Behavior change and obesity in America
With 17 percent of American children deemed obese and that number growing, the topic was much in discussion at this week's American Psychological Association meeting.
Diane Girardot is sending dispatches from the American Psychological Association conference in Orlando, Fla. from August 2-5.
By Diane Russell Girardot, L.P.C.
With 17 percent of American children deemed obese and that number growing, it is a conundrum to consider that many parents say they fear depriving their children if they don't stock the kitchen shelves with junk food. This statistic was one of many presented during the opening session of the American Psychological Association's 120th annual convention last night in Orlando, Fla.
The depriving part is "not true" according to Rena Wing, Ph.D., of Brown University, who was awarded an APA Outstanding Lifetime Contributions to Psychology award at the event. Wing, along with Kelly D. Brownell, Ph.D., who also received the APA Award for Outstanding Lifetime Contributions to Psychology, shared the stage in presenting current obesity research and intervention strategies.
Obesity is being labeled the second leading cause of death in the U.S. following cigarette smoking. Its genesis is long known to be a combination of a change in the way we eat as well as genetic interactions. In her opening remarks, APA President Suzanne Bennett Johnson, Ph.D., said the "U.S. leads the world in many things and unfortunately in obesity as well." She cited that nearly 2/3 of the population is overweight while 1/3 are obese creating a new normal in our current national environment.
Johnson cited an increase in diabetes and co-morbid medical issues and well as increased health costs due to this new normal. Prevention in the form of individual lifestyle changes, environmental and policy changes as well as increased regulation and possibly litigation are just a few of the strategies under investigation by scientists and psychologists working together to resolve this growing health crisis.
Part of the litigious prevention may be combatting the food industry, which is reluctant to implement health generated changes on its own. Brownell, of Yale University, likened the scenario to the regulatory conflicts with the tobacco industry and pondered if we needed to again "stand up to the powerful sources".
Across the globe, the food and beverage industries are "colonizing developing worlds" he pointed out and already statistics are showing an increase in the consumption of sweetened beverages compared to milk and juice.
Brownell believes companies are likely to move elsewhere as in a game of "Whack a Mole" as the U.S. continues to implement obesity and diabetes interventions.
"Kicking out soft drinks from our school cafeterias was unheard of not long ago because the proceeds paid for band uniforms," Dr. Brownell said, adding that now prevailing thought is of "protecting our children and our environment."
"Obesity is understood to be a consequence of our environment," added Wing, It is also understood and well-researched that changing the environment will lead to decreased obesity and increased health. "Just losing 10 percent of total body weight can remarkably improve health."
Wing is also a strong proponent of individual behavior change in the fight against diabetes and obesity. A Diabetes Prevention Program she tracked featured diet, exercise and behavioral strategies that in a 10-year follow up showed some weight gain after the initial loss, but no diabetes in the participants who had changed their lifestyles.
Modest lifestyle interventions were sufficient to alter a potentially dangerous health issue, she concluded.
The next step is cost-effectively disseminating lifestyle programs. Wing said the YMCA has a successful program as well as an internet version with physician and video lessons for diabetes prevention. Maintaining weight loss and lifestyle improvements includes continued diet and staying active for 60-90 minutes a day. A program called Stop Regain reinforces maintenance through scheduled face to face gatherings as well as connecting via the internet .
Just as some parents balk at regulating "junk food" in their homes, many people feel obesity is a personal choice and that government has no business regulating what and how much they eat and drink.
Until it reaches the level of a public health concern and it has, said Brownell, then, like immunizations, air pollution and even air bags, there has to be mandates to avoid a catastrophy. There are enough obesity statistics to support this being an epidemic and more and more people are going to want to give permission to mandate regulation, he added.
"Our choices are already controlled more than we realize," observed Wing, "Our food is already prepared a certain way for us." And, the way it is prepared and delivered is not necessarily healthy.
Diane Russell Girardot is a Chester County-based licensed mental health professional, who is a former Philadelphia Inquirer reporter now merging both careers with her coverage of the APA convention.
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