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Prologue


No-obesity-epidemic.org is far more than a polemic on the "obesity epidemic."
  It covers the topic of obesity broadly and in depth.  It looks at how the foods we eat relate to health and obesity.  We soon learn that much of what we have been told about protecting our health is untrue.  We also find out that medical advice for preventing obesity usually ends up harming us.

No-obesity-epidemic.org makes a strong case for the benign nature of our foods.  No food or macronutrient contained within possesses an inherent propensity to cause obesity.  Almost all weight gain is a reaction to previous restriction of calorie intake.  This is demonstrated by the high incidence of obesity in long-term dieters as well as in people that are food insecure.  Restriction of calories, whether through volition or because of an inability to procure enough caloric nutrition, will result in changes in hormonal levels and response, causing an increase in the hunger drive.  This is understood to be adaptive rather than pathological.

No-obesity-epidemic.org turns the current discourse on obesity on its head.  It challenges us to see that framing obesity as a problem that must be dealt with by restricting calories is exactly the reason why the incidence of obesity has been increasing.  Obesity rates began to trend upward in 1980, three years after the United States Senate Select Committee on Nutrition and Human Needs issued formal nutritional guidelines.  The guidelines were focused on preventing obesity.  It is ironic that our waist sizes have been increasing in tandem with a rising popularity of weight loss dieting, gym memberships, aerobic exercise, and a quest to eat healthy foods.  With a correct understanding of the forces at play, this sense of irony will vanish.

Using established principles of nutrition, biochemistry, anatomy, and physiology to support a process of cautious and creative scientific inference, no-obesity-epidemic.org breaks ground in a number of issues surrounding health and obesity.  Reasoning is clear and strong.  Many scientists make hay with loose associations and
vague generalizations.  No-obesity-epidemic.org approaches scientific inquiry with step by step logical analysis.

Below is a list of new understandings on the nature of obesity, many of which challenge current thinking.  Each item is linked to supporting information.   I invite you to investigate any of these assertions or continue to read on.


1.  The childhood obesity epidemic is refuted through observation.

2.  The childhood obesity epidemic is refuted through mathematics.

3.  The body mass index (BMI) assessment tool is highly biased. 
     BMI is largely responsible for the false perception of an
     obesity epidemic especially in children.

4.  Most obesity results from a change in hormonal response due to
     previous caloric restriction.

5.  Willful overeating does not cause obesity.

6.  Food insecure people become obese due to previous caloric
     restriction, not from eating cheap "junk" foods.

7.  Obesity is not genetically determined.

8.  Obesity is generally harmless to our health.  Other factors confound
     the results of obesity studies.

9.  No foods or macronutrients inherently promote obesity.

10.  Recent concerns over carbohydrates and obesity are not supported
       by science.

11.  Human anatomy and physiology do not provide a basis for glycemic
       effect (glycemic index).

12.  There is no such thing as sugar addiction.

13.  Cholesterol and saturated fats do not cause heart disease.

14.  Physical activity has no influence on body weight in the long run.

15.  Gastric bypass surgery is a dangerous and harmful procedure that
       should be avoided.


Thank you,

Gerald Rubin Ph.D., 1987, University of California San Francisco.


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Links of Special Interest:



THE PRIMARY CAUSE OF OBESITY
 
Weight loss dieting is a losing proposition

Genetics do not play a role in obesity

Why obesity has increased

Reasons for Childhood Obesity

Revised BMI Charts for boys and girls

For parents of a child thought to have a weight problem / potential dieters

Fat prejudice and hatred

How the notion of "unhealthy foods" came about

Click here for relevant external links at the bottom of the page.



Introduction

I have been investigating issues surrounding nutrition, health, and obesity since 2009.  The obesity epidemic is a fiction that has been imposed onto Americans by the government, medical establishment, drug industry, diet industry, and other institutions.  Two observations stand in the foreground.  First is the extent of falsified research generated to support a notion that certain foods promote obesity and that obesity promotes disease.  Second is the extensive harm that a "war on obesity" has done to American society as a whole.

When I went to graduate school at the University of California San Francisco in the 1980s, part of our ongoing education was to analyze and critique research papers in our area of expertise and meet once a week to discuss them.  Inept research was not uncommon but falsification of results was.  I perceive things differently today.  Perhaps obesity research is a higher stakes game than research in basic pharmacokinetics.  Perhaps I am just better at sleuthing. 

The propensity for fraudulent research is most apparent when such activity is known to lead to substantial financial gain.  This includes drug research and certain areas of medical research.  I bluntly assert that the whole foundation of obesity research is based on fraud.  If you look at other areas of endeavor, this is not true.  Once a concept from another field becomes incorporated into the obesity discourse, there is a high probability that it will be misused.  For example, the basic science of immunology appears sound.  However, obesity researchers have borrowed concepts from immunology and muddled them.  From this, obesity researchers have created a false dogma that allows them to claim that obesity produces chronic inflammation or that obesity is an autoimmune disease.  

Besides the profit incentive, physicians are motivated to falsify research by a pervasive attitude of health moralism.  The medical establishment seems to bar no effort in pathologizing our bodies if they possess a greater than average amount of adipose tissue.  Sometimes a physician's desire to pathologize our bodies results in outlandish research findings.  This is seen in the findings that high body mass index in adolescents is associated with brain damage and that infants ranging from 1 and 6 months of age require calorie restriction to prevent obesity.

Fortunately there is still good research out there as well as sound scientific principles to fall back on.  This has enabled me to do my own critical analyses on issues surrounding obesity.  For a vigilant and knowledgeable scientist who has been sleuthing this topic for the past 4 years, most fraudulent efforts are apparent at the outset.  After a while you get to know whether something is sensible or not on the face of it.

Once a false premise or theory is established, many scientists willingly and uncritically latch onto it.  So do many lay people.  Examples of theories that have no basis in science include a connection between glycemic load and obesity, a connection between high fructose corn syrup and obesity, passive overconsumption of high fat calorie dense foods, and the notion that vegetables promote health.  The biggest lies of all are the supposed existence of an "obesity epidemic" and that dieting is an effective means to lose weight.

Harm goes way beyond the fat person, it goes to all of us.  We as a nation have been made to fear our favorite foods, even our staple foods.  We have been indoctrinated with so many false concerns about the foods we eat the we have become a food phobic nation.  Overemphasis on nutrition and disease has led to a common experience of medical hypervigilance and a large increase in the number of people suffering from eating disorders.  To some, the only way to deal with the prevalence of "unhealthy" foods is to become a vegetarian.  And there are physician moralists out there that want to make all of us into vegetarians.  Vegetarianism is a false solution because vegetables are deficient in calories, proteins, vitamin B12, vitamin D, calcium, and iron.  Vegetables provide a very expensive way to be undernourished. 

If you happen to be one of the 50 million people in America who rely on food assistance, you will find that emergency food providers favor and promote vegetables as well as low fat foods because of the common belief that such foods are "healthy."  It seems that with some food banks the primary concern of hunger is relegated to secondary importance.  Instead of focusing on the procurement of low-cost high-calorie foods that are falsely associated with obesity, food banks spend much of their limited resources on highly expensive fruits and vegetables.  The massive tragedy of hunger ends up being pushed aside by efforts to prevent and reduce obesity, efforts that in fact make obesity worse in the long run.  Solving the problems of hunger and obesity is not a zero sum game.  Having adequate food available and learning never to get on the dieting roller coaster in the first place will end both hunger and obesity.

Calorie restriction produces hunger and weight loss, but this paradoxically leads to weight gain in the long run, because the hormones in our body want to protect us against a later occurence of calorie restriction.  The body cannot discern between voluntary calorie restriction and insufficient access to calories that might be due to a famine.  Do doctors care to know this?   They see all of their patients fail at weight loss, but doctors continue to blame their patients anyway.  It seems to be more satisfying to a doctor's ego to blame than to help, especially people who are "bad and refuse to take care of themselves." 
Many fat people will no longer go to a physician when they need to, because a large number of doctors treat them with condescension.  A growing number of doctors will not diagnose or treat a fat person until he or she loses weight.

There will soon be many more people for doctors to blame if we do not stop the false agenda of health moralists.  The United States Congress passed the Healthy and Hunger Free Kids Act in 2012 which mandates that all school children be served calorie limited lunches that include highly disfavored vegetables.  Instead of lean and fulfilled children, the new law is making hungry children, some of whom will later become fat due to insufficient calorie intake. 

The government needs to stop using paradigms of aggression for every situation that it perceives to be a problem.  The paradigm of "war" seems to be associated with every social initiative whether it is the war on poverty, war on hunger, war on drugs, and now the war on obesity.  Has a single war been won?   Collateral damage is produced everywhere, but in the end not one of these problems is improved, let alone solved.  With respect to the war on obesity which has done much to obliterate efforts to end hunger, the medical establishment has been a willing ally to the government by carrying out aggressive, expensive, and harmful policies. 

In the larger picture, spending on healthcare now accounts for nearly 20 percent of America's gross domestic product.  One quarter of American famiiies are either in debt or have gone bankrupt due to medical expenses. Most of these families carried medical insurance.  The medical establishment falsely blames the fat person for overusing medical resources, but it willingly doles out advice that leads to more obesity, advice that makes the fat person fatter.  The medical establishment is quick to recommend gastric bypass surgery that costs upwards of $25,000 for the procedure alone, even though a harmful outcome accompanied by huge medical expenses for the treatment of complications over a lifetime is virtually guaranteed.

The war on obesity has been fueled by the false proclamation of an obesity epidemic and the false classification of foods into good and bad categories.  Both constructs have resulted in great harm.  In final analysis, the war on obesity is really a war on the American people.


Let us open our eyes

I would often ask myself, where are the 64 percent of Americans that are defined as overweight or obese?  I think that the percentage of Americans cited to be overweight or obese is even higher now.  Why don't I see with my own eyes that most Americans appear too heavy?  I posited to myself that some agreed upon standard for defining the conditions of overweight and obesity must be very strict.  How else could this be explained? 

I invite readers of this website to do your own informal study on the frequency of overweight and obesity in adults and children by simply observing people.  I believe that you will soon determine that there is, in fact, no obesity epidemic.  Often, simple direct observation will give a more accurate picture than published numbers.  I am not denying the existence of fat people, you may see plenty of them over a day's time.   But I would estimate that less than one-quarter of adults carry "too much" weight.  The number of heavy children is exaggerated even more.  Obesity is uncommon among children.  The body mass index (BMI) assessment tool is responsible for grossly overestimating  the frequency of overweight and obesity, especially in children.

Body mass index is biased in several respects. The empirical equation for calculating BMI uses an incorrect power relationship between body weight (mass) and height; BMI standards for overweight and obese categories are arbitrary and overly strict, especially in children; and BMI does not account for differences in body composition, frame size, or body shape.  Due to the incorrect power relationship between weight and height, body mass index will be overestimated in tall people.


Why are we worrying about body mass index defined overweight anyway?

In 2005 research led by Katherine M. Flegal, PhD, Senior Research Scientist at the National Center for Health Statistics, Centers for Disease Control (CDC), determined that BMI defined overweight people, with BMIs ranging from 25.0 to 29.9, had a lower mortality rate than BMI defined people of normal weight.  Saying it another way, roughly one-half of the 64 percent of Americans who are defined as carrying too much weight are in fact at an optimal weight.  Why has such beneficial information been downplayed?  Such information would allow tens of millions of Americans to begin to rest easier, to worry less about "weight problems" and health, and to perhaps refrain from dieting that often results in weight gain in the long run.

The medical establishment has long played a game of pathologizing obesity.  We have become indoctrinated with its message.  If one investigates closely, one will begin to find gaps in its storyline where the light of truth shines through.  This often requires going to source material.  The three CDC sponsored National Health And Nutrition Examination Survey (NHANES) corhorts that served as Dr. Flegal's database shed considerable light on obesity and its relationship to mortality.  The CDC, a United States government agency, demonstrates bias against obesity, as most institutions in the United States do.  On the other hand research done under auspices of the CDC has a reasonable chance of being honest.  Under these conditions there is a good chance that any obese favorable findings issued by the CDC will be reliable.

Dr. Flegal's finding that BMI defined overweight is associated with the lowest mortality contradicts many earlier findings that depict mortality rate to bottom out at a BMI of under 25 with mortality increasing throughout the overweight range.  Knowing that there has been a substantial degree of falsification of obesity research in a direction of over-pathologizing, it becomes clear that Dr. Flegal's results are the more reliable.  NHANES data was derived from three cohorts, NHANES I (1971-1975), NHANES II (1976-1980), and NHANES III (1988-1994).  In a separate analysis, Dr. Flegal dropped data from the NHANES I cohort because death rates were anomalously high, skewing averages taken from all three cohorts.  Flegal herself beiieved that data in the later cohorts were more representative of current trends.  In her re-analysis, there were no excess deaths in the mildly obese category (BMI 30.0 to 34.9).  Excess deaths were highly attenuated in the moderate obese (BMI 35.0 to 39.9) and the severe obese (BMI greater than 40.0) categories.

Rates of obesity rose most between 1980 to 2000.  During that period, rates of heart disease dropped substantially.  The MONICA world wide coronary risk factor assessment trial that looked at 10,000,000 people in 21 countries over 10 years found that heart disease was negatively correlated with BMI.  The Strong Heart Disease study showed that in Native Americans with high rates of diabetes and heart disease, BMI itself was not correlated with heart disease.

The younger generation seems to be hit hardest by false medical concerns over obesity.  Health authorities assert that obese teenagers show greater susceptibility to various diseases.  This is questionable because the commonly cited frequency of children and teenagers that are obese, 20 percent, is several times too large.  If you walk through a public venue and observe, this will be obvious.  One must believe that many lean children are included in studies for determining morbidity related to obesity.  Looking at this from another angle, why are  BMI defined obese teenagers being pathologized more while data has been coming out, such as the three NHANES cohorts, that pathologize BMI defined obese adults less?   Standard thinking has been that it takes many years of experiencing risk factors before disease develops.  There appears to be much falsification of research concerning childhood obesity.  Health authorities have been warning us about an epidemic of Type 2 diabetes in children even though data from the CDC shows that less than 0.1 percent of children are diagnosed with Type 2 diabetes.  Another way that authorities mislead and create alarm is by citing that 2 million youth are diagnosed with prediabetes.  The diagnosis is based on a fasting glucose of 100 mg/dl.  Spurriously high fasting glucose levels are not uncommon.  In fact, less than 2 percent of children said to have prediabetes actually progress to clinical Type 2 diabetes.

Claims are sometimes so outlandish that a lay person can identify them as false.  Obesity researcher, Dr. Anthony Convit, claims to have found a correlation between obesity in teenagers and reduced IQ and brain damage.  He uses metabolic syndrome, abbreviated as MetS, in place of obesity for shady reasons that are explained elsewhere.  It is sufficient to say here that the media consistently conflates metabolic syndrome and obesity whenever it publishes an article. 

In the abstract of a research paper Dr. Convit writes:  "Adolescents with MetS showed significantly lower arithmetic, spelling, attention, and mental flexibility and a trend for lower overall intelligence. They also had, in a MetS-dose–related fashion, smaller hippocampal volumes, increased brain cerebrospinal fluid, and reductions of microstructural integrity in major white matter tracts." 

Convit's findings are outlandish.

In the real world smaller hippocampal volumes are associated with Alzheimers like dementias and damage to white matter tracts are associated with movement disorders such as multiple sclerosis. 

Convit's findings imply that teenagers not only have low intelligence, but are remarkably disabled and suffer from severe dementia as well.

Fortunately, the medical establishment appears to have ignored Convit's findings.  Convit resides at the extreme of a health system that has become more extreme in its own right, and there are other researchers like him.  What is perceived as outlandish today may be incorporated into the mainstream tomorrow.


Conflicts of interest

Billions of dollars in profit are to be made by speaking of obesity in terms of an epidemic that must be halted with extreme measures.  The anti obesity industry is a megabillion dollar behemoth involving governmental officials and agencies, physicians, obesity researchers, weight loss surgeons, pharmaceutical companies, advertising and the media, weight loss clinics, a diet food industry, and a physical fitness industry.  The diet food industry alone is cited to have sales of 66 billion dollars. 

The profit incentive motivates unscrupulous people to act contrary to a stated interest in benefitting humankind.  Many physicians incur substantial conflicts of interest.  The following is a description of Professor Xavier Pi-Sunyer, M.D., in Source Watch: "In 1995, when he was appointed to chair the NIH panel that re-classified many Americans as "overweight," he was also the Executive Director of the Weight Watchers Foundation.[2] In 1997, he joined the Board of Directors of the Weight Watchers Foundation - one year prior to the publication of the NIH report he chaired that lowered the weights at which Americans were considered overweight." 

Twenty seven million Americans were upwardly categorized from normal to overweight in one fell swoop.  How many of these 27 million people were induced to embark on a weight loss diet program due to this reclassification?  How many of these new dieters chose to join Weigh Watchers, Inc. as paid members, purchasing Weight Watchers, Inc. brand diet foods on a regular basis?  Pi-Sunyer's false attribution of overweight to 27 millions American's was surely a "gold mine" for Weight Watchers, Inc. 

Do not be fooled by the label of tax exempt non-profit, that is behind the word Foundation in Weight Watchers Foundation.  Non-profit status has become a favored way to falsely attribute goodness to an otherwise harmful entity.


Misinformed attitudes and prejudice

American society carries premiums on ambition, willpower, and morality.  This has roots in our Calvinist Protestant heritage.  In my opinion, ambition, will power, and morality have been emphasized to such a lop-sided extent that the quest for attainment of these traits has become a burden on our society.  People incorrectly assume that fat individuals lack these traits.  Willful calorie restriction is the primary cause of weight gain.  It is ironic that people who take on the most ambitious weight loss diets are the people who end up heaviest in the long run.

A liberal politically correct attitude embraces the pursuit of optimum health, a proper lifestyle, and a diet of foods described as "healthy."  Liberal political correctness decries racial prejudice, prejudice against gays, prejudice against the poor, prejudice against Jews, Atheists, Buddhists, and to some degree Muslims, but it embraces and incites prejudice against fat people.  It is politically correct to see fat people as consuming indescriminately and recklessly.  Fat people have been accused of wasting millions of barrels of petroleum used in the production of extra food and billions of dollars of unnecessary medical expenses.  The former accusation reeks of Bolshevism and the latter is just plain false. 

Healthist and foodist attitudes that we should eat only what is healthy is based on a false good food - bad food paradigm.  False valuations have been invented and promoted by notables such as anti carbohydrate activists David Ludwig and Gary Taubes.  Both individuals seem to harbor prejudice against fat people.  In their zeal to label the foods that we love as unhealthy, such individuals and the medical establishment at large have turned America into a nation of food phobic, eating disordered, body dysmorphic, calorie restricting, hypochondriacs. 

I will repeat ad infinitum, if necessary, that calorie restriction is the primary cause of obesity.


Emphasis on a non-existent obesity epidemic is not to be sloughed-off as a nuisance.  It is a serious assault on our freedom, dignity and well-being.



Children are the most oppressed by fat hysteria

Authorities claim that the number of obese children has increased dramatically over the past few decades.  Authorities speak of a "childhood obesity epidemic" as though it is separate from the phenomenon in adults.  American children have been placed under enormous pressure to lose weight and eat more "healthy" foods.  Childhood obesity prevention programs have become the norm and school lunches now limit calories.  As though they were already little adults, children are being conditioned to fear obesity, worry about what they eat, worry about their body images, worry about their health, and are made to give up their favorite foods for "healthier" ones.


For today's children, the natural, enjoyable act of eating has been turned into a matter of grave concern - something to be studied, manipulated, and continually improved on.


If you go to a public venue, you will see very few children who might be deemed to be carrying too much weight (preview below).  The vast majority of American children do not have a "weight problem" but are dealt with as though they do.  Numerous children are developing body image problems, eating disorders, and taking on unnecessary worries about their health.  When it comes to a childhood obesity epidemic "the emperor is truly wearing no clothes."

On webpage The Problem with Body Mass Index, I demonstrate how the so-called childhood obesity epidemic, may in its entirety, be attributable to biases in the body mass index assessment tool.  This includes demonstrating on a mathematical basis that BMI standards that denote obesity in children are considerably stricter than standards for adults. 


Physicians blinded by adhering to bad science

I found a research paper "Visual Recognition of Child Body Mass Index by Medical Students, Resident Physicians, and Community Physicians", C.R. Ahlers-Schmidt et al., Kansas Journal of Medicine, 2010.  The results and conclusions, taken from the Abstract, are quoted below.  The authors point out the difficulty that physicians have in recognizing children defined as overweight or obese by their BMI statuses.

Results: "… Only 15% of respondents correctly identified a 3-year-old boy, whose BMI was 95th percentile for his age, as obese. Nearly 86% correctly identified a 4-year-old girl with normal BMI-for-age, but only 21% correctly identified another girl who was overweight at the 90-95th percentile BMI-for-age."

Conclusions: "Medical professionals and trainees have difficulty visually assessing a child’s BMI-for-age weight status.  This underscores the importance of calculating and plotting BMI at healthy check-ups.

The authors of this paper, whom I believe are medical residents, criticize physicians when they don't use body mass index.  They favor anti obesity interventions in children between 3 and 5 years old.  The authors write: "Because parents have difficulty accurately categorizing children’s weight status, it is imperative that physicians can identify obese children to counsel parents regarding their child’s condition.  The problem of pediatric obesity may be common, but it should not be considered 'normal'."

Figure 1 on page 9 of the research paper shows a standard diagnostic picture of three children in underwear with their eyes masked in white to hide their identities.  The picture is not pleasant to look at.  The child on the left is defined by the BMI to be obese, the child in the center normal, and the child on the right, overweight.  The child labeled overweight shows no sign of excess adiposity.  The child labeled obese appears to have a bit more body fat than the others, but he is not obese.  That child will not become obese unless someone intervenes, as prescribed by the authors, and restricts his calorie intake.  There is a good reason why parents and physicians who use simple visual assessment do not commonly perceive that a child is  carrying excess weight.  Because the child is not carrying excess weight.

I am scratching my head in incredulity.  Why do physicians continue to discard common sense in favor of an empirical equation?  They have obviously not delved into the nature of that equation.  Why don't physicians question the obvious descrepancy between what they see and what the body mass index tells them?  Why is there little dissention among millions of physicians?   What is the use of 4 years of medical school plus 4 years of residency when physicians do not graduate with enough independence of thought to see what any parent can see?

An article from Mail Online (UK) reinforces why so many normal children end up classified as obese.  The article, which includes photographs of four normal children, discusses the plight of four families, each with a child who was falsely classified to be obese using body mass index measured at their schools.  By requirement of the National Health Service (United Kingdom), parents were notified of their child's "obese" status and were warned of dire health consequences to their children.   Each mother discusses her shock, incredulity, and indignation at receiving obviously flawed information about their child's status.  Each felt that her parenting was being falsely condemned.  Those children who learned of the school's message about their bodies' reacted with fear and confusion.  Each of these children began to manifest problems surrounding eating.

I am trying to get all of us to understand that visual impression of weight status is the best approach for children.  And if a child is objectively considered to have a weight problem, the last thing you want to do is to restrict his or her calorie intake.  As with adults, weight loss dieting does not work in the long run and usually ends up in further weight gain.  At the current state of knowledge, the best way to deal with this predicament is to eat as our appetites dictate.  As many people know, this can be difficult advice to follow.  If we eat according to our appetites and never diet again, our body weights will eventually level off at a new equilibrium and there will be no further weight gain, with the possible exception of a gradual increase with age.

This is the predicament we face.  We are all beset by internal and external pressures to restrict calories.  Until the medical establishment drops its false notion that calorie restriction works and comes on board, the status quo will be hard to change.  When it comes down to the nitty gritty, size acceptance and Health At Every Size are the only games in town.


At some point, the medical community must go beyond its unexamined attachment to a biased diagnostic convention that has taken away the ability of its members to name the obvious.



For the sake of our children, we must begin to heed information that is now available

On June 20, 2011, ABC news highlighted a story describing a 2009 University of Central Florida study that found that nearly half of the 3- to 6-year-old girls surveyed said they worried about being fat. 

In the Foreward to an article on childhood obesity by Dr. Jon Robison, Radley Balko states: “A recent report in the British Journal of Developmental Psychology says that girls as young as five years old are beginning to have problems with body image.  The authors concluded that the girls 'felt "paranoid" about their weight - partly because of the Government's anti-obesity message.'  Girls as young as eight are being diagnosed with eating disorders."

In a relentless pursuit to "set children right," anti fat crusaders have been placing an enormous burden on the children of America.  Children, especially girls, are being set up for a lifetime of severe body image and self-esteem problems.  As anorexia is fueled, among other factors, by extreme fear of appearing even the least bit heavy, numerous cases of anorexia as well as bulemia are sure to result.  I ask the government to leave us alone and respect our bodies whatever they look like.  You define a problem that does not exist and then you formulate policies that makes things worse.  You can not deal with an issue without making it into another war, and then you attack everything in sight.


A study on Native Americans highlights problems surrounding obesity research

My interest was piqued by an article in the February 11, 2010 issue of the New York Times "Child Obesity Risks Death at Early Age, Study Finds". The article opens with the statement: "A rare study that tracked thousands of children through adulthood found the heaviest youngsters were more than twice as likely as the thinnest to die prematurely, before age 55, of illness ...".

Attributing a high rate of premature death to childhood obesity is alarming.  Before we are overtaken by fear and concern a couple points should be made.  Dr. Flegal's analysis of NHANES II and III cohort data showed that obesity is not associated with appreciable excess mortality until BMI goes above 40 (i.e., morbid obesity).  Most children who are classified as obese by the body mass index present no visual evidence of carrying extra weight.  These points are telling us that obesity is not a major factor in adult mortality and childhood obesity is uncommon.  Such mitigating factors are not acknowledged by a medical community that depicts obesity in alarmist discourse.  The New York Times headline claiming that childhood obesity portends early death has dubious credibility from the get go.

I obtained the original research paper.  Obvious problems stood out.  Participants were chosen from the Pima (Akimel O'odham) and Tehono O'odham Native American tribes that reside in Maricopa County (Phoenix) Arizona.  Members of these tribes, as well as other tribes around the country, exhibit a phenotypic trait that does not manifest within other racial groups that populate America.  Pima and Tehono O'odham Native Americans possess what has been labeled a "Thrifty Gene" which is expressed in a powerful hunger drive that will lead to obesity if there are no constraints on food supply.  This seeming "jinx" is actually an effective survival mechanism.  The normal environment of Pima and Tehono O'odham does not assure an adequate food supply.  Pimas become obese simply because their hunger drive demands high intake of calories to enable a better chance at survival when food becomes scarce.

In their normal agrarian environment, Pima and Tehono O'odham Native Americans were lean, healthy, and strong.  They had a reputation for being good runners.  When Pimas and Tehonos were placed on reservations particularly after World War II, they went from being lean to having the one of the highest incidence rates of adult obesity and diabetes in the world.  

During an agricultural water shortage crisis in the 1800s, Pimas were supplied with emergency food rations based on a Standard American Diet.  Pimas became acquainted with American food this way.  After World War II, Pimas were placed on an Indian reservation, where despite poverty, they had access to as much food as they desired.  Pimas now live under circumstances in which there Is no practical limit to the number of calories available.  Pimas became obese, not from eating bad foods as some insinuate, but because their environment provided no restrictions on caloric intake.  Pima and Tehono Native Americans were able to eat as their hunger drives dictated.  As such, they ate and gained weight.

Data from Pima and Tehono O'odham Native Americans are not appropriate for predicting obesity trends and outcomes for the rest of the people in America.  Relevant genetic traits do not exist outside of these Native Americans.  Since the medical establishment mis-apprehends the relationship between hunger drive and obesity, it is bound to miss why Native Americans are not an appropriate model for the general population.  Such has obviously been missed both by the researchers and the author of the New York Times article.

Details within the article further invalidate its claims.  Only the top quartile (25 percent) of body mass indices demonstrated a statistically significant increase in premature deaths.  28.7 percent of study participants were obese when the study began.  Since 28.7 percent spans only slightly more than a quartile,  it can be inferred that participants within the top quartile spanned almost the entire range of obesity.  Since BMI overestimates obesity in a high fraction of children, it can be inferred that most children in the top quartile were not obese.  The whole premise of the research collapses under this knowledge.  Furthermore, when the most obese children were grouped together, the 51 subjects having a statistical z-score of 3 or more, not one died prematurely.  A z-score of 3 roughly coincides with the 99.9th percentile of BMIs for a given age group.  In other words these children have BMI values within the top 0.1 percent for their age, so these 51 children were assuredly obese.  As childhood obesity portends obesity during adulthood, the fattest children would have been expected to have the highest incidence of premature death.  But in the study there were no deaths in this grouping.

There is more.  The study defines early death as dying before 55.  The average age for study entrants was 11.3 years and the median follow-up was 23.7 years.  The sum of an average and a median is not statistically useful, but it gives a good indication of the age of a typical study participant when the study was terminated.  11.3 + 23.7 =35.0.  Early death was defined as dying before 55.  The study was ended roughly 20 years too early.  In fact 88.5 percent of participants were still alive when the study was concluded.

When looking at mortality with respect to a particular variable, such as obesity, it is important that an adequate number of definable events occur for statistical analysis.  The study began with 4857 entrants.  At termination of the study 559 died, including 393 from external causes (e.g., homicides, suicides, accidents). 166 died from disease.  59 died from alcoholic liver disease, 21 from infection, 12 from cancer, 9 from alcohol or drug overdose, and 33 from other causes.  Only 32 died from obesity related conditions, 22 from heart disease, and 10 from diabetes or diabetes related kidney failure.  Such is a small number of incidents from which to make statistical estimations.  The authors used all 166 deaths in their statistical analysis even though the majority of deaths were unrelated to obesity.  As such, the higher number of premature deaths that was related to childhood obesity may have been an aberration.  Since the study results do not make sense for a number of reasons, the results may have been falsified.

Life on an Indian reservation is characterized by a high incidence of poverty, crime, abuse, school drop outs, hopelessness, despair, mental illness, alcoholism, murder, and suicide.  Native Americans have suffered ethnocide and culturecide at the hand of European settlers.  These people were taken from their land and placed on reservations.  They have suffered and continue to suffer from all forms of oppression.  Such is reflected in the research as many more Pimas and Tehonos died from external causes such as accidents, homicides, and suicides than from diabetes or cardiovascular disease.  It is also reflected in the high rate of death from alcohol related liver disease and alcohol and drug overdoses.  Horrible living conditions will have contributed to the onset of disease as well as contributing to death rate.  Poverty and other negative aspects of the environment are known confounding influences in mortality studies.

Summarizing: The study to look at how childhood obesity correlates with permature death in adults was cut short by 20 years; only 6 percent of participants that died, died of obesity related causes.  Most study participants deemed to be obese at the outset were children of normal appearance that were miscategorized by the body mass index. No premature deaths occurred in the 51 study entrants inferred to be extremely obese because they were at or above the 99.9 percentile of age adjusted BMIs.  The preponderance of deaths used in the statistical analysis came from causes that were unrelated to obesity.  Finally, the unique genetic characteristic of the study participants that resulted in a high incidence of adult obesity and diabetes has no relevance to the general population.

Due to multiple factors, results from this study are not meaningful and have no predictive value with respect to premature death in Pima and Tehono Native Americans and certainly not in the American population at large.

One might wonder if the natural propensity for Pimas to become obese carries with it any health protection.  Perhaps the "Thrifty Gene" carries with it some protection from health conditions co-morbid with obesity.  While diabetes has been claimed to take a large toll on Pima health, there is published evidence that demonstrates Pimas are resistant to heart disease.  The Strong Heart Study, which found a higher death rate from coronary heart disease in Pima Native Americans compared to non Native Americans, cites earlier studies that had shown the opposite.  One of these studies reported that coronary heart disease mortality was less than one-half in Pima Native Americans compared to numbers seen in the Framingham study.  

The Strong Heart Study was done to elaborate on this observation as well as look at other Native American tribes in the United States.  I did not do an in depth critique of the study, but problems were apparent upon browsing the report.  It enlisted an unusually small number of Pimas (1500) for making statistical inferences on coronary heart disease.  A relatively small number deaths from heart disease were recorded and comparisons were done with non-Native Americans studied in a different protocol.  It would have been more appropriate for the Strong study to have recruited its own comparison/control subjects.  The publication reported "textbook values" (i..e., too good to be true) for heart attack risk ratio with respect to LDL (2.13) and HDL (0.55) even though mechanisms for LDL and HDL have no basis in science.  All of this brings in to question the propriety of Strong Heart Study results.

My own opinion is that the Strong Heart Study authors had a desire to  pathologize the fat Pima Native Americans.  Pima deaths from coronary heart disease went from one-half the rate observed in non Native Americans in the Framingham study to almost twice that of non Native Americans in the Strong Heart Study.  This is a 4-fold jump and frankly I do not believe the authors of the Strong Study.  I believe that fat Pimas have a lower incidence of heart disease but prejudice against the Native American as well as the fat person directed the Strong Heart Study authors to falsify results.


Obesity "experts" that do not understand obesity

Some "experts" urge Pima and Tehono Native Americans to return to their sparse diets, but in doing so they are ignoring the workings of the homeostatic hunger drive.  Pima eating behavior is in concordance with their genetic propensities to be hungry so as to store fat.  Dr. Eric Ravussen who has been studying the genetics of obesity within Pimas for 15 years states that: "[Pimas] want to have large quantities of food available all the time."  Dr. Ravussen also points out Pimas are not fat due to "sloth or gluttony".

I became acquainted with Dr. Ravussen while doing a Google search on the Pima Native Americans.  I found an article written in 2001 that depicted his work with the Pimas as well as his philosophy on obesity.  Dr. Ravussen seems to be friendly to the Pimas but he is not.  He refuses to mention the obvious, that Pimas get fat because they are hungry.  Hunger is the unfortunate price paid for possessing the thrifty gene, yet its mention is taboo.  Hunger is referred to obliquely when Dr. Ravussen tells us that "Pimas want to have large quantities of food available all the time."  Dr. Ravussen then diverts us from the truth by blaming a diet high in fat for obesity, rather than high intake of calories.   Another "expert" on obesity in Pimas blames refined flour (i.e., carbohydrate) instead of dietary fat.  Whether Pimas or any other ethnic group, the discourse on obesity always reverts to bad food.

Historically, Pimas lived on high carbohydrate low calorie diets.  There is no evidence that signifies high fat intake is necessary for the Thrifty Gene to be operative.  Pimas were not hunters, they did not have access to high fat foods.  Pimas most likely became fat during years of ample harvest.  Dr. Ravussen's concern over fat in Pima's diet are not consistent with the historical Pima that had an ability to get fat on low fat diets.

Dr. Ravussen is a health moralist. He speaks of obesity as a disease caused by economic progress.  He is willing to reverse that progress, make us do physical exercise, and tax our favorite foods, in the name of health.  He proposes governmental intervention to alter our lifestyles and eating behaviors.  As it is, the American government is stripping us of our rights one by one.  We do not need our doctors to prompt the government to take more control.  Petr Skarbanek, author of "The End of Humane Medicine" points out that as a prelude to fascism, governments often adopt policies of coercive healthism.

Rather than falsify results outright as many researchers do,  Dr. Ravussen has a propensity to dance around the issues that he wants to keep secret.  This was demonstrated previously when he would not say that Pimas experience hunger.  Here is another example of this. The above article attributes the high incidence of obesity in Pima Native Americans to efficient storage of fat.  Efficient storage of fat is a more impactful way to say slow resting metabolism.  The article shows a Pima woman sitting in a metabolic respiration chamber but never says anything about resting energy expenditure in Pimas.  In an earlier research paper, authored by Ravussen himself, Pima resting metabolism was determined to be no different than that of the Caucasian American.

Dr. Ravussen and the research community lament that Pimas have such a propensity for obesity and diabetes.  They propose stern measures such as calorie restriction to improve the health of Pimas, but never once will they discuss the degrading lifestyle that Pimas must endure while living on an Indian reservation.  Stress, poverty, hopelessness and depression, byproducts of living on an Indian reservation will of course influence the health status of Pimas.  It has been said that the large increase in life span during the 20th century was much more a byproduct of economic advancement than advances in medical care.  Many health promoting aspects of economic advancement do not reach Indian reservations.


Who cares about the 50 million who are hungry when there are fat people on the loose?

The medical establishment has used the popular media to hype its unsupported concerns over "bad food"' and a fictitious "obesity epidemic." The same medical community acts to increase food insecurity in America by promoting misguided anti fat policy based on calorie restriction.  Efforts to divert Americans away from "unhealthy foods" in order to battle obesity has been anathema to addressing the problem of hunger.  False ideas on nutrition have made stemming hunger and preventing obesity into a zero sum game.  Competition between efforts to fight hunger and efforts to fight obesity were manifest as early as the 1970s with the methodical hijacking of the United States Senate Select Committee on Nutrition and Human Needs from its original purpose of fighting hunger in the poor to that of fighting obesity and diseases of aging.  Eating unhealthy foods has been assigned a great degree of blame for many common maladies of aging.

The tragedy is that there is no form of macronutrient that inherently promotes obesity or causes disease.  Such alarmism is a "gift" from health moralists who want to run our lives.  They will falsify research findings to further their cause to "help us."  If we take to heart the false information issued by anti fat and anti carbohydrate crusaders, there is hardly anything left that we can eat.  Our only recourse is a vegan existence.  Many emergency food providers have been convinced to shun high fat and calorie dense foods and emphasize fruits and vegetables.  Such is clearly depicted on their websites.  Aside from lacking sufficient calories and protein, fruits and vegetables are very expensive especially for emergency food providers that have insufficient funds to meet demand.

Misplaced understandings are of high consequence to our society.  Food insecurity is a major cause of obesity.  It has nothing to do with favoring cheap junk foods as they tell us.  Food insecure people gain weight in the long run, because when food becomes available they will be hungrier than ever because calorie restriction resets the hunger set point.  Food insecure children suffer from developmental, psychological, and learning problems that continue to influence during their adulthood.  Low birth-weight infants are more commonly born to food insecure mothers(see pages 16 and 17 of linked article).  These infants commonly end up obese later during childhood.  Food insecure children also suffer from a higher rate of obesity later during childhood.  Such children now receive calorie restricted lunches as a matter of policy.  Government officials and physicians have teamed up to place upon millions of us problems that never existed in the first place.


A source book on obesity politics

J. Eric Oliver, Ph.D. is author of the informative book: Fat Politics: The Real Story Behind the Obesity Epidemic.  As a post-doctoral fellow at Yale University, he had set out to learn about the obesity epidemic and formulate a project on some aspect of the phenomenon.  He was soon surprised and disallusioned as he came to the conclusion that an obesity epidemic did not exist.  Fortunately, Dr. Oliver followed through on his revised understanding and wrote "Fat Politics" which is a comprehensive work that debunks the "obesity epidemic" from several angles.

I would like to include a salient passage quoted from page 11 of his book Dr. Oliver writes: "Ask any of the millions of frustrated dieters in America and they will tell you what molecular biologists have long known -- for many of us, our bodies are quite resistant to being slender. Nor do we have a safe of effective mechanism for helping us lose weight.  Indeed, the same doctors, health officials, and medical researchers who have spent the past four decades telling Americans they are too fat have not been able to devise a sound treatment for becoming thin.  As a result many Americans are going to extreme measures to make themselves lose weight, such as self-starvation, smoking, taking dangerous appetite suppressants, or even having their stomachs surgically shrunk.  Not only are such practices ineffective, they often do more harm than good.   Whether it is from a failed diet, a botched gastric-bypass surgery, complications from an eating disorder, or heart damage from diet drugs, every year thousands of Americans are literally dying to be thin."


Relevant links:

Press Release - October 25, 2012

List of Fat Friendly Health Professionals.

Original Article on weight cycling.

HAES coach Golda Poretsky speaks convincingly on dieting and weight cycling.

Dances With Fat blog post - The War on Obesity is a War on Fat People

The epidemiology of overweight and obesity: public health crisis or moral panic?  - Article by Paul Campos, Abigail Saguy, Paul Ernsberger, Eric Oliver and Glenn Gaesser.

Revisiting the Obesity Paradox... - Article by Stephan von Haeling, Wolfgang Doehner, and Stefan D. Anker.

THE DEATH OF HUMANE MEDICINE AND THE RISE OF COERCIVE HEALTHISM - Pdf eBook by Petr Skrabanek.  ExposŤ on a corrupt, authoritarian, hypermoralistic medical establishment.

Healthy Weight Network website - Obesity: Risks and benefits.

Health at Every Size website. Take the HAES Pledge.

Dr. Jon Robison's blog - Very astute on debunking food and nutrition myths.

Dr. Jon Robison blog artricle - Food Phobic Nation, a Brief History.

Dr. Jon Robison article that deconstructs the "Childhood Obesity Epidemic" with forward by Radley Balko.

Linda Bacon, Ph.D. - Ending Foodie Fat Bashing, a post initially sent to the Community  Food Security (Comfood) listserv, and later posted on La Vida Locavore blog, March 2011.

Linda Bacon, Ph.D. - Cutting the Obesity Epidemic Down To Size.

Bacon, L., & Aphramor, L. Weight Science: Evaluating the Evidence for a Paradigm Shift, Nutrition Journal, 2011, 10(9).

Judith Matz, LCSW - " Why Diets Make You Fatter" article.

Judith Matz & Ellen Frankel - Becoming a Diet Survivor: Q&A with Judith Matz & Ellen Frankel (Diet Survivors Handbook)

The Center for Consumer Freedom web page - Big Fat Lies


Last Updated on April 8, 2014.


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