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Friends Don't Make Friends Become Fat

In yesterday's post, I wrote at length about this study, which suggests that obesity spreads over social networks -- that is, close friends have more influence on each other's weight than do spouses, neighbors, or siblings who aren't especially close. I found the results intriguing, and accepted them uncritically (aside from the sample-size issues I noted in the comments).

But Sandy Szwarc totally harshed my enthusiasm with this post at her Junkfood Science blog. (Hat tip: Steve Adam).

First she went after the computer-modeling techniques the researchers used. That kind of analysis is far above my pay grade, so I can't even pretend to have an opinion about who's right or wrong. If Szwarc is right, though, this is damning:

What did they find? None of the odds ratios their computer model came up with were tenable. But they didn't simply admit the null findings. Instead, they reported that obesity was associated less with genetic, familial ties; less with geographical proximity, as in immediate neighbors or even friends hanging out together socially; less with even being married and living, eating and sleeping together; than in simply being friends with a fat person. [But among the fine print: the weight gain of a fat friend wasn't "contagious" if the friends were the opposite sex or among two females; the finding was only statistically significant among men.]

They made no efforts to give any physiological explanations for these implausible findings or how long-distance relationships might be more associated with obesity than genetics. Nor did they have any data on the closeness of the friendships or how often people were in contact with their supposedly fattening friends.

Forgetting that their study was a data dredge looking for correlations, which is unable to ever demonstrate causation, [one of the study's authors] said it showed the social effect was "a direct, causal relationship." In their University of California, San Diego, press release, he said: "What appears to be happening is that a person becoming obese most likely causes a change of norms about what counts as an appropriate body size. People come to think that it is okay to be bigger since those around them are bigger, and this sensibility spreads."

Szwarc concludes that there's a political agenda at work here:

This study illustrates the difference between politics and good science. The reporting and responses from media and medical professionals have illustrated the difference between prejudice versus knowledge, understanding and compassion. There is absolutely no credible science to support stigma against any group. You cannot "catch" fat from associating with a fat person anymore than you can catch "black" from a black person.

Like I said, I can't comment on the validity of computer-modeling techniques for data analysis.

At the same time, I'm baffled by the argument that obesity is entirely a genetic issue. (I got into that at some length in this review of Gina Kolata's latest book, Rethinking Thin.) Szwarc may be entirely correct in saying that "good science" hasn't yet discovered all the reasons for the dramatic rise in obesity rates. But science hasn't figured out lots of things when it comes to health and nutrition.

So, for now, the genetic explanation is the best we have. But every single person reading this blog knows that we all have some control over the choices we make, and that those choices affect our weight. For example, I couldn't be a 350-pound powerlifter no matter how much I ate, how hard I trained, or how many grams of anabolic steroids I injected into my buttocks, any more than someone who's genetically predisposed to be huge and strong could slim down to my size.

But there's a lot of room in between the extremes.  

I agree with Szwarc that we shouldn't stigmatize anyone. We all know people who've done all the right things and still ended up looking as if they haven't even tried. At the same time, we all know people who haven't even tried but look as if they have.

Genetics can be kind or cruel. We all accept and acknowledge that.

However, some interventions really do work, as Dr. Gil Wilshire notes here:

1) Current dietary recommendations that promote low-fat and low-cholesterol diets are unscientific, unproven, and fatally flawed; and,

2) The vast majority of modern humans appear to function best when eating nutritionally dense, whole foods that most closely resemble those foods on which we evolved.

If someone's following the pizza-and-beer diet, or eating fast food on a daily basis, why can't we be honest and say that person isn't trying? And if that person weighs significantly more than his or her parents, why do we have to pretend that person's size has everything to do with genes and nothing to do with choices?

Again, I'm not advocating prejudice or systematic discrimination against anyone. Live and let live, Golden Rule, don't judge a camel until you've walked a mile in his cloven hooves, etc. But we can be fair and compassionate without accepting that things have to be the way they are.

Wednesday blog meat

  • Speaking of choices, this article says that my consumption of Diet Coke puts me at higher risk of heart disease. Researchers at Boston University found that people who drank soda of any type -- diet or regular -- had higher heart-disease rates than those who didn't. (Hat tip: Erika Francoeur.) For obvious reasons, the idea that I'd be in no worse shape if I drank an equivalent amount of non-diet soda is absurd. And the researchers aren't claiming they've found anything beyond a correlation. (Although that didn't stop one of them from recommending that people abstain from all types of soda.) So, while there's no reason to believe diet soda causes heart disease, it's interesting to note that people who drink diet soda have higher cardiovascular risks than those who don't. I put it into the same category as this study, which showed that men who don't shave have more strokes. It's fun to know, but nobody's lining up to tell Grizzly Adams he'll die if he doesn't inflict some razor burn on his jowls.
  • Joe Stankowski has an entertaining take on the acronyms (or, as Joe says, "A.C.R.O.N.Y.M.S.") we use in the fitness biz.
  • Mike Roussell digs up the strangest fitness study ever. Quick tease: It involves a mechanical horse and elderly Japanese diabetics. Mike sees it as an infomercial in the making. Me, I'm already looking forward to the feature film: Urban Samurai.

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Szwarc
Not that she isn't correct in this case, but Sandy Szwarc is a big whig in the Fat acceptance movement. If you read much of what she writes, there is a bias, at least I perceive one, against dieting and exercise as worthwhile or effective.  

Kevin

by kadill on Aug 2, 2007 9:01 AM EDT reply reply actions actions   0 recs

Ah!
Thanks, I should've picked up on that.

I have to think, though, that we're coming full circle. We've gone from the idea that weight is almost entirely determined by willpower to the idea that it's almost entirely genetic.

Now I hope we move back to the middle, where we should've been all along, and realize that you can't blame your genetic predisposition for your weight if you're fueling it with a diet of Big Macs and Mountain Dew.

I'm not saying all heavy people eat that kind of diet, just that people who do can't credibly claim they were born to be exactly as big as they are.

by Lou Schuler on Aug 2, 2007 2:41 PM EDT to parent up reply reply actions actions   0 recs

Yup.
I read her blog -- I first came to it on a non-obesity-related evidence-based medicine issue that I felt she discussed very well -- and I agree about the bias. However she's also got a strong science background and does a good job of dissecting where the pop press coverage of a study diverges from the actual results.

by kimuchi on Aug 6, 2007 11:51 PM EDT to parent up reply reply actions actions   0 recs

re: walking....
 "As I wrote in New Rules of Lifting, short bouts of intense exercise have a life-extending, heart-strengthening effect that's far greater than what you can get from extended bouts of walking or the other non-strenuous activities that official organizations like to recommend."

Lou, this comment somewhat overlooks the MANY benefits of contra-lateral movement (e.g. walking) and furthermore, the sheer enjoyment of being in nature; so, I'll usually take a "non-heart pumping" 60 minute walk over an intense gym workout BUT think a combo of the two is ideal. Also the official organizations are recommending what's safer for the uneducated average Joe; so, they can't really be too progressive...

Thanks!

Todd

Todd Langer

by tlanger on Aug 5, 2007 10:02 PM EDT reply reply actions actions   0 recs

Good points
Like I wrote in today's post, we should always resist the temptation to oversimplify when we're talking about the complexities of health, fitness, and nutrition.

Now I just need to follow my own advice!

by Lou Schuler on Aug 7, 2007 11:53 AM EDT reply reply actions actions   0 recs

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