addressing Unhealthy Eating (obesity) Issue Part 2

“I moan with pleasure.

“Did you just have a foodgasm?” he asks, wiping ricotta from his lips.

“Where have you been all my life?” I ask the beautiful panini.”

Stephanie Perkins

“But if you’re gonna dine with them cannibals

Sooner or later, darling, you’re gonna get eaten . . .”

Nick Cave

<note: I originally wrote this in May 2010. At the time my point of view was certainly outside of the norm. As of today the concept – of unhealthy eating as a form of addiction – is now being discussed among experts. I still believe this is a viable path and have updated this slightly>

As stated in part 1 <https://brucemctague.com/unhealthy-eating-part-1-obesity-aint-the-issue > the issue we are discussing globally, and in the United State in particular, isn’t obesity … it is Unhealthy Eating <or unhealthy intake>. As of today … approximately 10% of the American population exhibits, in their words, a “loss of control over eating behaviors.” Unhealthy eating creates unhealthy bodies <regardless of size> and therefore creating health issues.

And the longer your body is unhealthy the higher likelihood of health issues.

That’s it.

Anyway.

Word haggling aside … how can we actually successfully address the issue?

Some of the things I am going to suggest are not going to be “politically correct.”

But.

I want to solve this problem.

But to solve the problem you have to clearly identify it and define it:

I believe we need to treat unhealthy eating as if it is an addiction

So.

Why do I feel so strongly about this?

Many people suffer from a preoccupation with weight and eating.

This preoccupation is almost as bad as being overweight or obese. It has a negative impact on the quality of life, can lead to health care bills, negative social aptitude, <which leads to additional Maslow like issues> and some absurd physical activity … or lack of activity. And it is not only binge eaters and the overweight population that are struggling with these issues.

Many people of ‘normal weight’ also suffer from preoccupation with weight and food.

Now.

Unhealthy eating is a behavior.

While this is simplistic example people don’t want one cookie they want a bunch of cookies when they grab one.

<gosh. That sounds like an alcoholic’s issue doesn’t it?>

Do I really believe we can actually become addicted to food? Clinical research suggests it is possible but at this point all I am truly suggesting is that we treat it like an addiction.

And if you buy that addiction premise than accept the fact a diet won’t resolve the issue. Diets are typically short term “show results” programs destined for long term failure. No program is gonna work until we accept the fact that if someone is addicted to unhealthy eating they will always been an addict therefore you are fighting a long term battle against desire <and this is a behavior model>.

The smartest thing I have seen from the government actually came from Michelle Obama:

“We don’t need to wait for some new invention or discovery to make this happen. This doesn’t require fancy tools or technologies. We have everything we need right now — we have the information, we have the ideas, and we have the desire to start solving America’s obesity problem.

“The only question is whether we have the will.”

Let me answer that last question Michelle Obama stated.

No.

As in “no, we do not have the will.”

Because it is an addictive lifestyle <why the heck is it that hard to actually change eating behavior ? … gosh .. maybe you are addicted to the behavior you currently have>.

So.

She is correct.

Any program that addresses unhealthy eating has to dig hard into an individual’s will to do something. And I will get back to the ‘dig hard’ phrase I just elected to use when I write Part 3.

Anyway.

Having worked on a variety of anti unhealthy eating initiatives I am going to use that experience to outline how unhealthy eating is an addiction and we should use learnings to attack the issue as such.

Please note.

In this next section I am going to use an anti-smoking campaign and research findings to make a point and show an example. I did not do Unhealthy Eating research. I simply used existing anti smoking focus group research excerpts and have replaced the words “anti smoking” and “quitting smoking/tobacco” with “Unhealthy Eating/eaters” and “Obesity” where appropriate.

I did so because I believe you will see how aligned addressing the tobacco addiction is to the idea of unhealthy eating as an addiction.

This is simply meant as a rough example.

(just caveating my ass here)

Unhealthy Eating as Addiction Example:

Poor Eating (often leading to obesity but also leading to unhealthy bodies) is ingrained in the culture of America, especially among adults but becoming a “way of life” for youth.  I recently read in an article (I apologize for not sourcing) that most adult Americans respect an individual’s decision to a Poor Eating (obesity) lifestyle, and they believe the individuals – not Poor Eating (obesity) contributing companies – are to blame for negative health consequences.  This perspective provides a nurturing culture for Poor Eating (obesity) users and cuts across cultural, socioeconomic and generational lines (although I also believe I have read that obesity skew toward lower income, lower educated households as does unhealthy eating).

I believe the scary part of this issue is that America unhealthy eaters are in a state of denial about Poor Eating (obesity) addiction and have little awareness or understanding of “quit” alternatives beyond superficial programs (which appeal more to vanity).  Without specific research, but being knowledgeable on Tobacco Addiction research, let me suggest a theoretical model outlining the kind of issues I believe we are facing with regard to Unhealthy Eating:

Unhealthy Eaters by Stage in a Theoretical Model

Note: Above are stages preceding action.

Pre-Contemplation

As a whole, the adults in America see Poor Eating (obesity) use as a personal choice that doesn’t necessarily affect others.  They recognize that Poor Eating (obesity) is bad for them, but stand by their conviction that “we all make decisions that are bad for us sometimes and everyone is entitled to do so.”  There is a great deal of denial that they have an addiction.  In short, two quotes summarize adult Americans’ mindset: “people are going to do what they want to do” and “no one wants to be told his choice is a bad one.”

• They believe there are Unhealthy Eaters and non-Unhealthy Eaters, and that’s “just the way it is.”

Each should be granted his or her rights.  They accept one another’s decisions, although some may secretly have very strong opinions for or against Poor Eating (obesity) usage.

• Unhealthy Eaters, in particular, are quite defensive about their eating as well as suspicious of anti-Poor Eating (obesity) ad campaigns.

Their reactions are borderline aggressive at times in response to anti-Poor Eating (obesity) messages.  They do not want to feel guilty about their addiction/personal choice and don’t appreciate advertising that suggests they should be.  In short, they don’t want anyone to tell them (preach to them) they should quit Unhealthy Eating.

They do not have a lot of hope for the future with regard to Poor Eating (obesity) prevention and cessation. They are quite entrenched in the status quo and believe that young people and adults will continue to make their own personal choices regardless of intervention efforts.

Contemplation

Adults in the contemplation stage acknowledge that they should stop unhealthy eating someday, but don’t have the desire to quit now.  They know the health reasons to quit, but rationalize those reasons away (one focus group respondent with <insert disease> told us that “we really don’t know if unhealthy eating can kill you and besides you could also die in a car accident.”)   Furthermore, most Unhealthy Eaters are not sure they can successfully quit if they wanted to.  This doubt that they will be able to quit creates some very complex defense mechanisms.  Focus group respondents talked about the problems of quitting, stress, weight gain, loss of control.  During the focus group we conducted, respondents were asked to create with words and images how they perceived the process of quitting.  There is an overarching feeling of being trapped, of wanting to quit, but not believing that they could quit.  While Unhealthy Eaters in the contemplation stage are responsive to the benefits of quitting, they tend to focus on the perceived struggles of quitting.  The struggles they go through to quit are immense – even overwhelming.  The habit of unhealthy eating is so ingrained in every aspect of life, that a lifestyle change would seem the only option for a successful quit attempt.

However, when asked to visualize what it would be like if they successfully quit, respondents created imagery of being healthier, more attractive, more confident.

Research participants gushed about the benefits of a Poor Eating (obesity)-free life, especially the overwhelming psychological boost they would receive knowing that they beat the Poor Eating (obesity) addiction. In fact, this audience appears to be especially responsive to the communication regarding the immediate benefits of quitting.

Preparation

Many Americans do not know how to quit unhealthy eating.  In focus groups we conducted with Unhealthy Eaters who have had at least one quit attempt, it was clear that there is low recognition that unhealthy eating is an addiction rather than a habit.  Thus, quit attempts were made with the same level of preparation one would use to kick a habit.  Key elements in preparation cited in the groups were, “getting your mind right,” “reducing your eating consumption” and “praying.”  The majority of our focus group respondents believe that quitting is something you do by yourself and “cold turkey” was the only way to quit.

So.

I hope you see what I saw.

A surprising amount of words and thoughts that I would associate with Unhealthy Eating and the personal issues involved with the preoccupation of weight … even though they were talking about smoking/tobacco.

I particularly felt the linkage in reading “preparation.’

…. clear that there is low recognition that unhealthy eating is an addiction rather than a habit.  Thus, quit attempts were made with the same level of preparation one would use to kick a habit.  Key elements in preparation cited in the groups were, “getting your mind right,” “reducing your eating consumption” and “praying.”

Regardless.

Is this flawed logic <using smoking addiction issue words to discuss unhealthy eating>? Possibly.

Is it worth pursuing? Yes.

If you accept the addiction premise … the objective of a program to address this addiction is complex and has to have several objectives:

• Educate Americans on the dire consequences of Unhealthy Eating.

• Increase awareness among all Americans that they can successfully quit their unhealthy eating addiction.

• Address the lack of understanding among Americans of how to quit and the circle of failure identified by people who have made previous quit attempts.

• Educate Americans on the immediate benefits of quitting Unhealthy Eating.

• Among those users in the contemplation phase in the Stages of Change Model, provides reasons to move into preparation.

• Address those users in the pre-contemplation phase in the Stages of Change Model.

These objectives also form a nice basis for evaluation.

But.

Success will be dependent in my eyes on three things <this program will not be for the faint of heart>:

• Credibility, Consistency and Continuity: Guiding Unhealthy Eaters to a successful quit experience.

• Credibility – Deliver compelling messages to health care professionals, community leaders and special population groups that communicate the efficacy of any Quit program (which I am not qualified to design)

The addiction concept will only work if the healthcare community is aligned. They need not be vocal just aligned.

• Consistency – Utilize (paid, matching and earned) media that will provide a consistent flow of “quitters”. (Develop communications that engage thought leaders and health care professionals and providers to create a growing group Quit advocates and referrals.)

Proof. At some point individuals need to understand and believe they are not a minority (a small group of people who are ashamed they have this problem) but rather a majority that is willing to have the “will” to tackle the issue.

• Continuity – Provide support for each phase of the Stages of Change model.

This has to be a complex campaign with several objectives targeted to a variety of groups. I do believe there is a “flagship” idea that can create an umbrella idea and I will outline that in Part 3.

I do believe we can beat Unhealthy Eating if we treat it like an addiction.

Lastly.

In the interest of sharing information I include this link. I do not agree with the total direction of the article itself <assessing blame on others> but there is some nice information and a thoughtful ‘here is what I would do’ plan of action:

http://drhyman.com/blog/2011/02/04/food-addiction-could-it-explain-why-70-percent-of-america-is-fat/#close

Hope you found it interesting.

Part 3 will outline an idea of how I would jumpstart the Unhealthy Eating campaign.

Sources for research and factoids:

USA Today

                                State of Health Study: North Carolina

                                Several anti-unhealthy eating/quitline RFPs I co-authored