The Ugly Truth About Obesity

May 30, 2013
A victim of prejudice?

A victim of prejudice?

Obesity, defined as having a BMI over 30, is increasingly common these days. In America 30 percent of the population is obese while many other Western countries have similar figures (no pun intended). When obesity is debated it’s usually about health issues, but there is also another aspect to consider, namely that of obesity bias and discrimination.  According to Obesity Society, obese people are often viewed as “lazy, sloppy, less competent, lacking in self-discipline, disagreeable, less conscientious, and poor role models” as well as “unintelligent, unsuccessful, weak-willed, unpleasant, overindulgent”.

This negative view leads to discrimination in for instance employment and college admissions. In the medical setting, the negative attitude towards the obese may also lead to patients cancelling appointments, with worse health as a consequence. According to a study from Yale University, self-reported weight discrimination is as common as racial discrimination.  This may seem especially problematic since the obese are not protected by any minority laws so in many cases discrimination is perfectly legal.

On the other hand, what if all these negative stereotypes are accurate? After all, many stereotypes have some truth to them – Jews do make more money than others; Black people are more often involved in crime; there is plenty of research to show that East Asians are more introverted than other people. So why can’t stereotypes about the obese be accurate?

Like most things, this has been researched. Intelligence shows a very clear connection to IQ, as illustrated here. And since intelligence is linked to work performance this suggests that the obese may be unsuccessful and less competent as well. This in turn may explain the “wage penalty” that the obese suffer – like all groups with low intelligence do.

As for the personality traits mentioned above, Angelina Sutin and colleagues at the National Institute on Aging, National Institutes of Health, and the Department of Health and Human Services, have conducted perhaps the ultimate study on this, using some 2000 participants, spanning over 50 years and applying 14 500 measurements of weight. And they didn’t just content themselves with the Big Five personality factors but looked at all the subscales. They found that weight gain was most clearly related to Impulsiveness (a facet of Neuroticism), Warmth, Assertiveness, Positive Emotions (all facets of Extraversion), and a lack of Order and Self-Discipline (facets of Conscientiousness). It’s also interesting to note that while strongest predictor, Impulsiveness, as mentioned a facet of Neuroticism in the Big Five model, none of the other facets of this factor – Anxiety, Depression etc, related to overweight. So they common idea of the emotional overeater seems to lack empirical support.

So yes, the obese group is not unlike its negative stereotypes. Of the, “lazy”, “sloppy”, “less competent”, “lacking in self-discipline”, “disagreeable”, “less conscientious”, “poor role models”,” unintelligent”, “unsuccessful”, “weak-willed”, “unpleasant”, “overindulgent”, it seems “disagreeable” and “unpleasant” are the only clear misses.

This is not to hate on the obese, but to call a spade a spade. The idea that the problems of the obese are outside themselves is an unhealthy illusion here examplified by Slate Magazine’s Daniel Engber,

Stop hating. If we weren’t such unrepentant body bigots, fat people might earn more money, stay in school, and receive better medical care in hospitals and doctor’s offices. All that would go a long way toward mitigating the health effects of excess weight—and its putative costs

This under the false assumption that fat people have the same intelligence and Self-Discipline and that the reason they cancel appointments is not due to Impulsiveness and lack of Conscientiousness but only because of other peoples prejudice. In doing so, he enables fat people to stay fat and to blame society for their problems, and to, like the Obesity Society, view the condition as unrelated to willpower.

The harsh truth is that the obese are in a lot of trouble. They are less attractive in the workplace because of their combination of intelligence (or lack thereof) and personality. Work performance is best predicted by IQ scores and next best of Conscientiousness. Impulsive behavior on the other hand predicts crime and accidents. Most employers are probably not aware of the research linking obese people to these characteristics and outcomes, but they know from experience that employing an obese person is a financial risk with no apparent reward.

They should of course look at the individual, but not everyone can afford testing every potential employee. Nor can a doctor test his patients. But he can use his experience, which tells him that the obese person is much less likely to follow his professional advice. And even if they could check every individual it wouldn’t solve the problem because the reason the group has these characteristics is because so many individuals belonging to the group have them.

So, is there any way to help this group? My guess is that the best solution would be to introduce vice taxes and similar paternalistic measures. You can’t leave someone who is out of control to their own devices. The worst solution is the one used right now – blaming negative stereotypes and discrimination, when scientific research validates those exact stereotypes as well as provides perfectly rational reasons for discrimination.

 

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Why Intelligent People Are Healthier

November 29, 2012

“If you ask what is the single most important key to longevity, I would have to say it is avoiding worry, stress and tension. And if you didn’t ask me, I’d still have to say it.” George Burns (1896-1996)

The studies on intelligence and longevity all agree that those with high IQs live longer. One of these studies, the Swedish Conscript Study, is especially impressive since it includes practically all Swedish men born between 1950 and 1976 – making the number of participants just under one million. They all took an intelligence test which uses a nine grade scale. Those scoring 9 were 20 years later shown to have a 70 percent less risk of mortality than those scoring a 1.

This may sound like something obvious – people with high intelligence come from better homes and have been brought up by parents who give them more fruit and vegetables and less pizza and soft drinks. However, it was shown that adjusting for things like parental socioeconomic status as well as blood pressure, weight, physical illness at conscription, the risk of mortality for those with the highest intelligence was still reduced by 60 percent compared to those with the lowest intelligence. This is really worth noticing – social background makes up less than 10 percent of the reduced risk of mortality. This is partly explained by the fact that the men were in their 40s at the follow-up, and few die from cardiovascular disease at that age. But it’s still interesting to note that social background is such a little factor in overall mortality.

So while it’s known that intelligent people engage in health behaviors – eating vegetables, exercising, following the doctor’s orders when ill. It’s reasonable to suspect that a healthy lifestyle is the mediator between IQ and longevity, even though this lifestyle is probably more a matter of personal decision than upbringing. It accords well with the connection between IQ and death in cardiovascular disease, the biggest killer. But if we look at cancer, the second biggest killer, the connection with intelligence is weak or non-existent. For skin cancer it’s even inversed. How can that be?

I haven’t found any explanation for this paradox in the literature, but looking at the causes of these two killers it’s clear that cardiovascular disease is related to stress in a way that cancer is not. And stress is a lot about lack of control. It’s a well-known fact that those prone to stress, that is those having the trait neuroticism, have more heart disease. This idea is supported by another large study, called the Vietnam Experience Study, which looked at mortality of veterans and found that the more neurotic a veteran was the more a high intelligence would lower his mortality.

This suggests that a major part of why intelligence promotes health is in that it protects against the harmful effects of stress and thus against cardiovascular disease. How? It could be that they use their intelligence to cope with stressful events better. It may also be a matter of what some researchers call system integrity. A high intelligence, according to this theory, is an indication of a  generally more robust and well built organism that doesn’t break under pressure as easily as the average. Although this has been hard to prove some studies have found that reaction time, as a proxy for system integrity, account for most of the correlation between intelligence and mortality. It could of course also be a combination of stress handling ability and system integrity.

All of these interesting findings are found in the relatively new field of cognitive epidemiology. While it doesn’t disprove that eating lots of vegetables is good for you (it really is) it shows that this may be of less importance than most of us imagine compared to stress – our proneness to it in form of neuroticism, but perhaps even more important how we cope with it, both psychologically and in terms of biological hardiness.

 


72 Is Not Going to Be the New 30 for Honey Boo Boo – A Few Thoughts on National Character, Health, and Longevity

October 22, 2012

30 might just feel little bit like 72 for this girl…

Under the headline “Modern humans found to be fittest ever at survival, by far” Los Angeles Times recently featured an article about a study from the Max Planck Institute for Demographic Research, on the increase in life expectancy,

A typical Swede, for instance, is more than 100 times more likely to survive to the age 15 than a typical hunter-gatherer. And a hunter-gatherer who has reached the ripe old age of 30 is about as likely to die in the following year as the world’s champion of longevity — a 72-year-old woman in Japan.

But are Swedes and the Japanese really representative of all modern humans, or even of populations in the developed countries? I think it’s safe to say that these two people are known to have certain traits, national characters, that set them apart. Hardly anyone would argue with the claim that they are less impulsive than the average.

Research on national characters – the specific collective personality traits that distinguish on nationality from another – has proven difficult. A large study by Terracciano back in 2005 found that the national characters don’t accord with mean levels of personality traits. So is this idea just in our heads, that say the Chinese are more introverted than Americans?

Most likely not, since all research into stereotypes so far tends to find a kernel of truth in them – Jews as a group make more money, African Americans as a group are more violent etc. But personality research is almost exclusively done with self-report questionnaires. When people answer question about their own personality they relate it to other people in their own country. This means that differences between countries can be due to other factors like how socially desirable a trait is in that country or how prone a certain people are to self-enhancement, portraying themselves as better than they are. Studies have found that East Asians are not as prone to this as Westerners which could explain why Americans for instance measure higher than the Japanese on conscientiousness.

Some psychologists have tried to get around this problem by looking at how personality traits are expressed in different cultures, or to use ethos in the form of institutions that embody ideals that are typical of certain traits. But that’s all very problematic since it involves measuring the same thing in different and indirect ways.

A better way to do this (which at least I haven’t read about) is to measure actual behavior related to personality traits. Because there are traits that have universal behavioral outcomes.  Take impulsivity for instance. This trait predicts drug abuse, violent crime, traffic accidents etc in all parts of the developed world.  So if these outcomes differ according to stereotypical notions of national characters then we have some evidence that these do reflect actual personality differences between nations.

Since I haven’t come across any such research I decided to dabble a little myself, just to see if there might be anything to this. I took two measures – adult lifetime use of cannabis, and road fatalities – and combined them into a composite measure of impulsivity. The countries included are mainly those commonly thought of as impulsive, New Zealand, USA, Australia, and Denmark. I contrasted these against the two nationalities mentioned in the article, those of Sweden and Japan. So here is what I found.

Adult lifetime use of cannabis according to Wikipedia/EMCDDA: Stereotypically impulsive nations like USA 42.4 percent, New Zealand 41.9 percent , Denmark 36.5 percent, and Australia 33.5 percent. As a contrast Sweden has 12 percent and Japan a mere 1.5 percent.

Road fatalities per 100K inhabitants and year according to Wikipedia/WHO: Again looking at the stereotypically impulsive nations we have, Australia 5.7, New Zealand 8.6, USA  12.3,  Denmark 7.4,  whereas Sweden has 2.9 and Japan 3.85.

If we combine these percentages to a composite measure of impulsivity by adjusting so both measures have the same average, we find the following order with life expectancy in the second column,

USA                       50           78.2

Australia               56           81.2

New Zealand        77           80.2

Denmark               67           78.3

Sweden                 24           80.9

Japan                    17           82.7

This gives us a clear indication that nations thought of as impulsive actually have more outcomes that are known to correlate with impulsivity on the individual level. Their average level is 62.5, which is 3 times the average of Japan and Sweden combined. It’s especially striking to see the big difference between the neighbors  Denmark and Sweden that are very similar in many other ways.  And this measure of impulsivity also correlates  -0.6 to life expectancy which is quite respectable.

…but not for this one.

Although it’s not a scientific study, I believe this little exercise clearly raises the question of whether any developed country can be taken as a measure of how technological progress translates to longer life expectancies in general. It suggest that this is not the case, and that differences in personality traits between countries, often referred to as national characters are in fact real, and affect health and longevity in the same way as they do on the individual level.


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