Ten years ago, right about this time of the year, I was writing a paper about the epidemiology of obesity. I was also conducting some very interesting research on childhood attitudes and behaviors on dietary intake, physical activity, and perceptions of body weight and image. My paper and research was being scrutinized and read by prominent researchers and public health strategists in the field. I was hoping to somehow make a difference toward what seemed like a hopeless situation, at that time, to help decrease the surge in the incidence and prevalence of obesity. At some point in the very long paper, here's excerpts of what I wrote in 2001:
'...the esteemed Secretary of the United States Department of Agriculture (USDA) Dan Glickman...succinctly, but profoundly stated, "our greatest challenge as policy makers and public health advocates remains to translate what the experts know in[to] what people do."...
In order to move global obesity prevention forward, from what experts know to what the people do, two major factors will have to be present:
1) environments --national and global--that enable, invite, and encourage health-promoting, obesity-prohibiting attitudes and behaviors
2) a shift in current responses of the public from obesity-causing attitudes and behaviors-- especially regarding dietary intake, physical activity and inactivity, and perceptions of weight and health -- to desired responses that are more consistent with health promotion and disease prevention.
Both factors are inextricably linked, especially in demand/supply, market-driven countries -- both established and developing. However, the environment needs to change first in order to elicit the desired responses. Obesity-enabling aspects of the environment are so ubiquitous at this point in time, that it is almost impossible, even unfair, to expect people to change. Experience has already proven, time and again, that people do not change, even under what experts think are the most optimal conditions:
1) evidence-based advice/recommendations,
2)appropriate manner to deliver recommendations, utilizing well founded models and theories, such as, social cognitive theory, the transtheoretical model, motivational counselling, relapse prevention...
3)signs from patients/clients of heightened knowledge of untoward effects of disease and benefits of prevention and proper compliance with recommendations.
The fact is, until environments that people live in, can empower them to live the recommendations, extolling the virtues of healthy eating and physical activity habits and expecting people to follow suit, is a futile charade, until behaviors and habits necessary for health-promotion and disease prevention become less "virtuous" and more "normal". Moreover, it is extremely confusing and de-motivating when people hear, read, and see messages from "experts" while society promotes, allows, encourages, and rewards an environment that makes it easier and more inviting to do exactly the opposite of recommendations. This whole dynamic greatly de-values evidence-based information, and renders the hard work and sound advice of obesity experts impotent.'
NOW, BACK TO 2011!
I stand by everything I wrote in the above, to this day, EXCEPT ONE THING....TODAY, I feel very strongly that the factor that NOW needs to CHANGE, FOREMOST, is:
2) a shift in 'responses of the public from obesity-causing attitudes and behaviors-- especially regarding dietary intake, physical activity and inactivity, and perceptions of weight and health -- to desired responses that are more consistent with health promotion and disease prevention.'
You see, the environment HAS changed! I would hope that I had something to do with that -- who knows? I certainly tried my best to work darn hard on that research and paper.
And, of course, we have a LONG way to go and much more still needs to be done, but there has been a fairly decent response from governments, industry, restauranteurs, public health agencies, society, and medical and other health-care communities to make changes so as to enable folks to make better choices. OF COURSE, there are numerous instances of companies acting like they ARE making changes, when, in fact, they are just engaging in tricky marketing, while they still peddle high-sugar, high-fat, low-nutrient, high-calorie foods and beverages -- often with a warped 'health halo' on their respective innovative food or drink.. And, initiatives that proclaim to be encouraging more physical activity backslide constantly. So, we still have fattening foods and opportunities for sedentary activities and lifestyles readily accessible and ubiquitous and there are STILL body weight and image issues GALORE to contend with -- BUT -- thinking and attitudes about obesity-enabling and encouraging HAS, at least, been knocked down a peg or two from when it was running amok and at its 'zenith of nonchalance', in my opinion, from say -- the late 1980's and through the 1990's.
So, the environmental response seems to be a scenario of the 2 steps forward, 10 steps backward 'tug'.
The fact is -- to MOVE FORWARD to SUSTAIN THE MOMENTUM to continue the changes in the 'environment' -- PEOPLE will NOW NEED TO MAKE CHANGES!
YOU will have to make decisions to EAT HEALTHIER, ENGAGE IN MORE PHYSICAL ACTIVITY, STOP WATCHING SO MUCH TV AND SITTING IN FRONT OF THE COMPUTER, and just optimize your behaviors and take full advantage of any and all changes in the environment that have been made.
WHEN YOU --- ALOT OF YOU -- through mass population response, at a continuing and sustained level, show the food and beverage, entertainment and media, exercise and physical activity industries; restauranteurs; civic planners and governments; and health-care sectors that THIS IS WHAT AND HOW YOU WANT TO LIVE -- THESE ARE THE SERVICES AND PRODUCTS YOU WANT -- then all these sectors will have NO CHOICE, but to continue to SUPPLY what YOU DEMAND -- FOR YOU AND YOUR CHILDREN AND YOUR CHILDREN'S CHILDREN and SO ON!!
THEN, my friends, WILL and can the OBESITY EPIDEMIC END!!! It is NOW UP TO YOU!!!
Believe me, I KNOW that doesn't make it any easier to MAKE the CHANGES. BUT, it is what has to happen and it IS possible. If you want to change and feel you need help, get it. If you contact me, I will help you get started.
Someday soon, I look forward to reading -- heck, maybe even writing myself -- a new paper on how the obesity epidemic was eradicated.
I'm really trying, each day, to live my health-promoting, obesity-eradicating changes and behaviors. It's not easy for me, folks, but I'm doing it! I've made MY DECISION(S) to do it.
END THE OBESITY EPIDEMIC TODAY! It's UP TO YOU!!!!!