Healthy Influence Blog

Today we learn that a medical Expert proposes a new solution to the obesity epidemic. According to an article in the “Daily Mail” newspaper:

“Oversize clothes should have obesity helpline numbers sewn on them to try and reduce Britain’s fat crisis, a leading professor said today. And new urban roads should only be built if they have cycle lanes, according to Naveed Sattar, Professor of Metabolic Medicine at the University of Glasgow.”

There’s more . . .

“Prof Sattar also wants ads for slimming services without independent evaluation banned, TV ads for sweets and snacks stopped before 9 pm, higher tax on high fat and high sugar foods and tax breaks for genuine corporate social responsibility.” (You can read the article if you’d like.)

Where to begin?

A point about journalism first. If free speech falls in the forest, and there’s no one there to hear it, does it make a sound? Whether it makes a sound is debatable, but it certainly doesn’t make a profit. The first rule of journalism in any form is to attract the ears and eyes and today journalism clearly believes it can attract ears and eyes with experts, particularly health and safety experts.

Second, let’s realize that obesity is a health risk and that we’ve known about this not just in the past year, decade, or millenium, but since we’ve got recorded time. When you get seriously overweight, you will have health problems. No news here.

And, third, we know that while there are multiple causes of obesity, when there is a sudden and large increase in the percentage of obese people in a society, typically the largest cause is not medical, but rather lifestyle factors. That is, when you find a society that quickly goes from a lot of lean people to a lot of fat people, the cause is not a virus or bacteria or some other new ailment, but rather that the society has figured out a way to generate a lot of cheap, abundant, and safe food for all of its people and people are having trouble controlling their behavior.

Professor Sattar must be an Expert in metabolic medicine. That’s beyond dispute. He’s a professor at a university, he’s got the lab coat, a bar chart, and probably a pill. He knows all about the biochemistry of anabolic and catabolic functions and everything that makes our motors run faster and slower. No news here.

But what has the Professor’s expertise in metabolic medicine got to do with any expertise in the lifestyle problem of obesity? His CV online makes no mention of any training, experience, or skill in behavior change at either the individual or social level. Now, on a fairly common sense basis, if I was trying to create behavior change in people I don’t think I’d say, “hey, find me an Expert in metabolic medicine.” In much the same way if I was suffering from hyperthyroidism, I don’t think I’d say, “hey, find me an expert in Behavior Change.”

Yet, the Professor has no shame in making behavior change recommendations and the “Daily Mail” of Britian has no shame in printing those recommendations. Should we take any of this seriously from a Healthy Influence perspective?

Well, let’s see . . . what kind of behavior change theory supports his recommendations (helpline phone numbers in oversized clothing, higher taxes on various foods, requirements for cycling lanes)? The range of recommendations vary from information (helpline numbers, nutrition labeling) to regulation (taxation, required road building policy).

There’s good evidence and simple common sense to demonstrate that regulation does change behavior. Primary seat belt laws, for example, do create greater compliance and lower mortality and morbidity rates. It’s arguable that regulations in the form of taxes and road building, however, would not do much to change individual behavior because these regulations do not address the primary causes (cheap, tasty, safe, abundent, accessible food) of the problem. It’s also an argument of last resort for an expert to make. (”I can’t persuade these damn fools to keep from hurting themselves, dammit, pass a new law RIGHT NOW!” Gee whiz, any citizen can make this appeal. What’s the point of being an expert if you fall into magical thinking?)

Then what about the more persuasion orientated ideas from the Professor? While there’s again good evidence and good common sense that providing information and education does change behavior, the literature is pretty clear that there is one very serious limitation to the effect: If people already know or think they know about the problem, “new” information is not likely to be seen as new and will be discounted or ignored. In other words, “new” information had better be truly new information and not simply the pedantry of an untrained and ignorant expert. It’s hard to imagine that anyone in Britain or the Western World is uninformed about the link between overeating and obesity. Information ain’t the Special Sauce here.

I do not doubt for a moment the sincerity of Professor Sattar. He believes what he says and he says what he believes. And while this is true, no one should doubt that his sincerity can do no good for the problem he seeks to solve. Further, I’d argue that experts like Sattar make the problem worse. His bad persuasion attempts only serve to reinforce the existing beliefs and attitudes of the people he’d like to change. His recommendations are likely perceived as weak attacks that people can easily overcome. Thus, Sattar is running a bad inoculation experiment that does make existing attitudes and beliefs stronger, but the problem is that he wanted to change those attitudes and beliefs. Instead of taking one small step toward success, experts like Sattar make a giant leap into failure.

If you can’t succeed, don’t try. All bad persuasion is sincere. It’s about the other guy, stupid.