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By Richard Asinof
By Richard Asinof
Rena R. Wing is a professor of psychiatry and human behavior at Brown Medical School and The Miriam Hospital. She is also the director of the Weight Control and Diabetes Research Center within the Centers for Behavioral and Preventive Medicine in Providence. She is an expert on behavioral treatment of obesity and its application to type II diabetes, with more than 200 peer-reviewed articles on these topics. In short, when it comes to research and methods about how to address issues of obesity, she is the go-to person.
Wing recently gave the keynote address at a gathering of the Rhode Island Business Group on Health on Dec. 16 about best practices for obesity prevention at the workplace.
Providence Business News asked Wing to provide her insights into what strategies work best in the treatment of obesity – and in keeping the weight off.
PBN: How important is it for health insurers to target families as well as individuals in their approach to obesity?
WING: It’s critical. Obesity runs in families, in part because of genetics and in part because of environment. If there’s an overweight child, [odds are that] there is an overweight parent. If they both change their behaviors together, they will be more successful. The overweight child is going to be in our workforce down the road, with a tremendous influence on health costs.
PBN: Why are behavior changes, rather than short-term diets, most effective in losing weight and keeping weight off?
WING: I spend a lot of time in helping people change their eating habits. We’re taking the emphasis off of short-term diets and putting on making long-term changes in eating and exercise behaviors. In order to lose weight, you need to eat less; you need to focus on eating less fat, and eating fewer carbohydrates. The goal has to be to take in few calories, to change the energy density of your diet.
It’s much more difficult to make significant changes in your physical activity than in your diet. If a person wanted to lose one pound a week, you would need to cut 500 calories a day from your diet, or increase daily walking by five miles a day. Walking five miles a day is a more difficult change.
PBN: What can businesses do to make the workplace more amenable to reducing obesity?
WING: Companies can start by removing unhealthy items to eat from the workplace. They can make healthier foods less expensive. And they can provide calorie information.
It would be wonderful if companies could set up gyms for their employees, but many don’t have the resources. There are a lot of smaller things that people can do, such as making sure that the stairways are open, available and clean [for walking], and there is nice artwork along the stairs, encouraging people to use the stairs, rather than the elevators.
Companies can also encourage people to take breaks during the day from sitting at their computer – to get up and walk around for five minutes – by setting timers on their computers. On a larger scale, companies can consider replacing the seats at the computer station with either a stand-up station, or a workstation on a treadmill. I’d be happy with either.
PBN: You have conducted research studies assessing the outcomes of Shape Up RI. What are some of the more important findings? How important is the sense of teamwork?
WING: We have conducted a number of studies assessing the outcomes with Shape Up RI. In Shape Up RI, there is a team effect. We know that with weight loss programs, when you implement them in groups, you get better results, because other people going through the challenge of weight loss can help each other. If other people are in the “room,” you often get greater support and problem solving.
With Shape Up RI, we’re using an Internet-based program, in combination with a team approach. People send their data to us, and we provide feedback, suggesting helpful strategies if they were not succeeding.
Most of my weight loss programs involve face-to-face meetings; many people don’t want to do that. Developing an Internet-based program is an alternative.
We recommend daily weighing. Making scales available to employees is one thing companies can do. If people don’t weigh themselves, it’s a strong predictor of weight gain.
PBN: Is there a need for a larger societal strategy to address obesity? Do you think that a tax on soft drinks with high sugar content would be an effective strategy?
WING: We have an epidemic of obesity. We need approach it from all different aspects of the community – families, schools and companies need to be working on it.
It should not fall just to businesses, though that’s one of the places spend a lot of their day.
I’m not big on single changes. The more different approaches we can use, the better. [In regard to taxes on high-sugar soft drinks,] I think that, to whatever extent, we [need to] evaluate such strategies through research to determine whether or not they will have the positive effects that we hope for.