Only Three Possibilities for Change

September is, of course, Childhood Obesity Awareness Month, so we are in its midst. Not surprisingly, it looks much like any other month, here at Childhood Obesity News.

The next few posts will focus on parental involvement. In any family where a child is dangerously obese (or combative, or pyromaniacal), it is widely recognized that while the child is the designated patient, the whole family is, to some degree, sick.

When a heroin addict goes through rehab successfully, then returns to the same set of circumstances where the addiction took hold in the first place, the odds for lasting recovery are abysmal. When addictive behaviors are the issue, the surroundings and the people in those surroundings are crucial. Even if a morbidly obese child is so fortunate as to be granted a year-long stay in the world’s best residential weight-loss facility, sending the child back into the same environment after the “fix” is unlikely to have good long-term consequences.

When journalist-turned-psychotherapist Lori Gottlieb wrote “What Brand is Your Therapist?” she brought readers along on her journey of realization, namely, that psychotherapy had been going out of style for some time. Insurers would much rather pay for a bottle of pills than for an unpredictable, open-ended prescription like therapy. Big Pharma figured out that while influencing doctors with fancy weekends in exotic locales was all well and good, the real money was in teaching patients to nag their doctors for solutions that originated in laboratories.

Branding? No thanks.

When colleagues suggested that a branding consultant might help, Gottlieb found the very idea at first repulsive, and then oddly intriguing. She contacted Casey Truffo, a professional in that field, just to see what such a person might have to say. Before going into the consulting business, Truffo had been a practicing therapist for nearly two decades, a strong indication that she knew what she was talking about, and it was this: “Nobody wants to buy therapy any more.”

What they want, Truffo says, is to buy a solution to a problem. On its face, there is nothing wrong with that sentiment. But in practical terms, what it boils down to is, the solution people hope to buy is that other people will change. While it is true that people sometimes will change in return for payment, too often force is involved. This is problematic because even a dictatorship (or a stay at fat boot camp) can only induce people to change their behavior, not their essential selves. Still, the sad reality remains — three things in the world are amenable to change — the environment, other people, and the self.

Narrowing it down

A neighborhood, an institution, or a legal system can be changed, generally with a great deal of dedication and hard work. The catch is, changing the macro-environment usually entails enlisting a large number of allies, i.e. other people. At that point, the project automatically moves into the territory of the second possibility, changing other people. If those other people were already on board with your desired conditions, the problem would probably not have arisen in the first place.

Now, think how difficult it can be to change even a mini-environment that involves just one other person. You want to live in safety, but your housemate is incurably negligent about locking the front door. Getting that person to change their level of security consciousness might prove so arduous, it would be easier to simply transform your micro-environment by moving, or replacing the housemate.

Trying to change other people is often a fool’s errand. But that does not stop anyone from signing up for therapy, in hopes of learning the secret formula to make other people change.

As Truffo told Gottlieb about her 18-year psychotherapy practice, “I’d see fewer and fewer people coming in and saying, ‘I want to change.’ ”

Your responses and feedback are welcome!

Source: “What Brand Is Your Therapist?”, 11/23/12
Photo credit: Steve @ the alligator farm on Visualhunt/CC BY-SA

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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