March 26, 2014

Are We Making Our Friends Fatter?

botero fat couple sculpture

When I sit down to eat with other people, I find it funny to watch their behavior.

I am not the food police, but because everyone knows I am a strong advocate for real, whole, fresh food and they make the link between food and health, they change what they eat, what they put on their plate, or what they order from the menu simply because I am at the table. I have no judgment and don’t monitor what my friends are eating, but it appears that my focus on health is “contagious.”

Recent research proves that this is, in fact, true.

Our social connections have an enormous influence on our health. You are more likely to be healthy if your friends are healthy and more likely to be overweight if your friends are overweight.

More striking: We are more likely to be overweight if our friend’s friend (who we may not even know) is overweight. We are also more likely to be happy if our friends or friends’ friends are overweight. Both good health and bad health are contagious. So is happiness or depression. Our mood affects people we don’t even know. We could make our son’s best friend’s mother unhappy if we are in a bad mood.

In 2007, Harvard researchers published a study in the New England Journal of Medicine (The Spread of Obesity in a Social Network over 32 Years“) that documented how our social connections play a larger role in our health than we ever imagined. They looked at the Framingham data and found 5,124 friends with 53,228 connections from 1971 to 2003. Their findings were striking.

Obesity appeared to break out in clusters. They were 57 percent more likely to be overweight if they had a friend who became obese. What was even more amazing was that the effect seemed to skip people. They were 20 percent more likely to become overweight if the friend of a friend became overweight and 10 percent more likely to become overweight if the friend of a friend of a friend became overweight.

People within three degrees of separation from us shape our behavior, even if we have never met them.

What’s even more interesting is something called directionality. If John thought that Steve was his best friend and John gained weight, Steve would gain weight too. But if John didn’t think Steve was his best friend (just a friend), John was less likely to gain weight if Steve gained weight. It seems, the more we feel connected to someone else, the more his or her behaviors affect us.

This study helped me understand that our approach to addressing the epidemic of obesity, diabetes and chronic disease may be backwards because we focus on the individual. We talk about personal responsibility and self-control. But how can that be the whole story if we are more likely to gain weight if the friend of a friend that wehave never even met gains weight. We have to rethink our approach to obesity and chronic disease.

The patient, so to speak, may not be a person, but rather the community—a social network of people who influence each other. Think of the power of this approach. Most of us are linked by three degrees of separation to 1,000 people, all of which we can theoretically make healthier and happier with our behavior. How we act, what we eat, or if we gain or lose weight will influence the behavior of 1,000 people, most of whom we don’t even know. That should make us stop, think, and change our ways of seeing the world.

We are now at a catastrophic point in human history, with over 1.7 billion people overweight (more than twice as many as those who go to bed hungry). We need to see that just like we see tuberculosis or AIDS, obesity, Type 2 diabetes, and chronic disease are contagious diseases affected by the environment we live in, surrounded by toxic industrial food and the people we are connected to.

Obesity is a social disease. And it needs a social cure.

Once I realized this, it became clear to me that we needed a completely different approach. Maybe social groups were both the cause and the cure for our obesity epidemic. That is why, when I met Rick Warren, pastor of Saddleback Church with over 30,000 members who met weekly in close-knit, small groups to support each other in every aspect of their lives, I had an aha! moment.

What if we create a social experiment and get people to get healthy together?  

We designed a healthy living curriculum and delivered it through small groups. We had 15,000 people sign up in the first week, and in one year, they lost over 250,000 pounds.

We found that those who did the program together lost twice as much weight. The changes in behavior in this group caused a ripple effect in the community. The restaurants started offering healthier options. The grocery stores put healthier items at the checkout counters.

If you do the math on the effect of social networks on health, keeping in mind the three degrees of influence and that each person’s behavior can affect 1,000 people, all it would take would be for one percent of the population to change (if they were in the right social networks) to create a tipping point that could reverse the obesity epidemic.

We need to rethink healthcare and put communities and social groups at the center of healthcare.

Think of it as Facebook for health. We have thousands of people in our online communities changing their lives together, reversing diabetes, losing weight, supporting each other and sharing ideas, recipes, suggestions and encouragement.

This is the way we will change our collective health, together. Think of it as the “Love Diet.” Combine real food with love and community and the result is health and happiness. Think of it as friend power rather than willpower. As my friend Rick Warren says, “every body needs a buddy.”


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Editor: Jenna Penielle Lyons

Photo: Flickr

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