What do Mike Adams, Todd Starnes, and William Proxmire have in common?

Readers of this blog of a certain age and above are likely to remember a U.S. Senator from Wisconsin named William Proxmire. Sen. Proxmire made a name for himself in the late 1970s and throughout much of the 1980s by issuing what he dubbed “The Golden Fleece Award,” which was meant to “honor” public officials who, in Proxmire’s view, egregiously wasted taxpayer money. It was a popular and often headline-grabbing device to highlight wasteful spending. There was one big problem with the award, though, that I increasingly appreciated as time went on, to the point where I’ve referred to the awards as the most ridiculously anti-intellectual and anti-science publicity stunt carried out by a politician for a sustained period of time that I can recall. It’s a tradition that continues to this day, where, as I put it, right wing politicians pander to their base by attacking funny-sounding science that they can’t understand. Sure, they can make the research sound funny—ridiculous, even—but when looked at dispassionately, from a scientific point of view, the science usually ends up being sound, or at the very least not the pointless parody that politicians launching Golden Fleece-style attacks on it portray.

In no way am I claiming that science is above criticism or that projects of dubious scientific value never receive NIH funding. Just look at the National Center for Complementary and Integrative Health, formerly known as the National Center for Complementary and Alternative Medicine, for near-endless examples. However, when it comes to funding issued by NIH and NSF branches not created to support quackery and pseudoscience, projects “worthy” of such mockery are much, much less common. In any case, it’s not surprising that FOX News has joined this disreputable tradition started by William Proxmire, particularly when the subject of the grant involves anything that can be drawn into the culture wars over, say, gay rights. Witness a particularly dim FOX Radio host attack a grant to study differences in obesity prevalence based on sexual orientation:

The National Institutes of Health awarded a Boston hospital more than $1.5 million to figure out why nearly three-quarters of lesbians are overweight — calling the disparities a significant public health issue.

“It is now well-established that women of minority sexual orientation are disproportionately affected by the obesity epidemic, with nearly three-quarters of adult lesbians overweight or obese, compared to half of heterosexual women,” according to a description of the grant.

Wow. I was completely unaware of this disparity. It sounds as though it’s a disparity that’s worth studying to me as a physician and a scientist. Not surprisingly, Starnes disagrees, quoting, of all people, Tony Perkins:

Tony Perkins, president of the Family Research Council, said it is disturbing that tax dollars are being used to fund the study.

“When you look at a nation that’s $17 trillion in debt – there’s a reason. It’s because we do frivolous studies that serve no benefit other than to give a special interest group something to talk about,” he told Fox News. “Why are we issuing grants to study things that have no affect on the well-being of the nation as a whole?”

Of course, a grant of $1.5 million is what, 0.005% of the roughly $30 billion NIH budget, which is in turn less than 0.8% of the $3.9 trillion federal budget. By Perkins’ “logic,” such as it is, studies examining why, for example, Ashkenazi Jews are more susceptible to breast cancer would have no affect on the nation as a whole, given that only 1.4% of the US population is Jewish. Yes, I chose this example intentionally, given that recent estimates find that 1.8% of men self-identify as gay and 0.4% as bisexual, and 1.5% of women self-identify as lesbian and 0.9% as bisexual, numbers slightly higher than the percentage of Jews in the US population. Does Perkins object to studies that target health concerns of Jews?

Be that as it may, to really ramp up the brain-meltingly antiscientific stupid with respect to medical research, even Todd Starnes is not enough. You need Mike Adams. Take it away, Mike:

This story is not satire. According to a study funded by the National Institutes of Health and awarded to a Boston hospital for more than $1.5 million, some mysterious phenomenon is covertly making lesbians obese, in apparent violation of the dietary laws of cause and effect.

For now, I’m calling this phenomenon “obesity gremlins,” and here’s how a NIH-funded study describes this extraordinary mystery.

And:

Astonishingly, the NIH is describing how lesbians are being made obese without having any role whatsoever in the process!

Yes, that’s the way to demonize science you don’t like. Make up a disparaging name for a phenomenon that the scientists aren’t even studying and then repeat it ad nauseam. In other words, construct a ridiculous-sounding straw man for what the scientists are actually proposing and then following up with deceptive analogies designed to pander to the scientifically illiterate:

Just to clarify how all this language is being parsed, allow me to explain the obvious:

If you are sitting in a city park and are suddenly impacted by, let’s say, a golf ball, then you have just been impacted by an outside force completely out of your control. But if you are sitting in front of a Golden Corral buffet, stuffing your face with genetically modified macaroni and cheese grub, then you are not “affected” by an “epidemic.” Nope, you made yourself obese by overeating!

Of course, this idea that any individual should be held responsible for their own actions is completely disavowed across both the medical community as well as the pathetic pop culture of victimization that has overtaken American culture. Now, even when people do things to themselves (or make bad decisions leading to results they don’t want), it’s somehow never their own fault. How could it be?

According to the rigorous scientific thinking at the NIH, some outside force is “affecting” the lesbians and making them obese in some sort of occult way that apparently violates the laws of cause and effect. The obesity epidemic has STRUCK them, didn’t you know? It’s kind of like being struck by lightning, but it involves a barrage of pizzas and chocolate truffles instead of really bright flashes of light.

Obesity is a complex phenomenon, and there is no doubt at all that over the last three or four decades Americans have been progressively, on average, getting fatter. You might have seen the animated maps of the United States that show graphically how obesity has become more and more common in each state since the 1980s. To give you an idea, in 1990 less than 15% of the adult population was obese in most states, but by 2010 26 states had obesity rates of 25% or higher and 12 of those had obesity rates of 30% or higher. Nationwide, around two out of three adults in the US are overweight or obese, and one out of three is obese. Worse, obesity is becoming more and more common in children, who are becoming overweight and obese at earlier ages. This is a major health problem, and there are major racial disparities in obesity prevalence.

Now, at a very basic level obesity is about energy in versus energy out, food intake versus energy expenditure. As Steve Novella points out, there are three main hypotheses as to what is causing the obesity epidemic, and they are not mutually exclusive. One is that we are more sedentary, spending less time exercising and more time in front of the computer or television. The second is that people are consuming more calories. A third is that certain types of calories have more of an effect on obesity than others; i.e., the type of calories (fat versus carbohydrates) is what contributes to obesity.

I tend to agree with Steve that the third hypothesis is better for selling fad diets and weight loss supplements but not particularly convincing as an explanation for the obesity epidemic. I also tend to agree that a major contributor is likely to be that Americans are consuming more food, with increased portion sizes and more and easier snacking contributing to the problem. I don’t want to make this into a post primarily about what is causing the obesity epidemic, as that is a topic for an Orac epic post, and I simply don’t have time for 5,000+ words today. The reason I briefly discussed this is to emphasize that it is a complex topic that we don’t understand that well and, more importantly, that it is worth studying. Moreover, studying reasons for disparities in obesity prevalence between different social, racial, and ethnic groups can suggest hypotheses and potential contributors to being prone to become obese. In other words, if there is a group, be it based on sex, race, or, yes, even sexual orientation, that has a higher prevalence of obesity, it is probably worth studying why. How much worth studying is a value judgment, but in the scheme of biomedical research, a single $1.5 million grant is not that much money. Certainly, it’s not worthy of such mockery.

Take a look at the description of the study. It turns out that there are virtually no data about why these disparities come about in lesbians:

Despite clear evidence from descriptive epidemiologic research that sexual orientation and gender markedly pattern obesity disparities, there is almost no prospective, analytic epidemiologic research into the causes of these disparities. It will be impossible to develop evidence-based preventive interventions unless we first answer basic questions about causal pathways, as we plan to do. Our study has high potential for public health impact not only for sexual minorities but also for heterosexuals, as we seek to uncover how processes of gender socialization may exacerbate obesity risk in both sexual minority females and heterosexual males. In response to PA-07-409 “Health Research with Diverse Populations,” we will rigorously test our innovative gendered biopsychosocial model that is both multilevel and multisystem to explain observed sexual orientation disparities in obesity. We will use longitudinal, repeated measures survey data and also biological data from three youth cohorts: Growing Up Today Study (GUTS) 1 & 2 and National Longitudinal Study of Adolescent Health (Add Health), all ongoing prospective cohorts that together total over 47,000 youth living throughout the United States.

Personally, as a heterosexual man myself, I was interested in the observation that gay men have a nearly two-fold decreased prevalence of obesity. So why are lesbians more prone to obesity than straight women and gay men less prone to it than straight men? No one knows, but don’t you think it’s worth studying? I do. I also wonder why Adams is complaining about this study now, given that it was originally funded in 2011 and runs until 2016. (It’s not as though right wing loons haven’t been complaining about this study for a while now.) In other words, the study is almost over. In fact, looking at the NIH entry on the grant, I see that it was originally funded as an R01 grant in 2011, and, as a five year grant, will end in 2016 unless the investigators can renew it, which will depend on productivity; i.e., publications. I also note that Starnes and Adams are clueless about how NIH grants work, namely that a five year R01 is treated as five one-year grants for budgetary purposes, that they didn’t realize that the total amount funded was actually $3.5 million.

Finally, note the fat shaming implicit in Adams’ little screed. He assumes that losing weight is entirely a matter of self-control and that if you’re fat it’s your own damned fault for choosing to eat too much. We know that the true situation is way more complicated than that, and that willpower-based methods of obesity reduction have a high rate of failure. Of course, Adams is blatantly selective about when he wants to blame only the obese themselves for being obese or blame something else. Of course, elsewhere on Adams’ website, it is argued that “calories are not the enemy” and “you are not weak” if you’re fat, while other NaturalNews.com writers blame GMOs, big pharma, and anything else he doesn’t like for making Americans obese and sick.

Same as it ever was. In fact, Adams goes even further, labeling the research “homophobic” when, if anything, his mockery of the study descends into bigotry when he writes that the reason for the study is because “the simple explanation that “maybe lesbians are just eating too much crappy food all the time” wouldn’t generate millions of dollars in government grant money, would it?”

Project much, Mikey?

Is this study a good study? I don’t know. There’s not enough information in NIH rePORTER for me to judge, and, even if I had the complete grant application in my hand, I still might not be able to tell. I’m not an epidemiologist. However, I trust peer reviewers at the NIH to judge what is and isn’t good science far more than I trust Mike Adams.