Psychological Dimensions of Childhood Obesity

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A web page titled “Confronting Childhood Obesity” asserts that diet modification and physical activity are “key,” and environmental conditions are important too. The page discusses food deserts, the dearth of exercise facilities in poor communities, the fear of crime, and the lack of physical education in underfunded schools. It urges parents to advocate for increased community policing and the removal of vending machines from schools.

On the home front, it advises parents to serve nutritious sit-down meals and to limit screen time. It mentions the harmful impact of food advertising.

That page originates with the American Psychological Association and, strangely, although the subject is confronting childhood obesity, it says nothing about the intersection between childhood obesity and psychological problems. A parent who seeks advice about what kind of psychological help might prevent or reverse childhood obesity will not find it here.

Moving on

As outlined by Medical Daily, a government guideline, in the process of being updated, advises treating child obesity with behavioral programs rather than drugs. This recommendation comes from the U.S. Preventive Services Task Force, an “independent panel of experts that guides nationwide screening practices.”

Two drugs are widely prescribed, the panel learned:

It found that metformin, a type 2 diabetes drug that doctors are increasingly using to treat obesity in children and adults, had a small degree of success, but that its long-term effects haven’t been adequately studied. Similarly, they concluded the drug orlistat, explicitly approved by the Food and Drug administration for treating obesity in people 12 or older in 2012, was lackluster and carried “moderate harms.”

Incidentally, the so-called moderate harms admitted to by orlistat include “abdominal pain or cramps, flatus with discharge, fecal incontinence, and fatty or oily stools.” Wow. As if an obese kid doesn’t have enough problems already, with this drug, she or he can worry about whether each new day’s school experience will include simply sharting, or perhaps dumping a full load in the pants. What a gift for the class bully!

The “intensive behavioral interventions” recommended by the USPSTF include bringing the whole family together for nutritional counseling sessions, better education on interpreting food labels, and supervised exercise. But as Dr. Pretlow has expressed time and time again, young people possess information that should be more than sufficient, if information were the essential factor.

Kids are knowledgeable about calories, and know why apples are better than chocolate-covered bacon, and have correctly answered questions about these topics and passed their tests in Health class. Yet the obesity rate remains impenetrable. Additionally, it seems that, in order to make a difference, at least 52 contact hours are needed per child. Fifty-two hours is the threshold that defines “intensive,” and represents a large investment to be undertaken by any cash-strapped school system.

Other behavioral interventions recommended by the USPSTF are the use of stimulus control, which translates as “limiting access to tempting foods and limiting screen time,” measures which are pretty much under parental control. Also recommended are goal-setting, self-monitoring, contingent rewards, and problem solving.

But here is the main problem to be solved. Motivation has to come from within, and something has to spark it. The drawback of behavioral interventions is that, unless the subjects are in a very restrictive environment like boot camp, people can’t be made to do things. The question of how to lead people to do things voluntarily, because they want to, is still very much a dilemma.

Your responses and feedback are welcome!

Source: “Confronting childhood obesity,” APA.org, undated
Source: “Treat Childhood Obesity With Behavioral Programs, Not Drugs, Says Updated
Government Guideline,” MedicalDaily.com, 11/02/16
Source: “Draft Recommendation Statement,” USPreventiveServicesTaskForce.org, November 2016
Photo credit: Cariffiti via Visualhunt/CC BY-ND

Mood, Food, and Funny

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Elizabeth S. Bast and Elliot M. Berry studied the relationships between obesity and the “hypothesized mechanisms” of emotional eating, and combined that knowledge with research to suggest that…

[…] the role of humor as a possible tool for aiding those in whom emotions, particularly negative ones, trigger eating as a means to improve mood. We then review the field of therapeutic humor and its ability to de-stress individuals, possibly through endorphin and opioid systems, both of which are also involved in eating behavior.

What they are getting at is the possibly that people could use humor as a “food substitute” — that humor can somehow serve as a no-calorie replacement for chocolate-covered bacon.

They call it a “novel hypothesis,” but it isn’t. Hippocrates said, “Let food be thy medicine,” and the Bible’s Book of Proverbs said, “He that is of a merry heart has a continual feast.” An old Jewish proverb said, “As soap is to the body, so laughter is to the soul.” Lord Byron called laughter “a cheap medicine” and Henry Ward Beecher called it “God’s medicine.”

The idea that food and laughter are equally capable of providing nourishment and curative power is an old one. In more recent times, Madeleine L’Engle said, “A good laugh heals a lot of hurts,” and Fred Allen uttered the seemingly cryptic but very telling formula, “It is bad to suppress laughter. It goes back down and spreads to your hips.”

The authors of this paper sum it all up by saying:

We propose that the phenomenon of emotional eating and the therapeutic potential of humor overlap in the domain of stress activity and management.

Anyone who wants to study something like this first needs to sort out the emotional eaters from the normal and restrained eaters, and there are tests for that. Emotional eaters, not surprisingly, are into hyperpalatable foods with plenty of sugar and fat, and share the traits of hope and expectancy that life will seem better if these things are consumed. One of the interesting things researchers have discovered is that the dynamic can work the other way — when people experience positive emotions they actually tend to eat more healthful foods.

The connection between mood and carbohydrate intake has been studied, and the connection between mood and protein intake. What with one thing and another, looking for nutrient-dependent effects has not been satisfactory.

Studies have shown that eating really doesn’t reduce a person’s stress level, although we live in perpetual hope that it will make a difference. Actually, comfort eating has been shown to make a negative difference, because guilt makes the person feel even more depressed.

Emotional eating is a maladaptive response, while research has shown that…

[…] mirthful laughter decreases serum levels of cortisol, epinephrine, growth hormone, and 3,4-dihydrophenylacetic acid (a major dopamine catabolite), indicating a reversal of the “stress response.”

Needless to say, reversal of the stress response is exactly what we are looking for in these situations. The notion that humor therapy can actually do what emotional eating pretends to do is an attractive one. Research has shown that laughter is an effective stress-reduction coping mechanism, with cardiovascular benefits, analgesic effects, and immune system improvements.

When a treatment can help a patient feel better without negative side effects, what’s not to like? But work needs to be done, however, because…

[…] many of these studies have methodological problems, and further research is required in all areas to develop a fuller understanding of the effects of humor on health.

Your responses and feedback are welcome!

Source: “Laugh Away the Fat? Therapeutic Humor in the Control of Stress-induced Emotional Eating,” RMMJ.org, January 2014
Images by (top to bottom): @mattZillaaaa, @batkaren, @AmnesiaRose, @T_Bonezzz_ (Twitter)

Brush Up on Nephrology

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Why? Because any serious encounter with childhood obesity just might involve the kidneys at some point. Contrary to the comforting notion that co-morbidities are far away down the road, renal problems don’t necessarily build up slowly or wait for years to strike.

A 2014 study of 242 subjects determined that close to one-fifth of severely obese adolescents have poor kidney function. According to the study:

Seventeen percent of the teens had protein in their urine, which is an early sign of kidney damage. In addition, 7 percent had indications that their kidneys were working too hard, and 3 percent showed evidence of progressive loss of kidney function… Those with reduced insulin sensitivity were more likely to show signs of progressive loss of kidney function.

The report from Cincinnati Children’s Hospital Medical Center noted that this is a connection, and not necessarily a cause-and-effect situation.

In the following year, obesity in children was confirmed to be associated with renal injury, as manifested by obstructive uropathy and diabetic nephropathy. Doctors have not customarily looked for tubular damage markers in children, but now increasingly find them when they look, which is a good idea because generally, renal disease associated with obesity is “insidious and asymptomatic.”

Earlier this year, Lauren Sausser reported the Children’s Hospital of Philadelphia’s examination of another problem that doctors are not used to seeing in young people:

Kidney stones were once considered a painful condition afflicting mostly white, middle-age men… But new research, based on patient records from 153,000 South Carolinians, shows kidney stones are increasingly common among adolescents, females and blacks…

Some cases require surgery, but many patients muddle through with painkillers and a prescription to drink plenty of water.

The study was led by pediatric urologist Dr. Gregory E. Tasian. This new trend is especially distressing because kidney stones are mainly detected by means of the CT scan. But that involves radiation, and for children, teens, and women of childbearing age, exposure to radiation should be minimized. Also, this condition can in extreme cases require surgery, which is never good news for anyone.

Regarding the probable causes of the increase in nephrolithiasis, Dr. Dennis Kubinski of Charleston’s Kidney Stone Center told the journalist that kids today take in too much sodium, but insufficient amounts of calcium. In particular, they don’t drink enough water. Dr. Kubinski added:

A lot of that has to do with processed food — potato chips, fries […] even sports drinks that kids are getting are very high in sodium.

Your responses and feedback are welcome!

Source: “Severe Obesity in Teens Tied to Possible Kidney Problems,” HealthDay.com, 04/25/14
Source: “Early markers of obesity-related renal injury in childhood,” NIH.gov, January 2015
Source: “Kidney stones on increase in women, kids, blacks,” PostAndCourier.com, 1/13/16
Photo credit: John Campbell (jlcampbell104) via Visualhunt/CC BY

Adolescence and Co-morbidities

Childhood obesity has two types of consequences: the slowly building kind that don’t become really obtrusive until decades later, and the immediate kind. When there is an early-onset consequence, a young person with already two strikes against him or her (obesity and adolescence) develops an abnormal condition in some organ or system. But difficult as it is, adolescence is not yet classified as a pathology.

A lot of teenagers are afflicted by obesity and something else. When two things go wrong, they are now co-morbidities. There may be discussion over whether A caused B, or B caused A, or maybe another factor, yet to be discovered, caused both of them. In any case, the frequency of association is indisputable. The amount of research that has already been done is paltry, compared to the amount that cries out to be done.

Gut feelings

An obvious location for a malady related to eating is the gastrointestinal tract. A press release from Baylor College says, “GERD is Now a Common Childhood Ailment in American Overweight Youth.” It refers to Gastroesophageal Reflux Disease, where stomach acid (and sometimes partly digested food) comes back up, a phenomenon referred to in pop culture as “I just threw up a little in my mouth.”

This may sound rather harmless, but don’t be fooled. According to the press release:

Persistent acid reflux can eventually lead to esophageal scarring later in life. Symptoms include heartburn, chest pain, bad breath and hoarseness.

GERD didn’t used to be seen much in kids, but now it appears with annoying frequency, often in tandem with overweight or obesity.

Seemingly, nothing is safe, not the heart or the bones, not even the brain. The liver is sometimes the hot spot, because of non-alcoholic fatty liver disease. According to the School of Medicine at UC San Diego:

NAFLD — the inappropriate storage of fat droplets inside liver cells — is the most common cause of chronic liver disease in the United States and affects nearly 10 percent of all children…

The disease is most common in children and teenagers who are overweight and can develop in conjunction with other health problems, such as diabetes.

Please note that the report does not say “nearly 10 percent of overweight children.” It says “nearly 10 percent of all children.” That in itself is alarming. Kids who have it, often don’t show symptoms, but fatigue and abdominal pain are danger signs. Aside from very likely being overweight, kids with NAFLD tend to have high blood pressure, which of course is also linked with overweight and obesity.

Oh, and one more thing:

Currently, there are no approved and effective treatments for children with NAFLD.

Your responses and feedback are welcome!

Source: “GERD is Now a Common Childhood Ailment in American Overweight Youth,” PRWeb.com, 03/15/13
Source: “Obese Children Burdened by More than Weight,” UCSD.edu, 11/19/14
Photo credit: cunaplus/123RF Stock Photo

Obese Teens May Be Plagued by Orthopedic Problems

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Yesterday we mentioned research concerning the effect of fat when it colonizes muscle tissue. By some as yet unknown process, obesity seems to negatively affect bone development. Some bones are more vulnerable than others.

One of those is the distal radius, the thicker of the two forearm bones, near where it meets the hand. With an obese patient there are extra difficulties initially, and also later. When a bone is set, correct positioning is essential. With an obese patient, the medic has a harder time lining up the broken ends. After the fracture site is immobilized, the healing process is also more problematic for the obese.

Consequently, it begins to look as if using metal pins might be an orthopedist’s best practice, both for good alignment and speedier healing. This is good to know, but any surgical procedure opens up a whole new can of worms, so to speak. It might turn from an outpatient procedure to a hospital stay. The risk of infection goes up. And it will cost a lot.

The study that brought these things to light was presented at the 2014 American Academy of Orthopaedic Surgeons annual meeting. It included 157 children with distal radius fractures, of whom 42% were deemed overweight, and 29% were classified as obese, and…

[…] researchers found that obese children were significantly more likely to require a second surgical procedure to reposition their fractured bones. They were also more likely to need more follow-up visits requiring X-rays or other images.

And what of the upper arm, or humerus? According to the American Academy of Orthopaedic Surgeons:

Among other complications, obese children who sustain a supracondylar humeral (above the elbow) fracture can be expected to have more complex fractures and experience more postoperative complications than children of a normal weight…

Same goes for the femur, another study indicated. Seriously overweight kids need more extensive surgery, and experience more complications.

As always, the purpose for bringing up all this bad news is to emphasize, again and again, how essential it is to recognize and curb childhood obesity from the earliest possible moment. The sooner obesity begins, and the longer it goes on, the worse the potential for damage, including the appearance of co-morbidities that make life very complicated and unhappy.

In Overweight: What Kids Say, Dr Pretlow wrote:

If overweight kids need progressively larger amounts of pleasurable food or higher pleasure-level foods to feel satisfied or comforted, this would certainly worsen the childhood obesity epidemic and contribute to morbid obesity.

Morbid obesity is skyrocketing because cheap, high pleasure, high calorie food is becoming even more widely available, in the face of ever increasing tolerance. Furthermore, the stress of morbid obesity continually stokes the vicious cycle of spiraling comfort eating.

In the post “Advice to a British Mum,” Dr. Pretlow said this to a mother who was very concerned about her daughter:

A vicious circle will cease rotating if broken at any point on the circle… Each time she’s able to break a vicious circle for even just a bit, the circle will get smaller and easier to break the next time.

Your responses and feedback are welcome!

Source: “Childhood Obesity Linked to More Broken Wrists,” CounselHeal.com, 03/14/14
Source: “Obese Children More Likely to Have Complex Elbow Fractures, Further Complications,” ScienceDaily.com, 02/10/14
Source: “Overweight: What Kids Say,” Amazon
Photo credit: Birdies100 via Visualhunt/CC BY-SA

More Instant Karma Danger

pediatric-ward-hospital-malaysia

Yesterday, we looked at examples of the “instant karma” effect, which is what happens when child obesity is accompanied by a co-morbidity that doesn’t even have the decency to lie in wait for a few years, hoping to ambush the unsuspecting victim, but begins to cause problems sooner rather than later. This definition is from Matt Discombe:

A person is considered to be morbidly obese if they have a BMI of 40 or more or 35 or more if they are also experiencing obesity-related health conditions, such as high blood pressure or diabetes.

Of British children in their sixth year of schooling, only eight have a BMI of over 40. But a rather more alarming group of 560 kids have a BMI of over 35, and also suffer from a related medical problem. These unfortunate young people are, in other words, well on their way to morbid obesity.

Of their number, at least seven live in Gloucestershire, a county in the south-western part of the country. The reporter quotes cabinet member Andrew Gravells:

In Gloucestershire our health and wellbeing board tackles obesity as a local priority. Our public health team is working with health colleagues, district councils and the community and voluntary sector to deliver a countywide programme to prevent obesity, and to help people who are obese to manage their weight… Gloucestershire is one of four areas in the country to be working with Leeds Beckett University on a whole-system approach to tackling obesity.

One possible consequence is cardiovascular pathology. Blood clots can form in the veins, a condition known as venous thromboembolism, and when recognized, it needs to be treated because it can lead to stroke, heart attack, and damage to other organs. Prof. Elizabeth Halvorson of Wake Forest Baptist Medical Center reminds us that “the incidence of pediatric VTE has increased dramatically over the last 20 years.”

Kids are showing up at Irish hospitals with cardiovascular systems that, if you didn’t know better, you would swear belonged to a middle-aged person. A cheerful headline warns, “Unfit teens show risk of heart disease typically seen in people aged 55-60.” An unacceptable number of teens also have high blood pressure and alarming levels of blood lipids, and are either diabetic or pre-diabetic. Only 12% of kids in Ireland observe the weekly exercise guidelines.

Another ominous headline states, “Excess Body Fats of Obese Children Found to Be Deposited in the Muscles and Could Possibly Endanger Their Bones, Study Says.”

University of Georgia researchers have found that body fat and bone growth are directly linked, and not in a good way. Muscles influence the bones to form properly, but if the muscles are infused with fat this could be a problem. It all has to do with bone geometry and density, and bone minerals, and the spatial distribution of various elements. Science does not know everything there is to know about these relationships, but knows enough to know that the matter needs to be looked into.

As always, the moral of this post is that childhood obesity is to be avoided if at all possible, and Dr. Pretlow believes that it is possible.

Your responses and feedback are welcome!

Source: “Seven children at risk of morbid obesity last year in Gloucestershire,” GloucestershireLive.co.uk, 11/25/16
Source: “Obesity ups the risk of developing blood clotting disorder in children,” IndianExpress.com, 01/17/16
Source: “Unfit teens show risk of heart disease typically seen in people aged 55-60,” IrishTimes.com, 09/22/16
Source: “Excess Body Fats of Obese Children Found to Be Deposited in the Muscles and
Could Possibly Endanger Their Bones, Study Says,” ParentHerald.com, 03/08/16
Photo credit: CDC Global Health via Visualhunt/CC BY

Obesity, Hypertension, and the Forming Brain

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There may at the moment be a relatively small number of morbidly obese kids, but the number of potential morbidly obese children grows every day for three solid reasons. First, so many never have a chance of a normal-weight childhood, their obesity guaranteed by maternal behavior. Often, it’s not even something the expectant mother did out of carelessness or even ignorance, but a factor she had no control over. Science has not yet identified all the factors that can cause harm to a developing fetus.

Second, the younger obesity starts, the more likely it is to develop into the category we call morbid. Third, the longer obesity exists, the more difficult it is for the body to adapt back to a normal, healthful weight. So, some kids are born with three strikes against them. Also, in the minds of many people, if they think about it at all, morbid obesity is understood as a problem with a later-life onset, a condition that will catch up with a person some day.

The accelerated future

But more and more, “some day” is now. We seem to have entered a new era of “instant karma,” where fate catches up sooner, and the co-morbidities can kick in before the person is out of high school. For instance, it has been known for some years that children who are overweight or obese are at a much greater risk of developing high blood pressure. Between 1997 and 2006, hospitalizations for hypertension-related pediatric illnesses almost doubled.

A study found that “convulsive disorder, headache, obesity and systemic lupus erythematosus were the most common secondary diagnoses when hypertension was the primary diagnosis,” which is kind of a roundabout way of spotlighting a problem, but the study was looking at other things, too.

As if the situation were not worrisome enough, it was recently discovered that in children and adolescents, high blood pressure comes along with cognitive issues. In other words, they can’t think straight. Led by Marc B. Lande, MD, MPH, researchers from eight highly respected institutions studied hypertensive young people between 10 and 18 years of age. The subjects did not include any children with other problems acknowledged to affect cognitive function.

Here is the bad news:

The children with hypertension performed worse on the cognitive tests that measured visual and verbal memory, processing speed, and verbal skills. Additionally, more children with sleep issues had hypertension, which intensified the effect of poor sleep on cognition and executive function.

Okay, to say they can’t think straight is a bit harsh and hyperbolic. The average test scores of the high-blood-pressure group and the control group were both pretty much within normal limits. Although the hypertensive kids didn’t test badly enough to be technically characterized as cognitively impaired, the sad fact is that they performed worse than their compatriots with normal blood pressure. In a highly competitive world where academic success is so vital, every little bit of edge counts.

This was not the first study to notice “instant karma” effects on the growing brain, and sadly, it will not be the last.

Your responses and feedback are welcome!

Source: “Kid hypertension hospitalizations double,” UPI.com, 06/19/12
Source: “Childhood hypertension associated with cognitive issues,” ScienceDaily.com, 09/29/16
Photo via Visualhunt

Obesity and the Legendary Philosopher’s Stone

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Long-term weight loss seems to be a goal as elusive as the fabled Philosopher’s Stone. Actually, the two are very similar. CrystaLinks.com says of the Philosopher’s Stone:

It was sometimes believed to be an elixir of life, useful for rejuvenation and possibly for achieving immortality.

Long-term weight loss is absolutely rejuvenating, and while it doesn’t bring immortality, it is believed to add years to a person’s life. Of course there is no way to know if any individual lives longer than they would have if morbidly obese — the possibility of being hit by a bus still exists — but the statistical trend does seem to point that way. Let’s look at what scientists call an anecdotal account, the self-reported story of a single person — not a medical professional, but a writer and entrepreneur.

In 2007, Kimanzi Constable weighed in at 332 pounds. He cut his nutrient intake to 1,200 calories a day, and exercised for four hours out of each 24. Just as the traditional diet-plus-exercise paradigm would predict, in six months he was down to a nice round 200 pounds. Ta-dah!

But no. For Constable, the victory was short-lived. He gained back that 132, plus an additional 38, and it only took a year to pile all that weight back on. Eventually, thanks to significant lifestyle revisions, he lost the entire 170 and got back down to a tolerable 200 pounds, a process which also occupied a year. As he told GoodMenProject.com:

June 17 of 2013 I didn’t start my weight loss journey, I started the journey to create healthy habits that ultimately changed my life.

In condensed form, we list the seven healthful habits to which credit is due. The first is patience, because sustainable weight loss takes time, and it’s more like a marathon than a sprint. “One day at a time” is the name of the game. Of course, the cultivation of patience brings benefits to other areas of life, which become more functional, so there is less to be stressed about, and less reason for emotional eating.

Another biggie is sacrifice. Constable gave up soft drinks, fast food, junk food, and TV. He gave up heedless automatic eating and instituted portion control (which is, as we have seen, an important component of Dr. Pretlow’s W8Loss2Go program.)

Realistic planning is important too. If you give yourself a year to lose 170 pounds, is that realistic? Apparently so, if you break it down to 15 pounds per month. That comes out to half a pound per day, which is doable with the right plan.

Also, while diet and exercise are undeniably parts of the plan, they do not make up the whole enterprise, which is lifestyle change. That means incorporating healthful habits into every moment of the day. The thing about exercise is to be consistent, which Constable says “gives you more energy and teaches you discipline that you can use in every other area of your life.”

Accountability means picking a positive, supportive person to whom you will be responsible by keeping them informed of your progress. And perseverance means, “Keep on keepin’ on.” It is a trait, Constable says, shared by all successful people in every walk of life.

Your responses and feedback are welcome!

Source: “The Philosopher’s Stone,” CrystaLinks.com, undated
Source: “7 Healthy Habits That Helped Me Lose 170 Pounds in One Year,” GoodMenProject.com, 09/14/14
Photo credit: Nico Time via Visualhunt/CC BY-SA

The Symbolic Eating Peril

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Dr. Billi Gordon has written extensively about the conjunction of family and holidays, and about holiday binge eating, and about what he calls “intricate symbolic involvement in our feeding habits.” This is the root of both the beauty and the craziness of family holidays. Things that are carved into ancient grooves become exposed. Unwelcome surprises show up.

Some families traditionally go to the country club for Mother’s Day Brunch and to Vail for Christmas. Other families only have one big blowout per year — Thanksgiving or maybe Independence Day. So there are class differences. But a vast majority of the time, family holidays cause stress, and it is very much a shared experience among cultures. Who will host a certain event? Who is expected to, and who wants to? Who makes the decision not to travel to a family gathering, and why?

Dr. Gordon points out that “compulsive symbolic eating is global.” He gives the example of how, in American Thanksgiving tradition, a person’s position at the table is meaningful, and the privilege of carving the turkey signifies rank. But all types of cultures and societies have equivalent customs. A great deal of our behavior and interactions are symbolic during these holiday periods, and that’s not all.

We eat symbolically and we eat comfort foods for nostalgia because they have personal meaning. Sometimes comfort foods are comforting because of the neurochemical benefits of the carbohydrate or fat content. That’s a different discussion. Today, we’re talking about the foods that comfort us because of their symbolic association with people or events in our lives.

That drive is intense, and Dr. Gordon explored its origin in intricate detail for Psychology Today, describing the human brain as “a Walmart cashier on Black Friday.” He goes deep. Considering the roles played by different brain regions, he concludes:

Conceivably, symbolic eating is not processed as a hedonic experience that satisfies a goal-directed behavior, but as gestures (eating event behavior) and objects (food and related utensils and fixtures). This raises the question: when food or an eating event is used to symbolically communicate, is it processed in the anterior and posterior perisylvian language area as language?

Dr. Gordon then goes on to explain why any of this matters. Because in order to understand compulsive eating there are things that must be considered. He takes the reader through a logic chain to arrive at the conclusion that emotional eating is very closely tied up with a life full of aversive experiences:

Emotional eating is always symbolic eating and among the chief architects of compulsive and binge eating. The probable source of conditioned fear is the associative, collateral context of aversive objects and events. It’s also likely that compulsive overeaters have more conditioned fears than normal eaters because they have more aversive experiences.

In other words, this eating disorder is a sequel of abuse, or relentless ongoing misery of other kinds. It is one of the ways in which the body expresses post traumatic stress syndrome. Despite the grim subject matter, Dr. Gordon imbues this essay with lyrical language and a feeling of hope.

Your responses and feedback are welcome!

Source: “Symbolic Eating,” PsychologyToday, 11/23/13
Photo credit: PrescottFoland via Visualhunt/CC BY-ND

Fairness and Sugar Tax in the United Kingdom

soda-aisle

Childhood Obesity News has mentioned how the public health director of Wolverhampton wants to remove sugary treats from the hospital vending machines because of the danger to diabetics and potential diabetics. The other side of that indisputable fact, voiced by proponents of individual liberty, is that everyone has their problems and their triggers, and we can’t go around “nerfing” the world just to protect people with serious illnesses who nevertheless have no self-control.

There may even be someone on staff who can prove that loss of the minuscule profit generated by the candy machines could cause a whole wing of the hospital to close, with the consequent firing of many people. Any time a sugar tax is proposed, anywhere, the same arguments are heard endlessly. Who benefits? Who gets hurt? Where does a government’s decent and appropriate concern for the citizens’ welfare end and the “nanny state” begin?

The beer lobby

One aggrieved party is the British Bar and Pub Association, or BBPA, which claims that beer taxes and general business taxes are already more than sufficient, and, furthermore, the drinking establishment industry already pays six times its fair share. Any time the subject of a sugar tax is broached, headlines pop up saying “Pubs face closure.”

The chief tenet of tax avoidance is, if anyone doubts that the protection of business should be the first priority, just mention the loss of employment and they will be silenced. BBPA-commissioned research has determined that a single brewery job generates one job each in agriculture, the supply chain, and retailing, plus 18 jobs in pubs.

In this typical example of the perceived need to look after the interests of profitable enterprises, the story follows the pattern. The headline is, “Pubs and restaurants oppose sugar tax over job loss fears.” It describes a study which showed that soft drink sales would fall by 1.6%, resulting in the elimination of 4,000 jobs in the Great Britain, Northern Ireland, Scotland, and Wales.

Think of the children

As with any other business, industry copywriters weave tales to show how the product serves the public good, especially if it involves kids. In March, when the British government announced that a soft-drink tax is coming, Coca-Cola hastened to deliver a scolding about how this is the wrong way to end childhood obesity.

A company bigwig said there is “no evidence in the world” that taxing sugar can bring about behavioral change in consumers. At most, people might exchange their sugary drink habit for a sugary food habit, which would be sad for Coca-Cola.

When the tax kicks in, a couple of years down the road, the British government plans to use the money for school sports. So, children will benefit in two ways, by not consuming as much soda and by receiving more exercise opportunities.

Getting back to the drinking establishments, an industry argument is seldom laid out before the public all at once. Instead, popular sentiment is built on a patchwork of cultural bits and pieces that are stitched together in the minds of the people.

Complete with underlying psychological nuances, this is the explanation of why it is good for civilization to leave soft drinks untaxed. Anyone who will be operating a motor vehicle is not supposed to drink. But people like to congregate in the pubs, and they have to drink something.

If sugar-sweetened beverages were to cost more, then people would figure, “What the heck, might as well have a beer” and there would be more road accidents, and children would die. So, no sugar tax. Meanwhile, diseases that are pretty generally recognized to result from sugar put non-hypothetical children in real danger every day.

Your responses and feedback are welcome!

Source: “Local Impact of the Beer and Pub Sector — The Vital Statistics,” Cask-Marque.co.uk, 08/27/14
Source: “Pubs and restaurants oppose sugar tax over job loss fears,” BigHospitality.co.uk, 08/16/16
Source: “Coca-Cola says sugar tax will not reduce childhood obesity,” Independent.co.uk, 03/17/16
Photo credit: Mike Mozart (JeepersMedia) via Visualhunt/CC BY

Childhood Obesity News | OVERWEIGHT: What Kids Say | Dr. Robert A. Pretlow
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