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Global Warming. Alternative Medicine. The “Obesity Epidemic.”

There seems to be a whole lot of passion on both sides of these issues:

• Shadowfax and Scalpel had a tet a tet regarding the whole “global warming debate,” so this is not just limited to the non-medical community. Al Gore won the Nobel prize for his flick on global warming, while John Stossel just talked about the suppression of discussion on this issue.
• Go wherever you want in the medical blogging community and you will see discussion on “alternative medicine.” I was inspired by this by a post on Dinosaur Musings, but many of my other medical blogger colleagues have gone after this issue (Rebuild Your Back, Panda, and Orac are but a few). The debate rages, the debate becomes personal. People are accused of closed-mindedness, while others are accused of harming others with misinformation.
• Sandy over at Junkfood Science has raised the issue of the reality of the “obesity epidemic.” She wonders if this is a medical or political phenomenon and challenges the science behind the assumptions. She has been attacked with passion by others regarding her opinions (I think that is why she does not allow comments).

I have personally been questioned in comments on this blog as to the scientific basis of the use of Statin medications, the value of good diabetic control, and the efficacy of surgery for sleep apnea.

Is this wrong? Should there be debates on these issues? My hope is that nobody would come out and say that the debate on these issues is a bad thing. Science is based on such debates. The geocentric view of the solar system was actually based on the best scientific data. It was not until better data came along that this view was overturned. Germ theory of disease was highly scrutinized for a long time, but once technology allowed the study of microorganisms, it became an issue of little debate. Even recently, the issue of post-menopausal hormone therapy was widely held by physicians as being beneficial, only to be overturned by better data. No scientific theory should be beyond debate. Once it is, it is no longer science.

What really bothers me, however, is when the debate steps out of science and enters the arena of belief and/or politics. The global warming debate is a prime example of this. You hear people say: “the issue is no longer open to debate. global warming is real.” This is a dangerous thing to say. Scientifically, it will always be open to debate. Once it is not, we are no better than the church who mistreated Galileo.

The debate on blogs can take the same turn. People stop attacking the theories with facts and instead view the people who believe those theories as being somehow inferior. Personal attacks happen, where people are called stupid, naive, and moronic. What makes it worse is that those people levying the insults are doing so in the name of “good science.” This is not science, it is arrogance and prejudice.

This does not mean that every belief has equal merit. There is objective reality and there are facts that can be gathered. The world really is round, germs do cause disease, and bacteria can really live in the stomach. If we are to be scientific, we are obligated to believe what the data points to, and not that which we emotionally are attached to. Belief despite the facts in the opposite direction is a very dangerous thing. It is saying “I don’t care about the facts, I am right.”

So here is where I stand on the issues:

•  I am not sure about the whole global warming issue. I hear good arguments on both sides. I think we should act like it is real, however, and that we can do something about it. If we act “greener” and global warming is not true, we have done no harm. If we ignore a real phenomenon that we can change, however, we are irresponsible.

  

• Alternative medicine is “alternative” because it lacks the science behind it. There is no big conspiracy to suppress it. Once it becomes scientifically shown that something is “true,” it then falls into the realm of regular medicine. While a lack of evidence does not mean that a claim is true, it is my responsibility as a physician to represent what my degree is in, and that is in Medicine.
• The idea of an “obesity epidemic” has gone from the scientific arena to the political arena. Parents are being accused of abuse for having overweight 6-month-old babies. Employers are forcing people to lose weight or lose their job. This really scares me. While I believe that the rate of obesity is rising, and I do believe this is not a good thing; I listen with a much more critical ear because of the challenges I have heard to this dogma. We need to be careful to not make the obese people pariahs, like what was done to those who smoked.
• I think the sun is at the center of the solar system.
• I think that magic flying ponies sprinkle water on the grass every morning to cause the dew.

I welcome challenges to these beliefs (except the last one).