Olivia Affuso 3 ways community creates a healthy life TED

Transcriber:

Making lifestyle changes
to not only lose weight

but to maintain a healthy weight
long-term is hard.

Ask anyone who has ever tried.

So let’s consider my mom, for instance.

She is 77 years old

and has struggled to maintain her weight

in order to achieve
good blood sugar control

over the past 30 years.

You see, good blood sugar control
requires maintaining a delicate balance

between diet, exercise
and insulin injections.

So early in the COVID-19
pandemic last year,

my mom came to stay with me,

which led to a change
in her usual dietary intake,

away from meals provided to the elderly

to more healthful, home-cooked meals.

What could possibly go wrong?

Well, overnight, her blood sugar
dropped dangerously low,

and she was incoherent
and nearly unconscious.

Imagine having to inject your mom

with a giant horse needle of glucagon
to boost her blood sugar

until she could take in
calories on her own.

I was terrified that she would not be OK

or that I might need to call
for emergency medical treatment

during the pandemic.

Luckily, she responded
to the emergency injection

and was able to consume enough calories
to bring her blood sugar back up.

But of course, this led
to a high blood sugar,

and she needed even more insulin,

which is a fat-storing hormone,

to get her blood sugar to a normal range.

Although it took a coordinated
effort with her doctor

to find balance between her diet,
exercise and insulin regimen,

I was happy to be
social-distancing with my mom.

And she was able to lose some weight,

even though she sometimes complained
that I was acting like the food police.

Nonetheless, I was grateful
to have my biggest fan

and run-streak motivator
with me during the lockdown.

We became a village of two.

Each day she would ask me,

“Did you go run yet?”

You see, she would ride
her stationary bike

while I was working during the day

and running at almost 10pm each night.

It was a tough year, to say the least,

but at least this arrangement allowed us

to create a healthy and supportive
environment together.

So the problem is,

we often think of weight control
as an individual challenge.

And of course, to some extent it is.

But we know that the environments
in which we live, learn,

work and play

affect our ability to engage
in healthful behaviors.

When the world around us
is what we might call

an “obesogenic environment” –

in other words,

systemically and perpetually
geared towards creating obesity –

acting like weight loss
or maintaining a healthy weight

is a personal responsibility

is simply not helpful nor effective.

To put this in simple terms,

I can’t blame you for being overweight

if restaurants and grocery stores,

or at least all of the ones
you can afford,

sell an abundance of high-sugar,

high-calorie processed
foods at low prices.

And then if you don’t have access
to good health care and fitness options

and work multiple jobs,

you don’t have time to exercise anyway.

That’s like tying your hands
behind your back,

pushing you into a pool
and yelling at you to swim.

And if you have a genetic propensity
towards excessive weight gain,

long-term weight maintenance
may simply be unattainable

given the current treatments available.

Although individual health behaviors

are important for positive
health outcomes,

these behaviors are driven
by the context in which we,

as individuals find ourselves.

Imagine what we could do
if we optimized systems,

policies and practices

for our physical,
not to mention mental, health.

There are a lot of things
that need to change,

but that won’t happen overnight,

such as our work schedules, wages,

the availability of healthy,
affordable foods in every community

and public spaces that make walking,

biking and hiking safe,
accessible and inviting.

As a society,

we need to start thinking
about these things as not only luxuries

but essentials for
a high-quality, healthful life.

But in the meantime,

while we push collectively for our local

and national governments
to take our health,

and the systems that facilitate
health, seriously,

there are also things we can do right now,

on our own, community by community.

We know from research
in animal and human populations

that connections provided
through social networks and communities

are associated with better health
and quality of life.

So until we fix the systems
that are harming our health,

we can all work to buffer
the negative impact of these systems.

Research also shows that individuals
living in socially cohesive communities,

or at least those with strong
social connections,

have better health outcomes

than those who are more socially isolated.

And these social environments
work to combat obesity-related behaviors

and promote well-being,

even in the face of systemic
obesogenic conditions.

And how do I know?

My research team and I
have been studying social environments

and women’s health.

I’ve also observed
the social support strategies

of the women in my own network,
and their struggles with weight.

Although their stories shed light

on the lived experiences of navigating
long-term health behavior change,

how do they align with the science?

In my work examining physical activity
behaviors among Black women,

for whom the prevalence of obesity
is disproportionately higher

than white women in the United States,

we have been able to describe aspects
of the social context

that support their success.

Even among overweight but active women,

more than half engaged
in physical activity

with others for companionship,

motivation and accountability.

One participant stated that,

“If my friends did not bug me,
I would rarely work out,”

while another encouraged other women
to get involved with a community

that will push you towards
your physical activity goals.

She described the community
as “like-minded individuals.”

Also in our work with social
physical activity groups,

the members said
that friendship, motivation,

encouragement and accountability
were the most important factors

for supporting their long-term
physical activity success.

From conducting research
on how social networks

and social support strengthen
our ability to achieve

and sustain health goals

and supporting a network
of hundreds of women,

I can tell you there are three things
that all of us should consider.

Number one,

find or build yourself a tribe
of like-minded individuals

for motivation and accountability.

This could be a tribe of two,
like my mom and me,

or a group of individuals
who enjoy walking in nature.

Number two,

create monthly wellness goals
and share them with your tribe.

One or two small changes
and realistic expectations will do.

And number three,

celebrate your success.

Don’t just push each other,

but throw parties and uplift each other
for making progress.

Remember, maintaining a healthy weight

takes more than diet and exercise.

It takes the collective power of a village
to create a healthy life.

Thank you.