Fitness Magazine

I Don’t Have Any Evidence But…

By Danceswithfat @danceswithfat

I Don’t Have Any Evidence But…

Today I was on HuffPo Live to talk about childhood obesity.  I was on the panel with Autumn Whitefield-Madrano from The Beheld which is a blog that I like, two self-identified “childhood obesity experts” both of whom were fat children, are now thin adults and claim to help children lose weight professionally, and the guy who runs the weight loss camp that was featured on MTV’s “Fat Camp.”  You can see the full segment online.  It was frustrating because it was 3 against 1, so I wasn’t able to correct all of the misinformation – confusing correlation with causation, substituting anecdata for actual data etc. without inappropriately dominating the conversation, but I did the best that I could.

What I want to talk about is what happened when the cameras went off.  We continued to talk in the online chat room.  I suggested that they look at evidence  – Wei et. al, Matheson et. al, the Cooper Institute Longitudinal Studies that show that habits are a much better indicator of future health then body size.

I pointed out that University of Minnesota researchers found that “None of the behaviors being used by adolescents (in 1999) for weight-control purposes predicted weight loss (in 2006).  Of greater concern were the negative outcomes associated with dieting and the use of unhealthful weight-control behaviors, including significant weight gain.”

I mentioned that a study that tracked 15,000 participants and was published in the Journal of Paediatrics,  found that adolescents who were put on diets were significantly more likely to gain weight than those who were not.

Autumn was respectful and helped support me in getting space to talk when others were trying to steamroll me. None of the three self-identified childhood obesity experts  named a single study to refute what I was saying or support their position. One claimed to know the research (though never citing any) but said that they didn’t need all these scientific studies  and evidence because they have common sense. Ah the cult of “everybody knows.”

This is not limited to the person who said it – I hear it all the time. “Studies change but I know in my gut…” or “I don’t have research but just do a Google Obesity and read some of the news stories….” So our kids’ health is at stake and we are dealing with a whole profession of people who call themselves childhood obesity experts, and make money with promises of weight loss for kids, who not only don’t have evidence to support their methods, nor refute evidence that suggests that their work does more harm than good; but who, terrifyingly, don’t seem to think that matters.

I’m pretty sure “I don’t need evidence, I have common sense” is what they said to Galileo.

To provide clarity, let’s do a quick exercise inspired by reader Ericka:

A child needs their arm amputated.

Their first option is someone who amputated their own arm during a climbing accident and succeeded despite near impossible odds, and plans to do the amputation guided by common sense and his own experience.

Their second option is a doctor who went to medical school and studied the research and evidence that have come from hundreds of thousands of arm amputations,  has performed many such amputations using this information, and plans to use that same information to perform this man’s surgery.

Who do you want treating this child?

One person’s experience is not extrapolatable to others.  The fact that someone was a fat kid and became a thin adult does NOT prove that everyone else can do it – or that anyone else can do it.  Just like the fact that I’m a 300 pound National Champion Dancer doesn’t prove that every 300 pound person can be a National Champion Dancer – that’s why we have studies. Every scientist knows that they could be wrong, but to suggest that common sense and personal experience are a substitute for information gleaned from a statistically significant sample size through a properly designed study is ludicrous, dangerous and, unfortunately, really profitable in the adolescent weight loss industry.

It would be bad enough if people who claim that they can help kids lose weight were just making fat kids into lab rats by testing out their unproven hypotheses on them, but what they are doing actually flies in the face of the evidence that does exist. Again, there are no studies that show that any weight loss interventions are successful in the long run.  There are studies that show that weight control attempts in kids leads to weight gain and eating disorders (in fact, hospitalizations for eating disorders in kids under 12 are up 119% in the last decade.  Kids.  Under.  Twelve.)

If we’re going to have a discussion about our experiences, then that is a valid discussion and is worth having and each of us is the best witness to our own experience – but let’s not confuse it with a discussion of how to approach kid’s healthcare.  If we are having a discussion about children’s health interventions then it has to be based on evidence – our kids deserve better than anecdata and somebody’s so-called common sense.

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