Monday, November 19, 2012

Weight ("Mis")Management

I had an incredible weekend: the kind where it was so simple and so relaxing that I have hope it can happen again and again and again and...

The best part is that I've been able to start my Monday off with the most clarity that my mind has had in a very, very long time.  It's a great feeling to sit down at my computer and have a refreshed sense of being and wanting to really dig in to my research rather than just peck words into Google and hit "search" and calling it "work".

Today, I am reading an Acceptance and Commitment Therapy for diabetes self-management therapist manual by Jennifer Gregg, Steven Hayes and Glenn Callaghan.  I only got a few paragraphs into the background before my mind started going off on tangents about why it's so damn difficult to control the behavior that affects our health.

So, being the visual person that I am, I started playing around with trying to put it into picture form.

Basically, I started thinking about the typical weight loss program.  The participant is told "Eat less. Exercise more."  Easy enough, right?  Ehhhh, well...  

What you see in this picture is that I made a rectangle and split it exactly in half.  On the left side, I plopped in two hexagons to represent the diet and exercise that an individual must focus on inorder to have the desired effect on their weight.  I had plenty of room to type a note to myself and have a representation of diet, exercise and the individual.  

But, then I wanted to see a more accurate picture of what a typical person is dealing with because it's unfair to assume that anyone can devote all of their attention to just trying to lose weight or maintain weight.  I didn't have enough room to squish in all those factors that influence our ability to manage weight... in fact, the circle that is labeled "individual" (ironically) is being pushed out of the picture!  

Oooooh!  Ahhhhh!!!

So, here's what I'm thinking:
As we look at factors influencing an individual's ability to manage weight, we see that when we look closer there are so many things that the individual gets crowded out!  *ACT/IE can help put the individual at center of their own life.  It gives them a point of view where they can handle things as they come rather than being overwhelmed.  Skills learned can help a person not only moment-by-moment, but also help them plan for the future.
Over the next few weeks, months, years I'll work hard to keep in mind that weight management isn't simple.  With that in mind, I need to help come up with a simple way to help people with a complicated issue.  Otherwise, it won't work.  Bariatric surgery, diet pills, and fad diets are "easy" solutions, but they come with nasty side effects.

I have a hunch that helping the individual learn to take a hot second to assess the present moment and act in a way that they nod to what they value is sooo crucial.  But, it's not enough.

It's tough to battle all those forces (on the right side of that picture above, plus all the ones that are missing) day after day after day by yourself.  It doesn't have to be/feel that way, though.  Social support is great.  Having a friend or family member that values healthy living can be great motivation to make decisions and carry them out so that the outcome leads to weight management (a.k.a. health maintenance/improvement). Yet, I don't think it's enough support for entire populations on a quest to be healthier.  I truly believe that we need to tackle the factors related to climbing obesity rates from many directions.  For example, making cheap, tasty foods less available (do you ever walk around and notice how readily available food is?!) or downsizing food packaging.

That last part, downsizing food packaging, has never been more obvious to me than now.  Living in New Zealand has been GREAT for observing differences between here and the United States.  The availability of foods in large packages is so much less common here.  I think that if the large package sizes of common foods (like peanut butter) were available in the large jars that we see at home then New Zealand's prevalence of obesity would match the U.S.

Now, ain't that food for thought?


*Acceptance and Commitment Therapy researchers have suggested that people avoid their overwhelming thoughts rather than accept them as thoughts.  When it comes to eating behavior, we may avoid our overwhelming thoughts/cope with these thoughts by eating.  In a culture where food is tasty, cheap and readily available it is no wonder how easily we can self-medicate with food; but, rather than overdosing and facing instant death, it's a slow process that leads to high blood pressure, diabetes, cancer and all sorts of problems that we don't see until we're further down the road.  Deciding, now, what we value may help us change our course of behavior when we have thoughts that conflict with our values.  Cool stuff, eh?