Horizon on fat: a mechanism is not a cause

Last night, BBC2’s Horizon programme discussed “new” discoveries about what lies behind the “obesity epidemic” that’s assailing us. It was a fascinating programme, and did indeed reveal some very interesting things: but fascinating as it was, it was also deeply misleading.

It was presented by a surgeon who began, so the programme told us, with the belief that obesity was a consequence of people eating too much, and exercising too little. People who exhibited such behaviour did so because they were too weak-willed to do any better. Ergo, what was required was some stern talking, possibly the compulsory viewing of “Supersize vs Super-skinny” (well, had it not been on a rival channel), and for those whose wills were not thus strengthened, the reluctant intervention of an already over-stretched NHS to deal with their inevitable type 2 diabetes, and perhaps an opportunity to recoup some of the money by selling voyeuristic clips of yet another stomach by-pass operation in action. The latter probably wouldn’t be very effective, as the market for gruesome shots of implements that “cut and staple simultaneously” would seem already to be saturated. Every time yet another programme turns the spotlight on our modern gross fatness, and what we might do about it, it seems it is de rigueur to include surgeons at this most unattractive pastime.

But the surgeon starring in yesterday’s programme was obliged to confess to an unsavoury attempt to “take the moral high ground” with her simplistic view that perhaps obese people might have some slight degree of responsibility for their predicament. Because she was wrong. It was all down to genetics. Fat people have a “hunger hormone” that is frankly too lazy to make them feel really hungry when its owner is really hungry, and instead merely makes the hapless person feel a bit peckish all the time. On the other hand, obese people have a “fullness hormone” that never gets its act together at all, and never informs the brain that enough is enough. Later in the programme it was revealed just how the brain was responding to all this hormonal misinformation: thin people’s brains were hardly exercised at all by pictures of cream doughnuts, whilst fat people’s brains produced a veritable frenzy of irresistible urges that their rubbish fullness hormone utterly failed to control.

So obese people are between a rock and a hard place. It is truly wrong to hold them responsible. On the one hand their hormonal chemistry is all up the creek, and on the other their brains conspire against their every attempt at self control. The answer? Well, it seemed to be either hormonal pills, or else an odd side effect from the ubiquitous stomach by-pass surgery referred to earlier, which seemed to have the unlikely additional benefit of re-educating the brain.

It was easy to be carried away with the programme’s scientifically certified approach. Except for one rather glaringly obvious point that was never mentioned at all. The human brain has been as it is for a rather long time. The body’s hormonal chemistry has been as it is for millennia. And yet the obesity crisis that we are constantly being told about has only really taken off in the last, say, 50 years. It’s only reached the consciousness of TV producers in the last 20. Thus I can with absolute confidence say that the cause of this crisis is not to be found in endocrinology or in brain functionality, neither of which has suddenly changed in the last half century. A cause and its effects cannot possibly be separated by such an extravagant slice of time. To believe this proposition is to believe that fundamental aspects of our biology, that never bothered our species before, have suddenly begun to do so. Obviously not.

What the Horizon programme so carefully and thoroughly revealed was not a cause, but a mechanism. The cause is much more obvious, and simpler. It is that our Western diet has changed over the last 50 years in very deleterious, but very profitable, ways. At the same time, our level of physical activity has dropped precipitately. What we can learn from yesterday’s revelations is that this sorry state of affairs does not affect us all equally. Some of us are better equipped than others to resist the doleful consequences of rubbish food and physical slothfulness. True also is the programme’s point that resistance is easier for some of us than others.

What would a rational response be? Surely it would be to attack the causes, rather than to fiddle about with the mechanisms, a fiddling about that is bound to bring other unforeseen consequences in its wake. Why don’t we do this? For two very different, but actually strangely connected reasons. We don’t attack the food culture that is causing our fat malaise because too many people make too much money from its continuance. And we prefer drug or surgical interventions in mechanisms to attacking causes because drugs and scientific medicine are also major money-spinners. Not only that, scientists are as seduced by their flashy toys as any adolescent is by his or her iPad, or Android device, or X-Box console. How much more fun to play with an MRI scanner, or wield a tool that simultaneously cuts and staples, than to wonder about the dominance of hawkers of confectionery or fast food? I can still remember my excitement when I first got to use an electron microscope.

Yes, we should be careful to remember that obese people are indeed people about whom we should care, and not fools that we should castigate. But we should also be very wary of those who would locate every problem in genetics or chemistry, and who seek to minimise human volition or responsibility.


Once more unto the breach for gay marriage

Do please forgive me if I’m boring you, because I know I’ve written on this subject twice before. To be honest, even I don’t think that gay marriage is up there with environmental degradation and nuclear proliferation in the pantheon of things we should be most urgently fretting about, but the issue does seem to have an extraordinary ability to part people on all sides from any sense of proportion, or indeed, of any sense of sense.

For those who believe simply that gay marriage is an abomination in the eyes of Almighty God, and then leave it at that, I have some respect even if no scintilla of agreement. But the opponents of gay marriage seem far too embarrassed just to leave it at that, and instead feel constrained to make up all sorts of other spurious and, frankly, scaremongering additional objections. None of them, it seems to me, stand up to scrutiny.

So here’s a canter through some of the most often advanced additional reasons, beyond that of God’s personal displeasure, and why they make little or no sense.

  • That gay marriage will somehow make it impossible to bring children up properly in future. Aside from the rather obvious point that we don’t seem, as a society, to be doing a very good job of bringing up children properly now anyway, without gay marriage, this seems the strawriest of straw men. How exactly will the fact that some gay men and women are married impact on how I bring up my children in my heterosexual marriage? Will it be the embarrassment of having to explain these same-sex couples to my children during the supermarket run? If avoiding parental embarrassment were central to successful child-rearing, then sex education would disappear overnight. Insofar as this argument has any coherent basis, it generally seems to be something to do with making it more likely that the off-spring of unsuccessful heterosexual relationships will find themselves coerced into gay ones. Well, if that’s so bad, it happens now anyway. How will being coerced into a gay marriage be any more damaging than coercion into a gay civil partnership? The same argument applies to gay couples adopting. If it’s so wicked, why will it be more wicked if the couple is married?
  • That society is founded on marriage between a man and a woman, and to extend the concept to gay couples will knock society’s struts from under it. I happen to be a supporter of marriage (now – I haven’t always been) but if too few marriages are threatening society’s cohesion, I should have thought that adding more marriages would be a good thing. I fail entirely to see how permitting gay marriage would undermine heterosexual marriage. As a heterosexual married man, why would the sight of gay married men, for example, make me more likely to be unfaithful, or to abuse my wife? Were I to be tempted to gay unfaithfulness, then perhaps the knowledge that I was also threatening someone’s marriage might give me greater pause. Hang on, I’m starting to give this notion more credibility than it deserves. I’m not tempted to gay unfaithfulness largely because I’m not gay.
  • That it’s OK to have heterosexual marriage, and gay civil partnerships, but calling them all marriage will cause the heavens to fall. I rather doubt it. But the fear that it may do is based on an old misunderstanding – that equality between things is tantamount to saying that they are the same thing. That’s not true. To say that gay people and heterosexuals are equal in being married is not to suggest that gay relationships and heterosexual relationships have mysteriously become the same thing. A pound of carrots is equal to a pound of potatoes, but carrots are not potatoes. Gay and heterosexual marriages would be equal, but not the same.
  • That allowing gay marriage is simply a giving-in to selfish demands for the indulging and normalising of sexual perversion. This is the crux, actually. This is why the opponents of gay marriage are so vulnerable to the charge that they are simply homophobic. Once the legitimacy of gay sexual attraction is conceded, then all the other objections melt away. No less an authority on the subject of sexual desire than St Paul himself accepted that it is better to marry than to burn.

Thus there are only two real objections to gay marriage, and they are often merged together. God is implacably opposed to it, and/or homosexuality is a filthy perversion anyway. Either or both of those is an honest position to take. If you believe those things, say so and be damned. But don’t witter on about society, bringing up children, or changing what has always hitherto been understood as the nature of marriage. Just stick to your guns, and I’ll stick to mine.

Chance is a cruel mistress indeed

The appalling coach crash in a Swiss road tunnel in which 28 people died, amongst them 22 children, is one of those news stories that simply transfixes you in dumb, mesmerised horror. You don’t have to have children yourself to appreciate the awfulness of course, but for any parent I suspect this strikes a deep and heartfelt chord of anguished empathy. I simply cannot begin to imagine the shock and despair that must engulf the parents of these children. They sent their kids off for a fun-filled skiing holiday, and never saw them again.

One might think that losing a child in this way represents some kind of ultimate limit of suffering, a sort of absolute zero on the scale of emotional experience. But in this incident there’s another layer, a twisting of a knife that one might have thought could not be twisted any further. The coach in which so many children died was but one of a convoy of three. The other two coaches arrived unscathed in Belgium, discharging their occupants to the loving arms of their families.

The agony of having one’s child killed in the third coach must surely be cruelly aggravated by the inevitable thought that they might just as easily have been travelling in one of the other two. For the parents of those killed, the temptation to fall into a bitter jealousy of those parents of children in the other coaches must be almost irresistible. And in a symmetric but equally unfounded manner, the guilt experienced by the parents of the safe children must be just as overwhelming.

The need which we all have to make sense of events, to construct some sort of narrative that explains what things mean, that looks beyond “how” into the realm of “why”, makes us vulnerable to all sorts of distortions and tortures every bit as destructive as the meaninglessness from which we are trying to escape in the first place. In trying to rationalise events that in fact are devoid of meaning, we ironically create irrationality.

We know with our heads that there is no answer to the question, “Why was it my child that was in the coach that crashed?” No answer to why my child was spared when others were not. Yes, chance is indeed a cruel and unforgiving mistress.

In the face of such a mistress we have nothing to offer except our prayers. Meaningless fantasy in the face of meaningless events, many might feel. Yet if I were one of those grieving parents, I might take the prayers anyway. Anything is better than empty nothingness.