George Monbiot says obesity is an ‘incurable disease’. Here is what’s wrong with his evidence

    12 August 2015

    In the pages of the Guardian today, George Monbiot claims that ‘obesity is an incurable disease’ that ‘resembles cancer’. Needless to say, capitalism and advertising are to blame.

    He presents two pieces of evidence for the incurability of obesity. The first is an opinion piece published in what’s left of the Lancet. Its authors don’t say that obesity is incurable but they do coin some colourful terms, such as when they claim that ‘individuals who formerly had obesity but are able to re-attain a healthy bodyweight via diet and exercise still have “obesity in remission”’. They recommend that doctors use anti-obesity drugs which, they say, are more effective and have fewer side effects than they did in the past. Perhaps they do, but given Monbiot’s deep suspicion of corporate interests, it is surprising that he doesn’t mention the authors’ long list of competing interests, including funding from the drug companies Vivus, Takeda, Novo Nordisk, Orexigen Pharmaceutical, Boehringer Ingelheim and Shore Pharmaceutical.

    His second piece of evidence is a recently published study which found that only 3,500 of a cohort of 176,000 obese Britons tracked in 2004 had returned to a healthy weight by 2014. A success rate of two per cent would have been disappointing if this was a clinical trial, but it wasn’t. It wasn’t a trial at all and no attempt was made to ‘cure’ the people involved. The researchers never met them, didn’t know their names, didn’t attempt any intervention and there is no evidence that they were even trying to lose weight. Their anonymous data was simply pulled out of the NHS computer so that their body mass index in 2004 could be compared to their body mass index in 2014. These people weren’t treated, they were monitored. Insofar as it can be called an experiment, it was one that only had a control group.

    Call me old-fashioned, but I think there should be an attempt to cure before a condition is called incurable. A doctor who claimed that his treatment had failed when he had never met, let alone treated, a patient would soon find himself up in front of the General Medical Council. If you want to know if obesity is ‘curable’, the best evidence comes from randomised controlled trials. Sure enough, they show that significant weight loss can be achieved through exercise alone, or through calorie reduction alone, or through a combination of both.

    Monbiot’s claim that obesity is as incurable as cancer is offensive not only to cancer sufferers but to the three-quarters of the population who manage to live in modern Britain without becoming obese. Monbiot says that obesity is ‘rising rapidly’ but, as I have mentioned before, that is simply untrue.

    Why such hyperbole and exaggeration? Monbiot uses it to take a swipe at David Cameron’s (silly and unpleasant) idea of withholding benefits from the obese and to tell us how food would be sold on Planet Guardian: ‘One day, though not before many thousands have needlessly died, it will become illegal to advertise any food or drink that merits a red traffic-light warning. They will be sold only in plain packaging, with health warnings, on high shelves.’ This sounds remarkably like the ‘slippery slope’ about which opponents of plain packaging warned. The only surprise is that Monbiot didn’t wait for it to be applied to tobacco before demanding the inevitable roll out. Alas, he may never be cured of his addiction to big government.