The obesity wars and the education of a researcher: A personal account.

Published on Jun 15, 2021in Progress in Cardiovascular Diseases6.763
· DOI :10.1016/J.PCAD.2021.06.009
Katherine M. Flegal98
Estimated H-index: 98
(Stanford University)
A naive researcher published a scientific article in a respectable journal. She thought her article was straightforward and defensible. It used only publicly available data, and her findings were consistent with much of the literature on the topic. Her coauthors included two distinguished statisticians. To her surprise her publication was met with unusual attacks from some unexpected sources within the research community. These attacks were by and large not pursued through normal channels of scientific discussion. Her research became the target of an aggressive campaign that included insults, errors, misinformation, social media posts, behind-the-scenes gossip and maneuvers, and complaints to her employer. The goal appeared to be to undermine and discredit her work. The controversy was something deliberately manufactured, and the attacks primarily consisted of repeated assertions of preconceived opinions. She learned first-hand the antagonism that could be provoked by inconvenient scientific findings. Guidelines and recommendations should be based on objective and unbiased data. Development of public health policy and clinical recommendations is complex and needs to be evidence-based rather than belief-based. This can be challenging when a hot-button topic is involved.
📖 Papers frequently viewed together
2 Authors (Alice Miller, Ruth Ward)
23 Citations
#1Madalina Garbi (University of Cambridge)H-Index: 16
Clinical guidelines are developed by professional societies and also, in England, by an independent non-departmental public body, the National Institute for Health and Care Excellence (NICE). Similarities and differences between these guidelines should be viewed in the context of different objectives, responsibilities and roles of guideline developers. This review describes the NICE clinical guidelines development principles and processes with the aim to provide the reader an informed perspectiv...
4 CitationsSource
#1Andrew Elagizi (UQ: University of Queensland)H-Index: 9
#2Salvatore Carbone (VCU: Virginia Commonwealth University)H-Index: 26
Last. Hector O. Ventura (UQ: University of Queensland)H-Index: 72
view all 5 authors...
Abstract The obesity paradox, which suggests a survival advantage for the obese in heart failure (HF) has sparked debate in the medical community. Studies demonstrate a survival advantage in obese patients with HF, including those with advanced HF requiring continuous inotropic support for palliation or disease modifying therapy with a left ventricular assist device (LVAD) or heart transplantation (HT). Importantly, the obesity paradox is affected by the level of cardiorespiratory fitness (CRF)....
13 CitationsSource
7 CitationsSource
#1Salvatore Carbone (VCU: Virginia Commonwealth University)H-Index: 26
#2Marco Giuseppe Del Buono (UCSC: Catholic University of the Sacred Heart)H-Index: 12
Last. Carl J. Lavie (UQ: University of Queensland)H-Index: 121
view all 4 authors...
Abstract The epidemic of obesity contributes to the burden of type 2 diabetes mellitus (T2DM) in the United States and worldwide. Importantly, obesity is not only preventable but can be treated, particularly with lifestyle modifications to forestall T2DM in those with excess adiposity. The mechanisms linking obesity to T2DM are numerous and involve adipose tissue remodeling as a result of unhealthy behaviors, including unhealthy diet, reduced physical activity (PA) and exercise training (ET), an...
39 CitationsSource
#1Katherine M. Flegal (Stanford University)H-Index: 98
#1Katherine M. Flegal (Stanford University)H-Index: 7
Last. Wolfram Doehner (Charité)H-Index: 67
view all 3 authors...
: Guideline recommendations and health policy decisions rely on evidence from clinical and epidemiological studies. Adequate methodology and appropriate conclusions are essential to support healthcare and health policy decisions. An analysis of body mass index and mortality by the Global BMI Mortality Collaboration (GBMC) concluded that the association of excess body weight with higher mortality was similar worldwide and that overweight and obesity should be combated everywhere. To reach this co...
14 CitationsSource
#1Katherine M. FlegalH-Index: 98
Last. Mitchell H. GailH-Index: 105
view all 4 authors...
: As the prevalence of obesity has increased over time in the United States (1,2), concern over the association between body weight and excess mortality also increased. In 2005, an analysis of estimated excess deaths, relative to the normal weight category (body mass index [BMI] 18.5-24.9), that were associated with underweight (BMI less than 18.5), overweight (BMI 25.0-29.9), and obesity (BMI greater than or equal to 30) in U.S. adults in 2000 was published (3). Both underweight and obesity, pa...
3 Citations
Publication in peer-reviewed journals is an essential step in the scientific process. However, publication is not simply the reporting of facts arising from a straightforward analysis thereof. Authors have broad latitude when writing their reports and may be tempted to consciously or unconsciously “spin” their study findings. Spin has been defined as a specific intentional or unintentional reporting that fails to faithfully reflect the nature and range of findings and that could affect the impre...
79 CitationsSource
#1Katherine M. Flegal (Stanford University)H-Index: 98
#1Katherine M. Flegal (Stanford University)H-Index: 7
Last. John P. A. IoannidisH-Index: 204
view all 2 authors...
Abstract Meta-analyses of individual participant data (MIPDs) offer many advantages and are considered the highest level of evidence. However, MIPDs can be seriously compromised when they are not solidly founded upon a systematic review. These data-intensive collaborative projects may be led by experts who already have deep knowledge of the literature in the field and of the results of published studies and how these results vary based on different analytical approaches. If investigators tailor ...
10 CitationsSource
#1Andrea Darzi (AUB: American University of Beirut)H-Index: 14
#2Elias A. Abou-Jaoude (Canisius College)H-Index: 5
Last. Elie A. AklH-Index: 96
view all 10 authors...
Abstract Background and Objective Our objective was to identify and describe published frameworks for adaptation of clinical, public health, and health services guidelines. Methods We included reports describing methods of adaptation of guidelines in sufficient detail to allow its reproducibility. We searched Medline and EMBASE databases. We also searched personal files, as well manuals and handbooks of organizations and professional societies that proposed methods of adaptation and adoption of ...
17 CitationsSource
#1Katherine M. Flegal (Stanford University)H-Index: 98
#1Katherine M. Flegal (Stanford University)H-Index: 7
Last. John P. A. Ioannidis (Stanford University)H-Index: 204
view all 2 authors...
4 CitationsSource
Cited By3
#1Meerim ParkH-Index: 10
#2Jiwon LimH-Index: 8
Last. Young Joo WonH-Index: 48
view all 8 authors...
Abstract null null Objective null Malignant ovarian germ cell tumor (MOGCT) is a rare ovarian malignancy accounting for less than 5% of all ovarian cancers. We aimed to evaluate the incidence, survival, and subsequent malignancies after the diagnosis of MOGCT. null null null Methods null Data from the Korea Central Cancer Registry were used to identify MOGCTs between 1999 and 2017. The age-standardized rates (ASRs), 5-year relative survival rates (RSR) and standardized incidence ratio (SIR) for ...
#1Walter C. Willett (Harvard University)H-Index: 385
Last. JoAnn E. Manson (Harvard University)H-Index: 297
view all 5 authors...
1 CitationsSource