1. Obesity is a Disease, Not a Lifestyle Choice Tricia Ligon Manager Advocate Weight Management September 2014 Why America is obese

2. Objectives  Quick overview of HOW and WHY America is where it is today  Identifying the addiction component of Obesity treatment  Motivation: when to be the Hammer or Hugger

3. HOW and WHY America is where it is  Only 9% of Americans can accurately estimate the number of calories they should consume in a day  1/2 of Americans are unable to estimate how many calories they burn in a day  Most Americans don’t track calories consumed or burned citing numerous barriers –Extreme difficulty & lack of interest –Lack of knowledge and focus IFIC Foundation Releases 2011 Food & Health Survey

4. HOW and WHY America is where it is  Facts About American Eating Habits –In a 2012 study, 52% of Americans believed doing their taxes was easier than figuring out how to eat healthy.

5. HOW and WHY America is where it is  Facts About American Eating Habits –At least 1 in 4 people eat some type of fast food every day.

6. HOW and WHY America is where it is  Facts About American Eating Habits –Data from the U.S. Department of Agriculture found that in 2011 the average American consumed nearly one ton of food. That’s 1,996.3 pounds of food a year.

8. HOW and WHY America is where it is  Facts About American Eating Habits –Americans consume 31% more packaged food than fresh food

9. HOW and WHY America is where it is  Facts About American Eating Habits –Healthiness of the food we eat decreases by 1.7% for every hour that passes in the day, meaning that people generally eat healthiest at breakfast and will most likely eat unhealthier food later in the day.

10. HOW and WHY America is where it is  Facts About American Eating Habits – Over 10 billion donuts are consumed in the US every year. – 20% of all American meals are eaten in the car. – Americans spend 10% of their disposable income on fast food every year.

11. HOW and WHY America is where it is The United States of America is the most over fed and under nourished nation!

12. Obesity and Addiction

13. Obesity and addiction  A hard habit to break –we starve ourselves for a week or two, then give in and binge with half a dozen donuts, all the while feeling intense shame and self-disgust, we can get ourselves into a lot of trouble. –unlike other addictions, we can’t just stop eating or stay away from all the things that remind us of food, because we have to eat to live.

14. Obesity and addiction  A hard habit to break –Relapse happens

15. Obesity and addiction  A hard habit to break –The power of a “cold turkey” program –Slow weight loss might not always be the best

16. Obesity and addiction  A hard habit to break –Sugar addiction Fact or Myth

17. Obesity and addiction  A hard habit to break –Sugar addiction Fact or Myth - Neuroscientists have shown, using fMRI to scan the brain‘s activity in real-time, that sugar leads to dopamine release in an area of the brain associated with motivation, novelty, and reward. This is the same brain region implicated in response to cocaine and heroin.

18. Obesity and addiction  A hard habit to break –Sugar addiction Fact or Myth -A researcher at the National institutes for Drug Abuse has shown, using brain imaging, that there are similarities in the brains of obese people and those of drug addicts and alcoholics. This is indirect evidence, as we don’t know that sugar consumption caused this effect.

19. Obesity and addiction  A hard habit to break –Sugar addiction Fact or Myth -While we don’t know for sure, it is possible that eating too much sugary foods could lead to cravings, withdrawal, tolerance (needing more to get an effect) and preoccupation with finding the favored food. “Seeking” behavior

20. Hammers and Huggers

21.  What works for you? –Tough love –The truth does not have to hurt –Sometimes it just not the right time…….

22. Hammers and Huggers  What works for you? –Patients need our respect Obesity is openly discriminated against in our society. Obesity is a disease not a lifestyle choice.

23. HOW and WHY America is where it is  Annual Gasoline Costs –1 billion additional gallons of fuel annually Overweight (BMI 27.5):  $8* Moderately Obese (BMI 32.5):  $16* Severely Obese (BMI 37.5):  $23* Morbidly Obese (BMI 42.5):  $30* Overweight (BMI 27.5):  $10* Moderately Obese (BMI 32.5):  $19* Severely Obese (BMI 37.5):  $27* Morbidly Obese (BMI 42.5):  $36* *data based off of 2009 average gas price of $2.35/gallon

24. Hammers and Huggers  What works for you? –Follow the BOE’s and you can’t go wrong!