Missing link in anti-obesity technology

It seems like every week at FierceHealthIT and FierceMobileHealthcare we're writing stories about new technologies to help patients eat less and move more.

Just a few recent examples:

  • Partners HealthCare in Boston gave school children wireless "sneaker chip" pedometers to help them track how many steps they take each day.
  • At Johns Hopkins University, nursing students have launched a pilot program to see if a smartphone app can encourage healthy eating and exercise.
  • Other researchers are using computerized geographic information systems to learn more about how environment impacts childhood obesity.

And all of this is terrific. Cutting edge stuff, really. But let's be clear: Despite these efforts and a host of others like them, we still are losing the fight against obesity.

We have done so much to improve the health and safety of Americans. More people wear their seat belts. Fewer people smoke. Americans are much more aware of the negative consequences of drinking and driving.

So why aren't we making any headway when it comes to obesity?

I think it's because the solutions we've come up with--tech-based or otherwise--don't include disincentives. As a society, we tiptoe around the issue of obesity. Even some doctors have a hard time having conversations with overweight patients. We are loath to criticize--let alone punish--people for being overweight even though they are not only hurting themselves, but are hurting society as a whole. 

And yet in other areas, we've managed to overcome that fear of limiting the rights of individuals to hurt themselves by using tobacco or not wearing a seat belt, for example.

States passed laws and started fining people driving without a seat belt. Newer models of cars ding ceaselessly if drivers and their passengers don't buckle up. And insurance companies offer discounts on premiums for folks who have cars with seatbelts that fasten automatically. If you don't buckle up, you will pay up.

Or consider smoking: Laws against smoking in restaurants now are common, and smokers pay steep taxes on cigarettes. More importantly, we have completely changed our mindset about smoking--what once was seen as glamorous now is widely seen as harmful not only for individuals, but also for those around them.

Although education and encouragement have a place in behavior change, methods that only encourage good behavior don't go far enough. To truly be effective, incentives must be accompanied by disincentives.

Consider the "snapshot" tool from the Progressive insurance company. Plug the device into your car's diagnostic port and it analyzes your driving habits. If you're a good driver, you get a discount on your insurance. Lovely.

But although the tool rewards safe drivers, it also penalizes bad drivers. If you're slamming on your breaks at every intersection and swerving all over the road at 3 a.m., you don't get the discount. In effect, you're paying more. (Progressive says that rates do not go up as a result of using the tool, but not getting a discount is the same as paying more, in my book.)

So, tell me--will our society ever overcome the taboo against delivering negative consequences for people who are overweight or obese? And I'm open to debate--should it? Will negative consequences work for obesity as it did for people who use tobacco, don't wear their seatbelts, or drive like maniacs? Let me know what you think in the comments section, below. - Gienna (@Gienna)

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