Behavior changes beat ‘scolding fork’ for improved health

Posted Jan. 17, 2013, at 12:45 p.m.

People struggling to adhere to New Year’s resolutions to lose weight will soon have a new weapon in their fight against obesity: the HAPIfork. The cutting-edge cutlery tracks eating habits such as the diner’s number of bites per serving, then syncs with a computer to store the data. The fork vibrates to warn users if they are eating too fast or too much.

The “smartfork” technology also allows users to share their information with others, which HAPILABS, the Hong Kong-based purveyor of the utensil, hopes will create a supportive online community of healthier eaters.

A high-tech fork that shakes its tines at overeaters to scold them when they overindulge may be a novel idea. But is it the right approach? Experts say successful weight loss comes not just from altering a diet but from comprehensive behavior change — and addressing any underlying reasons for the weight in the first place. Traumatic childhood experiences, for example, whether they involved abuse or neglect, have been shown to lead to obesity and physical inactivity.

Still, a recent study by The Associated Press-NORC Center for Public Affairs Research shows that few Americans adequately understand the risks of being obese. Most recognize the two major threats, heart disease and diabetes, but very few respondents made the connection between obesity and arthritis, respiratory problems, high blood pressure and high cholesterol. Those ailments aren’t as immediately debilitating as heart disease, but they incrementally inhibit daily functions and lead to more incapacitating conditions.

Only 7 percent of those surveyed mentioned the link between obesity and cancer. A September 2012 Trust for America’s Health report connects obesity to greater incidences of and more difficulty treating uterine, kidney, esophageal, colon and postmenopausal breast cancer. The same report lists 23,721 cases of obesity-related cancer in Maine in 2010.

The report also projects that if current trends continue, Maine’s adult obesity rate would swell from 27.8 percent, which was the figure in 2011, past 55 percent by 2030. But a 5-percent reduction in Maine’s average body mass index, the standard that measures obesity, would likely save the state’s residents 7.1 percent in health care costs, which equates to $2.78 billion by 2030. In human terms, that’s more than 40,000 Mainers who might avoid Type 2 diabetes, 38,000 who might escape heart disease and more than 3,600 who might live without obesity-related cancer.

Averages don’t account for individual circumstances, but, for context, a 5-percent BMI decrease for a 6-foot-tall person weighing 200 pounds translates to losing roughly 10 pounds. Dropping 10 pounds seems manageable, but focusing on numbers misses the point, according to Celeste Pascarella, coordinator of the Center for Weight and Lifestyle Change at Mid Coast Hospital in Brunswick.

Overcoming obesity in a way that sustains personal and public health requires behavioral change, which is why Mid Coast’s program blends mental health counseling with nutrition and exercise instruction.

“Our class is not a diet class. It’s a behavior-change class,” she said, suggesting that changing cultural attitudes toward weight, rather than counting pounds, will yield healthier results. “Having a three-pronged focus and a strong, nonjudgmental behavioral component really makes a difference. A lot of people deep down know what they should eat, it’s getting them to do it that’s hard.”

The Healthy Lakes Region of Maine, a consortium created with support from the U.S. Centers for Disease Control’s Communities Putting Prevention to Work program, offers another example of a behavior-changing approach to obesity prevention. Bringing together businesses, schools and other partners in the Sebago Lake area, the consortium increased access of low-income residents to healthier foods by making it possible for them to use food stamps at farmers markets and delivering local produce to food pantries. Another component of its focus on behavior change broadened access for low-income community members to eight exercise facilities that they otherwise could not afford to use.

Behavior changes comes slowly, as evidenced by Maine students’ sometimes unenthusiastic response to larger servings of fruits, vegetables and whole grains in school cafeterias, but working with Maine adults and children to shape their lifestyles in healthier ways, rather than trying to alter their shapes to reverse the negative impacts of obesity, represents a worthwhile investment in public health.

Maybe in addition to a scolding fork that counts chews, the folks at HAPILABS can also come up with a utensil that claps for diners who choose healthy foods.

http://bangordailynews.com/2013/01/17/opinion/behavior-changes-beat-scolding-fork-for-improved-health/ printed on September 30, 2014