unhealthy eating part 3.5: response to smart comments

 

organizations mature

So.

 

My friend and past business associate and one smart lady has been stepping up and challenging my solution to addressing the Obesity issue and Unhealthy Eating in general.

After I posted Unhealthy Eating part 3 she cranked out some fairly extensive thoughts in the comments and one-on-one and rather than get bogged down in the comments section I am taking them all on in a post.

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Dear Jen,

Geez. Jen.

I wrote Unhealthy Eating 3 months ago and now you are asking me hard questions and I have to think.

Geez <again>.

 

Okay.

Let me start with maybe I am smarter than I look. When I wrote this originally I had found one technical article citing the characteristics of addiction associated with unhealthy eating. Now when I Google “unhealthy eating as an addiction” my post shows up 5 on a fairly healthy top 10 list.

2 interesting ones included:

 

http://csr2health.blogspot.com/2010/04/should-unhealthy-eating-be-treated-as.html

 

http://www.thedoctorwillseeyounow.com/content/addiction/art1966.html

 

quote: “We pride ourselves on our intelligence but we still engage in many unhealthy behaviors — eating and drinking to excess, smoking, abusing drugs. Can doctors and therapists help us stop these unhealthy behaviors? The answer appears to be yes.”

 

So.

I do believe the conversation about “addiction” as the key to addressing behavior change is beginning.

 

Anyway.

Before I take each of Jen’s thoughts on I would like to point out that almost everything she wrote is very similar to what someone would have written about smoking/tobacco usage in the early 70’s. We could debate the “shades” of the comparison but self esteem and appearance and image and all that stuff came along with smoking as well as “long way down the road.”

 

I will take on the “Long road to change” habit to addiction or whatever more directly later on but I thought it was important enough to state that this concept is not a short term idea.

Anti smoking, when it begin in earnest in early 70’s, had a long road to success. It took decades to be successful.

Why decades?

Well. Not because they did anything wrong (in fact they actually did it correctly) but rather because they were not only attacking perceptions but also attempting to affect behavioral attitudes. And, honestly, the best way to affect behavioral attitudes is not in a generation that already has deep seeded behavioral patterns but rather a younger generation in its formative behavioral growth stage (think safety belts, smoking, and something else I cannot pull out of my aging memory banks) . Hmmmmmmmmmmmmmmm  … I wonder if aging memory is an addiction.

 

Sorry.

I digress.

 

The comments/questions I received with some type of response immediately following. Please note some answers may be slightly repetitive because of some overlap on what I believe on some underpinnings.

 

1) Not against the “food is addiction” idea, certainly there’s a lot of research that indicates the chemical “rewards” of eating certain foods.  But isn’t there a line between habit and addiction?  Or is every habit (even a healthy one) just a low grade addiction?  Is every overweight person an addict?  What about thin people with a bad sugar/junk food habit which could also kill them?  Not totally convinced (at least for now) that we should do a 180 in terms of obesity approach.  Think the problem is more nuanced than black & white.

 

 

–    Sorry Jen. I think as soon as we enter the nuance discussion we are destined for failure. Is every overweight person an addict? No.

Some people have chemical imbalance issues. If diagnosed properly they fall into a different solution group.

Are thin people will health issues because of their food intake addicts? Yes.

 

I believe the unhealthy eating addiction is non discriminatory of body type.

Are certain body types more likely to be indicative of an addiction? Sure.

Just as certain geographies or lifestyles are more indicative of tobacco usage or drug usage. But that is a “propensity to problem” discussion.

 

Also.

I do believe there is a distinction between habit and addiction (I am not a scientist so I don’t have nifty charts or studies to support this). But I do believe society has blurred them. I personally don’t believe there is such a thing as ‘low level addiction” (I think that is something like being kind of pregnant).

 

Addiction is self destructive behavior.

It seems crazy to me that people call shopping an addiction, or sex as an addiction (please, god, I want to meet one of those women) or any of the other wacky things we attach to ‘addiction.’

 

But it seems as a society we are comfortable talking about ‘raping of humanity’ or ‘raping people of their rights’ and missing and diminishing in some ways the reality of rape … so I guess we are a culture destined to abuse words and diminish their affect through misuse.

(sorry. You got me on one of my soapboxes … they make me feel taller)

 

But that doesn’t mean we shouldn’t do the right thing.

Black & white to me. Addiction.

 

 

2) Think it’s gonna be hard to change the reward for eating right from “not being fat” to “not dying”.  There are a lot of immediate, short term rewards for being less fat (social acceptance, self esteem, etc), while the concept of “dying” is (for most of us) a loooong way down the road and not very immediate or real.

 

–    Yup. Its gonna be hard. Almost impossible in the beginning in fact.

The biggest initial hurdle will be its lack of political correctness. Similar to tobacco a lot of physicians and politicians hesitated to join the team upfront. Its gonna be the same here.

But (and I wish I had written this and maybe copy writed it) “nothing really good in life is easy.”

 

 

3) So the communication challenge is to make “death” a more immediate reality.  I suspect this is why a lot of overweight people have to get a medical wake up call (diabetes, heart disease, etc) before they are motivated to action — death becomes reality.

 

–    Yes. This you nailed right on the head. I believe it is so much easier to focus creativity kill the caterpillarsand ignore all the other things you put in point 2 (self esteem, social acceptance, etc.) because they are not really “I” focused. They can be dismissed (and I am saying this flippantly but you get the point) as “stupid people around me … I am just me being me and I feel comfortable in my own skin.”

 

This is the exact same issue tobacco usage ran into in the beginning. “

All these issues are so far in the future … “I can put off doing something now and do it later.”

That is where addiction came into play. People in the beginning just didn’t think addiction played a role. They thought it was all choice or ‘managing habitual behavior.’

And while I don’t disagree it will be the communications challenge I just want to be sure by ‘communications challenge’ we are saying the same thing – alignment with regard to influencers and all outgoing discussion that ‘death’ is the outcome of unhealthy eating (or intake).

 

 

4) I was also thinking that “being healthy” is too squishy a goal.  It CAN include weight issues, and it can also include a lot of other things which don’t involve food at all.  So solving obesity would be a by-product of solving “everyone be healthy”, right?  In the same way we tell clients to set measureable goals, specific goals are definitely part of this solution.  I mean, quitting smoking or drugs is pretty specific:  you succeed if you don’t do it anymore.  But eating is different since you have to eat every day — so how will our “addict” know when they’ve succeeded?  To make it more complicated, what’s healthy for one person may not be the ideal for someone else.  Also, the more I think about this the more it STILL seems to me there are lots of programs and guidelines that kinda do what you’re talking about in your post — they simply don’t say “you’re a food addict and here’s your 12 step program” (although Overeaters Anon does exactly that).

 

 

–    I am going to debate on portions of your thoughts but honestly I could be talked out of a couple of things.

First.

I don’t think being healthy is too squishy. To be specific … to an unhealthy eating addict.

 

If you are addicted and you manage it and are successful in healthy intake you may remain ‘obese’ (or whatever measure we may elect to use) but you are maximizing your body type. You are making your body type healthy.

So ‘not squishy’ is the fact the reward, true success, is being healthy, living a full life, feeling good and being a good as you can be (not only for you but people you love and care about you). Shit. If that is squishy I will take it.

 

Second.

I do believe healthy eating can be very specific (and a portion of this belief I am addressing in the success discussion). I believe it can be very specific because similar to drugs and tobacco there is a firm list of “do not intakes.” An unequivocal list of don’ts.

 

Third.

Success.

Ahhhhhhhhhhhhhhhhhhhhhhhhhhh … and now we take on the hard one.

 

Well.

For an addict success is measured in moment and days … well … let’s say “day.” each day done right is a success. You go to sleep. The next day an addict has a blank slate of no success yet.

Moments of success occur and the day becomes a success. And start over again.

Sound tiring? Yes.

An addict’s life? Yes.

 

And I believe once we start thinking this way programs that say “it’s okay to reward yourself with a small piece of pie” will go away (or will not be the approved programs). A drug addict doesn’t reward themselves with a couple lines of coke. Nor does an alcoholic reward themselves with a drink.

 

Breaking addiction means depriving yourself of the perceived pleasure of the addiction and finding your pleasure stimulus elsewhere.  The reward system needs to be overhauled in all these weight management programs.

 

 

Fourth.

Yeah. Okay. You have nailed me on this one before (exiting programs out there).

You know? There may be. And there are certainly components of existing life not milestones but momentsprograms that are right on. Yet. I continue to believe a program developed from scratch with addiction in mind would look different than anything out there today.

 

Massive differences? Heck. I don’t know.

Meaningful differences? Probably. And it is those differences I worry are not in existing programs today.

 

 

5) If there were easy answers we surely would have found them by now…

 

–    I did chuckle when I read this.

Anyway.

This topic is probably a completely different post but let me stay with addiction type things.

In all cases, and I will state an unequivocal all, the answers have been easy. And stated pretty early on very clearly and succinctly.

 

The issue is rarely in finding the answer. Someone smarter than me has probably said this even better than I years ago. The issue is that it is hard to do. And hard to accept. And there will be a boatload of people who will fight the “easy,” and right, answer just because they will seek the gray within a black & white issue. This happens everywhere. But. As I said, this is a different post.

 

 

Beyond Jen several people have asked why I have written so much on this issue and invested so much energy on it.

 

Well.

 

First and foremost I hate how the entire obesity issue consistently diminishes women’s self esteem and sets these incredibly stupid social standards. I know a number of women who certainly have fought weight issues but regardless are really attractive in the bodies they have.

So all the diet scams and crap drive me nuts. Simply, with this first reason, I don’t like what this issue does to the women I care about and how it makes them feel about themselves and the unnecessary stress it puts on some pretty amazing, and beautiful, women.

Second.

I think there is way too much “fluff” happening and being discussed around a really important issue. Too much rhetoric and not enough ‘hard decision making’ for fear it will be too polarizing or not ‘politically correct.’

 

Is my thought the best one? Heck. I don’t know. But I do know it would create a hellacious discussion and debate and maybe someone would get off their ass and decide the right thing to do and not what ‘looks good to do.”

 

Anyway.

That said.

 

I have fought with weight stuff … or let’s say that I come from a family with weight issues and in my own way I am careful (in some ways), hopefully not preoccupied and I am surrounded by family who fight it, think about it and discuss it ad nauseam every day.

 

 

As for am I just spinning a theory here?

 

Well.

 

I won’t debate but I would like to think as my career has gone on and I have tried to learn as much as I can about behavior and the infamous JWT ‘stimulus-response’ as well as an earnest desire to strip away bullshit and focus on functional core to uncover the issue at hand that this is more than a theory but rather a solution to what is becoming an issue couched in politician speak and marketing aspirational verbiage rather than taking the hard road and attacking the issue.

(oh. And I just wrote an entire paragraph with one sentence)

 

Regardless.

 

This ends my commentary on Unhealthy Eating.

Well.

At least for today. Unhealthy Eating 4 is on implementation.

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Written by Bruce