Behavior Change and Physical Health

The following is an article from Ace Fitness. Feel free to weigh in on this important health issue:

Our Position

Because research shows that instilling sustainable healthy behavior patterns, including regular physical activity and sound nutrition, is key to addressing the obesity epidemic ( 1 ) ( 2 ), ACE seeks public policies that make highly qualified, science-based, interdisciplinary coaching, counseling, and support for sustainable behavioral change a functional, integral component of the nation’s healthcare continuum.

Discussion

Behavioral-change facilitation needs to be integral to the healthcare system, reimbursable by insurers, highly accessible, and culturally appropriate for the communities in which it is provided.Our nation’s traditional approach to healthcare—sick patients visit doctors for medical treatments—will not halt nor even slow the obesity epidemic( 3 ) ( 4 ). Obesity results from a complex mix of physiological, psychological, environmental, cultural and socioeconomic factors. Today, the healthcare system sends individuals at risk for obesity away from the system to manage those risk factors on their own. This approach is simply not working. While treating the consequences of obesity is costing the system billions of dollars annually and compromising quality of life on a grand scale, the system is still investing almost no money in primary prevention of the disease ( 3 ) ( 4 )( 5 ).

Interventions that establish healthy patterns of behavior will help reverse obesity trends ( 5 ) ( 6 ) ( 7 ). The healthcare system must invest in sustainable behavioral change at the individual, family and community levels ( 5 ) ( 6 ). Individuals at risk for obesity need ongoing, engaged support by professionals who are well trained in weight management and who specialize in sustainable behavioral change for the large and growing segment of the population at risk for obesity and its co-morbidities ( 6 ) ( 7 ) ( 8 ). Behavioral-change facilitation needs to be integral to the healthcare system, reimbursable by insurers, highly accessible and culturally appropriate for the communities in which it is provided ( 5 ) ( 6 ) ( 7 ) ( 8 ).

Public Policy Priorities

ACE urges federal and state government officials to advance public policies that effectively move obesity prevention and intervention into the healthcare system, including the payment system. Specifically, ACE calls for policies that:

• Ensure that obesity intervention and prevention is supported and paid for.
• Recognize and utilize NCCA-accredited health coaches , fitness professionals and other weight-management and behavior change experts in communities as part of the healthcare continuum.
• Incentivize medical professionals to utilize behavior-change facilitation by well-qualified health and fitness professionals for the large and growing segment of the population at- risk for obesity and its co-morbidities.
• Increase physical activity among youth at home, at school, and in the early care and education (ECE) setting.

Behavior-Change Facilitation and Addressing the Obesity Epidemic

Obesity is the symptom, not the problem

I was very excited when I first read about the ACE's study-Adverse Childhood Experiences. My first thought was, "duh, I could have told you that your childhood has a role on who you are as an adult." I was shocked that this was actually news. I knew this was true, both from personal experience from my own childhood, and from my professional experience working as a counselor; I would see childhood trauma play out in my adult clients all the time. 

For those of you who have not yet heard of the ACE's study, the following is a brief overview:

"The research found that significant stress that occurs during a child’s first 18 years has a profound and long-lasting impact, not only on issues like obesity, but on their overall life expectancy, the risk of diabetes and other chronic health conditions, the likelihood that they will become involved in drugs, alcohol and crime, success in marriage and relationships and even their risk of suicide.  What they found was that children who experience more serious stress (“adverse childhood experiences”) in their childhood face substantially greater health challenges as adults.  In fact, children who face high levels of stress, such as child abuse, or a parent with a mental illness, may face a shorter life expectancy of almost 20 years!  A child who experiences extremely high levels of stress was found to be 460 times more likely than others to become an IV drug user. 

The study found that almost 4 in 10 adults have an “ACE index” of 2 or more – meaning the child faced a combination of more than one major stress event, a level which begins to greatly increase the risk of future health risks and problems.  Given this surprising prevalence, individuals with high ACE scores are our neighbors, our fellow employees, our friends and our families.  Many individuals may be resilient and successful in one or more parts of their lives, but struggle behind the scenes from the lasting impact dating to their childhood." *

Dr. Robert Anda and Dr. Vincent Felitti are the co-founders of the study. This 10 year study began when Dr. Felitti wanted to know why half of the clients of the obesity clinic he worked dropped out of the program even though they were losing weight. 

By interviewing the clients who dropped out, he discovered they all had one thing in common: an adverse childhood experience. Basically what he discovered was that most of the obese people in his program had experienced some kind of trauma in childhood. Dr. Felitti realized that obesity, which is what brings people in for treatment, was not the problem - it was the symptom.

What is the point of this? For so many people, their weight is not what they eat or do not eat or how much they eat. It is not about how active they are. It is about the thinking and beliefs they have about themselves. It is about what they do to manage trauma and abuse from the past. 

I believe that no weight loss program is successful without addressing the thinking behind the desire to lose weight, what the person believes about self, coping skills, etc. Some people become addicted to drugs, alcohol, gambling, or shopping. Some people are addicted to food. Food becomes the way to cope with stressors, with the negative thinking about who they are. Weight becomes a protective barrier. 

This is not necessarily true for every single person who is overweight, but it is something to seriously consider. I'll use myself as an example. I'm currently overweight because I decided to punish my body when I was diagnosed with mild emphysema. It was my own fault that I had it; after all, I did smoke for nearly 20 years. When I was diagnosed I had already quit smoking. Logic says I would have been motivated to continue to be active and eat healthy, but that's not what I did. Humans are, as we know, not always logical. 

As I continue my journey to be healthy mind, body and soul, I find information like that in the ACE study to be helpful. I do not use the facts from this study as an excuse to continue to be unhealthy. This is not about using abuse to stay stuck in the past. Instead, it can be powerful to know that what you do today can be traced back to an event in the past. Of course, once you have this knowledge, you need to use the information to change your current choices, thoughts and behaviors. Knowing how your past effects who you are today is not an excuse to continue to make poor choices!

Click here to learn more about the ACE's study.

Click here to learn more about the connection between ACE's and obesity. 

*http://preventchildabusenj.org/blog/2014/03/19/adverse-childhood-experience-ace-study-findings-by-rush-russell/