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Medical Forum / Diseases and Disorders / Diabetes / March 2006

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DM Behavioral Change Research Not Sexy but Needed

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Uncle Enrico - 19 Mar 2006 23:43 GMT
We see lots of studies into new drugs,  medical procedures and equipment,
but there seems to be a shortage of behavioral research into how to help the
obese do what they know they should do.

I was glad to find this study, but after reading it, I found it to be one of
the least exciting abstracts of a research study I've ever read.

Where's the ground breaking, spectacular research into behavior change for
all those people who know what they should be doing but don't do???

Damn.
Julie Bove - 20 Mar 2006 00:53 GMT
> We see lots of studies into new drugs,  medical procedures and equipment,
> but there seems to be a shortage of behavioral research into how to help the
> obese do what they know they should do.

"Do what they should do?"  What's that supposed to mean?  There are plenty
of overweight people who exercise and do not overeat.  If only it were as
simple as that!

> I was glad to find this study, but after reading it, I found it to be one of
> the least exciting abstracts of a research study I've ever read.
>
> Where's the ground breaking, spectacular research into behavior change for
> all those people who know what they should be doing but don't do???

There isn't any.  This is an age old problem and there is no one solution
because the root of the problem is complex.  People don't do what they
should for a variety of reasons.  It is easy to say that a person won't
change their behavior unless/until they realize there is a problem and make
the decision to change.  People won't make that decision for a variety of
reasons.

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Uncle Enrico - 20 Mar 2006 02:07 GMT
Julie...perfect answer illustrating the essential problem.

Until we believe we can change, we won't.

Now...how to foster a belief that one can solve his own problem. That's step
1.

Behaviorists...where are you?

>> We see lots of studies into new drugs,  medical procedures and equipment,
>> but there seems to be a shortage of behavioral research into how to help
[quoted text clipped - 20 lines]
> the decision to change.  People won't make that decision for a variety of
> reasons.
Jenny - 20 Mar 2006 15:11 GMT
> Julie...perfect answer illustrating the essential problem.
>
> Until we believe we can change, we won't.
>
> Now...how to foster a belief that one can solve his own problem. That's step
> 1.

No. Finding a solution that actually solves the problem is step one.

If you give a patient a diet that is unpleasant to follow and results in
no weight loss they can believe they will change all they want, but they
won't lose weight.

I think most people with diabetes make the rational assumption that if
an unpleasant behavior modification does nothing to improve their
situation it isn't worth doing. Show them solutions that will solve
their problem and most of them work very, very hard at it.

Most of the drugs and dietary changes given to diabetics by mainstream
doctors don't improve their health much. Most diabetics are given orals
that drop them a whopping 1% on the A1c and low fat, low calorie diets
that raise their blood sugars and make them feel like crap while not
taking off the weight. Exercise is wonderful, if it gives results, but
there is a population who research has shown do not get the IR reducing
benefits of exercise because of mitochondrial abnormalities. Those
people are not going to stick with exercise programs if they leave them
drained and exhausted and they don't lose weight.

Every one here who posts about the benefits of some diabetes control
strategy is enthusiastic about it because it works for them!

You don't see people posting about how great exercise is who don't enjoy
exercise and don't see its impact on their bodies. You don't see people
posting about the benefits low fat diets who didn't lose weight on them.
You don't see people posting about low carb diets who didn't control
their blood sugars with them, etc. etc.

--Jenny

http://www.phlaunt.com/diabetes  Diabetes Info

http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood
Sugar Under Control
Uncle Enrico - 20 Mar 2006 16:49 GMT
There are libraries and bookstores full of diet solutions. There are
websites with solutions. The information is out there and much of it works,
if you follow it. The problem is following it, investing yourself,
committing to a plan and doing it, letting nothing deter you. Most of us
have years of diet failure behind us because we depended too heavily on  the
diet rather than developing the psychology that bonds us to change.

There is such a thing as "diet fit," finding  the right diet for the
individual, but the diet strategy is a tool, and tools alone don't do the
job. We do.

The best diets out there, South Beach and Zone, use body chemistry to the
dieter's advantage, but as good as those diets are, people  fail them
because they're not willing or able to alter their psychology and change
over a length of time.

The study I cited demonstrates the effectiveness of "lifestyle change" on
diet success.  But lifestyle change is easy to say, but hard to do.
Emotional/psychological enertia keeps us in the same harmful but  familiar
rut. Moving ourselves out of that rut  can require a strong counter emotion
like a fear of negative consequences if we don't change.

Even with that strong emotion, many people can't make the change. The
problem for  them is  to find a strategy that, unlike the diet, works
successfully on their head and heart, not their just their body.

The average successful  religious cult leader with an 8th grade education
knows how to effect change in people.  What do they use?  Emotion, lifestyle
change, confession, testimonials, verbalization of commitment,
visualization, and ego bonding to the new behavior.

If we've had years of diet failure and have become committed to the idea
that the problem is hopelessly complex and beyond us, we've invested in
permanent failure and our egos fight to maintain that losing position.

Those with strong intellects may be more adept at maintaining the losing
position than some of us simpler folks.

>> Julie...perfect answer illustrating the essential problem.
>>
[quoted text clipped - 39 lines]
> http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood
> Sugar Under Control
Uncle Enrico - 20 Mar 2006 17:06 GMT
Oops. Here's the study link I mentioned but didn't provide:

http://www.highbeam.com/library/docfree.asp?DOCID=1G1:69493739&ctrlInfo=Round19%
3AMode19b%3ADocG%3AResult&ao
=
 
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