Thinking in Circles About Obesity

by Hamid, Tarek K. A.

• ISBN13: 9780387094687
• ISBN10: 0387094687
• Edition: 1st
• Format: Paperback
• Copyright: 2009-11-30
• Publisher: Copernicus Books

Summary

Low-carb...low-fat...high-protein...high-fiber...Americans are food-savvy, label-conscious, calorie-aware-and still gaining weight in spice of all their good intentions. Worse still, today's children run the risk of a shorter life expectancy than their parents.

Author Biography

Tarek K. A. Hamid is a professor of system dynamics at the Naval Postgraduate School in Monterey, California.

Table of Contents

Mismanaging the Obesity Threat	p. 1
Like Boiled Frogs	p. 3
How the Problem Sneaked Up on Us	p. 3
The Temperature Is Rising	p. 5
The Heavy Burden of Obesity	p. 7
For Older Americans, The Future Is Now	p. 9
The Sociocultural Burden	p. 10
"Globesity"	p. 11
A Bucket Half-Empty?	p. 12
The Leverage (or the Impediment) Is with the People	p. 13
It Is Not Easy Becoming a Top Gun	p. 14
States in Mind	p. 16
Emotions Play a Role	p. 20
Failure to Learn from Failure	p. 22
Single-Loop vs. Double-Loop Learning	p. 22
Barriers to Learning	p. 27
What is to Be Done?	p. 28
Metanoia	p. 28
Synthesis, Not Analysis	p. 28
What Is Feedback?	p. 32
Circles, Not Straight Lines	p. 32
Dynamic, Not Static	p. 36
Obliterating, Not Automating	p. 38
Notes	p. 41
How We Changed Our Environment, and Now Our Environment is Changing Us	p. 51
Unbalanced Act	p. 53
Moving Beyond Individual-Centric Explanations	p. 56
Evolved Asymmetry of Our Physiology	p. 58
How Asymmetry Is Achieved by Our Physiology	p. 60
Asymmetry in Energy Intake	p. 60
Asymmetry in Energy Expenditure	p. 63
Asymmetry in Energy Storage	p. 65
Conclusion	p. 66
Human-Environment Interactions: Not One Way...and Not One-Way	p. 69
Human Behavior is Not Expressed in a Vacuum	p. 71
It is Not Just Physical	p. 72
A Symphony Out of Tune?	p. 75
Tilting the Energy Balance: More Energy In	p. 77
The Quantity of Food We Eat	p. 78
The Causes Behind the Cause	p. 80
How America's Eating Habits Started to Change	p. 80
The First Mechanism: The Time We Eat	p. 86
Soft Drinks: The Liquid Snack	p. 88
The Second Mechanism: Where We Eat	p. 90
Fast Food: Eat Anywhere, Everywhere	p. 91
The Qualitative Dimension	p. 92
The Quantity Dimension	p. 95
Events Give Birth to Trends, but What Escalates Them Are Self-Reinforcing Processes	p. 100
Demand-Pull	p. 103
Supply-Push	p. 105
Putting It All Together	p. 108
Hurricane Obesa	p. 109
Tilting the Energy Balance: Less Energy Out	p. 111
The Water is Boiling!	p. 111
Work: Engineering Energy Expenditure Out of the Workplace	p. 113
Moving About: Transport and Urban Design	p. 115
Play and Leisure	p. 118
The Burden Is Cumulative	p. 120
Dr. Jekyll and Mr. Hyde, or Changing the Vicious to Virtuous	p. 121
Individual Differences	p. 125
Some Are "Squares," and Some Are Not	p. 125
Deciphering the Code, One Gene at a Time	p. 126
Genes and Individual Susceptibility to Weight Gain: The Experimental Findings	p. 128
The Pimas	p. 130
Genetic × Environmental Interactions: Conclusion	p. 132
Is Ad-Lib Behavior Killing Us?	p. 135
A (Mis-)Match Made in America	p. 135
Like Our Genes, Our Mental Models Did Not Change	p. 137
Turning-Off Automatic Control and Asserting Cognitive Control	p. 138
It Can Be Done	p. 140
The Allure of the "Silver Bullet"	p. 142
Looking Ahead	p. 144
Notes	p. 145
We Can't Manage What We Don't Understand	p. 167
The Energy Balance Equation: Reigning Intellectual Paradigm or Straitjacket?	p. 169
The Magic Number	p. 170
From the Experts' Mouths to the Journalists' Ears to the Public's Mind	p. 171
We Like to Believe that We Are in Full Control	p. 173
What We Know that Ain't So	p. 175
Looking Back Versus Looking Forward	p. 175
The First Trap: Linear Thinking	p. 177
A Plumbing Analogy	p. 180
A Second Trap: Energy as a Single Currency	p. 182
We Need a Better "Map"	p. 184
Closing the Loops on Energy Balance: Energy Output Side	p. 185
Tip of a Physiological Iceberg!	p. 185
"Under-the-Surface" Determinants of Energy Expenditure	p. 186
The System in Action: "Under the Surface" Responses to Energy Imbalance	p. 191
Implications for Treatment	p. 193
Failure to Account for Individual Differences	p. 193
How an Energy Deficit is Induced Also Matters	p. 195
Seeing Through the Complexity	p. 196
Revisiting the Bathtub Analogy	p. 197
Learning to "Squint"	p. 199
Closing the Loops on Energy Balance: Energy Input Side	p. 203
Body Defenses on the Second Energy Front	p. 203
Two-Tier System: Short-Term and Long-Term	p. 204
Short-Term Component	p. 205
Long-Term Component	p. 206
Two Asymmetries, Not One	p. 208
A Homeostatic System with a Difference	p. 210
Beyond Physiology: Closing the Behavior-Physiology Loop	p. 215
Not Only Do We Eat Food, We Also Think About it	p. 215
Which Requires More Effort: To Do or Not to Do?	p. 216
Strength (and Weakness) Model of Human Self-Regulation	p. 217
A First Course in Managing Stocks and Flows	p. 219
The Evidence: To Use It Is to Lose It, at Least Temporarily	p. 221
A Challenge for the Self: How to Accomplish a Lot with a Little	p. 222
Why Goals Matter, and How More May Be Less	p. 224
Weight Cycling: Not Once, Not Twice	p. 230
Understanding How Cycles Happen	p. 231
Longer-Term Risks	p. 235
Less is More	p. 236
Looking Back and Looking Forward	p. 239
Looking Back	p. 239
Understanding is a First Step, But Far from Sufficient	p. 240
Looking Forward	p. 243
Notes	p. 245
We Can't Manage What We Mis-Predict	p. 263
Learning by Doing	p. 265
How Hard Can it Be?	p. 266
Trying Your Hand at Predicting Dynamics	p. 267
The Bathtub Exercise	p. 267
The Answer	p. 269
What Do These Results Tell Us?	p. 271
Beyond Bathtubs	p. 274
"Give Us the Tools, and We Will Finish the Job"	p. 277
Sources of Complexity in Systems	p. 277
The KISS Acronym: "Keep it Simple, Stupid"	p. 279
Argument for a Calculus	p. 281
Leveraging Computer Technology	p. 282
A Microworld for Weight and Energy Regulation	p. 283
Telescopes for the Mind	p. 283
Simulation Models are Operational Models	p. 284
Overview of Model Structure	p. 287
Energy Intake (EI) Subsystem	p. 289
Energy Expenditure (EE) Subsystem	p. 290
Energy Metabolism and Regulation Subsystem	p. 291
Glucose and Free Fatty Acid Metabolism	p. 292
Protein/Amino Acid Metabolism	p. 296
Exercise Metabolism	p. 297
Body Composition Subsystem	p. 298
Fat Mass (FM)	p. 299
Fat-Free Mass (FFM)	p. 301
Taking Off	p. 301
Experiment 1: Assessing Weight Loss-Reality Versus Fiction	p. 303
The Experiment	p. 305
Experimental Results	p. 306
Looking Inside a White Box	p. 308
It Is Not Academic	p. 310
Experiment 2: Going Ballistic-On a Diet	p. 311
Chasing a Moving Target	p. 311
The Experiment	p. 312
It is No Passive Tool	p. 314
Experiment 3: Understanding Why 250 Pounds Does Not Equal 250 Pounds	p. 317
Individual Differences: More than Meets the Eye	p. 317
The Experiment	p. 318
Phase 1: Overfeeding	p. 318
Phase 2: Dieting	p. 320
114 kg ≠ 114 kg ≠ 114 kg!	p. 321
One Size Does Not Fit All	p. 322
Experiment 4: Trading Treatment Options-Diet Versus Exercise	p. 325
Energy is Not a Single Currency	p. 325
Diet Versus Exercise: Do 500 kcal = 500 kcal?	p. 326
Trading Exercise Intensity for Exercising Time	p. 330
Manipulating Diet Composition	p. 332
Don't Trade ... Integrate	p. 334
PhDs for the Masses? (That's Personal Health Decision support)	p. 335
Notes	p. 337
Prevention and Beyond	p. 351
The Fat Lady...Models	p. 353
The Third Path: Prevention	p. 357
Can't Unscramble an Egg	p. 357
The Buck Starts Here	p. 358
Make Healthy Choices the Easy Choices	p. 361
Public Works to Level the Playing Field	p. 362
Energy Input	p. 363
"Thought for Food"	p. 364
Economic Incentives	p. 365
Energy Output	p. 367
Often Preventable But Rarely Prevented	p. 369
Location, Location, Location: Places to Intervene in Systems	p. 371
Behavior Change Cannot Be Legislated	p. 371
Lessons from Managing America's Other Energy Problem	p. 372
Leverage Points	p. 377
Leveraging Paradigms...and Succeeding	p. 379
Back in the United States: A Challenge and an Opportunity	p. 383
It Will Take More Than Food Pyramids	p. 387
"Educate Them and They Will Change"	p. 387
Haifa Century of Government Education	p. 387
It is Not Working	p. 389
It is Deeper than Just That	p. 391
Information is Not Enough to Change Mental Models	p. 393
Learning from Experience: A Bad Second Option	p. 397
Lessons from Business: Learning About Risky Stuff Without Experiencing the Risk	p. 400
Transforming Prevention from a Spectator Sport to a Contact Sport	p. 403
"Virtual to Your Health"	p. 407
Microworlds <$$$> Us	p. 409
Child's Play	p. 411
Learning About Healthy Behavior by Playing, Not by Lecturing	p. 412
Double-Loop Playing	p. 414
(Almost) Never Too Young to Think Systematically	p. 414
At Home, the Real Risk is in Expecting Too Little	p. 417
Shifting the Burden and Its Risks	p. 418
Keeping the Burden	p. 421
Teaching Children to Fish	p. 422
Balance of Powers and Responsibilities	p. 424
Beyond Prevention	p. 425
Wellness Does Not Mean Only a Lack of Disease	p. 425
Beyond Prevention of Disease	p. 427
Health Potential Programs for People?	p. 429
The Second Flowering	p. 431
Advances in Molecular Biology: The Know-How	p. 433
Computational Modeling of Physiological Processes: The Models	p. 433
Ubiquitous Computing and Intelligent Sensors: The Personal Specs	p. 434
The Internet: The Information Infrastructure	p. 437
Not Automating,... Obliterating	p. 437
Notes	p. 441
Subject Index	p. 463
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