On the Table

Many factors hinder healthy diet

February 26, 2013 

Why is it so hard to lose weight and keep it off?

On the most basic level, we’re eating more calories than we’re burning.

There’s been worldwide adoption of a diet full of processed foods rich in calories, sugar, sodium and fats and low in dietary fiber. At the same time, we don’t move much.

But the problem is much more complicated. I learned that firsthand a long time ago.

For the first 15 years of my career I counseled individuals like you and your family about what to eat to treat or prevent diseases. I sat with them in hospitals – big, small, urban, rural – and in clinics and classes.

What I learned was that all the scientific evidence in the world didn’t ensure that people could make the lifestyle changes needed to support their health. Most of the people I worked with sincerely and sometimes desperately wanted to eat right … but many of them still couldn’t.

It was frustrating. And it’s why I got out of the business of individual diet counseling and sought ways to affect the bigger picture. That’s because despite all the scientific uncertainties, it remains highly likely that other factors – the social, physical and policy conditions, among others – have an often overwhelming power to hinder or help you control your weight and support your health.

We have to fight to gain the conditions that will make it easier for people – including you and people you love – to be healthy.

Access to quality health care is one of those conditions, and when it comes to nutrition counseling, you probably don’t have it. That’s because most health insurance plans provide little coverage for nutrition counseling services by qualified professionals.

Earlier this month I advocated in this column for continued licensure for dietitians after legislators briefly considered eliminating the N.C. Board of Dietetics and Nutrition. A response from a reader questioned the efficacy of registered dietitians, considering that so many people continue to be overweight or obese.

Abandoning standards of practice for health professionals isn’t the answer to our obesity problem. That’s a simple answer to the wrong question.

What’s the right question?

What can each of us do to create the conditions all of us need to be healthy?

Suzanne Havala Hobbs is a licensed, registered dietitian and clinical associate professor in the Departments of Health Policy and Management and Nutrition in the UNC Gillings School of Global Public Health. Send questions and comments to suzanne@onthetable.net; follow her on Twitter, @suzannehobbs.

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