On a post about the BBC’s Men Who Made Us Fat, I wrote that I don’t think that nanny statism is the way to go wrt addressing obesity. Commenter P2ZR asked:
So what do you think *is* the solution? (Not a leading question whatsoever. I really have no idea if there is a solution that isn’t monstrously complicated.)
Well, I’ve mentioned before that I think obesity is a wicked problem, and as such, I don’t think there is a simple solution. In fact, just today Merrill Lynch published a report looking at a 25-plus year “global obesity investment megatrand” theme. So no, there’s no easy solution and part of that is because some solutions (e.g. the $4 billion diet industry) probably make things worse, not better.
As far as where *I* would put my energies, it wouldn’t be towards direct government interventions. While I respect a lot of folks who are invested in this work (like Marion Nestle or Kelly Brownell), it’s not for me.
However, this is NOT because I have any inherent opposition to nanny statism (truth told, I’m a bleeding heart liberal who is just fine with some government intervention).
No, I can’t get too excited about regulation as a solution for health because I think it’s an exercise in futility. I need only point to Ezra Klein’s recent why this is the worst Congress ever as exhibit A. And anyone who thinks the upcoming November election is going to change things in a meaningful way is far more optimistic than I.
So, if government regulatory efforts are tilting at windmills and corporations will only respond to market pressures then what’s left is changing the market.
Simple? No. Easy? Hardly. But I think there are reasons to consider such an approach, at least one simultaneous to other interventions.
The Tipping Point
I’m intrigued by the idea that there’s something to be learned from Rogers’ diffusion of innovations theory. You may be familiar with this because of Malcolm Gladwell’s The Tipping Point (if you’ve read my About page, you know that I chose the name “Weight Maven” because of Gladwell’s book).
There’s a LOT to this theory, far more than I’m sharing here. But a key idea is that technology adoption follows a basic path. And once a technology gets past the “tipping” point, there’s a kind of “they told two friends, and they told two friends, and so on and so forth” effect that generally leads to wider adoption by the marketplace.
This concept is illustrated cleverly by this Tom Fishburne cartoon, where the “chasm” represents the tipping point:
Of course, choosing to eat a healthy diet is not deciding to buy an iPad, but I think there are useful parallels.
And one of the things that really intrigues me about this is what we are already seeing with folks adopting real food diets and resolving various weight and health issues. And thanks to a technology that has been widely adopted — the Internet — we now have a way for a message about food and health to go viral in a way that doesn’t require governments or the media to lead or even be involved.
At this point in time, I’ve not really noodled through this seriously or written it up in any meaningful way, but in answering the question “what do I think is the solution?” it’s this. Diffusion of innovations theory suggests strategies (and roles such as change agent or opinion leader) that may prove valuable for those who want to change the health environment.
And it’s social, it’s in communities, it’s in the cloud, it’s real people having real success and having the word get out.
Worse before it gets better
While I’m intrigued by this conceptually, I do have to say that I am worried that it’s going to get worse before it gets better. It was all well and good for us to get fat and sick overeating processed food products like a 2300-calorie piece of cake while the health industry was making a boatload of money treating us.
But the gravy train for the health industry is running out. This is especially true now that the pig-in-the-python that is the Boomers is starting to wind its way through Medicare … just when chronic disease from poor diet really starts getting expensive.
Couple the increasing health costs with the fact that there’s no meaningful incentive for the food industry to change (acting now is counter to their bottom line), and we’re really in deep doo-doo. Instead of action, we get talking points.
In future posts I’ll probably tackle more on this subject, including 1) how a tipping point outreach might differ from behavior education; 2) why the food industry is laughing all the way to the bank while we squabble over paleo vs vegan, low-carb vs low-fat, and so on; and 3) interesting parallels between this and historical anti-smoking efforts.
Weight Maven is written by Beth Mazur. Beth believes that obesity is more symptom than cause and that the real problem is our Western diet -- especially sugar, refined grains, and industrial oils. Beth writes about nutrition, ancestral health & food policy. And cats! 
Beth, you said: I don’t think that nanny statism is the way to go wrt addressing obesity.
You also said: Couple the increasing health costs with the fact that there’s no meaningful incentive for the food industry to change (acting now is counter to their bottom line), and we’re really in deep doo-doo.
I agree about nanny statism. However, when IS the food industry going to change? I believe it’s unfortunate that many changes come about only because of regulations.
Well, the food industry will change if forced to, but if you look at the pushback whenever that’s tried (ref Bloomberg’s soda regs or really?? McDonalds is able to prevent anyone from selling *fries* at the Olympics?), it’s not promising. It’s not like us changing is a much rosier picture (lots of people like their 2300-calorie cake), but it’s pretty clear the industry will change if they see a market for it.
How can government provide a solution when there is no agreement on the root cause?
I’d like to see a list of all the potential root causes for the obesity epidemic as theorized by the nutrition enthusiasts in the paleosphere. Several that come to mind: BPA, excessive fructose, high-reward . . .
Kirk, I think Shft’s obesity system influence diagram is pretty compelling.
And yes, it is very hard to provide a solution without a clear cause. Government can try and address something that likely contributes — like soda — and winds up spending boatloads of time and money defending their choosing a single contributor.
I am constantly surprised at the lack of awareness about what the “food” industry is doing to food. I focus on it so I am aware. And I do not consume traditional media (or am very judicious with it) so I’m not being indoctrinated with the hype/clever marketing.
There is still SO MUCH work that needs to be done in terms of education. A good example is my stepdaughter, who has a 15-month-old son. Just yesterday she brought him over and some food for him, as well. One item was “no sugar added” (blazoned across the front) mandarin oranges. Well guess what? They were “sweetened” with Splenda and other “artificial flavorings” and still had six grams of sugar and 4 grams of “sugar alcohols.” She feeds him all kinds of other processed crap and I just don’t know how to approach it with her :-(
Lately the kid has had hives and diarrhea…sigh. Not to mention that he may now be lactose intolerant so she’s giving him soy milk, which is a whole ‘nother ball of wax.
I try and model healthy eating (and not from a weight loss perspective) so I can only hope it gets through. I’ve suggested to her that she take him to my naturopath but she says she trusts her pediatrician.
Looking forward to reading more posts Beth!
I sometimes think our dread of nanny statism is exactly the thing that keeps us from addressing obesity. The minute someone suggests that eating a 2300 calorie piece of cake might be something you should pass on, there are all kinds of folks lined up to eat it just because you can’t tell them what to do.
The tech adoption analogy is intriguing. But (1) the perks of becoming healthier aren’t always evident to the outside observer (cf. ‘lookit my shiny new iPad!!’), and focusing on the easily visible-superficial-markers of health (e.g., weight loss) might be counterproductive. And (2), the dividends reaped by adopting the new practice can vary wildly for different people; I’m reminded of Paul J’s quoting of Tolstoy (health is health; unhealthy people are unhealthy in their own different ways)-so the regulations would have to be watered down to some common denominator that is far less useful than anyone’s ideal.
Also, this: ‘I’d like to see a list of all the potential root causes for the obesity epidemic as theorized by the nutrition enthusiasts in the paleosphere. Several that come to mind: BPA, excessive fructose, high-reward . . .’
It’s this sort of desire for reductionist micromanagement that puts me on edge. Not to digress into epistemology (aka pedantry ;P), but there has to be a more systemically-oriented (if not systems[!!]) approach to this. Start with Michael Pollan, and many troublesome things like excess fructose, excess reward, and BPA will be sorted out in the process.
P.S. I promise I’m not a nihilist!-this is such an important but very tangly discussion. Thanks for keeping it alive :)
Call me a cockeyed optimist, but while health isn’t visible to the outside observer, weight most definitely is. I read lots of HAES blogs, and I’m very sympathetic to their point that dieting should be avoided because most weight loss efforts fail. But if people were actually to be successful losing weight, and more importantly maintainingtheir weight loss, that might create some buzz.
Here may be your one simple solution: EAT REAL FOOD IN SENSIBLE PORTIONS. Now all we need is mass education on what real food is, and where it comes from.
I think eating real food is definitely the solution, because I think that’s key to our body being able to use the mechanisms evolution has designed for maintaining an appropriate weight. Processed food hijacks those.
Of course, it’s not really that simple. People need to want to eat real food, and *that’s* where the challenge will be.