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No Health, No Care

The Big Fat Loophole in the Hippocratic Oath

In 2005, the moral panic about “obesity” was ramping up, and there was big money at stake, all resting on the idea that fat kills. 

Well, Flegal’s research pulled the rug out from under those views, not only showing that fatness was associated with only 1/3 the associated deaths that previous research estimated (and even that smaller estimate can be critiqued), but also showing that being “overweight” conferred no increased risk at all, and may even be a protective factor against all-causes mortality relative to lower weight categories. 

The reaction to these results – which have been verified over and over again in the years since and in decades of prior research – was swift and vicious. Powerful people launched a smear campaign against Flegal and her work:

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.

Flegal’s first-hand account of her experience illustrates how power and stigma pervade and bias weight science. This can have a chilling effect:

One of the effects of the public insults may also have been to deter or intimidate other investigators. An anonymous researcher was quoted elsewhere as saying if character assassination is the price for publishing data that contradicts established beliefs, fewer academics will be willing to stick out their necks and offer up fresh thinking.

Outraged by the Jan. 6 Capitol riot, a wilderness survival trainer spent years undercover climbing the ranks of right-wing militias. He didn’t tell police or the FBI. He didn’t tell family or friends. The one person he told was a ProPublica reporter.

Joanne Erickson’s story shows the looming challenges for millions of seniors struggling with health issues, an unforgiving housing market and little or no retirement savings.

When I first met her, Joanne Marie Erickson had not left her apartment in weeks and she was just days away from being evicted from her home of 23 years. She sat on a tattered couch, while her cat Muriel wandered around her cluttered living room. She was alone, overwhelmed. “I think I’m falling apart,” she said.

I had hoped, naively it turns out, that my reporting would be enough to help her get the assistance she needed and find stable housing. But long waitlists, leads that went nowhere and promises of help that went unfilled continually frustrated her efforts.

She was evicted in February and died in May, while homeless, just days short of her 71st birthday. Erickson’s tragic end — homeless despite a lifetime spent caring for others — illustrates the urgent and complex challenge of providing support for aging Americans, many of whom will outlive their savings. For the millions relying solely on Social Security, a modest benefit at best, survival in high-cost cities like Los Angeles can be untenable. Layer on the inevitable decline of the body and, for some, the mind, and the prospect for many older Americans grows even grimmer.

Erickson’s life unraveled steadily for years — and then, after she was evicted, all at once.

When she was in her mid-60s, she left her last steady job as an occupational therapist.

She began falling in public places, at CVS, at the grocery store — her frailty the result of post-polio syndrome, which leads to the weakening of joints and muscles.

She struggled with depression, was unable to keep her home in order and, according to a neighbor, suffered a nervous breakdown early in the pandemic.

Institutional COVID denial has killed public health as we knew it. Prepare to lose several centuries of progress.