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Post hoc, ergo propter hoc

Any "West Wing" fans out there? How about lawyers or law students? Or readers of the witty, vintage  Max Shulman short story, "Love is a Fallacy"?
If you're one, two or all of these, then you know the meaning of "post hoc, ergo propter hoc."
It translates, from Latin, as "after it, therefore because of it."
As the erudite President Bartlet points out in the second episode of "West Wing," it's almost never true.
In "Love is a Fallacy" (Quentin Kirk read it to our seventh-grade English class almost a half-century ago), the lead character, an arrogant law student, tries to teach his spacey girlfriend about critical thinking, and illustrates "post hoc, ergo propter hoc" with this example: "Let's not take Bill out on our picnic. Every time we do, it rains."
The air-headed Polly, of course, misses the point entirely when she gushes about a girl she knows who ruins picnics by making it rain every time she's invited -- prompting Polly's exasperated suitor to explain, again, that just because something happens after another event doesn't mean that the other event caused it.
Polly, however, is not the only who doesn't get (at first) that "post hoc, ergo propter hoc" is a fallacy.
Virtually every doctor I've ever run across employs this fallacy when it comes to body weight and health.
Did an overweight patient have a heart attack? Develop diabetes? Get cancer? Have their knee or hip cartilage wear away to nothing?
Well, what do you expect when you don't lay off the pepperoni pizzas or Ben and Jerry's?
And all you need to do to make it right is drop those nasty extra pounds -- even if you have to take health-threatening pills, undertake fad diets or questionable exercise programs, or undergo invasive surgery to do it.
Now, I would not be such a fool as to suggest that there are no health risks associated with carrying too many extra pounds, and that people should eat as much as they want of whatever they want and veg in front of the TV binge-watching "The West Wing."
But that's not the same thing as asserting that all health problems experienced by large people stem directly from their size, that all large people have the same health problems, or that all their health problems can be cured by losing weight by any means necessary.
At least in the U.S. health care system, medical practitioners tend to treat populations, not individuals. And in populations with high numbers of overweight or obese people, there also are higher incidences of conditions like diabetes, heart disease and osteoarthritis.
But it is a fallacy -- and I'd say a dangerous fallacy -- to conclude that all overweight individuals who have these problems can trace them directly to their weight, and solve them by reducing their weight, no matter how they do it.
Am I sorry that I lost the weight I did? Not at all. And I did it in what was, for me, the safest and most sensible way possible -- by changing what and how much I eat, and by being intentional about getting my body moving.
It was not, however, a cure-all.
My AFib didn't show up until after I lost weight.
And I don't jump to the conclusion that either my extra weight or my weight loss caused my heart to beat irregularly. It's just one of those things that happens to some people as a body ages. Furthermore, it's happened to at least two other people in my immediate family -- my late mother and my brother.
I do think, and my cardiologist agrees, that I'm better equipped to deal with AFib with a smaller, better-fueled, more active body.
But weight wasn't its cause. And weight loss isn't its cure. To suggest otherwise is a fallacy.



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