by Mike Critelli,
Over the past month, the MakeUsWell Network has welcomed Dr. Garry Welch and Colleen McGuire, a married couple who have formed a company called Silver Fern Healthcare. Silver Fern’s mission is to use the best available evidence to identify the psychological and sociological factors that prevent patients from effectively managing their chronic diseases.
They have particularly focused more recently in addressing the root cause of many chronic diseases, the obesity crisis. Obesity not only contributes to chronic diseases, but, as research has demonstrated, it made those with the SARS Cov-2 virus more likely to be hospitalized or die. The inflammation caused by obesity has also been linked to cancer by the CDC because of the faster cell growth required to compensate for insulin resistance.
Like other members of our MakeUsWell Network, Dr. Welch and Ms. McGuire understand that, while medications like Ozempic and other glucagon-like peptide drugs (GLP-1) are breakthroughs in driving weight loss, they will not be effective in the long run without an effective behavior change program. Weight loss through medication does not survive if patients do not engage in processes that make weight-reducing behavior change permanent.
They also understand that behavior change does not occur solely because patients are educated about the elements of nutrition, fitness, sleep and stress management necessary for weight loss. As we learned at Pitney Bowes through our onsite clinics and other health plan outreach programs, the behavior change required for individuals, families and communities depends on permanently modifying daily life routines.
While lower income individuals, families and communities often reside in “food deserts,” communities that have limited, costly, or inconvenient access to healthy foods and beverages, addressing these systemic issues is not enough. Behavior change counseling requires problem-solving to help individuals and families modify daily routines to reduce exposure and susceptibility to unhealthy behaviors and the social and environmental factors that trigger them.
As someone who has battled weight problems my entire adult life, I am acutely aware of the many subtle factors that cause us to overeat or consume unhealthy beverages. To name a few of these factors:
When we are in a hurry to get to work or some other time-sensitive appointment, eating a calorie-dense, sugary food or consuming a sugary beverage is often the lowest cost, most convenient option.
The cafes, bakeries, and bagel shops that offer calorie-dense foods and beverages to us price them very low relative to the calories they deliver.
We have been socialized from early in our lives to equate eating sugary foods with comfort and celebratory events. We are given large birthday cakes, sugary pies, and cookies as responses to stressful events or rewards for achievement.
We associate the big bucket of buttered popcorn and the big cup of soda with the fun experience of watching the newest blockbuster film or the hot dog and the bucket of nachos we consume at a sporting event with a pleasurable experience.
For stressed out parents, taking our children to the pizza parlor or the fast food restaurant is the easiest way to get some temporary relief.
Anyone traveling in economy class seats on airplanes is being served sugary snacks, even on cross-country flights. The food available at the airports matches the unhealthy foods and beverages we get on the way to work.
When we go to dinner or a bar on a weekend night with family and friends, our resistance to overeating is reduced by alcohol consumption.
Altering these deeply-rooted habits is monumentally challenging, but Dr. Welch and Ms. McGuire are also using evidence-based tools to identify motivations and tools to achieve the necessary behavior change.
The MakeUsWell Network has many other individuals tackling or interested in tackling the components of this complex public health problem. But we also are developing an AI platform that, initially, will complement human intelligence in helping guide healthcare professionals in affecting behavior change. Over time, AI will learn faster what works and present marketing strategies and messages from demonstrably trusted sources with the right kinds of financial incentives to accelerate behavior change.
But, at this stage, the work Dr. Welch and Colleen McGuire do every day is a vital addition to what we want to accomplish with the MakeUsWell Network.