Unfortunately the factors spawning the obesogenic environment are not only complex, they are here to stay and do not support our waist lines. They include:

· a readily available and expanded food supply

· technological and economic advancements which reduce energy expenditure such as cheap transport and outsourcing of tasks like gardening and cleaning

· food advertising

· a decline in physical activity

· increased sedentary behaviour such as TV viewing and computer games

· time constraints and dependence on convenience foods with short preparation times

· having easier access to food with the emergence of a supermarket society and the explosion of fast food outlets

· increased access to and consumption of alcohol

· a socio-cultural food focus as evidenced by the relationship between food and special occasions such as Easter and Christmas, as well the increasing numbers and variety of cooking shows on television and the emphasis we place on the positive relationship between food and socialising.

What makes economic and technological progress worse is the associated impact of living in societies saturated with a persuasive and invasive mass media supported by marketing genius that seduces even the most hard-nosed individual to take the path of instant gratification. We want what we want (and, don’t necessarily need) and we want it now, and are prepared to pay for it later, if at all.

In our obesogenic world, eating has become a leisure pursuit and a sedative. Food is no longer thought of as a substance for sustenance and survival, it has been bestowed a social, psychological and physiological significance that has become a major barrier to treating obesity.

Once we could say that weight loss was a simple maths equation of eating less and exercising more, but with the evolution of this more complex and technological society and the birthing of an obesogenic environment our consumption extends not just to food but to the media and marketing messages, our thoughts, beliefs and emotions, the substances we consume and even the chemicals and energies we are exposed to.

In acknowledgement of the obesogenic environment we now marinate in, some researchers refer to obesity as ‘a disorder of convenience’ and suggest that unless interventions are designed around the environmental issues impacting on individuals presenting for weight treatment, interventions are likely to be unsuccessful. However, the power of the mind in managing obesity should never be overlooked as effectively nothing is consumed by the body without the mind’s permission and it is the mind that determines if someone moves or exercises their body, and whether they comply with or give up on healthy eating plans. Therefore, unless we also address the vagaries of a mind that has maladapted to the obesogenic environment by using food for purposes such as managing emotions like stress and depression, to relieve boredom, or as a reward, then we are not addressing some of the major obstacles to weight management.

Weight loss is no longer simple. We live in an obesogenic environment that is here to stay. We must learn to adapt to the complex obesogenic world we live in if we wish to optimise our health and quality of life.

Related posts:

1. Our Obesogenic World: ADJUST or BUST
2. Why did the world get fat
3. Life in the Fast Lane- Fast Food, Fast Medicine, Fast Surgery

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And, if you were not aware, the medical conditions caused by obesity are placing a significant strain on peoples’ health and health systems. Doctors are overloaded and many are burning out, often before they leave medical school!  Their patients are complaining about the limited time the doctor spends with them, and the doctor’s seeming lack of interest and engagement with them. Very few of us have Family Doctors anymore and instead attend the big medical centres, which have surfaced. The high turnover of medical staff in these medical centres means we rarely see the same doctor twice. Given these changes, it was hardly a surprise when the term ‘fast medicine’ emerged in the media.

Now, while some of us may feel like we are just pieces of product in some medical processing plant when we visit the doctor, others of us have become immune to the lack of interpersonal warmth and brevity of our encounters with doctors because it matches our ‘fast’, time pressured lives – we don’t want to spend too long with them either because we live in our own time famine!

Unfortunately, ‘fast medicine’ doesn’t work for weight management. In a three minute, ‘fast medicine’ consultation the doctor’s prescription for weight loss is likely to be, “You need to lose weight”, or “You need to exercise”. They don’t have time to find out what caused your weight gain, or to provide strategies on how to lose weight, and many don’t have the training. The research literature has clearly identified that many doctors agree that time constraints in consultations and lack of training in the weight management area impact on their ability to address this important health issue.

Anyway, enter ‘fast surgery’. While the criteria for bariatric surgery are that you have a BMI>40, or a BMI>35-39.9 with a serious medical condition related to obesity, and have attempted previous weight loss using diet, exercise or medication, surgery is sometimes being recommended without really ensuring that the patient has genuinely attempted weight loss previously. We have become an instant gratification society. We want everything, and we want it now, and are prepared to pay for it later. Surgery to some offers an easy and quick solution. However, although research confirms the success of bariatric surgery in achieving more substantial and permanent weight loss outcomes than conventional forms of treatment incorporating diet and exercise, it is simply not realistic to depend solely on surgical or, even pharmacological treatments, to manage ‘globesity’.

We live in an obesogenic environment and must learn to adapt to it. Diet, exercise and behaviour modification retain their position as the most accepted approaches for weight management and offer the opportunity for multiple positive health outcomes such as improved nutritional status through to a level of mental and physical fitness that a ‘fast surgery’ approach does not promote.

So, enter the ‘slow movement’. Obviously, the ‘slow movement’ has evolved in reaction to the ‘fast movement’ – fast food, fast medicine, fast surgery! The ‘slow movement’ is about making a connection, about freeing us from our ‘nearly pathological’ need for instant gratification and living a life as pawns in a totally man-made time famine. Fast does not free us. We could all slow down and take time to smell the roses. Effective weight loss and lifestyle changes are not fast. They are best taken one day at a time, and don’t forget you have the rest of your life to do it.

Related posts:

1. The true meaning of Christmas is lost in an ocean of marketing mania, purchasing pillages and food fests
2. The Secret to Getting the Body and Life You Want (Part 2 of 4)
3. The Secret of Getting the Body and Life You Want (Part 3 of 4)

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The bad news is out and hard to ignore. Evidence is growing that links obesity and executive dysfunction in the brain and this refers not just to reduced mental functioning but to scary conditions that none of us want to end our dying days with such as Alzheimer’s dementia ^[1].

So, what is executive functioning and why do we need it? Well, with a name like ‘executive’ it clearly tells you that it is that part of the mind that takes charge of most things. In more scientific terms, executive functioning refers to your mental abilities that control and regulate other abilities and behaviors such as the ability to organize thoughts and activities, manage time, prioritize tasks, make decisions and work towards goals. In a nutshell our executive functioning enables us to think and act normally!

Teachers in schools often talk about the executive functioning of children in relation to their learning abilities. If you are worried about your child’s executive functioning, or your own for that matter, then I suggest you view the following link to get a brief overview on symptoms relating to executive function (you may have to copy and paste it into your url). See your doctor if you are at all concerned.

http://www.schoolbehavior.com/conditions_edfoverview2.htm

Now the good news is if you are carrying a few extra kilos of fat, it appears you will be able to delay the decline of mental functioning caused by excessive levels of fat tissue and even improve current mental functioning if you comply with the following:

· Manage blood pressure & actively avoid weight gain as you age. Why? Some research indicates that controlling mid-life high blood pressure and abdominal obesity may be strategies to reduce mental decline with age ^[2].

· Exercise and increase physical activity in general. Research^[3] states that regular voluntary physical exercise and exercise training can favorably influence brain plasticity (ie the ability for the brain to change in a positive way) and the decline in mental functioning with aging and neurological disorders like Alzheimer’s dementia.

· Ensure an adequate intake of Omega-3 Fatty Acid. Research ^[4] says that diets rich in omega-3 fatty acids can lower the risk of chronic disease.

o Rich sources of omega-3 fatty acids include: salmon, flax seeds and walnuts

o Other sources include soy beans, tofu, virgin olive oil, winter squash, halibut, scallops, prawns and to a lesser extent tuna & kidney & navy beans

NOTE: Frying damages the omega-3s so do not fry your fish or the olive oil. Use the oil in dressings instead.

1. ^[1] 1. Gunstad, J., Paul, R.H., Cohen, R. A., Tate, D. F., Spitznagel, M. B., & Gordon, E. (2007). Elevated body mass index is associated with executive dysfunction in otherwise healthy adults. Comprehensive Psychiatry, 48(1), 57-61 ↩
2. ^[2] 2. Wolf, P. A., Beiser, A., Elias, Merrill, F., Au, R., Ramachandran, S., & Seshadri, S. (2007) Current Alzheimer Research, 4 (2), 111-116 ↩
3. ^[3] 3. Dishman, R. K., Berthoud, H-R., Booth, F. W., Cotman, C. W. Edgerton, V. R., Fleshner, M. R., Gandevia, S.C. et al. (2006). Neurobiology of exercise. Obesity, 14, 345-356. ↩
4. ^[4] 4. Nutrition & Food Science; September 2007, Vol. 37 Issue: Number 5 p306-312, 7p. ↩

Related posts:

1. Preventing Obesity in Children (& adults)

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Prevention of weight gain must start with children commencing at birth. Guidelines put forward by Davis, et al  ((Davis MM, Gance-Cleveland B, Hassink S, Johnson R, Paradis G, Resnicow G. Recommendations for prevention of childhood obesity. Pediatrics.2007; 120(suppl 4) :228 –252.)), could well apply to adults, so if you are reading this blog, you can apply it to yourself as much as your children.

Davis et al (2007)  ((refer to note 1)) put forward the following extra guidelines based on research evidence:

1. limit consumption of sugar-sweetened beverages (consistent evidence). See the DietPsyche blog on the link between softdrink and mental health issues for further information on how bad soft drink is for your health.

2. encourage recommended serve sizes for fruit and vegetables which in the USA and Australia is 9 serves per day, normally 2 fruit and 5 vegetables (mixed evidence)

3. after 2 years of age limit television and other screen time to a maximum of 2 hours daily combined daily, and remove screens of all types from children’s rooms (consistent evidence). Prior to 2 years, do not encourage television.

4. eat breakfast daily (consistent evidence)

5. limit eating out at restaurants, particularly those serving large portions and particularly fast food facilities (consistent evidence).

6. eat with the family (consistent evidence), or others. Family meals have been shown to be of a higher nutrient quality, have psychosocial benefits and are associated with lower obesity prevalence.

7. limit portion sizes (consistent evidence)

Available data also suggests the following guidelines ((Barlow, S. E. (2007. Expert committee recommendatiosn regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: Summary and Report. Pediatrics, 120, S164 – S192. DOI:10.1542/2329C)):

1. eat a diet rich in calcium

2. eat a diet high in fibre

3. eat a diet balanced in the macronutrients, protein, fat and carbohydrate

4. encourage breastfeeding

5. promote moderate to vigrorous physical activity for at least 60 minutes daily

6. limit consumption of energy dense foods

Other possible prevention strategies

1. have your doctor plot your child’s BMI (body mass index) at visits so he can monitor your child’s weight and alert you to any problems

2. use numerical acronyms like 9210 to encourage your children to comply with healthy behaviours: 9 (9 serves of fruit and vegetables daily), 2 (2hrs only in front of a screen per day), 1 (hour of exercise daily), 0 (no sweet beverages)

3. watch your own weight, remember you are a role model, so role model healthy eating and exercise behaviours to your children

4. only keep healthy foods at home – out of sight, out of mind!

Please share any other strategies you may have.

Related posts:

1. Obesity is Associated with Brain Dysfunction- Another Good Reason to Lose Weight

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Over the last few decades we have simply eaten more than we needed.

While the increased rate of obesity can be attributed to changes in the food supply and eating behaviour combined with a reduction in physical activity it is obvious that underpinning changes in human energy balance are inter-related factors spawned by a world that is changing rapidly on a technological, psychological, sociological and economical level.

Here is an overview of what factors I came up with that have contributed to our obesity epidemic. Can you add some more?

Genetics and Hormones

As already noted, there is no way the obesity epidemic can be attributed solely to genetic factors; the epidemic has crept up too quickly to blame genetic mutations! While twin studies have clearly demonstrated a genetic risk for obesity, other research has proved that our genes are not destiny. It has been demonstrated time and again that even those with a genetic risk of obesity can manage their weight if they eat properly and exercise!

Similarly, while hormones have been identified that impact on satiety, appetite and fat distribution and that may predispose people to obesity risk we can’t blame our metabolisms either. There is no way that the 67% of overweight and obese men and 56% of the overweight and obese women in Australia have metabolic issues.

So, let’s look at more likely culprits contributing to the changes we have experienced over the past few years to see what affected the maths equation that determines our weight.

Energy in> energy out -> weight gain

Behaviour, Environment & Technology

When I looked at factors contributing to obesity it seemed to me that technological and economical progress have perhaps had the biggest impact on our environment, our social norms and how we live.

When I looked at what factors appeared to be impacting on our activity levels the most glaringly obvious perpetrator was technology.

Read the summary below.

a) Reduced physical activity appears to be due to a number of changes including:

• Technology. Technology has definitely reduced our activity levels.
• Electronic appliances and toys often have a stationary component. Examples include:
• Computers, laptops, notebooks, netbooks
• The internet
• Computer games
• Electronic games such as playstations and the x-box
• iPods, the new ipad, smart phones

b) Social networking on line involves sitting. People spend hours in a stationary position on internet sites like Facebook, My Space, Bebo and Twitter and on internet forums, blogs, dating sites and just ‘surfing the net’

c)Television and cable TV also keep us in a stationary position.

d) Elevators and escalators, electric doors, travelators in airports and aeroplanes offloading passengers straight into the terminal instead of on the tarmac have further eroded opportunities to burn a few calories.

e) We choose automated car washes over the hose in the backyard, particularly in areas experiencing water shortages

f) We press buttons to wash our clothes when a few years ago we struggled with twin tubs, wringer washers and hot coppers

g) Instead of burning up calories hanging the clothes on the line, then taking them off, we throw them in the dryer

h) We buy and eat pre-packaged food rather than growing our own vegetables or shopping for the food fresh then chopping and preparing it from scratch

i) We do things quickly, like cooking in the microwave as opposed to chopping, cutting, stirring.

j) Lack of physical safety in public areas has caused parents to be reluctant to allow their children outside. Similarly, many females may feel unsafe walking or running outside alone

k) Changing social norms when it comes to fraternising with neighbours has reduced our opportunity to “do” things with our neighbours. We keep our children indoors, reducing play time that burns up those extra calories. One in five children are now obese. They are electronically baby-sat and this makes them fat!

l) Better transport services mean that people take buses, trams and trains to work or school or drive. I have seen in my own practice that people who don’t have cars burn more energy because they are forced to walk more and often have lower weights.

m) Higher incomes mean that most people own labour saving devices such as cars and can drive places. Others can afford cleaning ladies and gardeners

n) With the decentralisation of some cities those that cannot afford inner city living tend to live in suburbs meaning they are required to drive to shopping centres and other venues

o) Apartment living is on the rise and often involves less energy expenditure that would be devoted to cleaning larger living spaces and caring for gardens

p) Longer work hours means we have less time to devote to physical activity and are more likely not to spend time shopping for and cooking food, so we eat more fast food and convenience foods

q) Growth of entrepreneurial business to save labour time for busy professionals has made us fatter. We have everything from dog washing services, cleaning services, complete meal services, house washers, gardening services and let’s not forget places like MacDonalds, Hungry Jacks and KFC.

r) Unemployment often means people stay at home and watch TV because they cannot afford to go out.

s) Mental health issues such as depression and anxiety are on the increase. One of the symptoms of these conditions is low energy and they tend not to do the thing that helps their condition most, which is to exercise. They have lower motivation and energy levels.

t) Increased food intake has also made us fatter.

• people are eating larger portion sizes
• access to food has become much easier. It was reported during the recession that three industries that did not suffer were fast food, grocery stores and the weight industry. Better food access is demonstrated by the following facts:
• we are a supermarket society
• fast food outlets abound
• we can dial in takeways or order them online
• some companies deliver the week’s food
• there are school tuckshops, and workplace canteens
• supermarkets offer more than 50,000 food choices, many of them prepackaged foods
• all shopping centres have food courts and you never see an empty food court
• we can access food at any time from 7/11 stores, 24 hour petrol stations and cafes
• we have unashamedly evolved into a cafe society; instead of going for a walk in the park,we go out to drink coffee, eat cake and watch people
• Bottle shops make the purchase of high calorie liquor easy
• Nightclubs are open till 3am giving ample opportunity to consume zillions of liquid ‘empty’ calories
• We have transport to travel to purchase food
• We have the money to buy takeaway food or eat out
• Most social functions involve food and the more extroverted of us may struggle with our weights purely because we are out and about and eating so much
• Having a food focus has become a part of our society
• Going out to a restaurant is a leisure activity
• We not only have cooking shows, we have taken cooking to reality TV levels
• There are travel tours based around cooking
• Cooking is regarded as an acceptable leisure pursuit or hobby
• We live to eat, not eat to live

u) Food technology

• We have a bigger range of soft drinks, sports drinks and milk drinks to choose from
• We have a larger range of tastier, higher calorie pre-packaged foods
• Food manufacturers get to put words like “lite”, “no fat” and other labels on food so we think we can eat more of it, but the truth is putting low fat on fruit juice while technically correct only distracts you from the fact that it is full of carbohydrate and has the same calories as cordial!

v) Increased alcohol consumption

• the easiest way to put on weight is to drink it on, particularly alcohol which is 7kcals or 37kjs per gram.
• We have become a planet that accepts alcohol consumption. In fact, cultures are recognised by their alcoholic preferences eg Aussies drink beer, the French drink wine, the Russians drink vodka….
• high binge drinking in women has increased
• people drink in order to be more accepted socially
• anxious people drink to calm their nerves so they can actually relax and manage to socialise
• some people even think they can’t have fun and let go unless they have had a few drinks
• night clubs open till 3am so we can drink all night
• both the pub and club culture provide an opportunity to consume more calories
• the tradition of visiting take-away food outlets after a night of drinking only adds to the overall calorie intake
• alcohol is a disinhibitor so after a few drinks people cease to monitor how much they eat or drink
• if your alcohol use becomes addictive the care factor for your health becomes even lower
• bottle shops have made access to alcohol easier
• wine clubs ensure we have heaps of the high calorie liquids in the house
• it’s legal
• it’s socially acceptable to offer it at social functions

w)  Change in work hours

• We live in time famines and have the excuse to take the easy way out when it comes to food – takeaways, fast food, pre-packaged food
• Working long hours also means we exercise less

x) Media and advertising

• research has shown that TV advertisements affect food choice
• research has also shown that TV advertising and the print and electronic media have been involved in eating disorders
• it is easy to condition ourselves to eating. For example, it has been shown that people who eat in front of TV, will cue themselves to wanting to eat each time they turn the TV on!

y) Environmental factors

• Increased population density in cities has led to smaller yards
• Apartment living, as noted above means we burn fewer calories gardening and cleaning, and if we have an elevator direct from the carpark to the apartment, well, there goes another opportunity to burn calories.

And, my list is not finished. I just got sore arms because the only energetic movement I made in the last hour or so was to type. I think typing is the most common exercise most of us are doing in the 21st century!

So please respond to this list with your comments on what you think has made the world fat. I am doing research at a tertiary level and I would rather hear it from you than read it in a research article!

Related posts:

1. Our Obesogenic World
2. Some Scary Facts on Fat
3. Fightening Facts About Fat

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According to The Australian News, obesity costs Australia over $20 billion per year. In fact an Access Economics report released in 2008 estimated that obesity cost Australia $58 billion! I have even seen quotes that Australians spend $1,000,000 a day on the weight industry. During the recession the weight industry was reported as one of the few industries that did not suffer financially. And why? Well, we just keep coming back. We keep on going on and off those diets. Basically, we never give up trying to find the panacea for weight loss success!

To see how fat the world has become just click on the following link to view an international graph on global obesity statistics:

A study by the U.S. Centers for Disease Control and Prevention , Weight of the Nation Conference (2009) in Washington, DC. reported that two-thirds of US Adults and one-fifth of US Children are obese or overweight. In Australia, one in four of our children are overweight or obese. In the 24 years between 1980 and 2004 obesity prevalence figures doubled.

Not surprisingly, the cost to the economy in lost working days and extra healthcare costs is staggering, in fact, something in the vicinity of  $45 billion a year. This study showed that obesity related issues now contribute more to healthcare costs than smoking or alcohol-related problems.

During the same conference, author Eric Fickelstein, director, RTI Public Health Economics Program in Research Triangle Park, N.C.  quoted  ”A normal-weight individual will spend about $3,400 per year in medical expenditures and that number rises to about $4,870 if that individual is obese. For people on Medicare, average expenses for a normal-weight person average about $4,700 a year, while costs for an obese person range about $6,400 annually”. “The biggest driver of these excess costs are prescription drugs”, Finkelstein said.” Among the normal-weight population, prescription drug costs average about $700 a year, but among those who are obese the cost rises to about $1,300 a year, an 80 percent increase”.

In the UK, the rate of obesity related surgery continue to rise. The direct cost of obesity to the NHS is £0.5billion or $0.9 billion US, while the indirect cost to the UK economy is at least £2 billion, according to Liam Donaldson, England’s chief medical officer.

The World Health Organization predicts there will be 2.3 billion overweight adults in the world by 2015 and more than 700 million of them will be obese. These trends, of course, will generate more weight-related health problems.

So what is the fate of being fat?

Ignoring fat will almost certainly impact on your life, and in some cases can be ‘deadly’.

Be informed, obesity is a risk factor for:

* diabetes

* high blood pressure

* high cholesterol and triglycerides

* arthritis

* gall bladder disease

* gynaecological problems

* some forms of cancer

Now, how do we achieve freedom from fat?

As unfortunate and unexciting as it may sound, THERE IS NO SECRET TO WEIGHT LOSS.

Weight loss is a very simple maths equation – less in, more out, and your body will be forced to burn your fat sources for energy.

Forget fad diets and one off quick fixes with drink mixes & meal replacements. You’ll never stick to them long term. Similarly, forget fat wobbling machines and creams to dissolve cellulite. They don’t work. And, save yourself some money buying magazines and books promising to give you “secrets to weight loss”. There is no secret. Be warned, I’ve just spent thousands on learning about internet marketing and they constantly encourage us to use the word “secret” because it sucks you in!

The cold hard facts are, unless you do something surgically drastic, self-discipline is the super highway to permanent weight loss. Self-discipline develops you on a personal level and is a lot cheaper and less risky than surgery.

So, roll up your sleeves and get serious. You want to change your life, and that includes your body, then change your minds, literally! There is a lot to be said for the practice of self-discipline.

Make a decision to stick to the weight loss maths equation (eating less and doing more), and review your motivation daily.

Motivation is like bathing, you need to attend to it daily.

And, never forget that your history is a good predictor of the future. If your “dieting” didn’t work in the past it is unlikely to work in the future. It’s not the diet that doesn’t work. It’s YOU.

To lose weight permanently you need to make lifestyle changes rather than just temporary changes, and you need to master your mind!

Some proactive activities for you to do could include:

1.  Setting the Right Goals

Effective goals are:

* specific

* attainable and

* forgiving

An example of an effective goal is “I will walk 30 minutes, five days each week”. This goal is specific, attainable, and forgiving. Forgiving infers that if you miss a day, you still have six more up your sleeve! Giving in and giving up CANNOT BE AN OPTION.

2. Build on Little Successes

Select a series of short-term goals that get you closer and closer to the ultimate goal. The Japanese call it Kaizen. Look at how they used kaizen to transform from a reputation of only making junk to becoming recognised for their technological achievements. Little by little, and without undue fan fare they worked towards their goal and proved the turtle wins the race, not the hare. The hare starts and stops. Keep going because persistence pays. Persistence and self-discipline are good friends to hang out with when you are losing weight and becoming physically active.

3. Reward Yourself

To keep your goals going, ensure you give yourself ongoing and non-food related rewards! Remember, weight loss is a maths equation that works best with a few psychological extras like persistence and self-discipline.

Increase exercise and activity and decrease food intake on an ongoing basis, and add a daily dose of motivation.

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