‘Tis the season for overindulging.

From office parties to family get-togethers, we are surrounded by temptations that threaten to throw us off our healthy eating wagon. But it’s not just the mashed potatoes and pecan pies that do us in. It’s often the holiday beverages that pack a hidden caloric punch.

The BBC has a great tool that has changed how I think about the impact of those holiday beverages. You might think nothing of drinking a few of glasses of wine at a holiday party, but you’d probably think twice before loading up your plate with Krispy Kremes.

Sometimes helping people change their behavior is as simple as changing the way information is presented.

Take the quiz.

I promise it will surprise you.

I just finished reading a fascinating book on the psychology of eating. Given all the media coverage over the last year or so on the American obesity epidemic it was interesting to read a psychological perspective on what leads to all that overeating.

Cultural and structural issues such as poverty, processed foods and even long commutes contribute to the epidemic. But psychological factors are also at work.

Sometimes it’s a simple as how we think about a meal.

For example, did you know that Americans tend to eat until we are full, while people in much of the developed world tend to eat until they are no longer hungry? What seems like semantics adds up to about 20% less calories consumed.

Back to the book I read, its author predicts that motivating long-term behavior change will be the key to living better in the 21^st century.

I think he may be on to something.

A recent article in the American Journal of Cardiology presents a modest proposal: offering a statin alongside fast food to counterbalance the negative effects of a cholesterol-laden meal.   Likening it to wearing a helmet to offset the dangers of riding a motorcycle, the proposal admits defeat before it starts.

Rather than expect people to do the hard work of making better food choices or the food industry to offer healthier fast food, the statin recommendation becomes the ultimate enabler.

Like “Mother’s Little Helper”of years past, the McStatin solution merely covers up deeper, more difficult issues.

Yes, it’s damn hard to get people to change their behaviors, especially in the face of larger socioeconomic and cultural challenges. But it can be done.   According to the CDC,  behavior is the single greatest health determinant.

So let’s start there.

Source: CDC

With apologies to Jonathan Swift, we have a Modest Proposal of our own: Using the science of what makes people tick to motivate them to initiate and sustain lifestyle changes that will save their lives.

We call it the Metabolic Mindset. See how it works, here.

I love peanut butter and jelly sandwiches.  Well, actually jam, but you get the picture. Even now that I am old enough to be making them for my own child, I still eat a PB&J at least once a week.

So when I saw the Candwich I thought it was a joke.  Really, what could be easier to make than a PB&J?

And do you really want a sandwich that’s shelf stable for a year?

It got me thinking,  how much is the popularity of processed foods related to our burgeoning obesity epidemic?

Convenient and cheap, processed foods are a godsend to the time starved and budget conscious, but a dirty little secret lies within.

Turns out, all calories are not created equal. Take a cheddar cheese sandwich on whole grain bread and compare it to Velveeta on Wonder bread.  Same number of calories, but the processed option has about a 10% additional caloric burden because it doesn’t require as much energy to digest.  So processed foods actually help you put on more weight than whole foods with the same calories.

It’s easy to recommend eating whole foods over processed ones, but the fact remains that eating whole foods is much easier when you aren’t trying to make ends meet.  To change that behavior, you’ve got some serious cultural, behavioral and economic hurdles to overcome.

As Elaine Livas, who runs the Project SHARE food pantry, explains, “A gallon of milk is $3-something. A bottle of orange soda is 89 cents,” she says. “Do the math.”

My colleague shared an editorial with me from the June 2010 issue of The Lancet. It really hit home for me based on some things that have happened this week. The editorial comments on the June issue of The Lancet which is a special, diabetes-themed issue. The author notes a “glaring absence” from the issue – there aren’t any lifestyle/behavioral interventions that focus on diabetes prevention or reversal.

So, getting back to my week…I had a brief conversation with a notable physician who has spent many years in research and practice. We were discussing MicroMass’ new behavioral study that sheds light on a “metabolic mindset.” My energy and excitement around our findings was quickly deflated by his commentary on how behavioral interventions don’t work, that there’s no proof that they lead to any sort of measurable and impactful health outcome. Huh? What did I study for 2 years in graduate school? And what have I been so passionate about in my work over the past ten years at MicroMass? Could it be foolery?

I glance over at my health behavior and theory textbook from grad school and reflect on its content. Is it all lies? Then quickly I’m mad because I realize that while the physician has a point, so do I. I have seen evidence that behavioral interventions work. But, is the rigor and volume of the evidence in behavioral intervention research just not enough? And potentially more problematic, does this physician’s viewpoint reflect a broader opinion of the medical community?

I come from a clinical background. I know the value of medicine and I have seen it in action. Science is amazing and the medical research discoveries over the past decade have been amazing. So, why don’t people embrace, advocate and fund behavioral intervention at the same level as medicine? Is it because as a society we ultimately blame “others” for their self-inflicted, lifestyle-related conditions? Yet in the same breath, we grumble about rising healthcare costs and suggest that a large contributor is people who make unhealthy choices.

Regardless, there are plenty of examples, especially in chronic diseases like diabetes, that lifestyle changes and medicine go hand in hand. Patients need both to be successful.

If we expect to make any real change in diabetes or obesity in America, we have to be honest with ourselves. And we can only hope that decision-makers at the policy level can be honest with themselves too.

We’ve talked a lot here about America’s issues with food and eating and hunger and obesity. We’ve even got our own research that promises to help people change the difficult behaviors that lead to metabolic diseases.

Now, here’s a film that illuminates the complementary issue of food waste. The amount we waste is staggering.

Jeremy Seifert’s mission is to change what America puts in the trash.

The Body Mass Index (BMI) has long been the standard for assessing obesity as its simple, convenient and cheap.  But it has also been dogged by complaints that it’s inaccurate and limited.  A study in the journal Pediatrics suggests there might a more accurate measurement to assess obesity in children – neck circumference (NC).

Neck circumference could give a more accurate measurement of someone’s body fat composition than BMI, particularly in the all important spare tire area.  NC has a strong correlation with central adiposity (fat around the middle), which studies have shown is a good indicator of obesity-related complications.

In the battle against obesity, more accurately measuring body fat composition is a big step in the right direction.  But obesity management, and the management of metabolic diseases commonly associated with obesity such as type 2 diabetes, high cholesterol and hypertension are things we need to focus on now. 

Through the use of behavioral science, we’ve learned that while the conditions varied, the motivations and barriers to change of patients diagnosed with those conditions are very similar.  We’ve called this a “metabolic mindset”, and believe that if approached correctly, is susceptible to change.

Changing behavior is difficult, especially in the face of structural and cultural disadvantages.

It’s even harder when an outsider, albeit a celebrity, comes in to save the locals from themselves.

I’m curious to see how British chef Jamie Oliver fares when he tackles obesity in America’s fattest city, Huntington, WV.

Watch Sunday, March 21 at 10 (ET) on ABC.

Knowledge alone is not enough. If it was, no one would smoke, be overweight or eat potato chips.

We’re fat. Fatter than we’ve ever been. America’s future is one in which obesity kills more people than smoking and alcohol.

Everyone’s talking about it. The First Lady is taking on childhood obesity. The Wall Street Journal is explaining how its roots are in our genes. Obesity’s links to processed foods,  portion creep and lack of sleep are being debated.

We’re working longer hours and commuting more. Our jobs have become more sedentary and we can’t find time to exercise. Not to mention the fact that healthy foods are expensive and unhealthy foods are cheap.

So we’ve got some disadvantages. But what about people who have lots of advantages? What about people like Oprah?  She can afford personal trainers and chefs. She has every financial advantage, yet she still struggles with her weight.

It’s tempting to think, “If only I had a personal chef, if only I had a personal trainer, if only I didn’t have to work such long hours.” But when you remove all of the “if onlys” that money can buy, success isn’t inevitable.

Why is it so hard for Oprah? For the same reason it’s so hard for the rest of us. Sometimes we don’t know any better. Sometimes we’re duped by clever marketers (remember Snackwells?)  But most of the time, even though we know better, we still make bad choices. Why?

Knowledge alone is not enough. Decision making is rooted in complex psychology.  It’s a complicated interplay between information, motivation, skills and confidence. Without all four, real behavior change is tough to come by.

Like everyone else, I make bad food and exercise choices. It’s ironic, though, because I work with smart people who make a living as health-inducing puppetmasters. I guess it’s a case of the shoemaker’s children.  Maybe I should walk down the hall and see how they can help me modify some of my unhealthy behaviors.

I’m going to do just that.  As soon as I finish these chips.