Three Tribes of Obesity
Last week’s immersion in ObesityWeek provided a stimulating exposure to crosscurrents from three tribes of obesity. It’s enough to make you dizzy.
Healthies swim ably in “the modern food supply and sea of technology” that people such as David Katz of Yale University imagine to be the primary source of obesity. Calls for attention to treatment of obesity are seen as reminders of unfortunate failures to prevent it. People with obesity are to be treated with “informed compassion” that drips with condescension. If we are lucky, they will allow for the provision of treatment options to those poor souls who have fallen into the trap of a predatory food industry. “What’s left to research?” asks a general from this tribe.
Quants sing an unwavering hymn of “show me your data.” They provide regular and annoying reminders of how much we need to learn about obesity and keep asking for randomized, controlled trials that can be challenging to conduct.
Buttouts are a fiercely independent tribe. They don’t like the tut-tutting they hear from the Healthies and they aren’t very patient with the Quants. Some of them are dealing with obesity on their own terms and some of them simply reject the construct of obesity as a disease. Others are studying it as a purely social phenomenon.
We’d like to teach this world to sing in something that resembles harmony, but it seems most unlikely.
Click here to read more on political tribalism from the American Conservative and here to read it from Mother Jones — whichever source your tribe may read.
Navajo Tribal Sheep, photograph © Donovan Shortey / flickr
Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.
November 14, 2014 at 9:18 am, Reeger said:
Ted,
When I first clicked on this I thought I would be reading about ASMBS, ASBP, and TOS. I still would like to read about the history and connection versus disconnection of those three organizations but I am not disappointed by your observations in this piece. Our biological imperative to “tribe up” is very fascinating and I agree with the divisions you have observed.I recently encountered a physician who acquired a patient who successfully lost weight on Qsymia but the physician took the patient of the medication after three months because he felt there was not enough data to support the patient being on the medication longer. The patient consequently regained his weight. I asked this physician if he still felt justified in his decision and he yes.
Of your three categories, when I ponder which tribe I might belong to, I do not have a clear-cut answer. Therefore I believe you need a fourth category, “Trench Runners.” The trench runner is someone who is in the trenches every day, working, keeping their head down, helping where they can and running between the three tribes grabbing what bits of information and assistance they can to help those in need. That’s me. That’s many of us.
Kindly,
Reeger
November 14, 2014 at 9:28 am, Ted said:
Reeger, I think you’re right about the trench runners. Not everybody has pledged allegiance to a single tribe, thank goodness.
November 14, 2014 at 11:23 am, Casey said:
Which tribe says kids shouldn’t be targeted with marketing for junk food?
November 15, 2014 at 9:06 am, Ted said:
My guess is that the healthies would most strongly endorse that one. The quants would want to study it. The buttouts might tell you to…