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Fair and Balanced —

December 5, 2013

Weight LossFat PoliticsFat HealthFat ScienceExerciseMy Boring-Ass LifeFat NewsDickweedDiet Talk

Trigger warning: This post includes discussions of research surrounding weight and health.

Over the past few weeks there have been a flurry of articles on the death of “healthy obesity,” also known as fat and fit. For example, in early November Time published the results of a Danish study that that analyzed the data of over 77,000 individuals who took part in the Copenhagen General Population Study. Between 2003 and 2011, subjects were examined and researchers collected detailed information about BMI, waist measurement, blood pressure and whether the subject had metabolic syndrome, a cluster of symptoms that indicates the presence of insulin resistance (for more information, check out this post on the man who discovered metabolic syndrome). Since first coming across the study I’ve been planning to comment on it.

Then, two days ago I received an email from a local television reporter who had previously interviewed me about Health at Every Size®  (HAES) asking my opinion on the research disproving fat and fit. I assumed he was referring to the Danish study, but when I clicked the link to the NBC News story I was caught off guard when I saw he was referring to a new study coming out of Canada.

Suddenly, I’m seeing articles everywhere declaring HAES dead and “proving” that fat people can’t be fit, no matter what the fatties say. Those articles spread like wildfire on reddit: there’s the /r/science subreddit post that took off with “told ya so” glee, seven links to a BBC article, three links to an article in the Toronto Star, two links to the CBC, and two links to a new Time article about this latest study titled “You Can’t Be Fat and Fit.” I could only find two links that actually direct readers to an actual study.

I decided to jump in the fray over at the /r/science subreddit by responding to this comment and explaining that his explanation of HAES was flawed. You can follow the thread I started here (as I was downvoted out of existence from the comment). Now, something interesting happened at this same time as I began responding to the Danish study on reddit: I got shadow-banned.

[NOTE: The following section is tangential to my analysis of this research. If you’d like to skip to the meat and potatoes of the research, skip down to the bold header that reads “Digging Deeper.”]

Silent Treatment

I’ve been on reddit for four years now, although I’ve only been actively posting links for the past year. I had never heard of the shadow-ban and only learned about it from two redditors who pointed it out to me privately. In essence, a shadow-ban is when a forum “bans” you from participating in conversations by preventing your comments or profile from showing up for other readers, but the shadow-banned user isn’t informed, while the user is still able to see his own comments and profile. So, unless someone points out that you’ve been shadow-banned, you don’t know.

After doing some digging, I discovered I was shadow-banned because a member of the subreddit /r/FitnessCircleJerk (FCJ) reported me for spam. For those who aren’t familiar with FCJ, they’re fitness trolls who loathe fat people, but have a special place in their little black hearts for Fat Acceptance bloggers like me and Ragen at Dances with Fat. They’ve been hate-reading our blog since last November when they launched a vigorous assault in our comments ranging from respectful, intelligent disagreement to profane, barely-literate tirades. In the end, I had to change our long-standing comment policy and start approving each comment by hand to prevent further disruption.

Pissed that I won’t allow them to shit on our forum, FCJ took steps to ensure I could not have such a forum on reddit. I began my own subreddit last March called /r/AskHAES, where people could ask questions about HAES and we would provide the HAES perspective. There was an immediate influx of FCJers who downvoted every response from HAES advocates, upvoted their own comments, and lobbed a relentless parade of insults at fat people, which Kitsune documented thoroughly here. I began moderating with an iron fist, banning anyone with even a whiff of disrespect for dialogue or who appeared to be part of FCJ or the other fat-hating subreddits I’ve discovered since then. To participate, you have to be able to disagree respectfully, which is too much for most of these knuckle-dragging mouth-breathers.

I’ve written about my theory as to why fat haters seem so deeply invested in shaming and degrading and humiliating fat people. But when FCJers talk about their hatred for fat people, their far more circumspect. I’ve repeatedly been told that they don’t hate all fat people — if you want to be fat, be fat! — but that they hate a particular type of fat person who claims that fat people can be healthy and they especially hate a particular type of fat person who tries to provide a scientific basis for that belief (i.e., me, Ragen, HAES bloggers).

We’re lying, they say. We’re justifying the unhealthy lifestyles of fat people by claiming that you can achieve Health at Every Size. That seems to be the biggest hangup for many anti-HAESers. Case in point:

So the name of this movement is Healthy At Every Size. Of course we all know that is ridiculous. Morbidly obese and walking skeleton is not healthy for anybody… A hideously fat or skinny person living an unhealthy lifestyle with no intent of changing could read about this movement, read the title, and say “Yeah, fuck society. Just because I’m so skinny my bones rattle and my dick looks like a tootsie roll except with more wrinkles, i am healthy at any size!”

That’s it.

That’s the argument.

HAES is bad because some fat person might read the name and say “HOORAY! I’M HEALTHY!” and go about their business.

But here’s the thing: it’s Health at Every Size, not Health No Matter What.

Could someone read the title of the movement and assume it means ALL fat people are healthy? Of course. And clearly many FCJers are incapable of seeing anything else. But the whole point of HAES is that you actually have to make lifestyle changes, including regular exercise, to improve your health. If you don’t make healthy changes, then your health will not improve. End of story.

This is the message gets completely ignored by FCJ and anti-HAESers. More accurately, this is the message that gets downvoted on reddit and ignored by society in general. They don’t want to have a discussion, they want to shout us down and overwhelm us with enough anecdotal evidence that we just give up the fight and start obeying their particular guru or meal plan or example. Where it is possible for them to control the conversation, they will use whatever tactics they have to silence us, not because the studies are flawed or the evidence is weak, but because they hate the name and they hate fat people.

And for a while their silencing technique worked on /r/AskHAES. I pretty much gave up participating because I couldn’t even answer a basic question about HAES. Instead, I focused on providing content to /r/BodyAcceptance instead, since the moderators requested that I submit links from our blog. And all that was moving along swimmingly until I got shadow-banned, which was the most effective silencing technique to date.

After reading up on shadow-bans, I learned that it’s pretty difficult to get a shadow-ban lifted. So I emailed the reddit admins and explained that /r/BodyAcceptance requested my links and pointed to the FAQ on what constitutes spam:

To play it safe, write to the moderators of the community you’d like to submit to. They’ll probably appreciate the advance notice. They might also set community-specific rules that supersede the ones above. And that’s okay — that’s the whole point of letting people create their own reddit communities and define what’s on topic and what’s spam.

About three minutes after I sent it, the admins unbanned me and I was free to post once more.

Victorious, I decided to rub it in FCJ’s face with this post titled “MFW reddit overturns the shadowban you pathetic sacks of shit tried to impose” (MFW stands for “My Face When” which linked to this photo:

Johnny Cash Middle Finger

If you’ve ever wanted to see the trolls get trolled, this is the thread for you. FCJ proceeded to meltdown as they posted over 200 comments attempting to insult me. To compare, this is a screenshot of the most commented on posts from yesterday, a max of 68 comments. This kind of response is caused by what the kids these day refer to as “butthurt.”

And not only did they have a field day responding to my trolling, they began submitting their own posts to take me down a notch, mostly through the clever (for a homunculus) photos.

Butthurt Brigade

You’ll notice that the third one down is a reference to my comments on the /r/science thread that discussed the fat and fit. If you actually go through the thread, you’ll see their attempts to refute my points, like comparing HAES to sumo wrestlers or mocking a functional walking test as a measure of health, despite the fact that the Rockport Walking Test is one of the best ways to measure cardio-respiratory fitness. How do these armchair Einstein’s propose we measure fitness? Here’s my favorite suggestion for measuring fitness:

Ate you useful in helping someone move their house? Could you carry someone up or down a flight of stairs? Are you a nuisance in a packed movie theater or airplane? Could you reasonably flee danger if needed?

There’s very little minutiae here. No jargon or big confusing words. You can test this just about anywhere for free, and you can’t skew the results to where people throw their hands up because they can’t tell who’s right.

Ah, yes, the far more functional test of if you can outrun a Bengal tiger, then you’re healthy; if you can’t, then you’re a lazy fatass. SCIENCE!

In a nutshell, this is what science has become: what do we feel is right. Did random redditor post photos of his 200 pound weight loss? SCIENCE! See a headline that says you can’t be fat and fit? SCIENCE! Forget actually reading the research, forget talking to experts, forget reading the fine print. Headlines and photos are all the evidence we need that no fat people exercise, eat healthy, or have a clean bill of health unless, of course, they’re in the midst of losing weight.

I don’t have much patience for this kind of armchair analysis, particularly when the person hasn’t read any research on the subject. Because when you present evidence to people who have already made up their mind, the proof is meaningless. You can show them study after study after study, but they will cling to their beliefs and never let them go, even in the face of overwhelming evidence that they are wrong.

But here’s where I want our readers to pay close attention because this often gets lost in the shuffle: FCJ isn’t alone in ignoring evidence that runs contrary to their preconceived notions. We proponents of HAES can be just as guilty of dismissing studies that disagree with our conclusions without truly understanding what that evidence says.

On Friday, Jen posted an article about Plan B contraception not working in women over 176 pounds. In the comments, Kala responded to Jen’s question as to how these pills got to market without realizing they were ineffective. Kala explained the clinical trial process and pointed out that over half the trial subjects were Chinese, which would affect the median weight significantly. She then went on to criticize Jen’s claim that 176 pounds is “pretty much average size for most segments of the female population ’round the world.” Jen, vesta and others responded to Kala questioning the clinical trial and whether fat bias played a role.

All this is well and good. This is the kind of discussion I want to have here. I want people questioning the science and I want other people answering those questions, disagreeing with the premise of posts and pointing to evidence contrary to our beliefs. I do not want Fierce Fatties to be an echo chamber where we all here the lovely things we want to hear. If you don’t want to read the science or the arguments for or against HAES, we’ve got the rating system to alert you to that.

Personally, I think it’s irresponsible of the Food and Drug Administration to have approved Plan B based on a clinical trial that is nearly half Chinese, which would significantly reduce the average body weight of subjects. Surely they could have found countries with more representative demographics from Germany, Australia or the UK for the clinical trial. There’s all kinds of complicated issues surrounding Plan B (especially in the US), so who knows what the politics of it was. But Teva Pharmaceuticals is ultimately responsible for not taking their larger customers into consideration when testing such a critical product.

But here’s the thing: the two articles that declared fat and fit dead? That’s science. The clinical trial that got Plan B approved? That’s still science. The researchers who worked on all of that? Scientists and experts. There’s no need for scare quotes, no need to dismiss the evidence sight unseen, no need for questioning their credentials (unless there’s an obvious conflict of interest).

Yes, science is constantly being used to scare society into believing that all fat people are walking timebombs, the two fat and fit articles included. Researchers play up the sensational bits of their research in hopes of getting more funding for future anti-obesity projects and the media gobbles up the abstracts and regurgitates them through an even more skewed lens. Science is constantly abused and mistreated in the quest for headlines and game-changers. But let me be absolutely clear on one point: science that gets shittily spun is still science.

Roughly speaking, there are two parts to research: data and analysis. The true power or weakness of science is found in the data, the results of whatever the researchers are studying. If you have shitty data, then you will draw shitty conclusions 10 times out of 10. However, a research team can have good, solid data, and still come to shitty conclusions. But to know how shitty the conclusion is, you have to understand the data first.

Recently, I wrote about the dangers of science denialism and I encouraged our readers and bloggers to stay away from the work of Sandy Szwarc and her dormant blog, Junkfood Science. Sandy is a perfect example of someone on the HAESish side who takes perfectly good data and spins it into shitty analysis. Some of her conclusions are solid, but there is so much obvious nonsense that it renders her good arguments useless.

We cannot allow ourselves to confuse shitty science with shitty analysis. The research teams that claim they have disproven fat and fit are making that analysis based on solid, reliable, trustworthy data. I’ve read the Danish study and did not see anything egregious about the data they used to draw their conclusions. The Danish study is science, not “science.”

What the Danish study and the Canadian study both suffer from, however, is shitty analysis. If you don’t mind, I would now like to explain exactly how you separate good data from shitty analysis.

Digging Deeper

HAES has plenty of research to back up its claims, but I haven’t seen an article yet that has asked a fat and fit proponent what they think of these studies. Fair enough, they don’t have to, but then they let the Canadian research team frame the evidence HAES provides for fat and fit. Remember that Time that definitively states in the headline “You Can’t Be Fat and Fit”? Here’s how they explain the different findings of previous research:

According to the current study’s lead author, Dr. Caroline Kramer, the discrepancy likely has to do with how the various studies were set up. For instance, some large studies only compared weight and the risk of adverse events instead of looking closely at people’s metabolic health. So some of the apparently healthy but overweight or obese individuals might have had signs of diabetes or hypertension or high cholesterol that simply weren’t recorded in the study. Other trials compared healthy obese people to unhealthy obese people, instead of comparing them to people of normal or healthy weights, and other studies relied on small groups of participants who were only studied over short time periods.

When you put it that way, it certainly sounds like this Canadian team has put the kibosh on any refutation of the facts they uncovered with their work. But what exactly did this team find? Well, here’s how the article puts it:

The researchers, from Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital in Toronto, Canada, found that people who tipped the scales at above their recommended body mass index (BMI) but did not have abnormal cholesterol or blood pressure, for example, still had a higher risk of dying from heart disease over an average of about 10 years compared to metabolically healthy individuals within normal weight ranges. In their analysis, published in Annals of Internal Medicine, the researchers separated individuals in the previous studies into six groups: normal weight and healthy, normal weight and unhealthy, overweight and healthy, overweight and unhealthy, obese and healthy, and obese and unhealthy. Their results showed that regardless of the person’s BMI, an unhealthy metabolic state — such as having hypertension, diabetes or high cholesterol levels — was consistently linked to an increased risk of dying during the study period or having a heart event. And contrary to previous studies that suggested that heavier people with normal metabolic readings could have “benign obesity” or “metabolically healthy obesity,” the team also reported that metabolically healthy obese participants had a higher risk of dying earlier or having heart-related problems than those who were normal weight and also metabolically healthy. [emphasis mine]

The whole goal of “getting healthy” through diet and exercise is so that your body will process the glucose we consume via insulin. When your body becomes insulin resistant, you stop processing that glucose and your metabolic health takes a dive. As a result, your blood pressure, blood lipids and blood sugars get worse, and you may gain weight. When a person has a certain amount of these symptoms, they are said to have metabolic syndrome. Left unchecked, this can lead to heart disease, type 2 diabetes, stroke, gout and more.

The definition of metabolic syndrome varies by the institution defining it, but the 2001 ATP III definition is the one most frequently used in diagnosing metabolic syndrome. Patients with three out of five of the following criteria are diagnosed with metabolic syndrome:

  • Central obesity: waist circumference ≥ 102 cm or 40 inches (male), ≥ 88 cm or 36 inches(female)
  • Dyslipidemia: TG ≥ 1.7 mmol/L (150 mg/dl)
  • Dyslipidemia: HDL-C < 40 mg/dL (male), < 50 mg/dL (female)
  • Blood pressure ≥ 130/85 mmHg
  • Fasting plasma glucose ≥ 6.1 mmol/L (110 mg/dl)

The study above is a meta-analysis (meaning it compares previous studies) which looked at eight previous studies that compared thin people with and without metabolic syndrome, overweight people with and without metabolic syndrome, and obese people with and without metabolic syndrome. It found that anyone who had metabolic syndrome was at increased risk for heart disease and early death, but the obese subjects who were metabolically healthy also had an increased risk. With a total of 61,000 subjects and a followup for half the studies of over 10 years, it sounds like pretty conclusive evidence that fat and fit is a myth.

Except for this:

But since obesity has different effects on the body for different people, researchers are still investigating how weight gain and its health effects may vary among people whose obesity is due primarily to things such as genetics and environmental exposures as opposed to unhealthy diets and lack of physical activity. [emphasis mine]

This is the $64,000 question. What is the difference between the fat people who are metabolically healthy and never get sick  and the fat people who are metabolically health, but who develop diabetes and heart disease 10 years down the road? This article waits until the very last paragraph to point out in fairly opaque language that when the Canadian researchers set out to debunk “fat and fit” they forgot to compare the whole “fit” thing.

The NBC article I referred to earlier does a much better job of pointing this out, but saves this information for the second-to-last paragraph:

“You’re not doomed if you don’t lose weight,” [Dr. Vicki March, medical director of the Healthy Lifestyle Program at Magee-Womens Hospital of the University of Pittsburgh Medical Center and co-director of BodyChangers, also at Magee] said. “In this study, they didn’t take exercise and other habits into consideration. We’ve known for a long time that someone who is physically fit is healthier than someone who is not, no matter what weight they are.” [emphasis  mine]

So, the Canadian team didn’t look at any studies where the fitness of the subjects was actually measured. The only separated groups by metabolic status. So, let’s say 1,000 fatties were rounded up today for a study and after a thorough physical examination find that half of us have metabolic syndrome. The half that does not have metabolic syndrome is the cohort representing “fat and fit,” and yet there is zero information on the lifestyle habits of those individual fatties. So you can have Fatty A who eats a healthy, balanced diet and gets exercise, but is still fat, and you’ve got Fatty B who eats McDonald’s every night and is mostly sedentary. Both of these fatties represent “fat and fit” in the mind of Dr. Caroline Kramer, and now in the mind of the American media.

And what is the increased risk they found for metabolically healthy fat people?

When Zinman and his colleagues looked only at data from studies with long-term follow-up and focused just on individuals who were “metabolically healthy,” they found that obesity raised the risk of death, heart attack, and stroke by 24 percent. Similarly, they found that people who were metabolically healthy but overweight had a 21 percent increased risk, but that finding was not statistically significant.

The interesting thing about this NBC article is that the article specifically references a study that came out in January that found people with a BMI under 35 (“obese” being a BMI of 30 or more) did not have an increased mortality risk. The study by Dr. Katherine Flegal’s team received some good coverage, but more hostile coverage as it set off a firestorm of criticism from Dr. Walter Willett and company. You may recall that Willett and his amazing mustache has a long history of attacking Flegal’s research, which consistently pours cold water on the fat panic. The Boston Globe summarized the fight this way:

Willett later faulted the study’s author, epidemiologist Katherine Flegal of the CDC’s National Center for Health Statistics, saying she failed to exclude data from smokers and the sick, two groups of generally thinner, higher-risk people that would give the overweight a relative advantage. When Flegal countered that she had adjusted for both groups and found little effect, Willett argued that properly adjusting for them was impossible.

But compare the Canadian team’s results with Flegal’s, which did find a 29% increased mortality risk for those with a BMI over 35. But the Canadian team didn’t divide up the obese category like Flegal did. The obesity category include everyone with a BMI over 30, even though the risk increases with BMI.

Referring to my comments on these studies being good science, it’s true. The way that the Canadian team used meta-analysis is scientifically sound. The way they culled the data was in line with research standards and there is nothing sketchy at all about the results they found. The problem with the research isn’t the science of it, it’s the way that science is presented by the research team and the media.

The question shouldn’t be “Do metabolically healthy fat people have an increased risk of dying or having heart attacks?”

The question should be “Do fat people who exercise and eat a healthy, balanced diet, but remain fat, have a decreased risk of dying or having heart attacks?”

In the Danish study, the authors nominally control for fitness by asking the subjects how active they are. The authors defined physical inactivity as “leisure time activity less than 4 hours weekly and predominantly sedentary work.” Keep in mind that the American College of Sports Medicine recommends recommends you get 2.5 hours of moderate exercise or 1.25 hours of vigorous per week, plus strength training. Also keep in mind that surveying people about their fitness habits isn’t as reliable as using an objective measure of fitness. Perhaps you don’t see yourself as exercising 4 hours a week, but maybe you have a daily commute that requires walking 15 minutes. That is exercise.

When controlling for their definition of physical inactivity, the authors found an increased mortality risk of 26% and 88% for overweight and obese people without metabolic syndrome, respectively. For ischemic heart disease, there was an increased risk of 8% and 45%, respectively.

Again, the obese group is not stratified the way Flegal’s study was, so we don’t know can’t compare the lower obese category to see if the risk is comparable. But my biggest problem is this self-reported fitness level. It’s not the best measure of fitness. The best objective measure of fitness is cardio-respiratory fitness. For that, we do have solid research that is virtually ignored.

In the September 2012 European Heart Journal, a long-term study that measured cardio-respiratory fitness with a maximal exercise test on a treadmill, and also compared both BMI and body fat percentage, with obesity being defined as more than 25% for men and 30% for women. The study included 43,000 subjects and had a median followup of 14 years. So this study actually measures the fitness of all the subjects. It also compares BMI, a blunt instrument for measuring “fatness,” and body fat percentage, a scalpel. This is also the first study of its kind to compare body fat and mortality. It’s also worth noting that when they excluded subjects with a BMI over 40 (aka morbidly obese, aka me) the results did not materially change.

The one thing that stands out, though, is that the subjects are “mostly Caucasian (98%), well educated, and worked in executive or professional positions.” So these are the most privileged of the privileged, who have access to healthcare and resources to help them eat a healthier diet and find an exercise regimen they enjoy. The fact that they are well-educated and white collar means this is a “best case scenario” study that doesn’t really reflect the reality for most moderate-educated, working class or poor people, particularly in the United States where access to healthcare is a still significant problem and the wage gap is growing wider.

But this is an ideal study to test, all things being equal, how one’s actual, physical fitness affects long term health for thin, overweight and obese people. Just 13% of subjects were obese based on BMI, while 30% were obese based on body fat (defined as having more than 25% for men and 30% for women. The metabolically healthy subjects comprised a third of all BMI fatties and nearly half of all body fat fatties. And here’s the cool thing: the authors of this study used a stricter definition of metabolically unhealthy than the Canadian or Danish studies. If subjects had two or more symptoms of metabolic syndrome, they were considered metabolically abnormal.

They followed all these obese subjects, as well as normal and overweight subjects for a median of 14 years for mortality and 8 years for non-fatal cardiovascular disease (CVD), which is comparable to both studies. And the results are incredible.

When obesity was defined using BF% and the models were fully adjusted by the set of confounders including fitness, metabolically healthy but obese individuals had a 38% lower risk of all-cause mortality than their metabolically unhealthy obese peers, while no significant difference was observed between metabolically healthy but obese and metabolically healthy normal-fat participants.

The evidence is crystal clear. In the following table, they compare the hazard ratios (HR) for mortality, CVD and cancer. HR compares the risk of some result compared to a referent group. If you’re twice as likely as me to get hit by a bus, you have an HR of 2 compared to my HR of 1. If you have an HR of 1.5 for bus accidents, then you have a 50% greater risk and should avoid major cities. Click to embiggen:

Cancer HR CVD HR Hazard ratios

This is the impact of exercise on a fat person. When you measure a person’s body fat and control for fitness, a normal-weight person has a 10% increased risk from all-cause mortality, a 13% greater risk of CVD death, and nearly identical risk for non-fatal CVD. By BMI, the normal-weight has a 9% lower risk for mortality, 27% lower risk for CVD death and 22% lower risk for non-fatal CVD. But the obese BMI is notorious for picking up people with higher muscle percentage, like our friends in /r/fitnesscirclejerk.

It turns out, health is far more complicated when you actually measure a person’s fitness by putting them on a treadmill and follow the Balke protocol, a method developed by the Air Force to determine VO2 max, or maximal lung capacity. VO2 max is widely accepted as the best way to actually quantify cardiorespiratory health.

Once fitness is duly accounted for and an accurate measure of adiposity is used, the metabolically healthy but obese phenotype is a benign condition, with a better prognosis (30–50% lower risk) for mortality and morbidity than metabolically abnormal obese people. Interestingly, no difference in the prognosis is observed between metabolically healthy but obese individuals and metabolically healthy normal-fat individuals once fitness is accounted for, suggesting a key role of fitness in these associations.

This study is good science and equally valid science beside the Canadian and Danish studies. The difference is in what questions the researchers actually asked and how they decided to frame the answers they got, as well as how the media chooses to project those answers to the public.

Bear this in mind when you read shitty articles saying fat and fit is dead, and Jezebel has a great roundup of the gloating over the Canadian study. Then there was this post someone submitted to /r/BodyAcceptance.

DickweedYou don’t have to be mad about the results of research as a result of ignorant bullshit like this. When you dig deep enough to find what is actually underneath the headline, you’ll find that the truth is far more nuanced and interesting than the knuckle-draggers can comprehend.

10 Comments leave one →
  1. quiltluvr permalink
    December 6, 2013 9:05 am

    Excellent article. Thank you for taking the time to put this together.

  2. vesta44 permalink
    December 7, 2013 12:19 pm

    Thanks, Shannon, for doing all the digging and explaining.
    I was going to write a comment about this, but it started to look a hijack, so instead, I wrote a post about it on my blog. Anyone who’s interested can find it here –

  3. Dizzyd permalink
    December 10, 2013 7:24 pm

    Vesta – I had a chance to read your blog about this post and I DEEPLY appreciate it. So what if you don’t have a PhD or a MS or BS or ABC or 123 or whatever, YOUR opinion matters as much as any “scientific” type who knows better than us “mere mortals” what’s what. Thank you for saying so eloquently what us non-science nerds are thinking. And as far as your family is concerned, if they can’t accept you for who you are, their loss!

    • Kala permalink
      December 11, 2013 1:07 am

      Dizzyd, I’m asking a serious question here.

      Do you truly believe that the opinion of someone who is self-educated or un-educated on a topic is equally valid and of equal weight to someone who is formally educated not only on the topic itself but also in the skills used to digest and process the research about the topic?

      What does my degree in a scientific field give me credibility for, if not for speaking about science from a more learned place than a layperson? Do you see BS, MS, MA, PhD, RD, RN, MD, MPH, DrPH, as merely obstacles of time and money, and not of knowledge, skill, and finesse? Do you think just anyone can go and get an advanced degree in a science if only for a lack of money or time or privilege?

    • vesta44 permalink
      December 11, 2013 11:23 am

      Thanks, Dizzyd, I appreciate that, a lot.

  4. Leila Haddad permalink
    December 11, 2013 2:02 am

    Kala. I come from a family of chemical and biological engineers, physicists, and PhDs and not one of them are self righteous as you are. They understand how studies are conducted and results can be manipulated as well. This does not answer a nagging question however: how is it defensible that a clinical trial was done for a birth control drug on such a small segment of the female population and then released to the general public?

    • Kala permalink
      December 11, 2013 4:15 am

      LOL, you don’t know the first thing about me Leila. But thanks anyway.

    • Kala permalink
      December 11, 2013 4:35 am

      Also, where did I say it was defensible? Where did I pretend that the pharmaceutical company bears a lack of responsibility in the Plan B One Step matter? All I did was explain how it could be that an approved drug could be found to not work as well as initially thought from the clinical trialing. And there are quite a few great reasons why that is, several of them have to do with ethics. I didn’t even have anything to say about any person at FFF until people started throwing scare quotes around words for no reason at all, and making all kinds of willy-nilly assumptions about how the evaluation of the drug was done. With this underlying idea that because some science isn’t done well, we can a priori assume that science that didn’t turn out the way we’d like it to was also done shittily. That’s not actual skepticism, I don’t even know what to call it.

      In my commenting here, I attempted to provide some counterbalance to the consistent pile-ons against research based upon how that research makes people feel, and not any deeper look at why the research says what it does. Vesta does this regularly with her articles, she reads a MedPage article written about a research paper, doesn’t read the research paper, and then suggests several stock reasons (“correlation doesn’t equal causation”, “insufficient sample size/diversity”, “follow the money”) as to why the research isn’t good. Ultimately she chooses these papers because she doesn’t like their results nor does she like the ensuing media frenzy that follows a lot of them. Then cue the commenters chiming in with “yeah, those ‘scientists’ and ‘experts’ don’t know what they’re doing” and so on and so forth. This is so facile it’s kind of unreal.

      So yeah Leila, you may have a family of PhDs, do they regularly comment on research articles they haven’t even read? Do they have strong opinions on how specific studies are done poorly, when that research is completely out of their area of expertise? I have plenty of criticism for research and the scientific process, but I also have criticism for the criticism of research as well.

      And if I’m self-righteous, so are a large chunk of the other people here.

  5. vesta44 permalink
    December 11, 2013 11:20 am

    Kala – If you had read my post about this on my blog, you would understand where I’m coming from with my cynicism. And yes, it is cynicism. When science is used to browbeat one for years and years and years (almost 40 of them for me), it’s really difficult to see where bias and prejudice don’t enter into those trials and research studies.
    No, I’m not educated in science fields like you are, but I can see where studies that are used to apply their results to a whole population are lacking credibility. I’m sorry if that upsets you – that I don’t take the time to read the whole study when I do a post. Some of those studies have to paid for in order to read them – I can’t afford that. Some of those studies, I don’t understand the statistics used – I’ve never taken classes in statistics. Some of them I don’t understand the science – again, I don’t have any education in science. I’m sorry that I just don’t have the spoons to do all the research you think I need to do in order to have a valid post on this forum. I’m dealing with fibromyalgia, arthritis, venous insufficiency, migraines, and several other ailments that limit the amount of time I can spend researching the articles about which I write. Some of those things affect my memory and my ability to keep my train of thought on the tracks all the time. I don’t have the ability anymore to sit down and take hours to do all the research you seem to think is necessary to write a post for this blog. Twenty-five years ago, when I was in college, taking the necessary composition courses to get my degree, I could have done it. But, 25 years ago, I wasn’t dealing with all the health issues that I have now. I do the best I can with what I have, and I’m sorry that isn’t good enough for you.
    Tell you what, I’ll send you all the articles about which I would post, and you can do all the research, reading, interpretation, etc, and you can write the blog post. I’ll gladly bow out and then maybe you’ll be satisfied with some of the blogging done here.
    Now, if you don’t like how I’ve written a post, why don’t you do the research and post a rebuttal to my post – tell us all exactly why that study is right, why that study didn’t fuck up, why the researchers weren’t biased, why their results weren’t affected by whoever funded it, why correlation just might be causation in that case, etc. In other words, put your money where your mouth is. (Yes, I’m pissed. I’m tired of this whole fucking conversation and being treated like I’m stupid just because I don’t meet someone’s standards for blogging about research.)

    • Kala permalink
      December 11, 2013 4:05 pm

      Vesta, I did read your blog article, I read it the day you posted it.

      You want to blog about your opinions and put that blog out into the public. When you put yourself out there, you open yourself for criticism whether you like it or not. You can have a thousand reasons as to why you don’t have the privilege to put a ton of work into it, but I fail to see how that changes how a random person would see and evaluate what you’ve written.

      And you know, it would be one thing if such cynicism were put out there in a moderate way. But often such opinions are presented with fire and brimstone about this kind of thing. Bold claims and a lot of anger. And then when someone chimes in to talk about “experts” or “research” in scare-quotes, what that says to me is that whatever is in the scare quotes is seen as total fucking bullshit. Something to be completely dismissed.

      Finally, just because I disagree with someone’s criticism of something, doesn’t mean that I think that the item in question is perfection. I don’t need to write articles about how some paper is the best paper ever that’s dripping in validity because I don’t like the analysis that you or someone else presents about it.

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