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.
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.