My reply to Dr. Ford

[Seth Roberts]

Dr. John Ford, a professor at UCLA's medical school, posted a criticism of me here. Below is my reply. I am interested in any comments you may have.

An obvious problem with Dr. Ford's critique is lack of evidence. Dr. Ford seems to be saying that my book is dangerous but on its face this is absurd. My book suggests that people consume vegetable oils or sugar water. Billions of people already consume these substances in amounts larger than what I recommend. Compared to the drugs that Dr. Ford prescribes every day, they are extremely safe and well-studied. If Dr. Ford is implying that these foods have dangers that he knows about but the rest of us do not, he should be explicit about it: Say what the hidden dangers are, and provide evidence for his claims.

Other problems are less obvious:

First, Dr. Ford has ignored facts that do not support his conclusions. If you search the Internet for people who are trying my weight-loss ideas, you will find many for whom it is working, often very well, and only a few for whom it has failed (harmlessly). Dr. Ford says nothing about this.

Second, factual mistakes. (1) “If Roberts were truly interested in investigating his approach, he should have subjected it to . . . peer review” – implying that I did not. In fact, my Behavioral and Brain Sciences article, which contained my weight-loss theory and support for my weight-loss methods, was peer-reviewed. So was a related article in Chance, which I told Dr. Ford about by email while he was writing his critique. Two is not zero. (2) He says I “present[ed] a highly speculative idea as proven science.” I did not. If he reads my book, he will see that I present a theory, a weight-loss method based on that theory, and promising early results. (3) He says my Behavioral and Brain Sciences paper is “not about validating his hypothesis or conclusions [but] a speculative commentary on the use of self-experimentation.” Actually, it is a long empirical article with a great deal of data – to call it “commentary” is misleading. The evidence in that article supports the theory of weight control on which my diet is based because the theory helped me discover new and surprising ways of losing weight. (4) He claims that self-experimentation is not “accepted methodology.” In fact, the 2005 Nobel Prize in Medicine was awarded for work on ulcers in which self-experimentation played a key role. Awarding someone a Nobel Prize constitutes acceptance of their methodology. As does publication in an oft-cited peer-reviewed journal.

Finally, Dr. Ford is a medical school professor. For a long time, medical school researchers have contributed no useful ideas to our understanding of how the average person can lose weight. At best, they have tested ideas that others have come up with. Could Dr. Ford’s rigid methodological beliefs have a downside? At UC San Francisco, my local medical school, the last time I looked at their online curriculum, about five years ago, medical students were being told to tell patients that weight loss is a matter of calories in versus calories out, therefore eat less, exercise more. Such advice was popular among doctors in the 1950s. It was no better advice then than it is today; it is based on a seriously-incomplete understanding of weight control. If that were my track record -- failure for more than 50 years -- I would be more open to new approaches.

I agree with Dr. Ford that my weight-loss ideas are not “proven science” and that “seasoned experts” (including medical school professors) may help the rest of us, including me, evaluate them. But I also believe strongly that non-experts can help the rest of us evaluate them. This is why I consider the Shangri-La Diet forums at sethroberts.net – full of non-expert views and observations -- to be very important. Dr. Ford and I probably differ here. I suspect he considers these forums useless, or nearly so, for what he calls “scientific” or “clinical” purposes. Time will tell which of us is correct.

[Will]

A nice reply.  I wonder if he will read it and take your comments as seriously as you did his.

[lisalgreer]

Bravo!  The reply is well done, and I found your ideas about medical researchers quite interesting.  I'm a friend to many biologists (Ph.Ds who now do academic and professional research and are top tier) and they have a tough time dealing with doctors and their takes on research (and the lack of research that many have done).  Doctors can be great healers, but the research is often something many seem to struggle with.

Best,
Lisa

[dred]

I thought his article was somewhat ridiculous, really. The point of the diet is not the underlying theory, but that folks seem to have this remarkable change in their appetite from something so counter-intuititive as chugging pure fat. Whether your underlying theory of the body adjustment mechanisms is accurate is really an interesting aside. If Dr. Ford believes what he writes, then he should be pushing for money to fund a study to examine some of your propositions, because certainly the anecdotal evidence is pretty convincing that this works for a lot of people.

My big concern is the long-term health effects of drinking 2-3 tablespoons of oil every day on the one hand, especially in the context of my general caloric intake dropping so I might not be meeting my nutritional demands. But I'm an adult and I know that if I eat less I need to be more cognizant of my food choices and not to eat, say, potato chips for meals. So far, so good. But the medical profession is not known for its libertarian instincts.

[DirkVA]

Lisa's reply accords with my thoughts as I read both the critique and Seth's reply.

It reminds me of the difference between professional degrees and research degrees in music. (I happen to have both.) Practitioners in both fields can be equally erudite or skilled. But a Doctor of Musical Arts (like a Doctor of Medicine) is trained as a performer, not as an exemplar of the scientific method. The Doctor of Philosophy in music practices what the Germans call Musikwissenschaft or music-science and uses normal historical, and scientific (acoustical/mathematical/theoretical/anthropological, etc.) research methods.

The difference in these approaches is reflected in the two sides of the SLD contention that Dr. Ford set off. Except that he also is not exhibiting the good traits of a superior performer or practitioner: the supremacy of excellent results.

[Christine Burke]

Hi Seth,

From the tone of Dr. Ford's article, it's clear that he's prejudiced against your claims.  To be fair, I think most health professionals would be skeptical about any miraculous answers to appetite control.  Given that, I will say that I agree with Dr. Ford on the following point: your Shangri-La theory would be more credible if a controlled, independent study confirmed the results.  Based on your response, it seems you would agree with that as well.  Has anyone approached you to conduct such a study?

For the record, my appetite seems to have responded well to your theory.  The skeptics may scream "placebo effect", but I don't care.  I've been on a really weird binge spree for about 2 weeks, and I'm so relieved that the crazy urge to eat is gone.

This is my first post.  I heard about you on the Freaknomics blog, and I enjoyed your guest blog.


yours, c
Christine Burke

[Seth Roberts]

After the Freakonomics column, I was contacted by a doctor in Washington State who was interested in doing a clinical trial. We discussed it. I haven't heard more about it since then, however.

[Cleo]

The content of your rebuttal seems valid but I wonder if a less reactive/emotional tone to your response would be warranted.  Who is your audience? It comes across as defensive rather than confident.

All eyes are on you right now and a courtier-like style of conduct would serve you well and would be a stark contrast to the arrongant and dismissive tone of his review.

Think PR, Baby.

[orwell46]

I think your reply is decent.  Regarding self-experimentation, one gathers ones data where one can.  You can learn a lot simply by paying attention, observing closely.

Occam's Razor is a famous principle of science philosophy. It means, more or less, as many know, "the explanation that requires the invention of the fewest constructs ought to be believed until further data comes along."

Roberts' proposed explanation of the paradox of oil-intake reducing appetite has the beauty of conciseness. Just on the basis of its conciseness and elegance, it needs to be taken seriously. Elegant explanations of paradoxical data don't come along every day. Sure it should be tested.

The doctor's complaints about you seem to me boiler-plate, thin on thought, standard stuff rehashed.  He may be right, in the end, but time will tell that or not.

[Stephen M (Ethesis)]

I think your reply is decent. 

... snip ...

The doctor's complaints about you seem to me boiler-plate, thin on thought, standard stuff rehashed.  He may be right, in the end, but time will tell that or not.

Pretty much on the mark.

[CalorieLab]

Occam's Razor is what makes the Shangri-La Diet theory hard to swallow. There are existing, alternative explanations for the results reported for the diet, including all the success stories in this forum.

Conciseness and simplicity describe the traditional explanations, not Dr. Roberts' explanation.

Here's Dr. Roberts:

(1) Tasteless calories  (2) lower set point, which (3) decreases appetite, which leads to (4) lower calorie consumption, which causes (5) weight loss.

From #3 on there is no controversy. But in the traditional explanation #1 and #2 are replaced with a simpler "something" (decreases appetite). What is the "something"?

Common experience shows that all kinds of things affect appetite: breaking up with your girlfriend (or falling in love with a new one), having the price of the drkoop.com stock you bought on margin collapse, being diagnosed with breast cancer, coming down to the finish line on a new project you're working on. In other words, psychological state is probably the most powerful influencer of appetite for modern people who are in an environment with a plentiful food supply.

Personally, I think the "something" in the Shangri-La Diet is the something in all diets: You get "psyched" to lose weight. You buy into a scientific-sounding back-story, really believe it, and believe and hope it will work and help you lose weight. You get psychologically motivated. And your appetite decreases.

(The Shangri-La Diet also includes the second component of all diets: eating restrictions, in the form of 4 hours per day that have to be set aside as a no-eat time.)

Dr. Ford's cart-before-horse point is also well taken. The Atkins diet followed the same trajectory of being a mass market book before it was subjected to scientific testing. Because of that it was stigmatized as a fad diet, and serious researchers, concerned about their reputations, didn't want to look at it seriously. No studies were done on it for decades, and only recently have researchers begun to look at some of its claims.

[Stephen M (Ethesis)]

Personally, I think the "something" in the Shangri-La Diet is the something in all diets: You get "psyched" to lose weight. You buy into a scientific-sounding back-story, really believe it, and believe and hope it will work and help you lose weight. You get psychologically motivated. And your appetite decreases.

Might be.  I just never experienced the mental state changes with any other diet and never the failure to hit a plateau and stick with my metabolism shutting off at about 20 pounds lost.

I'm as excited about the changes in mental state as I am about not having my metabolism shut off.

I've tried lots of diets where I believed the back story a lot more, lost a lot less.

[jzkc]

No, CalorieLab, you're missing something.  You are assuming that #3 should lead to #4.  Not in my case.  I am consuming about the same number of calories per day as I did before I started SLD, about 1300 a day, but now I am substituting 300 food calories a day for oil calories.  The difference is that before SLD, I lost 10 pounds in four months, and on SLD, I lost 10 pounds in one month.  The four months I took to lose the first ten pounds was a constant struggle of willpower over the cravings, meticulously measuring and logging, denying myself treats or the extra servings I really really wanted to eat.  With SLD, that's all gone.  Decreased appetite hasn't led to fewer calories for me, it has led to control over the same calories, lack of constant cravings and having my day revolve around my perpetual fight with food.  I guess we could simply speculate that the difference in pre-SLD and post-SLD weight loss is a matter of me psyching myself into it, or could it be that my body is lowering its set point and is shedding pounds to get there?   I think either explanation could be the "something" that leads to #3.

I have experienced many of those life events that you use to account for lack of appetite, and I can tell you that the hard kick you feel in the pit of your stomach and the resultant "basketball" you carry with you for a time when suffering a bad breakup, the death of someone close to you, coming down to the wire on a new project (I do this in my work pretty often) has no comparison to the lack of hunger or feeling of fullness I get from my 1300 calories now (which left me feeling empty and hungry the four months before).   All those examples you listed are traumatic or stressful events which, yes, often result in loss of appetite.  They are just as likely to make one eat uncontrollably. There's nothing traumatic or stressful about this way of eating.  And I really can't say that falling in love with a new boyfriend ever made me feel full after eating only half the food on my plate.

You know, I know the scientific community would love to find an explanation other than Dr. Roberts' theory for the successes we're having.  I just wish you would all quit speculating about it when you haven't tried it.

[jzkc]

(The Shangri-La Diet also includes the second component of all diets: eating restrictions, in the form of 4 hours per day that have to be set aside as a no-eat time.)

Yes and no.  It's only two hours at a time, which many people do without being on a diet (and which is comparable to the "eating schedule" I imposed during my prior four months) and in the middle of that two hours, in reality, you are having a 120-calorie (or more) "snack" of oil or sugar water.  I guess it is restrictive in that we are being told what kind of snack we can have in that two hours. 

I'll echo Stephen M's comment about the mental state that I'm operating under now, and if this turns out to be nothing more than psychological anomaly, I just hope I'm never cured 

[Ronnie]

Calorielab,

I must respectfully disagree that the "something" in the Shangri-la Diet is getting "psyched" to lose weight.  At almost 40 years old, with many years of struggling with my weight behind me, I know the difference between being psyched and not feeling hungry.  Being psyched might get me through feeling hunger by the force of my psyched-up willpower, but it will hardly decrease my appetite.  From the sound of many others on the boards, they also experience what appears to be the magic and the mystery of Shangri-La - a radically reduced appetite, and maybe even more remarkable, less interest in food.  I, for one, am grateful that this 'diet' does not involve psychological motivation (unless you have trouble taking the oil!). I've learned that psychological motivation is, most unfortunately, not enough for me.

So, as for that "something" you speak of, you said it - (1) Tasteless calories  (2) lower set point, which (3) decreases appetite, which leads to (4) lower calorie consumption, which causes (5) weight loss.  It works - and there is no doubt in my mind that it's improving my health based on losing weight and making much better food choices.  That's all I need to know.