Science, Magic Bullets, & the Holy Grail
'Eat as much junk food as you like, its fine, we have a pill that will make it all OK'. This is the Holy Grail of our social order, and of its science, actively searching for the Magic Bullets that can bring it about. In this post, I take up an article by mainstream scientist Stefan Guyenet that captures perfectly the project that is Modern science, and allows us to see the dystopian nightmare it is seeking to usher in.
We can see the search for this Holy Grail in an article by Stephan Guyenet from his website titled, ‘Has Obesity Research Failed ?’ (see here). This piece provides a unique insight into the project that is mainstream nutrition, and why it is paying so much attention right now to the question of genetics. It also offers me an opportunity to develop further my argument that science does not offer ANY solution to the question of what we should be eating, nor will it ever, it is the wrong tool for the job, we need to look elsewhere.
Guyenet and Gary Taubes on Joe Rogan
Guyenet is a good place to start because he represents both the best of what the mainstream has to offer, and the very worst. This is because he is without doubt an excellent scientist, and he articulates the scientistic world view extremely well. Yesterday I watched his March 2019 debate with Gary Taubes on Joe Rogan (see here), and much as I like Taubes there is no denying that Guyenet tore him to pieces that day, in part because at times he had some very interesting things to say, but mostly because he came very well prepared, he knows his stuff, and he successfully targeted the weakest aspects of Taubes’ position.
At the same time, while Guyenet certainly knows a lot, I came away from the debate feeling that he really doesn’t understand very much. This was obvious above all in his defence of the ‘Calories In, Calories Out’ (CICO) model. Taubes struggled to land his punches on the show, but when the dust had settled I still held to the view that his critique of CICO stands intact, and that Guyenet, like most mainstream defenders, just doesn’t get it. Anyone who believes that CICO answers anything just doesn’t get what the question is, and I think that came through in the discussion as it does on his website. This is an argument I will have to lay out in full at some point, but if you go to YouTube and catch Gary Taubes on a better day then you should start to build the picture. Taubes is essentially correct, CICO is not a helpful way to think about the obesity epidemic, it leads you nowhere, it forms part of a nutrition paradigm that has failed miserably, and while there are certainly problems with the carbohydrate insulin hypothesis, and with Taubes’ fixation on sugar as the cause of all our problems, its saving grace lies in the way it opens up a low carb way of eating, and an understanding of the role insulin plays. This IS a useful model, it DOES take us in directions that are fruitful, even if it is by no means the final word on the subject.
In fairness to Guyenet, there is much more to his work than merely a conventional defence of CICO. I have ordered his book, ‘The Hungry Brain’, and am looking forward to reading it. I am hoping to find, among other things, a development of our understanding over the role leptin plays, and am sympathetic to the idea that it is this hormone, rather than insulin, that plays a decisive role in the obesity story. I know Jack Kruse holds this view (see here), and my impression is that this is where some of the cutting edge research is being done. I’ve also watched Guyenet’s presentation to AHS17 (see here) on food cravings and I think this line of research has important validity, although I’m curious to see where he takes it, what conclusions he draws. I see a couple of possibilities, one good, one not so good… we’ll see when the book arrives. This relates to what I believe has been his most useful contribution, and which he also displayed on Joe Rogan, namely his discussion of different traditional diets adopted by indigenous peoples in various parts of the world, and his point that there is more than one answer as to ‘what we should be eating’, that under the right conditions even something as toxic as white sugar can be of minimal concern. I like this strain of thought, I intend to engage with it further in future.
'Has obesity research failed ?'
The article, ‘Has Obesity Research Failed ?’ reflects none of these positive aspects of Guyenet’s work. It may well be unrepresentative of his thinking, or of the direction his research is taking. Nevertheless, it does appear in his name, and it does express very well a certain type of scientific viewpoint, a very powerful one, and it is for this reason that I have picked it out. In many ways it captures the essence of Modern Science, and its not pretty.
Guyenet mounts a defence of obesity research. He argues it should be evaluated against two metrics, the first being, ‘Has obesity research gathered accurate information ?’. This in itself is a revealing way of posing the question, as it focuses on a pathology, or disfunction, rather than a positive, say ‘nutrition’. This is consistent with a theme I have developed elsewhere (see here) about how Modern medicine has only a negative definition of health – the absence of disease – and its focus lies exclusively in treating illness rather than building health. If we set this aside and reformulate the question in more neutral terms – ‘have we accumulated a body of knowledge about how human metabolism works, including when it goes wrong as in obesity ?’, then Guyenet is not strictly wrong in responding, “There can be no question that obesity research has been a smashing success… researchers have uncovered a tremendous amount of information about the human body that relates to obesity.” which he goes on to summarise, and which is at a certain level undeniable. As a first year student of nutrition, I am presently wading through the various textbooks, and there is no denying the breadth and depth of their contents, it is most certainly a large collection of data. However, I am not so convinced we can follow Guyenet when he concludes, “Collectively, the information we've gathered forms a massive, highly buttressed body of knowledge that meshes seamlessly with related fields of science.” My impression, as a newcomer, is very different – I see gaps all over the place, holes, inconsistencies, competing interpretations, and a failure to understand or explain even the most basic questions. I also see some breathtaking stupidities, like the idea you should eat fibre, or that salt causes high blood pressure, or for that matter, that CICO explains anything.
This takes me back to Gary Taubes, for Guyenet correctly states that the best part of ‘Good Calories, Bad Calories’ is its historical narrative, and its high estimation of where nutrition science stood in Germany pre-World War II. I find the idea that our understanding of nutrition, and obesity, has gone significantly BACKWARDS over the past one hundred years totally convincing, even though the amount of information on hand is undoubtedly infinitely greater in quantity today. This is an interesting phenomenon, part of my challenge on this blog is to come to terms with it, to get my own head around why this is so, what has gone so badly wrong with science, and why the picture continues to deteriorate with every passing day.
Guyenet seems to believe that we have a good understanding of obesity, and nutrition. My contention is that he has no idea what UNDERSTANDING is, what it looks like. This is not a personal failing, it is one that belongs to the entire scientific enterprise, and has done since it emerged in the 17th century. It is why the Medieval scholars shook their heads in disbelief when it first emerged, why they, correctly in my view, saw it as an enormous IMPOVERISHMENT of human knowledge. Anyone who is familiar with Aristotle’s conception of gravity, and contrasts it with Isaac Newton’s, will grasp this reaction immediately. Unlike contemporary scientists, Newton himself was acutely aware of this problem, admitting frankly ‘I have no idea what gravity is’. He himself didn’t mind too much, because he was both a Christian and an avid Alchemist, so he had a system of beliefs that could make up for the gaping hole his science left.
The issue is this –
we have information by the bucket full, but we have very little understanding.
How does this vast accumulation of facts and knowledge help us, if we can not even explain the most pressing question of the day – why are we getting so fat ? Guyenet seems to believe CICO covers it, but Taubes is absolutely correct to argue that this is NO EXPLANATION AT ALL, at best it is a description.
What is the cause of the current obesity epidemic ? I don’t know, nobody does. We do have parts of the picture, for sure, Guyenet’s own research on the food cravings and the workings of the brain are certainly one element, so is our current high carbohydrate diet, our reliance on processed foods, our sedentary lifestyle. But there are many other factors that need to be taken into account and in no way do we have a coherent picture of what is going on. Noticeable by its absence in the Joe Rogan debate was any mention of vegetable seed oils, which form a glaring lacuna in the mainstream view, and also in Taubes’ own thinking, as was seen in the conversation he had with Tucker Goodrich on the subject (see here). This only scratches the surface, if we leap over to Jack Kruse’s website we will get a glimpse of a whole set of still unexplored fields that could well turn out to be critical in our understanding of what has gone wrong, including the role of light, deuterium, electrical fields, and the whole world of the mitochondria which we are just on the tip of entering. Bart Kay has touched on some of these themes too (see here).
So has obesity research really performed so well using Guyenet’s first metric ? I would argue that providing a plausible, and helpful, explanation for why we are so fat is the ONLY QUESTION that matters, and in this respect it is a resounding failure, not even close. And yes, we WERE closer to an understanding one hundred years ago, closer still 500 years ago, to say nothing of what the Ancient Greeks knew that we don’t.
'Has obesity research delivered practical value ?'
Guyenet has a second metric, “Has Obesity Research Delivered Practical Value?”. Here he knows the ground is more shaky, the sheer fact of the obesity epidemic and the failure of the nutrition establishment to even make a dent in it is an argument with overwhelming force. Nevertheless, he makes a brave attempt to defend the indefensible. It does not get very far before stumbling badly. He writes,
“In an ideal world, obesity researchers would have discovered techniques for easily preventing and reversing obesity… Clearly, that hasn't happened… On the other hand, researchers have actually identified a number of effective techniques for preventing and reversing obesity. The simplest of these is calorie restriction.”
The key claim here lies in the word ‘effective’. This is where the case comes crashing down. As we all know, the conventional advice to lose weight through calorie restriction has been an absolute and total failure. Guyenet acknowledges this, but seems to miss its implication – if calorie restriction does not work, IN WHAT POSSIBLE SENSE is it ‘effective’ ? This takes us to the heart of the matter. He says,
“The problem with restricting calories isn't that it's ineffective-- in fact, it's 100 percent effective. The problem is that it's difficult to implement and maintain.”
This is why Taubes is correct on CICO, it does not take us anywhere we want to go. Its logical conclusion is precisely what Guyenet and the mainstream say it is – calorie restriction is the name of the game, eat less, move more – but as everyone accepts – THIS DOES NOT WORK. So does this line of thinking help us ? No, it is useless, we need to approach this from another angle. One such attempt is low carb, which has shown that it DOES WORK, that’s why its so popular, why it has taken off in recent years. It doesn’t work for everyone, and there are other ways to lose weight that also work, by different mechanisms, but it is SOMETHING, it’s a start, unlike the CICO model which is a complete dead end.
The weakness of Guyenet’s approach is beautifully captured in his statement above. What is going on here ? Why does he end up with such a nonsensical statement ? Here we have to be blunt, its not him, its SCIENCE, it’s the misuse of the scientific method, this kind of idiocy is where it leads. Science, the pursuit of truth and understanding, is a noble enterprise, but it has shown to be of NO USE whatsoever when it comes to the question of nutrition and obesity. This becomes clearer when we examine how Guyenet assembles his argument, and how in fact he approached the debate on Joe Rogan, which if you remember was to collate a vast body of ‘evidence’, some fifty odd references, which he cited during the program. The problem is the quality of this evidence, what does it actually show ? Taubes tried to make this point but he was off his game, nevertheless, he was right in claiming that the bulk of it is ABSOLUTELY WORTHLESS. Consider Guyenet’s evidence for energy balance being critical, not macronutrient content. He rested this (from memory) on studies, RCTs no less, where subjects were split into two groups, one on low carb, the other on low fat, and showed how the results were equal in both cases. Such studies have been done several times, including one by Taubes’ own NuSI, a debating point Guyenet can’t be blamed for exploiting to the hilt. But what do such studies prove ? Exactly what they say they prove, that is, if you conduct a study along these lines then what you get is that result. What does this tell us about the ‘real world’, outside of the laboratory or experiment ? Absolutely NOTHING. Believing otherwise is what gets a highly intelligent man to blurt out such nonsense as ‘restricting calories is 100% effective, except that it doesn’t work’ (I paraphrase here).
My argument is that RCTs of this kind are totally useless. They are not even close to an appropriate application of the scientific method. Overturning the conventional wisdom, I would argue that a better study would be an observational one, or several in fact, looking into WHY low carb diets work, why sometimes they don’t, and likewise why some other diets sometimes work and other times don’t. Learning lessons from real life experience in other words, to help develop a better means of achieving the goal at hand. I have argued this before (see here and here) science is not going to get us out of the mess we are in, trial and error might, at best science can help us understand why some approaches work and others don’t, but in truth, even this has little to no practical value, it is simply interesting from the perspective of intellectual curiousity.
Why has mainstream science struggled so much to make serious headway in the case of obesity. Guyenet gives a revealing account of the problem as seen from a Modern scientific perspective when he says,
“In an ideal world, obesity researchers would have discovered techniques for easily preventing and reversing obesity. Similar to how researchers identified the nutritional cause of pellagra (niacin deficiency) and virtually eliminated the epidemic with vitamin fortification in the early 20th century,”
Here we see the search for a magic bullet in play. Guyenet is well aware of this. In the Modern era, science has achieved its greatest successes by uncovering simple, linear, causal relationships that lead to negative outcomes. The classic example is of course the Germ Theory of Disease, which we can loosely describe as the idea – ‘one microbe, one disease’. Pellagra and beri-beri took a similar form, in this case being the product of vitamin deficiencies, so we have the variant, ‘one vitamin, one disease’. The appeal of these kinds of cases was that it only required discovering which microbe caused what disease, and how to kill it, or which vitamin deficiency caused what illness, and how to supply it, and the job was done. In our era, the same search for a magic bullet in relation to obesity is taking place in the form of genetic research. Guyenet talked about this on Joe Rogan, and it is a hot topic within the mainstream at present. I encountered it when I looked into the research interests of the chief author behind the UK’s SACN Report (see here) and it is also prominent in my nutrition textbook as an ‘exciting area of study’. The reason for this is simple, identifying individual genes responsible for directly impacting obesity responses offers a perfect target for drug therapies aimed at neutralising their effect, in other words, the prospect of another magic bullet treatment.
I don’t know if this is the direction taken by Guyenet’s own research. He hints that it might be when he states, “In recent decades, a number of drugs were developed that act on the brain pathways that regulate appetite.” and then goes on to discuss their merits. This would be a logical progression from his own inquiry into appetite and brain circuitry, and consistent with his enthusiasm for gene research. It also fits with the mainstream’s complete failure to tackle obesity using the CICO model, drugs offering an alternative avenue. How likely these efforts are to succeed I have no idea, or how far off they are from hitting the market, but in principle I don’t rule out the possibility that they might succeed. It is this prospect whose implications I would like you to consider.
An idea of what this might look like is given when Guyenet describes the drug, Orlistat. Unlike the others he mentions, which work on the brain, this one, “blocks about 1/3 of fat digestion so that some of it ends up in the toilet.” As he says, its effects are modest, but this is not its significance, far more important is what this drug represents, which is none other than the Holy Grail of our current social order – a drug that allows you to eat processed food, but avoid getting fat.
Guyenet may be as horrified at that prospect as I am, or maybe not, but in either case he is not the problem, Modern science is, because this is the essence of its entire project. It is the liberation, through technology, of human beings from all natural or physical constraints. It means, in this case, that we can consume whatever we like, as much as we like, purely for the sake of pleasure, and get away with it, without any negative consequences. Eat junk, you’ll be fine, we have a pill that will fix you.
This kind of mentality is already with us. It is expressed in the dietitian who argues ‘diabetics have the right to enjoy chocolate too’, so long as they take their insulin shot. It is widespread among those who go through life without ever thinking about their health or diet, in the belief that if they run into trouble, the doctor will sort them out with a prescription. It reflects the value system of a society that prizes hedonism above all else, that seeks to escape any aspect of reality that interrupts or undermines pure enjoyment of the moment.
This is what we need to understand about the nutrition mainstream. It is not necessarily that they won’t find a solution to the obesity epidemic in the form of a magic bullet, it is more the danger that they WILL, for in their hands the cure is worse than the disease, it takes us further into a technological dystopia.
So, has obesity research been a failure ? Yes, and thank God for that, long may it remain so.
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