by Dr. Sherri Thomas
It’s that time of year again when we make resolutions to eat healthier and finally start using that gym membership we signed up for last year. We (and our patients) feel motivated for a few days, weeks or even months but all too often recidivism sets in and we fall back into old patterns. If you’ve been attending our educational meetings, you know that the bias and stigma of weight would lead us to blame the patient and attribute this inability to stick to our best intentions to laziness. However, as we’ve been discussing, obesity is a multifactorial disease, and we often forget to address the social factors.
Humans are social creatures, so it should come as no surprise that multiple studies show correlations between changes in weight and social interactions. While I have yet to find a high-quality, prospective, controlled study that proves this beyond a shadow of a doubt, there have certainly been several over the last decade that have shown correlations (though not necessarily causation.)
A study of longitudinal data in 2016 noted that patients reporting a desire to lose weight were also more likely to possess social ties with heavier individuals while lessening their interactions with thinner individuals. On the other hand, it was also observed that those who increased their interactions with thinner people and decreased their interactions with heavier people were more likely to have weight loss.
A study that made headlines in 2007 done by Christakis and Fowler, at the time known for their work on the power of social ties, used data collected over 30 years from the Framingham Heart Study. They found that a person’s risk of developing obesity increased by 57% if their friend developed obesity during that time interval. If a sibling developed obesity, then their risk of developing obesity increased by 40%. Whereas if a spouse developed obesity, the risk of the other spouse developing obesity increased by 37%. There was no increased risk seen if a neighbor in the immediate geographic location developed obesity.
In my personal “MeSearch”, I have found that having a support network somewhere in my life has been crucial to helping me gain and maintain a healthier lifestyle. Many of my friends may be consistent with exercise, but they aren’t consistently committed to eating healthy. Or perhaps my husband is willing to exercise with me and eat what I prepare without complaint, but he continues to enjoy plenty of “extracurricular foods” when he eats outside our home. Even as an obesity medicine specialist I have found it challenging to help create a supportive social environment within my practice without compromising patient confidentiality or having to closely monitor everything shared on social media to make sure misinformation isn’t being spread.
This need for consistent social reinforcement of a healthy lifestyle is a big reason I’m such a huge fan of boutique gyms. When led by trainers and other staff that are passionate about engaging their members, they have the power to create a supportive community. Members may only be in the gym for 3-6 hours a week, but when they know that others are working hard at similar goals and their absence will be noticed, this can create a profound impact that carries on with them through the remaining hours of their week.
So when patients commit to a healthier lifestyle this New Year but start reporting difficulties sticking to their good intentions because they feel sabotaged by a spouse or close friend, we aren’t going to counsel them to get rid of their friend or spouse and we know it’s not useful to just tell them to try harder. Instead, directing them to one of the high-quality boutique gyms in your community just might be the supportive answer they are looking for.
Andersson, M.A. and Christakis, N.A. (2016), Desire for weight loss, weight-related social contact, and body mass outcomes. Obesity, 24: 1434-1437.
Christakis, N. and Fowler, J. The Spread of Obesity in a Large Social Network. N Engl J Med 2007; 357:370-379.
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