Childhood Obesity News A resource for health professionals, parents, teachers, counselors & kids on the childhood obesity epidemic. Fri, 19 Jan 2018 10:00:22 +0000 en-US hourly 1 31947156 Devices and EMA — a Match Made in Heaven Fri, 19 Jan 2018 10:00:22 +0000 robots-wearable-tech

Childhood Obesity News mentioned a meta-study designed to assess the usefulness of EMA (Ecological Momentary Assessment) in evaluating PA (physical activity). It spoke of eligibility criteria: validity, reliability, objectivity, norms, and standardization. PA can be tracked by gadgets that use mechanical and electronic means to monitor physical activity via many different parameters such as “direct and indirect calorimetry, maximum oxygen consumption/VO2max, doubly-labeled water consumption, or energy expenditure.”

When it comes to behavior, questionnaires depend either on self-reporting that is performed by the patient, or on secondhand narration that originates with professionals or other staff members who relate their direct observations of the patient. In either case the reporting is subjective, because it depends on impressions formed in the mind of an individual, whether that individual is the patient or someone whose job it is to take notes.

For the researcher who wants the most complete and accurate picture of subjects’ behavior, many caveats and nuances are involved. For instance, it would seem straightforward enough to accept that devices track activity most accurately. To relegate this important task to self-reporting seems unwise. But the authors make this counter-intuitive point:

Furthermore, as objective methods do not differentiate between periods of inactivity and periods when the device is not being worn, subjective methods are preferred for measuring sedentary behavior.

For this and other reasons, EMA and wearable devices are seen as a match made in heaven — capable, when they team up, of wringing almost every drop of information from any situation. The idea of using mobile phones to administer EMA protocols has been around for years.

The introduction to a 2010 study set forth the problems:

Children often experience difficulties remembering the intensity and duration of activities after 24 h or more has passed since the behavior… Also, when used alone, accelerometers and pedometers are unable to measure mood during or the context of activities, which may be the important factors that influence behavior.

The report offered exhaustively detailed explanations of every aspect of the study, and was very optimistic about the prospects of overcoming limitations via “technology-enabled real-time self-report assessment strategies.” That optimism has been proven to be justified. A few years later, a meta-study with very strict criteria published its results:

This systematic review examines current use of mobile health technologies in the prevention or treatment of pediatric obesity to catalogue the types of technologies utilized and the impact of mHealth to improve obesity-related outcomes in youth.

The section titled “Usability” is extensive and lavishly footnoted. For instance:

Studies described the best placement and accuracy of mobile device(s) to record PA and dietary intake (22, 34, 35, 37, 47), ways to lessen user burden (43) and which non-intrusive and practical devices (34, 37, 47) will actually be carried and used by participants (15, 22).

The authors go on to speak of incentives, social connections, privacy and sharing issues, competition, user-friendly formats, motivational techniques, language, positive feedback, costs, software and hardware compatibilities, and many other factors that need to be taken into consideration.

Your responses and feedback are welcome!

Source: “Using Ecological Momentary Assessment to Evaluate Current Physical Activity,”, 07/14/14
Source: “Investigating children’s physical activity and sedentary behavior using ecological momentary assessment with mobile phones,”, June 2011
Source: “Prevention and treatment of pediatric obesity using mobile and wireless technologies: a systematic review,”, 01/12/15
Photo credit: NYC Media Lab on Visualhunt/CC BY-SA

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More on Ecological Momentary Assessment Thu, 18 Jan 2018 10:00:43 +0000 field-notes

The most recent Childhood Obesity News post, “Ecological Momentary Assessment and Teens,” noted that Ecological Momentary Assessment (EMA) works effectively in combination with technological data-gathering devices. When researchers are able to capture 81% of the expected survey data from adolescent subjects, it is considered satisfactory.

Let’s look at another study, this one concerned with the compliance rate to EMA among 461 teenagers who had ever smoked cigarettes at all. Also investigated were several covariates “including gender, race, smoking rate, alcohol use, psychological symptomatology, home composition, mood, social context, time in study, inter-prompt interval, and location.”

What might be problematic is, the information about most of those variables is the product of self-reporting. Realistically, any teen in the survey could spin tall tales, and even lie about whether they had ever smoked or not. It seems as if the biggest question was:

To date, there has been little detailed research into the predictors of EMA compliance. However, patterns or predictors of compliance may affect key relationships under investigation and introduce sources of bias in results.

There is good reason for concern. A study using the EMA/wearable technology combo may seem to be rife with objective facts, but that is not true to the extent accepted by some practitioners. At any rate, this study found EMA protocols are less likely to be complied with by boys who smoke and drink and have bad attitudes.

One school of thought holds that any data that is the product of self-reporting should be disregarded. Nevertheless, EMA is showing up a lot in the domains of rehabilitation, sport science, and behavioral medicine.

A recent meta-study on using EMA to evaluate current physical activity (PA) included children, adolescents, and adults, and even encompassed one study of elder activity. Trouble is taken to define such terms as “physical activity,” “exercise,” and “sedentary behavior,” which helps to ensure that all debate participants are on the same page, as it were. This is actually encouraging, because it often seems that opposing parties in an argument are not even talking about the same subject.

The objective was to discover whether EMA “fulfills the criteria of validity, reliability, objectivity, norms, and standardization applied to the tools used for the evaluation of physical activity.” The researchers arrived at these conclusions:

Ecological momentary assessment is a valid, reliable, and feasible approach to evaluate activity and sedentary behavior. Researchers should be aware that while ecological momentary assessment offers many benefits, it simultaneously imposes many limitations which should be considered when studying physical activity.

This article goes into a great deal of detail about methodology, hardware, software, and planning. One disadvantage of EMA is that it requires active participation and is considered “a more burdening and time-consuming approach for participants in comparison with retrospective methods.” Usually, a retrospective method requires only a reporting session at the end of the day. Another drawback is, as mentioned, the need to bring all participants into alignment in regard to the definitions of terms.

Your responses and feedback are welcome!

Source: “Factors predicting compliance to ecological momentary assessment among adolescent smokers,”, 10/04/13
Source: “Using Ecological Momentary Assessment to Evaluate Current Physical Activity,”, 07/14/14
Photo via Visualhunt

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Ecological Momentary Assessment and Teens Wed, 17 Jan 2018 10:00:22 +0000 breakfast-coffee-notebook

In several previous posts, we looked at Ecological Momentary Assessment (EMA) which is, among other things, a tool that helps researchers collect data. Today we scan two reports from the National Institutes of Health for details that may or may not turn out to be salient. In young fields like this one, many discoveries lie in wait. A researcher never knows what stray notion might collide with which unexpected finding, and set off a revolution.

The point of EMA is for the subject to pause, at predetermined or random times, and describe the present moment so that the subjective experience can be matched up with what’s going on in the universe right then. A 2009 study posited that:

To provide the most-effective weight-management interventions for children and adolescents, practitioners are encouraged to assess all factors that target weight-related behavior change.

But how? In a study that looked into the connections between behavior, emotions, and sleep in obese teenage (11-19) girls, the researchers found that “technological devices that gather objective data have reasonably high compliance rates.” Specifically, they were talking about the BodyMedia SenseWear Weight Management System, which monitors “calories expended, physical activity duration and intensity, and sleep duration and efficiency.”

An armband collects metabolic data, and a watch-type display gives real-time feedback on the steps taken and the calories burned. Together these are called an actigraph.

In the course of three long weekends, the 20 adolescent female subjects were asked to make 14 cell phone calls to report on their status. This particular study had no parental involvement with the weight-management protocol.

The subjects were screened to establish that they did not suffer from diabetes or cardiovascular disease, were not currently enrolled in another weight loss intervention, and were not suicidal. According to the study:

The intervention consisted of four weekly, four bi-weekly, and three monthly individual sessions. Information focusing on nutrition, PA [physical activity], and behavior change was presented in ~45-min sessions using cognitive-behavioral therapy and motivational interviewing followed by ~30 min of PA.

The writers of another multi-author study say that in recent years, the combination of wearable sensors and EMA has shown that a combination of the two technologies offers “tremendous potential for identifying drivers of human behavior and accelerating behavioral medicine research.” Their subjects were 20 adolescents (both sexes) and the researchers set out to “determine the feasibility and acceptability of a novel, intensive EMA method for assessing physiology, behavior, and psychosocial variables utilizing two objective sensors and a mobile application (app).”

This paper includes very detailed information on the methods and measures used, including context and location questions. Apparently, compliance was pretty good, because the report notes that the participants “provided approximately 81% of the expected survey data.” Overall…

The findings support the use of an intensive assessment protocol to study real-time relationships between biopsychosocial variables and health behaviors.

Your responses and feedback are welcome!

Source: “Utilizing Ecological Momentary Assessment in Pediatric Obesity to Quantify Behavior, Emotion, and Sleep,”, 12/17/09
Source: “The promise of wearable sensors and ecological momentary assessment measures for dynamical systems modeling in adolescents…,”, 09/27/16
Photo credit: Tony Hall via Visualhunt/CC BY

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Childhood Obesity Developments in the United Kingdom Tue, 16 Jan 2018 10:00:16 +0000 brighton-amusement-ride

Because the United Kingdom is an English-speaking place with similar laws to the U.S.A. and a very familiar obesity problem, Childhood Obesity News has been tracking what goes on there. It is possible that awareness of how the Brits handle things could help America pick up some good ideas, or at least avoid predictable obstacles.

Brighton and Hove, although it sounds like a couple of different places, is actually the name of one city on the southern coast of England. It is a resort town, which may evoke visions of enthusiastically active kids partaking of many forms of exercise, but that is apparently not the case. It may or may not be pertinent that in the 2001 census, amongst all the main sections of England and Wales, this town had the highest percentage of people identifying themselves as followers of Jedism, a creed inspired by the Star Wars movies.

Inspired by the discovery that “almost one in five local four and five-year-olds was overweight” Public Health England created a program. Interestingly, this organization is mainly made up of food and drink industry representatives, which seems both counterintuitive and counterproductive to the purpose of helping kids avoid obesity.

Anyway, the rationale behind the Change4Life campaign (established in partnership with Disney and Sports England) was explained by Public Health England deputy director Angela Baker:

It is worrying that we are seeing so many more children leave primary school overweight than started, and we hope our Disney-inspired programme is one way of helping to reduce this… Any 10-minute burst of activity counts as a “shake up” and goes towards the hour of physical exercise each child should do each day.

In the same month, a member of parliament from South Shields, another coastal town but this time on the north side of England, wrote a column about the paradoxical conditions in the United Kingdom where “we have one of the worst records of food insecurity and child obesity — both forms of malnutrition.” Pulling no punches, Emma Lewell-Buck wrote:

The harsh reality is, that the combination of low income and a food system which makes unhealthy food more convenient, attractive and frequently cheaper than healthy food, is toxic for children’s health. It leads to children being overweight and obese, vitamin and mineral deficiencies, poor growth, development and poor mental health.

The people’s representative scolded the current administration for trying to deprive school children of their free lunches, and brought up several other food-related matters that could, in her view, be handled much more effectively. There, as here, the social “safety net” unravels more with each passing day. In the demographic of kids under 15, about one in five is subject to food insecurity rated moderate or severe.

The lunch debate has been a real can of worms. The government announced that thousands of children would be added to the free school breakfast program. The only catch was, thousands would first be kicked off of the free lunch program. The Conservatives said they had science showing that breakfast helps kids just as much, but only costs one-tenth as much as lunch. Of course, celebrity chef Jamie Oliver got into the mix and called the cancellation of the lunch program a disgrace.

Your responses and feedback are welcome!

Source: “Health chiefs hope Disney-inspired plan will combat childhood obesity in Brighton and Hove,”, 07/17/17
Source: “Foodbank Britain: Is Malnutrition The New Normal?,”, 07/17/07
Source: “Jamie Oliver calls Theresa May’s plan to scrap free school lunches a ‘disgrace’,” Independent,, 05/19/17
Photo credit: Andy Walker (Bear Clause) on Visualhunt/CC BY-ND

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News From the Flaky Fringe Mon, 15 Jan 2018 10:00:33 +0000 astronaut-chow

As Childhood Obesity News has noted during other visits to the outer limits of probability, a lot of people are called crackpots until, without having changed in any substantial way, they suddenly become geniuses. A subject as large as obesity is bound to attract a lot of theories. Among them, an effort to revive the “forgotten food sense” is an idea that might, as they say in Hollywood, have legs.

Salience is the quality of being noticeable, prominent, or important. Ryan S. Eldera and Gina S. Mohrb published a report called “The crunch effect: “Food sound salience as a consumption monitoring cue.” What they say, basically, is that the sound produced by chewing is an intrinsic sensory cue that somehow contributes to the perception of satiety. Consequently, more attentive listening could lead to reduced food consumption.

Or maybe to increased food consumption. Given that marketers communicate for only one reason, which is to induce consumers to buy more product, the last sentence of the Abstract is rather troubling:

Our findings are valuable to both researchers interested in understanding how sensory cues are connected to consumption and marketers utilizing sound in their communications to consumers.

Todd Hollingshead wrote about the research, on behalf of one of the institutions concerned, Brigham Young University. (The other was Colorado State University). He says “people eat less when the sound of the food is more intense.”

What it suggests, in practical terms, is that consciousness of the sound of mastication is a good thing, so turn down volume of the TV, stereo, or whatever, as you chomp and crunch. And enjoy your own internal soundtrack, as part of an exercise in mindfulness.

A related worry

At the same time, Sarina Locke reports, there is concern about the ascendency of what is essentially baby food, for people who are not infants. All kinds of nutriments come in plastic pouches, which may in itself be a problem. Maybe phthalates and similar packaging materials, just on their own, contribute to obesity.

Some experts are against the gratuitous pureeing of food, for the same reasons cited by Eldera and Mohrb. To persuade toddlers to swallow them, the vegetables probably contain too much sugar. Mush packets are given to kids at an age when they really should be getting more practice at chewing. The mush diet could impede the proper development of both dentition and speech.

Locke interviewed Sarah Hyland of the Australian Institute of Food Science and Technology, who warned of the dangers in depriving children of the “sensory perception of texture and simple tastes.” She went on to say:

It’s a reminder of the importance of visual, colour and textural cues in eating solid food for reasons of jaw development, speech development, and sensory literacy.

At the other end of the age spectrum, the purees seem to be very popular with elderly folks who may have compromised chewing ability, or physical dysfunctions that make eating difficult. But that’s not all. Busy adults apparently love the convenience of sucking a meal from a pouch.

Your responses and feedback are welcome!

Source: “The crunch effect: Food sound salience as a consumption monitoring cue,”, July 2016
Source: “The sounds of eating may reduce how much you eat,”, 03/14/16
Source: “Are we raising ‘generation suck’ who drink food with no need for chewing?,”, 08/25/16
Photo by Marco Gomes on Visualhunt/CC BY

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Dr. Pretlow Presents a Webinar Fri, 12 Jan 2018 10:00:30 +0000 dr-pretlow-speaking

At this moment, almost the entire homepage of the Food Addiction Institute (FAI) is occupied by information about the webinar it will sponsor — featuring Dr. Pretlow — on the evening of Sunday, January 14. The topic is “Treatment of Child/Adolescent Obesity as an Addictive Process,” and the time is 7 PM Eastern Time. Please go to this page for links and phone connections and all that good stuff.

Although the website is primarily geared for health professionals, all visitors are invited to view previous webinars or partake of several other resources, including acquaintance with the educational institution’s Mission:

Advocating widespread acceptance of food addiction as a disease of substance abuse and the availability of effective abstinence-based solutions.

The FAI is always on the lookout for promising new ways to treat food addiction, a type of substance dependency that ties the person to one or more specific foods, or that manifests as volume eating, where the addictor seems to be the act of consumption itself.

Childhood Obesity News has mentioned the Institute before, in several contexts. A post titled “The Food Addiction Institute Viewpoint” discussed the thoughts of Dr. Vera Tarman on Binge Eating Disorder (BED) and the failure of DSM-5 to include a food addiction diagnosis. As a result, Dr. Tarman predicted that many food addicts would be steered into a category that does not apply to them and “probably be given treatment that could ultimately undermine their recovery.”

Dr. Tarman and Phil Werdell, also of the FIA, co-authored the book Food Junkies: The Truth About Food Addiction, and Werdell feels that at least the inclusion of BED in the most recent Diagnostic and Statistical Manual is a step in the right direction, which could pave the way for the acceptance of food addiction as a Substance Use Disorder in the next edition.

The Institute also offers information on several self-help groups for recovering food addicts, with special attention to the 12-Step fellowships, of which Overeaters Anonymous is a venerable example. The FIA was mentioned in “Questions of Terminology” as one of the groups very interested in seeing that language is conscientiously applied throughout the mental and physical health fields.

Peripheral Professions in Obesity Treatment” described the three-year FAI/ACORN Food Addiction Professional Training which was developed there. To have actually experienced the problem is a requirement. Recovering food addicts are clients first, and then progress to being assistants, and finally become co-professionals getting ready to launch out on their own. They can find jobs or independently set up shop as coaches or consultants, taking the load off psychiatrists and psychologists.

Your responses and feedback are welcome!

Source: “Webinar Schedule 2018,”, 2018

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More BFRBs Revisited Thu, 11 Jan 2018 10:00:48 +0000 drinking-from-bottle-silhoutte

Childhood Obesity News is going back over the collection of posts about Body Focused Repetitive Behaviors (BFRBs). Just about everyone has either seen or done this: A person enters a semi-trance state, where the brain is somewhere else and the mechanical arm apparatus picks handful after handful of popcorn from a bowl and conveys each handful to the mouth, over and over.

Sure, the salt makes the popcorn tasty — but more than likely the real attraction is the eating process itself, with all the biting, crunching, chewing, and tongue acrobatics, and the interesting sensation of matter proceeding down the gullet. Sure, food is very attractive and sometimes shows indications of being addictive. But eating can have drug-like effects on mood and mentation, and often gives every appearance of being addictive, in and of itself, with little relation to the substance in question.

Chewing is not necessarily the only addictive motor action. Apparently, swallowing alone can provide stress relief, which helps to explain the enormous popularity of soft drinks. “More about BFRBs” went into additional detail about the concept of the hand-to-mouth motion as a powerful addictor.

We have talked about aggressive chewing, and stress eating in people and dogs, and “eating your stress,” and the relationship between inappropriate and disruptive chewing behavior and ADHD. There are also shared characteristics between BFRBs and another alphabetical problem, OCD (Obsessive-Compulsive Disorder), in which things must be done only one way, under perceived threat of some dark and terrible result. As we described:

A person might feel that it is a rule to eat cookies only in a certain mathematical progression. You can eat three, but if you mess up and eat four, then you have to go to the next multiple of three, which is six. Or, a person might hold a belief that the whole package of cookies has to be finished at one sitting, because to do otherwise would open the door to existential chaos.

Obviously, OCD could perpetrate overeating in myriad ways, which all add up to self-sabotage.  Technically, body-focused repetitive behaviors qualify as a coping mechanism, because they are used to cope with stress. But as coping mechanisms go, having a BFRB habit is not a promising path.

People seem to be massively infected with stress, because they love to crunch. Legions of scientists intensely research such concepts as “fracturability” and “first-bite hardness” for the benefit of corporations. On the most basic level, there really is nothing wrong with that.

No one wants to discourage chewing. Chewing is the very basis of the “fletcherizing” fad that swept the country, once upon a time. Horace Fletcher, the guru of chew, preached the gospel of chewing each mouthful of food dozens of times. The benefit to the digestive system is undeniable, but this practice also does something for the emotions.

As we learned, a major religious institution was interested in Fletcher’s teachings because people who practiced them tended to drink moderately, if at all. This might have been mere coincidence, resulting from personality differences between alcoholics and folks who try out new “crackpot” theories. Or maybe industrious, devoted chewing was a BFRB that relieved stress to the point where people felt no need to get drunk.

Your responses and feedback are welcome!

Photo on Visualhunt

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Body-Focused Repetitive Behaviors (BFRBs) Revisited Wed, 10 Jan 2018 10:00:19 +0000 problem-in-substance-quote

This is a retrospective look at some of the many interesting aspects of Body-Focused Repetitive Behaviors (BFRBs), with links to posts that expand on the basic points. But first, why does this quirky-sounding problem matter? What does it have to do with childhood obesity? Only everything!

Disorders do not often present with neatly delineated edges, and until more is known, people will unavoidably conflate various conditions that may or may not have any meaningful connection. For now, we know that displacement behaviors fill a certain function for troubled people, and BFRBs can reasonably be said to fall into that category.

To counteract nervous stress, people pick at their skin, bite their nails, pull their hair, or stroke their mustache. It looks like compulsive eating might also be fairly called a displacement behavior.

People do these activities unconsciously or semi-consciously while watching TV, studying, traveling by car, talking on the phone, sitting in class, or browsing the Web. While thinking of something else, they do compulsive actions that not only take a toll on the affected body parts, but alienate onlookers. Noisy and obnoxious snack-munching can be as off-putting as picking scabs.

BFRBs negatively affect a person’s social life. Many obese people feel that opprobrium is constantly aimed at them, but the reason might not be what they think. Maybe a friend is bursting with the need to say, “Look, I don’t mind that you’re fat. I’m tired of hearing you chew and slurp!”

Versatility in BFRB manifestation

Apparently, BFRB satisfaction can manifest as either an upper or a downer. Feelings of discomfort and emotional distress can be calmed by squeezing pimples or plucking out eyelashes; or feelings of listlessness and boredom can be elevated to a more bearable plane.

Either way, to an objective academic eye they look like self-mutilating behaviors, and are classified as OCD Spectrum Disorders, which are closely related to OCD, or Obsessive Compulsive Disorder. A doctor who specializes in the field notes that clients are very frustrated by their inability to stop doing these things.

In the various WeightLoss2Go smartphone app trials, Dr. Pretlow has seen a recurring pattern that almost makes no sense. In the big picture, children and teenagers have less trouble eliminating their special problem foods, and more difficulty with cutting down their amounts of plain old everyday mealtime foods. While there is plenty of evidence that the food industry makes an effort to invent addictive products, this does not explain why overweight kids cling to over-serving themselves with mundane Mom food.

Unless… there is more going here than flavor, or response to chemical additives. There is wider involvement, in the pleasures of chewing and swallowing, in the repetitive motion of the hand from the food source to the mouth.

This is good news because therapists have ways of dealing with other BFRBs, that also work on compulsive grazing and snacking. Childhood Obesity News wrote about a chain of adolescent treatment centers that had found success with nine different therapeutic modalities. Topics range from physical barriers to the realization that these particular disorders are extraordinarily susceptible to the benefits of group therapy.

Your responses and feedback are welcome!

Image: Quotation from podcast “#342 — Christopher Ryan,”, 03/25/13

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Comparisons Are Odorous Tue, 09 Jan 2018 10:00:20 +0000 odious-definition

The illustration shows what the Oxford University Press says about the word “odious,” which has over the centuries collected so many synonyms, you know it must be powerful. Probably the context most familiar to people today still dates back to the paraphrase of something written by John Lydgate in the mid-1400s — “Comparisons are odious.”

Shakespeare had fun with it, in one of his plays, twisting the line to “Comparisons are odorous.” As usual, he was correct. Comparisons stink.

Why do we think we not good enough, not beautiful enough, not thin enough, not smart enough, not successful enough, not happy enough — and just plain losers in every possible way? Because we compare ourselves to others. In the most basic sense, this is just fundamentally stupid. For starters, there is no proof that those fabulous others are really as good, beautiful, thin, smart, successful, or happy as they claim or appear to be.

The feeling of inadequacy engendered in us by their superiority might be based on nothing more than a construct of lies. But despite being founded on so much untruth, the perception that one’s self is inadequate leads to anxiety and depression. As it happens, anxiety and depression are two of the main roots of eating disorders.

Anxiety and depression

Professor of Behavioral Science Paul Dolan, based in the U.K., is one of the handful of experts who design happiness studies. What does he say about depression and anxiety?

[…] changing behavior and enhancing happiness is as much about withdrawing attention from the negative as it is about attending to the positive… The more a person is inclined to gratitude, the less likely he or she is to be depressed, anxious, lonely, envious, or neurotic.

In a perfect world, more psychiatrists would be dealing with obesity, but they have other things to do. Psychologists in the obesity field, says Dr. Pretlow, “seem to be treating only the psychological effects of being obese, rather than the psychological causes of obesity.”

In “What Else Can Non-Psychiatrists Do?” Childhood Obesity News talked about psychiatric nurse practitioners, one of the many varieties of mental health professionals who can help prevent and reverse obesity. In that same post we discussed the dangers of succumbing to “socially prescribed perfectionism,” or the mistaken belief that we are somehow obligated to live up to other people’s ideas about how we should look, act, believe, etc.

Fortunately, plenty of mental health professionals are trained to get rid of hangups, like the attachment to socially prescribed perfectionism. It doesn’t take a full-fledged psychiatrist — or even a credentialed psychologist — to help a person look inward instead of outward, and make better decisions about how to allocate the limited resource known as attention.

The skill of gratitude can be both taught and learned. So can the method of breaking down change into small, manageable increments or “baby steps,” as described by Chris Kresser.

Kresser also outlined the role of the health coach, who in his organization works along with a nutritionist to give a patient the intense and attentive support needed while adopting diet and lifestyle changes. He says:

They’re actually even going to take you shopping, they’re going to come to your house and clean out your pantry with you, and they’re going to give you recipes and meal plans and give you… Totally hold your hand…

There is room for, and need for, many types of professionals, because obviously this thing hasn’t yet been solved.

Your responses and feedback are welcome!

Source: “Happiness by Design: Change What You Do, Not How You Think,”, July 2015
Source: “RHR: A Three-Step Plan to Fix Conventional Healthcare,”, 11/07/17
Image: Google Books

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What Else Can Non-Psychiatrists Do? Mon, 08 Jan 2018 10:00:46 +0000 human-brain-illustration

It appears very likely that psychiatrists and psychologists are uniquely situated to treat obesity, yet psychiatrists have acquired a reputation for making short and infrequent appointments with patients, for the sole purpose of writing prescriptions. There also seems to be a current shortage of psychologists.

According to one theory, FOMO (fear of missing out) is not a silly fad, but a deeply ingrained response to a hostile universe. Hunters and gatherers both need to be on the alert at all times, lest any potential food source run away or be overlooked. We humans are designed to take advantage of anything that does not eat us first.

In many parts of the world, people still struggle with insufficient nutrition. This even includes most of the developing world and the so-called first world, where in one sense there may be plenty to eat, but a lot of it is not exactly food. The instinctual urge to consume everything that crosses our path does not serve us well. In order to survive today’s world, the omnivore reaction needs to be unlearned.

This is the exact kind of problem that a professional who is not necessarily a psychiatrist — or even a psychologist — is trained to deal with. A long succession of psychoanalytic sessions may help, but for most people it’s not a realistic option, and it’s not the only way.

Never enough

People today are beset by a variety of mental maladies which, although unfamiliar, are nevertheless real. A study of more than 40,000 college students in the U.S., Britain, and Canada concluded that an “irrational desire” drives members of the millennial and Z generations into depression.

What is this irrational desire? It is, according to Maggie Parker, contributing writer for Yahoo Lifestyle, a longing for… perfection.

The researchers define perfectionism as “a combination of excessively high personal standards and overly critical self-evaluations.” One of the big problems, notes Dr. Barbara Greenberg, is social media. Everybody compares themselves to the online portrayals of friends and strangers, and believes that they come up short. If body image is the area of concern, the eating disorder known as anorexia nervosa might develop. More commonly, it goes the other way.

The feeling of inadequacy, of never being good enough, causes anxiety and depression — two of the main conditions for which people use food to self-medicate. The unreasonable craving for perfection can lead to the most literal kind of hunger, the kind that results in obesity. And that’s just the enemy within. Plenty more hostility comes from the outside. Socially prescribed perfectionism is the kind demanded by others, rather than the self, and it needs to be quelled.

In other words, it is detrimental to a person’s emotional health, to care too much about what other people think. Socially prescribed perfectionism…

[…] was positively related to a range of psychological disorders and symptoms of disorders, including social phobia, body dissatisfaction, bulimia nervosa, and suicide ideation, and had the greatest relationship between other dimensions of perfectionism and depression and anxiety.

As we have learned, psychiatric nurse practitioners are trained in therapeutic modalities that enable patients to overcome anxiety and depression. This places them among the non-psychiatrists who can help reverse the obesity epidemic. Members of many job categories can impact obesity. Leading the way out of such hangups as socially prescribed perfectionism, is what therapists do.

Your responses and feedback are welcome!

Source: “The ‘irrational desire’ driving millennials and Gen Z into depression,”, 01/03/18
Photo credit: digitalbob8 via Visualhunt/CC BY

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