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Holocaust Good For You, Research Finds, But Frequent Taunting Causes Cancer In Rats

A study published this month in PLoS One finds that victims of weight discrimination (“fat-shaming”, in case you only speak Tumblrese) are more likely to subsequently gain weight.

It’s hard for me to like a study that so obviously got exactly the result its organizers wanted it to get. And obvious confounders are obvious – level of discrimination faced was based on self-report, and the sorts of people who hang around the sorts of people who fat-shame may differ systematically (in class? education?) than who avoid that kind of abuse – but the study’s endpoint of change in weight over time rather than just weight itself goes some of the way toward addressing those concerns. And I’ve got to give them credit for studying an important issue and getting a highly significant result. So let’s let them have their soapbox:

There are both behavioral and physiological mechanisms that may contribute to the relation between discrimination and obesity. Weight discrimination is associated with behaviors that increase risk of weight gain, including excessive food intake and physical inactivity. There is robust evidence that internalizing weight-based stereotypes, teasing, and stigmatizing experiences are associated with more frequent binge eating. Overeating is a common emotion-regulation strategy, and those who feel the stress of stigmatization report that they cope with it by eating more. Individuals who endure stigmatizing experiences also perceive themselves as less competent to engage in physical activities and are thus less willing to exercise and tend to avoid it. Finally, heightened attention to body weight is associated with increased negative emotions and decreased cognitive control. Increased motivation to regulate negative emotions coupled with decreased ability to regulate behavior may further contribute to unhealthy eating and behavioral patterns among those who are discriminated against.

New study! This one published – oh, look, isn’t that interesting – this month in PLoS One, finds that survivors of the Holocaust have greater life expectancy than control Jews who did not experience the Holocaust.

Here the authors definitely got a result they were not looking for and did not want. And here, too, we have all sorts of confounders: they tried hard to construct a matched control group of Jews who emigrated from Poland to Israel just before the Holocaust, but we have no idea what sort of differences there might have be in those populations (just to make up one story, maybe poor people who had less to lose were more likely to emigrate). And here too, there is no shortage of soapboxes. From here:

One possible explanation for these findings might be the “Posttraumatic Growth” phenomenon, according to which the traumatic, life-threatening experiences Holocaust survivors had to face, which engendered high levels of psychological distress, could have also served as potential stimuli for developing personal and inter-personal skills, gaining new insights and a deeper meaning to life. All of these could have eventually contributed to the survivors’ longevity. “The results of this research give us hope and teach us quite a bit about the resilience of the human spirit when faced with brutal and traumatic events”, concluded Prof. Sagi-Schwartz.

So, let me sum up what we’ve learned here today.

Having someone call you fat is a profoundly disturbing form of stigmatization that breaks your normal cognitive coping mechanisms and subjects you to levels of stress that the human body and psyche were never designed to withstand.

But being rounded up like cattle, having your entire family killed in front of you, and then being starved nearly to death in a concentration camp for several years is useful opportunity to grow as a person, and will leave you stronger and better-adjusted.

I shouldn’t be too sarcastic. Stranger things have ended up being true. Maybe constant low-grade minor stress has a deleterious effect but a single extremely stressful event can be salutary. Maybe stress is good for you only after you’ve achieved a safe distance from the stress and can reflect on it from a position where you’re absolutely sure it will never happen again. Maybe stress makes you obese in the short term, but also makes you live longer in the long-term. Maybe the cultural differences between elderly Polish Jews and middle-aged Americans mediate the effect stress has on their bodies.

Or maybe these effects are mediated by unexpected processes. Maybe the Holocaust survivors live longer not because of personal growth, but because they got a sort of involuntary caloric restriction that permanently altered their metabolism. Maybe (as the researchers point out in their paper) only people who were exceptionally healthy survived the Holocaust, and these people continued being exceptionally healthy into their old age. Maybe obese people who aren’t shamed stick to a careful diet to avoid shaming, but once the shaming starts they figure it can’t get any worse and go wild.

Or maybe one or both of these studies is totally and fundamentally flawed and we’re wasting our time here. I give 50% probability that the fat result is legitimate, and 90% probability the Holocaust result is due to something other than personal growth, probably survivor effect or caloric restriction – but I bet others will disagree.

Yet I think what struck me most about this combination was how “stress makes you miserable and unhealthy” sounds reasonable, but “stress is a salutary process that allows you to grow” also sounds reasonable. No matter what happens to stressed people, psychology can go “Oh yeah, according to our theories, stress causes that” and I will nod my head and agree.

Or maybe another way to put it is that I’m impressed with the ease at which we switch narratives. All the time I hear “Well, a little bit of adversity will be good for him/her”. Or else “What you’re doing is going to destroy his/her self-esteem and scar him/her for life.” Most people selectively use either or, depending on whether they want to excuse something or condemn something at that particular moment, and they have the science available to support either.

Not only do we operate on cached thoughts, but we have a store of contradictory cached thoughts sufficient to support any proposition or its opposite.

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41 Responses to Holocaust Good For You, Research Finds, But Frequent Taunting Causes Cancer In Rats

  1. @johnwbh says:

    Another obvious confounder, surely the people who survived the holocaust are going to be the most healthy of the group who were interned, and it seems plausible that some factor in innate health contributes both to ones ability to survive a very high stress situation and long term life expectancy.

    • von Kalifornen says:

      They included that. To me, it seems rather obvious that that would be the case.

      • I thought you meant “they controlled for that somehow” (by sorting by best-health-when-young and assuming the healthiest survived the holocaust? that doesn’t exactly work), but you just mean that they wrote about this obvious explanation (I came to post it too), right? Quoting study: “An alternative interpretation would be differential mortality, meaning that those vulnerable to life-threatening conditions had an increased risk to die during the Holocaust. Holocaust survivors by definition survived severe trauma, and this may be related to their specific genetic, temperamental, physical, or psychological make-up that enabled them to survive during the Holocaust [12]–[15] and predisposed them to reach a relatively old age.”

    • St. Rev says:

      Beat me to it.

  2. Maybe the difference is that Holocaust survivors live with a huge cultural structure telling them that the Holocaust isn’t their fault, while fat people live with a huge cultural structure telling them that being fat and being abused for being fat is the fault of fat people.

    For what it’s worth, anorexia doesn’t seem to be good for people, so I don’t think caloric restriction without optimal nutrition is the answer.

    Or…. “overweight” people live a smidge longer than “healthy weight” people and low-end obese people have lifespans that are intermediate between the two– Michael Vassar has suggested that maybe dieting is the explanation. My theory is that “healthy weight” is nonsense.

    • von Kalifornen says:

      That’s worth noting, actually, and one might want to compare different populations that suffered the Holocaust.

    • Berry says:

      Maybe the difference is that Holocaust survivors live with a huge cultural structure telling them that the Holocaust isn’t their fault while fat people live with a huge cultural structure telling them that being fat and being abused for being fat is the fault of fat people.

      In theory, we have a way of checking for this. The culture in Israel in the first few decades after the Holocaust was very much blaming the victims. Accusing them of going like sheep to slaughter, and so on. People who experienced this would have similar effects to fat people if your hypothesis holds.

      • Good point, but hard to check. Aside from the fact that the prejudice against Holocaust survivors eventually ended in Israel (or did it end completely?), what would you use for a test group? Holocaust survivors in the US presumably faced less prejudice, but that wouldn’t be the only difference.

  3. sixes_and_sevens says:

    If you don’t mind me saying so, you seem very motivated in your baseline of mistrust for the first study. I’m keen to understand your thought processes. Do you think this is the case?

  4. Foxtrot says:

    Unrelated but found someone else using the “proves too much” line of reasoning.

    The end of the article is rather entertaining in a silly, guilty kind of way (made me think of hpmor!Harry’s reform of Quidditch.)

  5. mattp says:

    So I’m really into powerlifting, fitness, nutrition, etc. and I’m fairly familiar with the practice of changing bodyweight through diet and activity changes, as well as inducing strength gains from application of stress. According to sports science, you apply a stress, and the body responds by becoming fatigued and ramping up recovery processes. After some amount of time, your recovery processes put you over your initial level of fitness, and you’ve become stronger (over time this returns to baseline if you don’t continue applying stress). However, if you continue to apply stressors without adequately recovering from them, you’re unable to adapt to the stress and your fitness level goes down.

    By considering things in life as stressors that cause an adaptation (if proper recovery time is allowed), then things start to make a lot of sense. An acute, highly stressful survival event will both select for survivors and make a person more adapted to survival. What adaption will a chronic stress where a person is made to feel bad about themselves produce? Probably that they’ll care less about the property being shamed — and if they care less about their weight, (demonstrating a prior preference for gaining vs. losing weight) they’ll likely continue gaining weight.

    I was going to include a paragraph on how crappy current popular ideas of fitness/nutrition are and how complicated metabolism is (dieting is a stress that your metabolism adapts to; and you can damage your metabolism by dieting wrong), but that’d end up being a big ol’ rant

    • impromptu says:

      Please post the rant! It would be valuable to a lot of people, especially those of us who plan to start dieting but don’t want to “do it wrong” and damage our metabolisms.

      • mattp says:

        Consider that “stress leads to adaptation.” A calorie deficit is a stress that leads to two adaptations: 1) Fat loss, 2) Reduced metabolism. If you just try to lose weight constantly, you’ll downregulate your metabolism until you find yourself maintaining weight on the bare minimum calories you need in order to get enough protein, healthy fat, and micronutrients. This leads to a disproportionate loss of lean mass vs fat mass. What’s worse, is that this reduced metabolism also means that any big meals (or binging) will disproportionately be stored as fat. The end result of continuous dieting (and occasional binging) is drastically reduced metabolism, lean mass, and a propensity for putting on fat very easily.

        To counter this, you want to preserve lean mass (eat 1.5-2g protein/kg bodyweight and lift weights) and cycle weight loss and weight gain/maintenance periods. Lifting and high protein intake at all points will help shift the balance to where you’re losing more fat than muscle, and gaining more muscle than fat.

        Dr. Layne Norton is a scientist/bodybuilder/powerlifter/coach who has an excellent series of videos on this topic, with this being the main one: I’d strongly recommend following his information on body recomposition.

        • impromptu says:

          Thank you, I will look into that. I was thinking of increasing my protein intake + doing Starting Strength, so it’s good to hear that I’m going in roughly the right direction with this.

    • Randy M says:

      However, the Holocaust was not an acute event for the people who went through it, even if it seems that way from a historical perspective.

      • gwern says:

        Seems like something that could be checked for. If there’s an acute versus chronic effect, then after a certain amount of time, the survival effect should flip sign from positive to negative. That is, we would find that say 6 months gave a few years on life expectancy, 1 year of Holocaust exposure resulted in no life expectancy and was the inflection point, and longer stays than that meant shorter lives.

        They don’t seem to have checked for this since they used Holocaust exposure as a binary variable:

        We employed a survival analysis using a Cox regression model, which provides estimates of survival probabilities and cumulative hazard, in our case with regards to age of death as related to the Holocaust experience. The hazard of death was the Cox regressed outcome and Holocaust versus non-Holocaust the predictive indicator for mapping the regression pattern.

        The gender pattern is interesting, though:

        A significant lower hazard ratio was found (HR = 0.843, CI (95%) = 0.800–0.889), guiding us to examine the hazard of death in Holocaust survivors and comparisons separately for males and females. Only for males did we find that the hazard ratio of Holocaust survivors was reduced. For females it did not make a difference whether they were Holocaust survivors or comparisons.

        This might be due to data mining, but it also makes sense in terms of gender differences and males having greater variability – with more variability, the less robust males get killed off and the skew is more extreme.

        (If you’re curious what no difference means, they break down hazard ratios by 3 age groups x gender in table 3, and you can see that 2 of the signs are for the Holocaust reducing female life expectancy and one for increasing, so this doesn’t seem to be a case of cargo-culting p-values.)

        That said, I should mention a serious caveat here: they do not mean by ‘Holocaust survivor’ a person who went into the concentration camps and got out alive. They mean simply being a European Jew during WWII:

        We constructed two groups – Holocaust survivors and comparisons – consisting of immigrants to Israel from Poland, born between 1919 and 1935, and immigrating to Israel (until May 1948 the British Mandate of Palestine), either between 1945 and 1950 (Holocaust survivors) or before 1939 (comparisons). The working assumption in Holocaust research is that Jews living in Europe during the years of the war, regardless of direct experience (i.e. camps, hiding), should be defined as Holocaust survivors whereas those who left Europe before the war are non-Holocaust survivors.

        • Randy M says:

          Ah, that is interesting and not what springs to mind when I hear ‘holocaust survivor.’ It’s kind of like saying the people in Texas survived Hurricane Katrina, because it could have potentially gone towards them instead. Not unreasonable but neither the first assumption.

  6. Douglas Knight says:

    I don’t think much of the first study, but your description in the title is over the top.

    You describe the holocaust as a one time event, but it was longer than the weight study! (which I don’t think asked about duration of discrimination).

    For the holocaust, one could distinguish between a selection hypothesis and a growth hypothesis by looking at the effect on the elderly, but this study only considered the young. It did see a difference between children and young adults, but I’m not sure that is so helpful. The sex difference is odd.

  7. amuchmoreexotic says:

    I don’t think the two narratives about stress are necessarily inconsistent, if you consider that all human populations have a diversity of temperaments.

    The kind of person who survived the Holocaust was probably unusually self-directed and determined to survive (on average; obviously luck would have been a factor). In a Holocaust condition, those people would have been better able to handle stress, and carry out whatever deals or scams they needed to avoid starvation, whereas less vigorous people would have spiralled down into Muselmann status

    In today’s Bizarro Holocaust condition of cheap, high calorie foods, it takes the same unusual self-direction to not end up obese. If you can only handle the shittiness of late-stage capitalism – a state where your life has no particular meaning or value beyond how much labour can be squeezed out of you by the rentier class, subjecting you to long hours doing meaningless busywork to prove your loyalty to the company or alternatively penury and persecution as a worthless ‘shirker’ – by drinking and eating pizza to make yourself feel better, like I’m doing now, then you’re gonna put on weight.

    I’m certainly heading towards a heart attack unless I start exercising more and eating less, and yet I don’t really care enough about my own life to do anything about it, even in the absence of any particular shaming. If I was being jeered in the street to the levels fat women get in my culture, I’d probably hate life even more. In Auschwitz, I’d probably have been the skinniest bitch in the line-up.

    There’s no paradox here, just the simple logic of a NOT gate.

    • There are people who aren’t obese because they just don’t put on that much weight– they aren’t exercising unusual self-direction.

      Tentatively offered: simple carbs may be contributing to your depression. If your metabolism is anything like mine, it’s a lot easier to add low glycemic food than to try to cut calories.

  8. You talk about whether fat people “hang around” those who shame them, but a good bit of fat shaming goes on in families. It’s harder to get away from family members than random street harassers (co-workers would be an intermediate case). It’s at least conceivable that families which include fat shaming are more inclined to anxiety and hostility than non-fat shaming families, so there could be a genetic difference in many of the people who are subject to fat-shaming.

    The matched group for the Holocaust survivors might have been suffering from survivor guilt, though it would be surprising if that’s more stressful than actually having gone through the Holocaust. Hypothesis: the early prejudice in Israel against Holocaust survivors may have been an effort to protect against survivor guilt. Was there a shift in health when the prejudice went away?

    I’ve seen a suggestion that the health effects attributed to obesity are also symptoms of excessive stress, and might be the result of stigma. How could this be checked?

  9. Vaniver says:

    “Maybe (as the researchers point out in their paper) only people who were exceptionally healthy survived the Holocaust”

    Talk about subject dropout!

  10. Swimmer963 says:

    The idea that short term intense stressors cause adaptation afterwards, but that long term chronic stressors are bad, is a pretty common one. That being said, I don’t know if “short but intense” describes most Jews’ experiences of the holocaust; it lasted quite long. (But not compared to the lifespan the survivors have gone on to live since, I guess).

  11. Nestor says:

    Others have said pretty much the same, but the ideas aren’t really contradictory. Outgroup insults are less stressful than ingroup harrassment. Hinkel calling you an untermensch on the radio is worrying, but sticks and stones. Mother saying you are a dissapointment to the family does have a barb.

  12. Deiseach says:

    “(T)he sorts of people who hang around the sorts of people who fat-shame may differ systematically (in class? education?) than who avoid that kind of abuse”

    I must be that “sort of person” then, Scott, because I’m of the overweight persuasion and you know, just walking down the street where I live, I had kids yelling at me. Just walking down a street in a city nearby, I had a perfect stranger tell me I should go on a diet.

    What kind of stupid fool am I that I can’t simply avoid these instances of abuse? Why don’t I automatically recognise the types who will and won’t “fat-abuse”? You’re right, I must be lower-class, poorly educated and simply too dumb to live.

    Nah, I get you’re not trying to say “Fat people are stupid” but you know, it’s not quite as simple as “Well, if you just avoided the kinds of people who wear t-shirts saying ‘I will insult you’, then you wouldn’t be so discouraged you need to shove excess empty calories into your gob, lardo!”

    • Scott Alexander says:

      I was speculating more that (at least in America) progressive and educated subcultures have more of a norm against fat-shaming.

      • suntzuanime says:

        Progressive and educated subcultures have a norm against suggesting groups differ, which you’ve just run afoul of. Have fun!

      • I hang out around fat acceptors more than with progressives generally. For what it’s worth, fat acceptors say that progressives tend to stigmatize fat either as yucky in itself and/or as a symbol of capitalism.

      • Deiseach says:

        I do get the idea that poorer/less educated/lower socio-economic groups are the fattest in the West (rich = thin, so far as it seems to go) and that poorer/less educated/lower socio-economic groups are more likely to be rude, not having been taught that “You shouldn’t make fun of those different to you” (in a nutshell).

        But it’s like saying “Only poor/less educated/lower socio-economic group men beat their wives, so if you’re a lawyer’s wife, your husband can’t be abusive to you”. In fact, I would say that “fat-shaming” is the one acceptable prejudice, and that people who wouldn’t dream of passing personal remarks about colour, gender preference, or personal living arrangements, find nothing problematic about it because “Obesity is unhealthy, and you’ll never get promotion in your career if you look like that, and we can back it all up with these studies showing your increased risk of stroke and how overweight people earn less, and it’s because we care that we say ‘You’re so ugly, why don’t you do something about this?'”

  13. Malcolm says:

    Maybe constant low-grade minor stress has a deleterious effect but a single extremely stressful event can be salutary.

    Absolutely. See this paper, The Peculiar Longevity of Things Not So Bad, which describes a mechanism by which this sort of thing can happen.

    A wife may do the costly cognitive work necessary to rationalize her husband’s infidelity (‘‘I guess men need to try this sort of thing once to get it out of their systems’’) but not his annoying habits (‘‘I guess men need to experiment with leaving their dirty dishes in the sink’’), and thus the wife’s anger about her husband’s disorderliness may outlive her anger about his philandering.

    • Doug S. says:

      The worst kind of annoyance is the kind that is bad but not quite bad enough to get you to take action to end it. Those just keep on bothering you forever.

  14. Deiseach says:

    An example of “the sorts of people who fat-shame” – apparently, furniture shop managers are the type.

    So remember, next time you replace soft furnishings, be sure to find out first if the store management are going to make racist/sexist/ableist/other kinds of discriminatory remarks should you have cause to complain about their customer service, otherwise it is your fault for hanging around the kinds of people who “race-shame”, “queer-shame”, “class-shame” and the likes.

    (Yes, Scott, I am going to flog this horse well past the point of death. Beware the wrath of the tubby!)

  15. Doug S. says:

    For every proverb, there is an equal and opposite proverb.

    • Scott Alexander says:

      Ah yes, but as the old saying goes, for every proverb there is not an equal and opposite proverb.

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  17. houseboatonstyx says:

    If you survived the Holocaust, you can survive anything?

  18. Viliam Búr says:

    Could it be related to the model of the world, and of you in that world? If you are at the concentration camp, you are a victim, and the guard are the bad guys. If you are fat, the society suggests it’s because you are bad.

    So perhaps being tortured by the bad guys can make you stronger if you survive, but being labeled as the bad guy can break you? Also, in the concentration camp you have many other victims who are on the same side, but as a fat person you may feel completely alone; this can influence your coping skills. (I don’t say I believe this explanation; it’s just another hypothesis to consider.)

  19. rrb says:

    Quoting Strong Inference:

    Some cynics tell a story, which may be apocryphal, about the theoretical chemist who explained to his class,
    “And thus we see that the C-Cl bond is longer in the first compound than in the second because the percent of ionic character is smaller.”
    A voice from the back of the room said, “But, Professor X, according to the Table, the C-Cl bond is shorter in the first compound.”
    “Oh, is it?” said the professor. “Well, that’s still easy to understand, because the double-bond character is higher in that compound.”

    I read that in college, and became terrified that in my chemistry classes, I would accept explanations for phenomena, while also accepting explanations for other phenomena from contradictory principles. I briefly tried to keep a list of every rule that I used as an explanation, so I could look over it for contradictions. But I didn’t keep at it.