Spin you right down, baby, right down

I'm technically a freelance science/medical writer. I do lots of other things, but if I need to make money, I ask people very kindly if they will let me write something for them, and then give me money in exchange for my words.

Nice system, really.

What I'm learning here at school is that there is not only an art to writing about science, but also an art to creating the stories you want to write. I didn't realize what a strange, bizarre world I was about to enter.

Any time you write a story, there's going to be spin. Sometimes, writers have a specific idea of what's happening and it can show. The infamous epidemiology maxim: you tend to find what you're looking for. Looking for stories on how bad overweight is? You'll find them.

The problem comes when you're looking for stories on how essentially inconsequential overweight is.

Those don't really exist.

The horrors of obesity are promulgated far and wide- so far and so wide, in fact, that hardly anyone seeks to question them any more.

Sandy at Junkfood Science posted two recent updates on the Women’s Health Initiative (WHI) Dietary Modification Trial, the latest results of which were published in the Journal of the American Medical Association. I read the science and health news section of most major publications on a very regular basis, yet I hadn't heard anything about the study.

So I searched Google News. I plugged in "Women's Health Initiative Dietary Modification Trial" and hit Enter. Nineteen results popped up. All of them- all, every last one- said that a low fat diet could reduce the risk of ovarian cancer.

Of course- the results of any study having anything to do with food/weight, has to have a conclusion that the intervention or whatever it is, helps people lose weight. Therefore, that must be the main point of this study. The actual objectives of the study are quite different:

To report data on body weight in a long-term, low-fat diet trial for which the primary end points were breast and colorectal cancer and to examine the relationships between weight changes and changes in dietary components.

However, after reading the results of the trial and then going back and reviewing the abstract, I realized that the scientists themselves were putting spin on this issue.

The results section- which consists of megalith tables, many over a page in length- posted many results. Some of them weren't all that surprising- the women placed on the low fat diet consumed slightly less calories from fat, more whole grains and more non whole grain carbohydrates. However, the interesting results were the issues of weight.

BOTH women who were told to follow and low-fat diet (the intervention group) and those who were told to follow their normal eating routines (the control group) lost weight during the study. They intervention group lost approximately 1.5 pounds, and the control group lost approximately 0.5 pounds. The difference, when you look at a massive group of 44,000 women, was statistically significant. However, is it meaningfully significant? Does one measly pound difference warrant all of this effort, time, and money (not to mention blood, sweat and tears)? I mean, if you told the control group to drink an extra glass of water on the morning they were weighed, there would have been no difference at all.

The researchers concluded the following:

Weights in the intervention group were lower than those of the control group, who followed their usual eating pattern during the follow-up period, suggesting that a low-fat dietary pattern may help attenuate the tendency for weight gain commonly observed in postmenopausal women.

Which is really interesting, considering they data they found showed no weight gain in post menopausal women. Also missing was the reference to the study that found weight gain amongst the elderly prevented many deaths.


Something has to be in it for the scientists. Money, for one. I'm not necessarily talking about billion-dollar greed here. But if they scientists want to keep their jobs, they need to bring money to the university. It's a brutal reality. The fact of the matter is that the NIH has money to spare if you look at "preventing obesity"- what lawmaker would want to say that obesity isn't a problem? It's a given. So scientists study obesity prevention. It's a cash cow.

Then there's the simple fact that scientists aren't immune to ignorance. There are some who believe, promote, and teach Intelligent Design. Sorry, but that's not science.* The anti-obesity message is so prevalent that it's hard to think otherwise. I sure as hell didn't until recently.

Lastly, there's that maxim I quoted earlier: you tend to find what you're looking for.

Just like researchers did in the most recent issue of JAMA. The title of their analysis was titled: Childhood Obesity as a Chronic Disease: Keeping the Weight Off

The conclusions were quite telling of the general attitude towards obesity prevention. If "A" didn't work, then we need "AAAAAAA!!!!!" What they never stop to ask is whether "A" in any variation, had a change of working. Or, first, whether there was a problem to begin with.
Nevertheless, the data provided a sobering message— despite a statistically significant effect of at least 1 of the active maintenance interventions over the longer term (with exclusion of outliers), the effects of all interventions diminished over time and even at their peak were small.

Then, two paragraphs later:

Further research to identify the most successful dietary and physical activity interventions could also augment the effects of the maintenance programs used in this study. For example, the authors used the traffic-light diet, which advocates reduction in fat consumption as its primary nutritional focus. However, the efficacy of dietary fat reduction has been questioned because prospective observational analyses do not show consistent associations between dietary fat and body weight, and because weight loss among interventional studies is not greater in lower- vs higher-fat diet groups.

That really says it all.

*This is also a bugbear of mine, as you would say, Marcella. One that I won't get into now.

**Sorry about the wacky fonts. I tried to change it for a long time, but I'm too frustrated now.


marcella said...

Fascinating stuff Carrie. The timing of our latest anti-obesity hype is what fascinates me - just when the Prime Minister was struggling in the opinion polls and about to enter some important negotiations with Europe. Hmmm

Harriet Brown said...

You've caught on, Carrie. This *is* the way mainstream media works. I'm grateful to the New York Times, actually, for letting me write stories from the other point of view. Having a parent's perspective as well as a journalist's is what helps, I think. But even they will go only so far.

Marcella, interesting point. Anti-obesity hype has become propaganda, which the powers that be haul out at the least sign that ordinary folks are restless or about to feel empowered. You can always shut 'em up by telling 'em how frigging fat they are, eh?

lauren said...

Your amazing Carrie! I just wanted to let you know that I am thinking about you RIGHT NOW and wishing you a wonderful day, take care of yourself sweetie
Love Lauren

Faith said...

Propagandized to the point that as a researcher with an ED, I still am finding this very hard to believe. I do believe you, but my ED brain is resisting...


Anonymous said...

Carrie, I really think you're onto something here. The "obesity epidemic" sells on so many levels - perhaps to the point of twisting statistics to promote it.

I hope Sandy at Junkfood Science reads this. I think she'd be proud.

Sarah said...

don't forget Congress! They tell NIH what to spend the $ on . . .

Great post. Science writing is a true art, in my opinion.

Laura Collins said...

I dream of the day when the "obesity epidemic" house of cards falls, and falls hard. Meanwhile, I'm getting used to being looked at like a nut.

You are Galileo, baby. The earth is just a planet. A burger is just a burger.

zubeldia said...

i think it would be wrong, though, to say that eating patterns are unrelated to health and disease prevention. There are too much data - even raw data - which suggest a correlation between eating habits and health. That said, THAT is a long way from connecting actual weight in a causative way with disease. Weight is a crude measure, for sure, and I think it has become the propaganda mantra of the day.

I think that focusing on the 'real' culprits would be too much for too many industries...which is why we focus on individual bodies and thus reduce the issue to individual pathology and 'greed'. Imagine if we actually looked at science not funded by lobbyist groups such as the dairy industry....We might find that the issue is far more complex than people being overweight. For example, the industrial farm industry, which makes a lot of profit from high fructose corn syrup, might have to be investigated, and into the limelight might come fast-food chains which target children with low nutritious foods, etc.

I do think that it's important for us in the ed community to be mindful of the importance of healthy eating - and that there IS good science out there which demonstrates that what we eat is crucial to out health. I think, though, that this is very different to reducing the chronic disease problem to a specific BMI. Not only in this reductive, but it also adds more shame and another layer of moral meanings on to what it means to be 'fat'.

not sure if this makes any sense!

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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Have any questions or comments about this blog? Feel free to email me at carrie@edbites.com

nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote


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