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The Big Picture – Again!


Posted on December 28th, 2012 by Jeff Thiboutot M.S.

I read a good paper this weekend, I know you’re jealous (I think I might need to start wearing brightly colored mismatch clothes). Anyway, the paper is; Time to abandon the notion of personal choice in dietary counseling for obesity? (Appelhans et al). The basic premise  is that people who struggle with maintaining a healthy weight are not lazy or weak willed. But rather, are strongly influenced by forces, biological and environmental, that they are often unaware of. These factors influence behaviors in a way that makes it very difficult to achieve a healthy weight. Therefore, just telling someone to eat less, exercise more, even with specifics attached (i.e., 30 grams protein per meal, exercise for 30 min, 3 times a week, at 70% of MHR, etc), is likely not enough to overcome these other mitigating factors.

The paper covers three particular areas;

  • 1-food reward
  • 2-inhibitory control
  • 3-time discounting

At this time I am not going to go into detail on each of these. In fact, I would recommend reading the paper, as the authors did a good job of summarizing the research on these topics.

What I think is important is the understanding, or realization that there are many things that can influence eating and exercise behaviors (actually ALL behaviors). Additionally, these tend to influence us on the unconscious level, so we are not aware of their influence while it is happening. This obviously makes it hard to modify their impact while it is happening. However, there is hope. There are strategies that can be utilized during a time when your conscious/rational mind (often referred to as System 2; see Kahneman) is in control.

This gets me thinking about a great book that came out a few years ago. I think it starts with an S….Oh ya, I got it now, its called SPEED! I hate to be so self-promoting (well actually I don’t hate it, but it always feels a little weird talking about yourself),  but Matt and I really did tackle the weight loss thing in a way that virtually nobody else was. We didn’t do this to be different, but rather because the evidence was clear to us that there are many things besides “low carb vs high carb” or “weight training vs cardio” or any of the many other dietary or exercise variables that are often discussed ad nauseum (To be clear, there are aspects within these components of weight management that ARE important, however, an excessive focus on them will result in an oversight of other equally or possibly more important aspects of weight management) . We felt there was a need to view the weight management thing in the context of the Bio-Psycho-Social model of behavior. There are a number of researchers that stress this view as well (see Dr. Guyenet for some good posts about it). However, this approach is usually not taken in the popular press. Well, until SPEED (ooops I did it again). This is probably due to the fact that this view acknowledges that weight management is actually very complex (see this post for a bit more on that) and does not lend itself easily to simple solutions or catchy sound bites.

To conclude, weight management is actually a rather complex situation which is heavily influenced by factors functioning below our conscious awareness. This does not mean it is hopeless. There are things that can be done that will help a person minimize the influence of these unconscious aspects of behavior.  I think there is a good book call SPEED that discusses many of them :)

References

Appelhans, B. et al (2011). Time to abandon the notion of personal choice in dietary counseling for obesity? J Am Diet Assoc; 111(8): 1130-1136.

Kahneman, D. (2011). Thinking, Fast and Slow. New York. Farrar, Straus and Giroux.

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