Island Life: The Prime Minister will see you now
324 Responses
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We live to learn, or learn to live,eh :) Gracias
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I think some auto-formatting buttons as used in Wikipedia edit-boxes would do the trick. Also embedding JPGs, GIFs & PNGs.
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Christ. I'm using interweb conventions so archaic that people have no idea what they are! I feel old.
the emphasis does seem to concentrate on the health effects rather than any blame
I think that can quite often depend on the medical professional you're dealing with at the time. There are some American studies (a couple are in the Journal of Obesity Research, 2003) which discovered that many GPs had underlying negative attitudes to their obese patients, associating them with laziness, stupidity, and worthlessness, and that obese patients' treatment for anything else (cancer screenings, say) was more likely to be delayed or put off, either because doctors were more likely to blame everything on obesity even if the illness was irrelevant to that condition (I have actually seen this happen to someone I know!), or because patients tried to avoid their doctors altogether and put off their own preventative medical care.
Obviously, that's really really really not good. If you dread going to the doctor, and the doctor thinks you suck because you're a fatty, yet because you're a fatty you *should* (oops, I did it again) be going to the doctor more than other people (I am kinda dubious about this point, but whatev), there's clearly a self-defeating spiral of crapola in the making...
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Christ. I'm using interweb conventions so archaic that people have no idea what they are! I feel old.
You feel old, I feel odd :)
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The more *blame* is taken away from the whole obesity equation, the better. Information, and education - and support- work. Blame doesn'.
Sure. But since nobody here is blaming anybody for anything (right?), responding with rants makes me wonder whether obesity as a health issue can be talked about at all. Because it is an issue, correct? I take Danielle's point about the non-existence of any such thing as a medical Objectivity Vacuum outside society, but the response is surely to have more discussions that are aware of judgment issues.
I also happen to think that some blame actually exists: in the diet industry, in the food industry, in urban planning and in the way we do work, to name but a few. Banning advertising on soft drinks and fast food chains, and putting health advisory warnings on some diet books I don't think would be out of place. Likewise building cities and our timetables in a way that make it easier to walk and cycle, and perhaps a little less easy to drive.
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But since nobody here is blaming anybody for anything (right?), responding with rants makes me wonder whether obesity as a health issue can be talked about at all.
I think Ben's posts about how sneaky and duplicitous The Fatties are with their food intake were pretty insulting and judgemental in a couple of different ways. Particularly (as Dyan noted) since people can and do become obese without eating much at all.
I also happen to think that some blame actually exists: in the diet industry, in the food industry, in urban planning and in the way we do work, to name but a few.
Yeah, but for some reason we don't talk about that stuff so much. Which is a bummer.
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Allowing sugary drinks with no nutritional value to be widely sold to children makes as much sense as cigarettes being legal.
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Love to hear a "more market" solution to either of those.
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Thanks Danielle. Failure to read backwards on my part. I thought Dyan was the terminal of the rants and that perplexed me greatly.
Yeah, but for some reason we don't talk about that stuff so much. Which is a bummer.
Those are easy targets, though. I think there'd be a lot to say about our relationships to food as well, but that's harder to do without perpetuating the old "you eat badly, therefore you are a bad person" thing. In that respect I do wonder sometimes about vegetarianism/veganism and to what extent they might reflect the frustration of being unable to find a space for political expression elsewhere, but I'm reluctant to say so because it's, well, judgmental and unfairly dismissive.
But deeper (and perhaps a little more usefully) than that, I think we are so ignorant of just what it is that we eat, to a dismaying extent in fact, and that's bad politically, socially, for our health. I find Michael Pollan's work very important in that regard.
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And yes, she's a critic of the food industry and her surname is Nestle
She sounds sweet.
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Love to hear a "more market" solution to either of those.
Abolish public healthcare, so that obese poor people die, preferably before breeding.
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The first study of estrogen as a preventative measure for heart disease was done solely on men. Isn't that nutty?
Danielle, you are not in a position to have any relevant opinion on the value of a study like this unless you are conversant with at least the basics of endocrinology, biochemistry, clinical chemistry, histology, physiology, cardiology and epidemiology.
Read up on the subject and you will certainly revise your opinion on the nuttiness of any study involving the role of estrogen in men with cardiovascular disease. For instance:
Cardiovascular Actions of Estrogens in Men by Krishnankutty Sudhir and Paul A. Komesaroff from The Journal of Clinical Endocrinology & Metabolism
"Although in men estrogens are produced in significant quantities by local tissue aromatization of androgenic precursors from the testes and adrenal glands (5), there has been relatively limited study of the biological role of these hormones or their clinical implications. An investigation conducted 25 years ago into the cardiovascular effects of estrogen administration in men after myocardial infarction, the "Coronary Drug Project" showed an excess of deaths and recurrent infarction in the treatment group. This trial, which employed high doses of conjugated equine estrogens, was subsequently abandoned, and the subject has not been studied in detail since (6). Data gathered over the last quarter century on the epidemiology of cardiovascular disease, the mechanisms of actions of estrogens in women and men, and the biological role of endogenously produced estrogens in men, suggest that it might be time to re-open the Coronary Drug Project file, and re-assess the potential for estrogen therapy in men. Newer approaches to treatment and an ability to identify more preciselyindividuals at risk of coronary heart disease (CHD) may lead to new clinical applications for this group of hormones."
You suggest that the use of only men in studies done in the previous century was somehow a sexist or cultural bias held by the medical research community. Are you aware that the first symptom of heart disease in women is often death? Men with CVD are likely to survive 4 events, whereas women usually present with CVD much, much later in life and often just die from the first event.
Men are rarely used in studies on the treatment of breast cancer yet men suffer from breast cancer, and it is very likely their needs for treatment of this disease differ from those of women with breast cancer. Do you interpret this as a bias against men?
You and the profoundly unqualified person who writes Junk Food Science make a lot of very wrong assumptions about the validity of medical research and the motives of the researchers.
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Danielle if you are genuinely interested in this subject (I am fascinated by medical science myself) you might get something from these papers also.
Complex Actions of Sex Steroids in Adipose Tissue, the Cardiovascular System, and Brain: Insights from Basic Science and Clinical Studies.
J. L. Turgeon, M. C. Carr, P. M. Maki, M. E. Mendelsohn, and P. M. Wise (2006)
Endocr. Rev. 27, 575-605Sex-related dimorphic response of HIF-1{alpha} expression in myocardial ischemia.
M. Zampino, M. Yuzhakova, J. Hansen, R. D. McKinney, P. H. Goldspink, D. L. Geenen, and P. M. Buttrick (2006)Stimulation of N-Terminal Truncated Isoform of Androgen Receptor Stabilizes Human Ether-a-go-go-Related Gene-Encoded Potassium Channel Protein via Activation of Extracellular Signal Regulated Kinase 1/2.
Z.-Y. Wu, K. Chen, B. Haendler, T. V. McDonald, and J.-S. Bian (2008)
Endocrinology 149, 5061-5069 -
Men are rarely used in studies on the treatment of breast cancer yet men suffer from breast cancer
What? This is hardly fair. Do women get testicular cancer? Who wrote this book anyway? Dammit!
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You suggest that the use of only men in studies done in the previous century was somehow a sexist or cultural bias held by the medical research community.
I'm afraid, Dyan, that the concept of sexist bias in medical research is not my idea, has nothing whatsoever to do with Junk Food Science, and has been a rather well-discussed and researched tenet of feminist medical history for at least 30 years. Perhaps you could take this issue up with feminist medical historians? There are a fair number of them.
Danielle, you are not in a position to have any relevant opinion on the value of a study like this unless you are conversant with at least the basics of endocrinology, biochemistry, clinical chemistry, histology, physiology, cardiology and epidemiology.
I am really trying to maintain politeness here, Dyan, but, um, sheez. I even used references. Frankly, I don't think my viewpoints are particularly extreme, I don't think what I'm saying is particularly crazy, and I don't think you're likely to hector me into submission any time soon. Sorry.
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I am really trying to maintain politeness here, Dyan, but, um, sheez. I even used references. Frankly, I don't think my viewpoints are particularly extreme, I don't think what I'm saying is particularly crazy, and I don't think you're likely to hector me into submission any time soon. Sorry.
My apologies, I'm sorry if I was rude, I don't mean to hector you, only to contradict your point.
Your opinion that a study on the effects of estrogens on CHD in men is nutty is puzzling, and anyone in the field would find it so.
I am not entirely sure why you found the study nutty, but am I wrong in assuming your assessment is made from a position of complete ignorance of the subject? What is nutty about studying the role of estrogens in men with CHD?
This isn't meant to be insulting, but either you are conversant with the relevant fields and your opinion is informed, or you are ignorant of the field and your opinion is not relevant.
The study of estrogens in men with CHD is not nutty at all. The excerpt I chose (which should be fairly easy to understand even by those with no background in the field) should explain to you why these studies are far from nutty.
I hope you don't thing ignorant means the same thing as stupid - it doesn't. I am profoundly ignorant in the field of computer software design - I may have opinions as to the user-friendly aspects of software design, but I don't really have any opinion about the field of study, and if I did, it would be an irrelevant opinion that would be from a position of complete ignorance. Hope this helps!
Sorry if this sounds like hectoring.
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Sorry if this sounds like hectoring.
It kind of does, Dyan, even though I accept that's not your intent.
Knowledge is not black or white - except where science is unable to resist making it so. I respect that having a clinically relevant opinion requires certain training - but there are other perspectives which provide relevance.
From cultural studies or feminist angles, the word "estrogen" means something beyond clinical or scientific considerations. The folks here bring depths of expertise in many different fields. The cross-pollination can be delightful as well as fractious at times.
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Sacha. Thank christ. I was beginning to feel slightly batty. (Not unusual.)
This isn't meant to be insulting, but either you are conversant with the relevant fields and your opinion is informed, or you are ignorant of the field and your opinion is not relevant.
Dyan, I think you might be Mr Spock. ;)
Here's the thing. That particular study example is cited in quite a lot of feminist medical history (even some written by MDs, whom I presume are 'conversant enough with the relevant fields' for you) as an example of sexist bias in medical research. Now, perhaps they are all, uniformly, using a terrible example, but I didn't make it up out of thin air. (In fact, it was part of the background research for my thesis, which was about the contraceptive pill. You might recall that the introduction of the contraceptive pill from 1960 or so was fraught with difficulties for many women because synthetic progesterone and estrogen had been *insufficiently tested on women* - the drug was rushed onto the market. That's how you get fun things like a higher risk of thrombosis, because the dosages were too strong. Etc.)
So let's get meta: the damn study about the estrogen is actually a long, tortured way from my larger point, which is that thing about the Objectivity Vacuum and how it doesn't magically exist, and that research may reflect inherent bias on the researchers' part, and so therefore we should be questioning and analytical about things like that.
Now, Dyan, you don't think sexist (or other cultural) bias exists in medical research, so you believe in the Objectivity Vacuum. I just happen to disagree with you, and my clinical ignorance is... how do I put this... 'not relevant' to that point.
Also, I know I'm not stupid. Cheers though.
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So let's get meta: the damn study about the estrogen is actually a long, tortured way from my larger point, which is that thing about the Objectivity Vacuum and how it doesn't magically exist, and that research may reflect inherent bias on the researchers' part, and so therefore we should be questioning and analytical about things like that.
Of course, although climate change deniers often make appeals to healthy scepticism and wanting to question the received wisdom of science too. It seems to me that the evidence with regards to the problems we are facing due to the rise in obesity is mounting to the point where we might have to admit there is in fact a problem.
(That was quite possibly the most awfully worded sentence I've ever written, so I'm going to leave it like that for its kitsch value.)
Regarding feminism and the Objective Vacuum thing, I am rather indebted to the mind broadening powers of this book.
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This isn't meant to be insulting, but either you are conversant with the relevant fields and your opinion is informed, or you are ignorant of the field and your opinion is not relevant.
Dyan, I think you might be Mr Spock. ;)
Actually, that bore a striking, pretty much word for word resemblance to something that Chairman Mao once wrote.
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Of course, although climate change deniers often make appeals to healthy scepticism and wanting to question the received wisdom of science too.
Dude! I am not a denier about Teh Fat! I just question the current batch of shitty 'solutions'.
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Goodness I go away for a week and I've started a shitfight?
Danielle, if you think my having an opinion on fatness based on observations of both myself and other people around me is insulting, judgmental and anecdotal, then all I can say is: Too bad. They're still based on actual observations and I don't need to study for 50 years to know that overeating makes you fat as. I've tried it. I've also tried eating less, and lost fat. It doesn't take a genius to see the correlation. It doesn't take all sorts of sophisticated analysis and endless science.
I'm not judging fat people. I'm just saying something obvious. Cretinously obvious. The kind of obvious you have to be trained not to see. The kind of obvious that I refuse to not see.
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Cretinously obvious.
Yeah, most people can control their own body weight within a 10-20 pound range. That's certainly true. When it comes to obesity and things like type two diabetes or PCOS, however, you're just pulling your 'cretinously obvious' information completely out of your ass. You want references?
I'm not judging fat people.
Uh-huh. They're just lying to themselves and others about food, and you know allllll about their lives. But you're not judging.
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Danielle, I don't care what issues you have with me, or what information you require. The simple fact is that fat comes from eating food. Period. It really is that simple. And yes, denying that is lying. And no, I'm not judging. I know and like a lot of fat people. Most people I know and like are fat. I don't think any less of them as people. But I don't think they know JACK SHIT about losing weight, despite most of them having spent a lot more time than me studying everything known to man about nutrition.
Yeah, most people can control their own body weight within a 10-20 pound range.
I don't care what most people can control. The point is it can be controlled. By the most simple advice that can be given. The only barrier to it working is actually following it.
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By the most simple advice that can be given.
That's kind of Marion Nestle's point: the food industry has been trying to fudge that advice, complicate what is essentially a very simple message that ought to work for most people. (And again, I'm speaking strictly of averages, not individuals. On average, we're getting fatter, and it's a problem. If we could bring that number down, it would be great.)
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