More About Laughter As a Displacement Behavior

Many professionals see laughter as a displacement activity, with the same function as the several other behavioral alternatives, previously mentioned — fight, flee, freeze, feed, fornicate, fool around, fidget, and faint. When a creature is anxious and threatened, the bad feeling needs to be pushed away, and those are some of the options.

Canine expert Patricia McConnell often draws parallels between dogs and people. When faced with two incompatible desires, both species tend to react by manifesting displacement behaviors. About terminology, McConnell makes some very interesting points:

Note that being “stressed” is not inherently a negative state. Stress, if defined and used correctly in the biological sense, refers to being pushed out of a state physiological homeostasis, either by something negative or positive. Being excited about seeing a rock concert is as stressful as being afraid of going to the dentist.

We have probably all heard someone say, “I drink when I’m happy, I drink when I’m sad.” The same goes for eating. To celebrate victories, people consume massive feasts. To console themselves for losses, they do the same.

The uses of laughter

Laughter can be not only a defense, but a tactic. How so? A good case can be made that the bully, on some level, feels threatened, which is painful. To avoid that feeling, she chooses “fight,” and attacks the world preemptively, before it can hurt her again.

A familiar cultural figure is the little guy — or the fat guy — who survives in prison or some other hostile environment by being funny. Real laughter is involuntary, and the ability to tickle a bully’s funny-bone has genuinely saved lives. The rationale even fits with the theory.

If a potential victim is given the chance, he may not have to choose between fight and flight. If he can get the bully to laugh, there is a chance that the monster will keep him around as the court jester. The ability to (1) see something funny; (2) laugh about it; and (3) convey that thought to the bully — it all adds up to a displacement behavior that saves a life.

It triggers a complementary displacement behavior in the bully. Something bugged her and gave her a bad feeling that needed to be dispelled somehow. Violence would have been her first choice. But the victim caused the involuntary reaction of laughter, and diverted the bully onto a different track, with something new to alleviate her malaise.

Independent researcher Brad Bowins addressed this topic:

Mature defenses, including humor, sublimation, anticipation, altruism, and suppression, represent well-orchestrated composites of less mature defenses. These mature defenses involve relatively minor cognitive distortions, largely consisting of an attenuation of unwelcome experience. Humor alters the content of a potentially disturbing scenario so that it becomes lighter and more tolerable.

Your responses and feedback are welcome!

Source: “Stress? Fear? Or “Displacement Behavior”?, PatriciaMcConnell.com, 07/26/16
Source: “Psychological Defense Mechanisms: A New Perspective,” ResearchGate.net, April 2004
Image by naomii.tumblr.com/Attribution-NoDerivs 2.0 Generic (CC BY-ND 2.0)

Laughter As Displacement Behavior

In an essay (as distinguished from a scientific paper) Basil Hugh Hall proposes that laughter is a displacement response — or at least, a phenomenon that parallels displacement activities, in being an effective alleviator of stress.

He establishes that displacement activities are likely to result from motivational ambivalence, anticipation of change in activity, actual change in activity, or internal conflict. (How, one might ask, is motivational ambivalence any different from internal conflict?)

This is a very long and complicated essay, so we will touch on only a few points. Here is an interesting thought:

The concepts of laughing with and at individuals have arisen due to a misunderstanding… I do not believe we laugh at, or laugh with, anyone, as the disinhibition of laughter is an involuntary response to conflict during event processing on a neurological level.

But here today we are not going that deep. When something is used for a different purpose than evolution intended it for, that’s exaptation. Hall’s piece is titled, “Laughter as an exapted displacement activity: the implications for humor theory.”

It is apparent how this makes sense in a very basic scenario, like the classic banana peel slip. The victim’s arms fly into the air; he drops any parcels he might be carrying; he makes hilarious faces and noises, and winds up butt-first on the ground. Which all seems, to any modern human, sufficient reason to laugh. But it goes much deeper.

Our ancestors

When a person sees someone fall, it provokes an instinctive response. If one member of the herd goes down, the enemy might also take down another member — namely, you. The sight of a fallen comrade is perceived as a threat, so the body gets ready to fight or flee (or perhaps to do one of the other displacement activities that have been discussed in recent posts.)

Or — the body laughs. Hall quotes an Oxford University Press dictionary that defines displacement activity as…

[…] the substitution of a irrelevant pattern of behaviour for behaviour that is appropriate to a particular situation, especially as a reaction to a conflict of motives.

Now, it makes even more sense. For most people, watching someone fall involves a conflict of motives. I, the onlooker, feel an impulse to flee from the unseen enemy. It is countermanded by the altruistic instinct to stay and help. On the third hand, even though my brain instantly computes that there is no physical danger, helping would simply be a lot of hassle. Either way, I want to get out of there. So instead, I laugh.

Hall refers to experts who say:

[H]uman laughter has its counterparts in the laughter-like behavior in the apes, it is likely that the evolutionary forerunner of human laughter was of value in intraspecific interactions in some primate groups including our hominid ancestors.

In this scenario, a “staccato vocalization” existed before language. For a band of apes ambushed by a predator, it is appropriate to scatter in panic — but not if this is a false alarm. The theory is that the alpha male would decide whether the threat was legitimate, and if not, would calm the group by producing “an audible and contagious displacement activity” that was the precursor of laughter.

But the late Mitch Hedberg, a revered comedian, could set up and almost complete a joke, and then pause, and wait. In few microseconds, the audience would deduce the punchline, and break into delighted laughter. It was telepathy, genius, magic — a whole different level of transaction. Obviously, there is a spectrum.

Your responses and feedback are welcome!

Source: “Laughter as an exapted displacement activity: the implications for humor theory,” ResearchGate.net, June 2009
Image by Anno Málie/Attribution 2.0 Generic (CC BY 2.0)

Animals, People, and Displacement Behaviors

Experts have posited several different kinds of displacement activities: fight, flee, freeze, feed, fornicate, fool around, fidget, and faint. As Dr. Pretlow says, “Displacement activity is out-of-context behavior that is inappropriate for the situation at hand, the re-channeling of overflow energy from conflicted or thwarted drives into another drive.”

Among animals, fight and flight are presumably their first instinctual choices, but instinct might also prompt them to try something else, like pretending to notice a specially tasty blade of grass. This is a stalling tactic, based on an ancestral memory that the predator might lose interest, or be diverted by a worse predator that can kick its butt. This is hope.

Humans have a more extensive palette of displacement behaviors, and an abundance of hope. A lot of therapy is founded on the idea of substituting a compulsive or addictive behavior with a non-damaging behavior. Dr. Pretlow points out a detail that not everyone seems to grasp: “This is tricky, as the energy must be re-channeled to an actual drive not just a behavior.” He will say more about this at the World Obesity Federation 2019 Regional Conference in Muscat, Oman, in December.

Will we know the clues when we see them?

The trouble with humans is that many of us are not often up against existential threats. We face not a wild boar, but an angry boss who might refuse to grant vacation time in June instead of August. We are armed with a huge assortment of displacement behaviors ranging from silly to dangerous.

If eating makes us feel safe and comfy, then in an effort to erase our tense, conflicted, threatened, bad feelings, we can eat until it turns into something that looks very much like an addiction. We can even eat ourselves to death.

Just as animal trainer Laura VanArendonk Baugh observes displacement behavior in dogs, another animal trainer Robyn Hood tracks it in both dogs and horses. She too delineates boundaries, categorizing fight and flight as responses from core instinct, while freeze, fidget, and faint are “rarely considered except in the context of behavior or attitude.” (But aren’t they all behaviors?)

Hood totally ignores feeding and fornicating, and substitutes “fidget” for “fool around.” So, what is fidgeting, and why is it germane to the subject of child obesity? Hood writes,

It is a form of displacement behavior — taking the focus off of one situation onto another. For instance, if you are trying to groom some dogs, they may roll on the floor and grab the brush in play. It is a way of displaying concern that is often not identified because the dog is not shaking nor is the dog growling or biting. Some children, and adults, fall into “fooling around” when the pressure is on.

Hood also talks about misunderstood horses who seem to be stubborn and rebellious, but who are merely trying to cope with a stressful situation. She recommends,

If you have a horse that displays this type of behavior, watch to see when it most often happens, notice what you are doing and change or stop doing it. Does the horse’s behavior stop, and then start again when you resume your behavior?

In other words, through the time-honored system of operant conditioning, let your horse train you.

Faint as a response

Hood moves on to discuss an infrequent response, fainting, where the overwhelmed horse will fall over or “simply lie down and give up.” People faint too, or sometimes stress just makes their brains go offline. When people use excessive sleep to avoid stress, it might be interpreted as a milder version of fainting. Either choice brings welcome oblivion.

Your responses and feedback are welcome!

Source: “The 5 F’s — Flight, Fight, Freeze, Fidget, Faint,” TellingtontTouch.com, Nov 2001
Image by Bureau of Land Management via Flickr/Attribution 2.0 Generic (CC BY 2.0)

The Mysteries of Displacement Behaviors

Canine expert Laura VanArendonk Baugh says “fight and flight are probably the final stages in stress reaction, chosen when other coping mechanisms are not perceived to be working.” The implication here is that volition is involved. This suggests that when milder coping mechanisms are not doing the job, the will can still be exerted to keep a lid on, or to fight, or to flee.

In other words, the person who feels threatened has the intention of putting on the brakes, so the encounter does not progress to violence. The disgrace of flight would be an equally bad outcome. Consciously or subconsciously, in this transaction the victim (or about-to-be victim) still retains the belief that either fight or flight can be “chosen,” as Baugh suggests.

This is interesting, because another school of thought holds that fight and flight are the two top-rank possibilities, being instinctive and instantaneous. In the human world, it is probably a little of both. We run into a lot of situations where danger is present, and different circumstances bring different options.

A dark analogy

It’s the difference between a mugger and a con artist. The con artist lives in the middle ground of displacement behavior, pulling excuses and fabrications from a hat, one after another, with the cooperation of the victim, who is anxious to avoid arriving at the stage where either fight or flight are indicated.

Conversely, the violent street criminal, if smart, wants to preclude any possibility for middle ground, negotiation, distraction, or any other nonsense. The victim has no choice of range in response. Intermediate coping mechanisms are not even on the table. The thief takes what he or she wants and leaves the scene.

A very, very poor choice of method

When faced with stress, which the body interprets pretty much the same as an assailant with a hatchet, far too many humans use one of those coping mechanisms that can’t really be characterized as “working.” One of its names is compulsive overeating. This coping mechanism causes limitless human misery, and strains the economies of even the most prosperous of the compassionate nations.

Science knows that obesity has to be caught young, because the earlier it starts and the longer it continues, the more difficult it is to reverse. This is why the whole subject of displacement activities or behaviors is so tantalizing. It’s like a ball of twine with many loose threads sticking out.

Any one of them, if disentangled from the mass, might lead to a magical clue or a silver-bullet cure. Any one of these oddball facts about animals might be the key to the kingdom, somehow. If we understand a bird that picks out its own feathers, maybe we can understand the girl who pulls out her own hair.

If we can help the hair-pulling girl, maybe we can help the boy who puts everything edible into his mouth. Some people think of these activities as addictions. This quotation is from a scientific paper about students from an alternative high school:

Theoretically, as an example, one might think of these 11 addictions as grouping to reflect active-nurturance (e.g., Internet, shopping, work), active-pleasure seeking (e.g., sex, love, exercise), and passive-pleasure seeking (alcohol, cigarette, other drug use, eating) motives.

Does this really mean anything to another type of expert, who believes that designating groupings is a pointless task, because all addictions are one? All addictions have one purpose, to avoid pain. All displacement behaviors have one purpose, to avoid pain. From this philosophical point of view, fancy labels are baloney, and paying people to think them up is a waste of precious resources.

Your responses and feedback are welcome!

Source: “The Four ‘Fs’ of Fear,” ClickerTraining.com, 10/01/13
Source: “Prevalence and co-occurrence of addictive behaviors among former alternative high school youth,” NIH.gov, 02/03/14
Image by QUOI Media Group via Flickr/Attribution-ShareAlike 2.0 Generic (CC BY-SA 2.0)

Displacement Activities in Animals and Humans

As Dr. Pretlow has noted, displacement activity is found in fish, insects, birds, reptiles, and mammals. It tends to show up when a threat is felt but neither fighting nor fleeing is possible; and also, as some believe, as preparatory behavior that can ratchet up to the more active options of fighting or fleeing.

Mental and emotional stress can come from many sources, but what they have in common is that the body seems to react as it would to a physical threat. Apparently there are a number of behaviors that animals (and sometimes people) might engage in to relieve the discomfort of a threat, whether physical or intangible. People might bite their nails or pick at their skin.

A dog that compulsively licks its paws is not seeking pleasure, but avoiding pain. A person who compulsively eats potato chips is not seeking pleasure, but avoiding pain.

Looked at from a certain perspective, either one of them could be labeled as addicts. One of the displacement activities a physically threatened animal might engage is feeding. And so might a person who is threatened by unpleasant thoughts and bad feelings. In humans, comfort eating is a popular choice for relieving stress.

So, if the body only wants a displacement activity to make it feel better, why not choose something else other than feeding? In the realm of childhood obesity, could something else replace compulsive eating? Something with fewer calories and less destructive potential?

Depending on how they are defined, seven or eight candidates have been proposed as displacement behaviors: fight, flee, freeze, feed, fornicate, fool around, fidget, and faint. Psychologist neurosurgeon Karl H. Pribram, who published over 700 books and scientific publications, is credited with creating the first displacement activities list, back in the 1950s. His four choices were fight, flee, feed, and fornicate.

At canine school

Dog trainer Laura VanArendonk Baugh references the behavior expert Ted Turner, who recognizes five displacement behaviors but distinguishes between the passive one, which is freezing, and the four active ones: fight, flight, fool around, and fornicate.

From her experience with canines, Baugh learned that while some dogs simply want to play, for others it is a coping mechanism. She writes:

“Fooling around” can appear frequently as a displacement behavior, out of place and sometimes inappropriate. Have you ever been at a funeral or visitation when someone made a joke and everyone laughed too quickly, or more than the joke seemed to deserve? That is classic stress relief by “fooling around.” A bit of humor, appropriate or not, can be a coping mechanism to relieve stress.

Of course, it can go the other way, too. Introducing laughs to a tense situation can backfire, and actually raise the threat level. Baugh continues,

With dogs, fooling around often presents as intense play, such as jumping up on a person, play bows, very pushy greetings, or any over-the-top behavior. It’s easy to assume a dog is just being rude or is over-excited (and that might be the case), but sometimes it can be a desperate-to-fool-around response to fear or stress.

For humans, fooling around (in the sense implied by this context) can change things for the better. Baugh says “fight and flight are probably the final stages in stress reaction, chosen when other coping mechanisms are not perceived to be working.” She advances the theory that if stress is addressed and alleviated at the fooling around stage, escalation to fight or flight may be prevented.

Your responses and feedback are welcome!

Source: “The Four ‘Fs’ of Fear,” ClickerTraining.com, 10/01/13
Image by Dmitriy K. via Flickr/Attribution 2.0 Generic (CC BY 2.0)

Responses to Perceived Threat

In order to recognize PTSD and depression in chimpanzees and apes, scientists use specific criteria described in the Diagnostic and Statistical Manual of Mental Disorders. But this only works in close confinement. In the wild, and in sanctuary sites, it is hard to measure physiological markers because the whole point of those environments is that animals are not interfered with.

In the wild, chimpanzees groom themselves and each other. This has nothing to do with hair styling or fingernail painting, but could be more accurately be called hygienic cleaning. It just means picking off parasites and other insects, dirt clods, dried skin, or plant debris. It gives them something to do with their hands, and serves important social functions. The information may seem gratuitous in this context, but the big picture is that possibly these animal investigations could reveal important secrets about how to prevent childhood obesity.

Like detectives or lawyers, medical researchers sift through tons of evidence in the hope of connecting two obscure facts and making some kind of breakthrough. The habits of non-human creatures may seem off-topic, but everything has to be noticed. Nobody wants future researchers to look back in scorn, asking, “Why didn’t they see that?”

Different strokes for different folks

When faced by the internal threat of anxiety or the external threat of attack, some animals engage in feather-plucking, paw-licking and hair-pulling, as mentioned in the previous post. Those weird behaviors (and no doubt others) could be regarded as grooming gone wild. It is normal, acceptable activity multiplied to the nth power, crossing over the line into self-harm.

While some species will react to bad feelings with self-soothing grooming activities, distressed chimps generally do not use grooming as a displacement activity. They are much more likely, when mentally/emotionally upset, to avoid grooming themselves or others. When confined, they may smear their feces around the environment, which could qualify as a displacement behavior.

Freezing as a response

We also mentioned how professionals in the field have speculated that there may be many more possible threat responses than previously believed. Depending on how they are defined, those would be fight, flee, freeze, feed, fornicate, fool around, fidget, and faint. Some are very relevant to human overeating; others not so much.

Leon F. Seltzer, Ph.D., talks about freezing, an option that sometimes works for animals, being adaptive in many cases. Immobility can equal invisibility, depending on the degree of camouflage that nature has provided, and how the predator’s eyes are constructed, and whether the predator has a great sense of smell, and on whether something more interesting attracts the monster’s attention in the meantime.

When both fight and flight are impossible, freezing is an option. Even a spider on a wall is less likely to be noticed when still than when walking.

In a human we might call freezing impractical, based on a childish belief that the aggressor will become bored or distracted; or forget about, or literally be unable to see the victim. But as many children have learned from alcoholic or otherwise rage-fueled parents, immobility can sometimes buy safety. Dr. Seltzer says,

Under such unnerving circumstances, “freezing up” or “numbing out”  in a word, dissociating from the here and now  is about the only and (in various instances), best thing you can do.

In horses, a brain chemical causes the freeze reflex, but it can be deceptive. Senior instructor at Tellington TTouch Training Robyn Hood writes,

We often see a “freeze” response, labeled by some people, as the horse being “stubborn…” At this point the horse is usually holding his breath and when the rider insists the horse go forward, the horse shoots forward or explodes bucking.

Study of the defensive responses in both animals and humans inspired Karin Roelofs, Professor of Experimental Psychopathology at the Behavioral Science Institute at the Radboud University in Nijmegen, Netherlands, to write,

Freezing is not a passive state but rather a parasympathetic brake on the motor system, relevant to perception and action preparation.

Your responses and feedback are welcome!

Source: “Trauma and the Freeze Response: Good, Bad, or Both?,” PsychologyToday.com, 07/08/15
Source: “The 5 F’s — Flight, Fight, Freeze, Fidget, Faint,” TellingtontTouch.com, Nov. 2001
Source: “Freeze for action: neurobiological mechanisms in animal and human freezing,” NIH.gov, 02/27/17
Image by Arend via Flickr/Attribution 2.0 Generic (CC BY 2.0)

Displacement Behavior and the Many Related Fs

In the popular mind, a threat brings about two possible reactions: fight or flight. This is part of the stubborn general tendency to think in dualities, when actually life often presents more than two alternatives. Various thinkers devise different systems, so they might include three, four, or five responses. Also, scholars ignore activities that others see as totally legit, so it is confusing.

There are at least seven possible F-words: fight, flee, freeze, feed, fornicate, fool around, fidget (which seems not that different from fooling around), and faint (which at first glance could be just a more intense form of freezing, but is probably something entirely different, as we will see in a subsequent post).

Evidence for these various claims overlaps with the study of mental illness in animals, which apparently is not unusual. Shreya Dasgupta wrote for BBC:

Some pet birds obsessively pluck their feathers, and some dogs obsessively lick their tails or paws, much as some humans obsessively clean their hands. Some animals are also known to self-harm, for instance pulling out their own hair.

The threatening situations that cause these reactions include “the loss of family or companions, loss of freedom, stress, trauma and abuse.” Our information about this phenomenon comes mostly from observing captive animals, including pets, who are mostly mammals.

It is more difficult, the author points out, to deduce what is going on with other kinds of animals. Can an octopus experience anxiety, and how does it show up? Would he rub his tentacles together obsessively? Can a bee have a nervous breakdown?

We don’t know enough about their normal behavior to recognize deviance from the norm. But the question is definitely tied in with uncertainty about whether all animals recognize and react to existential threats.

Some of the speculation about animals rests on the idea that they are unable to conceive of the future, which would seem to be a necessary condition in order to experience anxiety or dread. But aside from anticipation of future danger, past experience seems quite capable of causing mental and emotional damage. NPR’s Barbara J. King writes,

Elephants get PTSD not just from trauma inflicted on them but from witnessing cruel things done to other elephants. Dogs rescued from terrible circumstances may get better, but some of them never get well.

She notes that in prison conditions (zoos and laboratories), chimpanzees and apes do not fare well. They manifest behavioral disturbances. If they live through long periods of captivity and/or social isolation and medical experimentation, they are retired to sanctuaries where they show enough symptoms of PTSD to interest researchers.

Plenty of trauma to choose from

For many animals used by science, maternal separation is only the first trauma they experience. To a chimpanzee called Negra, this happened from both angles — she was removed from her mother too soon, and then when she was used as breeding stock, her babies were taken from her before nature intended. Then she was isolated and used in hepatitis experiments for years.

When relegated to a sanctuary, Negra was a nervous wreck. “In response to an unexpected touch, she would “threat bark, scream, or run away.” So, fight or flight — but there is apparently no way to discover what kinds of displacement activities she might have engaged in when unobserved.

Your responses and feedback are welcome!

Source: “Many animals can become mentally ill,” BBC.com, 09/09/15
Source: “Ape Dread, Dog Worry: Animals And Anxiety,” NPR.org, 02/20/14
Source: “Signs of Mood and Anxiety Disorders in Chimpanzees,” NIH.gov, 06/16/11
Image by Mariposa Veterinary Wellness Center in Lenexa, KS via Flickr/Attribution 2.0 Generic (CC BY 2.0)

How to Hoist a Cow

Elevating awareness has been a recent topic here at Childhood Obesity News. This includes concepts like recognizing — and not trying to force — what is known as a “teachable moment.”

We have talked about the importance of making the effort to switch magnetic poles by adjusting a negative attitude to a positive one. Here is an example of why this comes in handy.

When some fresh new aggravation shows up, the old-fashioned, authoritarian parental attitude dictates stomping on it like the first spark of a forest fire on a windy day. Theoretically, a strong initial reaction will shut the thing down forever. Unfortunately, it often works the other way. Once they discover that dropping the cell phone in the toilet can get a rise out of Mom or Dad, some kids will delightedly add it to their repertoire.

A parenting scenario

As usual, little Wendy is having a sandwich for lunch. But today, she carefully picks each molecule of crust from around the edges, and only eats the middle. The parental temptation might be to lecture about how wasteful that is, and how the child has been consuming the crusts up until now with no damage to their health or well-being, and besides, it’s stupid because the browner parts are exactly the same as the rest of the bread.

But rather than make an issue out of it, the parent might pause and reflect. Tomorrow, Grandma is taking Wendy to the farmers’ market, where they will buy something nice from a stall and eat it picnic-style, sitting on the adjacent grass. The next day, the family will go to church and stay for the brunch. Two lunch-sandwich-less days are on the horizon. Let’s just wait and see what happens.

Monday comes around, and there is a sandwich for lunch, and Wendy eats it as if the idea of picking off the edges has never entered her head. Mysteriously, crust rejection is no longer on her to-do list. It can go that way. Occasionally a child will try out a behavior that she or he is not really that invested in, merely to see a result. If nothing extraordinary happens, they might just give it up and move on.

Behavior can be unpredictable

The message here is that sometimes, the lack of parental reaction will send a particular bit of annoyance into oblivion. Which is why the importance of picking your battles cannot be over-emphasized. Not to strain the war-like metaphor, it is also vital to appreciate small victories. The thing about little wins is that you can have them every single day, and they add up to changing behavior over the long haul.

So says a Medium writer Thomas Oppong, reminding us of the importance of marginal gains. Here are some of his encouraging words:

Almost every habit that you have built over the years  —  good or bad  —  is the result of many small decisions you have made over time. If you insist the habit changes within the shortest possible time, you are bound to fail. If you relax and give yourself permission to only improve a little each day, then a good habit works.

He encourages ditching the attitude of demanding instant results, and think about measuring improvement in tiny increments, like 1% at a time. He relates this to the Japanese concept of kaizen, or continuous gradual progress. Some Americans grew up hearing the story of a boy who picked up a calf every day, and as the animal grew bit by bit, the boy’s strength grew bit by bit along with it, until eventually he could lift a whole cow.

Your responses and feedback are welcome!

Source: “Small Wins, Marginal Gains: That’s How You Change Behavior in The Long Term,” Medium.com, 06/09/18
Image source: Jim Legans, Jr. via Flickr

Making Pounds Disappear

On reading Anne M. Fletcher’s book, Sober for Good: New Solutions for Drinking Problems — Advice from Those Who Have Succeeded, Dr. Pretlow remarked that “the parallels with overeating/obesity are striking.” Of course, Childhood Obesity News readers will recognize a similarity to the title of Dr. Pretlow’s book, Overweight: What Kids Say.

The two authors share the very interesting idea that people who have experienced a problem or a condition might be worth listening to. The publisher’s description of Fletcher’s book says,

Finally someone has gone straight to the real experts: hundreds of men and women who have resolved a drinking problem. The best-selling author Anne M. Fletcher asked them a simple question: how did you do it? The result is the first completely unbiased guide for problem drinkers, one that shatters long-held assumptions about alcohol recovery.

However, Fletcher seems to avoid the word “addiction” and even “alcoholism,” and that bothers some critics. Others are perturbed because she believes that alcohol does not have to be totally given up. Admittedly, only “a small number” can have an occasional drink without losing control and sliding back into alcohol dependency. But some feel that alcoholics should not even be exposed to this idea, even if it is true.

Food and eating

Fletcher also published several books about losing weight and keeping it off, and has been a guest on several television shows. A 2010 review of Thin for Life, which appeared at EverydayHealth.com, begins by giving Fletcher’s credits as a registered dietician and a health and medical journalist. Reviewer Katherine Lee wrote, “the real force behind the book is the collection of stories from the weight-loss masters.”

There are 10 guidelines, the most important of which is to believe that you can do it in the first place. In addition to that initial positive attitude, another key is to maintain the positivity, and not mentally beat yourself up over the occasional misstep. The plan is said to be not about deprivation or elimination, which is a controversial stand.

Prospective readers are warned that it is not about quick weight loss, but that is actually much better because quick loss almost inevitably precedes gaining it back up again. This is a plan for the long haul. Aside from mental attitude, the most important factor is exercise, and quitting soft drinks is also an important factor.

Teens and weight loss

In 2008, Fletcher published Weight Loss Confidential: How Teens Lose Weight & Keep It Off — And What They Wish Parents Knew. The publisher’s press release is basically an outline of the book itself, giving away the shattered myths and all the things that young people wish their parents would wise up to.

It also includes several quotations from teens, and an interview with Fletcher about her inspiration:

I actually got the idea years ago, when my overweight teenage son came home from camp and excitedly told me about a boy he’d met who had lost 40 pounds. It occurred to me that a great model for a book would be “teens helping other teens” with weight management. My son lost more than 60 pounds when he was 18 and, when he’d kept it off for a few years, I decided it was time to write the book.

I chose to talk about the issue because I wanted readers to know that my son and I have “been there.” […] My son’s story shows that if you give overweight children the tools to succeed, they may eventually do it.

As sources of information, Fletcher only included teens who had been truly overweight, not just carrying a few extra pounds. Each participant filled out an eight-page questionnaire. Here is a quotation from one of the teens, Sandra D.:

Many different things make a person worthwhile. If you’re not an ideal-sized body, it doesn’t mean you’re not an ideal person.

Your responses and feedback are welcome!

Source: “Sober for Good,” Amazon.com, undated
Source: “Sober for Good,” PublishersWeekly.com, 04/01/01
Source: “Sober for Good,” Goodreads.com, undated
Source: “Thin for Life,” EverydayHealth.com, 07/06/10
Source: “Weight Loss Confidential,” HoughtonMifflinBooks.com
Photo credit: Michael Coghlan on Visualhunt/CC BY-SA

More Teens Try to Lose Weight But Success Is Elusive

A report from the Centers for Disease Control indicates that weight loss aspiration is trending with the young. “More U.S. Teenagers Are Trying to Lose Weight Than in Years Past” is the title of a recent piece by Jamie Ducharme. Granted, a lot of kids approach this problem in healthful ways. But many are doing it wrong, which explains the subtitle, “That May Be Reason for Concern.”

The observation that “rising childhood and adolescent obesity rates likely play a part in the increase,” while it may not be totally in the “Well, duh!” category, seems rather obvious. But that is the nature of scientific reports. Authors in that genre are obliged to spell things out in the plainest language, so the people who pay for the information can benefit from it.

Among obese teens, it appears that the proportion of individuals who are actively trying to shed pounds has increased to around 75%. About 30% of obese boys are taking active measures to reduce, while about 45% of the girls are trying. Hispanic teenagers of both genders are more likely to be trying to lose, than their white, black or Asian counterparts.

What an expert says

Ducharme quotes Dr. Sarah Armstrong, to the effect that efforts to place the emphasis on overall health are not succeeding as well as the medical community would hope. This may be because the zeitgeist still generates plenty of social stigma, and teenagers are very sensitive to it. You can tell them that general fitness is the most important thing. You can suggest that, rather than speak in terms of losing weight, they concentrate on merely holding steady and not gaining for a few months. But all they hear is that they are too fat.

Of teenagers interviewed on the subject, four out of five claim to have tried exercise. Dr. Armstrong is a researcher in adolescent obesity at Duke University, and sympathizes with the efforts made by teens, who often sincerely try to cut their food intake.

The thing about adolescents, she points out, is that they are not particularly knowledgeable about methodologies. In pursuit of thinness, they are liable to take things to extremes, and pass from the land of reasonable and prudent measures into the territory of eating disorders and street drugs.

Dr. Armstrong casts her gaze beyond the unhappy patients and sees “the systems and environmental-level drivers of obesity.” She would like for schools to take a more active part, by providing better nutrition options and physical activity programs. The food industry is also regarded with suspicion.

Policy changes, expense does not

Not long after that article was published, Dr. Armstrong appeared in the news again as the lead author of new policy from the American Academy of Pediatrics. In October, the institution issued guidance based on studies suggesting that…

[…] bariatric surgery in teens can result in marked weight loss lasting at least several years, with few complications. In many cases, related health problems, such as diabetes and high blood pressure, vanished after surgery.

Even children who have not reached puberty have had weight-loss surgery that is considered successful, or at least better than not having it. Pre-teens account for fewer than 2,000 such operations each year. Dr. Armstrong always stresses the importance of the patient having full understanding of the future consequences which, admittedly, children are unlikely to possess. She says,

It’s a lifelong decision with implications every single day for the rest of your life.

Of course, for most of America’s severely obese young people, the question is moot, because the costs of preparation, surgery, and aftercare can easily mount to $20,000. Even in cases where money is not an obstacle, many pediatricians are still reluctant to recommend surgery. The new published policies, hopefully, will help them form a better picture of what to expect and what to recommend to their patients.

Your responses and feedback are welcome!

Source: “More U.S. Teenagers Are Trying to Lose Weight Than in Years Past,” TIME.com, 07/17/19
Source: “More kids who are severely obese should have weight-loss surgery, pediatricians say,” LATimes.com, 10/28/19
Image source: Wellness GM on Flickr

 

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Profiles: Kids Struggling with Weight

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The Book

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:

Presentations

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.

Food & Health Resources