Sunday, October 31, 2010

Obesity acceptance

I was reading Dr. Sharma's weekly links. One interesting discussion is  obesity is like alcoholism. Commenters rightly noted that obesity doesn't at all lead to the types of behaviour alcoholism does with the effects on others. But if obesity was treated as an addition like alcoholism perhaps more people would seek treatment.

I'm not sure we're seeking a solution that doesn't exist. A long time ago, a friend (who was taking a psych course at the time) told me that all people have addictive personalities as part of their pleasure/reward system. Research has not contradicted that pleasure is a powerful motivator and reward and we see it in all aspect of life. It's just as some are more socially acceptable than others. Most people admire successful/rich people. In the past, a well fed body was an indication of wealth. Now that there is an overwhelming availability of cheap palatable food everyone can have this wealth indicator.

I admit, I find it difficult to empathize with obese people. I don't really understand why, once you have to increase your clothes size a couple of times that you don't take steps to stop the increase by checking your portion size and making yourself eat different foods. Replace food as a reward with an activity you would do more of if you had more time/money. Take time to build new habits and don't multi-task while eating.

And then I remember dog training. My first dog never went on furniture - a firm rule but he also had to be on a leash because he was intermittent on coming when called. We're now on dog number 4. None of them have had really solid recalls though all of them come when I call them to watch tv or go in their space because I'm going out. I can make all the excuses in the world about time and other commitments but, in the end, as much as I would like (really like) my guys to come when I call them ALL THE TIME, it's not that important to me because I haven't made time to effectively work on it to make sure that they do.

Why does obesity matter to you? If you're activity level is slow walking, sitting, driving and you can do that, what is your motivation for change? If you don't mind taking pills to compensate for metabolic shortcomings why lose weight? If you are willing to take the increased risk of surgical risk, poor medication dosage then being larger isn't going to be a motivator. If you don't care how long you live because you'll be seeing everyone who matters in heaven, why would you be concerned about your length and quality of life?

Why does your obesity matter to me? Well, in a universal health care system there is a finite amount of money. I am currently healthy. A little physio and an annual checkup is about the extent of my use. But every dollar that goes towards a intervention of a manageable health problem is unavailable for other use. That means poorer assessment and treatment of cancer and other diseases. Longer surgical wait times because of the increased surgical complexities with increased likelihood of poor outcomes. Less research and/or health education funds.

Research shows that it's really is the calorie intake that matters; we over eat way more than we can compensate for with exercise. If the reward not being obese is not self evident, perhaps it means MORE food processing to take out calories while maintaining nutritional needs and inducing a sense of satiety. I'm not talking about deceitful marketing or emphasizing of one nutritional aspect in the face of overwhelming lack of value for calories (like chocolate milk and twizzlers). I'm talking about more intrinsic single serving packaging like precut pizza made with low fat cheese and salt substitutes with flash freezing for optimal palatability. Prefer pop/soda? Make it with stevia (natural has a better image!) and load it with nutrients. Many people denigrate food research because it is done by multi-national, profit based food companies. This is like denying the good that has come out of medications because they are developed by multi-national, profit based pharmaceutical companies. Use food processing to help those people who are not going to take the effort to garden, prepare raw food, measure serving sizes and all those other things that go into healthy eating habits.

I would like everyone to be more like me. Making the choice to eat healthier foods in moderate quantities. Exercising for fun and all that. But that's not realistic. Instead of using an authoritative control for a widespread problem, play into the behavioral aspect. Making the low calorie choice convenient, attractive and tasty may seem like giving up or giving in but what am I losing? The ability to be judgmental about people who make different lifestyle choices? Sure but I'm also hoping to lose the strain on the health care system and see people live with less medical intervention.