Saturday, December 08, 2007

Ludicrosity

This new "study" deserves its very own made-up word--that's how utterly ridiculous and misleading it is.

It's a classic case of distortion, from the headline--"Obese? Drive at Your Own Risk!"--to the bait-and-switch of its conclusion. Based on research involving people in car accidents, it purports to look at how BMI affects your risk of dying in a car accident.

Here's how it opens:

Being obese may increase the risk of perilous diseases like diabetes, heart attack, stroke and cancer. And it can be fatal in one more way -- it enhances the risk of dying in a car crash.

What's the connection? Well might you ask. This is one of those reviews masquerading as a study, where researchers look at data--in this case, data on people involved in car accidents and their BMI.

Researchers divided over 230,000 people into groups based on their body mass index (BMI) . The rate of always wearing seat belts was 82.6 per cent for non-obese motorists (BMI less than 25), 80.1 per cent for overweight motorists (BMI 25-29), 76.6 per cent for obese motorists (BMI 30-39) and 69.8 per cent for extremely obese motorists (BMI 40 and above). The gap climbed from 2.5 per cent for overweight, to 6.0 per cent among the obese, to 12.8 per cent among the extremely obese.

Um, what we've got here is a correlation between not wearing your seat belt and dying in a car crash, along with a statistical analysis of percentage of seat belt wearers and their BMI.

As Sandy Szwarc is fond of saying correlation is not causation. Or, to put it another way: The media is willing, but the evidence is weak.

Practicing with a license

I've given serious thought to going back to school and getting an MSW so I could get licensed as a therapist and work with people who have eating disorders. I've often felt this year like I was practicing without a license--giving therapeutic advice while not being a therapist or having any medical training myself--and wondered if I should get some training.

And I probably will get more training, at some point. But this advice column reminded me that a license doesn't necessarily mean that a) you know what you're talking about, or b) you give good advice.

It's written by someone with an MSW who displays appalling ignorance about eating disorders and the state of treatment. She sounds a lot like the first therapist we saw when my daughter was diagnosed with anorexia. A mother wrote in about her young daughter, who she believes is showing signs of anorexia, and this social worker responded by, first, pooh-poohing the mother's sense of her daughter's health:

Though child anorexia is now being diagnosed in girls as young as six years old, my gut tells me that it’s not the case here. X's weight is stable, and girls suffering from anorexia usually exhibit a rapid and profound weight loss.

Wrong, wrong, wrong. That's what I thought when my daughter got sick, and because she hadn't lost a lot of weight, I figured she couldn't have anorexia. In fact with children and adolescents the issue is often a failure to gain weight rather than a dramatic weight loss. When you weigh only 70 pounds to begin with, it doesn't take much to tip you into a state of malnutrition.

The therapist goes on to say that

Anorexia, which is an eating disorder, is linked to an emotional problem. It is not about food, but rather about feelings. These are often feelings of intense levels of tension and anxiety, or an inability to cope with one’s surroundings. It’s complicated, and it’s certainly not something that most parents would be qualified to “fix.”

Wrong again on every count. As readers of this blog already know, the latest research on eating disorders shows that they are biological illnesses--brain disorders. The head of NIMH has gone on the record saying so. And while they surely are complicated illnesses, there's no one in a better position to help "fix" them than a parent, because the treatment is food. Not psychobabble*. Not circular discussions about feelings. There may be value in therapy, but later on, when the brain is nourished and working properly again.

I guess having a license doesn't mean you know what you're talking about. And not having one doesn't mean you don't. I won't be going back to school but I'm going to keep on trying to educate families and professionals about the realities of eating disorders until the so-called professionals get a clue.


*Apologies to my therapist friends. I'm a big believer in therapy--just not for someone who's acutely malnourished. Food first, talk later.

Monday, December 03, 2007

Would you rather be fat or live another 20 years?

Readers of this blog have no doubt heard about the study* that showed a shockingly high percentage of people would rather be blind, lose a limb, live a shortened lifespan, and suffer other calamities--so long as they didn't have to be fat.

Now a new study may put that fatphobia to the test. Researchers at the Fred Hutchinson Cancer Research Center in Seattle have found that nematode worms who were exposed to one of the tricyclic antidepressants lived up to 30 percent longer lifespans. Their hypothesis: the drug disturbed the balance of chemicals in the brain and created a "perceived, but not real" state of starvation that altered the creatures' natural lifespans.**

Sounds like sci fi, doesn't it? After all, humans have been chasing a longer lifespan since Ponce de Leon hunted for that fountain--and probably long before that. But wait, said the researchers, even if this effect could be shown in people, they're not going to go for it, because that class of medications causes "weight gain and increased appetite."

So someday we really might be faced with a choice between being fat and living significantly longer.

What would *you* do?

*See www.yale.edu/opa/newsr/06-05-16-02.all.html
** See www.news-medical.net/?id=32859

Sunday, December 02, 2007

Want to lose weight fast?

Carrie over at Ed-Bites has some brilliant ideas for you.*



*Please note: My tongue is inserted firmly in my cheek.