Thinking in Circles About Obesity

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  • Edition: 1st
  • Format: Paperback
  • Copyright: 2009-11-30
  • Publisher: Copernicus Books

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Supplemental Materials

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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 Threatp. 1
Like Boiled Frogsp. 3
How the Problem Sneaked Up on Usp. 3
The Temperature Is Risingp. 5
The Heavy Burden of Obesityp. 7
For Older Americans, The Future Is Nowp. 9
The Sociocultural Burdenp. 10
"Globesity"p. 11
A Bucket Half-Empty?p. 12
The Leverage (or the Impediment) Is with the Peoplep. 13
It Is Not Easy Becoming a Top Gunp. 14
States in Mindp. 16
Emotions Play a Rolep. 20
Failure to Learn from Failurep. 22
Single-Loop vs. Double-Loop Learningp. 22
Barriers to Learningp. 27
What is to Be Done?p. 28
Metanoiap. 28
Synthesis, Not Analysisp. 28
What Is Feedback?p. 32
Circles, Not Straight Linesp. 32
Dynamic, Not Staticp. 36
Obliterating, Not Automatingp. 38
Notesp. 41
How We Changed Our Environment, and Now Our Environment is Changing Usp. 51
Unbalanced Actp. 53
Moving Beyond Individual-Centric Explanationsp. 56
Evolved Asymmetry of Our Physiologyp. 58
How Asymmetry Is Achieved by Our Physiologyp. 60
Asymmetry in Energy Intakep. 60
Asymmetry in Energy Expenditurep. 63
Asymmetry in Energy Storagep. 65
Conclusionp. 66
Human-Environment Interactions: Not One Way...and Not One-Wayp. 69
Human Behavior is Not Expressed in a Vacuump. 71
It is Not Just Physicalp. 72
A Symphony Out of Tune?p. 75
Tilting the Energy Balance: More Energy Inp. 77
The Quantity of Food We Eatp. 78
The Causes Behind the Causep. 80
How America's Eating Habits Started to Changep. 80
The First Mechanism: The Time We Eatp. 86
Soft Drinks: The Liquid Snackp. 88
The Second Mechanism: Where We Eatp. 90
Fast Food: Eat Anywhere, Everywherep. 91
The Qualitative Dimensionp. 92
The Quantity Dimensionp. 95
Events Give Birth to Trends, but What Escalates Them Are Self-Reinforcing Processesp. 100
Demand-Pullp. 103
Supply-Pushp. 105
Putting It All Togetherp. 108
Hurricane Obesap. 109
Tilting the Energy Balance: Less Energy Outp. 111
The Water is Boiling!p. 111
Work: Engineering Energy Expenditure Out of the Workplacep. 113
Moving About: Transport and Urban Designp. 115
Play and Leisurep. 118
The Burden Is Cumulativep. 120
Dr. Jekyll and Mr. Hyde, or Changing the Vicious to Virtuousp. 121
Individual Differencesp. 125
Some Are "Squares," and Some Are Notp. 125
Deciphering the Code, One Gene at a Timep. 126
Genes and Individual Susceptibility to Weight Gain: The Experimental Findingsp. 128
The Pimasp. 130
Genetic × Environmental Interactions: Conclusionp. 132
Is Ad-Lib Behavior Killing Us?p. 135
A (Mis-)Match Made in Americap. 135
Like Our Genes, Our Mental Models Did Not Changep. 137
Turning-Off Automatic Control and Asserting Cognitive Controlp. 138
It Can Be Donep. 140
The Allure of the "Silver Bullet"p. 142
Looking Aheadp. 144
Notesp. 145
We Can't Manage What We Don't Understandp. 167
The Energy Balance Equation: Reigning Intellectual Paradigm or Straitjacket?p. 169
The Magic Numberp. 170
From the Experts' Mouths to the Journalists' Ears to the Public's Mindp. 171
We Like to Believe that We Are in Full Controlp. 173
What We Know that Ain't Sop. 175
Looking Back Versus Looking Forwardp. 175
The First Trap: Linear Thinkingp. 177
A Plumbing Analogyp. 180
A Second Trap: Energy as a Single Currencyp. 182
We Need a Better "Map"p. 184
Closing the Loops on Energy Balance: Energy Output Sidep. 185
Tip of a Physiological Iceberg!p. 185
"Under-the-Surface" Determinants of Energy Expenditurep. 186
The System in Action: "Under the Surface" Responses to Energy Imbalancep. 191
Implications for Treatmentp. 193
Failure to Account for Individual Differencesp. 193
How an Energy Deficit is Induced Also Mattersp. 195
Seeing Through the Complexityp. 196
Revisiting the Bathtub Analogyp. 197
Learning to "Squint"p. 199
Closing the Loops on Energy Balance: Energy Input Sidep. 203
Body Defenses on the Second Energy Frontp. 203
Two-Tier System: Short-Term and Long-Termp. 204
Short-Term Componentp. 205
Long-Term Componentp. 206
Two Asymmetries, Not Onep. 208
A Homeostatic System with a Differencep. 210
Beyond Physiology: Closing the Behavior-Physiology Loopp. 215
Not Only Do We Eat Food, We Also Think About itp. 215
Which Requires More Effort: To Do or Not to Do?p. 216
Strength (and Weakness) Model of Human Self-Regulationp. 217
A First Course in Managing Stocks and Flowsp. 219
The Evidence: To Use It Is to Lose It, at Least Temporarilyp. 221
A Challenge for the Self: How to Accomplish a Lot with a Littlep. 222
Why Goals Matter, and How More May Be Lessp. 224
Weight Cycling: Not Once, Not Twicep. 230
Understanding How Cycles Happenp. 231
Longer-Term Risksp. 235
Less is Morep. 236
Looking Back and Looking Forwardp. 239
Looking Backp. 239
Understanding is a First Step, But Far from Sufficientp. 240
Looking Forwardp. 243
Notesp. 245
We Can't Manage What We Mis-Predictp. 263
Learning by Doingp. 265
How Hard Can it Be?p. 266
Trying Your Hand at Predicting Dynamicsp. 267
The Bathtub Exercisep. 267
The Answerp. 269
What Do These Results Tell Us?p. 271
Beyond Bathtubsp. 274
"Give Us the Tools, and We Will Finish the Job"p. 277
Sources of Complexity in Systemsp. 277
The KISS Acronym: "Keep it Simple, Stupid"p. 279
Argument for a Calculusp. 281
Leveraging Computer Technologyp. 282
A Microworld for Weight and Energy Regulationp. 283
Telescopes for the Mindp. 283
Simulation Models are Operational Modelsp. 284
Overview of Model Structurep. 287
Energy Intake (EI) Subsystemp. 289
Energy Expenditure (EE) Subsystemp. 290
Energy Metabolism and Regulation Subsystemp. 291
Glucose and Free Fatty Acid Metabolismp. 292
Protein/Amino Acid Metabolismp. 296
Exercise Metabolismp. 297
Body Composition Subsystemp. 298
Fat Mass (FM)p. 299
Fat-Free Mass (FFM)p. 301
Taking Offp. 301
Experiment 1: Assessing Weight Loss-Reality Versus Fictionp. 303
The Experimentp. 305
Experimental Resultsp. 306
Looking Inside a White Boxp. 308
It Is Not Academicp. 310
Experiment 2: Going Ballistic-On a Dietp. 311
Chasing a Moving Targetp. 311
The Experimentp. 312
It is No Passive Toolp. 314
Experiment 3: Understanding Why 250 Pounds Does Not Equal 250 Poundsp. 317
Individual Differences: More than Meets the Eyep. 317
The Experimentp. 318
Phase 1: Overfeedingp. 318
Phase 2: Dietingp. 320
114 kg ≠ 114 kg ≠ 114 kg!p. 321
One Size Does Not Fit Allp. 322
Experiment 4: Trading Treatment Options-Diet Versus Exercisep. 325
Energy is Not a Single Currencyp. 325
Diet Versus Exercise: Do 500 kcal = 500 kcal?p. 326
Trading Exercise Intensity for Exercising Timep. 330
Manipulating Diet Compositionp. 332
Don't Trade ... Integratep. 334
PhDs for the Masses? (That's Personal Health Decision support)p. 335
Notesp. 337
Prevention and Beyondp. 351
The Fat Lady...Modelsp. 353
The Third Path: Preventionp. 357
Can't Unscramble an Eggp. 357
The Buck Starts Herep. 358
Make Healthy Choices the Easy Choicesp. 361
Public Works to Level the Playing Fieldp. 362
Energy Inputp. 363
"Thought for Food"p. 364
Economic Incentivesp. 365
Energy Outputp. 367
Often Preventable But Rarely Preventedp. 369
Location, Location, Location: Places to Intervene in Systemsp. 371
Behavior Change Cannot Be Legislatedp. 371
Lessons from Managing America's Other Energy Problemp. 372
Leverage Pointsp. 377
Leveraging Paradigms...and Succeedingp. 379
Back in the United States: A Challenge and an Opportunityp. 383
It Will Take More Than Food Pyramidsp. 387
"Educate Them and They Will Change"p. 387
Haifa Century of Government Educationp. 387
It is Not Workingp. 389
It is Deeper than Just Thatp. 391
Information is Not Enough to Change Mental Modelsp. 393
Learning from Experience: A Bad Second Optionp. 397
Lessons from Business: Learning About Risky Stuff Without Experiencing the Riskp. 400
Transforming Prevention from a Spectator Sport to a Contact Sportp. 403
"Virtual to Your Health"p. 407
Microworlds <$$$> Usp. 409
Child's Playp. 411
Learning About Healthy Behavior by Playing, Not by Lecturingp. 412
Double-Loop Playingp. 414
(Almost) Never Too Young to Think Systematicallyp. 414
At Home, the Real Risk is in Expecting Too Littlep. 417
Shifting the Burden and Its Risksp. 418
Keeping the Burdenp. 421
Teaching Children to Fishp. 422
Balance of Powers and Responsibilitiesp. 424
Beyond Preventionp. 425
Wellness Does Not Mean Only a Lack of Diseasep. 425
Beyond Prevention of Diseasep. 427
Health Potential Programs for People?p. 429
The Second Floweringp. 431
Advances in Molecular Biology: The Know-Howp. 433
Computational Modeling of Physiological Processes: The Modelsp. 433
Ubiquitous Computing and Intelligent Sensors: The Personal Specsp. 434
The Internet: The Information Infrastructurep. 437
Not Automating,... Obliteratingp. 437
Notesp. 441
Subject Indexp. 463
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