Non-Science Fridays: Fie on my fat friends edition

Meatheads of the Week (or so)
Michael Vick, Tim Donaghy, Michael Rasmussen, and Barry Bonds for good measure. For Dogs, Gambling, Lying, and Doping. The Wonderful World of Sports!

Genius of the Week
Kyle Smith. For his brilliant review of The Simpsons movie as a Simpsons script. You must go read it.

Fat people are very politically correct.
(Shouldn't we start calling it socially correct since politicians routinely say the worst things?) Anyways as I'm sure you're all aware, there was a study in NEJM that showed that you were more likely to be fat if your friends were fat. It's findings lead to the conclusions that personal choices are primary and that stigma actually helps keep people thin. Is that what the news stories said? No way. They, almost invariably, used the virus metaphore - it just spreads. As if those doing the spreading had nothing to do with it. Almost all of the papers set this problem as one of an influence you just can't do anything about. The LAT went as far to say that "treatment programs should move away from their emphasis on individual will power". First, that's crap and not supported at all by the study. Second, if you did that what would the treatment program look like? Cordoning off a 150 ft space around the person that overweight people couldn't enter?

There are a lot of cultural issues that promote obesity in the US, the disincentive to walk, the cheapness of bad-for-you-food,...ETC. This makes it very hard to stay in shape for sure. However, what this study showed was that obesity was caused mainly by cultural associations. It was effected by friends and couldn't be impacted by the types of food you eat (spouses were unimportant), where you live (friends living accross the country had an effect as did those nearby), or genetics (weight of sibilings didn't explain it). So what we're left with is what people think is culturally acceptable. You can either try to fight it or ditch your fat friends and find some fit ones.

That's really nasty. Which is exactly why all the papers screw it up. We don't want to hear that stigmatization works (because it probably wreaks havoc on your self-esteem, unless of course you become thin). In fact all the experts are careful to tell you that you shouldn't chuck your overweight friends without much reason why. This flys directly in the face of what the study found. We don't want to be nasty. We want to be nice "I'm OK, you're OK" everyone. Maybe that's part of the problem; we haven't figured out how to promote a healthy body self-image while exhorting people to get in shape at the same time.

Like it or hate it, there it is. Frankly I find it somewhat disturbing but it makes sense. As harsh as this sounds, I don't think it's that harmful to say. I was a bit chubby myself once upon a time. You know what fixed me up? Dating. I wanted to look good to get more/better dates. Also, in college almost all my friends were in good shape 1) It worked (both getting in shape and getting more dates. Woo Hoo!) 2) I realized how much better I feel being fit and also how much I liked to cook 'real' food so now I keep in shape both for my spouse and for me. For the time that I was overweight there was no one to blame but myself. I excersized but I was also known to be able to put away a whole large bag of Cheetos in one sitting (Cheetos are still a weakness). That's a problem with me, not Frito-Lay.

What's up with Cheetos and Fritos?
Fritos are made of "corn, oil, and salt". That's it. For all the processed stuff we have around it's nice to know that even some really tasty, bad for you, commercial stuff can be simple (no preservatives, corn syrup,...etc). Also, Cheetos are made with real cheese. No kidding. That neon orange stuff is just a mixture of cheese that has totally dried out (I think they get it in to a liquid and then spray it on in a heated tumbler). Who knew?

Assult Blower Ban
The CPSC released the following this week "The Toro Company Recalls Electric Blowers Due to Projectile Hazards"
Apparently the impeller breaks apart and then it gets shot out of the blower at high speed. This is moderate on the cringe factor but high on the 6th grade cool factor (a shooting leaf blower? Awesome!). The highest cringe factor was on one last year that said something like "Handle breaks on chainsaws create laceration risk". The handles were breaking while the saw was in use. Ewww...

Weekly Aural Pleasure.
The latest offering from The Heavy, 'That Kind of Man', is fantastic. It reminds me of what would happen if the O'Jays and Led Zepplin got together. And that's a very good thing. Up till 1:30, it's a pretty good video. The booze and bimbos thing at the end is just tired. Not tired enough to be retro, just tired (and not a small bit male chauvinist). It's the video version of phoning it in. It makes me think that the directors thought, "well, we can't have them in the truck the whole time, that's boring" and they're out of ideas. "Hey, how about we have a bunch of floozies jump in truck?" Note to The Heavy: this ain't a beer commercial; get a new director. They should have recorded it in the backs of different trucks and cars stopping to pick up the band members and spliced it together. Not brilliant but better. See, how hard was that? Enjoy the music.

Happy Friday! (and yes, I'm munching on a doughnut right now. All things in moderation.)

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"treatment programs should move away from their emphasis on individual will power"

The LA Times printed that. They quoted a legitimate medical doctor at a legitimate medical school who does legitimate research in the field. The "experts" to whom you refer, the ones who "are careful to tell you that you shouldn't chuck your overweight friends," include the study's authors, according to the New York Times:

If the new research is correct, it may say that something in the environment seeded what some call an obesity epidemic, making a few people gain weight. Then social networks let the obesity spread rapidly.

It may also mean that the way to avoid becoming fat is to avoid having fat friends.

That is not the message they mean to convey, say the study investigators, Dr. Christakis and his colleague, James H. Fowler, an associate professor of political science at the University of California, San Diego.

You're free to accuse them of "social correctness" (which, try as I might, I can't manage to construe as a slur) as well.

Honestly, I have no idea why you think "[the study's] findings lead to the conclusions that personal choices are primary and that stigma actually helps keep people thin." I don't think the study supports those claims at all, but that's another argument entirely. I just want to point out that representing this as a case of hard-nosed scientists versus PC journalists is dishonest.

Public Health does seem to be turning back to social stigmatization as an effective method for behaviour change.

Off the top of my head:
Old campaigns that worked: Public Spitting in response to TB in westernized nations. I think the chinese are trying to do this now before the Olympic games?

Markerters have also shamed all males into buying Diamond rings for our brides-to-be. To not do so is now shameful.

Newer campaigns that have worked to some degree: Smoking. Possibly condom use?

New Campaigns that may work: Speeding in young male drivers (the ads in Australia are fairly hilarious. They are equating speeding with making up for having small genitalia)

I don't know how this will work in obesity though as being obese is already highly socially stigmatized. I was talking to somebody's grandfather a couple of years ago and discussing the obesity rise with him. He remarked 'whatever happened to the sin of gluttony? (I'll call it a concept rather than a sin)'. Perhaps it's eating too much (the antecedent cause) that needs the re-stigmatization?

Getting a new set of friends seems to be one of the ways that people conquer other vices like smoking and drinking. Someone who wants to stop drinking is asked to stay away from bars, friends who drink and situations associated with drinking. Someone who wants to quit smoking should try to avoid situations where smoking has become a natural part of the environment, including people who continue to smoke. It is definately more problematic when it comes to eating behaviors since eating is necessary for survival, but replacement of one thing for another can certainly help. The most obvious situation is sitting in front of the TV and snacking. The advice is to avoid watching TV or to obstruct your view with a large piece of exercise equipment.

I concur with Nat's idea to change the focus of the stigmatization to the behavior that causes the problem, and I would add sloth to gluttony.

By natural cynic (not verified) on 29 Jul 2007 #permalink

The flip side of this is that before turning it into public policy, we have to step back and look at the bigger picture. What the result apparently says is that we can make people thinner by making fat people miserable. Is the misery we create (and the corresponding health risk of making millions of people emotionally distraught) going to be outweighed by the health benefit of making them thin? To some extent it's a question of values. So I'd also question someone who immediately jumped from the result to, say, announcing that everyone has to act like jerks toward their fat friends NOW.

I agree with Matt to some extent, that emphasizing the stigmatiization of the obese may in some ways be more harmful. The point that I would emphasize is that we stigmatize the behaviors, namely sloth and gluttony, that get them that way. How to separate these may be difficult, but we should try as much as possible.

By natural cynic (not verified) on 30 Jul 2007 #permalink

The study noted that it works both ways. Fat friends seem to make you fat, but thin friends also influence in the other way. So maybe the answer isn't stigmatization, which may tend to cause fat people to hide away from social interaction (already a problem for many). Maybe it's that thin people *should* make friends with fat people, invite them over, go out and do active things, eat healthy food together, *not* stigmatize them. And not as a "program" or conscious attempt to "change" or "better" them or otherwise be patronizing, but rather as a genuine friendship, in which they may then influenced naturally to healthier habits. Most fat people are already terribly unhappy about it, and adding to their unhappiness isn't going to do anyone any good.

PhilB

By Phil Boncer (not verified) on 30 Jul 2007 #permalink

I am not advocating stigmatization of obese people. That already exists and it's clearly not working. What I was throwing out as an idea was the re-stigmatization of gluttony.

However, I'm certainly not convinced that stigmatization of gluttony is going to work. Food intake, unlike tobacco and alcohol, is essential. One cannot go cold turkey or have a 12 step program for eliminating food from ones life.

On the sloth side I'm much less keen on the iea of re-stigmatization. The problem being that the effects of sleep on metabolism is a very active field of research right now. It might be that adequate sleep protects against obesity compared to too little sleep. As it is too many people associate sleep with being lazy of slothful. Reducing food intake however probably won't cause more obesity.