Sorry to advertise for Burger King....but this ad must be shared and Funny Friday's definitely the day to share it.
Have a great weekend!
(email subscribers head to the blog to watch)
[Hat tip to friend and blog reader Jesse Elliot]
Friday, May 31, 2013
Sorry to advertise for Burger King....but this ad must be shared and Funny Friday's definitely the day to share it.
Thursday, May 30, 2013
I've blogged in the past about breakfast cookies - and with Dare's Bear Paws Morning Snack cookies can now claim their rightful role as snack food too.
Wonder when I'll be blogging about the world's first dinner cookie?
Hi Yoni -For those keeping score, even Dare thinks they're cookies as that's what they're calling them on their nutrition facts panel online:
Have you seen this yet?
They're Bear Paws - "Morning Snack" - and yes, this is actually what they are calling the cookie with a 'yogurt' filling. Funny, I usually like my yogurt from the fridge, not packaged between sugar, more sugar and processed flour.
Apparently, the kids in the commercial (and by default, all kids) need a cookie snack to 'keep them going" in the morning because they like to play. Parents should 'feed the fun'
Feed the fun?? Seriously??
Very interesting focus on the morning snack as well - I'll say when my kids were in kindergarten, their teachers used to make kids eat their "healthy" snack in the morning and save their "junky" snack for the afternoon. Notice how the assumption was all kids showed up with a 'junky' snack... but I digress. I'm just dismayed at the additional level of up-marketing this product to the level of a 'healthy, morning snack". I see how that will feed right into a parents desire to give their kid 'healthier' versions of snack foods.
OK - enough rant from me.
Rebecca Davids, MSc, RD
PS - An interesting addendum as we were discussing this product at an RD meeting yesterday. A dietitian mentioned that she's seen these products pop up on child care menus at morning snack. Unfortunately, Dare's marketing tactics seem to be working.
Wednesday, May 29, 2013
|Photo from McDonald's website highlighting last year's McHappy Day to support Ronald McDonald House|
Cases in point.
A few weeks ago I was part of a round table discussion on public private partnerships between the food industry and public health. With me on the panel was Mr. Richard Ellis who in turn is McDonald's Canada's Senior VP of Communications, Public Affairs and Corporate Social Responsibility.
I've embedded his few minute speech below, but for me his highlights were the public health interventions he reports McDonald's strongly supports that presumably are also proof positive for him that food industry partnerships serve the public good "in pursuit of a common goal".
Let's go through the public health partnerships championed by McDonald's and reported by Mr. Ellis one by one:
1. The Building Trust Initiative
The Building Trust Initiative as put forth by Canada's Institutes of Health Research was straightforward. Their aim was to literally build "trust" between the public health sector and the private sector. I did not participate in a primary workshop, but I did attend a brief conference based session and can tell you there was a clear and wholly unhidden agenda. The Building Trust workshops weren't designed to suss out whether trust was deserved or useful to public health, but rather were workshops truly designed to find means to inspire and cultivate trust.
Mr. Ellis, in his presentation, explained what was valuable to him personally consequent to the Building Trust workshops. He reports having been able to, "build a lot of great relationships", and reported that "when we meet each other as individuals we look beyond the brand and we see that we're all caring people who want to facilitate some broader system change".
And those relationships are precisely what's in it for the food industry.
By building personal relationships suddenly when faced with industry unfriendly considerations public health folks may find it more difficult to be vocal which in turn benefits industry and may help to protect sales. I experienced this phenomenon personally and I blogged about it regarding a meeting I once had with David Moran, a very nice and seemingly sincere man who at the time was also Coca-Cola Canada's Director of Public Relations.
2. The %DV Program
When it was launched I refered to the %DV program as, "the most useless nutrition campaign in history".
Briefly the campaign promotes nutritionism. It explicitly encourages Canadians to look at nutrition facts panels and decide if a food is a good choice or not on the basis of what percentage of a very limited number of nutrients are in a food.
The campaign undermines efforts at more rigorous nutrition fact panel reform and plays right into a food industry that likes to sell food on the basis of health halos which suggest because of the presence or absence of a particular nutrient suddenly the food is a healthful choice.
[I notice for instance McDonald's now has the number of grams of whole grains listed on their sandwich boxes as if to suggest your sandwich choices there are always wise ones.]
3. The Sandbox Project
According to the industry supported and included Sandbox Project their mission is to,
"provide the leadership to act as a catalyst for change in Canada. We will work directly with parents, business, health industry leaders, governments and non-governmental organizations to raise awareness, pursue research, collaborate to develop solutions and better public policy."And while the project is young their recent response to Ontario's Healthy Kids Working Group suggests a very industry friendly agenda.
Included in their response is their assertion that the medical literature reports providing children with health education causes harm, that the panel's concerns regarding the rising weights of children is unfounded, that the report's emphasis on the food industry's marketing to children was overdone, and that the time to act is not now.
4. British Columbia's Informed Dining Program
Simply put the Informed Dining program is a farce that provides people with permission to eat out. It involves restaurants signing on to hand out detailed nutritional information to consumers who ask (or hanging up large detailed posters) and currently the National Restaurant Association is using the existence of this program as a means to try to prevent the legislation of calorie postings on menu boards.
The fact is no one uses pamphlets. Really. Pretty much no one. One study conducted in 2011 tracked 4,311 consecutive patrons of McDonald's, Burger King, Au Bon Pain and Starbucks where information pamphlets, kiosks and posters were available. 6 customers out of 4,311 used them.
Canadians eat out far too often. Providing them with permission to do so and ensuring they don't in fact utilize information is for the food industry what Informed Dining is all about - that and forestalling the legislated posting of menu board calories.
5. Ronald McDonald House
There's no denying that Ronald McDonald House provides wonderful services to those who use it. There's also no denying that it serves McDonald's as a tremendous goodwill generator and more to the point of this piece as a means to market food to children, to introduce children to the good deeds of McDonald's, to provide a reason to eat at McDonald's, and to create incredible and fierce brand loyalty.
Looking at these five reported interventions as examples - sometimes food industry public health partnerships will involve programs that directly increase sales or improve brand loyalty (Ronald McDonald House), sometimes partnerships will put a public face on a corporate entity and in turn may well soften criticisms (Building Trust Initiative), sometimes partnerships will promote messages which in turn might serve to help to protect sales (The Sandbox Project), sometimes partnerships will serve to deflect potentially industry negative legislative efforts (Informed Dining), and sometimes partnerships will serve to or to foment industry friendly confusion or obfuscation (%DV).
And I want to be clear here. I don't think publicly funded corporations are evil. To be evil would require a corporation to have the luxury of pursuing ideals regardless of balance sheet impacts and that's a luxury corporations simply do not have. If profits and health collide I've got great faith that the food industry will lend a hand.
At the end of the day here's a truth.
A public corporation cannot invest in a program or intervention that in turn would ultimately serve to decrease sales more than not being involved in that same intervention. Doing so would not only be an affront to their shareholders, it'd be grounds for their lawsuits.
Mr. Ellis seems like a genuinely nice man with real concerns for the well being of others. McDonald's seems like a genuinely profitable publicly funded corporation with real concerns for the well being of its balance sheet.
Don't confuse one for the other.
[I left out discussion of McDonald's involvement with the WWF out of this post as I don't feel sufficiently informed therein to comment with any authority]
Tuesday, May 28, 2013
Monday, May 27, 2013
Thanks to Tosha Rhodenizer, YMCA vice-president of health, fitness and recreation for sending this craziness my way.
Wondering if it's a local one-of or a chain wide inanity?
Either way, someone out there seems a bit confused, no?
Saturday, May 25, 2013
The Militant Baker and her open letter to the CEO of Abercrombie and Fitch along with some brilliant photographs.
A great piece by Patrick Mustain in Scientific American, "Dear American Consumers: Please Don’t Start Eating Healthfully. Sincerely, the Food Industry"
A bonus piece: If you want your heart to warm some and to be proud of at least two of your fellow human beings, read this. I mean it. Read it.
[And if you don't follow me on Twitter or Facebook, here's my quick 6 minute "Nay" in opposition to public private partnerships between public health and the food industry as it played out a few weeks ago at the Canadian Obesity Network Summit]
Friday, May 24, 2013
Or at least trying out a labour pain simulator.
And that's today's Funny Friday.
Have a great weekend!
(email subscribers head to the blog to watch)
Thursday, May 23, 2013
|Photo by Will Lyon, Via Flickr|
That photo up above? That's the state of information on the internet. And us? With our tweets, blog posts and Facebook updates, we're effectively our readerships' valves where our jobs are to turn the torrent into something drinkable.
And being a valve I think comes with a simple obligation.
Before we tweet, post or update with links to, or commentary on, a press release, newspaper article or scientific abstract, I think it's our valvular duty to our readers and followers to read the source story's actual study and evaluate it critically to determine whether or not we're publicizing worthwhile information.
Sadly - and at times we're all guilty of this - many readers and followers don't get past the headline, or the 140 characters, or the update, let alone even make it through a story's first paragraph, and I'd venture nearly none pull and read the source study. Instead they take our link, retweet, or update as confirmation that we agree with the piece and feel that the study was a valuable addition to the literature, and as you all know, despite the existence of peer review, simple publication by no means guarantees quality.
And I know it's incredibly tempting to retweet a press release, news story or a blog post about a study that neatly confirms our own confirmation biases, but please, before we do, it's that much more important for us to first read the actual study and evaluate it just as critically (if not more so) as we would those studies that don't complement our own personal beliefs and narratives.
Now I'm not suggesting that we all have to come to the same conclusions, nor that we're all going to do a bang up job in our critical appraisals, I'm just suggesting that we owe it to our readers to ensure that the information we provide is information that we've personally and carefully curated (or at the very, very, least disclose right off the bat we haven't actually read or evaluated the study at hand).
The fact of the matter is, people follow our work because they trust us and it's up to us to ensure that we're deserving of that trust.
Simply put, you've got to read it before you tweet it.
(P.S. - because this blog post doesn't in fact refer to a particular study, please feel free to share it far and wide without the need for further review)
Wednesday, May 22, 2013
For those of you who don't know what they are, an FFQ serves in many research studies as the underpinnings of diet history whereby research subjects recall what they've eaten which serves as the basis for the diet aspect of the study at hand.
That pear up above?
It wasn't an exotic variety - it was a Bartlett. It weighed 0.9lbs (60% more than a "large" pear is supposed to) and contained more calories than a Mars bar.
I've also had oranges larger than grapefruits, plums larger than apples, and grapes the size of golf balls.
Coupling the facts that we often forget what we've consumed, that our eyes are terrible scales, and that food has grown dramatically over the years (even foods like fruits), I can't help but question the veracity of FFQs.
Has made me wonder whether or not a photo diary to go along with an FFQ would reduce error.
Might make for a good study.
Tuesday, May 21, 2013
Since 2005 I have been a certified Diplomate of the American Board of Obesity Medicine (ABOM) - now a joint venture between the American Society of Bariatric Physicians and the Obesity Society - and in a few more years I'll be faced with the choice of re-certifying, or letting my credentials lapse.
Part of my decision no doubt will be whether or not I feel the ABOM and I are on the same page in regard to science, medicine, ethics, and values when it comes to obesity medicine and I'm not convinced right now that we are.
You see a few months ago the ABOM put out a press release (that's a screenshot up above) highlighting the upcoming appearance of one of their board members on the Dr. Oz show. Her name is Dr. Denise Bruner and she was on Dr. Oz to promote the use of 5-HTP as an appetite suppressant. The ABOM also showcased her upcoming appearance of their Facebook page:
Both the press release and the Facebook update were quickly removed after I pointed out that given the ABOM's ultimate aim to be accepted as a credible medical organization it might be best to not promote 5-HTP supplementation for obesity given that the evidence base on its utility is anything but robust (here's a pubmed search that includes the 25 total citations that mention 5-hydroxytryptophan and obesity whereby the most generous take on the research would be that in the late 1980s and early 1990s two small studies suggested the possibility that 5-HTP supplementation might help ever so slightly with weight management).
But that's not the end of the story. While I was heartened that the ABOM saw fit to rapidly remove their endorsement of a nationally televised promotion of a non-evidence based supplement, I still struggle with Dr. Bruner's ongoing inclusion on the ABOM's board.
I struggle not simply consequent to Dr. Bruner's at best highly preliminary promotion of 5-HTP to literally millions of members of a very trusting public, I struggle because Dr. Bruner is currently a provider of the, "HCG Diet Protocol". Below is a screenshot from her office's website, and because I found it so incredulous that a board member of the ABOM was an HCG diet provider just to be sure I called her office yesterday and confirmed that if I paid Dr. Bruner $200 for an initial consultation, and then an additional $800, that she would inject me with HCG daily for a month.
The evidence base to date on the hCG Diet is clear. It's quackery.
The Obesity Society put out a position piece on the hCG diet last year. In it they state,
"We conclude that the scientific evidence does not support the use of HCG for the treatment of obesity. This position is in agreement with the U.S. FDA. The Obesity Society is committed to advocating the use of therapies for the treatment of obesity that are evidence-based and rejects those that have been shown to be ineffective."The American Society of Bariatric Physicians also has a position piece affirming their non support of the HCG diet and in a 2011 press release supportive of the FDA's removal of "homeopathic hCG" from the market noted succinctly,
"Obesity is a chronic disease which is best treated by a physician who specializes in weight loss and practices medicine based on sound scientific principles. Unfortunately, hCG does not live up to those standards."Dr. Bruner's practices, both in what I see as a markedly overhyped promotion of 5-HTP on national television and her use of hCG on her patients, run contrary to my take on what represents evidence-based obesity medicine, and the fact that she sits on the ABOM's board gives me great pause as to the value of that certification. So too does the title of one of the ASBP's upcoming webinars, "Controversies Concerning HCG for Weight Loss". Malpractice isn't controversial, it's malpractice.
Perhaps with this post the ABOM will see fit to consider whether or not Dr. Bruner represents their organization's aims, and moreover, whether or not there should be some mechanism to de-certify physicians whose practices belie the ABOM's standards of practice.
At the end of the day if the ABOM is hoping to be deemed credible it's going to have to choose to stand strongly against quackery and it's going to have to do so without external blowhards like me needing to point that out.
Saturday, May 18, 2013
The story of Bret - he's a runner.
Nature covers genetically modified crops along with some scary truths and some myths.
Friday, May 17, 2013
I do loves me Parks and Recreation.
I had tried to put this clip up before but it was an unofficial version and NBC yanked it down....but now they've put it up themselves. So sit back and enjoy the future of child-sized in today's Funny Friday feature.
Have a great weekend!
(Email subscribers, head to the blog to watch)
Thursday, May 16, 2013
Apple's app folks determined it was for users aged 4+ (see that little symbol I circled in the top right corner)
And you should know too that Apple also has a 12+ designation which according to their guidance system means,
"Applications in this category may also contain infrequent mild language, frequent or intense cartoon, fantasy or realistic violence, and mild or infrequent mature or suggestive themes, and simulated gambling which may not be suitable for children under the age of 12."And while I realize there's no violence in the game, the age of 12 is where Coca-Cola claims to draw the line at advertising,
"We have historically not placed – and continue the practice today of not placing – advertising for any of our beverages on any media that is primarily directed to, and has an audience of 50% or more, children under the age of 12."
Aside from Apple's suggestion it's for children above the age of 4, it doesn't explicitly say, but after spending a few minutes with it I can tell you this - the gameplay's dead simple.
So simple in fact that even a young child could play it.
So simple in fact that only a young child would want to.
But don't you fret. Coca-Cola's part of the solution, not part of the problem.
Wednesday, May 15, 2013
And what a partnership it is! Not only does the partnership steer people to visit McDonald's, but it also steers them explicitly to a large beverage from Coca-Cola whereby consumers who buy a large Coke (not small or medium Cokes) at McDonald's can trade the cup it came in for discounts at various Ohio tourist destinations.
And clearly a salient example of just how important obesity is to the Coca-Cola corporation who now promote themselves as being partners in trying to create a healthier America. Maybe they'll also give them all soccer balls?
[For those who like numbers, a large Coca-Cola from McDonalds? At 30oz it's just 1/4 of a cup shy of a litre and it packs 280 calories coming from its 19 teaspoons (76g) of sugar.]
Tuesday, May 14, 2013
What sort of help?
- Distributing thousands of "Coca-Cola soccer balls" at major sporting events.
- Encouraging people to sign up for myCokeRewards to get a chance at winning a pedometer....and enjoy an immersive Coca-Cola centric marketing experience on their website and give Coca-Cola permission to market to them directly.
- A new campaign calling on Americans to vote for their favourite parks so Coca-Cola can give them a grant to build something.
- Coca-Cola "Happiness" trucks to roll through more neighbourhoods and towns to inspire people to "move to the beat"....and drink a Coca-Cola bottled beverage.
Just a few quick quotes to keep in mind as to what's in it for Coca-Cola when considering these interventions. Here's Coca-Cola's marketing chief Joe Tripodi chatting about the value of getting people voting and involved with "charitable" programs like myCokeRewards from last year's Wall Street Journal
"If we can get 40 million-plus fans, or even some subset of them talking positively about the things we’re doing, ultimately that’s a good thing for us”And by "good thing" Mr. Tripodi means sales,
"I think it’s probably a leading indicator of potential sales."And what kind of sales does Mr. Tripodi hope for? He told CNBC in 2011,
"We want to double our business in basically a decade."Somehow I don't think a doubling of Coca-Cola's business is going to help obesity much, do you?
Probably not soccer balls or permission marketing either.
Monday, May 13, 2013
"Dear Dr Freedhoff,I reached out to him and asked if his granddaughter might want to write a short comment regarding her decision as well as send along a photo of her protest shirt.
Thought you would like to know that my granddaughter Frances (9) has refused to participate in a Cola-Cola dance which her school has arranged as part of some sports sponsorship thing, this without any prompting from me. She must have been reading your blog. She wants to wear a t shirt with "water " written on it."
"I did not want to be in the coca cola dance, because little children shouldn't be dancing in the favor of a soda company. Also my sports teacher shouldn't be encouraging small children to drink it. You need to stick to healthy foods like fruit,vegetables,meat,and occasionally oils and sweets.And for those public health folks who think partnerships of their organizations with the food industry are a-ok now you know that even some 9 year old kids perceive them as problematic conflicts on interest.
Granddad - I imagine you're darn proud of your granddaughter. Good on her!
Saturday, May 11, 2013
Why the New York Times dubbed Grade 4 student the Michael Moore of the Grade School Lunchroom.
Hyperbole and a Half's Allie with an incredibly personal, insightful, artistic, and cuss word filled look at the current state of her depression.
[And if you don't follow me on Twitter or Facebook, this week's US News and World Report piece is on how desk jobs probably aren't responsible for societal weight gain, and here's an interview I did with Global when I was in Halifax on the issue of parental "No"s and healthful eating.]
Friday, May 10, 2013
Thursday, May 09, 2013
McDonald's fry containers to help teach reading.
And people wonder why their child who has "never been to McDonald's" recognizes those iconic arches by name.
It's not just the food industry who markets junk food, the food industry has many willing marketers including folks whose jobs it is to nurture our children.
And no doubt the teacher who put the display together wasn't going out of his or her way to market McDonald's, they likely didn't give it a second thought, instead they played upon the normalized ubiquity and allure of junk food to try to engage young minds and in so doing, further normalize it into everyday life.
It's not McDonald's that's the problem, it's its normalization.
[Tara also mentioned that her daughter's preschool teacher is buying her daughter's class a McDonald's lunch as an end of year celebration. Sure Tara could say "No", but is it really that easy?]
Wednesday, May 08, 2013
Thanks to Eating Rules' Andrew Wilder for forwarding this my way but it would seem that Abercrombie & Fitch CEO Mike Jeffries doesn't want women with overweight or obesity to even shop in his store (the largest pant size Abercrombie & Fitch make for women is size 10).
And you know what, my 3 girls, I'm pretty sure they'll be just fine with our family's boycott of Abercrombie & Fitch as perhaps unlike Mr. Jeffries, who in the past has been quoted as being very supportive of his store's exclusionary practices, my girls are decent human beings.
(though I suppose I probably already ought to have had Abercrombie & Fitch on my boycott list for making thongs for little girls)
Tuesday, May 07, 2013
That 710ml Froster?
444 calories and 103.2gr of sugar (26 teaspoons - half a teaspoon more than half a cup!)
And of course it also comes with the message that good deeds deserve sugar sweetened treats and that said treats are rewards for a job well done.
Would free passes to city run sporting facilities have been too difficult to obtain for the city run police department to give out in sugar's stead?
Monday, May 06, 2013
The first - we won't be treating children. At least not directly.
I've always worried about the risks for children involved in weight management programs. I've worried about risks to their self esteem, body image and relationship with food and I've worried that they would feel, unfairly, as if their weight were their own faults. Consequently, Family Reset, an interdisciplinary year long program involving 6 months of unlimited access to registered dietitians, social workers, personal trainers and physicians, followed by 6 more months of careful follow-up with the same team, will be delivered exclusively to parents of children aged 13 and younger whose weights put them in the 85th percentile or higher. In so doing we'll be working hard to ensure that parents don't in fact download guilt or blame onto their children, but rather work with us to improve their entire family's healthy home environments hopefully without the child ever being aware of the intervention. And while children themselves won't be "treated" for their weight, they will however receive some group classes with a social worker with a special interest in children where the classes will focus on mental and social health and well being.
The highlights of our Family Reset program include the following:
- All parents are followed by a physician.
- All parents receive 6 months of unlimited one-on-one counselling from a registered dietitian, behaviourist and exercise specialist who will work on family health, parenting, nutrition, healthy active living and the cultivation of healthy attitudes surrounding weight and body image. Parents will continue to meet with all team members following those 6 months at prescribed intervals, but if the need arises, emergently as well.
- All parents who themselves have overweight or obesity will be provided with BMI’s existing 6 month behavioural weight management program which also includes unlimited access to all team members, as well as on-site group fitness classes three times weekly for 6 months.
- Five group classes for children, led by a specialized social worker/behaviourist with sessions focusing on self-esteem, anti-bullying, body image and stereotypes, depression, anxiety, and anger management. There will be no emphasis or discussion on weight at these meetings aside from how weight might play into the emotions and issues being discussed.
- One group class for parents led by clinical psychologist on mental health issues and their impact on self-efficacy, stress management, self-esteem, relationships and their interplay with weight management.
- One group class for overweight and obese adults led by a clinical psychologist on common psychological roadblocks to self-efficacy.
- Ten hours of one-on-one therapy with a clinical psychologist for parents struggling with mental health issues such as depression and anxiety as improving the treatment of mood disturbances will likely improve those parents' interactions with their children
- Monthly group fitness outings designed for families led by exercise specialists to introduce families to different active living options.
- Two group cooking classes for all parents at a rented outside facility designed to teach basic cooking and meal preparation skills. Thanks too to the generosity of best selling cookbook authors Greta and Janet Podleski, each family will receive a free copy of their latest compilation The Looneyspoons Collection which was Canada's best-selling cookbook of 2012.
Our Family Reset program has been funded by Ontario's Ministry of Health, and consequently, despite the tremendous amount of resources being offered, won't be a financial burden. Our office is extremely humbled and honoured to be involved with this project and we would like to extend special thanks to Health Minister Deb Matthews for her consideration and for rapidly responding to Ontario's recent Healthy Kids Panel Report which called for further investment into treatment programs for children with obesity.
This pilot program will run for the next 3 years, support 375 families, and for Ottawa, will help to alleviate the current burden on CHEO's REAL program for children with obesity which in turn has a year long wait list, and stricter enrolment criteria.
If you have a child 13 and under whose weight places them in the 85th percentile (for an article on how to calculate this click here) or higher and would like to be considered for our Family Reset program please give our office a call at 613-730-0264, or send Caroline an email and we will add you to our list of interested parents and contact you sometime in the next 4-6 weeks to discuss next steps.
[Ottawan bloggers, facebookers and tweeters - would greatly appreciate it if you could share this post and spread the word.]
Saturday, May 04, 2013
Sweet brilliant revenge on gaming pirates.
And lastly some crazy riders from musicians on Vice.
[And if you don't follow me on Facebook or Twitter, here's this week's US News and World Report piece on how scales don't measure how you're doing.]
Friday, May 03, 2013
Today's Funny Friday video involves squats.
And a cute workout partner.
Have a great weekend!
(Email subscribers head to the blog to watch)
Thursday, May 02, 2013
Wanna know what has 100% less sugar and calories than the leading Trop50?
Sugar water with vitamins, even watered down sugar water with vitamins, is still sugar water with vitamins (and is most assuredly not a fruit).
Drink your water.
Eat your fruit.
Wednesday, May 01, 2013
Sara’s research group, Applied Research Collaborations for Health (ARCH), uses a social-ecological approach to understand lifestyle factors influencing health status and health services utilization, particularly in relation to excessive weight gain. In particular, ARCH is looking at how obesity is managed within the health setting, as well as in understanding the contribution of the "obesogenic" environment to population weight status.
Today Dr. Kirk shares with us an innovate project out of her ARCH group that looks at the dialogue between a person with obesity and their physicians.
The recent guest post “Do Medical Schools Teach Future Doctors About Weight Management?” by medical student, Jill Trinacty, highlights a number of shortcomings with the current model of medical education when it comes to doctors counselling obese and overweight patients. The frustration Jill feels is indicative of the health care system as a whole: as we grapple with rising rates of obesity and an overburdened health system, there is a lack of clarity around who the key players in managing obesity are, particularly in the primary care setting, and how they view this problem. Many health care professionals feel ill-equipped to identify and deal with issues around weight management and are unsure of their roles and responsibilities.
These deficiencies deserve attention within the Canadian health system, and indeed elsewhere, and innovative research in Nova Scotia is tackling them head-on. Through a series of in-depth interviews, we have examined the experiences of individuals living with obesity, the perceptions of health care providers and the role of social, institutional and political structures in the management of obesity. This study is the first, to our knowledge, to look at the challenges of managing obesity from these multiple perspectives.
In over 40 interviews, we observed how the management of obesity within the health care system is rife with weight bias, stigma and blame. Individuals living with obesity felt that they did not receive the support they needed from their health care providers, while health professionals did not know how best to raise the issue in a respectful way. Furthermore, many participants shared that the relationship between the individual and the health professional was critical for successful weight management. Individuals living with obesity reported feeling that, due to the sensitive nature of the topic of weight, the existence of a trusting, mutually respectful relationship with their health care provider was essential. Unfortunately, this was not their experience in practice. On the other side of the therapeutic relationship, health professionals shared their views related to their own professional frustrations regarding the challenges involved in managing obesity within a system that is not structured to support chronic health conditions and a health issue for which they receive inadequate training. Many health professionals wanted to be able to offer more support, but simply did not know how to within the constraints they faced. Our findings highlight the need for better education for health professionals as Jill identified in her post.
The rich narratives we obtained from our participants have subsequently been developed into a dramatic presentation, depicting the relationship between a health professional (family doctor) and an individual living with obesity (patient). In this dramatic presentation, both internal and external dialogue highlights the spoken and unspoken tensions that were identified by our participants. Early data from pilot work suggests that the presentation offers a powerful medium to raise awareness of these tensions and to provoke a constructive dialogue to address them. We have shared two videos (also embedded down below), one discussing the study findings and a shorter recording of the dramatic presentation. These are available for educational use. This dramatic presentation is ideal for use as an educational tool for health professionals to address the tensions identified through this study. We will also be showing the live drama at interprofessional education events across Atlantic Canada. If you are interested in having the dramatic presentation performed live at an event, please email for details.
Our findings add to a growing body of literature that challenges a number of widely held assumptions about obesity within a heath care system that currently is not designed to provide the support that individuals living with obesity need. It is our goal that the study data inform obesity policy management practices for the future. We think helping health professionals see what is going on behind the scenes is a step in the right direction and we look forward to hearing the views of your readers on our approach.