A Cancellation and a Firing at Obesity

This story begins this spring with a commentary we wrote for Obesity, the
journal of The Obesity Society (TOS). The subject of our critique was a manuscript, since
published, titled “Gap of Women Leadership in Global Obesity Research.” When we wrote our commentary, one of us—Michael Jensen—was Editor-in-Chief of the journal. However, he was not the reviewing editor for the “Gap” manuscript. He only learned of it after the journal accepted IT but before it went to print – a discovery that dismayed him.

In his view, the study was not scientifically sound. Were it up to Dr. Jensen, in fact, he would have rejected the submission on scientific grounds at the editorial level. But with the article scheduled to appear, Dr. Jensen took his prerogative as an editor to write a commentary outlining its methodological flaws. He invited Sally Satel, a psychiatrist with a particular interest in politicized medicine, to co-author.

Our commentary was scheduled to appear in the same issue as the “Gap” study. It did not: someone within The Obesity Society leadership cancelled its publication.¹ As they told Dr. Jensen, our co-authored commentary, coming as it did in combination with his earlier handling of a TOS-sponsored, pro-DEI position paper (that was withdrawn for publication), was sufficient evidence of his disinclination to support what he interpreted as the progressive values of TOS leadership to warrant firing.²

The Gap of Women Leadership article, authored by Xiangxin Kong and colleagues, reported findings based on a review of obesity-related publications and research grants awarded between 2003 and 2023 from national health agencies in nine countries, including the US, China, France, and Germany.

The authors found that male investigators receive more obesity research funding than females. In addition, they documented that obesity papers written by male corresponding authors garner more citations than those by women and that highly cited obesity papers written by women still had fewer citations than those written by men.

These results, they wrote, “stem[med] from systemic biases within the research ecosystem,” contending that “gender equality” in obesity research should be attained by “consciously nominating and advocating for female researchers to leadership positions.”

We do not question the authors’ facts. Instead, we challenge their interpretation of those facts based on a failure to account for the statistical and social contexts in which their data are embedded.

For example, the authors lump all obesity research together. Yet some projects are very expensive (clinical trials, hospital-based physiological studies, complex animal models), and others are less costly (examining databases for epidemiological trends, meta-analysis, survey-based research). Some types of research require longer training periods, more post-training mentorship, and more extended periods of mentor support to learn how to maintain bench laboratory space, equipment, and personnel. Inattention to these variables casts doubt on any conclusions the authors might draw.

Kong and colleagues also found that while male corresponding authors were attached to two-thirds of highly cited obesity papers, women were associated with under half. Bias based on gender? One first needs to discern how many women are corresponding authors in the first place and, after that, to consider their place in the academic pipeline. Typically, the corresponding author is the senior contributor to the study. While women are now more represented at the senior reaches of obesity, they didn’t get there overnight.

To judge whether a problem exists, we would need to know more. Whether, for example, women publish in low-impact journals more often than do male researchers. Does their research expertise have broad relevance to obesity researchers (i.e., are widely cited) or does it pertain to narrow, but important topics within the field, and thus is less likely to be cited?

In sum, while Kong and her team collected extensive data, the missing data we outlined above are essential to proving any claim of unfair representation of women in obesity research.

Now we turn to the dubious nature of their inherent assumptions about women in obesity research. The overarching problem is that their logic is circular. They claim, reflexively, that the discrepancies between male and female researchers in funding and professional recognition are proof of barriers to “equity.” In short, it points to unequal outcomes as proof of inequity without considering other causes of the disparities it identifies.

Another problem is the authors’ assumption that the field of obesity research should comprise men and women in a fifty-fifty split. Why should women and men be present in equal numbers in any enterprise? Or even proportionate? But if the latter, then what is the apt denominator? The percentage of women in society? In medicine or among PhDs in human biology? In medical research or in obesity research more narrowly? Within each specialty area within obesity research?

A descriptive article like Kong et al. does have value, however. It can function as a database of gender-associated differentials and, as such, a stimulus for generating hypotheses about the causes of those differentials. Bias could be one such cause, but Kong and colleagues failed to deploy proper inferential methods to illuminate that it is.

Sally Satel, MD, is a senior fellow at the American Enterprise Institute and a lecturer in psychiatry at Yale University School of Medicine.

Michael D. Jensen, MD, Professor of Medicine, Division of Endocrinology, at Mayo Clinic, Rochester, MN.

1. Although our commentary, Women researchers should ask why they are underrepresented before concluding that gender bias is the cause, was never published, we are happy to share the original here.

2. Dr. Jensen’s objection to the DEI position paper was based on the author’s inability to support her contention that gender diversity enhanced research quality. As a result, the DEI position paper was never released.