rewiring the conversation: how the brain and language can shape obesity treatment
4 minute read
sharing stories and having conversations in a safe, non-judgmental way is important for people, whether they’re living with obesity or trying to work through the trauma of divorce or death of a loved one.
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kids can be like sponges for learning, but the adult brain is also capable of learning new things and new behaviours. in other words, it’s never too late for people to think and do differently.
so, if you’re having trouble replacing that craving for a cigarette with chewing gum or crunching on an apple, there’s a way to tap into the potential of your brain’s neuroplasticity to change and adapt in response to learning and self-discovery. one way to do it effectively is with a healthcare professional like dr. peter selby. he’s an addiction medicine physician at the centre for addiction and mental health in toronto, a renowned scientist and professor at the university of toronto. he sums up what he does in simple terms: he helps people “unpack what is keeping them stuck in their behaviour.”
his therapy technique is called motivational interviewing. during his sessions, he asks questions and listens to his patients, looking for clues to understand why they’re “stuck” and help them build new neural connections in the brain that can change their mental and physical health.
“so when i’m dealing with people with addictions, i know that my path to these deeper structures in the brain is through connection and conversation,” he explains. the foundation of his work is recognizing that diseases like obesity are both a biological and brain dysfunction.
selby will be talking about the power of language and storytelling to challenge stigma at the obesity matters’ your health matters summit in toronto on june 8. following a panel, he’ll be leading interactive “story weaving,” which is much like an improv class to highlight how different perspectives shape our experiences. he says it’s where art and science come together.
therapy digs into ‘the why’ behind human behaviours
“there are common factors that determine negative human behaviour, or what i would call consumption or consumptive behaviour—genetics, early childhood environments, you see trauma and you see commercialization of substances that are addictive, that are pushed on a population that consumes them in ways that harm them either immediately or in the long-term, but harm them nonetheless.”
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while obesity is complex, the underlying neurobiology is the same whether you’re talking about people using highly-processed foods or alcohol or nicotine or cocaine, he says.
“there are more commonalities than differences. in my work, we’ve looked at these common determinants of human behaviour. and if you take a look at what you eat, what you do, how you feel and how you think and how you sleep,” he adds, you’ll see the commonalities of many health problems that are plaguing society.
when people living with obesity are pulled toward unhealthy foods, there can be a constant tug of war between engaging in consumptive behaviour and then moving away from it. this relentless mind game is determined not only by your thoughts but by your feelings, habits, and also attachments and appetites.
selby, like many neurology experts, talks about the brain as the control centre of how people live and feel. the brain determines how someone will respond to the environments in which they find themselves or create for themselves. for instance, a child who is abused may recognize that food is comfort, forming that connection early on and it can snowball. people often use food to comfort themselves during times of stress, but if they are genetically vulnerable to addiction, that comfort stops being helpful and becomes problematic, selby says.
“the beauty is that the brain can learn, so by engaging people in therapy and in combination of that with medicines, you can help people get better and get into the directions that they need to go. there are behaviours that we do that can surely help us live better.”
the power of sharing and learning to talk about obesity
sharing stories and having conversations in a safe, non-judgmental way is important for people, whether they’re living with obesity or trying to work through the trauma of divorce or death of a loved one.
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obesity matters
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but here’s the critical takeaway: the traditional outdated approach of many healthcare providers when they counsel patients with obesity backfires every time.
“when somebody gives you unsolicited advice, which you’re not ready for, and says something like ‘why don’t you just eat less’ or ‘why don’t you try a diet?’ what that generates from the person is ‘yes, but i’ve already done this and this. i’ve tried that. i can’t afford it.’”
selby says that kind of conversation generates all the reasons for the person to stay the same and remain stuck. the focus needs to be using language that generates motivation rather than defeat and self-blame. this is something that he’s training medical residents and other practitioners to understand to use to empower patients.
“i ask the person a question about what’s worked and what hasn’t worked for you, and what have you found? so now they’re providing a narrative and reflecting on what did work and what didn’t work,” he says of guiding the conversation to discuss what allowed certain habits to work and what lessons can be learned.
“it’s a very different conversation that enhances motivation rather than ‘i failed at my diet’ or ‘the diet doesn’t work.’ so the idea is to help people unpack that so that they can spend more time in the spaces of change than in spaces of staying the same. and in dialogue, the more you push somebody, the more they push back. it’s really important to know how to guide, not push in dialogue for health behaviour changes.”
register now for free and secure your virtual spot at the your health matters summit by obesity matters on june 8.
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