Consumer Focused Health

As we think about the increasing sophistication and technological instruments we bring to medicine, we’ve increasingly neglected the human/ psychological components of healthy behaviors.

For example, how much of a difference can primary care docs make on smoking in a 6 minute visit? And when smokers resist the temptation, what is the impact on the rest of their health?

“There is no question that smoking affects the epidemic” of obesity, said Dr. Neil Grunberg, a psychologist and neuroscientist at the Uniformed Services University of the Health Sciences in Bethesda, Md.

Smokers who quit, he noted, gain about 10 to 12 pounds on average, in part because they crave sweet foods and carbohydrates. In addition, Grunberg said, smokers’ metabolism slows after they quit.

Which brings us to an interesting perspective on willpower published in the NYtimes:

Interestingly, restraining our consumer spending, in the short term, may cause us to actually loosen the belts around our waists. What’s the connection? The brain has a limited capacity for self-regulation, so exerting willpower in one area often leads to backsliding in others. The good news, however, is that practice increases willpower capacity, so that in the long run, buying less now may improve our ability to achieve future goals — like losing those 10 pounds we gained when we weren’t out shopping.

The brain’s store of willpower is depleted when people control their thoughts, feelings or impulses, or when they modify their behavior in pursuit of goals. Psychologist Roy Baumeister and others have found that people who successfully accomplish one task requiring self-control are less persistent on a second, seemingly unrelated task.

The implications for healthy behavior are really startling in a world where temptation abounds…unless we become almost puritanical in developing our abilities to resist temptations, healthy behavior that requires willpower will become increasingly displaced. There are two messages that emerge from this:

1. There will be a select few that will engage in healthy behavior because they have massive willpower
2. Healthy behavior needs to become increasingly easy, as the rest of consumer purchases/activities have become easier/more available/more personalized.

I’m betting that #2 is the right approach, meaning that focus on marketing/ distribution/ personalization of healthy behaviors to make them so visible and easy that no willpower is required. Existing approaches requiring a Puritanical work ethic are likely to continue our slide into obesity and chronic illness. Making it easy (or even helping folks to recognize existing good behavior) would be a method of improving health while conserving willpower.

Langer and Crum took several measures of the women’s basic fitness levels, which indicated that they, indeed, had the poor health of basically sedentary people. Then just over half the women were told an unfamiliar truth: cleaning 15 rooms daily — pushing recalcitrant vacuum cleaners, scrubbing tubs, pulling sheets — constitutes more than enough activity to meet the surgeon general’s recommendation of a half-hour of physical activity daily. The researchers even provided specifics: 15 minutes of scrubbing burns 60 calories, 15 minutes of vacuuming burns 50. The basic message and the details were then posted in the maids’ lounges in the hotels where the 44 women worked, to serve as reminders, while a control group was left in the dark.A month later, Langer and Crum checked back with the women to find, as they reported in the February issue of Psychological Science, remarkable results. The average study-group maid had lost 2 pounds, while her systolic blood pressure had dropped by 10 points; by all measures the 44 women “were significantly healthier.” Yet there were no reported changes in behavior, only in mind-set, with the vast majority of the women now considering themselves regular exercisers.

I know in my increasingly time-crunched world, that exercise is harder and comfort food is easier. Switching the equation to help me tap into the fun of participating in sports and being active will reverse that equation and help me bring a carrot into the pursuit of good health, and may help reduce the stress of knowing I should be taking better care of my health.