Why Politicians Shouldn’t be in Charge of Medical Decisions: Example Number

Hi there! We haven’t posted much on COVID and/or coronavirus news lately. It’s a fast-moving target, there are other places to get information (but be careful!) and we have already said that the US needs better testing, better planning and more coordinated responses, as well as a reduction in panic-mongering and an increase in realistic risk-reduction strategies.

But sometimes…you just want to say something, especially about our particular pet peeve: politicians, who may be fine as administrators and lawyers, stepping into the realm of practicing medicine, where they most definitely do not belong.

Example number…whatever…the UK’s Boris Johnson. The vast majority of people exposed to coronavirus get no symptoms or maybe a cold, but Mr. Johnson wasn’t so lucky. He actually got a fairly serious respiratory illness and had to be in the hospital. He recovered, as again do most people, and has returned to work, but it was undoubtedly a scary experience for him.

Now, Mr. Johnson, being someone who is a successful politician and a prime minister, is obviously someone who likes, wants, and in fact, needs to be in control of things. For a person like this, the loss of control involved in getting an infectious disease, and having to put your life in the hands of other people who are more knowledgeable and now running the show is an incredibly difficult experience. Clearly, now, Mr. Johnson wants to regain or leverage some control of the situation and he has done so by focusing on something he can do something about, his weight. A strategy very familiar to anyone with an eating disorder.

Because of this control issue, Mr. Johnson has abstracted one piece of information, which he doesn’t really understand, from what his doctors told him; that “overweight” people are doing worse with coronavirus.

As an aside, to clarify, the data the doctors were referring to was a study or observation showing that in Britain, about 3% of the population is “morbidly obese,” usually defined as a BMI (a fairly useless measure being used improperly, but that’s another story) over 40. However, some number of ICU cases were reviewed and the morbid obesity rate was 8%.

Is this significant? Is it chance? How many people were studied? Fifty? Five hundred? Is it just correlation—older people are heavier? Does Boris Johnson understand all this? All good questions.

But what’s important to call out here is that Mr. Johnson is using his “bully pulpit” as prime minister to trumpet that suddenly weight loss is an important tool in fighting coronavirus. He is extending his personal “eating disorder” behavior onto an entire country. And unfortunately, people have been brainwashed into believing that weight is a simple health measure, and they do not understand that government agencies seeking funds have for years deliberately blurred the distinction between having a few extra pounds and being dangerously overweight. The UK, like the US has its share of “fat shaming” as well. Bottom line: weight and health are a lot more complicated than many people think, and the vast majority of “overweight” people are not over weight enough to really impact their health.

But why is this a problem? So Boris Johnson (no sylph himself) wants people to bicycle more and eat less candy, so what? Well, it’s a problem for two main reasons. Firstly, it reinforces an unhelpful narrative that misstates the effects of weight on health, and it promotes interventions that have been shown not to work. Second, and more acutely, it can distract and divert energy and resources from better interventions, as far as fighting infectious diseases go.

And a as a physician, this writer is just going to do a mental face plant over the specter of even more government programming and requirements that will distract doctors from actually doing their jobs.

TL;DR? Boris, we know you’re a control freak. But have some self-awareness and stop trying to project your issues onto the whole country. And come on people, can we just stop having politicians drive our response to a medical situation?