Tipping the SCALE
Program uses 'mindful eating' to help inner-city residents drop pounds
In low-income black and Latino neighborhoods of New York City, as many as 40 percent of adults are overweight or obese. "It's a very significant problem," says integrative medicine professor Mary Charlson—but Cornell faculty aim to tackle it using tiny steps. With a five-year, $6 million grant from the National Heart, Lung, and Blood Institute, professors at the Medical College and the Ithaca campus recently launched a program called Small Changes and Lasting Effects (SCALE). They're working with residents of Harlem and the South Bronx at three levels: individuals, families, and religious congregations. "Because weight loss is so difficult for so many people, we need to create an environment in which it's easier to make healthy choices," says nutritional science professor Carol Devine, PhD '90. "That's a classic public health approach. You don't say, 'You just have to screw up your willpower,' because that's not a solution."
SCALE is using techniques designed by another of its faculty collaborators, applied economics and management professor Brian Wansink. Author of the general-audience book Mindless Eating, Wansink has garnered widespread media attention for his simple, common-sense approaches to weight control. SCALE organizers are currently conducting focus groups to see which of Wansink's methods might work best. They include using smaller plates (which encourages people to eat smaller portions), leaving serving dishes in the kitchen rather than on the table, turning off the television during meals, and not eating snacks directly from the bag. "It's easier to change how you eat than what you eat," says Charlson. "Keeping food lists and counting calories are hard for busy people—and those strategies haven't overcome the problem of obesity. So rather than saying, 'You can't eat rice,' if you're visually led to a small portion because your plate is smaller and looks full, those are the kinds of things that Dr. Wansink's work suggests will be sustained over time."
When it's fully rolled out, the project will comprise several hundred participants. The goal is to achieve a 7 percent weight loss, which has been shown to prevent the development of diabetes. In addition to the mindful eating strategies, SCALE will encourage small changes to increase physical activity, like getting off the elevator one floor early and taking the stairs the rest of the way; while joining a gym may not be realistic, says Charlson, dancing to a CD in the living room might be. "The big problem is that when people tackle weight, they go on a diet and want to lose forty pounds in the next week with drastic changes," she says. "As time goes on and they encounter the stresses of daily life, the diet's gone and the weight's regained. The question is, what can people adopt and hold over the long term that will lead to gradual, sustained weight loss?"