The Guardian ran the headline “Obesity ’causes one in five cancer deaths'” with the sub-headline “Heavier people are more at risk, warns cancer expert at Chicago conference.”
So wait – the headline says that one in five cancer deaths (not just cases of cancer, but cancer deaths) is CAUSED by having a weight in pounds times 703 divided by height in inches squared that is equal to or greater than 30. But the subhealine is that one cancer “expert” at a conference warned that heavier people are at a higher risk?
What the researcher actually said was ““The average weight of our citizens is increasing dramatically. We’ve really got a critical mass of evidence where we see this relationship: the heavier people are more at risk [for cancer]” The suggestion that we can go from “heavier people are more at risk for cancer” to “one in five cancer deaths is caused by obesity” is not just embarrassingly bad reporting, it’s dangerously bad reporting susceptible to the common issues that we see in research about health and body size.
And it’s not surprising given the combination of society’s willingness to believe anything bad being connected to being fat, the media’s ravenous appetite for anything to do with fat people, health, and/or weight loss, and the lack of scientific literacy (combined with dramatic laziness) of many reporters.
To demonstrate this dangerous relationship, John Bohannon created a study (in exactly the same way that many of the studies around weightloss, and linking fat people and health issues are created) that showed that people who followed a low carb diet and ate a 1.5 ounce dark chocolate bar every day lost weight 10 percent faster and had better cholesterol readings and higher scores on the well-being survey than those who just did low carb or those in a control group. The study included 15 people and was done over 21 days.
The researchers involved (who included a General Practitioner, PhD in Molecular Biology, and Financial Analyst) said the following things:
- Our study was doomed by the tiny number of subjects, which amplifies the effects of uncontrolled factors
- When asked why they chose to test bitter chocolate the GP who ran the trial said it was because of people’s beliefs around food “Bitter chocolate tastes bad, therefore it must be good for you, It’s like a religion.”
- You might as well read tea leaves as try to interpret our results
They utilized one of the many journals that accepts money in lieu of peer review and will publish anything (the journal editor pronounced the manuscript “outstanding” and said that for 600 Euros “it “could be accepted directly in our premier journal.” and published it within two weeks of accepting payment without changing a word.) Once published in a sciencey-sounding journal they set about getting press. And what amazing press they got, according to Bohannon:
We landed big fish before we even knew they were biting. Bild [Europe’s largest daily newspaper] rushed their story out—“Those who eat chocolate stay slim!”—without contacting me at all. Soon we were in the Daily Star, the Irish Examiner, Cosmopolitan’s German website, the Times of India, both the German and Indian site of the Huffington Post, and even television news in Texas and an Australian morning talk show.
When reporters contacted me at all, they asked perfunctory questions. “Why do you think chocolate accelerates weight loss? Do you have any advice for our readers?” Almost no one asked how many subjects we tested, and no one reported that number. Not a single reporter seems to have contacted an outside researcher. None is quoted.
These publications, though many command large audiences, are not exactly paragons of journalistic virtue. So it’s not surprising that they would simply grab a bit of digital chum for the headline, harvest the pageviews, and move on. But even the supposedly rigorous outlets that picked the study up failed to spot the holes.
Shape magazine’s reporting on our study—turn to page 128 in the June issue—employed the services of a fact-checker, but it was just as lackadaisical. All the checker did was run a couple of sentences by me for accuracy and check the spelling of my name. The coverage went so far as to specify the appropriate cocoa content for weight-loss-inducing chocolate (81 percent) and even mentioned two specific brands (“available in grocery stores and at amazon.com”).
Some dodged the bullet. A reporter from Men’s Health interviewed me by email, asking the same sort of non-probing questions. She said that the story was slated for their September issue, so we’ll never know.
So, it may be helpful to remember that the news that gets to us about weight and health faces the following challenges to being remotely true:
- Scientists creating small studies to help form hypotheses, the results of which get reported as if they are large scale studies and as if the results are absolute truth.
- Scientists creating studies to get the results that they want
- Industries that profit from the results of research and the accompanying headlines funding and creating the press releases about that research
- The confirmation bias fueled by fat bigotry encouraged by the government and found at every level of society
- “Scientific” Journals that will publish anything for money
- “Scientific” journals that have a lowered threshold for evidence when it comes to weight and health
- Reporters who don’t read the studies Ior even the abstracts of the studies) they are reporting on
- Reporters who lack the scientific literacy to understand the studies if they did read them, especially studies that are manipulated by researches/corporations for profit
- The need to draw eyeballs superseding the need for accuracy in headlines (as evidenced by The Guardian article that I opened the blog talking about.)
That’s a few of the ways that the news that comes to us can be very wrong, there are more (and feel free to leave them in the comments if you have some.) Regardless, news in general – and especially when it comes to body size and health – is always reader beware.
The quotes about the chocolate experience are from a truly excellent article that I definitely recommend reading in its entirely
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My mom reads a lot of medicinal studies for her job and she told me that in Germany even only studies that come to the conclusions they want to get to in the first place are published (I don’t know about other countries, but suspect similar practices). So if there would be a study that wanted to prove that… let’s say, “obesity leads to a higher risk for cancer”, but during the study they would find out that this is not true or can’t be proven or the opposite is true, this study would never be published.
Plus there’s this annoying thing in the “academic world” that people have to or want to publish a certain (high) amount of papers and essays and studies to proceed in their career, so naturally these papers suffer more and more form a lack in quality and they are often published in pseudo-scientific magazines that publish any essay if you pay for it…
And what about the so-called studies paid for by big corporations to boost their sales? I always have to laugh for example when I read on a shampoo bottle “95% of women reported shinier hair after using our product”, and when you look at it, they gave it to 20 women who probably work for their company.
Honestly, I doubt all these so-called scientific studies more and more. There are so so many cases when the label “scientifically proven” is misused. Thank you for this post!
That German things doesn’t sound so bad actually. It is probably a matter of wording, but it’s likely that they only publish studies where the (strong) result of rejecting the hypothesis is warranted. Which would mean accepting their claim if they have designed their study with intelligence. Publishing anything else if iffy, at best.
Academics do indeed have to publish to keep their jobs, BUT they have to publish in reputable, peer-reviewed journals. A publication in a “pay-to-print” journal would count for nothing in one’s tenure or promotion file. I’ve served on the tenure and promotion committee at my university, and I can tell you that only peer-reviewed publications count for anything at all. Anyone who thinks they can help their academic career by paying for a publication in one of these pseudo-journals is delusional.
How about if they publish a book, instead of articles? They might have a bit more freedom to do it right then, and you’d think it would count as much.
Or maybe the “freedom to do it right” (by means of using someone other than the giant publishers) would counteract the fact that they wrote a whole book, rather than a small article.
Whatever happened to academics being about learning and finding the Great Truths of the Universe, rather than about toeing the political line? Or was that never really a thing.
At most major research universities in most fields, to get tenure (i.e., to NOT be fired after your sixth year) you will probably need to publish a book as well as several articles. I’d published three books by the time I got tenure, but I had a couple of non-tenurable jobs (i.e., limited contracts) first. And then to get promoted from associate to full professor, you probably need another book or a good many articles.
I wouldn’t say it’s about “towing the political line,” though. Peer review is more a matter of quality control — ensuring that the author in question has read the relevant materials, constructed a sound and defensible argument, isn’t flat-out whackadoodle, etc. — than of enforcing one viewpoint or another. Same thing for using established (not necessarily “giant”) publishers. A book published with Harvard University Press, or Oxford University Press, or Stanford … you get the idea … is going to carry more weight than a book published with some independent publisher that no-one’s ever heard of, because the major scholarly presses have intellectual credibility and credentials that small, non-peer-reviewed presses just don’t (and shouldn’t!) have.
I’ve served as a peer reviewer for many scholarly articles in major (humanities) journals. When I make those evaluations, what matters to me is NOT whether I agree with the author’s viewpoint. If the author knows the material, has read the appropriate sources, and constructs a substantive and supported argument, I’ll recommend publication even if I vehemently disagree with the point the author is making. If the author is clearly unfamiliar with the scholarship on the topic, doesn’t support his/her argument, etc., then I’ll recommend against publication even if I agree with the overall point. Again, it’s about quality and depth of scholarship, not about one particular viewpoint.
This reminds me of this story that made the rounds last fall and showed up on NPR. I tried to post a comment on their site challenging the premises of the two trillion (!) figure, but their comment mechanism wouldn’t let me.
http://www.npr.org/sections/goatsandsoda/2014/11/20/365514156/the-whole-world-is-fat-and-that-ends-up-costing-two-trillion-a-year
Just a few days ago, The Lancet Journal of Diabetes and Endocrinology published a study called “reversible biological adaptions in obesity” showing, for the eleventy-millionth time since 1990, diet and exercise do not result in measurable, permanent weight loss. It’s hard not to don a tinfoil hat at the temporal proximity of this obvious panic piece. “No, no, no don’t listen to those other guys! You’re still a terrible person for having a body that isn’t shaped like an hourglass and you still need to hand over all your resources and autonomy to us for the repair fee!”
This seems like a pretty great study, if anyone wants to fact-check and bias-check it to see it if is suitable to promote 🙂 http://www.techtimes.com/articles/58696/20150608/fat-can-save-you-from-heart-disease-heres-how.htm I found it in the corners of Health News next to “your toothbrush has E.coli on it” and other frivolous articles, if it’s a truly size positive study then let’s try to publicize and support it! 🙂
The “one in five” figure comes from a peer-reviewed study published in the New England Journal of Medicine (http://www.nejm.org/doi/full/10.1056/NEJMoa021423).
It took a lot of poking around to find the source. It would certainly be nice if the dozens of articles using the same quote would cite their source.
Also, this study doesn’t show causality – it simply shows the death rates at different BMIs. It’s possible that the higher numbers are caused by a lifetime of dieting, or that the heavier someone is the more likely a doctor is to ignore their symptoms, refuse to do tests, and simply diagnose them as fat and prescribe weight loss (missing the cancer entirely for who knows how long), or the fact that the poor treatment fat people receive from doctors makes them less likely to seek medical care until their cancer has progressed, or if part of the issue is the stress of the constant stigma and oppression faced by fat people. They didn’t control for any of those things in the study.
Don’t forget about under-dosing.
No kidding! For decades, I avoided the doctor like the plague. By the time I was willing to go to a doctor again, and found a good one who didn’t fat-shame me, well, it’s just a good thing I didn’t already have cancer, or I’d be dead. Did I mention decades?
Now I have one I really like, and I see him every three months, for regular follow-up (chronic disease), and I talk to him about anything that comes up and he LISTENS! No fat-shaming, and he’s willing to run tests and schedule appointments with specialists.
I love my current doctor. I hope I die (from a very quick and painless death, please) before he retires, because I don’t want to go through all this all over again, especially when I’m old and have even less strength and stamina than I have now.
I read a book earlier this year called “Less Medicine, More Health” where the author, Dr. H. Gilbert Welch, talks about “the signal and the noise.” He says to basically ignore any risk that is under 100% — and even this peer-reviewed study has a rate below that. This says your risk is increased by 52%. That means that if your risk to start with was 5%, your risk is now 7.6%. And if it was 1% to start with, it’s now 1.52%. Whoop-dee-doo.
Not only that, but 66% of the population are classified as obese/overweight according to BMI measurements (since we are talking about clinical studies here, my use of these terms will refer to the technical definition of BMI in scientific studies). If you assume that the cancer population reflects the general population, then 66% of people with cancer are overweight/obese; if only 20% of all cancers are attributed to weight, and we assume direct overlap, that’s only 1/3 overweight/obese people with a cancer that’s attributable to weight, which is kind of what Mich is saying below.
Perhaps it seems like I’m massaging the numbers, and perhaps I am! But that’s exactly what researchers do all the time.
Thanks for the great article, Ragen. I loved the coverage on the “chocolate” study!
This sounds similar to the findings published in the journal Science just last year: 2/3 cancers happen anyway, and there is 100% chance of not preventing them. This was picked up by the media as saying that: 1/3 of cancers are YOUR FAULT.
Fat people may be at higher risk for developing cancer, but are we not also more likely to SURVIVE cancer? Because we have the cushion to keep us alive, when we’re wasting away, whereas a thin person, with a wasting disease, wouldn’t last long enough for any treatment to work?
At least, that’s how I understand it.
I went to read that article, and started laughing at the headline in the picture next to the article:
“Pass the Easter Egg! New study reveals that eating chocolate doesn’t affect your Body Mass Index… and can even help you LOSE weight!”
Well, which is it? Either it helps you lose weight (thus affecting your Body Mass Index), or it doesn’t affect your Body Mass Index (which means NO weight change).
That article was a laugh riot. Or a very sad and depressing expose of our world’s modern view of “science” and “health.”
I think I’ll laugh.
Bahaha, the article you are referring to mentions the chocolate study that Ragen referred to! Yet funny, it doesn’t mention the (bogus) journal that it came from. “Diet Turbo effect” is just hilarious.
Brava, Ragen! I’m having my Intro to Sociology students read this so they can start thinking through some of the media bias in processing and reporting on statistics and research. Or, ahem, “statistics” and “research.”
Thanks, as always, for the fodder!
I just read last year over a few weeks in summer, the classic How to Lie with Statistics. I understand so much more from that. I wonder why it’s not the standard text for every course (not just math)??
I might be a terrible person, because I laughed so hard when I first heard of this.
I’m just so sick of bad research being misreported so people can hop on some new diet bandwagon that I had some serious schadenfreude.