Monday 13 July 2009

You fat bastard? [update 2]

There was a time back there in history when the biggest problem was malnutrition. Now, if you believe the headlines, it's obesity.

Latest headline you're supposed to believe says "Hefty price as kiwis get too fat," and continues by 'reporting' that New Zealand is the "third fattest nation" in the developed world.
The report puts New Zealand's obesity rate at 26.5 per cent in 2007, Mexico was at 30 per cent in 2006 and the United States led with 34.3 per cent of its population classed as obese in 2006. The latest figure for Australia was 21.7 per cent in 1999."
Now there's many things to be said about this "report," perhaps the first of which is to point out the different dates at which these things were measured -- that's some 1999 apples with 2007 pears thank -- and then to notice that the last time New Zealand's "obesity rate" was "measured" was back in 2003, when the OCED claimed it to to be just 20.6 percent of the population [PDF]. Quite some jump, don't you think. Around a thirty-percent increase in fat bastards in just four years.

You really think we've eaten all those pies in four years? I don't know about you, but it smells a lot like bullshit to me. So given that the ban-it merchants over at the Green Party are already calling for the government to ban tasty foods and spend more money on Green party activism, and the wowsers at the taxpayer-funded Obesity Action Coalition want to have fat taxes, vegetable subsidies and to ban everything Sue Kedgeley doesn't, it's worth taking a closer look at where these bullshit figures come from. Says the report:
Estimates relate to the adult population (normally the population aged 15+ unless otherwise stated) and are based on national health interview surveys for most countries (self-reported data), except for Australia, the Czech Republic (since 2005), Japan, Luxembourg, New Zealand, the Slovak Republic (since 2004), the United Kingdom and the United States where estimates are based on the actual measurement of weight and height. This difference in survey methodologies limits data comparability, as estimates arising from the actual measurement of weight and height are significantly higher than those based on self-report.
Note those words: "This difference in survey methodologies limits data comparability." Which means there are limits to how seriously one can take headlines like "NZ third fattest country in developed world ," and to how much political capital one should try to make from them.

But it gets worse for the scaremongers and headline writers. The so called "obesity rate" is given by "The Body Mass Index (BMI," says the report, "a single number that evaluates an individual's weight status in relation to height (weight/height2) with weight in kilograms and height in meters."
- Overweight is defined as a BMI between 25 and 30 kg/m² (25≤ BMI <30>
So much so straighforward, right? Wrong. First of all, even by the report's authors' own description the "obesity rate" includes both overweight and obese. This is a rather convenient way to, ahem, overload your figures. But there's a more significant concerdn, and that's with the bullshit index itself.

As Keith Devlin at NPR explains [hat tip Dr Shaun Holt] "this Body Mass Index fails on ten grounds." I'll summarise, but I suggest you head to the full explanation to realise just how serious is the failure -- perhaps the most fundamental being that "a high BMI does not mean an individual is even overweight, let alone obese. It could mean the person is fit and healthy, with very little fat." Here's the top ten objections:
  1. The person who dreamed up the BMI said explicitly that it could not and should not be used to indicate the level of fatness in an individual.
  2. It is scientifically nonsensical.
  3. It is physiologically wrong.
  4. It gets the logic wrong.
  5. It's bad statistics.
  6. It is lying by scientific authority.
  7. It suggests there are distinct categories of underweight, ideal, overweight and obese, with sharp boundaries that hinge on a decimal place.
  8. It makes the more cynical members of society suspect that the medical insurance industry lobbies for the continued use of the BMI to keep their profits high [or that professional lobbyists ensure their continued use to support nonsense like this].
  9. Continued reliance on the BMI means doctors don't feel the need to use one of the more scientifically sound methods that are available to measure obesity levels.
  10. It embarrasses [wealthy countries like] the U.S.
Basically, there was a time back there in history when the biggest problem was malnutrition. Now, the more scientifically, technologically and medicinally advanced you are as a country, then chances are the further you are from being malnourished. Which means that "studies" like this are less about real science (since it's it's very far from that) than they are a way to bash countries that are rich and well-fed. As always, when you add politics to science, the result is going to be bullshit.

And chances are, too, that the more self-responsible you are then the leaner, healthier and fitter you are (which, ironically, can actually raise your BMI).

So if the nett effect of banning stupidity is to fill the world with fools and fat bastards, (to paraphrase a famous saying just slightly), why not just stop the bans and try self-responsibility instead.

UPDATE 1:The Onion saw all this coming in August 2000: Hershey's Ordered to Pay Obese Americans $135 Billion.
"This is a vindication for myself and all chocolate victims," said Beaumont, TX, resident Earl Hoffler, holding a picture of his wife Emily, who in 1998 succumbed to obesity after nearly 40 years of chocoholism.
And my fellow NOT PC columnist Bernard Darnton wrote about it a year earlier in "Achtung Fatso!" But when he wrote it as satire, he didn't realise that Sue Kedgeley was taking notes:
All New Zealand residents will be required to register with the Body Mass Index Safety Authority. Those at risk will be encouraged to attend programmes carefully designed to train clients to adopt a less damaging lifestyle. Advertising of products with a high caloric content is a significant factor in inducing young people to consume harmful foods. This advertising will be banned. Government funding, through the EatSmart brand, will be available to compensate for any losses this may cause. To assist in offsetting the high cost of treatment of fat-related disease, a calorie tax will be introduced. To assist in offsetting the high cost of collecting the calorie tax, a salt tax will also be introduced.
All persons involved in the cooking or preparation of food will be required to submit samples to the Food Quality & Composition Commission. This will ensure that every meal adequately meets the prescribed conditions. To assist in the identification of suitable foods, a useful diagram has been developed & will be distributed to every household in the country. The Healthy Eating Swastika has four branches illustrating the four acceptable types of food. For example, an excellent meal may consist of muesli, broccoli, prunes & mung beans. . .
Read on here.

UPDATE 2: Cactus Kate has spotted the problem: It's not how we're eating at all, it's who is eating.
If you are Pacific Islander you are three times as likely to be obese as a European and Maori are twice as likely.
So I'm calling fat on this one. Until Maori and Pacific Islanders can "improve" their statistics in excelling at being fat, I propose a 20% health levy on all pre-tax income derived by Maori tribes such as Tainui and Ngai Tahu, to be tagged for their healthcare. Levying Pacific Islanders is a tad harder as they didn't receive government handouts because of their race, so lets slap a dedicated 20% health levy on all welfare payments and grants made to their communities to be paid into the health fund.
If it's good enough in America for the supposed "wealthy" to be paying more tax to fund obese bludgers (and we know Obama is an idiot), it's good enough in New Zealand for the source of the problems to start paying differentiated tax rates and levies based on their propensity to use services if they can't be made to pay for their own treatment thanks to the overly-generous New Zealand public health system. . .
Government cannot be expected to interfere in the lives of people and tell them they cannot eat foods, and these "5 plus a day" huggy campaigns just do not seem to work for the right people so lets look at it the other way - like insurance companies do. Passing responsibility on based on risk.

28 comments:

Elijah Lineberry said...

Excellent post, Peter; pleased someone is getting stuck into this obesity nonsense.

There is an hilarious film called 'The Onion' which parodies the obesity epidemic in America, readers should view it and have a good laugh! ha ha!

Sean Fitzpatrick said...

Speaking as a health and fitness professional no one in my industry uses BMI. It is a well known fact that most well muscled individuals would come out as overweight using BMI (muscle cells weigh 5 times as much per unit of volume as fat cells do). Percentage of body fat is a much more accurate and useful measure as regards health status.

Greig McGill said...

As a bit of a fat bastard myself, I'm not sure I take issue with the stats (though your analysis reveals many holes) or the issue itself (people DO seem fatter over the last decade or so), just, as usual, the idea that it's anyone else's fault except we who put on the weight in the first place. I am the weight I am due to a love of fine food and beer, and a busy lifestyle/sedentary job combo making exercise something I fail to prioritise as much as I should.

Whose fault is that? Mine. Who should do something about it? Me. Who should pay if it becomes a medical problem? Well, me of course. I don't pay insurance for nothing.

This ban it mentality should be banned! ;)

Seriously though, I really don't understand why people ask the government to do something about every little issue, and then whinge about a nanny state when they get what they asked for! If it didn't affect me, it'd be hilarious to watch and laugh from the sidelines.

Anonymous said...

The fairest solution is to microchip fat people.

Kurt said...

Parekura Horomia is Parliament's fat bastard.

Oswald Bastable said...

The solution is so simple!

PUT DOWN THE FORK, YOU FAT BASTARDS!!

Fat Girl turned Slim said...

I am glad that I am not in that fat category anymore as I have slimmed down to my netball days original weight before I gave birth to my 2 young beautiful children. I know how one feels when people stared at you if you're out to do your weekly grocery shopping in the local super-market.

AngloAmerikan said...

A major problem with government intervention into people’s diets is that nobody really knows what is a good diet. Or else pressure groups and commercial groups will push their own agendas. A perfect example is the food pyramid published by the US Department of Agriculture that recommended up to 11 servings of bread, cereal, rice and pasta a day. A recipe for obesity if there ever was one.
Following the food pyramid recommendations has resulted in holocaust like casualties and the general destruction of human health. It’s like we’re now all living in a permanent circus freak show.

Anonymous said...

Junkfood Science has a few good posts on this issue, including

http://junkfoodscience.blogspot.com/2009/06/even-obesity-paradoxes-cant-excuse.html

Obviously being hugely fat isn't aesthetically pleasing, but the health concerns are way overblown.

Again just an excuse to bash capitalism and consumerism.

Fat Girl turned Slim said...
This comment has been removed by a blog administrator.
Anonymous said...

For research purposes BMI is very good. Once you add a few controls (eg, sex), you obtain virtually identical results (at a population level, which is what this research is doing) as you would if you were to use % body fat.

At an individual level it may not be so useful. This is especially the case in a gym setting. However, those are unusual cases, which don't affect the population level data so much. It is important to distinguish between the two situations.

Let the abuse fly!

Greig McGill said...

AngloAmerican said:

A major problem with government intervention into people's diets is that nobody really knows what is a good diet.

I really hope you're not implying that if they DID know, it would be fine for the government to intervene?

How is it the government's business whether I choose to follow a healthy diet, or to pack on the pounds?

Marcus said...

Considering the sheer number of elite athletes that fall into the obese category when they do BMIs on them, I'd take that as proof that the BMI is flawed beyond belief if it's used as the sole judge of fat bastardidity.

But now that we've been named the third fattest country on earth, it won't be long before someone (probably a Green party MP) stands up and says something about obesity being "our problem". Maybe even 'New Zealand's Shame". Someone is bound to bang on about it from the collective responsibility angle, in the same way that child abuse is 'our problem', binge drinking is 'our issue' and problem gambling is 'society's concern'. There will be a call for government task forces, health initiatives and taxpayer subsidised weight loss schemes.

As long as we use this screwed up approach to absolve people from individual responsibility, nothing will ever improve. I know that stating that here is like preaching to the converted, but I'm a rant.

Child abuse isn't MY problem - I'm fucking refusing to accept responsibility for some piece of shit who beats a child to death. My way of dealing with the child abuse problem in NZ is by not beating my kids - if everyone else with kids tried that same approach... fucking SHAZAM!!!! Problem Gone.

Problem gambling isn't MY problem - pumping your rent money into a slot machine is a dumb thing to do, but I'm not going to wail and ganash my teeth over somebody doing it.

Binge drinking WAS my problem - so I fucking did something about it. Being a fat bastard was my problem, so I'm doing something about it. Deceptively fucking simple isn't it?

Sorry for the rant!

Sus said...

That wasn't a rant, Marcus.

It was a damn good post.

Cactus Kate said...

Sean and others

Most New Zealanders ARE NOT professional or elite athletes however.

Marcus said...

Also keep an eye/ear out for the constant calls for "more education".

More education? When it comes to education about the dangers of obesity/drugs/booze/cigarettes/drivinglikeacock... I challenge anyone to find a non-retarded person over the age of 12 who is ignorant on these matters. From a young age we're bombarded with adverts that taxpayers have coughed up for, yet the statistics continue to worsen. What more education can we possibly give people?

Sus said...

"Healthy Eating Swastika".

Still chuckling. :)

AngloAmerikan said...

How is it the government's business whether I choose to follow a healthy diet, or to pack on the pounds?
Greig McGill

I might be revealing my ingrained statism here but is it not allowed for the Government to provide information? For instance if a beach was polluted or a Tsunami coming should that information be relayed to the people? In the same way a government could, in theory, provide a health warning about diet. The problem is that diets are like religion. Governments have promoted grains and demonised animal fat whereas I believe grains are almost poisonous and that there is nothing better for you than a dollop of pig fat and I have a lot of science to back that up. Dietary theories are constantly changing.

BTW I have a BMI of 22.4 (26, 9 years ago) I think it is useful for most ‘normal’ people who don’t want to buy callipers or be weighed underwater.

Sean Fitzpatrick said...

Cactus

Correct, but I am not sure of the point you are trying to make with that comment - could you please elaborate? Thanks :o)

Sus said...

"I might be revealing my ingrained statism here but is it not allowed for the Government to provide information?"

'Ingrained statism': good term to describe the status quo, AA!

The govt, technically, has no business in "providing information" of this nature.

We believe its core duty is to protect individual rights, via the operation of police and defence forces, together with the administration of justice/courts.

It has, or should have, no business anywhere else in the lives of its citizens.

So the answer is an emphatic 'no'. It should keep its nose right out.

Anonymous said...

Sean, it means that in most cases BMI is a reasonable estimate of body fat, but there are extreme examples where it fails (eg elite athletes). You wouldn't use BMI if you wanted to study body fat in elite athletes.

But you probably knew that anyway.

Sean Fitzpatrick said...

Anon

I see where you are coming from but there is a problem with that.

The problem is it is not simply in extreme examples. BMI is simply not a useful measure because, as PC's post points out, the arbitary nature of the ideal height / weight ratio the index is based on.

The ratio was based on a small group of people from mainly western European stock, as I recall. It ignores that some ethnic strains tend to be larger boned (eastern Europeans, some Polynesians etc) and others tend to be longer limbed and taller (Africans and Australian Aboriginies etc).

Take the case of anyone going through body composition shift.

For example if someone 'overweight' looses 3kg of fat and gains 3kg of muscle their BMI would be the same, however their body fat percentage will have shifted, possibly quite dramatically in the case of a smaller person.

The issue then becomes the purpose of taking the measurements - if the purpose is to assess the effectiveness of the training program this individual was on it would erroneously indicate no appreciable effect, whereas a body fat percentage testing method would have proven otherwise.

Cactus Kate said...

As anon has stated. The "I am an elite athlete" excuse can only be applied in a few cases.

Okay Sean, lets have a go at your measure.

Those little Chinese girls you see in the street - tiny, petite.....my gym instructor in Hong Kong states many have massively high body fat due to their lack of tone and exercise, remembering the measure is a percentage.

But most of us would swap our fat for theirs any day of the week.

AngloAmerikan said...

For example if someone 'overweight' looses [sic] 3kg of fat and gains 3kg of muscle their BMI would be the same..

This is an extreme and unrealistic example. Most people over-estimate the amount of muscle they gain when on an exercise program using it as a bit of an excuse to explain why their BMI has remained the same. The fact is exercise has very little effect on weight loss – weight loss is 95% the result of diet. Exercisers commonly step up heir carbohydrate intake.

Of more concern is the now very common miss-spelling of the word ‘lose’ by spelling it as ‘loose’ which is an entirely different word. I even saw it in a Microsoft error message the other day. I predict that one day it will become the correct spelling because of the Internet and because it is not detected by spell checkers.

Peter Cresswell said...

"Of more concern is the now very common miss-spelling of the word ‘lose’ by spelling it as ‘loose’ which is an entirely different word."

You're absolutely right, and we've talked about this before. Time to stamp it out -- and there's only one way to start: by announcing that any and all perpetrators are banned for a month!

That should put a stop to it, eh. ;^)

Greig McGill said...

AngloAmerikan said:

is it not allowed for the Government to provide information?

Sure. Just not with my money, thanks, so in other words... no. ;)

Sean Fitzpatrick said...

Cactus

Your trainer is correct - its all relative. Many very slim girls may well be 40% body fat. Bear in mind however that ideal body fat levels for females are much hight than for males.

As for swapping your fat for theirs why ever would you want to? You look just fabulous, dahhhling :)

AA

You wrote:
"This is an extreme and unrealistic example. Most people over-estimate the amount of muscle they gain when on an exercise program using it as a bit of an excuse to explain why their BMI has remained the same."

I would have to take issue that this is either extreme or unrealistic - increasing or decreasing weight by 3kg is not at all rare or uncommon. However, I will let that pass - if we were talking a genuine 300g change in either my point would still hold true.

"The fact is exercise has very little effect on weight loss – weight loss is 95% the result of diet."

A bit of a generalization I am afraid - for some people, especially those with physically active jobs but poor diet this may well be the case. For many however it is not.

Physical activity levels have a major impact on such things as resting metabolic rate (which account for about 68% of the boy's total energy expenditure) and levels of HGH and other hormones - all of which play a massive role in body composition and general health.

"Exercisers commonly step up heir carbohydrate intake."

Indeed, but so long as these are not mainly processed carbohydrates, no problem.

Good discussion BTW all, thanks :)

Mich said...

What pisses me off, and I refer to one of the cartoons with the two lying on the chairs, is that it is another attack on McD's, (though subtle) McD's unfairly gets the blame for a lot of things. Sure, it is not food you would want to eat all the time, but neither is the corner store fish and chip shop either.

With regards to the BMI, it is a shite measurement.