BOWLING GREEN, O.—For many people, obesity starts in childhood. Conditioned to the words “clean your plate,” they grow averse to the thought of “wasting” food, feeling terrible if they throw any out while those oft-mentioned children in Africa are starving.

“It makes absolutely no sense,” but practically everyone has heard it, says Dr. Robert Carels, a Bowling Green State University psychologist. And some never get over the idea—an example of what can become a thoroughly ingrained belief about food and a contributing factor to obesity, he adds.

Carels works with small groups of people in a weight-loss program, hoping to motivate them to re-examine entrenched attitudes and see the benefits of change in eating, as well as exercise, behaviors. The obstacles, he points out, are formidable.

Losing weight can be “torture because we’re at a point in history with so much palatable food,” the assistant professor at BGSU says. “We’re inundated with it.”

Then there’s what he and other researchers call the current “toxic environment” of sedentary lifestyles—both at home and work—highly processed food and super-sized portions. “Portion sizes are out of control,” says Carels, continuing that they’re even more problematic “if you’re a member of the clean-your-plate club.”

These conditions have helped produce an alarming increase in the number of overweight people, despite the realization in recent years that being even a little overweight has health consequences, he notes.

Solutions to the problem seem simple—eat less and exercise
more—but are more complex when considering individuals’ attitudes toward eating and exercise. Changing some of those habits can take months, he says, but even subtle shifts in diet and exercise patterns can have tremendous long-term impact.

Working with graduate students in clinical psychology and often with Drs. Bonnie Berger and Lynn Darby, both from the human movement, sport and leisure studies department, Carels counsels about 50 people each year in groups of six to 12.

While his clients know that they want to lose weight, they are often ambivalent about making the needed lifestyle changes to do so, he says. The problem, he adds, is usually with motivation rather than a lack of knowledge necessary to effect change.

A motivational enhancement approach, borrowed from alcohol treatment research, encourages clients to think particularly about benefits of exercise, eating healthy and losing weight, and to talk about what they think they can do to make a positive change, Carels explains.

Urging clients to talk about benefits and changing behaviors helps them move from ambivalence to action, he says.

Some people have to be “hypervigilant,” watching what they eat more closely and working harder to burn it off, says Carels, who thinks the federal government needs to take a larger role in encouraging healthy eating just as it has with discouraging smoking. “Personally, I believe that’s part of the solution,” he maintains.

But a significant amount of evidence indicates that obese people can lose weight and keep it off, he adds, citing participants in the National Weight Control Registry as examples.

Based at the University of Colorado and Brown University, the registry tracks adults who have successfully maintained a 30-pound weight loss for at least one year. About half of the nearly 3,000 registrants lost weight on their own, making changes in eating and exercise habits.

Participants in Carels’ small groups weigh in at the end of each week because he wants them to learn how the changes they make impact their weight loss. He also tries to send the message that the changes don’t have to end when the program does.

“If you’re incorporating these changes into your lifestyle, your life won’t change after the program ends,” he tells participants. And if they need the continued support that the weight-loss group offers, he advises finding another program, or even a walking partner—whatever the individual needs to be successful, he says.

Carels earned his Ph.D. in clinical psychology from the University of North Carolina-Chapel Hill in 1996, then served as a clinical associate at the Duke University Medical Center, whose Duke Center for Living offered several prominent diet programs that dealt with lifestyle issues. He was at Duke for three years before coming to Bowling Green in 1999.

(Posted February 17, 2005)