What Causes Cancer: Probably Not You

The perennial temptation to blame disease on sin or at least some grave moral failing just took another hit. A major new study shows that women on a virtuous low fat diet with an extraordinary abundance of fruits and veggies were no less likely to die of breast cancer than women who grazed more freely. Media around the world have picked up on the finding, cautioning, prudishly, that you can’t beat breast cancer with cheeseburgers and beer.

Another “null result” in cancer studies – i.e., one showing that a suspected correlation isn’t there – has received a lot less attention. In the May issue of Psychological Bulletin, James Coyne and his colleagues at the University of Pennsylvania reported that “there is no compelling evidence linking psychotherapy or support groups with survival among cancer patients.” This flies in the face of the received wisdom that any sufficiently sunny-tempered person can beat cancer simply with a “positive attitude.” For example, an e-zine article entitled “Breast Cancer Prevention Tips” advises:

A simple positive and optimistic attitude has been shown to reduce the risk of cancer. This will sound amazing to many people; however, it will suffice to explain that several medical studies have demonstrated the link between a positive attitude and an improved immune system. Laughter and humor has [sic] been shown to enhance the body's immunity and prevents against cancer and other diseases. You must have heard the slogan 'happy people don't fall sick'.

So far no one appears to have read Coyne’s study. On June 30, a month after its publication, all-purpose guru Deepak Chopra assured Sanjay Gupta on CNN that the mind can control the body: “…You know, of course, the … study where women who supported each other in a loving environment with breast cancer the survival doubled.” Gupta, last sighted seeking to discredit Michael Moore’s “Sicko” with his “fact-checking,” simply nodded, although the study Chopra was referring to was discredited years before Coyne’s research came out.

For the last decade or so, adherents of the new discipline of “positive psychology” have been insisting that not just cancer, but almost any health setback, can be conquered with optimism or a “positive attitude.” But as Coyne and other critics point out, the science here is shaky at best. Even the theoretical lynch-pin of the supposed happy-mind-healthy-body connection – that a positive outlook strengthens the immune system – took a kick in the teeth two years ago when Suzanne Segerstrom at the University of Kentucky found, to her own apparent surprise, that optimism can have a negative effect on the immune system when the stressors are intense, as in the case of serious disease.

Even if veggies and smiles don’t cure cancer, aren’t we still entitled to blame some people for their diseases? Lack of exercise and dietary indiscretions play a role in the development of diabetes and coronary heart disease, so we indulge in self-gratifying contempt for the fat lady scarfing down Doritos. But before you rush to judgment, ask yourself: What nutritional alternatives does she have? (And, yes, I know they have “salad” at Wendy’s now, but they don’t offer apples on Amtrak.) As for exercise, gym memberships easily cost $500 a year, and far too many of us are forced to spend 10 hours or more a day sitting in a cubicle, a car or a bus.

In the case of breast cancer, one victim-blaming theory after has wilted under scrutiny: The “cancer personality” theory, for example, which breast cancer victim Susan Sontag took on in her 1978 book Illness as Metaphor, and now high-fat diets and negative attitudes. Something other than genetics causes it, though, and one leading candidate is the Hormone Replacement Therapy that doctors pushed on menopausal women for decades as a supposed way of preventing heart disease, Alzheimer’s and wrinkles. When, in 2002, HRT was found to be correlated with breast cancer and millions of women stopped taking it, the incidence of breast cancer plunged.

Which suggests that optimism, especially about the validity of the conventional wisdom, can be hazardous. What you need is a narrow-eyed, deeply skeptical attitude.

Comments

[rebecca]

Barbara,

I'm a longterm admirer of your leftist writing and activism. I would like to ask you to apply some of your stellar "narrow-eyed, deeply skeptical attitude" to your notions of fat people.

Your support for "the fat lady scarfing down Doritos" is progressive in terms of class politics, but it depends upon stereotypical, oppressive notions of fat people. Fatness is not mostly caused by scarfing down Doritos. Some fat people scarf them down, but so do some thin people. Surely you've heard some bits from the fat politics movement. We work to show society (against all cultural lies to the contrary) that fat people can be fit; that fat people don't on average eat any more food (or junkier food) than thin people; and that fat people are systematically oppressed by the health care system and many other institutions on a daily basis.

Fatness indeed has some class connections. But the connections aren't simple or few, and your assumption fuels the stereotypes that wreak material damage every day.

Barbara, you're so excellent at deconstructing faulty paradigms of oppression. Please use those critical lenses to re-evaluate how you think of fat people.

-Rebecca Rabinowitz

[gaby]

"that fat people don't on average eat any more food (or junkier food) than thin people;"

All the fat people I know eat considerably more than thin people and have a knack for turning healthy food into junk food (ie heaping sour cream, butter and bacon bits on a baked potato which is not a "bad" food by itself.)

I have never believed that having a positive outlook can prevent any diseases. My own mother, who was a cheery, upbeat, life-loving woman, died of cancer at age 48, while my father, a prone to severe depression, outlived her by many years.

[Jessica]

Why don't you replace the word "fat" in this sentence:

"All the fat people I know"

with any of the following:

Black
Jewish
Gay
Muslim
Latino

And see how ignorant that statement really is. When you generalize about a group of people you are stereotyping.

Instead of being a bigot, perhaps do a little research. Your prejudice and discrimination against fat people is tainting your otherwise well developed, thought-provoking blog.

You are correct that people who live at or below the poverty line have a greater chance of being fat. There is a correlation between their health and their lack of access to healthy eating and exercise choices. Without the money to afford a gym membership or fresh fruits and vegetables, or without safe playgrounds or funding for school activities in their neighborhoods, poor families -- especially poor children -- suffer greatly.

However, your "doritos" line and your comment in response to the first comment posted only serve to diminish your credibility on the topic.

It is most disappointing when intelligent people like you perpetuate ignorance through stereotyping.

"The flip side of this neurosis is intolerance towards fat people...

Like so many prejudices, this one is rooted in myth. Dr. Martin Seligman, an authority on obesity, writes: 'Nineteen out of twenty studies show that obese people consume no more calories each day than non-obese people.'"

2. Martin Seligman, What You Can Change and What You Can't (New York: Fawcett Columbine, 1993), pp. 177-8.

[Kathy Barron]

This is what I know for sure:

1) My wonderful mother who always watched what she ate, controlled her weight, exercised, took her vitamins and supplements and was sort of a health food nut and definitely a positive person is now at age 72 being quickly eaten alive by breast cancer. It is horrific beyond description. Her mother, my Grannie, lived to 89 although she never exercised a day in her life and ate mostly fattening Southern home cooking.

2) People of all sizes, classes, lifestyles, attitudes, and every other type of group get diseases and illnesses. Nobody is immune, no matter how "good" they are or how hard they try. It is hurtful to everybody to act like we are actually able to control life and death. We are not. Some things are actually beyond our control -- health and life are two of them, even though we don't like to admit it. Good health is a gift -- a blessing. Plenty of people with horrible lifestyles are relatively healthy. Plenty of people with exemplary lifestyles suffer inexplicably.

3) It would do all of us well to have compassion for each other at all times, particular for those who suffer.

4) Every single so called "lifestyle" disease, such as cancer, diabetes, and heart problems strikes people of all different lifestyles. And studies are showing that being fat actually gives people a better chance of surviving some of these catastrophic illnesses. Not saying that fat is better -- just that it isn't worse.

5) You cannot tell a person's lifestyle or life choices by looking at them. I know people who are much fatter than I am who eat less and exercise more. Conversely, I know people who are thinner that eat significantly more and don't exercise as much. Scientific studies (not based on prejudice and stereotyping) show that fat and average size people generally eat around the same amounts and the same types of foods. Check out http://www.junkfoodscience.blogspot.com/ for some factual information.

6) The diversity we have in body size is a beautiful thing. Fatness is a beautiful variation. It would do us all well to become more appreciative of diversity and accepting of people who differ from us, particularly when we are talking about physical characteristics. It's really about the human beings that inhabit our miraculous bodies. We all deserve respect, compassion, and the ability to lead full, rich lives free from discrimination and oppression.

7) Finally, normally I tend to ignore sizeist remarks written on blogs --everybody has their opinions and prejudices. But these kind of prejudices and stereotypes are informing public policy. Fat children are being kidnapped by social services from their parents because people can't get it through their heads, no matter how many times it is proven, that fatness has much more to do with genetics than it does lifestyle. Fat people's civil rights are being violated every day. And that needs to stop.

[fedup]

I agree with most of these comments.

A friend of mine (one of the most up-beat, healthy persons you could ever meet) was diagnosed with breast cancer. After numerous radiation treatments, and a torn ligament by an inexperienced radialogist, she stopped her treatments. She started going to a holistic healer. Two years later, her M.D. told her that her cancer is totally gone.

The late Eddie Albert had a video produced explaining how cancer is big business for the healthcare field. Can't rememberthe name or how to get it.

[chris]

Jessica, you wrote:

"Why don't you replace the word "fat" in this sentence:

"All the fat people I know"

with any of the following:

Black
Jewish
Gay
Muslim
Latino

"And see how ignorant that statement really is. When you generalize about a group of people you are stereotyping."

Okay. All the fat black, fat Jewish, fat gay, fat muslim, and fat latino people I know are fat because they eat too much, they eat too much fattening food and they lie about how much they eat.

Amazingly, in this country, there are two contradictory problems that observers believe they are witnessing. One is the privations of poverty. Some "experts" say the poor have too little food.

On the other hand, in every poor urban setting in the country, obesity, especially childhood obesity, is a major problem. A walk through any poor neighborhood in Brooklyn confirms that the poor are portly. More than portly. Bustin' out.

Why? Because they eat too much. And they lie about it.

Anyone who desires to lose weight needs only cut out all foods made with sugar and all foods made from flour. Okay.

No Dessert. No Bread. No canned junk.

Fresh fruits, vegetables, chicken, canned tuna, and a whole lot of other food is okay.

But for those who can't live without their Big Macs, well, trouble lies ahead.

Anyway, bottom line -- obese people lie about their food consumption. That's the common trait. Not some phony claim about faulty genes.

[Radfattie]

There is nothing "faulty" with fat genes. Fat genes are what have allowed people to survive through times of famine.

There's nothing wrong with being fat. It is not a disease. It is not a problem. The media and the $40 plus billion dollar a year diet/medical/pharma industries who profit by making people believe fat is bad are the problem.

"Dieting is the cure that doesn't work for the disease that doesn't exist." -- the Fat Underground.

You can live without sugar or flour or "canned junk" if you like. Doesn't mean you'll be healthy. Just bitter and small-minded, I imagine.

People who value their prejudices, stereotypes and bigotry above normal human values are troublesome. You can't fix stupid. And that's the bottom line.

[laflaca]

If the fat-power movement was really about erasing stereotypes, why is latent hatred of skinny folk inherent in it?

For example, Radfattie wrote that is more beneficial to be fat, even going to far as to argue for an evolutionary selective advantage.

"There is nothing "faulty" with fat genes. Fat genes are what have allowed people to survive through times of famine," Radfattie writes.

Now let's play fair. We all know that if someone touted skinniness as more natural and more beneficial than fatness, there would be an uproar about weight and gender issues.

The word 'bigot' would certainly be thrown come the most innocent reference to condiments or snack-foods.

Why the double standard?

[Radfattie]

I never said that fatness was more beneficial or more natural than skinniness -- or better in any way. I just said that fat genes are not "faulty." There is no latent hatred of skinny folk in that statement. I love and cherish many thin people. The goal is a weight neutral, diverse-body positive society, where people are not judged -- or discriminated against --based on size.

My hatred is reserved for people who are hateful. And people who throw around hateful prejudices, stereotypes and promote discrimination will find themselves on the receiving end.

There is no double standard here ... and there is no such thing as playing fair with people who promote hatred and fear. And there is NOTHING that "we all know."

[Monica]

Talking about fat is confusing because it mixes the morbidly obese with people who are anything from moderately plump (they call them "overweight" nowadays) to moderately obese but relatively healthy.

Have you seen portraits of queen Anne of Austria, who was said to be very beautiful in her youth and who inspired a great by tragic love? By the way, apparently, the duke of Buckingam just took some liberties, such as touching her behind in some park or garden when he was drunk. But I digress.

The beautiful queen, and many other famous beautiful women, were fat, or pictured that way in their portraits. Being moderately fat used to be fashionable because the rich were well fed. Nowadays, the fashionable thing is to voluntarily starve in a world of plenty and pay for the privilege of performing unproductive physical activities (exercise) instead of being paid, or doing for oneself or one's family, some useful physical work.

The poor don't necessarily eat a lot or pig out. They may choose foods that are more filling and less expensive (fresh veggies can be expensive when on a low income). Some foods, such as pasta, raise insuline levels and don't contain enough protein, promoting overeating. Notice that protein-rich food such as meat may be more expensive, although it is rare nowadays not to be able to afford any. Some of the poor may live in substandard housing where they cannot cook, or are way too tired to cook after work. Even the less poor may be too tired and choose fattening foods, as they eat at work or not too far and don't have much time to cook after work. Many jobs are very sedentary, so even if not eating way too much, the body just can't burn all the calories and even 50 or 100 calories per day eventually end up as stored fat. For transportation, we use cars or public transportation instead of walking.

So that's why people are getting fat, not necessarily because they are pigging out. In fact, in a more natural environment, that would not even be an issue, as there would be more physical activity. In less sophisticated societies, humans would hunt by getting their prey exhausted before they themselves had to stop. I know that sounds incredible, not to speak of the dirt and sweat, but humans used to do that. No wonder we are meant to thrive when we get the opportunity to expand that energy instead of sitting down all day and buying the "prey" at least killed if not even cooked. And overeating and not losing weight too quickly (in fact, actually doing it more slowly after starving) is also part of our genetic programming, because we had to eat quickly what we could find (sorry, no fridge for you!), and some days, there wasn't much to eat.

[chris]

Radfattie, you wrote:

"There is nothing "faulty" with fat genes. Fat genes are what have allowed people to survive through times of famine."

Oh. I see. You are so concerned with what you believe others are thinking that you have created some far-fetched heroic quality for the fat gene that does not exist. The problem is in your head. Not your genes.

You wrote:

"There's nothing wrong with being fat."

Are you repeating this phrase to yourself? You are the person equating fatness with wrongness.

However your connection of the two should confirm for you the deception over-eaters use upon themselves.

You wrote:

"It is not a disease."

Again, are you talking to yourself?

You wrote:

"It is not a problem."

On this count you are probably wrong. Overweight people suffer from health problems tied directly to their excessive eating and weight.

You wrote:

"The media and the $40 plus billion dollar a year diet/medical/pharma industries who profit by making people believe fat is bad are the problem."

Throughout the history of man trim, toned well made people have always appealed more to the eye than those of Falstaffian stature. Rotundity has never increased anyone's appeal.

You wrote:

"Dieting is the cure that doesn't work for the disease that doesn't exist." -- the Fat Underground.

Ahh. A disingenuous attempt to change the subject. And another example of someone speaking to him/herself.

No one except you has connected fatness with illness and diet with cure.

Not the least of this false claim is the notion that food is medicine. It isn't medicine. It's fuel. Some forms are more easily and readily stored -- on the body.

You said:

"You can live without sugar or flour or "canned junk" if you like. Doesn't mean you'll be healthy."

Ahhh, more dissembling. How does one calculate health?

Since eating a bad diet can lead to heart disease and other self-induced maladies, it is also true that eating other foods will steer the body away from heart disease and other maladies.

Meanwhile, it is also true that no diet protects or immunizes a person from many diseases. But we know that virtually every case of lung cancer is found in smokers, cirrhosis is the province of drinkers and heart disease is a result of too many rich foods.

Meanwhile, excessive weight is a factor in strokes and heart attacks. Yet despite all the seen and unseen benefits of staying trim, the untrim demand that observers embrace the delusion that appearances don't matter.

You wrote:

"People who value their prejudices, stereotypes and bigotry above normal human values are troublesome. You can't fix stupid."

What are "normal human values"? Values defined by you, of course. That means they reflect your prejudices, stereotypes and bigotry. Troublesome indeed.

Meanwhile your troublesome class of humans contains almost every one of us. Thus, the world is beyond repair.

You wrote:

"My hatred is reserved for people who are hateful."

The preceding is circular and suggests you should disapprove of yourself.

You wrote:

"And people who throw around hateful prejudices, stereotypes and promote discrimination will find themselves on the receiving end."

With respect to the discussion on this site, one's self-worth is in one's own hands. It is not in the hands or minds of others. To suggest that some cosmic payback will follow certain insensitive behavior is to admit you think the other guy has a point.

[Hattie]

What makes me furious is the way HRT was sold to women as a privilege--a drug for educated, affuent white women which would keep them nubile into extreme old age, with good bones, strong hearts, and moist vaginas.
I never took HRT, having been warned of its dangers by health professionals in the know; I had to endure the pity or scorn of my friends who thought I was endangering my health and sex life by not accepting the "hormone invitation."
Every day I thank god I was able to sidestep the HRT disaster. So much breast cancer and heart trouble and strokes. And the fear. It's a crime. Where are the class action suits anyway?

[chris]

News Flash:

WASHINGTON - If people keep gaining weight at the current rate, fat will be the norm by 2015, with 75 percent of U.S. adults overweight and 41 percent obese, U.S. researchers predicted on Wednesday.

A team at Johns Hopkins University in Baltimore examined 20 studies published in journals and looked at national surveys of weight and behavior for their analysis, published in the journal Epidemiologic Reviews.

“Obesity is a public health crisis. If the rate of obesity and overweight continues at this pace, by 2015, 75 percent of adults and nearly 24 percent of U.S. children and adolescents will be overweight or obese,” Dr. Youfa Wang, who led the study, said in a statement.

They defined adult overweight and obesity using a standard medical definition called body mass index. People with a BMI of 25 or above are considered overweight, while those with BMIs of 30 or above are obese and at serious risk of heart disease, diabetes and some cancers.

Studies show that 66 percent of U.S. adults were overweight or obese in 2003 and 2004. An alarming 80 percent of black women aged 40 or over are overweight and 50 percent are obese.

Sixteen percent of U.S. children and adolescents are overweight and 34 percent are at risk of becoming overweight, according to federal government figures.

Every group is steadily getting heavier, Wang said.

“Our analysis showed patterns of obesity or overweight for various groups of Americans,” said May Beydoun, who worked on the study.

“Obesity is likely to continue to increase, and if nothing is done, it will soon become the leading preventable cause of death in the United States.”

[Radfattie]

Wow, how convenient! Yet another press release denouncing the dangers of fatness! As if that doesn't happen EVERY day!

Thank you for showing who you really are. Your own words say it all. I don't need to say another thing.

[Laura]

I'm glad that someone out there is at least talking about this issue. Barabar makes a great point in her blog about how we blame people for their disease.
I've been "overweight" my whole life - so is every woman on my dad's side of the family. There are a lot of alcoholics too. After a battery of weight loss programs, excercise programs, diets, hating myself, and starving myself only binge the next day didn't help me lose weight, I gave up and read The Fat Girl's Survival Guide.
I changed my attitude about weight and focused on being healthy. I eat as many fresh organic vegetables as I can afford. I became vegetarian. I don't drink or smoke. I work out for an hour 5 days a week. As far as "lifestyle" is concerned I'm the healthiest person I know. Sure I lost some weight. About 30 pounds but not a significant difference.
But every time I see a doctor for something like the flu I have to be told that I need to lose weight and "cut out the crap" in my diet. I am not able to buy clothes in a mall because stores don't carry my size and am encouraged to stay at home and buy "extended sizes from their online cataloge" because people don't want to see people like me out in public in the mall.

Don't tell me there's not something in our society that equates fatness with wrongness. There is definatley size predjudice in america. I try not to focus on it when there are so many other prejudices at work in our society. I try to remind myself of all the ways I've been privleged.
But just for today, thank you for giving me a voice.

[Barbara E]

Friends of All Sizes: First, this is a blog about cancer and other serious diseases, not obesity. Second, the "fat lady" is mentioned only to attack the self-rightous prejudice against larger people. What I'd really like is some comments on the victim-blaming that goes on with breast cancer.

[Solo]

Hurray Barbara...I was just about to post a comment regarding how odd that in an essay about how people are blamed for their diseases the focus became a single phrase regarding fat. Just another indication of how obsessed we are on the subject.

HRT is just one more in a long line of medical "miracles" that backfired. I wonder how many people know that the estrogen in HRT was derived from pregnant mares?

The media plays a significant role in promoting new and unproven theories about health and disease. Vitamins are good,no they're bad. Eggs are bad, no they're good. Wine is bad, no it's good and on and on and on.

For many years women were blamed if their child was austistic because some half baked theory claimed the mother rejected the child while in the womb. Also homosexuality was the result of a weak father and strong mother. I could go on and on, but I won't.

When I was in school we were taught that human health was 30% genetic and 70% choice. Science now shows that genetics, how your individual string of DNA is wrapped, is a much more significant factor in the health of longevity of an individual.

Yes, too many kids are heavy and have poor eating habits. Why, because neither Mom or Dad have the energy or time to raise healthy kids.

The point is Be AWARE, Be VERY AWARE and SKEPTICAL of any "new" theories and treatments that result from them.

[chris]

Barbara asks:

"What I'd really like is some comments on the victim-blaming that goes on with breast cancer."

There are no credible people or comments on the subject of blaming breast cancer on the patient.

Why ask the lunatics to come out of the woodwork to make such comments when not one of them can present a valid point?

The fact that some people still claim the world is flat means nothing.

Of course it's always fun to start a firestorm. When Larry Summers -- formerly the big cheese at Harvard -- suggested it's worthwhile to investigate the POSSIBILITY that men are better mathematicians than women to explain why there are so few prominent female mathematicians, he was pressed to quit his Harvard job.

In other words, there are nutty factions everywhere that equate TRUTH with BLAME and FACTS with BIAS.

The burning question stands: What causes breast cancer?

The answer: We're not sure, thus EVERY possibility must be examined and tested. If individual behaviors related to lifestyles are examined, well, that's doing the right thing. Would anyone rule out smoking as the dominant cause of lung cancer? Or heavy drinking as the chief cause for cirrhosis?

Given the fact that breast cancer strikes women in every segment of society over the entire range of lifestyles, the most reasonable hypothesis to pursue is probably gene-based. But the PROBABILITY of finding the answer in one area does not eliminate the POSSIBILITY of finding it elsewhere.

Raising the emotional pitch over where to look is foolish. To suggest lifestyle isn't a factor might mean important research goes undone and advances go unmade. That's bad.

[PaulK]

"But before you rush to judgment, ask yourself: What nutritional alternatives does she have? (And, yes, I know they have “salad” at Wendy’s now, but they don’t offer apples on Amtrak.) As for exercise, gym memberships easily cost $500 a year, and far too many of us are forced to spend 10 hours or more a day sitting in a cubicle, a car or a bus."

She does have alternatives:

1. for $1.50 she can buy a bag of corn flour, fry her own corn chips in 15 minutes and season them the way she wants. It only takes 5 minutes and $1.25 to make home made guacamole. These will all be lower in fat and tastier than doritos. She can pack apples or a healthy lunch to bring on amtrak. 2 weeks worth of salad would cost about $15. She can make a weeks worth at one time in about 20 minutes.

1b. If she is low income, what is she doing eating at Wendy's? Why is she buying Doritos? What is her cable bill running her every month?

2. Walking is totally cost-free exercise. How about getting the kids and friends together for a daily hour-long stroll instead of watching "I Love New York" on TV? Also calisthenics and yoga are exercises that cost absolutely nothing (I learned about yoga from a DVD that I found in the library..cost? $0.

3. How about walking at luch time away from those cubicles and around the block? A quick stretch or exercise every couple hours? Find a job that doesn't require so much sitting? Find a job that is closer to your living place so you can walk or bike to work? These are all choices. We choose to take a sitting job, choose to drive to work, choose to eat poorly, choose to sit all day.

Would these possible changes cure or prevent cancer? who knows? But they are steps that will lead to a healthier and cheaper lifestyle, a decrease in obesity (remember, we didn't have a 60% obesity rate until recently...I doubt our entire population's genes changed that much in 25 years), and more money to put away for savings to dig people out of poverty.

[chris]

Laura, you wrote:

"I've been "overweight" my whole life - so is every woman on my dad's side of the family. There are a lot of alcoholics too."

It appears you are claiming there are a lot of alcoholics in your family in addition to overweight women.

Thus, you seem to be linking alcoholism and weight problems. As though you believe their origins are similar. Interesting.

In other words, you believe a person is an alcoholic whether he/she drinks a lot or not at all. You believe alcoholism is a condition that is in you, for which there is no cure.

While this view may be accurate, there is no need for a "cure" if one simply does not drink. In other words, the problem is overcome by a change in behavior.

Does one's desire to consume too much alcohol matter if one does not drink? No. The weakness for alcohol may be a permanent part of a person's make-up, but no harm occurs if one does not drink.

Though those who have had serious drinking problems should not drink at all, the body itself would not likely suffer from an occasional drink. Of course, it may well take only one drink for the alcoholic to lose his resolve and restart his destructive habit. But a small ration of alcohol is unlikely, by itself, to cause physical harm.

Is there any difference with food? In a nutshell, NO.

Fat is the body's method of storing excess energy. The body will not store food at the expense of meeting immediate energy needs. Thus, to gain weight (fat, not muscle) one must eat more than the body needs. To lose weight, one must consume less.

You wrote:

"I work out for an hour 5 days a week."

"Working out" is an undefined term. It is too often used as a deception by a person who is actually walking around at the gym making limited use of the facilities.

At my YMCA several obese people are regulars in the exercise rooms. They ride the stationary bikes, walk on the treadmills and use some of the weight machines. But it is difficult to describe their efforts as "working out". Yeah, they raise their pulses for a while, which is good. But...

It is good that they are doing what they can. But what they are doing isn't much. Medical sense may direct them to avoid heart attacks and other problems by exercising in moderation, but that usually means they limit themselves to the point of incurring almost no benefits.

They deceive themselves about the impact and value of their gym efforts. If they do this with such ease, I have no difficulty believing they fool themselves about their eating habits as well.

[Meowser (formerly Promentalbackwash)]

To anyone who hasn't posted here before: Please group ignore Chris. He is a troll who apparently has all day to argue with people here about the color of the sky, just to get the final word in. I am ashamed that he has the same name as my boyfriend, who is a wonderful human being.

Barbara, rest assured that many of us fat people bring our own apples on Amtrak and barely touch Doritos, and it hasn't made a dent in our weight, even with regular moderate exercise (I am not obligated to work out like a gerbil for anyone else's comfort, thank you). Which actually doesn't refute anything else you said, it confirms it. This blaming people for their illnesses is absolutely ridiculous. And highly selective. When trim, super-athletic types need knee replacements and MRIs for sports-related injuries, which are completely voluntary, nobody bats an eyelash. They "deserve" treatment, after all, because they are lean and virtuous. But gods forbid a working-class person enjoys a few "dietary indiscretions" after being on his/her feet all day and winds up (incidentally) getting sick. You'd think they'd strangled some yuppie's Akita.

[Larry In Lethbridge]

Hey Barb,

What about all these companies that profiteer from "claiming" they support breast cancer and fly the pink ribbon ?

There are some legit companies and organizations, but even the American Cancer Society has absolutely no idea how many are part of this scam. Nor do they know how much money is being raised.

I think some refer to it as the 'overpinkification".

This is very wrong and I it would stop it if we hand out some stiff prsion sentences to abusers.

Be wary of the pink ribbon.It is being sadly abused.

Chris, don't bother responding to this please. You are really starting to bug me.

[Radfattie]

Respectfully, Barbara, at the same time that you told people not to pick on larger people, you also pushed a stereotype.

At the same time that Solo was saying to be AWARE and SKEPTICAL, she also promoted a stereotype: that kids are fat because the parents aren't paying attention. Bad parents! So, thin kids are all well-adjusted and have all the parental attention they need? Come on! These kinds of stereotypes hurt everyone, fat and thin alike.

PaulK comes up with a smug response -- but seems not to have realized that the CDC changed the numbers that define overweight, so that yes, millions of Americans became "overweight" overnight. And if you're working 2-3 jobs just to stay afloat, you don't have time or energy to fry up your own chips and make homemade guacamole, as delightful as that might be.

Breast cancer is a hugely important issue -- as is the casting of blame on people who are ill for having brought it on themselves.

So, when you have something important you want to talk about, I suggest you attempt to not fly a stereotype up your pole and attract attention. Because fat people are organizing now and we're going to be speaking out.

Laura, I'm glad you feel like someone is speaking for you. If you haven't already, check out www.naafa.org. That is just one of many places where fat rights activists are organizing for civil rights for fat people -- size discrimination is wrong!

DFTT (Don't feed the trolls) Signing off. Peace out.

[Hattie]

Summers is a horse's neck. I'm glad he lost his job. In another generation women will have reached parity with men in math and science. It's all prejudice against women, because aside from getting women pregnant, there is nothing men do that women can't do. Prove me wrong. You can't.
On the breast cancer subject: I found out today that another one of my friends now has estrogen-dependent breast cancer. She's lucky. They got it soon enough. But you know with breast cancer it can always come back. I begged her not to take HRT. She thought I was crazy.
But I don't blame her. I blame her doctors.

[chris]

Hattie, you wrote:

"Summers is a horse's neck. I'm glad he lost his job."

Really? You think people should lose jobs for asking questions that need answers? You've got the sense of a muslim mullah.

The situation in which he became the lightning rod began with the question of why there are virtually no women at the cutting edge of mathematics. In response he suggested we might look into the possibility of innate differences between men and women for the answer.

As you pointed out, there are innate differences. Why would differences be limited to procreation?

You wrote:

"In another generation women will have reached parity with men in math and science."

Well, on this you are simply wrong. Little boys play with trucks and guns; little girls play with dolls and plan weddings. Big boys design trucks, guns, computers and pretty much everything else; big girls design clothes, become doctors and lawyers and run businesses. But they don't become LEADING scientists, engineers or cutting edge MATHEMATICIANS.

You wrote:

"It's all prejudice against women, because aside from getting women pregnant, there is nothing men do that women can't do."

Nice try. Because you know women do not hold the lead in many areas, you attempted to change the argument. NO ONE SAID women can't perform math. NO one said women are incapable of obtaining bachelor's degrees, master's degrees or Ph.Ds in MATH.

What Larry Summers observed is the FACT that throughout history almost NO women have proven themselves as leading edge mathematical theorists. There is no female Newton or Fourier or Euler or Fermat. Why is that?

But to cover up, you changed the question. Instead of asking why are there no women among the top ranks of mathematicians, you rewrote it to the tune of the old song "Anything You Can Do I Can Do Better."

The real question regards the gender differences in outcomes. Not some silliness about whether women can balance checkbooks.

You wrote:

"Prove me wrong. You can't."

You proved yourself wrong. First, you weren't honest enough to consider the real question. Second, you provided the most concrete example of what men and women CAN and CANNOT do.

But just to add a few more items to the list, women cannot play sports at the same level as men. Period. Serena Williams is a great tennis player -- for a woman. But if she played against male pros, she'd lose to some anonymous male player so far down the list that no one would know his name.

Due to the innate physical difference between men and women, women will never perform at the same levels as men in any sport.

Take government. In countries where citizens chose their leaders, women rarely are chosen. Of course Israel was early to elect a woman. Meanwhile, more women are reaching elective office today -- in the US.

Historically, however, monarchies don't count. On the other hand, dictatorships do count.

How many women have seized dictatorial power in the history of the world? The number is close to zero. It probably is zero.

Lastly is the area of medical experiences. Larry Summers wanted to know if innate differences between men and women explains the absence of women at the top rung of the mathematical world.

Following his lead, why is it that breast cancer strikes women almost exclusively? Why are men almost never struck by breast cancer?

Maybe medical science already knows the answer to this question. If not, however, it seems that acknowledging and studying this lopsided disparity is crucial.

However, people with your mindset prefer to see gender imbalances ascribed ONLY to discrimination or male control of females. Then there's the gratuitous addition of the concept of "blame".

These diversions only slow the drive toward uncovering the FACTS.

[Alex]

Hi Barbara,

New to you and came to this site via syndication of the article in The Guardian newspaper.

Quick question.

You state "When, in 2002, HRT was found to be correlated with breast cancer and millions of women stopped taking it, the incidence of breast cancer plunged.".

I cannot find any corroborating evidence for this statement. Could you provide a peer reviewd scientific paper as a source? Leaving aside any argument over the necessity or otherwise of HRT or the politco-socio-economic rationale for using it it is dangerous for people in the media, such as yourself, to make such wild claims without a credible source. People impressed by your reputation might mistakenly believe that HRT is the main cause of breast cancer. This is simply not true. Such misleading comments in the media have done much to foster distrust of science and medicine.

[Alex]

Just to clarify, I would like to see proof of the claim that breast cancer has declined since 2002 as a result of people stopping HRT. Not that HRT can cause breast cancer.

[Monica]

You are confusing the issues. Women can't play sports at the same level as men, and are much more likely to get breast cancer then men, for physical reasons. Things like math and seizing political power are at least partially due to social reasons. Would men have been willing to listen to a woman who wanted to seize power, and taken her seriously? In the past, most women simply did not have the same educational opportunities as men, so of course they did not become mathematicians.

[Emily]

Chris says: "Due to the innate physical difference between men and women, women will never perform at the same levels as men in any sport."

But Chris is forgetting extreme endurance sports like Channel swimming. Sometimes a woman has the record and sometimes it's a man.

[Emily]

Right now a woman holds the record for swimming the Santa Barbara Channel. She broke the record held by a man. She beat the old record by more than two hours. http://www.prleap.com/pr/85195/

[PaulK]

PaulK comes up with a smug response -- but seems not to have realized that the CDC changed the numbers that define overweight, so that yes, millions of "Americans became "overweight" overnight. And if you're working 2-3 jobs just to stay afloat, you don't have time or energy to fry up your own chips and make homemade guacamole, as delightful as that might be."

If you are working 2 - 3 jobs to stay afloat, you are doing something wrong. Maybe time to find 1 job that pays the bills? Cut back on your spending so you can eliminate one of those jobs? move somewhere cheaper, move somewhere that pays more for the same work, go back to school to change careers. You CHOOSE to work 2 or 3 jobs. You CHOOSE your lifestyle. Empowering feeling, isn't it?

[chris]

Emily, I wrote:

"Due to the innate physical difference between men and women, women will never perform at the same levels as men in any sport."

You responded:

"But Chris is forgetting extreme endurance sports like Channel swimming. Sometimes a woman has the record and sometimes it's a man."

First, this example cites an arbitrary form of contest that is largely undertaken by amateur athletes.

The results say nothing about the limits of human potential.

However, in other long-distance competitions, like running marathons, men hold the absolute records.

In the case of long-distance swimming, I doubt the activity has attracted enough practitioners to yield any meaningful data.

But if women prove better at long-distance swimming than men, well, then they are better at it. No man will lose any sleep over that determination.

However, it seems as though you think there is a brotherhood among men that connives to keep women from reaching their absolute limits and experiencing their full powers. That's pretty funny.

[PaulK]

And yes, my answer was smug. I have good reason to be. I use to weigh 220 lbs, now weigh 165. I used to be broke all the time, but now am not and will be returning to school. How? Buy looking in the mirror, examining what I was doing to make myself overweight and broke. I now work at a job that isn't exactly what I want, but it's a means to an end, because it pays the bills and will pay for school so I can eventually live the lifestyle I want. I lost all the weight by 1. doing a short fast and 2. paying close attention to what I now eat. I found I was drinking a lot of juice which was loaded with sugar which packed on the pounds. I was eating a food right before bed and not burning those calories. I was sitting a lot, so I got off my butt and started walking a lot. There are three facts about being overweight:

1. If you are overweight, you eat more than your body needs.
2. If you are overweight, you eat more than your body needs.
and
3. If you are overweight, you eat more than your body needs.

We can all do something about our health. It is pure laziness and victim mentality if we don't.

[Emily]

Chris:

I think you're manking an unwarranted assumption. You said "women will never perform at the same levels as men in any sport." All I did was mention a sport (long distance swimming)where this was not the case. I don't see how you get from there to thinking I believe there's a "brotherhood among men that connives to keep women from reaching their absolute limits and experiencing their full powers."

I assure you I don't believe that at all. I'm closing in on 60 and I find most men are quite supportive of women's athletics. I recently began to work out with weights for the first time. The college age men in the gym have all been polite and helpful to me.

If you'd said that in MOST sports, the best man is better than the best women, I'd agree. But that's not what you said.

[Ceci]

....off topic, but a reply to a brief Larry Summers thread above....

------------
For me this quote is why I'm glad Larry Summers lost his job at Harvard.

"I think the economic logic behind dumping a load of toxic waste in the lowest wage country is impeccable and we should face up to that"

What a shame that the powerful people in the world use pure economic reason to justify unethical behavior. Of what use is a job when your wages still require you to live in squalor that's now tainted with toxic (and to tie it back into this blog post; cancerous) waste?

[Chris S.]

I have been lifting weights for years and have a physicaly active job. Muscle weighs more than fat. I'm 5ft 11" and weigh 210lbs. I don't look fat and I'm not but according to those stupid weight charts I am. Any skinny but flabby man that is my height would both be lighter and have alot more fat on his body. One person I know is completely out of shape but is proud of his light weight. He's scrawny and looks like a bug with his paunchy stomach ,stick legs and spaghetti arms. That weight chart is total crap.

[chris]

Emily, you wrote:

"If you'd said that in MOST sports, the best man is better than the best women, I'd agree. But that's not what you said."

Correct. I said that in ALL athletic contests, the best male contestant will beat the best female contestant. I meant ALL, not MOST.

You mentioned a specific race. The Channel Race. I don't believe there is any serious training for such races. I mean training like training for Marathons, Iron Man Competitions, or Ultra Marathons.

On top of the fact that people engage in no real training regimen, it probably doesn't matter if they do. Swimming in open water is unlike any other activity. One day the water may be smooth as glass, the next, 10-foot swells and heavy chop. They face shifting currents and tides that might actually drive them toward or away from their landing point.

Even contestants in the same race are likely to face different water conditions.

Thus, contestants do not compete on a "level playing field" as they say.

To find the best long-distance swimmer, it would be necessary to hold the race in a calm body of water. A lake. but then the swimmers would not enjoy the added bouyancy they enjoy in salt water.

Anyway, if highly trained athletes compete under controlled conditions -- conditions that cause all contestants to face the same challenges -- I have no doubt men will win.

But if serious long-distance swimming becomes popular enough that the races are true competitions of well trained athletes -- if that happens and women are better than men, well, that's okay with me. I won't lose a minute of sleep over that outcome.

[Monica]

The problem with weight charts is that they are based on the body type of the average individual who is not particularly fit and who is more likely to have too much fat than a very strong, well-muscled body. But then, how could that be improved? And how would one easily determine who is a "skinny but flabby man" and who is merely thin, or who is very muscular or really fat? More importantly, how would anybody be able to explain to the "skinny but flabby man" that, according to the improved charts, he is actually fat? After all, a very strong man actually has the extra weight, even if it's due to muscle mass, but the skinny man does not.

[Antoine]

One small observation...
There is no need to join a gym to benefit from exercise...nor, in fact, is anyone "forced" to be in a car. These opinions are presented as some sort of "facts", which they are not.
Nothing prevents anyone from walking- up stairs, on sidewailks, to the store, around the block, in a park, anywhere, really. We have grown accustomed to thinking that we need to join a gym and that we need to drive everywhere. If people want to believe this, let them, but there is nothing stupider to watch than someone on a treadmill or a Stairmaster, PAYING to do something they could simply, and more enjoyably, do elsewhere and anywhere. All it takes is time, and if people didn't fill their life with nonsense, they'd have some.

[Emily]

Argh. Why do I bother?

Chris made a specific claim that men were better than women in ALL sports. I refuted that claim by pointing out one sport where that was not the case. Chris responded by thinking up all sorts of reasons why long distance swimming doesn't count. (He even claims people don't do any "serious training" for such events. I'd like to see somebody swim 28 miles through open water without having done any training.)

But what about the Iditarod? Sometimes a man wins and sometimes a woman. But I'm sure Chris will be able to think up some reason why it, too, doesn't count. It involves dogs. Conditions might change. Not enough people do it. Whatever.

Don't like the Iditarod? Check out the 2004 Summer Olympics Individual Dressage. Men compete against women in the very same contest. The top four were females. http://en.wikipedia.org/wiki/Equestrian_at_the_2004_Summer_Olympics_-_Individual_dressage

My point remains unrefuted. There are a few sports where women are at least as good as men, maybe better.

[Barbara E]

Alex: Just google "breast cancer," decline, "hormone replacement therapy," 2002. For a start. It was in all the papers.

[Demockracy]

The study saying vegetarian eating makes no difference is meat/dairy industry propaganda. See this website for the debunk:

www.drmcdougall.com/misc/2007other/070723study.htm

[chris]

Emily, you wrote:

"Chris made a specific claim that men were better than women in ALL sports."

Correct. ALL SPORTS. Keep the concept of SPORTS in mind.

YOu said:

"I refuted that claim by pointing out one sport where that was not the case. Chris responded by thinking up all sorts of reasons why long distance swimming doesn't count."

First, we are not discussing a sport when we discuss an activity undertaken by about 550 men and 250 women. That's how many people have swum the English Channel since the first time it was crossed, which was 1875.

Meanwhile, the record time is held by a male -- a little over 7 hours. No women are close to that time.

Training is haphazard. There is no protocol other than get strong and practice swimming.

Most of the swimmers are in it for a lark. Since there are no "professionals" who swim the Channel, time is not terribly important. Anyone who completes the swim is a winner.

YOu said:

"(He even claims people don't do any "serious training" for such events. I'd like to see somebody swim 28 miles through open water without having done any training.)"

Check the history of swimming the English Channel. It's not a serious activity. It may be work, but there's no true competition involved, other than the individual swimmer discovering whether or not he/she can actually complete the crossing.

You wrote:

"But what about the Iditarod? Sometimes a man wins and sometimes a woman. But I'm sure Chris will be able to think up some reason why it, too, doesn't count. It involves dogs."

Look, maybe if men or women were pulling the sleds I'd agree the Iditarod is a sport, but that's not the case. Dogs are dragging around a sled and a driver. The dogs are the athletes. Maybe female dogs are better sled-pullers than male dogs. I don't know. But the gender of the person yelling "mush" is irrelevant in this contest.

By extension, I guess you believe horse racing is really about jockeys, as though they carry the horses around the track.

You added:

"Conditions might change. Not enough people do it."

Those issues play into it, but the activity isn't a sport. It is an example of COMPETITION. But not a sport, despite the assertions of some.

You wrote:

"Don't like the Iditarod? Check out the 2004 Summer Olympics Individual Dressage. Men compete against women in the very same contest. The top four were females."

It's competition. It's a skill. It's not a sport.

You wrote:

"My point remains unrefuted. There are a few sports where women are at least as good as men, maybe better."

Look, the Olympics include target shooting as a "sport". It's not a sport. It's a skill. People routinely identify billiards and pool as sports. They are not. They are skills.

It is probably because the skill is combined with competition that it is called a sport.

On July 4th every year there is a Hot Dog Eating Contest at Nathan's on Coney Island, Brooklyn. Two nuts pound down a sickening number of hot dogs in a contest described as a sport. It's not. I don't know what to call this one. But eating is not a sport.

Lastly, competing in Spelling Bees isn't engaging in a sport either. It's competition. But spelling isn't a sport.

[Larry In Lethbridbge]

I thought this was Barb's blog. Why is it this Chris know it all is taking up so much space then ?

You opinions are asked for from time to time, but buddy, you are staring to make everyone puke with that arrogant attitude and "need to get the last word in edgewise" position.

You are sounding like a punk. In fact, a real weak one.

I know the reasons why you don't have your own blog and that is because you are not very well liked
and people will not revist after 1-2 visits.They sense an idiot when idiots abound.

I would like to have just 5 minutes with you alone. I'd whup you good and I doubt we would have any more goofy commentary.

Just why are you so arugmentative and need to be the center of attention anyhow ? poor childhood, no friends, girls shun you ?

That would explain most of your behaviours.

[chris]

Larry in Umbrage, you wrote:

"I would like to have just 5 minutes with you alone. I'd whup you good and I doubt we would have any more goofy commentary."

I live in Brooklyn, NY. When you get to town, let me know. It's always a pleasure to meet people from different lands who want to share their ideas.

Most recently, I've enjoyed getting to know a woman from Paris and a man from Berlin. A good summer so far.

[Emily]

The US Dressage Foundation calls dressage a sport and that's good enough for me.

Chris remains refuted. There is at least one sport where women are as good as the men.

This is my last post on the matter and I better sign off quickly before Chris can move the goal posts again.

[Larry In Lethbridge]

Umbrage? You spend your chilhood memorizing dictionaries and thesaurus'?

Hey I am glad you are having a good summer and all, but can you direct some of that hot air elsewhere and let some of the others have a go here ?

You have got way too much time on your hands, and your insistence of beating the hell out of people's viewpoints , item by item, makes you look like a buffoon. An intelligent buffoon, but an annoying buffoon.

Why don't you take some of that buffoonery and apply it
constructively somehow? You are a smart guy. You can figure something out.

Why don't you help bring Brooklin NY back to prominence then ?

[lc2]

Well I've tried time and again to warn others about chris but he manages to get under our skin collectively and individually and takes all the fun out of the dialogue. In fact I got sucked into it recently and really regret it. I have a lot to say on this subject as a first-degree relative of a pre-menopausal breast cancer survivor (my mom had it in her early 40s) ... which means I'm at very increased risk. I have suspicions that plastics and early versions of the Pill have contributed to this epidemic. But why bother? Chris will just ruin it. Thanks for nothing Barbara.

[Hattie]

Yes, you have to have almost had your blog ruined by this troll to appreciate the damage he can do.He is getting very clever and elaborate, posting under various names and changing his IP number. But it's just one person who lives in the Toronto area. We're giving him all this power.
So let's move our comments over to the Huffington Post, where Ms. Ehrenreich posts the identical content she does here. She gets great comments from very smart people. And if Mr. Troll shows up we can jump right on him with embedded replies. We can get him banned , too, by flagging him every time he shows up. Let's gang up on him and get rid of this pest!
BTW: "Monica" is supposed to show how silly women are. She is one of the troll's many aliases. Look closely at how dumb her remarks are, such as killing prey making you all sweaty. Big ha ha. Does anything she writes make sense?
These time wasters never get to my blog! In fact, I'm ashamed of myself for wasting time on them here.
It's just that entering into dialogue with Barbara Ehrenreich is so great. But we can just go to Huff Post.
Or she could start moderating Barbara's Blog.

[Curly Earl]

My name is Earl. I do live in Toronto and I can assure you I am not the "troll" Ms.Hattie ( Marianna Scheffer) speaks of.
I am also not Monica.

Ms.Bitter at the World has many delusions that cause her to to spout off stuff like the above, and ABSOLUTELY does not like anyone having a different opposing viewpoint to hers.

I have said this before. Countless times.She surfs different sites and leaves inciteful messages similair to Monica's inducing people to backtrack to her hack site.She craves attention and will do anything to become a legit blogger, that people respect. So far, no takers.

For all it's worth, she is most likely Monica ,and therefore a Troll Supreme.

Hattie, If you think I am Chris you are much more crazier than I thought. That dude is way too smart for you either you or me. You don't stand a chance big mama against him. Too bad he doesn't vist your sad site.

[Anarcissie]

PaulK: '... If she is low income, what is she doing eating at Wendy's? Why is she buying Doritos? What is her cable bill running her every month? ...'

In the culture of destitution, there is no point in saving money, buying wisely, accumulating goods, and so forth, because if you keep anything, someone is likely to take it away from you before you can use it.

The cable is important because television is a drug; the lives of the poor are mostly frightening and ugly and painful, and drugs anesthetize.

[Hattie]

Check the IP numbers.

[Hattie]

Here are the latest missives to me from "Curly Earl:"

"Did ya hear from Monica or Chris or any of the other voices happening inside your head ?

"Do you actually write anything at this blog or do you just provide links to others sites and posts as you don't have much to say ?

"Those pics of you on vaction were rather nasty, don't ya think ?

And:

"Having fun yet ? I am going to post the sites where you leave your jackass responses.

Me: He's escalating again. His service provider is Bell CA in Toronto. His new IP number is 76.64.50.90
Every time I block his number he changes it. He is really awful and needs to be banned. Note that he says he is going to follow my links around and harass the people I post to and who post to me. That is really stepping over the line, I would say, even overlooking the personal insults.
I'm wondering if there is any legal action I can take.
Sorry for this intrustion into this blog, but if Ms. Ehrenreich does not go to moderation, there will be no controlling the troll situation.

[Monica]

Me, Monica, have nothing to do with any Chris or Hattie. I'm in Montreal, I must have a different IP since I'm not these individuals, and the blog owner can reach me and get my full name and contact information at the email address I would indicate when posting. I trust Barbara not to abuse this information. Actually, I have no secrets, although I may tell you less information than I would tell a well-known and presumably trustworthy person like Barbara. Anybody who wants can write to me at [email protected]

[Curly Earl]

Well, Hattie is getting her exposure. Did you detect a hint of dictatorial direction she is giving Barbara ? Hey Hattie, this is not your blog and you have no say.

One more thing. I did say I would post some of your more colorful responses you leave at blogs, including the ones laced with profanity, and never did I say I would harrass anyone posting to you or to those you post to. Those kind of lies are really stepping over the line.

I think if you speak to a lawyer you will find out you are the one in deep kaka by posting stuff like this.

What is it that makes you crave this attention so much ?

[Justin K.]

Out of respect to Barbara E. I think we should stick to the topic of Cancer. It's disrespectful to conduct childish fighting on her blog.

[Lulu Maude]

Well! Hasn't this thoughtful blog attracted a tall cart of baggage on related issues?

To return to the original, Barbara-generated point, we serve no one well --let alone the truth itself-- in blaming people for their illnesses. I have a very dear friend who has been battling cancer for the last dozen years and is now in remission, though it has metastasized to her liver. She has hit every support group under the sun, done traditional and alternative therapies of every kind, even attending one of Chopra's seminars in La Jolla, which she said was incredible.

I don't know whether the research (which is usually multifaceted) supports her activities in combating the cancer. I do know that she has raised the quality of the life she has in the pursuit of support and alternative therapies. She is blessed with good medical coverage and the income (past--she had to retire but had saved some) to pursue life and straighten out whatever karma she'd identified as needing tidying up. Herein lies a revelation of sorts--that those with the means can approach disease as metaphor and do something with it. Such are the advantages of privilege.

On the weight stuff--Somehow I'm reminded of all those magazine cover stories of how Janet Jackson lost all that weight... I think to myself, the lady's bod is her fortune. Getting herself into shape can be a full-time, if temporary occupation if need be. The rest of us have to fit in whatever fitness as we can.

I was blessed with decent weight genes till I moved from my fitness-encouraging home state to another clime... depressed, I ate lots of Ben and Jerry's and drank lots of vodka... I am now in the obese category with no one but myself to blame. I have taken care of the sobriety part through A.A. and will need to address the ice cream, whose butter fat I have reduced but not eliminated. I will not, however, try to turn myself into an Aunt Martha statistic.

We must each look with honesty into the origin of our physical discomfort, and when it favors us, accept it, and when it reveals us, challenge it.

But enough. Barbara, I continue to love reading and reflecting your always challenging words and ideas. It's challenging to sift through both rhetoric and research to arrive at whatever truth we can find.

[Hattie]

My Barbara appreciation goes back many years.
Which is why I keep posting here in spite of the unpleasantness.
Thanks for your comments, Lulu.
It's true that with cancer as with so many other afflictions money makes a difference.

[chris]

The following commentary appeared in today's (8/3/07) Wall Street Journal. The writer is a member of the Italian Chamber of Deputies:

Sicko Europe
By DANIELE CAPEZZONE
August 3, 2007; Page A9

Rome

We live in an age of unprecedented medical innovation. Unfortunately, most of today's cutting-edge research is conducted outside Europe, which was once a pioneer in this field. About 78% of global biotechnology research funds are spent in the U.S., compared to just 16% in Europe. Americans therefore have better access to modern drugs. One result is that in the U.S., the annual death rate from cancer is 196 per 100,000 people, compared to 235 in Britain, 244 in France, 270 in Italy and 273 in Germany.

It is both a tragedy and an embarrassment that Europe hasn't kept up with the U.S. in saving and improving lives. What's to blame? The Continent's misguided policies and state-run health-care systems. The reasons vary from country to country, but broadly speaking, the custodians of public health budgets aren't devoting the necessary resources to get patients the most modern and advanced medicines, and are happier with the status quo. We often see news headlines about promising new cures and vaccines next to headlines about patients who can't get life-saving drugs as politicians impose ever stricter prescription controls on doctors.

The human toll can be measured in deaths and unnecessary suffering. It also costs us a lot of money. Prevention is cheaper than treatment. Modern medicine can prevent many medical complications that would otherwise require hospitalization and other expensive care. For every euro spent on new medicine, national health-care systems could save as much as €3.65 in later treatments, according to a National Bureau of Economic Research study.

This situation is especially dire in Italy. The government has capped spending on pharmaceuticals at 13% of total health-care expenditures while letting expenses for infrastructure and staff skyrocket. From 2001 to 2005, general health expenses in Italy grew by 31% while expenditure on medicines increased a mere 1.7%. Italian patients might well have been better off if the reverse was the case, but the state bureaucrats who make these decisions refuse to acknowledge the benefits of advanced drugs.

Also as a result, pharmaceutical research in Italy is falling behind even faster than in the rest of Europe. In 2004, pharmaceutical R&D spending was €3.9 billion in Germany, €3.95 billion in France and €4.78 billion in Britain, compared to only €1.01 billion in Italy.

Part of the problem is that regional authorities manage most of Italy's health-care spending. A strike by health-care personnel has an immediate impact on the region, but the consequences of cutting the budget for medicines are only felt in the long term and distributed across the nation. Hence, local authorities continue to focus on personnel and infrastructure in an age when medical research has become the most efficient way to improve public health.

Most recently, some Italian regions decided to drastically expand the scope of reference pricing, in open defiance of the central government. Reference pricing is used in most European countries to reduce government spending on medicine and is one of the reasons the Continent is lagging behind in pharmaceutical research. New drugs are grouped with existing drugs used to treat the same medical condition, and the government typically limits reimbursement to the cheapest price in the reference group. This way, patients are discouraged from using the most modern and more expensive medicine.

The Italian regions, however, are taking reference pricing one step further by grouping together drugs that do not necessarily have identical therapeutic effects. This way, the reference groups grow larger, and the regions can save more money. But patients are forced to choose between paying high out-of-pocket expenses or the risk of taking the wrong medicine.

This is a tragic state of affairs in a country with a higher natural demand for advanced medicine than most others in Europe. The older people get, the more likely they are to get ill, and today 20% of Italians are 65 years of age or older -- by far the largest percentage of any European country. The proportion is projected to rise to 24.5% by 2020.

Italian leaders have a responsibility to prevent parochialism from undermining public health and pharmaceutical research. But it is worth repeating that the combination of an aging population and an inefficient health-care system is a European, not exclusively Italian, problem.

It is time for politicians and regulators to confront our backward health-care systems and unleash the powers of medical research. Besides expanding drug budgets, European countries should work together to deregulate the pharmaceutical industry -- for instance, by speeding up the approval process for new drugs. The EU can better ensure that drug patents are adequately protected both in Europe and around the world against compulsory licensing and other infringements. Finally, we should give medical researchers tax incentives to slow the brain drain to the U.S. -- much like Ireland is attracting artists with favorable tax laws. We Europeans are getting older; we should be getting wiser, healthier and happier, too.

Mr. Capezzone is the president of the productivity committee of the Italian Chamber of Deputies.

[tulip]

Barbara, I would love to oblige you with comments about breast cancer, and how women may be blamed for their own cancer. I know you are probably tired of fat comments -- but here is is: If I went to the doctor to ask about concerns I have about my breasts, most of my doctors would first lecture me about my weight. No? You don't think so? I spent 45 minutes in my gyn's office last year being told by a very concerned NP that I just need to try harder to lose weight, maybe try Weight Watchers, and "be honest" about what I am eating. Did this have anything to do with any reason I was at my gyn's office? NO. Every doctor I have seen in the past ten years is morbidly obsessed with my weight -- and I am not the fattest woman. I shudder to think of what must happen to larger women than me when they ask for medical help. Many fat women won't go to the doctor's because they don't want to be shamed. And how does that impact a woman's survival from cancer? There is very little evidence convicting moderate weight of causing disease or illness, and yet people feel very righteous about blaming and shamming fatties. Please write us a book about that.

[anonymous]

The one with IP address 76.64.50.90 (i've nicknamed him Big Irv) has it out for me too. But the odd thing is that every time he slanders me on someone's blog, i get increased traffic on my site.

The added benefit is he led me to this blog by attacking here too. Barbara, your blog is interesting and insightful. I'm glad to have found it and look forward to reading more of your work.

best!

[anon]

As Barbara has pointed out, the comment about the Doritos was intended to reflect the way a portion of society feels about that woman, not Barbara's own personal views of the woman.

Per Barbara's request, I'll talk about the victim blaming. I do see an interesting amount of victim blaming in breast cancer, even by women with breast cancer!! I went out of town to help my mom after she had a mastectomy. A few months before, I had hit my all time high weight of 250 and I had been working on it. I was down to 225. Even though I was in the process of losing weight, my mom made it a point to warn me that I'd better lose weight or I might get breast cancer too. I've since gotten under the 200 pound mark & I'm aiming for 150-160 (at 5'8). Of course, when I was at the 200 point at the next visit after that, I was offered Ben & Jerrys (which I declined) repeatedly. But that's another topic for another blog :)

I think the focus on health should encourage folks to exercise & eat sensibly. Not to be model thin, just healthy. I know I feel better since I've made some changes. I have more energy and flexibiiity. I've watched a couple of shows like Celebrity Fit Club & The Biggest Loser. These shows focus so much on the pounds lost, but I'd really like to see them show things like blood pressure & cholesterol too. You can lose weight on crash diets without improving your health.

And there's a lot of nutrition ignorance around. One veggie dish I'll make is green beans with a small, portion measured amount of almonds sauteed in a small, portion measured amount of olive oil. My mom wouldn't eat it because she thought there was too much fat. She opted for the premade mashed potatoes picked up in the store. I went with some precut salad I pick up when I go there to keep on hand.

And many people have no idea about portions. The food/restaurant industry is lobbying against legislation requiring eateries to post nutritional info. A few legislators have said, if you're in a fast food place, you know the food is bad for you. Yes, but say it's a road stop & that's the only place around. Let's say Dorito Lady goes for that salad at Wendy's. I go for the Mandarin Chicken Orange salad myself. If I skip the crunchy noodles & substitute my own reduced fat, etc. Asian style salad dressing, I save over 200 calories. I know that because I've gone to Wendy's website to look it up. 200 calories may not seem like a big deal to most, but to someone like me, saving calories here & there adds up when you're trying to lose weight.

As for the money issue, it is a lot easier to eat better if you have more money. Ordering a salad from a deli near where I work (midtown Manhattan) can cost you nearly 10. While other, less healthy foods are a lot cheaper. Which is one of the reasons I usually bring my lunch. Yes, it is possible to lose weight on a budget. But it's a lot easier if you have the extra money to spend on healthier food.

[Ann Cameron]

Breast cancer has a very interesting correlation with brassiere wearing. Overall, one of 8 American women get breast cancer. 3 out of 4 who wear bra 24 hours a day get breast cancer. Of women who wear a bra rarely or not all, only 1 out of 168 get breast cancer. Researchers' assumption is that bra wearing stops natural movement of the breasts and the circulation of the lymph, which carries toxins out of the body. See the book Dressed to Kill for details.