The error in the “eat less, move more” paradigm

The alarming rates of obesity have brought huge attention to trying to find effective treatments for this major public health issue. As you may know, much of the current research here in the DiSH lab investigates the implications of weight stigma on health, as there seem to be widespread misconceptions regarding the causes of obesity, as well as how we can go about solving the crisis.

In a commentary published in the journal Lancet Diabetes and Endocrinology, a group of physicians from the medical faculties of University of Colorado, Northwestern University, and the University of Pennsylvania, challenges the commonly practiced “eat less, move more” treatment for obesity, and states that for people who have stayed obese for more than a few years, this treatment is a prescription for failure.

When thinking about effective treatments for obesity, it is easy to neglect the distinct biological differences in formerly obese people and people who have maintained a normal weight their whole life. The body responds to weight loss with adapted defense mechanisms that are all directed at trying to return to the highest sustained weight. This leads the commonly held “eat less, exercise more” belief to fall short in reality, as previously obese people will constantly be at war with their bodies even long after dieting has stopped.

This disappointing reality is however well known to obesity researchers, and you may wonder why this group of physicians wanted to further bring up the topic?

“It’s not just that most people still stigmatize obesity–as they say, it’s the last acceptable form of stigma,” said Ochner, one of the physicians. “What really bothers me working around and with clinicians, is that some of them–a disturbing percentage–still believe it’s all about personal choice: that if the patient just tries hard enough, and if we can just figure out how to get them a little more motivated, then we’d be successful. And that’s just not right.”

Lifestyle changes are undoubtedly a necessary condition for enduring weight loss, Ochner said. But they’re far from sufficient, and when physicians believe they are–when they say “you already know what to do, I told you what to do,” he said–“that’s certainly cruel, and it’s harmful: It prevents them getting the care they need.”

Physicians should acknowledge the biological challenges of keeping weight off by emphasizing on intervening earlier, and try to prevent overweight people from becoming obese, Orchner states. Additionally, they should recognize FDA approved medications, surgery and device-based treatments as supplemental alternatives. Orchner also emphasizes the need to focus on weight-loss maintenance as a part of obesity treatment, and states that this highly necessary aspect seems to be neglected by most physicians.

In conclusion, the group holds that it is a lack of understanding when it comes to the broader causes and consequences of obesity that prevents many potentially beneficial treatments from being considered and developed, and that this is underlined by a deep-rooted stigma that is even maintained by physicians and other professionals in the field. Read the full article here!

Dr. T featured in U magazine!

Our very own Dr. T, along with Dr. McCurdy, staff psychologist with the UCLA Eating Disorders Program,  were featured today in UCLA’s Health magazine! They discussed the role of psychology in obesity, in particular the implications of stigma and prejudice towards overweight people. What’s the relationship between who we think are unhealthy and who actually are unhealthy? What’s the role of stress in obesity?

Check out the interesting conversation here!

“How am I doing?” – Why tracking your goals might be harder than you think

Does eating a carrot do more good than eating a doughnut does bad? That is what people tend to think when they’re on a diet, at least according to these researchers from the University of Colorado, Boulder. They call their finding the “progress bias”, and what it basically means is that people tend to over-exaggerate the positive and downplay the negative when they’re considering how their doing in terms of goals and progress.

Especially now that the new year is here, a lot of us have made the vow that this will be the year where we finally start losing weight, saving money, or begin exercising. Engaging in behaviors that help us get closer to the goal, so called goal-consistent behaviors, feel like big accomplishments, while behaviors damaging to the goal, might not feel like they are equally negative. One of the many reasons why the process of dieting can seem so maddening could be that we think we have made all the right changes, but still we don’t see the desired results. This study points to one of the reasons why: maybe we aren’t as successful in working towards our goals as we think we are. Statistics suggest that as many as 45% of Americans made New Year’s resolutions this year, and also that the majority of these people will fail. Apparently we find it all too easy to close our eyes to the bad and only focus on the good, leaving us with an unrealistic idea of how we are doing. No wonder dieting is so frustrating!

Are there ways to overcome the progress bias, one might ask? “Monitor, monitor, monitor”, Margaret Campbell, one of the lead researchers, says. “For example, dieters need to pay close attention to calories in and out – both aspects – during this tempting time to keep from falling prey to the bias”.

If that is not really your thing though, it helps to know that the bias might be a motivator to some, as we are bound to have some relapses during times of change, and this helps us from lingering on our failures and look at the bright side. Check out the article here to get the full image of what else this bias might do!

Aaron RA blogs: It’s the Little Things that Matter

We are often told that in life it is the little things that matter, and this saying applies readily to health psychology. In two studies, one conducted right here in the DiSH Lab and another one in Sweden, it was found that using negative language and stigmatizing overweight individuals was directly correlated with weight gain.

Here in the DiSH Lab, a study was conducted recently which found that being labeled as “too fat” in childhood was a significant predictor of obesity in early adulthood (almost a decade later). In a related study in Sweden, researchers found that a significant increase in BMI was associated with individuals with severe obesity who were also stigmatized for their weight in the health care setting.

These studies underscore the idea that these “little things” like labeling and the language we use to describe others are not so little after all. Just being told you are overweight, or having your weight spoken about in a negative light, is correlated with weight gain in the future, and that doesn’t help anyone. In order to curb this problem, maybe it is time to start using more positive language and thinking about how what we say and how we act towards others really can affect them in the long run. In addition, more research being conducted on stigmas, body image, and the effects on weight could bring about very helpful information about how these issues relate to one another.

 

Blog by Aaron Lapidus

Bernice RA Blogs: Weight stigma does not reduce obesity

As one of the top public concerns in United States, obesity draws huge attention from social media, and unfortunately, most portraits of obese people are linked with negative characteristics, such as lazy, weak willed and self-indulgent. However, some public health campaigns claim that stigmatizing obesity may encourage people to lose weight and such belief contributes to the prevalence of weight stigma. On the other hand, there are experimental evidence that shows that weight stigma may lead to both psychological and physiological consequences. A recent study by Dr. Major supports the latter proposition.


Major’s study shows that women who perceived themselves as overweight, and were randomly assign to read a news article about the stigma faced by obese people feel less capable of controlling their eating, and consume more calories during a fixed waiting time, compared to women who perceived themselves as normal weight. Moreover, exposing one to weight stigma by reading news causes both women who self-perceived themselves as overweight and those who self-perceived themselves as normal weight to be concerned more about being a target of stigma.


Such result implies that weight stigma is not a possible solution to reduce obesity. Rather, it leads to weight-based identity threat among self-perceived overweight people, and consequently, the threat and concerns cause those folks to become more prone to unhealthy eating or weight control behavior. The only way to break such vicious circle is to reduce public weight stigma and alter the self-perceived body image.

Blog by Bernice Cheung 

Ilana RA Blogs: Freshman 15?

As we are just beginning our third week of the quarter, a relevant topic to address with all the new bruins around is the dreaded “Freshman 15”. Is this weight gain something to be concerned about or is it just a myth?

According to an article by Hovell and colleagues entitled, “Risk of Excess Weight Gain in University Women: A Three-Year Community Controlled Analysis”, researchers compared a group of freshmen women living on campus to a group of freshmen women living in the community. Results of the study found that the freshmen living on campus were almost three times as likely as the women living in the community to gain weight; however, by their junior year, the women who initially lived on campus were almost back to their baseline weight. This return to their original weight was attributed to moving away from the buffet-style food and going back to a more regulated eating pattern.

In another instance, a researcher named Cecelia Brown found through examining peer-reviewed journals, magazines, and newspapers that half of the popular press state that freshmen gain 15 pounds. In actuality, the 14 studies in the peer-reviewed journals revealed that the average weight gain in freshmen was less than 5 pounds. The press seemed to make out that the weight gain was much higher than in reality and constantly reinforced the fear of the “Freshman 15”.

All in all, it is definitely easy to be tempted with all of the dining hall food and the new freedom that comes with living away from home. However, the fear of gaining weight itself and the term “Freshman 15” can cause a lot of harm through the self-fulfilling prophecy. The bottom line is to make smart choices and not get too preoccupied with gaining weight. Get out there…enjoy the sights of Los Angeles and stay active. The “Freshman 15” will soon be a thing of the past!

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Blog Post by Ilana Greenberg

It’s Weight Stigma Awareness Week!

According to the Binge Eating Disorder Association (BEDA), weight stigma is “what a person experiences when weight bias is internalized as being ‘deserved’.  This occurs frequently today, resulting in larger people feeling shame, anxiety, depression, and self-hatred. These diminish a person’s body esteem and motivation for self-care.” 

That being said, weight stigma is a highly prevalent and serious problem, making it critically important that people learn more about this weight-based discrimination. Luckily, to help spread the word, this week is BEDA National Weight Stigma Awareness Week! Click the link here to see what else BEDA has to say. In addition, if this topic interests you, be sure to also check out the following papers on weight stigma by Dr. T!

-Tomiyama, A. J. (2014). Weight stigma is stressful: A review of evidence for the Cyclic Obesity/Weight-Based Stigma Model. Appetite, 82, 8-14.

In 1 Bite: Weight stigma feels bad, but could it even result in weight gain? Dr. T constructs a model to explain this vicious cycle.

-Tomiyama, A. J., Epel, E. S., McClatchey, T. M., Poelke, G., Kemeny, M. E., McCoy, S., & Daubenmier, J. (2014).Associations of weight stigma with cortisol and oxidative stress independent of adiposity. Health Psychology, 33, 862-867.

In 1 Bite: Can weight stigma get under our skin? This study examines the relationship between weight stigma and biological stress and long-term cellular aging.

Dr. T on Comfort Eating

We are all guilty of using food for comfort at one time or another. But does comfort eating actually work? Amazingly, it really does!

In the words of Dr. T:

“Comfort-eating rats showed dampened biological stress reactivity in a stress system called the Hypothalamic-Pituitary-Adrenal (HPA) axis. Sustained over-activity of the HPA axis is associated with poor health, and these studies suggest that comfort eating is playing an important role in managing an organism’s stress levels.

The implications of this are enormous. If comfort eating functions in the same way in humans (the human literature is in its infancy, but my research and that of others offers preliminary evidence that comfort eating is associated with dampened HPA activity), then we need to substantially shift the way we think about stress eating.

Stress eating is currently treated like a villain, a negative health behavior that we should intervene to eradicate at all costs. The science of comfort eating, however, indicates that we may be engaging in this behavior for very good reasons, and that eating that brownie might mitigate the negative health effects of stress hormones—which may be even more harmful in the long-term than a few extra calories.”

Click here to check out what else Dr. T has to say on comfort eating! It’s highly relatable and also at the top of the RWJF Human Capital Blog today! Go Dr. T!!

Angela at #APS14SF

What is DiSH lab doing this weekend? Some of our team traveled north to San Francisco, CA to attend the Association for Psychological Sciences 26th Annual Convention. As part of a fun foodie symposium focused on challenging lay theories about eating, Angela C. Incollingo Belsky gave a talk titled Profiling personalities of long-term calorie restrictions: Why dieting may not be the cure for the “obesity epidemic,” where she discussed the individual differences potentially underlying successful dieting in a unique group of long-term calorie restrictors. Her results show that the CR participants are more likely to have psychosocial profiles demonstrating high future time orientation and low hostility and neuroticism. These results suggest that dieting may be a viable weight loss option for only individuals with certain personality traits, thus dieting might not be the most effective way to cure the obesity crisis.

Taking Angela’s talk into consideration, it is important to realize that dieting isn’t for everyone and we shouldn’t blame the failed diet on the dieter but rather question for what type of person dieting is even a recommendable option. You can read more about this study and the results here.

 

 

National News Coverage on DiSH Research!

What’s all the buzz about? Our fabulous DiSH lab team: Dr. T and Grad student Jeff Hunger! The recent publication of their article “Weight Labeling and Obesity: A Longitudinal Study of Girls Aged 10 to 19 Years” captured the attention of major news outlets from all around the world.  Huffington PostHealthfinder, Yahoo News India, LA Times, Reuters Health, Canada News and Science Daily are just a few that covered their study.

We’re going national! And it’s a good thing that we’re reaching people who are not only from the United States. Many people do not understand the long-term effects of weight labeling and it’s correlation with obesity. Often times, parents and such, engage in negative feedback such as calling their children “fat” and hoped that it might act as a motivator to help them lose weight. However, results from  Dr. T’s and Jeffery Hunger’s study indicates that young girls who are called or labeled “too fat” are more likely to be obese ten years later.

The study looked at 2,000 young girls at age 10 and followed them over nine years. Over half of the girls were labeled “fat” and reported that of those remarks, 60 percent came from family members and 40 percent came from friends and teachers. It seems that weight labeling is an independent predictor of weight ten years later.

So stigmatizing weight isn’t going to help people lose weight. What then should parents, family, and friends say instead of labeling their loved ones as “too fat?”

In the words of Dr. T:

“I think the focus of the conversation needs to change. Right now, we have a laser focus on weight instead of health, but many studies show that weight is a really imprecise indicator of actual health. Parents can talk to their child about adopting healthy behaviors without once mentioning weight.”

For more information, watch Jeffery Hunger’s live interview with Huff Post!