However, the situation has changed. In the 1970s, the WHO lent a too-willing ear to acupuncture. The tide has not exactly turned on this tradition. In May 2002, the report Traditional Medicine Strategy 2002–2005 was published. Strangely enough, this report also included alternative forms of medicine which are very popular in the West. The man responsible for this strategic report is Dr. Xiaorui Zhang, who is in charge of two WHO departments that—curiously—merged to­gether: the Depart­ment of Essential Drugs and Medicine Policy and the Department of Tradi­tional Medicine.

According to a press release, the report presents “the first global strategy on traditional and alternative medicine.” It is a very pro-alternative report, recommending the issuance of rules and government policies with regard to alternative medicine, bypassing, for instance, the usual methods of testing medicine by accepting “assumed safety” after sustained use. A substantial part of this report was written by the World Federation of Chiropractic (WFC) and the World Self-Medication Industry (WSMI), which represents manufacturers and distributors of nonprescription medicines—that is, over-the-counter medicines—two organizations that are not exactly known as promoters of evidence-based medicine. Resentment against “Western medicine” is tangible on every page. Countries like China, North and South Korea, and Vietnam are praised as having fully integrated traditional medicine into their health systems. The indigenous flora of such regions are conceived of as rich and so far uncultivated sources of new remedies, from whose supposed benefits only the Third World countries should derive the profits. For example, the South African plant Sutherlandia microphyllia is claimed to be a promising medicine that helps increase the weight of AIDS patients.

Since 2002, Dr. Xiaorui has persevered, and the situation is getting worse. In 2003, the WHO issued Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials. This review circumvented public evaluation and totally avoided the peer-review system.

Indiscriminate Medicine

The consequences are grave. Showing great contempt for the prevailing view in medicine, the report touts the effectiveness of acupuncture for, among other ailments, acute dysentery, hay fever, high blood pressure, rheumatoid arthritis, white-blood-cell deficiency caused by chemotherapy, colic caused by gallstones, strokes, and sciatica. The very pursuit of a recommendation to apply acupuncture in the case of dysentery—a dangerous and not infrequently lethal infection—would cost many lives.

Only few people are aware of the insignificant legal and medical status of such reports; little wonder that quacks are very eager to loudly proclaim the content of this report. The label “Recognized by the WHO” inspires misplaced confidence.

Meanwhile, news of preparations for a similar report, this time on the subject of scientific research on homeopathy, have leaked out. By chance, we were able to take a look at this secret draft report, which was handed around to a number of unknown experts by Xiaorui in November 2004. We immediately conveyed our objections to him. An answer remains forthcoming, and that’s why we feel compelled to raise the alarm over this, before the WHO actually proceeds to publish.

A letter that accompanied the draft states that it “is intended for a restricted audience only” and that the draft text “may not be reviewed in any form or by any means outside the restricted audience.” Comments were to be sent before the end of January 2005. Reading this draft report reveals why this secrecy is required. The tenor of Homeopathy: Review and Analysis of Reports on Controlled Clinical Trials is no better than the content of the report on acupuncture. The report refers to the infamous research of Jacques Benveniste on water-memory effects. Indeed, Benveniste’s study did make it to Nature (with serious reservations by the editor), but there’s not a word on the subsequent revocation of that same article.²

The draft report also indiscriminately adopts the ill-quoted conclusion of German scientist Klaus Linde, whose research was published in The Lancet in 1997. Linde stated that the clinical effects of homeopathy could not be entirely attributed to the placebo effect. (Linde has since renounced this conclusion.) But he also added that he had not found a single piece of evidence that homeopathy clearly works. The WHO clearly applies a method which countless homeopaths also use: selective critical thinking.

‘Factually Wrong’ and ‘Problematic’

With regard to homeopathy, the draft report presents some indications for which effectiveness is claimed to be proved: tropical diarrhea among children, hay fever, beginning influenza, fibromyalgy, stomatitis during chemo­therapy, and postoperative ileus, among others. Also, senseless explanations are brought up to support the supposed effectiveness of submolecular diluted solutions. The statements on the importance of agitation during the preparation of homeopathic remedies are downright hilarious.³

As in the report on acupuncture, critical reviews by the most influential authors/authorities that are specialized in scientific research on alternative treatments—the Web site Bandolier (Oxford University), the Cochrane Library, and Edzard Ernst (Exeter University)—are entirely ignored. In fact, Ernst considers the report to be “misleading and factually wrong” (personal correspondence).⁴

Even more damaging to the credibility of the WHO report is the recent opinion of Klaus Linde, ironically, the most cited author in the same report. He considers the draft report on homeopathy as ‘overoptimistic’ and would find it ‘problematic’ if this would be circulated as an official WHO paper.”

Science by Majority Vote?

When it comes to health, what is decisive for the WHO—popular belief or expertise? As a matter of fact, it looks as though the majority opinion among the Third World countries in the WHO is the deciding factor and the organization’s policies on some alternative remedies are determined by popular vote. If the application of holy water and irradiated tomatoes for the treatment of athlete’s foot becomes popular, will the WHO also buckle under arguments of popularity? Listing the category “experience-based medicine” alongside the category “evidence-based medicine” is plainly misleading. For centuries, experience made people believe that treatments like bloodletting were excellent for one’s health—until someone decided to scrutinize this claim.

The contempt for scientific standards in the evaluation of alternative and traditional medicine has disastrous consequences for the reputation and authority of the WHO, and leads to a considerable increase in quackery.

By legitimizing acupuncture while at the same time asking for “more research,” the WHO is blowing hot and cold, creating a dangerous precedent. Also, the too-favorable judgment of “traditional medicine” by the WHO definitely won’t alleviate the urgent need for rational and effective medicine in the Third World. It is very important that the WHO office realize that its documents are scrutinized. The quack lobbies that have infiltrated the WHO cannot be given a free ride. We ask all scientific and skeptical organizations to contact their health officials to let the WHO know that they expect the highest scientific standards to be applied in all official WHO statements on medicine.

Furthermore, the WHO’s recommendations for methods of treatment should no longer be made by a majority votes but instead be based on a set of undisputed scientific criteria. Contribu­tors to WHO reports should be above any suspicion of conflicts of interest. We also insist that Dr. Xiaorui should put any future draft reports under review by experts. In our opinion, a degradation of the WHO standards presents a sad and dangerous situation.

Notes

1. Since its foundation in 1948, the WHO has been publishing strategic documents in which it addresses global health problems and announces its plans. The 1977 report Action Programme on Essential Drugs, which listed 300 essential medicines and vaccines, is a good example. Since 1986, this action program has become part of the WHO strategy on the rational use of drugs, pleading in addition for national regulations on the registration of medicines, more schooling and exchange of information, [reduction/elimination] of deceptive drug advertising, and more research on tropical diseases. Another important report was Health for All in the Year 2000, which was the result of a conference in Alma Ata, Kazakhstan, in 1978. The recommendations in this document were undisputed and included the guideline that developing countries should spend at least 5 percent of their gross national product on health care.

2. About Benveniste, the report says: “A study published by a group led by Benveniste (Davenas 1988) attracted wide attention. . . . Although these studies have proved irreproducible, subsequent studies using a modified method . . . have shown positive results, which have been reproduced by several different laboratories. . . .” One of the studies quoted was from Belon et al. in 1999. This study was the subject of a carefully conducted experiment by the BBC and proved not to be able to demonstrate any specific effects of ultra-diluted solutions, contrary to the unequivocal assertions. Neither the immediate refutation by Davenas et al., the subsequent one by Hirst et al., nor the invalidation by the BBC are mentioned in the report.

3. About the role of agitation (shaking and knocking), the report states: “Theoretical work predicts that a body of water containing about 1015–1017 molecules will spontaneously self-organise into a ‘coherent domain’ similar to electrons in a free electron laser (Del Giudice 1988). It appears that such coherent domains could be triggered by the process of dilution and agitation used in the preparation of homeopathic medicines.”

Similar wording can be found in the February 2002 edition of Chembytes, the monthly e-zine of homeopath and chemist Lionel Milgrom, who is quoted in the draft report although he is not recorded in the bibliography.

Obviously, all this has nothing to do with the “clinical trials” in the title of the draft report. What this nonsense conceals, however, is that the quoted article is not at all concerned with fixed structures that exist long enough to be replicated but rather with the eventuality that the movements of the rotation axes of free-water molecules show a certain connection. It is a fact that water molecules are generally stuck to one or more neighboring molecules with hydrogen bonds. Structures that come into being in this way have a life span of about 10-14 seconds and during the same duration, any pattern in the random movements of the molecules crumbles away. This temporarily shared movement shows no preferential direction, but Del Giudice speculates that it might arise in the vicinity of substances with a charge distribution (like proteins). However speculative this may sound, Del Giudice does not comment on any effect of agitation (shaking) and dilution. Nor is it evident how this mechanism would take effect in alcohol or lactose (the vehicles most often used for homeopathic solutions). After all, it remains unclear how the effect of knocking a vial on a leather-bound book (Organon of Medicine § 270, note 3) could have the slightest effect on molecules that constantly bump into each other at speeds of hundreds of meters per second.

This appeal to the highly speculative article of Del Giudice et al. can be treated in the same way as the “proof” of Hahnemann that links a personal observation about the intoxicating smell of roses with an anecdote about the Byzantine emperor Alexius, who passed out and was restored to consciousness with rose water by his sister (Organon of Medicine §117, notes 1 and 2).

4. E-mail message from Klaus Linde to Willem Betz.

You have probably heard that we are in the midst of an obesity epidemic. The Centers for Disease Control and Prevention (CDC) have been fervently warning that we are in imminent danger from our expanding waistlines since the beginning of this decade. However, evidence has recently emerged indicating that the CDC’s warnings were based on questionable data that resulted in exaggerated risks.

This new evidence has led to a hostile backlash of sorts against the CDC. The editors of the Baltimore Sun recently called the earlier estimates the “Chicken Little Scare of 2004.” The Center for Consumer Freedom, a group that has long been critical of the CDC, declared unequivocally on its Web site and in print ads in several newspapers around the country that the obesity scare was a myth (figure 1). Even Jay Leno poked fun at the CDC in one of his Tonight Show monologues, making the observation that “not only are we fat. . . . We can’t do math either.” Not everybody believes the new data, however. Cable talk show host Bill Maher commented during an episode of his show Real Time with Bill Maher about it being a shame that lobbyists were able to manipulate the CDC into reducing the estimated risk.

So which is it? Are we in imminent danger, or is the whole concept a myth? Looking at the scientific evidence it is clear that the extreme views on either side of the argument are incorrect. There is no doubt that many of our concerns about obesity are alarmist and exaggerated, but it is also apparent that there is a real health risk associated with it.

The Controversy

Between 1976 and 1991 the prevalence of overweight and obesity in the United States increased by about 31 percent (Heini and Weinsier 1997), then between 1994 and 2000 it increased by another 24 percent (Flegal et al. 2002). This trend, according to a 2004 analysis, shows little sign of slowing down (Hedley et al. 2004). The fact that more of us are getting fatter all the time raises a significant public health concern. The Centers for Disease Control and Prevention (CDC) began calling the problem an epidemic in the beginning of this decade as the result of research that estimated 280,000 annual deaths as a consequence of obesity (Allison et al. 1999). Since then there has been a strong media campaign devoted to convincing Americans to lose weight. In 2003, Dr. Julie Gerberding, the director of the CDC, made a speech claiming that the health impact of obesity would be worse than the influenza epidemic of the early twentieth century or the black plague of the Middle Ages. In 2004 the campaign reached a fever pitch when a report was released that increased the estimate of obesity-related deaths to 400,000 (Mokdad et al. 2004). Finally, in March of this year, a report appeared in the New England Journal of Medicine that predicted a decline in life expectancy in the United States as a direct result of obesity (Olshansky, et al. 2005).

Despite the assertions that obesity is causing our society great harm, however, many scientists and activist groups have disputed the level of danger that it actually poses. Indeed, a recent analysis presented in the Journal of the American Medical Association (JAMA) by Katherine Flegal of the CDC and her colleagues calls the severity of the dangers of excess body fat into question, indicating that the number of overweight and obesity-related deaths is actually about 26,000—about one fifteenth the earlier estimate of 400,000 (Flegal et al. 2005).

There is little argument about the fact that, as a nation, more of us are fatter than ever before; the disagreement lies in the effect that this has on our health. The campaign to convince us to lose weight gained much of its momentum in 2004; not only were there high-profile public health initiatives devoted to stopping the obesity epidemic, but the idea had pervaded popular culture as well. Movies like Morgan Spurlock’s Super Size Me were the topic of many a discussion, and there were regular news reports about the dangers of too much fat.

During this campaign, however, there were some notable dissenters. Paul Ernsberger, a professor of nutrition at Case Western Reserve University, has been doing research since the 1980s that led him to assert that obesity is not the cause of ill health but rather the effect of sedentary living and poor nutrition, which are the actual causes. Another prominent researcher, Steven Blair, director of the Cooper Institute of Aerobics Research in Dallas, Texas, has been an author on several studies indicating that the risks associated with obesity can be significantly reduced if one engages in regular physical activity, even if weight loss is not present. According to Blair, weight loss should not be ignored but a greater focus should be placed on physical activity and good nutrition. Both Ernsberger and Blair indicated to me that they thought the new research by Flegal and her colleagues provides a more accurate picture of the mortality risk associated with obesity.

While scientists like Ernsberger and Blair have been presenting their conclusions in the scientific forum, others have taken a more inflammatory approach. In his 2004 book, The Obesity Myth, Paul Campos argues that the public health problem we have associated with obesity is a myth and further claims that our loathing of fat has damaged our culture (see Benjamin Radford’s review on page 50). The most antagonistic group, however, is the Center for Consumer Freedom (CCF) (www.consumerfreedom.com), which implies that the obesity epidemic is a conspiracy between the pharmaceutical industries and the public health establishment to create a better market for weight-loss drugs. Numerous articles on the organization’s Web site bash several of the most prominent obesity researchers who have disclosed financial ties to the pharmaceutical industries. Paul Ernsberger echoed this sentiment. He told me that the inflated mortality statistics were all based on the work of David Allison, a well-known pharmacoeconomics expert. “These experts create cost-benefit analyses which are part of all drug applications to the FDA. These self-serving analyses start by exaggerating as much as possible the cost to society of the ailment to be treated (obesity in the case of weight-loss drugs). The risks associated with the new drug are severely underestimated, which results in an extremely favorable risk-benefit analysis, which is almost never realized once the drug is on the market. Experts who can produce highly favorable risk-benefit analyses are very much in demand, however.”

The claims made by the CCF are given some credence by Ernsberger’s corroboration; however, there is a noteworthy problem with their own objectivity. On their Web site they present themselves as a consumer-minded libertarian group that exists to “promote personal responsibility and protect consumer choices.” Upon closer examination, however, it becomes evident that the CCF is an advocacy group for restaurants and food companies, who have as much to gain by the threat of obesity being a myth as the pharmaceutical industry does by the danger being dire.

It is clear that there are agenda-determined interests on both sides of the issue. Therefore, the best way to discern what is necessary for good health is to shift our focus away from the sensational parts of the controversy and look at the science itself.

Current Science and Obesity Risks

In their recent article, Katherine Flegal and her colleagues (2005) point out that the earlier mortality estimates were based on analyses that were methodologically flawed because in their calculations the authors used adjusted relative risks in an equation that was developed for unadjusted relative risk. This, according to Flegal’s group, meant that the old estimates only partially accounted for confounding factors. The older estimates, furthermore “did not account for variation by age in the relation of body weight to mortality, and did not include measures of uncertainty in the form of [standard errors] or confidence intervals.” These authors also point out that the previous estimates relied on studies that had notable limitations: “Four of six included only older data (two studies ended follow-up in the 1970s and two in the 1980s), three had only self-reported weight and height, three had data only from small geographic areas, and one study included only women. Only one data set, the National Health and Nutrition Examination Survey I, was nationally representative” (Flegal et al. 2005). In their current investigation, Flegal’s group addressed this problem by using data only from nationally representative samples with measured heights and weights. Further, they accounted for confounding variables and included standard errors for the estimates.

Obesity was determined in this analysis using each subject’s body mass index, which is a simple height-to-weight ratio. A BMI of 18 to 24 is considered to be the normal weight, 25—29 is considered overweight, and 30 and above is considered obese. The data from this study indicated that people who were underweight experienced 33,746 more deaths than normal-weight people, and that people who were overweight or obese experienced 25,814 more deaths than the normal-weight folks. This estimate is being reported in the popular media as being one- fifteenth the earlier estimate of 400,000. However, conflating the categories of overweight and obesity this way is misleading.

At first glance, it appears that underweight poses a bigger threat to our health than overweight and obesity, and that the earlier estimates were profoundly exaggerated. However, in this study the people who fit into the obese category actually experienced 111,909 excess deaths compared to normal-weight subjects. In contrast, those who were categorized as overweight experienced 86,094 fewer deaths than those who were normal weight. The figure of 25,815 is the difference between the obesity deaths and the overweight survivals. In the original study by David Allison and his colleagues (Allison et al. 1999) it is actually estimated that 280,000 deaths result from overweight and obesity and that 80 percent, or 224,000, of these deaths occurred in people who were in the obese category. However, the study by Mokdad and colleagues (2004), using the same methods developed by Allison et al., estimated 400,000 obesity-related deaths, and subsequently fueled much of the recent fervor surrounding the obesity epidemic. In this study, no distinction was made between overweight and obesity and the authors failed to distinguish between obesity, physical inactivity, and poor diet. All of these variables were simply lumped together.

A few things become clearer after examining the data. First, it appears that our categories are mislabeled; being classified as overweight appears to give one an advantage (statistically, anyway) over those who are in the ideal weight range. [1] Moreover, it is inappropriate to consider overweight and obese as one group. Despite the current hype, the initial overestimation by Allison and his group was not as exaggerated as is being publicized; compared to that study, the new estimate is actually about half of the old number. Finally, it is apparent that many at the CDC were simply confirming their own biases when they accepted the estimate by Mokdad et al. The categories in that study—that was, intriguingly, co-authored by CDC director Julie Gerberding, which may provide some insight into why it was so readily accepted—were far too broad to provide useful information. The fact that this flaw was ignored shows how easy it is to accept evidence that supports our preconceived notions or our political agendas.

There is another problem inherent in all of the above mortality estimates. They are based on epidemiological data that show correlation but leave us guessing as to causation. Various factors are interrelated with increased mortality—obesity, inactivity, poor nutrition, smoking, etc. Yet, without carefully controlled experiments, it is hard to determine which factors cause—and which are symptoms of—poor health. This is a difficult limitation to overcome, however, because we can’t recruit subjects and have them get fat to see if they get sick and/or die sooner. Most institutional review boards would not approve that sort of research, and furthermore I can’t imagine that there would be a large pool of subjects willing to participate. There are, however, observational data that were collected with fitness in mind, which help to clarify the picture somewhat.

In 1970 researchers at the Cooper Institute for Aerobics Research in Dallas, Texas, began to gather data for a longitudinal study that was called, pragmatically enough, the Aerobics Center Longitudinal Study (ACLS). This study looked at a variety of different variables to estimate the health risks and benefits of certain behaviors and lifestyle choices. What set this study apart from other large-scale observational studies, however, was that instead of relying on self-reporting for variables like exercise habits, they tested fitness levels directly by way of a graded exercise test (GXT). A GXT requires a person to walk on a treadmill as long as he or she can with increases in speed and incline at regular intervals. This is the most reliable way we know of to assess a person’s physical fitness.

With an accurate measure of the subjects’ fitness levels, researchers at the Cooper Institute have been able to include fitness as a covariate with obesity. Analysis of the data obtained in the ACLS shows that there is a risk associated with obesity, but when you control for physical activity, much of that risk disappears (Church et al. 2004; Katzmarzyk et al. 2004; Katzmarzyk et al. 2004; Lee et al. 1999). One study showed that obese men who performed regular exercise had a lower risk of developing cardiovascular disease than lean men who were out of shape (Lee et al. 1999).

Steven Blair, who runs the Cooper Institute and was an author on all four of the above-mentioned studies, however, does not think obesity should be ignored. “I do think obesity is a public health problem, although I also think that the primary cause of the obesity epidemic is a declining level of average daily energy expenditure . . . it will be unfortunate if it is now assumed that we should ignore obesity. I do not think that the [health] risk of obesity is a myth, although it has been overestimated.” Blair believes that a focus on good nutrition and increased physical activity rather than on weight loss will better serve us.

In spite of the fact that there are virtually no controlled clinical trials examining the effects of obesity in people, we can make some inferences from animal research. Investigations performed by Ernsberger and his colleagues have shown that, over time, weight cycling (temporary weight loss followed by a regain of that weight, otherwise known as yo-yoing) in obese laboratory animals increases blood pressure, enlarges the heart, damages the kidney, increases abdominal fat deposits, and promotes further weight gain (Ernsberger and Koletsky 1993; Ernsberger et al. 1996; Ernsberger and Koletsky 1999). This indicates that the yo-yo effect of crash dieting may be the cause of many of the problems we attribute to simply being fat.

Even though there is a health risk from being too fat, you can eliminate much of the potential risk by exercising. Moreover, it is probably a bad idea to jump from diet to diet given the negative consequences the yo-yo effect can have. According to another study published in JAMA, the risk of cardiovascular disease has declined across all BMI groups over the past forty years as the result of better drugs (Gregg et al. 2005).

None of this means, however, that we should simply abandon our attempts to maintain a healthy weight; obese people had twice the incidence of hypertension compared to lean people and, most significantly, there has been (according to the above study) a 55 percent increase in diabetes [2] that corresponds to the increase in obesity. So while we are better at dealing with the problem once it occurs, it is still better to avoid developing the problem in the first place.

Condemning the CDC

Whatever side of the argument you are on, it is apparent that many in the CDC acted irresponsibly. However, despite the fact that the initial, exaggerated estimate came from people at the CDC, we should keep in mind that so did the corrected number. While this can be frustrating to the casual observer, it is also a testament to the corrective power of the scientific method.

Science is about provisional truths that can be changed when evidence indicates that they should be. The fact that scientific information is available to the public is its greatest strength. Most of us, for whatever reason—whether it’s self-interest or self-delusion—don’t view our own ideas as critically as we should. The fact that scientific ideas are available for all to see allows those who disagree to disprove them. This is what has happened at the CDC; the most current study has addressed the flaws of the earlier studies. It is true that many of those in power at the CDC uncritically embraced the earlier estimates and overreacted, or worse simply accepted research that was flawed because it bolstered their agendas. But that failure lies with the people involved, not with the CDC as an institution or with the science itself.

The evidence still shows that morbid obesity is associated with an increased likelihood of developing disease and suffering from early mortality, but it also shows that those who are a few pounds overweight don’t need to panic. What’s more, it is clear that everyone, fat or thin, will benefit from regular exercise regardless of whether they lose weight.

The lesson to be learned from this controversy is that rational moderation is in order. Disproving one extreme idea does not prove the opposite extreme. As Steven Blair told me, “It is time to focus our attention on the key behaviors of eating a healthful diet (plenty of fruits and veggies, a lot of whole grains, and not too much fat and alcohol) and being physically active every day.”

Notes

1. This is not the first time this has been shown. The following studies are also large-scale epidemiological studies that have found the overweight category is where the longest lifespan occurs: Waaler H.T. 1984. Height and weight and mortality: The Norwegian experience. Acta Medica Scandinavica Supplementum 679, 1—56; and Hirdes, J., Forbes, W. 1992. The importance of social relationships, socieoeconomic status and health practices with respect to mortality in healthy Ontario males. Journal of Clinical Epidemiology 45:175—182.
2. This is for both diagnosed and undiagnosed individuals.

References

• Allison, D.B., et al. 1999. Annual deaths attributable to obesity in the United States. Journal of the American Medical Association 282: 1530—38.
• Blair, Steven, and James Morrow, Jr. 2005. Comments on U.S. dietary guidelines. Journal of Physical Activity and Health 2: 137—142.
• Campos, Paul. 2004. The Obesity Myth. New York, New York: Gotham Books.
• Church, T., et al. 2004. Exercise capacity and body composition as predictorof mortality among men with diabetes. Diabetes Care 27(1): 83—88.
• Ernsberger, Paul, and Richard Koletsky. 1993. Biomedical rationale for a wellness approach to obesity: An alternative to a focus on weight loss. Journal of Social Issues 55(2): 221—259
• Ernsberger, Paul, and Richard Koletsky. 1999. Weight cycling and mortality: support from animal studies. Journal of the American Medical Association 269: 1116.
• Ernsberger P., et al. 1994. Refeeding hypertension in obese spontaneously hypertensive rats. Hypertension 24: 699—705.
• Ernsberger P., et al. 1996. Consequences of weight cycling in obese spontaneously hypertensive rats. American Journal of Physiology: Regulatory, Integrative and Comparative Physiology 270: R864—R872.
• Flegal, Katherine M., et al. 2000. Journal of the American Medical Association 288(14): 1723—1727.
• Flegal, K., et al. 2005. Excess deaths associated with underweight, overweight, and obesity. Journal of the American Medical Association 293(15): 1861—67.
• Gregg, E., et al. 2005. Secular trends in cardiovascular disease risk factors according to body mass index in U.S. adults. Journal of the American Medical Association 293(15): 1868—74.
• Hedley, A., et al. 2004. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999—2000. Journal of the American Medical Association 291: 2847—2850.
• Heini, Adrian F., and Roland L. Weinsier. 1997. Divergent trends in obesity and fat intake patterns: The American paradox. Journal of the American Medical Association 102(3): 254—264.
• Katzmarzyk, Peter, et al. 2004. Metabolic syndrome, obesity, and mortality. Diabetes Care 28(2): 391—97.
• Katzmarzyk, Peter, Timothy Church, and Steven Blair. 2004. Cardiorespiratory fitness attenuates the effects of the metabolic syndrome on all-cause and cardiovascular disease mortality in men. Archives of Internal Medicine 164: 1092—97.
• Lee, Chong Do, Steven Blair, and Andrew Jackson. 1999. Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men. American Journal of Clinical Nutrition 69: 373—80.
• Mark, David. 2005. Deaths attributable to obesity. Journal of the American Medical Association 293(15): 1918—19.
• Mokdad, A.H., et al. 2004. Actual causes of death in the United States. Journal of the American Medical Association 291: 1238—45.
• Olshansky, S, Jay., et al. 2005. A potential decline in life expectancy in the United States in the 21st century. New England Journal of Medicine 352(11): 1138—45.

So states Dr. Steven Sharfstein, president of the American Psychiatric Association (APA), in response to recent talk show activities of actor Tom Cruise. Weeks earlier, Cruise had criticized actress Brooke Shields for taking anti-depressants for postpartum depression. Cruise believes all psychiatry to be pseudoscience, chemical imbalances to be imaginary, and all psycho-tropic medication and therapy to be unnecessary and dangerous. His solution to the roller coaster of life? The Church of Scientology.

The topic arose while Tom Cruise was promoting the alien-invasion film War of the Worlds. Because celebrity opinions can carry great weight with fans, Cruise’s comments worried many in the mental health field. In an appearance on the Today Show, Cruise proclaimed a profound understanding of psychiatry that reinforced his belief that the field was bogus. The gist of Cruise’s message was that mental illness was not real and that people should not look to psychology for help. The APA responded with the following statement:

Science has proven that mental illnesses are real medical conditions that affect millions of Americans. . . . Over the past five years, the nation has more than doubled its investment in the study of the human brain and behavior, leading to a vastly expanded understanding of postpartum depression, bipolar disorder, and attention-deficit / hyperactivity disorder. Much of this research has been conducted by the National Institutes of Health and the nation’s leading academic institutions. Safe and effective treatments are available and may include talk therapy, medication, or a combination of the two. Rigorous, publish- ed, peer-reviewed research clearly demonstrates that treatment works. Medications can be an important and even life-saving part of a comprehensive and individualized treatment plan. As in other areas of medicine, medications are a safe and effective way to improve the quality of life for millions of Americans who have mental health concerns. Mental health is a critical ingredient of overall health. It is unfortunate that in the face of this remarkable scientific and clinical progress that a small number of individuals and groups persist in questioning its legitimacy. . .

Brooke Shields also responded: “To suggest that I was wrong to take drugs to deal with my depression, and that instead I should have taken vitamins and exercised shows an utter lack of understanding about postpartum depression and childbirth in general. If any good can come of Mr. Cruise’s ridiculous rant, let’s hope that it gives much-needed attention to a serious disease.”

Shields wrote a book on her experiences, Down Came the Rain: My Journey Through Postpartum Depression, in which she states: “I wasn’t thrilled to be taking drugs. In fact, I prematurely stopped taking them and had a relapse that almost led me to drive my car into a wall with Rowan [her newborn] in the backseat. But the drugs, along with weekly therapy sessions, are what saved me—and my family.”

Scientology, a movement based on the science fiction novels of L. Ron Hubbard, claims the notion of mental illness is a fraud and a scam. Hubbard himself equated psychiatrists with terrorists. Since the publication of Hubbard’s self-help treatise Dianetics in 1950, the American Psychological Association has warned people of the potential danger of scientology’s professed “cure.” In 1969 the Church of Scientology founded the Citizens Commission on Human Rights, an organization designed to “investigate and expose psychiatric violations of human rights.” In an informative article entitled “Scientology’s war on psychiatry” (available at salon.com), Katharine Mieszkowski reports:

Recently, Scientologists have promoted legislation in Florida, Utah and New Hampshire that seeks to discredit psychiatry and drug therapies, especially for kids. The laws would penalize, even criminalize, schoolteachers who recommended mental health treatments to students or parents.

Those speaking on behalf of Scientology in the Florida courts included actors Kelly Preston and Kirstie Alley. Those speaking against were trained scientists and mental health practitioners. A Scientology-backed program, Narcanon, has been touring public schools lecturing to children about the danger of recreational drugs. According to the Scientology handbook, “Answers to Drugs,” the core treatment for those who abuse drugs like marijuana, Ecstasy, or cocaine is sweating out drug residuals and other toxins by taking saunas and jogging. Remedies also include the B-complex vitamin niacin, oils and other minerals, a detoxification service which “is available under expert supervision in Scientology organizations and missions around the world.”

While there is an ongoing debate within society about the use of medication, especially by children, scientific organizations are an integral part of this discussion. Contrary to what the Scientologists claim, medication is not always diagnosed as the most effective treatment. Psychiatrists and psychologists work with an individual to tailor a mental health program to fit his or her needs; in many cases medication has been found to be very effective.

Mark Plummer, a former Scientology member for fourteen years, states:

“Their goal is to take over entirely the field of mental health. Their beliefs stem from Hubbard’s dogma that psychiatry is evil. Scientology teaches that psychiatry views people as ‘meat bodies’ without a spiritual aspect, and that Scientologists alone should be allowed to treat mental illnesses.” Church leader David Miscavige agreed, stating quite clearly at the International Association of Scientologists in Copenhagen: “Objective one—place Scientology at the absolute center of society. Objective two—eliminate psychiatry in all its forms.”

While this is indeed puzzling, it is not a logical flaw in relativity. The twins do not have similar experiences during B’s long journey, and that resolves the “paradox.” (While the fiction of very short deceleration/acceleration periods is useful to keep this discussion from getting into general relativity theory, it should be noted that such accelerations would almost certainly reduce twin B to a thin red puddle. It would take weeks to make the velocity changes at tolerable accelerations, say 5 to 10 g. See my accompanying sidebar “On Problems with Near-light-speed Travel” for more on this type of difficulty.) The journey of B, as viewed by twin A, is depicted in figure 1.

The workings of the “Twin Paradox” can be explained with the aid of space-time diagrams. A space-time diagram for the stay-at-home twin, A, appears in the left half of figure 2. The grid marks show years on the vertical axis and distance in light-years on the horizontal axis. The thick lines represent A’s and B’s positions over time, while the thin lines with arrows represent the paths of light beams sent between the twins. During the fifteen years (in A’s frame of reference) of outbound travel by twin B, B gets out to a distance of nine light-years (0.6c315 years) from twin A. However, signals or light rays sent from B’s turnaround point won’t even reach A for another nine years, or until twenty-four years (15+9) after B’s departure. That is, A will see his brother B recede for twenty-four years, and then approach for just six years, arriving thirty years after his initial departure.

This is in marked contrast to B’s observations: B will see his stay-home brother recede for twelve years. After B turns around, he will see A approaching for twelve years and will return a total of twenty-four years after his departure. However, the same interval is thirty years by A’s calendar. The difference is that, during the short but intense accelerations experienced by B, B’s velocity relative to the universe (and to A) is changing. Twin B effectively “loses synch” with the rest of the universe, including his twin brother, A. Twin B is not in an inertial reference frame over the entire trip—and his bouts with intense accelerations will certainly remind him of that fact. Of course, A won’t be aware of B’s velocity changes until many years later.

The space-time diagrams for B’s journey appear on the right of figure 2. These can’t be represented as a single diagram, because they are views of two different inertial frames (B outbound versus B inbound). The twin that undergoes acceleration will be the one who returns home younger than his stay-at-home brother. The loss of synchronization due to acceleration is the key and the reason it’s not a logical “paradox.”

Figure 2: Twin paradox space-time diagrams for stay-at-home twin A (left) and traveler B (right).

This point is crucial: the time discrepancies between the twins are absolutely real. Here is a quick example, presented with the “radar method”: since any radar beams sent from A meet the target (B) at only one point in space-time, those beams must spend equal times outbound and inbound with respect to the sender. Figure 2 shows that a radar beam emitted by twin A at his time of two years will be reflected from B at some unknown time, and received again by A when his (A’s) calendar reads eight years. Likewise, a beam emitted by twin A at four years will be reflected from B and received by A when his calendar reads sixteen years.

Twin A can calculate the time and distance (in A’s frame of reference) of reflections from B, knowing only his own sending and receiving times and that the signals propagate at the speed of light. Since A’s two-year pulse returns at eight years, the reflection occurred (by A’s calendar) at the midpoint of the send/receive times, (2+8)/2=5 years. Since A’s four-year pulse returns at sixteen years, the reflection occurred at (4+16)/2=10 years by A’s calendar. Therefore, A measures the interval between these reflections (at five years and ten years) as being five years long.

Because the twins are separating rapidly, there will be a delay in B’s receipt of A’s transmissions. In particular, while A’s transmissions were sent two years apart by his clock, they were received by B over an interval longer than two years, say, K*2 years, where K is a factor greater than 1. However, the same must hold true for B’s “transmissions” back to A: whatever period separates the reflections from B’s craft, A’s measurement of receiving times will be longer—in fact, precisely K times longer—since B is moving away from A exactly as fast as A recedes from B (“relativity”). So, A’s original pulses were sent two years apart; these were received by B at K*2 years apart and received again by A at K*K*2 years apart, or eight years. Clearly, K must equal 2, and B’s interval between receipt of A’s two signals must be 2*2=4 years, while A’s measurement of the time for the pulses to return from B is K*4=8 years, as required. This is how “Time Dilation” comes to be measured by twin A: the five-year interval that A experiences in his own frame of reference takes only four years in B’s frame of reference.

One hundred years after Albert Einstein gave us the theory of special relativity, we have made good progress in applying the equations he gave us, but we have difficulty absorbing his central message about time and simultaneity. Time and again, his predictions have been tested; the Global Positioning System simply wouldn’t give us good results unless Einstein’s equations were hidden in the little handheld GPS instruments used by hunters and hikers to find their way in the woods. Special relativity has been combined with quantum physics to produce quantum electrodynamics, the most accurate physical theory ever devised. Shortly after Einstein finished his famous paper, he used it to derive the famous equation E=mc², showing that when a body radiates energy, it loses mass.

So what’s the problem? Well, we haven’t yet absorbed his message that “we cannot ascribe absolute meaning to the concept of simultaneity; instead, two events that are simultaneous when observed from some particular coordinate system can no longer be considered simultaneous when observed from a system that is moving relative to that system” (Einstein 1905, 130). As long as we think there’s such a thing as “a point in time” or events that can be described as universally simultaneous, we will be faced with misconceptions such as “moving clocks run slow” and “moving objects shrink in the direction of motion.” The following simple thought experiment shows how such misconceptions can arise.

Imagine two identical space ships, A and B, far out in space, away from any large gravitating bodies, traveling away from each other at a high velocity. Neither one is accelerating, no engines are operating, and the occupants of each ship consider their ship to be motionless while the other ship is moving rapidly away. The two ships have just passed each other, almost colliding, and at their closest positions, they have synchronized their identical clocks at 12:00. The clocks each cause a bright blue light on the outer hull of their respective ships to flash each hour, and the ships are separating so rapidly that the passengers on each see the blue light of the other shifted to half its frequency, into the infrared. This is the famous red shift caused by the Doppler effect, in this case a shift of 100 percent. The same shift means that the light signals sent out by A at 1:00, 2:00, and 3:00 according to A’s clock will be received by B at 2:00, 4:00, and 6:00 according to B’s clock. Similarly, A will receive signals from B at 2:00, 4:00, and 6:00 according to A’s clock.

Now, consider the signal sent by A at 1:00 according to its own clock. B will receive it at 2:00 according to B’s clock, and it will be reflected back to A along with B’s 2:00 signal to be received by A at 4:00 according to A’s clock. A will receive the reflected signal as deep in the infrared, one-fourth the frequency it had when it was sent out. The crew of A can now calculate that this signal, which was sent out at 1:00 and returned at 4:00, must have been reflected at 2:30, halfway between 1:00 and 4:00, because it traveled an equal distance each way. If they learn that B’s clock read 2:00 at the time of reflection, they may think B’s clock must have been thirty minutes slow. The situation is exactly parallel; B will receive its 1:00 signal return at 4:00 and its crew may conclude that A’s clock was thirty minutes slow.

As simple as the above description may be, it’s worth reviewing to see the following points:

1. A and B are equally justified in considering themselves to be at rest. This is in accordance with Einstein’s postulate that all inertial systems are equivalent.
2. Both A and B consider light to travel away from the space ship at the same velocity as it returns. This reflects Einstein’s postulate that the speed of light is the same in all inertial reference frames.
3. A and B observe the same red shift in the light coming from the other spaceship.
4. Sending and receiving a reflected signal shows how a distant event on a moving body can be timed.
5. Lack of agreement over the time of reflection is shown to occur even though all clocks are working perfectly. This lack of agreement isn’t normally seen, because we don’t usually deal with such high velocities (in this case, three-fifths the velocity of light) or super-accurate clocks. Disagreement could be avoided by A and B refusing to judge what happened at a distant point as “simultaneous” with the ticking of their own clocks.

To measure the length of a moving object, it is necessary to measure the distance to both its front and rear ends at the same time. Without being able to agree on what’s simultaneous, different observers will measure different lengths of moving objects. This effect is called the Lorentz-Fitzgerald contraction, in recognition of the two scientists who concluded that moving objects are physically shortened in their direction of motion. This was before Einstein explained the same effect as a result of the relativity of simultaneity.

Another common misunderstanding concerns the so-called “clock paradox” (or “twin paradox”—see the sidebar on page 35), which says that if B’s clock is transported to be compared with A’s, it will show that less time has elapsed than will A’s. This is not a paradox, because the two clocks have no longer had identical experiences. Specifically, B’s clock will have been accelerated so that it could be returned to A’s position. The behavior of clocks has been accurately tested, and Einstein’s equations have been verified. More troublesome, though, is trying to understand what “really” happens to B’s clock, or more accurately, what we “really” mean by time. We have an intuitive concept of time that resists accurate definition, and we have seen that the timing of a moving clock by sending light signals back and forth gives nonintuitive answers in experiments involving high speeds and very accurate clocks. Our intuitions work perfectly well with everyday clocks and everyday velocities, so it’s a slow process trying to give up the idea of absolute simultaneity.

Perhaps the best approach belongs to Stephen Hawking: “I take the positivist viewpoint that a physical theory is just a mathematical model and that it is meaningless to ask whether it corresponds to reality. All that one can ask is that its predictions should be in agreement with observation” (Hawking and Penrose 1996). We have the model that gives accurate predictions. Perhaps a new concept of time will gradually work itself into our collective intuition as more and more practical applications of special relativity are realized.

References

• Bondi, Hermann. 1962, 1964. Relativity and Common Sense. New York: Dover Publications. Chapters VII, VIII, and IX are recommended for learning the method of tracing light beams on simple space-time diagrams.
• Darwin, C.G. 1957. The clock paradox in relativity. Nature 180 (November), 976—977. This is the ultimate short-and-sweet explanation of the clock paradox.
• Einstein, Albert. 1905. On the electrodynamics of moving bodies. In John Stachel (ed.). 1998. Einstein’s Miraculous Year: Five Papers that Changed the Face of Physics. Princeton, New Jersey: Princeton University Press. This is a recent translation of Einstein’s famous paper.
• Einstein, Albert. 1961 [1916]. Relativity: The Special and General Theory, 15th edition. New York: Crown Publishers. Pp. 21—27. These pages clearly show that simultaneity is not an absolute.
• Hawking, Stephen and Roger Penrose. 1996. The Nature of Space and Time. Princeton, New Jersey: Princeton University Press. Pp. 3—4.

Most people who believe in God assume their belief to be pretty reasonable. “Perhaps God’s existence can’t be conclusively proved,” they’ll say, “but it’s a fairly sensible thing to believe—far more sensible than, say, belief in fairies or Santa Claus.” But are they right?

Christians, Muslims, and Jews all believe that God is both all-powerful and all-good. Indeed, God is often characterized as an infinitely loving father. Yet most of the popular arguments for the existence of God allow us to deduce little if anything about his moral character. Take the argument from design, for example. Even if it can be shown that the universe does show signs of design, what’s the evidence that its creator is all-good?

There is also a well-known argument that, even if the universe was created by an all-powerful being, that being is not all-good. The argument is called the problem of evil, and runs roughly as follows: if God is both all-powerful and all-good, why is there so much suffering in the world? Why does God inflict earthquakes, floods, famines, and the Black Death upon us? Why does he give small children cancer? Why does he make life so grindingly miserable for so many? Why does he arrange for millions of us to end our lives horrendously scarred—in many cases both physically and psychologically crippled—by the world he created for us? This hardly sounds like the behavior of a supremely compassionate and loving father figure, does it? Surely, there’s overwhelming evidence that the universe is not under the control of a limitlessly powerful and benevolent character.

Many find this argument compelling. But of course, there are plenty who believe the problem of evil can be dealt with. How? Religious thinkers have, over the centuries, developed a number of ingenious solutions. Here are some popular examples:

The free-will solution. God gave us free will. We are not blind automata, but free agents, capable of making our own choices and acting on them. As a result of God having given us free will, we sometimes choose to do wrong. We start wars, steal, and so on. So some suffering results from our possessing free will. However, it is still better that we have free will. Free will is a very great good that more than compensates for the suffering it can bring.

The character-building solution. We know that a bad experience can sometimes make us stronger. We can learn and be enriched, through suffering. For example, people who have suffered a terrible disease sometimes say they gained greatly from it. Similarly, by causing us pain and suffering, God allows us to grow and develop both morally and spiritually. It is only through our experiencing this suffering that we can ultimately become the noble souls God wants us to be.

Some goods require evils. Theists often point out that God inevitably had to include quite a bit of suffering in his creation in order that certain important goods could exist. Take, for example, charity and sympathy. Charity is a great virtue. Yet you can only be charitable if there exist others who are needy. Similarly, you can only sympathize with someone whom you perceive to be suffering. Charity and sympathy are so-called “second order” goods that require “first order” evils like neediness and suffering (or at least the appearance of such evils) to exist. It’s argued that these second order goods outweigh the first order evils, which is why God allows the evils to occur.

Play the mystery card. Some theists point out that God works in mysterious ways. It’s arrogant of us to suppose that we can understand the mind of an infinitely powerful and wise being. The evil God inflicts upon us is, actually, all for the best. It’s just that we, being mere humans, can’t see how.

Many believe that these and other similar arguments largely take the sting out of the problem of evil. Some think they dispose of the problem altogether. I find them utterly inadequate. The following dialogue is my attempt to convey why.

Welcome to Eth, a modestly proportioned planet on the far side of our galaxy. Here, beneath the great marble spires of Eth’s finest university, the debate of the age is taking place. Arrayed on either side of the university’s Great Chamber are Eth’s finest scholars and thinkers. They are here to decide the most controversial and emotional issue dividing the inhabitants of Eth: Does God exist?

To the right of the Great Chamber are arrayed the believers. To the left sit the skeptics. The public galleries are nearly bursting with those waiting to observe the proceedings. At the end of the debate, the audience will vote.

Booblefrip, the birdlike Professor of Origin, and Gizimoth, the portly Arch-logos Inquisitor, lead the debate.

Gizimoth: Here, on Eth, many of us believe in God, do we not?

Booblefrip: Certainly.

Gizimoth: So what is God like?

Booblefrip: Well, God is all-powerful, of course. God can do anything. He created the entire universe, including every last one of us. God’s awesome power knows no bounds!

(A whisper of approval ripples across the believers on the right side of the Great Chamber.)

Gizimoth: Let’s agree about that, then. God, if he exists, is omnipotent. But here on Eth, those who believe in God also attribute another property to him, don’t they?

Booblefrip: Yes. As you know, we also believe that God is all-evil.

Gizimoth: Can you explain what you mean by that?

Booblefrip: Not only does God’s power know no bounds, neither does his depravity. His cruelty is infinite; his malice without end.

(Booblefrip casts a cool look across the right side of the chamber.)

Gizimoth: I see. All powerful. And all-evil. Now Professor Booblefrip, do you think that you could briefly explain why you think it’s reasonable to believe in such a being? What grounds can you provide to justify belief in this evil God?

Booblefrip: Well, I don’t say I can conclusively prove beyond doubt that God exists. But it seems to me that there are at least two rather good reasons for believing in God. First, it seems obvious to me, as it does to many, that the universe must have come from somewhere. Don’t you agree?

Gizimoth: Of course. The scientists assembled here will tell you that there is a perfectly good scientific explanation for the existence of the universe—the Big Bang. About 14 billion years ago, an unimaginably violent explosion occurred, in which all matter and energy came into existence, and in which space and even time itself began.

Booblefrip: We’re all familiar with the Big Bang theory, Professor Gizimoth. But of course, the Big Bang really only postpones the mystery of why there is anything at all, doesn’t it? For now we need to explain why there was a Big Bang. Why did the Big Bang happen? Science can’t explain that, can it? There’s a real mystery here, isn’t there?

Gizimoth: Hmm. Perhaps.

Booblefrip: The only satisfactory explanation we have for why the universe came into existence in the first place is that God created it. So, there’s my first reason to believe in God.

(Gizimoth frowns—he’s clearly not buying Booblefrip’s argument—but he encourages Booblefrip to continue.)

Gizimoth: And your second reason?

Booblefrip: Take a look around you at the wonders of the universe. Life. Conscious beings like ourselves. Do you suppose that all this appeared just by chance? Surely not. The universe shows clear signs of design. And where there’s design, there’s a designer!

Gizimoth: But science can explain life. What about the theory of natural selection? That explains how, over millions of years, life forms evolved and developed. It explains how complex life-forms can gradually evolve from even the simplest of bacteria. Science can perfectly well explain life without introducing your supernatural designer.

Booblefrip: Natural selection can’t explain everything. For example, it can’t explain why the universe was set up to allow natural selection to take place in the first place, can it?

Gizimoth: Hmm. Well, no, it can’t explain that.

Booblefrip: Did you know that if the laws governing the universe had been only very slightly different, the universe would not have survived more than a second or two? Either that or it would have quickly dissipated into a thin sterile soup, incapable of producing life. For life to emerge and evolve, you need very specific conditions. The universe must be set up in an extremely precise fashion. And of course, we know that it was set up in just this way, don’t we!

Gizimoth: I guess so.

Booblefrip: Now, that it should just happen to be set up in just this way by chance is too much to swallow. That would be a fluke of cosmic proportions. It’s much more sensible, surely, to suppose that someone deliberately designed the universe this way, so as to produce life and ultimately ourselves. That someone is God!

(Another warm ripple of approval arises from the right side of the Great Chamber. The assembled academics feel that, so far at least, Booblefrip is getting the better of the argument. But Gizimoth is perplexed.)

Gizimoth: Very well, let’s suppose the universe does show clear signs of having been designed by an intelligent being.

Booblefrip: Ah, a convert!

Gizimoth: Not at all. I’m supposing this only for the sake of argument. You still haven’t given me much reason to suppose that this designer is all-evil, have you?

Booblefrip: But God is, by definition, all-evil.

Gizimoth: But why define God that way? Why not suppose, instead, that God is neither good nor evil? Or why not suppose he is all-good?

(Booblefrip thinks Gizimoth has gone too far.)

Booblefrip: What a bizarre suggestion. It’s obvious our creator is very clearly evil! Take a look around you! Witness the horrendous suffering he inflicts upon us. The floods. The ethquakes. Cancer. The vile, rotting stench of God’s creation is overwhelming!

Gizimoth: Yes, our creator may do some evil. But it’s not clear he’s all-evil, is it? It’s certainly not obvious that his wickedness is infinite, that his malice and cruelty know no bounds. You’re deliberately ignoring a famous argument against the existence of God—the problem of good.

Booblefrip: I’m familiar with the problem of good—we theologians of Eth have been debating it for centuries. But it’s not fatal to belief in God.

Gizimoth: Really? Let’s see. The problem of good, as you know, is essentially very simple. If the universe was designed by an all-powerful, all-evil God, then why is there so much good in the world?

Booblefrip: That’s the supposed problem, yes.

Gizimoth: Why, for example, does God allow at least some people to live out happy, contented, and fulfilled lives? Why doesn’t he torture them instead? If God is all-powerful, he certainly could torture them, couldn’t he?

Booblefrip: Well, yes, he could.

Gizimoth: In fact, he could make their lives utterly miserable. And we know that, since he is also supremely evil, he must want them to suffer. Yet, he gives some people every consideration. Why? It makes no sense, does it?

Booblefrip: Perhaps not at first sight, no.

Gizimoth: Here’s another example. Why does God allow us to do good deeds, to help our fellow Ethians? He even allows us to lay down our lives for each other. These selfless actions improve the quality of our lives no end. So why does God allow them? Why doesn’t he force us to be nasty and do evil, just like him?

Booblefrip: I grant you that the fact that God allows so much noble and selfless behavior might seem like very good evidence that he is not all-evil. But appearances can be deceptive.

Gizimoth: Also, if God is absolutely evil, why did he put so much beauty in the world for us to enjoy? Why did he create such sublime sunsets?

Booblefrip: Good question.

Gizimoth: And why does God give us children, who bring us immeasurable happiness? You see? There are countless ways in which our lives are enriched by God’s creation.

Booblefrip: But there’s also evil!

Gizimoth: True, there’s evil in the world. But there’s an awful lot of good. Far too much good, in fact, for anyone reasonably to conclude that the universe was created by an all-evil God. Belief in a supremely wicked creator is palpably absurd.

(There is much quiet nodding to the left of the Great Chamber. Gizimoth’s argument has struck a chord even with the unbelievers. But Booblefrip thinks Gizimoth’s argument is far from conclusive.)

Booblefrip: Look, I admit that the amount of good in the world might seem to undermine belief in an all-powerful, all-evil god. But actually, we believers can explain why a supremely evil God would allow all these good things to happen.

Gizimoth: By all means try.

Booblefrip: Surely you are familiar with the free-will defense?

Gizimoth: Perhaps you would care to explain it.

Booblefrip: Very well. God’s malevolence is without end. True, he lets us do good. He allows us to act selflessly for the betterment of others, for example. But there’s a reason for that.

Gizimoth: What reason?

Booblefrip: God gave us free will.

Gizimoth: Free will?

Booblefrip: Yes. God could have made us mere automata that always did the wrong thing. But he didn’t do that. He gave us the freedom to choose how we act.

Gizimoth: Why?

Booblefrip: By giving us free will, God actually increased the amount of suffering there is in the world. He made the world far more terrible than it would otherwise have been!

Gizimoth: How?

Booblefrip: Think about it. By giving us free will, God can be sure we will agonize endlessly about what we should do. For free will brings with it the torture of temptation. And then, when we succumb to temptation, we feel guilty. Knowing that being free, we could have done otherwise, we feel awful about what we have done. We end up torturing ourselves. The exquisitely evil irony of it all!

Gizimoth: Hmm.

Booblefrip: By giving us free will, God allowed for far more intense and subtle forms of suffering than would otherwise be possible.

Gizimoth: But what about the good that people sometimes do?

Booblefrip: It’s true that people do sometimes choose to act selflessly and nobly and that this can produce good. But this good is far outweighed by the additional suffering free will brings. Just take a look at the world, for goodness sake! It’s a world full of people who not only behave despicably but also agonize endlessly about what they have done!

Gizimoth: But this is ridiculous!

Booblefrip: Why?

Gizimoth: Well, for a start, this only explains the good that we bring about by acting freely. It doesn’t explain the existence of naturally occurring good.

Booblefrip: Such as?

Gizimoth: Well, what about the glories of nature: sublime sunsets, stunning landscapes, the splendor of the heavens? We’re not responsible for those things, are we?

Booblefrip: No. God is.

Gizimoth: But why would an all-evil God create something that gives us pleasure? Also, why does he give us beautiful children to love? And why does he choose to give some people extraordinary good fortune—health, wealth, and happiness in abundance? Surely, the existence of these goods provides us with overwhelming evidence that, even if the universe has a creator, he’s not all bad?

Booblefrip: You’re mistaken, Gizimoth. Such things are exactly what we should expect if God is supremely evil.

Gizimoth: But why?

Booblefrip: Some natural beauty is certainly to be expected. If everything was uniformly ugly, we wouldn’t be tormented by the ugliness half as much as we are when it’s laced with some beauty. To truly appreciate the ghastliness of the environment most of us inhabited—urine-stained, concrete-and-asphalt wasteland peppered with advertising billboards, drug addicts, and dog dirt—we need to be reminded every now and then that things could be different. God put some natural beauty into the world to make our recognition of the ugliness and dreariness of day-to-day life all the more acute.

Gizimoth: Hmm. But why would a supremely wicked God give us beautiful children to love?

Booblefrip: Because he knows we’ll spend our entire lives worrying about them. Only a parent can know the depth of torture a child brings.

Gizimoth: Why does he give us healthy, young bodies?

Booblefrip: He makes sure that both our bodies and their vitality and health are short-lived. You see, by giving us something and then snatching it away, our evil creator can make us suffer even more than if we had never had it.

Gizimoth: But then, why does God allow some people to live out such contented lives?

Booblefrip: Of course an evil God is going to bestow upon a few people lavish lifestyles, good health, and immense success. Their happiness is designed to make the suffering of the rest of us even more acute! We’ll be wracked by feelings of envy, jealousy, and failure! Who can be content while others have so much more!

Gizimoth: Oh, honestly!

Booblefrip: Don’t you see? The world clearly was designed to produce life—to produce conscious beings like ourselves. Why? So that its designer can torture us. The world is designed to physically and psychologically crush us, so that we are ultimately overwhelmed by life’s futility and bow out in despair.

(Gizimoth is becoming frustrated. Every time he comes up with another piece of evidence that the universe wasn’t designed by a supremely evil deity, Booblefrip turns out to have yet another ingenious explanation up his sleeve. And yet, thinks Gizimoth, the evidence against the existence of an utterly evil God is overwhelming.)

Gizimoth: This is ridiculous. You have an answer for everything!

Booblefrip: Yes, I do have an answer to all your arguments. So far, you’ve given me not the slightest reason to suppose that the world was not created by a supremely evil being. But if you’re unhappy with my answers, let me try a rather different approach. There are some evils that require good in order to exist, aren’t there?

Gizimoth: Such as?

Booblefrip: Take the evil of jealousy. Jealousy requires something to be jealous of. God gave good things to some people so that others would feel jealous. Or take lying. Lying requires that people often tell the truth—otherwise, there would be no point in lying, because no one would believe you. The evil of dishonesty requires that there be a certain amount of honesty.

Gizimoth: And you think this evil outweighs the good it depends on?

Booblefrip: Exactly. God allows some good things into his creation. It’s the price he has to pay for the greater evil.

Gizimoth: These tricky replies of yours are patently absurd. You can’t seriously maintain that the world you see around you—a world full of natural beauty and laughing children—is really the handiwork of an infinitely evil God?

Booblefrip: I do maintain that, yes. True, I may not be able to account for every last drop of good in the world. But remember that we are dealing here with the mind of God. Who are you to suppose you can understand the mind of an infinitely intelligent and knowledgeable being? Isn’t it arrogant of you to suppose that you can figure out God’s master plan?

Gizimoth: I’m arrogant?

(There’s some subtle nodding from the believers on the right.)

Booblefrip: Yes, arrogant. Evil God works in mysterious ways. Ultimately, everything really is all for the worst. It’s just that, being mere humans, we can’t always figure out how.

Gizimoth: Oh, really. This is—

Booblefrip: I think it’s arrogant of you to suppose otherwise—to suppose that you must be able to figure it all out.

(At the end of the debate, the audience votes. After the deliberation, a spokesperson steps forward with their verdict.)

Spokesman: It seems to us that Booblefrip has made a powerful case for supposing the world was created by God. In addition, Booblefrip has provided a compelling defense of belief in this evil being. He has successfully explained why even an evil God would allow a great deal of good. And so the motion is carried—we are persuaded that Evil God exists.

Are you persuaded by Booblefrip’s defense of belief in a supremely evil God? Of course not. His explanations are clearly utterly feeble. Surely, despite all of Booblefrip’s convoluted maneuverings, the fact remains that belief in a supremely evil God is patently absurd.

But of course, Booblefrip’s defense merely flips around the standard explanations that theists offer in defense of belief in a good God. His attempts to explain what good there is in the world mirror the theist’s attempts to explain the evil. If Booblefrip’s explanations are deeply inadequate, why aren’t the theist’s explanations? That’s the question theists need to answer.

Of course, theists consider belief in an all-evil God to be downright silly. And rightly so: there’s clearly far too much good in the world. So why is it that they consistently fail to recognize that the sheer quantity of suffering in the world renders their belief in an all-good God equally silly? Surely, even if the universe does have a designer/creator, isn’t it patently obvious that this being is neither all-evil, nor all-good?

Titled Secrets & Mysteries of the World, it is an exception to Browne’s usual practice of collaborating on a book “with” so-and-so. This time the cover simply reads, “Sylvia Browne.” (She added the e following her 1992 felony conviction and divorce from Kenzil Dalzelle Brown.)

In producing this book, she says, she augmented her “intense research” with her “psychic abilities.” (Or alleged abilities, because she continues to refuse to allow her powers to be tested by psychic investigator James Randi, who offers a million dollars to anyone who can genuinely demonstrate extrasensory phenomena.) Browne also claims assistance from “Francine,” the imaginary playmate of her childhood who is now the aging Browne’s “spirit guide” (11).

Browne says she used psychometry (psychic object-reading) at Stonehenge and got “images of people—hundreds of individuals dragging huge monoliths across a plain” (5—6). However, although she consulted a couple of Web sites regarding the Bermuda Triangle, she says it “still remains an enigma to this day” (26, 27). She had better luck with fairies, having seen one—“with wings and all!”—in Ireland (62). However, she can only say she believes in the reality of the chupacabra (a blood-sucking entity), being convinced that “it’s actually a creature from another planet that was put here for research purposes and sometimes runs amok” (90).

Regarding extraterrestrials, Browne mentions that her great-uncle, “who was psychic and worked in the old Spiritualist camps in Florida,” was “rabid about UFOs” but had never seen one. However, her Grandmother Ada once encountered an alien being, “a man dressed in all-silver clothing” and with whom she communicated telepathically. The man was tall, but otherwise looked normal. Francine points out that she and other guides have only seen aliens that are humanlike and so go undetected among us (94—96). (So much for the little big-eyed, big-headed “greys” reported by abductees.)

Browne claims that she herself has seen and talked with a tall extraterrestrial from planet “PX41,” located “beyond the Andromeda galaxy” (99). And why not? She also allegedly sees apparitions, talks to ghosts, has visions, divines past lives, makes psychic medical diagnoses, and solves crimes clairvoyantly. She has even formed her own religion, Novus Spiritus (“New Spirit”). Browne makes others with fantasy-prone personalities seem creatively challenged.

Browne quickly dispenses with spontaneous human combustion. It is a reality, she maintains, citing Francine: “She said that SHC is caused by a buildup of phosphorous, which is highly flammable—that’s what causes the body to implode upon itself and start burning from the inside out” (164).

However, if readers will stop laughing, it is Browne’s ideas on the Shroud of Turin (the reputed burial cloth of Jesus) that interest me most. She shows some admirable skepticism, concluding: “I believe that the Shroud is a representation and not a true relic—but I don’t think that should put a dent in our Christian belief” (199). Citing a fourteenth-century bishop’s report that the image was painted, Browne writes (196):

If the Shroud were in fact painted, it would explain some image flaws that have always raised questions. For example, the hair hangs as for a standing rather than a reclining figure; the physique is unnaturally elongated (like figures in Gothic art); and the “blood” flows are unrealistically neat (instead of matting the hair, for instance, they run in rivulets on the outside of the locks). You see, real blood soaks into cloth and spreads in all directions rather than leaving picturelike images.

I found that passage intriguing since I had written (in the July/August 1998 Skeptical Inquirer, p. 21):

That the Shroud is indeed the work of a medieval artist would explain numerous image flaws. For example, the physique is unnaturally elongated (like figures in Gothic art!). Also, the hair hangs as for a standing rather than recumbent figure. . . . Everywhere the “blood” flows are unrealistically neat. Instead of matting the hair, for instance, they run in rivulets on the outside of the locks. . . . In addition, real blood soaks into cloth and spreads in all directions, rather than leaving picturelike images.

Now, the shared phrasing between Browne’s passage and mine may give new meaning to the term ghost-written. Considering the book’s lack of any reference to my article, one may wonder: Has Francine stooped to plagiarism? What does Browne know about this? Was she in a trance when she wrote it? Are there other Secrets & Mysteries of the World yet to be revealed?