I work in public health as well and when I heard this episode, I sat down to outline all the misunderstandings and bad faith arguments I heard, but it was such a tangled web, I gave up. Thanks for doing this, it was an interesting read.
This has been a relief for me to find you. I greatly appreciate the nuance and detail with which you’ve criticized the glib and patently false claims of Maintenance Phase. These two twittery millennials lack the patience, analysis, and depth to pursue these topics with any rigor. The podcast has annoyed me for months. My hat is off to you!
Hi! I was sent here from reddit, this is incredible work, thank you for your service! I’m a research scientist and my background is in psychology, so while I understand stats stuff I don’t understand the epidemiology bit as much. I’m curious - in the Flegal and Mokdad papers, was BMI used as a continuous variable or categorical in the analyses? Because if it was used as a continuous variable, and then at the end the ranges of BMI were grouped by category to explain the results, then the issue that Michael is saying about the self report data doesn’t matter. But if each individual reported their weight (within some margin of error) and then were categorized right away into a BMI category then I can see how the margin of error could have more impact for some individuals than others in terms of which BMI category they fall in. But as you point out, self report isn’t the big issue.
Hi Erika! I'm glad you found me! Psych is very stats-heavy so I appreciate you being here and would love any feedback you might have. :) The papers used BMI categories for the models. It's worth noting, though, that the results from the Allison paper (see Table 3: https://jamanetwork.com/journals/jama/fullarticle/192032) do not differ meaningfully across datasets, regardless of self-reported or measured BMI. So I'm not convinced that self-reported BMI is as big of an issue here as Michael suggests!
I had no idea about this podcast, saw it a couple of times in the app, but never listened. I started reading your blog without listening to the podcast and will continue to do so through an RSS feed - don't mind me for not subscribing through e-mail, but it is way too cluttered.
You are harsh, yet right, on your criticism regarding journalism. I will go the extra mile and look at the discourse around the podcast, the praise the hosts get from journalists who base their whole opinion on listening to an episode and hearing something that confirms their bias. In writing that, a journalist (a profession I also practice) may think that they take a stance against Something, though they reproduce poor quality and low standards.
Thanks for sharing this piece! I hadn't realized that she had a documentarian follow her around. Very interesting. I don't mean to be too harsh, but I do think we have to hold journalists to a higher standard than what Aubrey and Michael are putting out through this podcast.
"That’s false. I’m not sure what Aubrey’s definition of “evidence-based” is. But there are many evidence-based treatment strategies." I'd love to know what these are, because I'm yet to find one that has worked for me
Hi! Thanks for reading. I'd first say that "evidence-based" doesn't mean "works for every individual." So just because it hasn't worked for you doesn't mean it isn't evidence-based. Anyway, there is evidence backing diet-based treatments, behavioral/lifestyle-based treatments, and pharmacotherapy as well as surgical options. Here is a review of many long-term studies of behavioral and pharmacological interventions: https://www.bmj.com/content/348/bmj.g2646
The thing is, this isn't peer review! Michael and Aubrey have a TON of sass and attitude. I have very little, other than pointing out how problematic their content is. You seem to have a double standard. Anyway, the great news is that a lot of people really appreciate my writing, so I'm going to keep doing it the way that other people enjoy it.
I'm not arguing anything - I am detailing the facts. The statement "the earliest connotation of BMI was the fattest 15% of people would be considered overweight" is false. The BMI categories were "based on the 85th percentile of BMI for men and women aged 20-29." That means that the cutoff was the BMI which 15% of 20-29 year olds were over. This does not mean that 15% of the entire population (i.e., all ages) was over that BMI. So again, yes, Aubrey IS misrepresenting statistics and lacking attention to detail. I'm not here to "prove" anything about Aubrey. I'm posting to present the actual facts and show how MP is getting things wrong.
Ok, so you are saying that the misrepresentation was that she generalized the results of the study to include all ages of people rather than people 20-29?
Oh this clarification was so helpful! I thought the problem was that the 85th percentile is not the top 15% and I was like shit I don’t understand percentiles.
I am aware that the screnshot you shared is from the book she references. My point is that I was not able to check the rest of the book to see if it references Tobias Venner's Via Recta ad Vitam Longam from 1620.
Ok. Let me try this a different way. The book, which Aubrey cites, quite literally says that the notion of an obesity epidemic goes back to the 1860s. That is counter to what Aubrey says. You googled something and found another thing which she did NOT cite and now you are reaching to defend her by suggesting that this book would cite that thing. But if this book cited that thing, it would NOT say that the term originated in the 1860s. The book does cite Venner, but in other contexts. Because, again, the origin of the term "obesity epidemic" was not from 1620. Even the Wikipedia page, which may be where you are getting your information, does not suggest that. Since you Googled that, you can Google what the content of Via Recta ad Vitam Longam is. It does not say anything about an "epidemic."
I work in public health as well and when I heard this episode, I sat down to outline all the misunderstandings and bad faith arguments I heard, but it was such a tangled web, I gave up. Thanks for doing this, it was an interesting read.
Thanks for reading! I'm glad it was interesting. Would also always welcome your thoughts/comments if you have things to add! :)
This has been a relief for me to find you. I greatly appreciate the nuance and detail with which you’ve criticized the glib and patently false claims of Maintenance Phase. These two twittery millennials lack the patience, analysis, and depth to pursue these topics with any rigor. The podcast has annoyed me for months. My hat is off to you!
Just saw this now, Elizabeth! Thank you for reading and for the kind words! Glad to know I'm not the only one who feels this way about the pod!
This is great, important work. Thank you!
Thank you for reading! :)
Hi! I was sent here from reddit, this is incredible work, thank you for your service! I’m a research scientist and my background is in psychology, so while I understand stats stuff I don’t understand the epidemiology bit as much. I’m curious - in the Flegal and Mokdad papers, was BMI used as a continuous variable or categorical in the analyses? Because if it was used as a continuous variable, and then at the end the ranges of BMI were grouped by category to explain the results, then the issue that Michael is saying about the self report data doesn’t matter. But if each individual reported their weight (within some margin of error) and then were categorized right away into a BMI category then I can see how the margin of error could have more impact for some individuals than others in terms of which BMI category they fall in. But as you point out, self report isn’t the big issue.
Hi Erika! I'm glad you found me! Psych is very stats-heavy so I appreciate you being here and would love any feedback you might have. :) The papers used BMI categories for the models. It's worth noting, though, that the results from the Allison paper (see Table 3: https://jamanetwork.com/journals/jama/fullarticle/192032) do not differ meaningfully across datasets, regardless of self-reported or measured BMI. So I'm not convinced that self-reported BMI is as big of an issue here as Michael suggests!
I had no idea about this podcast, saw it a couple of times in the app, but never listened. I started reading your blog without listening to the podcast and will continue to do so through an RSS feed - don't mind me for not subscribing through e-mail, but it is way too cluttered.
You are harsh, yet right, on your criticism regarding journalism. I will go the extra mile and look at the discourse around the podcast, the praise the hosts get from journalists who base their whole opinion on listening to an episode and hearing something that confirms their bias. In writing that, a journalist (a profession I also practice) may think that they take a stance against Something, though they reproduce poor quality and low standards.
Apparently some documentarist followed her around for years to document her rise to stardom - https://www.theguardian.com/film/2024/jan/26/your-fat-friend-documentary-aubrey-gordon-jeanie-finlay-interview - though from this Guardian piece it shows nowhere an interrogation of her research.
Thanks for sharing this piece! I hadn't realized that she had a documentarian follow her around. Very interesting. I don't mean to be too harsh, but I do think we have to hold journalists to a higher standard than what Aubrey and Michael are putting out through this podcast.
"That’s false. I’m not sure what Aubrey’s definition of “evidence-based” is. But there are many evidence-based treatment strategies." I'd love to know what these are, because I'm yet to find one that has worked for me
Hi! Thanks for reading. I'd first say that "evidence-based" doesn't mean "works for every individual." So just because it hasn't worked for you doesn't mean it isn't evidence-based. Anyway, there is evidence backing diet-based treatments, behavioral/lifestyle-based treatments, and pharmacotherapy as well as surgical options. Here is a review of many long-term studies of behavioral and pharmacological interventions: https://www.bmj.com/content/348/bmj.g2646
This is also a great review of the evidence for multiple types of treatment: https://www.sciencedirect.com/science/article/pii/S0735109713060300?via%3Dihub
The thing is, this isn't peer review! Michael and Aubrey have a TON of sass and attitude. I have very little, other than pointing out how problematic their content is. You seem to have a double standard. Anyway, the great news is that a lot of people really appreciate my writing, so I'm going to keep doing it the way that other people enjoy it.
I'm not arguing anything - I am detailing the facts. The statement "the earliest connotation of BMI was the fattest 15% of people would be considered overweight" is false. The BMI categories were "based on the 85th percentile of BMI for men and women aged 20-29." That means that the cutoff was the BMI which 15% of 20-29 year olds were over. This does not mean that 15% of the entire population (i.e., all ages) was over that BMI. So again, yes, Aubrey IS misrepresenting statistics and lacking attention to detail. I'm not here to "prove" anything about Aubrey. I'm posting to present the actual facts and show how MP is getting things wrong.
Ok, so you are saying that the misrepresentation was that she generalized the results of the study to include all ages of people rather than people 20-29?
Yes. That's a pretty important distinction and it's not hard to get that right if you do your research.
Oh this clarification was so helpful! I thought the problem was that the 85th percentile is not the top 15% and I was like shit I don’t understand percentiles.
You're good, hah! Let me think about how to reword this to make it clearer. I appreciate your comment!
Hi! The screenshot in the post is from the book she explicitly referenced as the source of that information.
I am aware that the screnshot you shared is from the book she references. My point is that I was not able to check the rest of the book to see if it references Tobias Venner's Via Recta ad Vitam Longam from 1620.
How would that matter? Aubrey cited this specific book. This specific book explicitly does NOT say what she says it does.
I'm telling you I can't verify that because I do not have access to the entire text of the book.
Ok. Let me try this a different way. The book, which Aubrey cites, quite literally says that the notion of an obesity epidemic goes back to the 1860s. That is counter to what Aubrey says. You googled something and found another thing which she did NOT cite and now you are reaching to defend her by suggesting that this book would cite that thing. But if this book cited that thing, it would NOT say that the term originated in the 1860s. The book does cite Venner, but in other contexts. Because, again, the origin of the term "obesity epidemic" was not from 1620. Even the Wikipedia page, which may be where you are getting your information, does not suggest that. Since you Googled that, you can Google what the content of Via Recta ad Vitam Longam is. It does not say anything about an "epidemic."