本文对话David Allison，一位在肥胖研究领域深耕20年的资深学者。他坦诚地探讨了肥胖科学的已知与未知，分析了营养流行病学在公共卫生中的影响、局限性以及应对肥胖问题的未来之路。Allison分享了关于双胞胎研究、手术治疗、BMI解读、体重维持等方面的深刻见解，并深入讨论了科学研究的信誉危机，以及如何重建公众对科学的信任。此次访谈为我们理解肥胖问题提供了多角度的思考，并对改善公共健康具有启示意义。

🧐 访谈伊始，David Allison分享了他对肥胖研究的兴趣，以及对证据和数据的关注。他详细介绍了肥胖危机被确认的时刻，以及随之而来的科学研究的不足之处。

👯‍♂️ 访谈中，Allison探讨了双胞胎研究对肥胖遗传学的启示，以及医生和科学家们在历史上是如何处理肥胖问题的。他还讨论了肥胖手术是否能延长寿命，以及“肥胖悖论”等话题。

📊 访谈深入探讨了BMI和死亡率数据的解读，以及混杂因素的考量。Allison还阐述了身体成分和种族因素在BMI数据中的作用，以及用于衡量个体肥胖的更优工具。

⚖️ 访谈中，Allison讨论了使用BMI数据采取行动以对抗肥胖的方法，以及为什么维持体重减轻比减轻体重更具挑战性。他还分享了对营养流行病学的不同观点，以及如何改进营养流行病学。

💡 Allison还讨论了解决肥胖问题的未来之路和需要克服的障碍，以及他认为我们可以采取的最有希望的干预措施，以解决肥胖问题和改善公共健康。最后，他探讨了科学的可重复性，以及如何重建对科学的信任，区分科学和倡导。

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Episode Description:

David Allison is an award-winning scientific writer who has been at the forefront of obesity research for the last 20 years. Currently the Dean of the Indiana University School of Public Health, he has also authored many publications on statistical and research methodology and how to improve research rigor and integrity. David’s focus on evidence and data brings forth an interesting discussion of what we know (and don’t know) about the science of obesity. He provides an insightful and unemotional explanation of the potential impact of nutritional epidemiology in public health while also explaining its many pitfalls and limitations. He offers his take on the path forward in addressing the obesity epidemic, and he closes with a lucid explanation for the evident lack of credibility in science and the steps we can take to change that. 

We discuss:

• David’s background, interest in obesity, and focus on evidence [5:00];
• The moment when the obesity crisis was recognized, and the sloppy science that ensued [13:00];
• What twins studies tell us about the genetics of obesity [20:30];
• How doctors and scientists have historically approached obesity treatment [23:45];
• Do surgical procedures for obesity prolong life? [32:00];
• The ‘Obesity Paradox’ [36:00];
• Interpreting BMI and mortality data and considering confounders [43:15];
• How body composition and ethnicity factor into consideration of BMI data [50:30];
• Superior tools for measuring obesity at the individual level [57:15];
• Using BMI data for actionable steps to combat obesity [1:02:00];
• Why maintaining weight loss is more challenging than losing weight [1:06:00];
• Differing perspectives on the utility of nutritional epidemiology [1:16:30];
• A mouse study illustrating the impossibility of fully controlling for confounds in observational studies [1:22:15];  
• Limitations of nutritional epidemiology and how it can improve [1:26:30];
• Addressing the obesity epidemic—the path forward and obstacles to overcome [1:37:15];
• What David believes to be the most promising interventions we could take to address obesity and improve public health [1:47:30];
• Reproducibility in science, normative and non-normative errors explained [1:51:30];
• Rebuilding trust in science and differentiating between science and advocacy [1:59:00];
• More.

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