Month: April 2008

Successful Weight Loss

Is successful weight loss possible?  Beginning from the presumption of “will power,” no.  People who “diet” generally lose and gain weight in a yo-yo fashion, often with greater rebounds.  But some people do successfully lose weight and maintain that loss.  What makes them different, and what lessons does that hold for thinking about weight loss?

 

Let us start with this 2005 article by leading researcher Rena Wing and Suzanne Phelan.  Here’s the abstract:

There is a general perception that almost no one succeeds in long-term maintenance of weight loss. However, research has shown that 20% of overweight individuals are successful at long-term weight loss when defined as losing at least 10% of initial body weight and maintaining the loss for at least 1 y. The National Weight Control Registry provides information about the strategies used by successful weight loss maintainers to achieve and maintain long-term weight loss. National Weight Control Registry members have lost an average of 33 kg and maintained the loss for more than 5 y. To maintain their weight loss, members report engaging in high levels of physical activity (1 h/d), eating a low-calorie, low-fat diet, eating breakfast regularly, self-monitoring weight, and maintaining a consistent eating pattern across weekdays and weekends. Moreover, weight loss maintenance may get easier over time; after individuals have successfully maintained their weight loss for 2–5 y, the chance of longer-term success greatly increases. Continued adherence to diet and exercise strategies, low levels of depression and disinhibition, and medical triggers for weight loss are also associated with long-term success. National Weight Control Registry members provide evidence that long-term weight loss maintenance is possible and help identify the specific approaches associated with long-term success.

 

A 2001 review article by Rena Wing and James Hill makes their argument more explicit: “common behavioral strategies, including eating a diet low in fat, frequent self-monitoring of body weight and food intake, and high levels of regular physical activity.”

 

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Keep Communication Open: Net Neutrality

Sometimes it’s about the medium, not just the neuroanth message.  Damian Kulash has an editorial today, Beware the New New Thing, on net neutrality and how companies are trying to sell us something “good” (for those who can afford it) that replaces something better that we already have, an open Internet.  There’s just one problem, we might have that–but not legally.

Here’s one good excerpt: “For some parallel examples: there are only two guitar companies who make most of the guitars sold in America, but they don’t control what we play on those guitars. Whether we use a Mac or a PC doesn’t govern what we can make with our computers. The telephone company doesn’t get to decide what we discuss over our phone lines. It would be absurd to let the handful of companies who connect us to the Internet determine what we can do online. Congress needs to establish basic ground rules for an open Internet, just as common carriage laws did for the phone system.”

To support net neutrality, you can go to the website Save the Internet.

Martin Luther King Jr. on Vietnam and Dreams

My niece sent me the first link, Why I Am Opposed to the War in Vietnam, which is as relevant today as it was then.

And for the second, I Have A Dream, came, of course, at “the greatest demonstration for freedom in the history of our nation” against the “flames of withering injustice” and “the long night of [our] captivity”

The third is Miri Ben-Ari’s Symphony of Brotherhood, an uplifting and haunting piece of music that resonates deeply with me.  I’m not a big fan of music videos, and this one is not particularly well done, so I listen to it with the video in the background.  It’s the music that speaks.

Errol Morris and The Thin Blue Line

Sometimes art is way out ahead of science.  Errol Morris has an essay, “Play It Again, Sam (Re-enactments, Part One),” which speaks to the complexity of human life, the mixture of moral judgments, memory, and evidence.  It is well worth a read.

He discusses the making of his documentary The Thin Blue Line, which helped to overturn a murder conviction in Dallas.  His essay, in one sense, is a long meditation on who we are, who we think we are, and how to show both.  His creative use of interviews, re-enactments, police evidence, audience perspective, and storytelling show how he already knew, intuitively, much of what we try to discuss here.

 I’ll copy his ending here:

Perception is endlessly colored by fantasy and belief – perception of the present as well as the past. If there is a story that we wish to believe, our perceptual apparatus will usually modify or reinterpret what we see rather than the other way around. We see things that do not exist and fail to see things that are right in front of our eyes. We often remember things incorrectly and our memories change over time.

The brain is not a Reality-Recorder. There is no perfect replica of reality inside our brains. The brain elides, confabulates, conflates, denies, suppresses, evades, confuses and distorts. It has its own agenda and can even work at cross-purposes with our conscious selves. Consciously, we may think that we see all and know all, but our brains may be “blind” to much of what is going on around us.

Many people believe they have found a way around the eccentricities of the brain by substituting a camera, but this only defers the problem. It does not solve it. Even photographs have to be perceived. They have to be seen. There is no shortcut around the Cartesian riddle of separating reality from the appearance of reality. There is no shortcut to reality. The brain is all we have.

Culture and Inequality in the Obesity Debate

So far in the posts I’ve done on obesity, I have been focused on the biology behind obesity.  Part of that is due to my class and what this particular section of the course covered—showing them a biological approach to a health problem.  But as I have been going over research on obesity, I’ve collected a number of links and articles on culture, social class, and obesity.  So I am going to share those here. 

Culture 

Let me say one thing.  In biomedicine and particularly in epidemiology, there is an overarching orientation towards the individual.  It is how treatment is planned, how data is collected and analysis proceeds.  This approach misses out on the central insight of culture theory—that aspects of our environment get bundled together due to accumulating human action and our cultural systems of meaning making.  Epidemiology, by separating out factors, has little recourse to understand the dynamics of these larger patterns.  At least in epidemiology, one alternative might be Nancy Krieger’s ecosocial framework (pdf), complemented by James Trostle’s Epidemiology and Culture and Carol Worthman and Brandon Kohrt’s Biocultural Approaches to Public Health Paradoxes. 

In any case, some cultural anthropology and obesity.  First, check out Gina Kolata’s article Chubby Gets a Second Look, including quotes from Emory anthropologists Peter Brown and George Armelagos, teachers of mine when I was in graduate school.  “Being thin really isn’t about health, anyway, but about social class and control.  When food was scarce and expensive, they say, only the rich could afford to be fat…  Those notions of fashion gradually gave way to a more streamlined physique… The body mass indexes of Miss America winners, according to a 2000 study, have been steadily decreasing since 1922, so much so that for most winners in the last three decades their indexes would cause them to be considered underweight.” 

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Utilitarianism and the Brain

Guy Kahane has a discussion of Utilitarianism and the Brain over at Ethics Etc.  In particular, he is discussing Joshua Green’s fMRI studies of moral judgments that have claimed to distinguish between utilitarian and non-utilitarian thinking (and the latter claimed as more rational, the former more emotional and hence not quite as good).  Kahane in particular pays attention to the methods used to generate the evidence and claims, and finds it wanting—the experimental scenarios themselves don’t clearly distinguish between the two types.

The debate has taken place in Nature, and here is a link to the actual text of the Nature critique by Guy Kahane and Nicholas Schackel as well as the response by Michael Koenig and colleagues.

Hat Tip: Natural Rationality