in the Atlantic that sums it up nicely. But since most of us are not statisticians, we must rely on the “experts” to interpret them for us. The problem is that they can be so easily misused and misleading.

If you recall, there was a famous study by Christakis and Fowler (NEJM 2007) on the spread of obesity through social networks that relied on statistical analysis. In 2008, a refutation of this article was published by Cohen-Cole and Fletcher in the Journal of Health Economics. In fact, I would bet you a pack of bubble gum that for every statistical analysis ever published, a refutation of that analysis is subsequently published. So what are the non-statisticians to do?

I say we all need to learn to take most studies with a grain of salt, and approach them skeptically. This is something that children should be learning in school – it is essential to the scientific process. If this concept were something that all of us learned in school, we wouldn’t be so quick to jump on the published results of any study even if they would prove our dearly held beliefs.

NB: In their blog “Retraction Watch,” Ivan Oransky and Adam Marcus have touched on the problems caused by faulty statistical analysis in climate change research. I hope to see more of this in the future. I attended a conference 2 days ago entitled “Bioethics Bootcamp,” sponsored by the Hastings Center, Science Writers in New York, and the National Association of Science Writers. Ivan, the Executive Director of Reuters Health, said that he routinely tells his reporters to “always carry a statistician in your back pocket.” Easier said than done, but I hope this will get easier in the future.

Health At Every Size (HAES)

Tara Parker-Pope, in the health blog section of the New York Times website, addressed in her post “A Diva’s Lessons on Weight and Beauty” the scientifically based concept that controlling body weight is not a matter of will power. Thank G-d, it’s finally dawning on the New York Times’ editors that fat people actually don’t deserve to be punished for their lack of will power (particularly after that awful Times magazine cover touting Clive Thompson’s misguided article (“Are Your Friends Making You Fat?”) on Christakis and Fowler’s research).

What many people don’t understand about the very important concept that controlling body weight is not a matter of will power is that people can still be healthy, or improve their health dramatically, no matter what they weigh. Everyone can make changes in their lives that will improve their health. It is absolutely true that a sedentary lifestyle combined with poor eating habits is clearly linked with disease, such as diabetes and heart disease. The important thing is the process of learning to incorporate healthier habits, while doing away with prejudice or discrimination against fat people. Shaming fat people will not lead to improvement in anyone’s health. Instead, it will continue to engender low self-esteem, unhealthy dieting practices that will slow down metabolic rates, and eating disorders. In short, the focus should be on learning to live a healthier lifestyle that doesn’t involve beating oneself up on a regular basis, based on one’s appearance or a number on a scale. Check out Linda Bacon’s website and the website for the Association for Size Diversity and Health.

Causation, Correlation, Dogma, Weight, and Health

After acquiring the book almost a year ago, I (again) started reading Gary Taubes’ book entitled Good Calories, Bad Calories. Based on what I’ve read so far, and knowing Gary Taubes’ background, I believe it’s a very scholarly work, and very thoroughly researched. From the title, it’s obvious that this book considers the scientific evidence for specific types of diets and how they affect body weight regulation.

Feminine Beauty: The Dada-ist view

Part of the purpose of this blog is not only to examine the science behind metabolic regulation of body weight, but also to understand how current standards of beauty (read: thinness as opposed to fatness) evolved in modern Western culture. These two seemingly unrelated topics are actually very intimately tied together, as the ever-present, pervasive, all-encompassing, in-our-face images of our society’s ideals of beauty are so powerful that they have a profound effect on our perception of health. This is true for all members of our society, including health professionals.

Dr. Christakis’ Reply

It has taken me several weeks to post this reply, which Dr. Christakis sent almost immediately after I sent him my email (see previous entry entitled “An Email to Dr. Nicholas Christakis”). During this time I’ve had the opportunity to learn and think more about Dr. Christakis’ work, and was not shocked to discover that my knee jerk response to his NEJM article on the spread of obesity through social networks was premature. However, I was far from alone in this reaction.

An Email to Dr. Nicholas Christakis

In 2007, Dr. Nicholas Christakis, a medical sociologist at Harvard University, published a study in the New England Journal of Medicine on the effect of social networks on the prevalence of obesity. I recently came across this study online, through links in a post by a friend, and revisited the results of the study. You can view a 3-minute interview with Dr. Christakis about his study and findings here.

After watching this interview and looking over Dr. Christakis’ website, I composed this email to him:

Here a SNP, There a SNP

A “SNP” is a single nucleotide polymorphism. Within a genetically distinct population, i.e. people of a certain ethnicity, religion, or geographic region, there are several versions of the DNA sequence of any given gene that is almost identical, with the exception of one sequence unit at a specific site. This single nucleotide variation occurs in the population at observable frequencies.

Diabetes or Diarrhea – Take Your Pick*

Metformin, otherwise known as glucophage, is a medication that works to lower elevated blood sugar and help the body process the excess sugar more efficiently. However, if you have the unmitigated gall to eat sweets while taking this medication, you will be punished by having copious diarrhea. I found this out first hand. I guess this is the price I pay for feeding my addiction.