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It is easy enough for critics to trace America’s over-consumption of things like food and fuel to the excess power of our profit-making corporations. Americans consume more food and fuel than Europeans in part because these companies in America are better able to resist taxes and regulations.
Osteoarthritis is a chronic condition of the synovial joint. The disease develops over time and most commonly affects the knees, hips and hands, and less commonly the shoulder, spine, ankles and feet. It’s a prevalent, disabling disease, and consequently has a formidable individual and social impact.
It is well known that obesity rates have been increasing around the Western world.
The American obesity prevalence was less than 20% in 1994. By 2010, the obesity prevalence was greater than 20% in all states and 12 states had an obesity prevalence of 30%. For American children aged 2 – 19, approximately 17% are obese in 2011-2012. In the UK, the rifeness of obesity was similar to the US numbers. Between 1993 and 2012, the commonness of obesity increased from 13.2% to 24.4% for men and for women from 16.4% to 25.1%. The obesity prevalence is around 18% for children aged 11-15 and 11% for children aged 2-10.
Policy makers, researchers, and the general public are concerned about this trend because obesity is linked to an increase likelihood of health conditions such as diabetes and heart disease, among others. The increase in the obesity prevalence among children is of concern because of the possibility that obesity during childhood will increase the likelihood of being obese as an adult thereby leading to even higher rates of these health conditions in the future.
Researchers have investigated many possible causes for this trend including lower rates of participation in physical activity and easier access to fast food. Anderson, Butcher, and Levine (2003) identified maternal employment as a possible culprit when they noticed that in the US the timing of these two trends was similar. While the prevalence of obesity was increasing for children so was the employment rate of mothers. Other researchers have found similar results for other countries – more hours of maternal employment is related to a higher likelihood of children being obese.
What could be the relationship between a mother’s hours of work and childhood obesity? When mothers work they have less time to devote to activities around the home, which may mean less concern about nutrition, more meals eaten outside of the home or less time devoted to physical activities. On the other hand, more maternal employment could mean more income and an ability to purchase more nutritious food or encourage healthy activities for children.
We looked at this relationship for Canadian children 12-17 years old – an older group of children than studied in earlier papers. For youths aged 12 to 17 in Canada, the obesity prevalence was 7.8% in 2008. We analysed not only at the relationship between maternal employment and child obesity, but also the possible reasons that maternal employment may affect child obesity.
We find that the effect of hours of work differs from the effect of weeks of work. More hours of maternal work are related to activities we expect to be related to higher rates of obesity – more television viewing, less likely to eat breakfast daily, and a higher allowance. On the other hand, more weeks of maternal employment are related to behaviour expected to lower obesity – less television viewing and more physical activity. This difference between hours and weeks of work raises some interesting questions. How do families adapt to different aspects of the labour market? When mothers work for more weeks does this indicate a more regular attachment to the labour force? Do these families have schedules and routines that allow them to manage their child’s weight?
Unlike other studies that focus on younger children, we do not find a relationship between maternal employment and likelihood of obesity for adolescents. Does the impact of maternal employment at younger ages not last into adolescence? Is adolescence a stage during which obesity status is difficult to predict?
The debate over appropriate policy remedies should not focus on whether mothers should work, but rather should focus on what children are doing when mothers are working. What can be done to reduce the obesity prevalence in adolescents? Some ideas include working with the education system and local communities to create an environment for adolescents that fosters healthy weight status, supporting families with quality childcare, provision of viable and high-quality alternative activities, or flexible work hours. Programs or policies that help families establish a healthy routine are important. It may not be a case of simply providing activities for adolescents, but that these activities are easy for families to attend on a regular basis.
One of the critical skills of any student of politics — professors, journalists, public servants, writers, politicians and interested members of the public included — is to somehow look beyond or beneath the bigger headlines and instead focus on those peripheral stories that may in fact tell us far more about the changing nature of society. It was in exactly this sense that I was drawn recently not to the ‘War in Whitehall’ or Cameron’s speech on the UK’s future relationship with the European Union but to a story about the launch of a ‘smart fork’. The ‘smart’ feature being the existence of a shrill alarm which would inform its user if they were eating too quickly. This, I have quickly realized, is just the latest in a long stream of innovations that seek to nudge individuals towards making better choices about the way they lead their lives (eat less, save more, drive more slowly, etc.). And so it turns out that the ‘smart fork’ is just one of a great series of new innovations that seeks to deliver a form of liberal-paternalism by somehow reconciling individual freedom and choice with an emphasis on collective responsibility and well-being. My favorite amongst these innovations was the ‘smart trolley’: a supermarket trolley with sensors that beeped (and flashed) at the errant shopper who succumbed to the temptation to place a high-fat product in their trolley.
There was something about the idea of a smart fork, however, that I found particularly disturbing (or should I say ‘hard to swallow’, ‘stuck in my gullet’, ‘left a bad taste in my mouth’, etc.?). My mind jumped back to Michael Sandel’s argument that ‘the problem with our politics is not too much moral argument but too little…Our politics is over-heated because it is mostly vacant’. My concern with the launch of the ‘smart fork’ is that it arguably reflects an unwillingness to deal with the moral arguments that underlie the obesity endemic in large parts of the developed world. If Sandel’s concern about the imposition of market values is that it could ‘crowd out of virtue’ then my own concern is that behavioral economics revolution risks ‘crowding out thought’ in the sense that new technologies may provide little more than an excuse or displacement activity for not accepting responsibility for one’s actions. In the twenty-first century do we really need a computerized fork or shopping trolley in order to tell us to eat less food more slowly, or to buy less high-fat food and exercise more?
The smart fork therefore forms little more than a metaphor for a society that appears to have lost a sense of self-control and personal responsibility. This, in turn, pushes us back to broader arguments concerning the emptiness of modern political debate and to the relative value of the public and private sectors. As Alain de Botton argued in Citizen Ethics in a Time of Crisis, we could ask whether individual freedom has really served us so well as the leitmotif of modern life. ‘In the chaos of the liberal free market we tend to lack not so much freedom [but] the chance to use it well’ de Botton writes; ‘We lack guidance, self-understanding, self-control….being left alone to ruin our lives as we please is not a liberty worth revering’. Slavoj Žižek paints a similar argument across a broader canvas in his provocative work Living in the End Times. ‘The people wanted to have their cake and eat it’, Žižek argues; ‘they wanted capitalist democratic freedom and material abundance but without paying the full price’. He uses an advert on American TV for a chocolate laxative—‘Do you have constipation? Eat more of this chocolate’—to mock the modern public’s constant demand for results without ever having to suffer unpleasant side effects.
Although hidden far beneath the front-page headlines, the story of the launch of the smart fork (in Las Vegas — need I say more) highlights the existence of an underlying problem in the sense that most politicians appear either unwilling or unable (possibly both) to tackle the issue head-on. Between 1980 and 2000 obesity rates doubled in the United States to the extent that one in three adults (around sixty million people) are now clinically obese, with levels growing particularly amongst children and adolescents. In this context it may well be that individuals require — even want — not a nudge but a shove or a push towards a healthier lifestyle? If this is true, it is possible that we need to revisit certain baseline assumptions about the market and the state and not simply define the role of the latter as an inherently illegitimate, intrusive, and undesirable one. To make this point is not to trump the heavy hand of the state or to seek to promote some modern version of the enlightened dictator, but it is to inject a little balance into the debate about the individual and society. Is it possible that we ‘hate’ politics simply because, unlike those unfeasibly self-contained, sane, and reasonable grown-ups that we are assumed to be by liberal politicians, most of us still behave like disturbed children (or political infants) who simply don’t want to take responsibility for our actions or how they impact on the world around us? Or — to put the same point slightly differently — if the best response we have to the obesity crisis is an electric fork then in the long term we’re all forked.
Public health officials and academics identified cigarette smoking and related disease as the nation’s number one killer and foremost driver of health costs in the 1980s. At that time overeating and obesity were not major problems, yet they may soon cause more disease, deaths, and health care costs than cigarettes. Food addiction, which may explain part of the epidemic, is slowly and finally “catching on”. It’s been controversial, with some scientists dismissing it out of hand, so like any hypothesis, it needs additional tests.
If overeating is due to food acquiring drug-like or tobacco-like brain reinforcement properties, then the current globesity and overeating-related health crisis might have lessons to learn from tobacco. For example, taxes on tobacco products have been the single most important prevention tool in reducing smoking. Based on food addiction hypothesis, higher prices might also reduce soda consumption. A review suggested that for every 10% increase in price, consumption decreases by 7.8%. An industry trade publication reported even larger reductions; as prices of carbonated soft drinks increased by 6.8%, sales dropped by 7.8%, and as Coca-Cola prices increased by 12%, sales dropped by 14.6%. It follows that a tax on sweetened beverages might help consumers switch to water or more healthful beverages. Such a switch would lead to reduced caloric intake, and less weight gain.
Changing the attitudes and behaviors of the public combined to reduce smoking and smoking-related health care costs and suffering. Changing access to cigarettes by elimination of cigarette vending machines, raising the price per pack to decrease numbers of cigarettes or packs/day smoked, crafting PSAs to reduce smoking initiation, and training medical professionals to intervene and not look the other way, all helped reduce smoking.
Age of onset and exposure can change genes, and make use and addiction more likely. We know that early exposure to tobacco via second-hand-smoke, either in utero or in early life greatly increases the risk of life-long tobacco use and addiction. In the 1990s, children’s intake of sweetened beverages surpassed that of milk. In the past decade, per capita intake of calories from sugar/HFCS-sweetened beverages has increased by nearly 30%. Beverages now account for 10–15% of the calories consumed by children and adolescents. It is likely that food addiction models can be used to explain early exposure and changes in preference becoming fixed and persistent for life. An extra can or glass of sugar or HFCS sweetened beverage consumed per day increases the likelihood of a child’s becoming obese increases by 60%.
Our efforts to manage and treat overeating and obesity might benefit from addiction methods and experience. We could develop realistic food addiction models and test new treatments. Would animals self-administer food or food constituents, avidly, with bingeing and loss of control? Yes. Our work (and Bart Hoebel’ s before) clearly demonstrates that sucrose and fructose corn syrup are self-administered as if they were drugs and that an opiate-like abstinence syndrome could be produced by detoxification or antagonist administration. Sugar stimulates its own taking causes craving, wanting, withdrawal, and can motivate and change our behavior.. If the food addiction hypothesis were relevant to the human condition, these animal models could be used to test new medications. New treatments developed for overeating and obesity were previously shown to be effective in addiction medicine.
These new treatments approved by the FDA include phentermine plus topiramate and bupropion plus naltrexone. Topiramate has been used with success in alcohol dependence, bupropion in nicotine dependence, and naltrexone in opiate and also alcohol dependence. While early, these treatments are important tests of the addiction hypothesis and harbingers of more progress in the future. With addiction medicine and food addiction model systems, we may develop treatments which change food preference and not just appetite.
Food addiction may explain some, but certainly not all obesity. The Yale Food Addiction Scale may be used to screen patients for addiction-like pharmacological and psychological interventions. Medically-assisted smoking cessation efforts were enhanced once treatment advanced from simple nicotine replacement or detoxification, to the brain and the neurobehavioral attachment to cigarettes. With an addiction hypothesis that included dopamine, we discovered the efficacy of bupropion and then Chantix. Thus, rather than a successful short term treatment rate of less than 20%, we routinely helped 30% of smokers. Still, addiction-inspired public health measures rather than medically-assisted treatment were responsible for most of the successful cessation efforts, early intervention, and prevention.
Smoking-related disease caused 400,000 deaths per year in the USA plus an additional 40,000 deaths due to second-hand smoke. Until recently little effort was directed at preventing smoking or treating smokers, although we treated the lung cancers, stroke, erectile dysfunction and other diseases caused by smoking. With all this progress, all of the health savings related to smoking cessation will soon be replaced by obesity-related costs. Are these two events related? As smoking and addiction is associated with decreases in eating and weight, a nation detoxifying from smoking addiction should be expected to become overweight. Until recently, with the scientific support provided by food and addiction models, we have not applied the same lessons learned from tobacco to overeating and obesity.
Proposals for food taxes have been made and calculations formulated of revenue-benefits based on our experiences with tobacco taxation. Even when these fail, the public and health experts have to think through the idea that fruits and vegetables are more costly than fatty, sweet, fast foods. Using taxes on ingredients such as added sugar and fructose corn syrup would decrease exposure according to addiction models. This might make Coca-Cola and other sodas return to sucrose as in Mexican or Kosher Coke. Reducing portion size, while supported by cigarette experience with numbers of cigarettes per pack and purchase limits, is a weaker intervention than other approaches. Now we see food labels and calorie postings. This educates everyone as they consider is it worth the calories and do they have the time and energy to exercise away the calories ingested. Exercise is important, and promotes health, but is not a stand-alone obesity treatment or management strategy. Stigmatizing the overweight with added health premiums and workplace incentives has not worked well in the past. Blaming the patient, creating shame and guilt, doesn’t do much to inspire treatment efficacy.
Obesity has changed the width of the seats in airplanes, dress, and trouser sizes. It has also made high cholesterol, high blood pressure, high blood sugars, knee and joint pain, and other obesity-related problems routine in medical practice and treatment. Over the past three decades, rates of obesity have increased in the United States and elsewhere, so that now more people are obese and in need of treatment than ever. New approaches, evidence-based approaches, like those that have been used successfully to develop novel public health and treatment approaches for tobacco, alcohol, and other addictions are needed.
Mark S. Gold, MD is the co-editor of Food and Addiction: A Comprehensive Handbook with Kelly D. Brownell. He is the Donald Dizney Eminent Scholar, Distinguished Professor and Chair of Psychiatry at the University of Florida. Dr Gold is a teacher of the year, researcher and inventor who has focused for much of his career on the development of models for understanding the effects of tobacco, cocaine, opiates, other drugs, and also food, on the brain and behavior. He began his work on the relationship between food and drug addictions while at Yale working with addicts in withdrawal. He has worked for 30+ years trying to understand how to change food preferences, make eating and drugs of abuse less interesting or reinforcing at the brain’s dopamine and other reinforcement sites. Kelly D. Brownell, PhD is professor of psychology, epidemiology, and public health at Yale University and is director of Yale’s Rudd Center for Food Policy & Obesity. Dr. Brownell does work at the intersection of science and public policy. The Rudd Center assesses, critiques and strives to improve practices and policies related to nutrition and obesity so as to inform the public and to maximize the impact on public health.
For the past few years, the topic of establishing healthy habits at an early age has garnered much news, investigation, and governmental action across the nation. As centers for community life and lifelong education, libraries are uniquely positioned to contribute to the formation of these healthy habits in young people. Indeed, given the special role of social responsibility many libraries assume in their charters and mission statements, supporting healthy habit formation may be viewed as a necessity in your library.
The Indiana State Department of Health summarizes the need for and suggests a direction to library involvement in this issue: “Ideally, population-based, sustainable approaches for changing the weight status, diet, and physical activity of people should include creating environments, policies, and practices that support increases in physical activity and improvements in diet, especially among those disproportionately affected by poor health. Interventions should go beyond people acquiring new knowledge and allow people to build the skills and practice the behaviors leading to a healthy weight.Supportive environments are necessary to sustain healthy behaviors.” [emphasis mine] (Indiana State Department of Health 2011)
What follows is a list of activities young adult librarians can put into practice to stimulate interest in and action towards healthy habit formation with their teen patrons.
Book displays on healthy habits. (A classic library tactic, and it never hurts to cover the classics.)
Create QR codes linking to healthy habits websites.
Distribute dream journals with blurbs on healthy sleep habits printed on the pages.
Administer an online cooking challenge where teens upload a picture of a healthy meal they cooked.
Amend the food and drink policy to allow water in the library.
Serve healthy snacks at TAB events, such as popcorn and juice rather than chocolate and soda pop.
Display samples of healthy and unhealthy organs (such as lungs, livers, brains, and bones), as supplied by a nearby medical school.
Start a co-cooking program with teens. (This has been the most popular teen program at my library for two years. We have cooked smoothies, shish kabobs, hummus, baked apples, and more.)
Host tournaments for Wii Fit and Xbox Kinect. (For lower-tech options, try ping-pong, Twister, and other active games. The teens at my library lit up when I told them we would play Twister with face paint dolloped on the dots.)
Arrange for your local car insurance company to bring their impaired driving program to the library parking lot.
Host local experts in demonstrations with audience participation, such as yoga lead by fitness instructors or cooking by local restaurateurs.
Add library programming with a physical element: a college football boot camp, circus performer experience, etc.
Arrange a Glee with the Stars program where teens learn a routine performed by your local theatre or high school group. (Granted, this will take a great number of volunteers, a large space, and some very enthusiastic teenagers.)
Consider adding “healthy eating during pregnancy” and “breastfeeding and childhood obesity” to to your outreach efforts to pregnant teen patrons.
Work with your local school librarians and physical education and health teachers to limit the junk food and soda pop available to students at school. Perhaps you can even collaborate with these educators to recruit and support a chef for the Add a Comment
We are failing to deal with one of the most important issues of our time – in every country we are getting fatter. Although being fat is not automatically linked to illness, it does increase dramatically the risk of cardiovascular disease, diabetes, and other so-called non-communicable diseases. We are starting to see very high rates of these diseases in some places, sometimes affecting 50% of the population. Even in some of the poorest parts of the developing world, where such disease itself is not yet common, we nonetheless see warning signs of its arrival. There is great concern that it may soon outweigh the burden of communicable disease such as HIV/AIDS. The humanitarian and financial cost of this non-communicable disease in such parts of the world will be unbearable, and made even worse because the risk is passed across generations, so children born today and tomorrow will have a bleak future.
It seems that we don’t know how to tackle this problem, because current attempts are obviously failing and obesity continues to increase. Governments, doctors, and even NGOs seem to have adopted the same strategy – to focus on our sins of “gluttony and sloth” and to transfer the responsibility for slimming down to each of us as individuals. Of course it’s true that we can’t get overweight unless we eat more than we need to, and the wrong types of foods, and get too little physical exercise. Our biology did not evolve to protect us from obesity and its consequences in today’s sedentary world with such easy access to food. But why is it that we find it so hard to lose weight and, if we do shed the kilos, it seems very hard not to put them back on again?
What we are missing is a focus on our early development. We’re just not adopting the right approach to the problem. And it seems that the generals who are leading us in this global war on obesity and disease have adopted the wrong strategy, and they stick resolutely to it as if they were wearing blinkers. They blame us for the failure to win the war, for our greed and laziness; they blame parents for letting their children get fat; they blame the food industry for peddling unhealthy food, and so on. As if we choose to be fat. It’s important to realise just how limited this way of attacking the problem is on a global scale. Does the little girl force-fed before marriage in Mauritania have any choice in her life? Does the 12-year-old child bride in rural India have any choice when she becomes pregnant and drops out of school? Does the little toddler in Detroit have any choice when his mother feeds him French fries? Does the little boy from Tonga whose mother had diabetes in pregnancy have any choice about developing obesity? Does the little girl in Beijing have any choice in being an only child? And yet every one of these scenarios, and many more, sets that little child up to be at greater risk of becoming obese and to have non-communicable disease.
But new research is uncovering many things that will give us new tactics and strategies for the war against obesity and non-communicable disease, and so we’re hopeful. We now know that we will have to give much greater focus to the mother and unborn child. We may well have to give emphasis to the lifestyle of the father as well. And most importantly of all, we’re starting to realise that behaviours such as propensity to exercise, or appetite and taste for certain foods, which we previously thought to be based on individual choice, have a large constitutional component – in part based on inherited genes, in part on epigenetic changes to gene function in response to the developmental environment, and
Sad that Doreen Tudela abused her position. Sad that she forgot how important it is to keep personal and professional separated. Sad that our kids, who deserve the best, had a principal who made a big mistake. I'm glad she's paid back what she took, and admitted what she did. I don't doubt that she's used her own money for school things a lot and never kept track, but that isn't an excuse, either. It's just a shame, and it will be hard on the students who must now process that their principal, whom they respected and relied upon, has let them down.
But I'm also mad at the underlying story. That Barney's Pizza pays to put pizza into the schools. We already have an obesity and diabetes problem in the CNMI. We don't need our kids eating junk food like greasy pizza. And Barney's paying to feed it to them is a double corruption.
Does your child come home from school complaining of aches and pains? Do they, perhaps, suffer from backache?
According to a report issued recently by the British Educational Suppliers Association (BESA), increasing numbers of children are running the risk of back problems caused by spending the school day jammed into ill-fitting desks and chairs.
And why is school furniture so uncomfortable? Well, according to BESA, it’s because children are so much bigger now - taller, but also heavier. “Although our starting point was not a question of obesity, when we looked the average child today is very different to a child in the 1960s, which is the last time children were actually measured for determining measures of furniture”, remarked BESA’s director general.
We shouldn’t be surprised. In 2003, 27 per cent of children under eleven in England were either overweight or obese. In the US, where different methods to measure obesity are used, nearly 20% of children aged 6-11 were classified as overweight or obese in 2004. The numbers have almost doubled in a decade.
How did so many children get to be overweight before they’ve even reached the ripe old age of eleven? The answer, of course, is a complex one. If adults are eating much less healthily than they used to, so are their kids. Instead of spending their evenings playing outside, children now have the delights of multi-channel TV, computer games, and the Internet to choose from. And then there’s the fact that increasing numbers of us just won’t let our children outside on their own.
More than 40 per cent of UK adults questioned in a recent survey thought that fourteen was the earliest age at which children should be allowed to go out unsupervised. Two-thirds of ten-year-olds have never been to a shop or the park by themselves, and fewer than one in ten eight-year-olds walk to school alone.
What are we so worried about? Well, it’s partly that our children are going to be abducted by a paedophile. And who wouldn’t be worried? All of us can call to mind horrific cases of child abduction and murder. The world seems a much more dangerous place today than it did when we were kids. It’s a world, indeed, in which no sane parent should let their child out of their sight. And if that means our children adopting the sedentary lifestyle of so many adults, that’s a small price to pay.
In fact, despite all our parental vigilance, the number of children murdered in the UK has remained pretty much constant over the past 30 years – around 60-80. In most of those cases, a parent is the principal suspect. In 2006, 55 children were killed in England and Wales; 12 were murdered by strangers. In the US, between 40 and 150 children are abducted and murdered per year (in around 14% of cases, the killer turns out to be the child’s parent).
These are grim statistics, but they’re a drop in the ocean compared to the risks our kids are running by not going out. The number of obese of overweight children in the UK and US runs to millions. The less we exercise, the more likely it is that we’ll become overweight. And the more overweight we are, the greater the chances of us developing serious illnesses like cancer, heart disease, diabetes, stroke, and arthritis. So why, when the risks to our children of a sedentary lifestyle are so much greater than the risks of letting them out on their own, do we persist in ferrying them to school and allowing them to spend so much time in their bedrooms playing computer games?
Part of the explanation is simply that we’re not good at comparing risks. We’re more frightened of events that almost certainly won’t happen (abduction) than things that quite possibly will (obesity).
Psychologists have a familiar word for the exaggerated or unfounded fear that other people (for example, paedophiles) want to harm us: paranoia. And over the past decade, a slew of research studies have suggested that it’s much more common than anyone had previously suspected.
In fact, paranoia affects up to a quarter of us at any one time. It’s as common as depression and there are good reasons for thinking it may be on the rise, not least the tendency of the media to over-report sensational but relatively rare dangers – such as the murder of a child. The way our minds function makes us particularly susceptible to the media. The more something is repeated, and the more graphic and emotional it is, the greater the impression it makes upon us. This is why people consistently tell surveys that crime rates are rising, even though for the last decade or so they’ve been falling. It’s why they overestimate the chances of dying in a violent incident and underestimate the risk of dying from a stroke. And it’s why rates of post traumatic stress disorder in New Yorkers after 9/11 correlate directly with the amount of TV coverage of the catastrophe they watched. Our perception of risk becomes skewed.
It’s time to wise up to paranoia. We need to recognise how widespread it is, and understand both how it can be triggered and how it can be challenged. The health of our children may depend on it.
Unrealistically scrawny pop culture ideals, issues of acceptance and fears of unhealthy body image have made fitness and healthy eating tricky issues to address. This brazenly British picture book pulls no punches about the dangers of the couch potato lifestyle.
What do you think?
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Michelle Obama is taking on America’s obesity problem—starting with kids. But health behaviors are notoriously difficult to change, and food-related modifications are especially challenging because they require adjustments in an area that we are forced to encounter multiple times each day. Going “cold turkey” from food is simply not possible—we have to eat! And exercise—well, we don’t have time, it’s not fun—the excuses come easily. Michelle, along with the rest of us, needs some tools with which to address this obesity problem.
While not magical, the three-factor model is both simple and powerful. A review of decades of research on adherence and health behavior change reveals that three components must be in place in order for individuals to successfully adopt and maintain the healthy behaviors to which they aspire. First, people must have information—they have to really understand what it is that they need to do, and why. Second, people must be motivated—they have to want to make the change (sometimes this stems from a good understanding of their medical issue and the repercussions associated with failing to make changes, but there are many other potent motivators). Third, people need strategies—barriers will be encountered and obstacles will arise, so plans must be in place for dealing with these. Making healthy behavior rewarding in the short term, even if the ultimate goal will take much longer to accomplish, is also an important strategy; and many others, all solidly grounded in empirical research, are outlined in our book.
The Information-Motivation-Strategy model is relevant to a whole host of health behaviors, not just weight management. It emphasizes the pivotal role that provider-patient communication plays at each stage in the process and recognizes that there is no single strategy that works for everyone—instead tailored, multifaceted approaches work best. Despite its strengths, there is nothing high-tech or expensive about the IMS model, which makes it especially compelling as we strive to improve the quality and efficiency of our healthcare systems.
Obesity is epidemic in this country and the news is full of stories about the excesses that are ruining our health and shortening the lives of our children. Before you get defensive you need to understand that as parents we are only partly responsible for the situation. Food manufacturers and restaurant owners, and yes, our government must share the blame, but we need to do something about it.
Everyday there is a news story telling us that what we were once told about a particular food is now considered incorrect and what we once thought was good for us is now thought to be bad for us. While the government is telling us obesity in children is a major problem, fast food restaurants are advertising bigger, fatter, more calorie-laden options. It is confusing for all of us. How can we keep up? What can we do about it?
I believe certain basics are true. I believe the closer our food is to its natural state the better it is for us.That doesn't mean meateaters should eat their meat raw, but if it isn't covered with cheese or creamy gravy it is probably better for you. I personally believe we eat too much meat in this country but this post isn't about that. I am not interested in changing meateaters to vegetarians. This post is about healthier eating and making changes toward better health.
I married a meat and potatoes man. One day I decided, after a lot of reading on the subject, that we should become vegetarians. Vegetarian cookbooks that were available at the time were not encouraging. Becoming a vegetarian seemed to involve mixing and matching different kinds of protein foods to get the right combination to make up for not eating meat. After reading the cookbooks I was sure there was no way I would be able to convert my husband to a vegetarian lifestyle. I almost gave up, but I had the cookbooks so I figured I had to at least try a few recipes. I did and I was right, hubby wouldn't eat them.
Then it dawned on me! I could fix most of the dishes that we were accustomed to eating but make them vegetarian. And that is what I did. If I removed meat from a recipe I replaced it with something else to make up for what was missing. (Portabello mushrooms have a texture similar to meat. Today the stores have many meat substitutes.)I didn't worry about complementarity but instead I concentrated on preparing good meals, that tasted good and that fit our style but without meat. Why should this matter to you? Read on...
On the road to healthier eating you have to expect a few bumps, but that shouldn't stop you. It is a retraining of our thinking and our tastebuds. If you are used to eating food that is drowning in cheese sauce it will take a while to adjust to the idea of eating food without cheese sauce, but it can be done. Make changes slowly. Perhaps you will need to slowly reduce the amount of cheese in the sauce, and reduce the quantity of sauce in a serving. Look for other healthier ways to season your food, and eat the less-healthy choices less often until you can elimate them completely. Concentrate on the foods that you like that are healthier choices.
Lightly salt foods before serving and take the salt off of the table. Make eating healthier a family project and get the kids involved. Teach them, and yourself, to read product labels. Know what unhealthy things to look for (high fructose corn syrup, all kinds of sugars, sodium quantities, che
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Picking up the story, recall that I was invited to testify before the House Agriculture Committee on May 13, to share my views on new farm legislation for 2012. I was expecting a frosty reception, since I have expressed some disparaging views of farm subsidies, and also of the House and Senate agriculture committees, in my newest book. Yet the hearing took a surprising turn. The Committee wasn’t that interested in my views on farm subsidies (they have well established views of their own). Instead they wanted to talk about obesity.
In both my written testimony and in my oral statement I bravely repeated my view that farm bills were too wasteful of taxpayer money, thanks in part to the “logroll” tactics used by the House Agriculture committee. When I was asked by a senior member what I thought the chances were that this tactic could work again in 2012, I said “100 percent.” He said he “took it as a personal compliment” that I had noticed and remarked on the success of this strategy.
What got the committee’s attention, however, was my warning that drafting another business-as-usual farm bill in 2012 was going to be more difficult, because of a strengthening belief that the farm subsidies are contributing to our nation’s obesity crisis by making unhealthy foods too cheap. The committee knew, and I confirmed in my testimony, that this is in fact an unfounded charge. When the farm bill places restrictions on sugar imports to protect the income of American sugar growers it actually make all sweetened products – from candy to ice cream – artificially expensive rather than cheap. And when Congress enacts subsidies and mandates to divert 30 percent of our corn crop to the making of ethanol for auto fuel, it is making both corn and other animal feeds – and hence all meat products – artificially expensive as well. Nor is it true that corn-based sweeteners are more obesity-inducing than natural sugar. Nor is it true that the price of junk food has fallen in America while the price of healthy foods (fruits and vegetables) has remained high. All of these misconceptions about farm programs are explained in Chapter Eight of my Oxford book, my chapter on “The Politics of Obesity.”
Yet the House Agriculture Committee also knew, and I confirmed, that over the past several years a number of highly influential non-scholarly books such as Michael Pollan’s Omnivore’s Dilemma, plus vari
Sander L. Gilman is a distinguished professor of the Liberal Arts and Sciences as well as Professor of Psychiatry at Emory University, where he is also the Director of the Program in Psychoanalysis and the Health Science Initiative. His new book, Obesity: The Biography, traces the history of obesity from the ancient Greeks to the present day, acknowledging that its history is shaped by the meanings attached to the obese body, defined in part by society and culture. In the excerpt below we learn about “globesity”.
The view that fat spreads across the map, spread by chickens or by genetic transmission across generations, means that there could be populations free from obesity. This fantasy of the Enlightenment physicians, of utopias where obesity could not exist because of the very nature of its inhabitants, their diet, the activities, reappears today with the public health model of globesity. The “French diet” and the “Chinese diet” as cures for obesity: all assume populations without even the potential for obesity. In 2001, the World Health Organization stated that there was a brand new pandemic of “globesity” sweeping the world. What is labeled as “globesity” is in fact the more recent iteration of an obsession with bodily control and the promise of universal health. Its modern iteration, however, comes with an unstated and complex history. If, said the ancients, you would only eat well, sacrifice to the gods, and avoid beans, then your health would improve or simply never decline. There have always been changes in eating patterns. Perhaps in the twenty-first century these changes speed around the world more quickly than in the past. But the notion of a world in decay due to the growth of girth carries with it odd and complex subtexts. What the central implications of “globesity”?
“Globesity,” according a publication of the Pan American Health Organization in 2002, “places the blame not on the individual but on globalization and development, with poverty as an exacerbating factor.” The focus on what have been called earlier in the twentieth century “disease of extravagance” postulates a model not so much of change but of invasion – a Gresham’s Law of Food in which the bad drives out the good. It is a modern version of “degeneracy theory,” with the new assumption that the ills of the world are to be traced directly back to the developed world. In this way it is a dietary version of the basic global warming thesis: developed nations destroyed their environment and now they are invading the rest of the world, corrupting it. “Nature” was benign, even kind; now it has become threatening. “Globesity” argues that inherently healthy eating practices have been corrupted by the expansion of development and the resultant poverty. “Fat” is a product of globalization and modernity. The utopian “undeveloped” world, in Enlightenment jargon, the world of the “noble savage,” is a world in which “diseases of extravagance” could not exist, as they are a reflex of a “civilized” model of exploitation and capitalism. The “cure” for “Globesity” in the twenty-first century is “natural” or “slow” food as a prophylactic against obesity as well as illness…It is a return to the inherently “healthy” eating practices of the Edenic past.
Such views have a relatively long history. The French food writer, Jean Anthelme Brillat-Savarin, could write as late as 1825 that &ldq
I wrote my book Strong Man for many reasons but there was one big one. The book is about a lot of things: A coming to America story, overcoming adversity, rags to riches, etc. But it is also a book about staying in shape and how doing so will not just benefit you physically but also mentally. I have an autoimmune disease. I am on multiple medications such as Lyrica and Prednison that can cause drastic weight gain. When I started on Prednisone again I gained 15 pounds in 2 weeks! What did I do? I stopped eating so much and started doing much more cardio. That’s why working out for me is really important. When I work out a lot my metabolism speeds up and my heart rate goes way down (resting rate 48 beats per min – so it’s very efficient). BUT I do so for another reason. I mentally feel SO much better after working out. I feel like things will be okay-- Like I can concur my problems.
I have always been an active child. I wasn’t allowed to watch TV when I was little and that’s something I tell kids when I go around to schools. I usually get a group HOWL every time I say this. “NO TV!!!!” And then when I say I wasn’t allowed to play video games I get more screams. Kids can’t imagine this at all! But I explain how I used my imagination instead. And this imagination helps me with my creativity today.
But back to the topic at hand. I am writing this post today because Alvina said that a blogger from Marie Claire was a bigot for saying that she had a problem with the characters on a show about two overweight people. The blogger said:
"I also think it's at least equally crazy, albeit in the other direction, to be implicitly promoting obesity! Yes, anorexia is sick, but at least some slim models are simply naturally skinny. No one who is as fat as Mike and Molly can be healthy. And obesity is costing our country far more in terms of all the related health problems we are paying for, by way of our insurance, than any other health problem, even cancer."
She then admitted that she was grossed out by fat people.
She later apologized saying: "I would really like to apologize for the insensitive things I've said in this post. Believe it or not, I never wanted anyone to feel bullied or ashamed after reading this, and I sorely regret that it upset people so much. A lot of what I said was unnecessary. It wasn't productive, either. I know a lot of people truly struggle to lose weight — for medical and psychological reasons — and that many people have an incredibly difficult time getting to a healthy size. I feel for those people and I'm truly sorry I added to the unhappiness and pain they feel with my post."
What really upsets me is to see overweight children. I know what this is from. It’s from watching too much TV and not allowing kids to be kids. Let them run around and play. A few hours of playing tag and manhunt and then making a healthy dinner instead of McDonalds will pretty much insure that the child is not overweight. If he or she still is then they need a complete blood work up etc.
It's been raining here all week and (partly because of that, partly because family troubles have left me exhausted), I've been letting the kids watch some TV-- normally, I have a No Screen Time policy. Even when allowed to watch TV, some of the kids preferred and jumping on the mini-trampoline I just bought.
I hate that slack-jawed, glazed, drugged look small children get when they watch TV. Normally, when it rains, we make things or play cards or dress-up or cook or if there are enough kids over, play hide and seek or sardines or make things with Sculpy or play boardgames .....(another time I will post about these activities: back to the point).
But this week, we watched TV. And maybe because of Meghan's post, maybe because I'm dieting (and you know what THAT makes you think about!), I noticed what the kids on the shows and in the ads were eating. With the exception of the shakes Ricky serves on Hannah Montanna, it was always fast food -- and one episode of I Carly was about her brother making "spaghetti tacos." Another show's plot revolved around kids pretending to be on a ping pong team so they could spend the club money going out to a fancy restaurant -- and what food was dwelt on and lovingly photographed? The cake they had for dessert--one kid was so stuffed he couldn't eat it, so a friend held his mouth open and massaged his jaws so he would chew. The show also showed them grunting with pleasure while they stuffed themselves.
Is it just this week? Was I super-aware of it because of Meghan's post and my diet? Or is this happening all the time? Maybe the BEST way to help kids lose weight would be to show the cool teenagers eating vegetables.
Some of the kids I babysit eat a lot of junk food, none are overweight--but they lead pretty idyllic lives. Some live on a street with other kids their age; they all play outside together after school, every day. Others spend most of the day playing outside on estates like this:
In this, the 10th Oxford Comment, Lauren and Michelle investigate what makes a classic beauty icon, learn about appearance-based discrimination, talk body politics, and discover the threads that tie fashion to beauty.
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Historian, archaeologist, and classical scholar, Duane W. Roller is emeritus professor at Ohio State University and the author of eight books, the most recent of which is Cleopatra: A Biography. Read his OUPblog posts here.
Margitte Leah Kristjansson is a PhD student in communication at UCSD whose work is situated within the emerging field of fat studies. She is interested in all things fat, and blogs about her interests at margitteleah.com and riotsnotdiets.tumblr.com. Margitte recently completed a documentary on fat female bodies and visibility available for viewing here.
By Lauren Pecorino
The statement "cancer is personal" can have several meanings. The fact that cancer affects one in three people over their lifetimes means that it is a disease that will hit close to home for everyone. Everyone will have family or friends that will be affected and loved ones will become cancer patients. Cancer is personal. Luckily, we are living in a new age when cancer patients are more likely than ever to be cancer survivors. There are 28 million cancer survivors in the world today. Out of approximately 12 million cancer survivors in the United States, 4.7 million received their diagnosis at least ten years ago. The good news that everyone should know is that there is progress in cancer management.
By Bianca Haase
Cats are among the most common household pets and they share the same environment with humans and thus many of the risk factors. Obesity is a growing problem for feline health for the same reasons as it is in humans and has become a serious veterinary problem. Multiple diseases, such as type II diabetes mellitus and dermatosis, are associated with excess body weight and obesity in cats and may result in a lowered quality of life and potentially lead to an early death. Appleton et al. demonstrated that about 44% of cats developed impaired
Today’s post comes to us from Camilla Nord, who found some striking statistics about kids’ fast food eating habits in the wake of some recent self-imposed health-focused changes by food marketers. Despite changes for the better, kids... Read the rest of this post
By Michael Otto
Dear First Lady Obama:
I am writing this letter in support of your Let’s Move campaign against obesity. As you well know, traditional recommendations for physical activity and good nutrition have met with failure in the United States. According to the Center for Disease Control, rates of adults who engage in no leisure time physical activity have been in the range of 20-30% for over 20 years. Moreover, over 75% of individuals do not
Friday evening I was walking along the Beach Road pathway, getting some much needed exercise. When I'm shuffling along at my loser's pace, I feel a kinship with all of the healthy, active folks who jog past me. I'm part of the community enjoying Saipan sunsets and the sound of the ocean. I'm a contemplative person, mulling over the day's events and enjoying other thoughts, both the mundane and the complex. In other words, I'm alive.
At one point, a child raced past me. Then I heard the mother call out, scolding the child for running. "Stop running," she said. "You'll get tired." And I thought, what are you doing to your child? Why shouldn't a child run on the beach path? What's wrong with getting tired, especially after sunset when bedtime can't be all that far away? Is this a child with a heart disease who must guard against over-exertion? There was no indication of this.
And this isn't the first time I've heard parents scold their children for doing normal, healthy activities in an appropriate place. I've witnessed parents I know telling children to stop jumping and leaping from spot to spot when they were playing out of doors. I've listened silently as other parents I know caution their children not to "get dirty" when they are at home on a Saturday afternoon and nothing is about to happen.
What's wrong with some exuberant exertion? (Nothing) What harm does a little dirt cause? (None)
I've also heard praise for the sluggish, the lazy, the apathetic. Puh-leeze. The child who sits still, the child who doesn't wander far, the child who lacks the curiosity to find out what's making that noise, causing that light, creating that smell may be an "easy" child to care for now, but in the long run these are the children who face obesity and boredom.
I don't say anything when these things happen. I feel it would be rude to insert myself unwanted and unbidden into someone else's parenting decision.
But to my own daughter, I say run, run and run faster. Wear old clothes so you can get dirty. Move, go outside, and have fun.
Author Neil Gaiman's blog post adds a little Brit humor and perspective IN HIS FEBRUARY 20, 2007 POST. He has an update on February 28, 2007 from a Medina Ohio Librarian that is very touching. NeilGaiman
But if a word in a book can arouse such a backlash of prudish fear, I wonder when the censors will get to this HHS / government offering.