The Los Angeles County Department of Health has blitzed the LA region with billboards and bus advertisements extolling people to eat less. The ad campaign caught my attention last week the day before Thanksgiving. So timely.
The ad campaign is obviously getting our collective attention. Steve Lopez of the LA Times penned his thoughts in today’s column. The ad campaign is being funded by a 1 million dollar grant funded by the Centers for Disease Control in the name of “…something has to be done” (a quote by LA County’s Public Health Director, Johnathon Fielding that I plucked from Lopez’s piece).
Yet, there is ample evidence that research doesn’t show any link between nutritional awareness and one’s waistline. The truth is that knowledge doesn’t readily translate into behavior. Why is LA County Health Department spending $1M on this campaign?
THE COSTS OF POOR METABOLIC HEALTH ARE REAL
Obesity–and more specifically, poor metabolic health–is likely to cripple us. Economic costs are ballooning and it is not just the cost of health care. The cost to business is also enormous. Unhealthy people are less productive, take more sick time, use more medical care, and drive up health insurance premiums.
Teenagers who are diagnosed with type II diabetes today are just as likely to develop kidney failure as previous generations, eventually living their life on dialysis or on a transplant list. Except they will be in their 30’s and 40’s –not their 60’s and 70’s. Who is going to be healthy enough to work?
IS “DOING SOMETHING” ENOUGH?
The general panic in public health and medical communities regarding “the obesity crises” can lead to wishful thinking. We are a knowledge based society and health care is a knowledge driven discipline. It is easy to get stuck in the illusion that knowledge is the solution (ie: if we tell people what they should eat, they will.)
It is true that eating less for some people will result in weight loss. But it is also true that most people who struggle with their weight already know this. Knowledge is not the problem. The real challenge is translating knowledge into behavior.
“Sound bite nutrition” tends to exaggerate the benefits of any simplistic solution. It sounds so easy, “just do it.” But if it was that easy, people would. True change takes readiness, willingness, and ability. Knowing what you should do is merely a component of ability. Telling people what they should do without addressing why they can’t or don’t do it often just creates guilt, shame and/or depression.
WHY PEOPLE CAN’T OR DON’T EAT LESS
To be truly effective, the entire health care community needs to appreciate factors contributing to the challenge for any one person. Then that person deserves the support and resources to figure out an approach to eating that works.
The solution is a public health nightmare. But it is disingenuous to pretend that eating less can be accomplished without addressing why people eat more. There are many factors influencing the capacity to self regulate as well as the biological mechanisms that regulate hunger, satiety and energy metabolism, including:
- An environment that encourages indulgence and celebrates the extremes
- A culture that pretends more is always better, or that there is never enough.
- An abundant and adulterated food supply
- A farm and food policy that subsidizes extremely refined and processed foods, making them the easy and cheaper choice
- FDA policy that continues to confer GRAS status to problematic ingredients like trans fats
- A culture that celebrates stress junkies and the sense that you can (or should) be willing to manipulate your body to accomplish whatever is expected
- A modus operandi that values money more than our environment, time, energy, or any other resource
- EPA’s chemical management policy that allows thousands of chemicals that are known endocrine disruptors and persistent organic pollutants to be spewed into our environment. 95% of these agents enter our bodies via the food chain and interfere with glucose tolerance and thyroid function.
- A GNP that gives no value to traditional “women’s work” which means there is no value for the time, energy, skill or resources needed to prepare food and eat well
- A work environment in which too many people are unwilling or unable to take time off or work reasonable hours
We live in a society that is constantly bombarded with pressure to do more and be more. A chronic level of stress leads to all kinds of maladaptive behavior, including craving sweet and overeating. We have no time to teach our children how to survive abundance, but we do teach them how to cope with ever more destructive behaviors. As the bar of expectation raises higher, more and more people struggle. We are literally creating mental illness as well as a whole host of conditions linked to poor metabolic health.
CALORIES COUNT, BUT THEY ARE NOT THE ONLY THING THAT COUNTS
In the mix, public health authorities tell us to eat less. We are told to count calories. We are increasingly disassociated from our bodies in a quest to meet someone’s idea of what we should be eating.
Those of us working in the trenches need to be more honest. There is no one right way to eat. Eating less doesn’t always lead to healthy weight loss. A lower BMI doesn’t not guarantee good health. Thin people don’t necessarily eat healthier than heavier people. Thin people diet of heart disease, diabetes, cancer and a host of other maladies. Truth be told, we should stop hyper focusing on obesity and we need to tone down the rhetoric regarding calories. After all, if weight loss was a mere math problem, some very intelligent people would have solved it by now.