From: nadel@attatash.aero.org (Miriam Nadel)
Subject: Re: Adiposity 101
Organization: /usr/lib/news/organization
Date: Tue, 5 Jan 1993 18:13:28 GMT

In article <#kwr3-c@lynx.unm.edu> bhjelle@hydra.unm.edu () writes:
>In article <1993Jan4.164932.611@speedy.aero.org> nadel@attatash.aero.org (Miriam Nadel) writes:
>>
>>If you want to play conflicting studies, there was a study
>>some years ago of women who had plateaued on a diet in which they were
>>kept in a carefully controlled environment and all intake and output
>>measured.  Of the women in the study, some did resume weight loss on the 
>>diet, suggesting that they had been underreporting their intake.  
>>The rest, however, continued to remain 
>>incapable of further weight loss and 2 even gained weight.
>
>That is compatible with (1) the possibility that the caloric goal
>was set too high for some of the subjects, and (2) systematic
>errors in measuring caloric intake, as you describe later.
>In other words, it is not, as described, in conflict with the NEJM
>study.
>
It was in conflict with the report that I heard of the NEJM study which 
implied that *all* of the subjects were grossly underreporting their intakes.

It is my reading of Gordon's statements that he doesn't believe (1) is
possible.  The point I was making is that there have been controlled
studies in which at least some of the subjects failed to lose weight
or even gained weight while consuming low numbers of calories.  I looked
up the numbers and the study involved 29 women.  10 of them failed to lose
weight on a 1500 calorie diet and 1 gained.  (I remembered it wrong above)
Objection (2) is not really valid in this case as everything was measured and 
the environment was set up to prevent the possibility of cheating (no 
privacy, for example).

There was a methodological flaw though, in that the women studied were not
tested for possible defects in thyroid function.
>
>>A more serious concern about the recent study to do with interpretation.  
>>I heard an interview with the researchers involved in which they were trying
>>to be careful not to suggest a character flaw but instead came away sounding
>>like the subjects just never registered how much they were eating.  It's
>
>It is truly unfortunate the the researchers have to spend so
>much of their efforts worrying about whom they may have offended,
>rather than the findings, which are interesting in themselves.
>
The problem is that research results get reported publicly in very sketchy
ways by people who don't understand them and then get used for political
purposes.  Take someone who actually *does* fail to lose weight on
a 1500 calorie diet.  Their family, their "friends," their employer, and
even their doctor now turn to them and say "Oh, you must really be eating
twice that - I heard about this study that proved that."

>>In particular, the whole issue of why the
>>underreporting occurred has really not been approached in any systematic
>>way but is instead an area of speculation.  (To be fair, the researchers
>>admitted this.)
>>
>I'm not sure any great insight would follow an inquiry as to
>*why* underreporting occurred. An argument that has been
>proffered repeatedly here and elsewhere is that there are very
>heavy individuals who can fail to lose weight despite very low
>calorie diets, even combined with exercise. This study would
>suggest that some of that problem has to do with underreporting
>caloric intake and exercise.

Surely you mean overreporting of exercise?  

I think there would be some useful insight into how someone could so grossly
underreport their intake.  Missing by a couple of hundred calories is
within the bounds of measurement accuracy, but it doesn't seem to me that
missing by a thousand calories can be attributed to that.  I think one has
to really understand a problem before solving it and the speculation that
I heard did not seem to me to be very productive.  

Miriam Nadel
Newsgroups: sci.med