Archive for October, 2008

Coping with the obesity misinformation epidemic

October 2, 2008

There has been much talk lately about the obesity epidemic which is sweeping the world, and the ensuing panic has resulted in an avalanche of books and articles packed with ideas about why we are growing larger and what we can do about it. The sheer quantity of information is overwhelming and would be hard to digest even if most of it were helpful. But much of it is unhelpful and misleading, so that the consumers of all this misinformation are left to throw up their hands in frustration, and down another cheeseburger.

As a physician struggling with making sense of all this over many years, I have come up with a few areas to consider when evaluating the constant stream of data about diet, weight loss and lifestyle. Hopefully, these suggestions will be helpful for therapists and other health professionals as well. Here is what I look for:

  • Bias. If the author of an article stands to profit from what s/he is promoting, there may be a conflict of interest leading to bias. Some magazines, journals and websites now require authors to disclose any significant income from a product (or competing product) s/he is reviewing. Be suspicious of an overly dramatic or sales-oriented tone, an extreme position, or a statement that seems “too good to be true.” In research reports, the author should point out weaknesses and limitations of the study.

  • Balance. Obesity and weight management are complicated. Articles and books on these topics should acknowledge this and indicate which part of the problem the author is addressing. In general, there are at least three components to the problem and its solution: biological, psychological, and social. For example: complex genetic and hormonal systems interact with the brain and environment to affect how much we weigh, our fat composition, our body shape and even our cravings and appetites; stress, coping patterns, how we think, and how we react emotionally affect our eating and metabolism; and our culture and social relationships affect our lifestyle choices and our ability to adhere to a plan.

  • Timeframe. Changing how we eat, move, and what we weigh should be a lifelong project. Time-limited diets and programs may help for a while, but much research indicates that we will not put up with boredom, difficult tasks, and self-deprivation for long, and that once we stop a short-term program we are very likely to regain any weight we may have lost, and then some. The good news is that the more we practice healthy habits of eating, moving, and thinking, the easier and more natural the new behaviors become.

  • Reality check. There is no quick and easy substitute for following a sensible diet, controlling serving size (we all suffer from “portion distortion” and underestimate how much we actually eat), and increasing energy expenditure through both “spontaneous” activity and planned exercise. Realistic weight loss should be a gradual process; otherwise, our body “thinks” it is starving, and powerful biological systems take over to prevent further weight loss. We must choose a realistic weight maintenance goal. For example, if my natural weight range (some call it “set point”) is between 170 and 200 pounds, my ability to maintain a desired weight may be practically limited to keeping it between 175 and 180 pounds. Efforts toward maintaining a desired weight range, even if still overweight according to standard weight tables, do pay off in terms of better health outcomes (for example, preventing type 2 diabetes and lowering blood pressure). Also, alcohol intake (and taking certain drugs) affects weight; any diet which ignores this fact is unrealistic.

  • Impact on the planet. This criterion is “optional,” but I think very important. Is the proposed diet or program good for the planet? For example, one of the biggest threats to our global climate and resources is meat farming. So, any diet or lifestyle which advocates eating more meat (especially beef) is harmful to the planet. Cutting down the meat portions in our diet, or eating meat less frequently, can benefit the planet.

Considering these five categories has helped me cope with information overload. If you follow these simple guidelines, I predict you will feel less overwhelmed and will then be better able to help yourself and/or your clients address issues with weight and health.