I’ve been working on a new Protein Power site with a whole new level of functionality for this blog. I keep thinking it is going to be finished any day, and I keep getting held off for one reason or another. Since I keep thinking it’s going to be finished, I’ve held off posting anything since I wanted to post on the new, updated site.
But I came across a morsel of irony so delicious that I want to go ahead and offer it up for your enjoyment, even if I have to do it on this old, crotchety site.
As I’ve mentioned often, Medscape is an online site for physicians.** I subscribe by email and get about a dozen posts a week. These are broken out by specialty, and since I subscribe to several, I get the latest mainstream info on cardiology, gastroenterology, family practice, endocrinology, diabetology and internal medicine. (Sadly—but actually not so surprisingly—there is no Medscape for nutrition.) I usually stick these in a file and rapidly sort of cyber flip through them when I’ve got a few minutes to spare. I just came across one sent back in May that set my teeth on edge.
Then I did a little research and came up with the delicious irony.
The guy pictured above, Arthur Caplan, Ph.D., is the Drs. William F. and Virginia Connolly Mitty Professor and head of the Division of Bioethics at New York University Langone Medical Center in New York City. He gave a video presentation on Medscape titled It’s Not Genes: People Are Fat Because They Eat Too Much.
The gist of his talk is that people are overweight because they succumb to gluttony. He arrived at this conclusion, he says, after reading a paper published in the British Medical Journal correlating the geographic distribution of fast food outlets to obesity.
The basic idea, presented with a plethora of graphs and scientific sounding gibberish, is that clusters of fast food purveyors are making the people living in the surrounding areas obese. The authors of the article fall victim to the false causality fallacy. And Dr. Caplan falls right along with them.
Not only does he fall victim to this nonsense, a whole lot of other people do, too. When I last checked the comments on this video post, there were over 400, most of whom agreed with the sentiments of the video.
Since I run with a more enlightened crowd, it’s difficult for me to believe this lack of any level of understanding is as widespread as it obviously is. But I know there are many physicians out there who think this way, too.
And there are many people out there who, like Dr. Caplan, apparently don’t have the critical thinking skills to see beyond the false causality presented in the medical paper that so influenced him. It would probably be more correct to say ‘people who don’t exercise their critical thinking skills’ rather than people who don’t have them.
We can all pretty much think critically, if we put our minds to it and make an exercise of it. And we don’t even have to peruse medical journals to find people who should know better using faulty logic to make their points.
Let me show you just one quick example I’ve run across recently using false causality to show you what I mean.
Kirsten Powers, a journalist who is a Democrat, but who usually isn’t really a partisan (i.e., she is capable of seeing both sides of an issue), wrote an article for USA Today about the conservative case against the death penalty. Most people would think conservatives would be all for the death penalty, which is why this article was written. It’s kind of a man bites dog story.
(Just in case you’re wondering, I’m a fiscal conservative, but I am strongly against the death penalty. Why? Because I like to think I’m consistent in my thinking. Most conservatives – I’m no exception – feel like the government is basically incompetent and screws up many more things than it fixes. But most conservatives are pro death penalty. Which, to my way of thinking, is totally inconsistent. Why trust the ‘just’ taking of a human life to a group of people you think are mainly bumblers and incompetents and can’t even be trusted to get your license plate fees assessed correctly? Plus, I have an additional reason. I know someone, unjustly convicted of murder, who spent 18 years on death row before being released.)
In her article, Ms. Powers writes the following paragraph referring to Marc Hyden, the advocacy coordinator for a conservative group against the death penalty:
He rejected claims by death penalty supporters that it’s a deterrent to crime. [Here’s where she goes off the rails.] He’s right. According to FBI data, the South accounts for more than 80% of U.S. executions but has the highest murder rate in the country.
Let’s think this through.
Why are people executed? In almost all cases, for being convicted (rightfully or wrongfully) of committing murder. So, if according to FBI data (which we assume are valid), the South has the country’s highest murder rate, it would seem reasonable to assume it would also have the highest arrest and conviction rate for murder, and, therefore, the highest execution rate in the country. It says nothing about a deterrent effect one way or another given the data presented.
I have several more I’ve recently come across, but I don’t want the comment section in this post to degenerate into a political debate, so I’ll leave those. (Be assured that these assaults on logic are not the province of any one side of the political spectrum.) The point is, these logical fallacies appear all the time, and people of all stripes use them to make their points. You’ve got to be on guard because if you’re not thinking critically, you’ll fall victim.
Take a look at Dr. Caplan’s video: [Unfortunately, the link to Dr. Caplan’s video is no longer functional. Here is the transcript and a link to Medscape.
It’s Not Genes: People Are Fat Because They Eat Too Much
Hi. I am Art Caplan, from the Division of Medical Ethics at the New York University Langone Medical Center in New York.
Why are your patients fat? Why are people fat generally? Struggling with weight is a problem. I personally have done better with it lately, but it is a challenge. We all know we are in the middle of an obesity epidemic in the United States. Indeed, worldwide obesity is an increasing problem.
If you look at the medical literature, the answer is clear. The problem is in our genes. Again and again, in media reports and in articles that catch the attention of editors at the most prominent medical journals, the answer to why we are all fat is that we have bad genes.
Think about it. You go to a cocktail party. You are chatting with people and you start talking about weight. The person says, “I’m one of those high metabolizers (or low metabolizers),” hinting that there is a genetic or biological basis for their size. Or people will say to me, “I must have inherited bad genes. I just can’t seem to keep weight off.”
We love the genetic explanation. That is why it was so interesting to see a paper recently in the British Medical Journal that looked in a very different, but I believe a more fertile, direction for understanding the obesity problem.
Researchers from the University of Cambridge conducted a very simple study. They wanted to know how many fast-food outlets are in Cambridgeshire, the county that includes Cambridge and the university. They also looked at where people commuted to work, and whether there was any association between going by these fast-food places and obesity and diabetes.
Bad Food, Not Bad Genes
Guess what they found? If you put a bucket of fried chicken out every half-mile along the route people take to work and back, they are fatter. There is a correlation between fast-food outlets and being diabetic or being fat.
The point is this: Genes certainly play a role in how people handle food, but if you live in a culture that overwhelms you with opportunities to eat junk food and fatty food, even the best genes can easily be overwhelmed.
We are that kind of country, too. We promote eating more food. I took a ride recently from Moosic, Pennsylvania, to Wilkes-Barre. Having read this article, I decided to count how many fast-food places I could see from the road in a relatively rural area. The distance was 13 miles. I counted 19 kings, arches, colonels, and so on. Fast food is ubiquitous. Bad food opportunities are everywhere.
If we are going to get a handle on the obesity epidemic, then we need to stop saying, “All you have to do is control your diet, and somehow manage the responsibility that your genes gave you.” Telling people they have a genetic basis for obesity is kind of an excuse, or an easy way out.
We also must begin to say, “Hey, those places you drive past, those places that are advertising and marketing? They are dangerous for you. You might want to avoid them.” I think we have to ask people and patients, “How often do you go? How often are you eating there? Do you realize that even if a place has a salad on the menu, if you get 3 Big Macs and French fries, it does not matter that a salad is on the menu?”
We must start taking more seriously the dangers that are out in the environment. We also should think about telling our patients that a lot of fast-food promotion and fast-food presence is leading to some of the problems that their kids have.
Maybe a better philosophy is to make it a special treat to go to one of these outlets, rather than going simply because you have run out of ideas about what to do in terms of getting a quick and easy meal. It may be quick. It may be easy. But as this study showed, it is dangerous.
Let us not point the finger of blame at our genes or say, hey, exercise some self-control [without providing some kind of support]. Let us realize that in a world in which temptation is put out all around us, that is a problem we have to discuss with patients too.
Is your blood boiling? Isn’t it comforting to know that at least someone, somewhere categorically knows the solution to the obesity problem? Even though other equally learned people fiercely debate why it is that people get fat.
Maybe, though, Dr. Caplan is a lot smarter than all the rest of us. According to his Wikipedia entry, he is the author or editor of thirty-two books and over 600 papers in peer-reviewed journals of medicine, science, philosophy and health policy.
Not only that, according to the same source, he
is the recipient of many awards and honors including the McGovern Medal of the American Medical Writers Association and the Franklin Award from the City of Philadelphia. He was a person of the Year 2001 from USA Today, one of the fifty most influential people in American health care by Modern Health Care magazine, one of the ten most influential people in America in biotechnology by the National Journal and one of the ten most influential people in the ethics of biotechnology by the editors of Nature Biotechnology. He holds seven honorary degrees from colleges and medical schools. Discover magazine in December, 2008 named him one of the ten most influential people in science. In 2014 he was given the public service award of the National Science Board/National Science Foundation.
As I say, I’m sure Dr. Caplan is a very smart guy. But even smart guys don’t look so smart when they stray into areas about which they know very little. And when in the thickets of strange science, they, like everyone else, can become entangled in various logical fallacies.
If we simplify his video monologue, here is how it plays out. Dr. Caplan reads a medical article, filled with a lot of scientific looking graphs and diagrams, arguing that many obese people live near fast food restaurants and drawing the conclusion that the fast food outlets cause the obesity. Dr. Caplan is perhaps predisposed to this point of view anyway (which is just a guess on my part since I have no idea what goes on in Dr. Caplan’s brain), so he decides to check it out.
As Yogi Berra is alleged to have said, “You can see a lot just by looking.” So Dr. Caplan takes a look along a road he’s driving and finds a total of 19 fast food outlets. He decides that the paper is true, fast food outlets do lure people into eating too much and cause obesity.
I would argue that John Lennon’s take on it would be more apropos: “Living is easy with eyes closed, misunderstanding all you see.”
As I know from bitter experience, operating a restaurant is an expensive operation. My experience, thank God, was on a small scale, so it didn’t totally bankrupt me, but came damn close. Unlike me, site location experts for giant chain restaurants don’t just drive around aimlessly and all of a sudden say, Hey, this looks like a great place to put a McDonald’s. These giant outfits spend millions of dollars in demographic research to make sure they put their outlets in locations where there are plenty of customers.
They find the overweight people, then plant their stores in the middle of them.
If Dr. Caplan saw 19 fast food outlets on his drive, then I can guarantee you the site developers for those 19 restaurants – even of the 19th one that went in – had determined there were enough customers in the area to keep the cash registers ching ching chinging.
Even if fast food outlets did cause obesity instead of simply supporting it, anyone who has seen Tom Naughton’s brilliant movie Fat Head knows making the appropriate selections – even at a McDonald’s – can help your weight-loss efforts, not hinder them.
Now for the delicious irony…
I was searching for Dr. Caplan’s video on YouTube, so I wouldn’t have to rely on my own limited abilities to record it from Medscape. And during my search, I discovered that Dr. Caplan is quite the bon vivant and lover of good food (actually, he sounds like just the kind of guy I would like to hang out with). And I mean good food in the fast food, truck stop, diner sense of down home, comfort food (read: high carb, high fat, high everything). In fact, Dr. Caplan narrates what appears to be a TV show, doing reviews of these kinds of greasy spoons. Interestingly, this hobby of Dr. Caplan’s somehow got left out of his Wikipedia entry.
Take a look. And bear in mind while watching, this is the same guy who is exhorting you in the video above not to fall prey to the ads for fast foods lest you succumb to their siren’s song and explode into obesity overnight. If someone wrote this as fiction, no one would believe it.
If you search YouTube for Art Caplan, you’ll find a bunch more.
If you would like to learn more about all the logical fallacies we can all fall prey to, give The Art of Thinking Clearly by Rolf Dobelli a look. It’s an easy to read, fun book with a few pages devoted to each fallacy. Nassim Nicholas Taleb goaded Dobelli, his Swiss novelist friend, into writing the book, so it’s much better written and a lot more enjoyable than most books written by logicians.
**Although Medscape is a service targeting physicians, you can get a free subscription whether you’re a doc or not. Just go to Medscape and sign on as a guest.