Mamamia! A Logical Fallacy Extravaganza in 7 parts: Trolling, Fat-Pride, BMI and Body Image.

This is a rebuttal to a minefield of a post over at mamamia.com.au, from yet another journo seemingly in favour of the promotion of overweight, obesity and associated chronic diseases – all seemingly in disguise as the altruistic promotion of self-acceptance of body image.

I’m going to start this rebuttal by first disclosing a few potential conflicts of interest on my part:

  1. I work as an Exercise Physiologist with clients with chronic illness, musculoskeletal injuries, and other diseases, so I have a specific interest in overweight/obesity and how it impacts on their health conditions. You might even go so far as to say that my opinion is somewhat informed and that I have some background on the matter.
  2. I’ve written a post in the past on my blog Skeptifit.com about my views on the “Big is Beautiful” crowd. Admittedly sensational, but keep in mind that that too was a rebuttal to a misinformed journalist, so do excuse some of the loaded language.

In a nutshell, I’m not a supporter, and I believe the journos should stay out of healthcare alltogether and stick to what they know best, reporting the news, not attempting to understand and interpret scientific literature that is well outside their scope of practice.

Discussion Points:

1. “Concern trolling”. The author writes:

“At the bottom of nearly every article celebrating body diversity, you will likely find some version of the following comments:

Concern trolls? Don't think so!

Concern trolls? Don’t think so!

  • “Aren’t you promoting an unhealthy lifestyle?”
  • “I’m all about confidence, but this is just unhealthy.”
  • “I just don’t find fat people attractive, that doesn’t make me a bad person.”
  • “I have no sympathy for these people, they bring it on themselves.”
  • “Think of the children!”

This is not concern trolling, it’s genuine concern. The author is either unaware of what trolling is or is straw-manning genuine comments for trolling comments, and we’re left with the impression that she’s attempting to undermine any valid criticism that have been levelled at her or others by poisoning the well and launching personal attacks.
For a definition of what concern trolling actually is I’ll paste a defintion from Urban Dictionary, which I think is sufficient for our purposes (second definintion was clearer):

“In an argument (usually a political debate), a concern troll is someone who is on one side of the discussion, but pretends to be a supporter of the other side with “concerns”. The idea behind this is that your opponents will take your arguments more seriously if they think you’re an ally. Concern trolls who use fake identities are sometimes known as sockpuppets.

(eg) In the 2006 election, an aide to Congressman Charlie Bass (R-NH) was caught concern trolling the opposition on local blogs. While pretending to support Bass’s opponent, Paul Hodes, the aide argued that Hodes couldn’t win because Bass was an unbeatable candidate. Hodes won the election.”

I won’t go into depth examining semantics, technical vs colloquial usage of terms and different dictionary definitions. I think the tone of the opening speaks for itself and immediately calls into question the existance of alterior motives or conflicting interests on her part.

2. “People are allowed to make their own decisions regarding their own bodies, but we need to start treating people of all sizes with respect”

You deserve respect? Nope, you have to earn it.

You deserve respect? Nope, you have to earn it.

Nonsense. We no more need to respect a persons decision to live an unhealthy lifestyle than we respect their decision to engage in any other behaviour which might harm themselves or others, or that creates a burden on the healthcare system. An important distinction here – we respect their right to *make* that decision, but we don’t have to respect the decision itself, and we certainly don’t have to respect the person.

Many people might think I’m splitting hairs here, and I agree it’s a fine distinction, but again I think it’s an important one as I truly believe that respect is earned through displaying reasonable action and behaviour, and not freely given. In addition, the fact that all overweight/obese people immediately deserve respect for their lifestyle habits regardless what those habits actually are is an absurd generalisation which is almost as ridiculous as claiming that all overweight/obese people are in their condition because they are lazy. Neither extreme is correct, neither the straw-man examples provided by the author nor the authors position on the subject.

3. “BMI is BS”

Somewhat agree, for the reasons stated, but this is hardly a controversial point and most people (at least those who walk into my office) are already aware of this. Also this is only support for the fact that they should be talking to a health professional who takes a variety of anthropometrical and girth measurements to assess health measures within the context of other presenting chronic disease, rather than a simple BMI, and those readings then interpreted in context.
The historical points were an interesting read, however it’s a shame the link was broken and the source of the authors information can’t be verified (the source, not the information iteslf). It also makes one wonder why the sourced website might have pulled the page, if the link was the correct one in the first place.

4. “Fatness”

What exactly does this word mean? The author keeps using it as

Fatness? What?

Fatness? What?

though they’re trying to claim it and instill some sense of pride, which I guess is fine, but outside of that it’s a subjective term that adds absolutely no value to the discussion. While the inherent BMI problems with overweight and obesity were already outlined, they’re certainly much more useful classifications than totally subjective terms like “fatness” which appeal more to individual aesthetic preferences than anything else. Further to this, BMI certainly is a very useful tool for everyday, regular people who are not rugby players or pro athletes with an absurdly muscular build, as long as it’s interpreted within the context of other readings and measures.

5. “One’s relationship to food shouldn’t reflect on who they are as a human being”

Again, I call nonsense. Why shouldn’t it? Everything we do reflects on us as human beings, if your relatioship with food is unhealthy or you simply like to eat a lot, well I have news for you…that’s going to reflect on you, just like any other behaviour that you engage in reflects on you. You don’t get a free pass simply because some people (like the author) seem to want to make the issue taboo to discuss.

6. “But that’s not always the case: Multiple studies have seen little to no connection between weight loss and decreased risk of mortality.

Now this is probably the most salient point of the authors post, but again I think she missed the mark and is incredibly short sighted – perhaps due to her lack of expertise in the area of chronic disease.

The first link here is to an article posted on the NIH for people with Type 2 diabetes and obesity (not other demographics), so while it’s certainly informative for that sub-group of people it does not apply to the general population. The second link is a single study which shows that dietary intervention was not associated with improved health outcomes in the absence of exercise and health service interventions. It’s true that the issue of weight loss in overweight and obese people is controversial if they do not also present with other indicators of disease, but it’s also true that many overweight/obese individuals who also have chronic disease can see plenty of benefit from weight loss.

It seems as though the authors entire argument hinges on the Obesity Paradox, something which she’s implicitly generalising to all obese people as though it’s the norm. Just because there are exceptions for a small demographic doesn’t mean we should wholesale shift our position on the health risks of overweight and obesity, and I think the preponderance of evidence is still in favour of decreasing fat mass if a person is in the overweight/obese category, and achieving this objective through both nutritional and exercise-based methodologies.

7. “Not everyone wants to be skinny”

image

Image from original article

I find it kind of ironic that at this point, not only is the author implying that healthy weight = “skinny” (aka underweight, typically – so here she’s using a false dichotomy fallacy between being overweight or being skinny), and in addition to this slight of hand posts a picture of two women who for all intents and purposes, as far as can be seen from the picture, or at a relatively healthy weight range – which is exactly what health professioanls are advocating that most people should be striving to achieve!

Don’t drink the coolade, stay skeptical.
What are your thoughts?

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The Science of Broscience in Fitness Forums

Earlier this year, Dr Bryan Chung of Evidence Based Fitness wrote this blog post on scientific abstracts and those who share them, along with their opinions, without actually having read the full research articles.
For those of you who aren’t ‘sciency’ minded, an abstract is essentially a very short summary of 2-3 paragraphs length, of a research paper which can sometimes be up to 20 pages long. Full papers usually include background information, methodological procedures, results & statistical analysis, final conclusions, study design floors and suggestions for future research directions. For a relevant example, see this abstract on protein consumption.

An intimidating figure?

An intimidating figure? Full research articles really can be this scary.  (Photo credit: andreasandrews)

It really is as intimidating as you imagine – particularly the ‘results’ section which, from my experience, most science-medical students don’t even pretend to have read when citing journal articles for their assignments. In fact it’s a bit of an in-joke amongst us, and I say that tongue-in-cheek knowing it’s a bad thing! It wouldn’t surprise me to find the same attitude amongst scientific and medically qualified professionals.

After some to-and-fro with Dr Chung (see the comments at the end of his blog post) I found myself agreeing with the essence of his post but in some ways not the method of delivery. Add to this the fact that some important issues ought to be addressed, such as the repercussions of a lack of critical thinking and skepticism in the fitness community and what our role, as fitness professionals, ought to be in all of this.

It’s taken me quite a while to separate out the issues in this topic and to arrive at what I think is essentially complete agreeance with this anti-abstract, “abstracts are entertainment only” viewpoint that is put forward.

Central Arguments

Do you even science? Do you? (Photo credit: Me! Parody of Pubmed.com home page).

Do you even science? Do you? (Image credit: Me! Satire of Pubmed.com home page).

The central argument is this: that people, fitness enthusiasts in particular, are linking to and discussing abstracts in isolation from the context of the full paper. While he doesn’t provide any links to give his audience context (I’m going to hazard a guess it’s at bodybuilding.com where broscience runs rampant), I still believe he makes several good points.

For the most part, if you don’t have access to anything more than the abstract for a piece of scientific research then you’re probably not able to frame the conclusion of a study in it’s proper context. In addition, enthusiasts who have no science background or science education probably don’t possess the cognitive tools to adequately assess the research papers, even if they do have full access to said papers. And by “cognitive tools” I’m not calling anybody stupid, simply referring to the critical thinking and the depth/breadth of knowledge acquired from studying at minimum 3-4 years in a medical or science degree.

That’s not to say that all tertiary science educated fitness professionals are well equipped to interpret the scientific literature – hell, even some pHD qualified Professors at my university probably don’t possess the cognitive capacity to assess the literature with any significant competency, but at the very least they meet minimum requirements.

It really is a matter of appreciating how little we know about topics in which we’re not qualified, experienced, practicing and professional specialists, and being humble about it, and deferring our opinions to those who quite obviously are better equipped and more knowledgable on the subject. I think this, in essence, is the crux of the issue – that many “bro’s”, personal trainers and even fitness enthusiasts in the fitness industry view themselves as experts, and that really is quite problematic.
Just because you can apply fitness protocols to yourself and others, and even see short term results, doesn’t mean that you’re doing it well, that chronic injuries won’t follow, nor does it mean that what you’re doing is methodologically sound. This harkens to the Dunning-Kruger effect.

Repercussions

Are scientific abstracts comparable to movie previews? (Image credit: Wikipedia)

Are scientific abstracts comparable to movie previews? (Photo credit: Wikipedia)

I appreciate the metaphor of comparing an abstract to a movie preview, while the full research paper is comparable to seeing the actual movie. Let’s build on this by saying that instead of paying $20 for the movie you’re actually paying *$200, and instead of being in English the movie is in a foreign language. Additionally, your understanding of the movie is dependent on your abilities to interpret it, and each person who watches this foreign film has a slightly different interpretation.

Now ask yourself this: how many movies would you see if each of them cost $200, regardless how good the movie is supposed to be? If all your friends were talking about it as though they had seen it, wouldn’t you want to join in the conversation too? Might you pretend to have seen the movie, even though you hadn’t, and just extrapolate from the previews?

Yeah that would be bad, dishonest in fact, but that’s kinda what happens with the online fitness community.

In Summary

Perhaps it’s best to leave it to well qualified professionals to interpret the literature, with full access to scientific research being one of the minimum requirements for interpretation and education. Without making an appeal to authority, I think it’s also a safe bet to say that qualifications in science or medicine are also a minimum requirement, and if you’re listening to a **fitness enthusiast discuss the latest scientific research they found on Pubmed.bro you should probably not only take it with a grain of salt, but the entire salt shaker too.

How does this differ from something you read in the media? Well that’s the point, it kinda doesn’t, and arguably falls on the same rung of the hierarchy of evidence as does a well written, science media article. It’s entertainment, informative, perhaps even useful, but not for redistribution in an educational manner.

Where to Now?

(Image credit: Alan Aragon)

Subscribe. You won’t regret it. (Image credit: Alan Aragon)

So you consider yourself a science and fitness enthusiast? That’s not a bad thing, nor should it be discouraged, and I leave you with a final recommendation: Alan Aragon’s Research Review. He fits the bill as a well qualified, experienced, knowledgable (and well known) exercise physiologist who releases a monthly review/newsletter of the most interesting and relevant fitness, exercise and nutrition based research.
So forget Pubmed abstracts, delete your Pubmed bookmark, and subscribe instead to an exercise physiologist who’s predigested the food for you! It’s not free, but from my experience as a (former, now lapsed) paying member it’s well worth it.

What are Your Thoughts?

What are your thoughts on the topic of abstracts as nothing more than a form of entertainment, similar to that of media articles? Have you experienced bro-science in fitness, or been frustrated by the lack of critical thinking and skepticism? Feel free to comment below and share your experiences!

*1 year subscriptions to scientific journals can cost anywhere between $100 and $600. This metaphor treats a single movie as a 1 year subscription, with the understanding that a ‘movie’ is actually a successive number of research trials and metareviews which require consumption together in order to get a complete picture. Actual individual articles can be acquired for around $35.

**Yes, “fitness enthusiast” includes those who deadlift 300lb’s, are members of their local barbell society, and hang out in well known fitness forums. In fact, it probably encompasses this demographic above and beyond most others – excluding those who are qualified.

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Crossfit Outrage & Rhabdomyolysis

Crossfit Basel

Crossfit Basel

A few short days ago, Eric Robertson, a Professor of Physical Therapy at Regis University, posted a short blog post entitled “Crossfit’s Dirty Little Secret” to Medium.com, discussing his observations about the prevalence of a condition known as Rhabdomyolisis in CrossFit, and the unusual awareness amongst CrossFit coaches and enthusiasts about this typically very rare condition. If you read the post (I strongly encourage you to) you’ll notice that it’s actually quite reasonable and balanced, even if it does give CrossFit a slightly unpleasant taste.

The Prediction Causes a Stir
Prof Robertson makes it fairly clear that his thoughts are all observations and anecdotal, provides quotes and sources from CrossFit articles and ex-CrossFit athletes, and even clearly outlines his ‘prediction’:

“My prediction: in a few years, the peer-reviewed scientific literature will be ripe with articles about CrossFit and Rhabdomyolysis. “

It should be clear from this that Prof Robertson’s position is that of a ‘pre-scientific’, hypothetical, “Let’s investigate this” type of approach. This is where all scientific research begins, with an anecdotal observation of an area which might yield some fruitful results for discovery or confirmation of a significant correlation or causal relationship between two variables.

every dog has its snarl

You say something bad about CrossFit?

CrossFit’ers Respond with Outrage
The CrossFit community has responded to Prof Robertson’s hypothesis with a rabies slathering outrage. Huffington Post, meanwhile, continues to demonstrate it’s inability of both it’s contributors and commentors to think at all critically, instead appearing to string together clever looking sentences which are in fact mostly devoid of real knowledge, thought or insight, and continue creating straw-men out of **Prof Robertson’s easily comprehendible blog post while refusing to understand the spirit in which it’s delivered.

Huffington Post
*Huffungton post had these choice quotes in their repertoire of banal verbosity:

“The authors of these pieces always have some kind of personal problem with people who do CrossFit, but the core of it is a mystery.”

There is no “personal problem” that can be reasonably surmised from Prof. Robertson’s post except for a rather reasonable and level-headed analysis of some anecdotal evidence and observations of a trend that deserves further scientific investigation. This is a perfect example of an implicit ad hominem, an attempt to attack his character instead of the issues themselves by implying that he has an alterior motive. If you want to see “some kind of personal problems” then just read the comments in Prof Robertson’s article and the comments in the Huffington post.

Injured Yourself Exercising? It’s Your Fault!
At least, this is the view of many of the CrossFit-cult-like-worshippers who are rabidly coming to the defense of their preferred exercise modality. To quote Huffington Post:

“Rhabdomyolysis — an extreme condition thwarted upon oneself — is not the fault of CrossFit. It’s not the sport, the organization or even the coaches. It’s your own fault.”

And this:

“Folks will say CrossFit causes injury and is irresponsible. Newsflash: CrossFit does not cause injury — individuals do things that cause themselves injury. This is what it comes down to: personal responsibility”

Does this sound familiar to anybody? Let me prompt your memory “Guns don’t kill people, people kill people“. That’s right, that tired old United States of A. sound byte used to defend gun ownership, regardless the number of school massacres that take place.

In fact I’m pleased to hear that if clients injure themselves under my supervision, as a personal trainer or an exercise physiologist, then I am not responsible and I can just trot out the ol’ “Well you’re personally responsible for your own health, you injured yourself haha!”, though it goes against everything I’ve learnt about burden of care and kinda nullifies having private insurance, Advanced First Aid + CPR, and registration with Fitness Australia (the national registration body which provides practice guidelines and policies for the fitness industry in Australia).

You want to talk about taking personal responsibility? Coaches, personal trainers and fitness specialists of all calibres have a burden of care to ensure a safe environment and safe exercise delivery. If the culture fosters an unusually high rate of injury, then it could be argued that they’re not fulfilling that burden of care.

In Summary
The CrossFit defenders have done themselves more harm than good with their level of outrage to Prof Robertson’s post. A nail has obviously been hit firmly on the head, and I look forward to any future research into rhabdomyolysis and it’s prevalence in the cult-like-attitudes of many CrossFit enthusiasts.
While my response here is clearly denegrating to CrossFit, I want it to be clear that I’m addressing those rabid and overly emotional followers, not those who are able to string together comprehensible thoughts and sentences without foaming at the mouth.

Keep it sane, keep it reasonable, and be skeptical.

What are your thoughts? Do the benefits for Crossfit outweigh the drawbacks? And was Prof Robertson’s blog post blown way out of proportion? Share your thoughts in the comments!

*I don’t see it as important to use the name of the person in particular who posted the article, as she has no actual qualifications in the field. This doesn’t necessarily detract from any valid points she makes, if she had made any, but I believe it is relevant to note for the discussion.

**Unlike the CrossFit worshippers, I’ll give Prof Robertson the respect he deserves by using his actual name and title instead of attempting to put us all on the same even surface by glossing over his credentials and credibility on the topic. Let’s get one thing straight – you should be listening to somebody with pHD in physical therapy with a lot more interest than some ‘random’ over at an online news site when the credentials place them as a specialist, if not an expert, in the field.

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Say What? Why?

If a fitness professional, medical professional, doctor, lecturer, your mother, friend, or brother make a claim, it needs to be supported by evidence. Of course there are different standards of evidence applied to different situations depending on how we gauge their importance, but when analysing medical science or health based claims (e.g. fitness industry related), then peer-reviewed, scientific research is the best available method for acquiring reality-based evidence. Abstracts are even freely available to the public over at Pubmed, and statistics can be accessed at ABS.

Criteria for Providing Evidence

Providing supporting research for a claim or opinion is one thing, but it should meet several criteria (Here I have listed only a few):

  1. Peer reviewed: so that the research has been scrutinised by other qualified professionals in the field, and found to meet a high standard.
  2. Actually support the claim: Why provide “supporting” evidence that doesn’t support a claim? It either means that the conclusions of the research haven’t been interpreted properly, or that the references were thrown in to lend an air of legitimacy to the claims in the hopes that nobody would check them.
  3. Not be superceded by more recent research: studies conducted in 1930 just don’t cut it if there’s more modern research available which is both valid and reliable.
  4. Be valid: does the design actually test the hypothesis and are the results applicable to the real world situation?
  5. Be reliable: If others were to repeat the experiment, would it give the same or similar results?
  6. Be balanced: It’s easy to cherry-pick data – providing references to scientific research in a bias manner in order to support preconceived points of view. It’s much harder, but more honest and rewarding, to review available research and adjust our opinions accordingly.

Be sceptical, be a critical thinker. Demand evidence, and try to avoid believing things for emotional or intuitive reasons, or simply because the local newspaper reported it as such. When this process fails the result is something along the lines of Crossfit, detox diets, acacia berry madness, homeopathy, “organic” food, and acupuncture.

Don’t take my word for it, go out there and gather some evidence.

What are your thoughts on critical thinking in fitness? Feel free to comment below!

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Who Needs a Personal Trainer?

”Who would pay somebody to torture them for an hour? I know how to jog and lift a weight, why would I pay somebody?!”

These are rhetorical questions I have heard people posit for years, both before I was a qualified personal trainer & fitness specialist (yes that latter is a qualification, not something I just made up) and after I had completed my Diploma. In order to answer these questions I’m going to take a half dozen steps backward…

Exercise. Everybody has goals and an ideal body type, even if they have no idea when or how to achieve it. On the one hand it seems intuitive: eat less, exercise more – do this for long enough, and with enough intensity, and you will achieve your goals. On the other hand there is chronic illness, acute exercise injuries, lack of motivation, lack of time, lack of skill and knowledge, lack of equipment access.

There is an over-abundance of information on the internet, but only a fraction of that information is reliable or what I like to call “reality based”. In other words, some people just like to make stuff up, to hell with all of that science stuff (after all, what does some middle aged, white-coated scientist know about what’s going on in the real world?).

I’m a science kinda guy, I think that the techniques and methodology which I use to train my clients should be solidly reality/science based, and I like to think that *most* of you out there are also reality (and science) based, whether you realise this or not. In short, we want what works, and what we know works. That is where science comes in. It gives us the most reliable, testable, repeatable, falsifiable, and best controlled technique for evaluating what works and what doesn’t. It’s by no means perfect, it by no means provides all of the answers (nor does it pretend to), it *is* however self-correcting, peer-reviewed, and more reliable than any other reality-testing methodology we know of.

All very well and good, but how does a *client* know that their PT is implementing training methodology that works or is evidence/reality/science based? How do we know the difference between a PT who even has a methodology vs one who is simply regurgitating the routines they learnt from a 4 week online course provided by a questionable means and questionable testing criteria? (and does that even matter if they are actually training clients and getting results?).

As a holiday project for my end of year break I decided to sign up with the local gym – (although it’s been contrary to my personal ethos for the past 7 years to step foot into a gym in the role of client/member). It’s obvious to me that a large majority of the clients at this gym who engage in resistance training, and I would wager at any gym, fall into three distinct categories:

  • Having no real idea what they’re doing, but knowing that they don’t know (the majority of the weight machine users)
  • Having no real idea what they’re doing, but thinking they do (the majority of the free weights users)
  • Knowing what they’re doing, and doing it quietly and methodically (an extreme minority)

You might argue that another PT has a different opinion from me, that I think (and write) one thing, they think another. So who’s right?

It comes back to the science – who is more up to date with the latest research? And how relevant and applicable is that to the field of exercise? Is the PT even *aware* of the scientific research, or at least somehow tapping into the results that the latest scientific research is discovering, perhaps through reputable online journals or other official channels (ie Fitness Australia newsletter and updates).

There are many biomechanical reasons why exercise technique exists, why the shoulders, knees and hips should not be placed in certain positions in high risk exercises which make them more vulnerable to injury. This is an important example where a PT is valuable, directing a client in the appropriate technique and execution of an exercise so as to avoid injury and gain maximum benefit from their exercise routine. Of course many other reasons exist, such as motivation, exercise programming, fitness testing and goal assessment.

Who needs a PT? Most people, if not for technique correction and injury prevention, then for motivational direction and goal achievement. A good PT will help you to discern truth from nonsense, after all – there’s a lot of information out there, and most of it’s worth the amount you’ve paid for it.

What are your experiences with personal trainers? If you’ve never hired one, would you consider doing so? Comment below!

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