Economists’ weight loss plans

What do car mechanics and doctors have in common? They know that the very first step in deciding the best way to fix something is to make sure from the get go that they’ve correctly diagnosed the problem and its cause. While the steps they take in the course of their work may be similar, professional car mechanics would never profess to have the expertise to practice medicine, and vice versa.

Few of us would think to go to our car mechanic for medical advise, either, any more than we would go to our accountant. So why do public health officials and the media look to economics majors for medical information and health policy solutions?

When economists have addressed obesity, their strategies have shared similar problems. First, they define the issue as being that an epidemic of obesity exists and that it’s a societal health crisis. Critical examinations of the facts behind these premises are nonexistent. They then adopt popular beliefs about the causes for obesity and proceed to apply economics to suggest solutions. Critical examinations of clinical research and understanding of the medical science are equally absent.

Economics — a social ‘science’ that looks at the supply and demand of goods and services — approaches body weight like it would balancing a checkbook. Harvard economics professors, led by David M. Cutler, in their classic 2003 paper “Why Have Americans Become More Obese?” explained the methodology:

“We start with some basic energy accounting....Calories in versus calories out.”

But, as we know, medical research and obesity researchers long ago disproved the belief that obesity is simply a matter of calories in-calories out. Nor is it due to eating some certain diet or not engaging in some ideal volume of activity. So, not unexpectedly, we get some of the most unsound (to downright wacky, wasteful and risky) ideas about obesity from economists.

Working women and food costs

According to the Harvard economists, their equation can be used “to estimate the net caloric imbalance behind the obesity epidemic.” Hence, economists balance calories produced in the food supply and calories spent in various activities. In this paper, they proposed a new theory as to the cause of “the obesity epidemic:” women spending less time at home cooking food and cleaning than they did in 1965.

The newest paper just released from the National Bureau of Economic Research said it had to be that people were eating more calories. Using their energy accounting and working backwards from the weight they estimated people have gained, the economists pointed to various societal changes associated with rising weights as being the reason why the developed world was obese: a 10% increase in the female labor force was associated with an increase of about 70 calories; lower food prices were associated for another 38 calories; and urbanization with about 113 calories, they claimed.

Coco Pops

Last month, economists at the Organization for Economic Cooperation and Development blamed obesity in Bermuda on Coco Pops (yes, the breakfast cereal). Many people are eating Coco Pops for breakfast, according to the economists, because of the two-for-one deals at the market.

Commitment devises

Sunday brought an especially egregious example of misinformation that was not only cruel and hurtful, but potentially harmful, when an economist and journalist pieced together medical advice using another economic theory — one they called a ‘commitment device.’ Their operating premise was the same myths of obesity: “[T]he cause is, essentially, that people eat too much; and the cure is, essentially, to eat less,” they wrote in the New York Times Sunday Magazine. Fat people, they suggested, are mentally weak gluttons unable to show any restraint when it comes to food and need only a commitment devise to eat less.

They proposed diet techniques of their own creation that were so odious, the only purpose served was to spread insensitive fat hate speech. Suffice it to say, there is absolutely no credible research to support their suggestion that placing a life-like model of a ‘fat blob’ on the kitchen counter or wearing a ziplock baggie of rotted stench around one’s neck will effectively result in weight loss and transform everyone’s bodies into tall, thin models of youthful perfection.

This wouldn’t be the first time these authors have promoted spurious diets gimmicks. They once told readers that drinking a few tablespoons of canola oil and a few ounces of fructose sugar water between meals produced an astounding 40 pound weight loss that would never come back.... Oh, and cleared acne, improved sleep and elevated mood, to boot.

More disturbing, in their article “The Stomach Surgery Conundrum,” these Freakonomics authors went on to endorse dangerous surgical interventions as being the ultimate commitment devise. Taking their lead from a single source with vested interests, they became emersed in reporting disputable information.

They told readers that bariatric surgery “isn’t terribly risky,” and uncritically reported that the risks are mostly faced by patients in the hands of inexperienced surgeons and that bariatric surgeries pay for themselves and result in significant health cost savings. They led readers to believe research was behind their medical advice, citing medical literature that had clearly not been critically examined. None of their assertions were supported in the studies they supplied, or any others.

It’s hard to know what is more disturbing: the harm and hurt that results from stories like these, or that they’re given a national platform to spread such misinformation and have sold 3 million books worldwide.

Sadly, there is no commitment device sold that will keep economic majors from practicing medicine, or politicians and media from turning to economists for health policy guidance.