George Monbiot says obesity is an ‘incurable disease’. Here is what’s wrong with his evidence

In the pages of the Guardian today, George Monbiot claims that ‘obesity is an incurable disease’ that ‘resembles cancer’. Needless to say, capitalism and advertising are to blame.

He presents two pieces of evidence for the incurability of obesity. The first is an opinion piece published in what’s left of the Lancet. Its authors don’t say that obesity is incurable but they do coin some colourful terms, such as when they claim that ‘individuals who formerly had obesity but are able to re-attain a healthy bodyweight via diet and exercise still have “obesity in remission”’. They recommend that doctors use anti-obesity drugs which, they say, are more effective and have fewer side effects than they did in the past. Perhaps they do, but given Monbiot’s deep suspicion of corporate interests, it is surprising that he doesn’t mention the authors’ long list of competing interests, including funding from the drug companies Vivus, Takeda, Novo Nordisk, Orexigen Pharmaceutical, Boehringer Ingelheim and Shore Pharmaceutical.

His second piece of evidence is a recently published study which found that only 3,500 of a cohort of 176,000 obese Britons tracked in 2004 had returned to a healthy weight by 2014. A success rate of two per cent would have been disappointing if this was a clinical trial, but it wasn’t. It wasn’t a trial at all and no attempt was made to ‘cure’ the people involved. The researchers never met them, didn’t know their names, didn’t attempt any intervention and there is no evidence that they were even trying to lose weight. Their anonymous data was simply pulled out of the NHS computer so that their body mass index in 2004 could be compared to their body mass index in 2014. These people weren’t treated, they were monitored. Insofar as it can be called an experiment, it was one that only had a control group.

Call me old-fashioned, but I think there should be an attempt to cure before a condition is called incurable. A doctor who claimed that his treatment had failed when he had never met, let alone treated, a patient would soon find himself up in front of the General Medical Council. If you want to know if obesity is ‘curable’, the best evidence comes from randomised controlled trials. Sure enough, they show that significant weight loss can be achieved through exercise alone, or through calorie reduction alone, or through a combination of both.

Monbiot’s claim that obesity is as incurable as cancer is offensive not only to cancer sufferers but to the three-quarters of the population who manage to live in modern Britain without becoming obese. Monbiot says that obesity is ‘rising rapidly’ but, as I have mentioned before, that is simply untrue.

Why such hyperbole and exaggeration? Monbiot uses it to take a swipe at David Cameron’s (silly and unpleasant) idea of withholding benefits from the obese and to tell us how food would be sold on Planet Guardian: ‘One day, though not before many thousands have needlessly died, it will become illegal to advertise any food or drink that merits a red traffic-light warning. They will be sold only in plain packaging, with health warnings, on high shelves.’ This sounds remarkably like the ‘slippery slope’ about which opponents of plain packaging warned. The only surprise is that Monbiot didn’t wait for it to be applied to tobacco before demanding the inevitable roll out. Alas, he may never be cured of his addiction to big government.

  • Chalcedon

    If you read the comments on the Grauniad article you will find most commenters say his article is not only utter tripe, but tripe with bollocks too. I commented. Gluttony isn’t a disease. Also, you cannot beat the laws of thermodynamics either regarding eating and metabolising food. Monbiot just proves he is a bit of an idiot and one totally devoid of any shred of scientific or medical knowledge.

    • Callipygian

      The human body is not subject only to the laws of thermodynamics. It is also subject to the workings of hormones, chief among them in metabolism: insulin. Any account of metabolism that fails to acknowledge this is not worth your time or mine.

      • CallsignMissing

        If you expend more calories than you eat, you will lose weight. The human body cannot create energy.

        • Callipygian

          That’s not helpful information for most people, though. It’s a brute observation that explains almost nothing. The question is HOW does the body allocate its calories? Calories after all are a concept (kcal: the energy needed to heat 1 kilogram of water up by 1 degree), while the body deals in physical realities. It does not treat refined carbs or sugar in the same way that it treats protein or fat.

          • jivatmanx

            A good diet of healthful food (whole grains, lowfat dairy, nuts/seeds) vs crappy processed food, of the same caloric content, were compared several times in studies. Yes, the hormonal effect is different, in fact, the better diet reduced abdominal fat much more than the bad diet – abdominal fat being particularly associated with health problems and being particularly unattractive – but total weight loss was exactly the same.

          • Callipygian

            Well, one can eat rubbish and be X lbs, or eat well and build muscle and be Y lbs, and I know what I choose: better body composition. Muscle weighs more than fat, so a better measure is one’s dimensions, and the tautness of one’s skin. As you say, abdominal fat is serious business and the less of it, the better!

          • Zarniwoop

            Healthful? Try saying “healthy” instead of that awful Americanism 😀

          • CallsignMissing

            “That’s not helpful information for most people, though.”
            If that’s not helpful then most people are in a stupid state of denial. A kcal is a physical reality. In fact, it would be very hard to have a fact more basic than what a kcal is. It deals with a very basic concept – energy. It doesn’t matter one bit what kind of calories you take in; if you burn more than you take in, you will lose weight.

            Eat less than you use and you will lose weight. Simple. The human body does not and cannot create energy. Calories are not preferential.

            The human body is, in fact, completely subject to the laws of thermodynamics. No other ‘laws’ supersede them.

          • Callipygian

            The human body is an immensely complex organism with an amazing array of forces all working at the same time and sometimes not for the same ‘goals’ (your pancreas isn’t ‘interested’ in the stresses your other organs are undergoing: it has a job to do with the aim of homeostasis, and that’s that).

            However, your desire to reduce everything to a simple formula is understandable. It’s also the reason that we have had lousy and worse nutrition advice for the past few decades (margarine was a ‘health food!’; sugar had no role in diabetes!) so that we now have an obesity epidemic.

          • CallsignMissing

            And yet, for all its complexity, the human body cannot produce energy out of nothing. Eat less calories than you burn, and you will lose weight.

          • Callipygian

            You’re arguing at cross-purposes and refusing to acknowledge my own argument so we’ll leave it there. I never mentioned HAES and that has nothing to do with what I’m saying. You clearly have no comprehension of metabolism, and if you think that a recent fad has caused 40 years of increasing obesity despite a booming ‘exercise craze’, you’re off your rocker!

          • CallsignMissing

            Calories in < calories out.

            You will lose weight. Period.

          • HAES nonsense is right. The reason these people gained weight despite exercising is because they think being active gives them the license to eat copious amounts of ‘treats’.

  • Monbiot’s piece reads like those articles from the late 19th and early 20th Centuries warning of the evils of drink or “racial impurity”. The same confident predictions of inevitability, the same drawing of false parallels, the same hope for an authoritarian future in which everything will be Put Right by the wise and enlightened.

    As always in political matters, it’s hard to tell whether he’s a halfwit or a charlatan. Either way, he’s dangerous.

    • The Laughing Cavalier

      He is both. That’s why he’s nicknamed “Moonbat”

  • Sheumais

    I can only wonder if Moonbat was dropped on his head as an infant. Your BMI score is as helpful to know as the shoe size of a pygmy hippo. Either you are fat or you’re not and it’s very easy to tell if you are. If you are so fat as to require a seat for each buttock, you are in need of some stern advice re eating habits. If you choose to ignore it, that does not mean you are ill, just self-indulgent. You may be of some use for sitting on Moonbat, but probably little else.

  • Phil Lindley

    Obesity is basically the result of lack of intelligence. All dumb creatures will become obese given a limitless provision of food. The animals we keep as pets demonstrate it, unless we feed them strictly. In nature food has to be worked for and is generally hard to find unless perhaps you’re a herbivore in which case the food you consume is plentiful but nutritionally very poor. Doing anything which badly affects your own health for no obvious benefit is unintelligent – STUPID, in other words.

  • Callipygian

    Why is the person in the picture using what looks like a 3-lb weight? I can’t tell for sure because in a fat hand it could be higher, and in America pink weights are usually (invariably) only 2 lbs each while light green ones are usually (invariably?) 3 lbs.

    G. Monbiot is a deeply unwise man — wrong on the facts, wrong in his impulses… irrational, sentimental, and wrong.

  • Bandit 1

    You don’t even have to scratch George Monbiot to find a fascist. It’s right there on the surface. Like all chattering class scumbags, he is mentally ill and wants to inflict his sickness on the rest of us.

    “They will be sold only in plain packaging, with health warnings, on high shelves.” I bet he rubs himself at the thought of it.

    Still, he’d better hope that CRUK don’t get wind of his ramblings. Their funding relies entirely on the premise that cancer is curable.

  • Zarniwoop

    “George Monbiot says obesity is an ‘incurable disease’”

    I’d say the roadkill munching George Monbiot is an ‘incurable disease’