6.10.2009

A little humility about conscious control

It is apparently relatively easy to solve certain mental problems. Panic attacks and phobias can often be gotten over with therapy and thoughtful diligence on the part of the patient. Drug and alcohol addictions can be solved, but, however, not nearly so easily -- the success rate is much lower. And overeating? Fuhgeddaboudit. It is, apparently, easier to kick heroin than to lose weight. Gary Taubes in "Good Calories, Bad Calories," (bad title, good book) has an excellent description of the lack of good evidence for the widely held beliefs that all dietary fat is bad for you (we seem to be letting go of this one), and that calorie-restricted diets are effective. Not only that, he does a great job analyzing just how such beliefs got disseminated.

This is not unknown, even in the popular press. At least three popular books have been written recently on just how little conscious control we have over many of our own actions and decision-making (one wildly successful yet scattershot and philosophically ill-informed, the other quite enjoyable -- I have yet to read this, but the writer seems versed in the literature). While we can control some things, there is a lot of behavior that is quite difficult to control.

I wish this message would get out there, so people could have a little humility about their own ability to be complete master of each and every action. There are two different kinds of cases I've been thinking about recently where we could all use a little more knowledge of the limits of our cognitive systems to be in complete and utter control of ourselves.

One is weight and food. Doctors still regularly recommend calorie restriction to patients, despite the fact that well over 95% of people who actually manage to lose weight gain it back (usually plus some more) in five years. I cannot imagine that most doctors would continue to recommend any other kind of treatment with such a dismal record of success. It is also perfectly socially acceptable to complain about fat Americans who lack self-control.

Taubes amusingly describes the psychological effects on a group of volunteers several decades ago who went on a "starvation diet" (1600 calories per day...more than many current diets considered healthy, such as Weight Watchers). You can eat this little, but at enormous psychological cost - obsession with food, extreme mood swings, etc. Fat people seem to experience deprivation of this sort at a different point than do thin people.

I plead this as someone who is in that tiny minority of people who have lost weight (75 pounds in my case) and kept it off for years. This has made me more convinced of the difficulty of doing this, not less. When fat, I used to berate myself for lack of will power and try every diet, etc. Then a doctor tried a drug to control my blood sugar, and all of a sudden, I could diet. It's not that the weight just fell off without effort. I had to count calories and exercise, and still do in order to maintain a weight others find easy. In other words, I have will power. It's just that regulating my blood sugar brought this from a condition that was not amenable to will power to one that was. To this day, if I forget to take my medicine for a day, that day is marked my uncontrollable food obsession and cravings - not the mere resistable temptation of other days. If you are naturally thin, and sometimes want a donut but pass it up and cannot understand why fat people cannot do as you do, please try and understand that their temptation may not be your temptation. Try eating 1600 calories a day for a few days and see how that goes for you. Eating less than your body is telling you to eat is extremely difficult.

Another kind of case I've been thinking about recently arose from reading this article about parents who accidentally leave children in cars to overheat to death (not the parents who are under the influence or who do it on purpose -- the normally loving attentive parents who simply forgot that their child is in the car). I have rarely read a more heart-rending news article and confess I cried through the reading of it. I'm still shaken days later. One of the worst things detailed in the article was the vitriol some spewed toward these parents, who had made an honest and terrible mistake and were already going through hell. Another article suggested that these parents were part of culture of too much forgiveness of bad parenting. If even the most devoted parent thinks for a second that this could not happen to them, even if they are operating on a lack of sleep or their routine has changed or what have you, they need a little more acquaintance with the way our cognitive systems actually work.

1 comment:

  1. Look, I get your particular situation is caused by chemistry, but I really don't agree with your general thesis. American diets stink. Eat like an Asian and you will lose weight and not feel deprived (I am not talking about American asian, I am talking genuine Asian). I lost 30 pounds in Asia and kept it off for years only regaining it when I returned to the west.

    Obviously Americans can't all move to Japan and China but we can eat like the Japanese and Chinese, and more importantly raise our children on these diets. My children eat greens because that was a major part of their diet when they were very young, and all of my children are underweight because of the diet their mother has them on. (no soda, not many sweets, etc.) My weight problem now is because I eat at work, drinking a soda as an afternoon pickmeup or treating myself to a package of cookies, etc. things my kids don't have access to. By the way, I took my two older sons, 5 and 7, on a 3 hour hike up a mountain. I was surprised by their stamina. I doubt a quarter of the kids their age could have done it. And yes, I know it is not my doing. They eat well so they don't crash easily.

    charo

    ReplyDelete