Where we get fit and spin (wool)

Archive for September, 2013

I Don’t Even Know What to Say

I just saw this article about a 2 year old getting bariatric surgery. They included images:

picture of an obese 2 year oldI don’t know about you, but my knee jerk reaction is “what’s wrong with the parents?” I have no doubt there is something there, but I can’t say that tells the whole story. We do know that obese parents are more likely to have obese children. I would lay that at the door of environment, rather than genetics. You don’t get obese without practicing certain habits. Anyone can get overweight without really trying, but obesity, defined as a bmi over thirty, takes overeating and underexercising with a certain amount of effort. You have to see a trend and continue to persist in that path, despite the consequences. The larger you get, the more calories it takes to maintain, so you have to increase your eating to continue to gain weight.

Having said this, we now know that genes are responsible for certain aspects of hunger and satiation. ghrelin and leptin are two hormones that control appetite. The production of, and sensitivity to are influenced by both environment and genes. It is a chicken and egg scenario though, does over eating reduce your sensitivity to leptin, the “full” hormone? Or were you already desensitized, and that’s why you got obese? We know that ghrelin makes you crave high calorie foods, but does eating those foods make you produce more? We are only starting to see the full picture on this. Here is a link if you’d like more.

Getting back to this poor little boy. As much as I would like to say this was child abuse, it may just be the state of our world for some time to come. I’ve seen in heavy families that not all members gain the same amount of weight. In one family, the older boy was very obese, and the younger perfectly normal. I’m certain both were faced with the same food choices, and the one could not stop, whereas the other could. Of course we want to educate parents about good food choices, and encourage making the right choices, but are they faced with a child who is constantly hungry? I’m not letting them off the hook, the child did not feed himself, but how hard was it to resist a child who is always crying for food? I know, you’ll say- if they were feeding him vegetables he couldn’t have gotten that big. What is my granddaughter eating? Yogurt, raisins, Cheerios, cheese, and what the rest of the family eats. If she binged on those things, could she eat enough to get obese? I would think it’s possible. If her mother was not smart about food choices, and there were chips and ice cream, hot dogs with buns and other high calorie, questionable choices, and she was faced with a child who just kept wanting more, I think it would be easy to go to far.

What do you think? Should we just give the parents a blanket indictment? What are the long-term consequences to this little boy and his health from this surgery? Is that better or worse than what he’d face with uncontrolled obesity?

Behavior Modification and Feedback

I have been using the Fitbit Flex along with the Myfitnesspal app to track and monitor my fitness. I’m not trying to lose weight, I am already at an appropriate weight. I started doing this in order to have adequate experience to help my clients who are trying to lose weight, and just because I’m curious.

I’ve made several discoveries from this. First, it is addictive. Normally, I try tracking things and lose interest rather quickly. Since the software provides lots of feedback, with it’s  charts, graphs and goals, it creates motivation in me to reach those goals. I have started recommending some kind of tracking software and hardware to all my clients. Doing this tracking has changed my behavior, possibly permanently. I will go for a walk at the end of the day, even if I’m tired, just to up my step total. I won’t eat something if I see I’ve reached my calorie goal, or I will make a lower calorie choice to keep from going over.

The extrinsic reward of seeing the happy face on my phone is powerful. If you wonder how strong of a motivator could that be, ask anyone who plays video games how important hitting a certain score is, or clearing a level. This is the same motivator, only with a real world application. I feel very strongly that we should harness this behavior pathway to change our society. We keep talking about the obesity epidemic, and I think this is a potent tool to counteract the social trends leading to obesity. We talk about the difficulty of getting kids to lose weight, this would be a way to reach them without shaming, embarrassing  or harassing them. They could monitor their own progress, and own the whole process. There could be an app that gives a visual reward when they reach their calorie goal, that would be removed if they go over. Food choices could earn them points, and every day and every week they could improve their score.

I don’t see a down side to this use of technology. Too many people tell me, “oh, I eat all right”. Or, “My nutrition’s ok”. Looking at them, I don’t believe it. People need real feedback to know where they are. We all have rose colored glasses on when thinking about our eating.  Once you have a mirror held up to your behavior, it does change.

Another potential use is research. So often research suffers from bias, when the subjects put down what they think the researcher wants, or what vanity dictates. We have millions of people keeping digital logs. If researchers were allowed anonymous access, what could they glean from all of that? I’m not saying all those logs are terribly accurate. If I go to a buffet, I just quick add 600 calories, rather than try and log each food. That’s average for what I normally eat in a meal, and I figure it covers it. Could it be a lot more or less? Sure. I’m certain most people out there are like me,  guesstimating amounts, rounding portions up or down and leaving things off. I’m under my calorie goal most weeks. If that were really true, I would be losing weight, and I’m not, so we know there’s some fudge factor in there somewhere. Still, it is better than a questionnaire sent out once a week, or once a month, asking people to remember how much they ate.

 

I’d like to know what you think. Do you use tracking software?  What software/hardware do you use? What do you like or dislike about it? How has it changed your behavior? Do you feel good about how it’s changed you? What was your biggest surprise? How accurate do you think it is?

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