The Giraffe Effect: What Obesity Headlines Hide

Chapter summary

When reading articles, look at the whole picture and the real issues. The real issue is not obesity alone. Consider metabolic syndrome.
Do not believe everything you read. Research, investigate and experiment.
The Giraffe Effect: science and politics focus on the big, visible issue, while the real consequences may lie elsewhere.

The term comes from data analyst Pini Yakuel. Giraffes are portions of data that dominate the rest and hide important insights.
Imagine watching animals on a nature reserve. A giraffe stands out, and the smaller animals all look small.
If you look away from the giraffe, you see the differences in size among the others are much larger than you thought.
When data contains very large members, important differences among the rest disappear from view. Sometimes this leads to wrong conclusions.

Everyone looks at obesity. The popular press quotes the 65% of people who are overweight or obese.
The less visible animals:
- 38% of people have metabolic syndrome.
- About 15% have chronic kidney disease (CKD). In Australia 13% of people are understood to have CKD, against 4% with diabetes, and one in seven hospital admissions involves CKD.
- 4% have life-limiting diabetes.
- 20% of normal-weight people have metabolic syndrome and are on the path to chronic disease, out of the limelight.
These lower-profile groups are the ones using up much of the health system.

Obesity as the target: Most health policy, media and research funding focus on weight and BMI.
The author’s view: Weight is only a marker. The target should be metabolic health, including normal-weight people who are “thin on the outside, fat on the inside”.
A caution: Obesity and metabolic syndrome overlap heavily, so the author is not saying obesity does not matter.

Ask what the headline number hides.
Measure waist, blood sugar and blood pressure, not only weight.
Good health is possible at a range of weights, and poor health at a normal weight.