And that is exactly where Brewis is hoping to look next. "What we really need to do next is get the behaviors down as well—are they eating together; are they exercising together?" Brewis says. "I think it might be what people do together" and the behavioral cues they follow from those around them—even if they are not related to deep-seated beliefs. "We'll call it the 'Would you like to see the dessert menu?' phenomenon," she says, offering as an example the moment when a waiter arrives to ask if anyone would like to see the dessert menu. In this situation, people often pause to glance around the table and see if anyone is going to ask for it; if no one else asks for the menu, an individual will often pass as well, whereas if one person does ask for the menu, others will be more likely to order dessert.
Fowler and his colleagues are looking into this behavioral side, he says, trying to figure out, "If I start eating more fatty foods, do you start eating more fatty foods?" And Christakis emphasizes that ideas and actions are all part of the complex web of forces that shape us—"Both are part of the story," he says.
In addition to social attitudes and socially determined behaviors, other factors might be at work influencing people in the same social networks.
The environment—from the prevalence of fast food restaurants to the availability of good walking trails—has been shown to play a large role in people's health and BMI. But in their analysis of the Framingham data, Fowler says, his team found that "it's true that your environment has an impact on you, but it doesn't seem to be the reason" for your body weight. Having an obese neighbor did not make a person more likely to be obese, but having a friend or relative who was—even if that person lived hundreds of miles away—did.
Because a large portion of the social relations in the study were listed as family members, genetics could be playing a role, too. And Brewis notes that, "in terms of moving this research forward, that's certainly something to think about."
Winning hearts and minds?
How this and other studies are interpreted could have a large impact on public health messages going forward, determining whether campaigns focus on changing attitudes surrounding healthy body size, zeroing in on directly changing what people eat, or a combination of these.
"We assume that changing the way people think changes how people behave—that's really a core message of public health," Brewis says. "Maybe what people think doesn't really matter that much."
Public health messages have long relied on the notion that by changing attitudes, you can shift behavior. But this and other recent research has shown how this simple notion can be dismantled by a host of complex and still poorly understood factors. People understand that improving their diet and getting more exercise are key to losing weight. "They know, and they want to do it," Brewis says. But that "is really different from being able to do it." Even study-based weight-loss interventions fail to help most people keep weight off—"and we really don't understand why they fail," she says.
And that key disjunction is what Brewis and a host of other researchers are targeting. "If it's not social norms, it's a clue we can start looking for something else," she says.
Fowler says that even if social norms are exerting a minority of influence on weight status, they could still play a powerful role in curbing the rise in obesity. "It still tells you that networks have got to be a key to understanding—and potentially fighting—the obesity epidemic."
Social norms are, after all, an appealing target for intervention. As Fowler points out, they are "very easy to act on. You don't have to change eating or exercise behavior," which are hard habits to alter directly. Instead, "all you have to do is operate on what they think is an appropriate weight" and, at least theoretically, people's weight will follow suit.
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4 Comments
Add Comment'Birds of a feather flock together' & 'water seeks its own level' and maybe even more apropos: 'misery loves company'....nothing really new here is it?
Reply | Report Abuse | Link to thisI saw a minivan yesterday with 6 or 7 morbidly obese women packed in; that's a support group if i ever saw one, just not much support for the poor suspension. There needs to be room for some social pressure against this epidemic without it crossing over to 'hating'. It's really sad and disgusting to see society moving this direction but what to do? Many of them won't just die with heart attacks but be in and out of hospitals for years while they slowly die with diabetes, skin diseases, etc etc. I know one guy whose wife is a whopper and she's mostly wheelchair bound and in and out of the hospital on the public dime. What a pathetic existence and not good for a country's health either!
I believe obesity issues began back when elementary gym programs were cut, continuous recessions caused increased stress and technological advances put people into seated jobs.
Reply | Report Abuse | Link to thisDon't worry, as food production stagnates and populations grow the cost of excess eating will counter act this trend. Nature is self cleaning.
Reply | Report Abuse | Link to thismichalshome:
Reply | Report Abuse | Link to thisJr High and High School physical education programs ceased to be mandatory due to a misconception that physical health and mental acuity were unrelated.
Since a direct correlation has been consistently and repeatedly shown, various reasons have been pursued to deny reinstatement of these vital programs in schools.
Such reasons as fiscal come due in far higher and earlier medical costs, psychological problems, and resultant infrastructure costs across the board, from insurance, building, self-medication, to increased pressure on government to care for a population increasingly handicapped by ill health from sedentary lifestyles.
Long-term healthy lifestyles and activities had historically been promoted by the inclusion of instruction in a range of physical skills and testing of strength, cardiovascular fitness, and other parameters of health to adolescents and preadolescents.
A complete education must include a wide variety of physical skills. Only in this way will our species continue in physical activity as adults.
Our mating preferences do not change at the same rate as social norms. We are bound by slower evolution in this. Most individuals prefer the same body shape that has denoted health for tens or hundreds of thousands of years, while the lightning-sudden trend to obesity occurring due to overpopulation/sedentary behavior (perhaps due to withdrawal from induced stress from overly-dense populations - cultural anthropology has studied such issues and offers some well-supported hypotheses), food technology aimed at maximizing profit (by appealing to sensory structures evolved before we domesticated animals and increased their obesity!), and even political-correctness in attempting to dowonplay the seriousness the obesity problem.
Normative pressures on behavior are perhaps the most significant single factor in inclusion of physical activity throughout life. Since the social norm is now dominated by overweight members of our species, expect that returning to a healthier norm will be extremely difficult and vigorously opposed.
Do remember that earlier in the past century, tobacco smoking was used to diminish appetite, and that the problem of sedentarism is deeply ingrained in the cultural lifestyle. Even emotional bias toward activity is now overwhelmingly corrupted by vicarious "professional spectator sport", which has only existed for a bit over a century. Correlation.