Role Models

My own efforts in the last 6 months to eat really well have certainly illustrated to me just how much our diets are effected by the eating habits of the people we surround ourselves with. The social dynamics of the food environment are a huge part of the healthy eating equation.

This week, my own experience is reinforced by yet another study linking social environments to food consumption. The August issue of American Journal of Clinical Nutrition released a study that looked at children's eating behaviors when paired with friends or strangers with varying body types. Here is what the researchers found:

Results showed that friends who ate together consumed more food than participants who were paired with someone they didn't know, and that friends were more likely to eat similar amounts than participants paired with a stranger.

However, overweight children who were paired with an overweight peer, whether friend or stranger, ate more than the overweight participants who were paired with a normal weight youth.

I am not surprised by these findings. I think most of us tend to eat more when we are in the company of people we know because we have established our eating habits with them already; they know how much we eat at mealtime, and we are less concerned about being judged based on our food consumption.

Most human beings, unfortunately, take their cues about when to stop eating from their external social environment and not from their bodies. It is a lot easier to pig out on a pint of Ben & Jerry's with a friend who is doing the same than it is with a friend who eats only salads. It is not surprising, really, that kids who ate in the company of obese peers wound up consuming more food. Something about the obese peer, be it their eating habits during the study or their size, made these kids feel ok about eating more calories.

These findings really underscore the importance of the right kind of social pressure in the quest for healthy, sustainable, and affordable food. The message is clear: in order to eat better, we need positive role models to send us the right social clues. And, all of us have a duty to become better role models to the people in our lives by improving our own dietary habits.

Last Monday the LA Times ran an article titled "Does it matter what the doctor weighs?" Apparently, there is a war going on about healthy role models. On one side there are people who are calling on doctors to practice what they preach about diet and exercise and lead by example. This camp feels that Obama's nominee for surgeon general - Dr. Regina Benjamin - is carrying around too many extra pounds and is thus sending the wrong message to the American public. We are in the midst of an obesity epidemic, after all.

On the other side are the people of the Fat Acceptance Movement. They say, first of all, that a doctor's size does not matter because people come in all shapes and sizes. On a more exteme level, proponents of Fat Acceptance call for Fat Pride and decry descrimination again the obese. Some even challenge the claims that obesity is really all that harmful to one's health, saying that current research has blown the health consequences of obesity way out of proportion. Two years ago the New York Times explored the growth of the Fat Acceptance Movement with a look at a new academic discipline: Fat Studies.

Since then, Fat Studies and the Fat Acceptance Movement have continued to gain momentum, and I am pretty concerned about that trend. I consider most elements of the Fat Acceptance viewpoint to be a considerable barrier in the quest for healthy and sustainable lifestyles. I actually think radical Fat Acceptance is downright dangerous.

No one should be persecuted for their size, and we certainly need to recognize that overweight is a very complicated issue involving a mixture of voluntary behavior, heridity, and involuntary barriers to a healthy lifestyle such as lack of access to good food and lack of education about nutrition. I do not in any way think that obese Americans should face cruently or discrimination. No one should.

But, I do agree with the scientific evidence that suggests that obesity is indeed bad for one's health. I think it is dangerous to encourage people to be proud of a condition that has been so clearly linked to preventable diseases and early death. Rather, we need to be compassionate to our friends and ourselves in this regard, recognizing that we all need support in getting healthy - from the people around our dinner tables to the people sitting around conference tables making decisions about food policy in Washington.

I think that a doctor's size does matter. Do doctors and health care professionals have to be perfect, muscular, and totally fit? Of course not. In fact, a doctor who has had to work at establishing a healthy lifestyle is a huge asset to the profession because they are able to empathize with patients who are struggling with diet and weight issues. A doctor doesn't have to be perfect, but I do not think it is ok for them to be "dangerously overweight and proud of it" either. There is a line between being obese and being a healthy, curvy, non-supermodel human being, and I think the more radical voices in the Fat Acceptance Movement are missing that line.

Don't get me wrong, I celebrate Love Your Body Day with the best of them. But, I think that part of loving your body is respecting it enough to keep it healthy with good food and adequate exercise. Health care professionals should make an effort to be good role models by loving their own bodies and taking care of them.

Dr. Regina Benjamin is overweight. She is also an incredibly accomplished woman who probably works crazy hours and has little time to exercise. But, instead of declining to comment publicly about her weight, Benjamin could have addressed the issue head on. What barriers has she faced in the quest for better health? Benjamin is blessed with a huge megaphone: she is a well known public figure, and people will listen if she talks. So, why not talk about the challenges she is facing? Why not set an example but setting some goals? Hell, she could even blog about her own quest to get healthier and thus inspire other Americans to do the same.

If I am aware of the fact that study after study continues to suggest that our eating habits are heavily influenced by social and societal clues, I am sure the nominee for Surgeon General is aware of them too. I would like to see her sending a better message, because role models do matter.

The Food Bank for New York City has a fantastic campaign on their website called The Change One Thing Pledge. This campaign calls on people to make one diet change that will simply move them towards "a more active, longer and healthier life." I would like to see doctors around the county, especially Dr. Regina Benjamin, take this pledge. Maybe I should send her the link?

(I am not blessed with a huge megaphone. Yet.)