Newsgroups: sci.med
Subject: Re: Adiposity 101
From: RGINZBERG@eagle.wesleyan.edu (Ruth Ginzberg)
Date: 12 Dec 92 05:34:33 EDT
Distribution: world
Organization: Philosophy Dept., Wesleyan University
X-News-Reader: VMS NEWS 1.20In-Reply-To: geb@cs.pitt.edu's message of 11 Dec 92 22:18:42 GMTLines: 74

In <17744@pitt.UUCP> geb@cs.pitt.edu writes:
> In article <1992Dec05.003236.11454@omen.UUCP> caf@omen.UUCP (Chuck Forsberg) writes:

>CF> The current Adiposity 101 cites almost 20 papers that conclude
>CF> the obese generally didn't get that way by feeding their faces.
> 
GEB> Well, not exactly.  If you don't feed your face you eventually will
GEB> suffer the same fate as those currently in Somalia.  Even if the
GEB> obese don't eat more, they are eating too much for them.

Sorry to get in the middle of this can-o'-worms, but allow me to impersonate a
logician for a moment:

I believe that Chuck doesn't deny that
	IF (you eat too much) THEN (it means you can get fat). <IF e THEN f.>
I believe he is merely pointing out that this does not logically imply that
	IF (you are fat) THEN (it means you eat too much). <IF f THEN e.>

This is logically correct; i.e., It is not the case that <IF e THEN f> implies
<IF f THEN e>.  However, it does imply that <IF NOT-f THEN NOT-e>, i.e., IF
(you are not fat) THEN (it means you are not eating too much). This is Gordon's
point about Somalians.  Technically, these two assertions do not contradict one
another. (Chuck's assertion & Gordon's response, above.)

>CF> adipose tissue.  Dietary manipulatons have not been very
>CF> successful in the long term control of obesity; the 95% failure
>CF> rate approaches that of laetrile, and I see no indication that
>CF> another 50 years of tinkering will improve the success rate of
>CF> either.

It is my impression that Chuck is attempting to distinguish between the disease
of obesity and one of its common symptoms, excess body fat.  Chuck does not
deny that dietary manipulation accomplishes temporary remission of this primary
symptom;  he is claiming that temporary symptomatic relief (losing weight) is
not the same as treating the condition (obesity).

I think analogies here might be: Causing weight gain by force feeding is not a
treatment of anorexia, it is merely relief of a symptom.  Relieving the pain of
strep throat with analgesics is not treatment of the disease of strep throat,
although it may be said (in some reasonable sense) to "work" for relief of a
primary symptom of the disease, at least temporarily.

Chuck's further (& stronger) claim, about which the most skepticism has been
expressed here, is that the very treatment which temporarily alleviates the
major symptom (dieting removes fat) exacerbates the underlying disease of
obesity even at the same time that it is providing symptomatic relief from
excess body fat. This claim rests on the assertion that the symptom of excess
body fat and the disease of obesity are two different things.  If you don't
accept that claim, then this claim doesn't make any sense.  However you could
accept that first claim & still deny this stronger one.

GEB> enjoy periodically having to diet to keep from weighing over 300lbs?
GEB> The only thing worse is weighing over 300lbs.  Diet works for me,
GEB> although it doesn't work perfectly or I would be 175 lbs all the time.
GEB> Until something better comes along, I'm going to use it, and so
GEB> are a lot of other former morbidly obese.

Chuck would probably not deny that those who are desperately ill with any
condition which is currently untreatable have to make difficult decisions
regarding symptomatic relief, especially if the symptoms themselves can be
life-threatening.  However, he argues that research models which fail to
distinguish between symptom and disease will get no closer to actual treatment
or cure of the disease itself (rather than merely symptomatic relief) until
they make that distinction. 

Please don't flame me for "taking one side or the other" of this debate.  I am
merely trying to sketch out the structure of the argument, hopefully without
undue bias.  Thats what philosophers trained in the USA in the last 75 years
studied when we were in grad school...  %^(


------------------------
Ruth Ginzberg <rginzberg@eagle.wesleyan.edu>
Philosophy Department;Wesleyan University;USA
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