Monkey See, Monkey Do — How Behavioral Modeling Influences Health

by on July 1, 2014

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My 2-year-old granddaughter seemed to welcome her newborn baby sister with bland indifference. I observed her as she played with her blocks and other toys and did not appear to be perturbed by the presence of a new member in her family. After she had dinner, I was surprised when she set out deliberately for the couch, wrapped her mother’s pillow around her lap, lifted her shirt, and clutched her bear to her chest. It was dinner time for her bear! While it was fun to watch her precise imitation of breast feeding, it made me stop and wonder how we as adults subconsciously follow patterns of behavior that may not reach our cognitive awareness.

There was a landmark study in 2007 in the New England Journal of Medicine that looked at social networks over a 32 year period as an explanation of the growth of obesity in the U.S. The researchers pointed out the profound increase in obesity over the past few decades could not be explained by genetics, so they looked at social networks to see how one person’s weight gain influenced others around them. They found the strongest determinant of obesity was being mutual friends, whereby if one friend was obese the risk of obesity increased by 171% for the other! Same sex friends had the strongest correlation, and geographic distance did not diminish the effect. In married couples, despite sharing the same household, the couples’ mutual friends had a much stronger bearing on the risk of weight gain. A person’s social network is more important to our health than we realize. How can this be?

Think about the last time you decided to have “seconds” at a dinner gathering. You may have this internal debate of “I want, but I shouldn’t” going back and forth in your brain. However, when one person in the group decides to have seconds, it automatically gives everyone in the group permission to do so. In a University of Illinois study of October 2013, the researchers looked at how peer pressure influences food choice ordering in restaurants. When restaurant goers ordered audibly, they were happier when they ordered something similar to what others around them ordered. How many times when you go out to eat do you hear the expression, “I’ll have what she is having”? The authors of the study concluded that it was better to be the first to order because “the first person is the only one who truly gets what they want.”

My three daughters remind my wife and me, especially around Mother’s Day and Father’s Day, how much our behaviors have influenced their behavior. This applies to how we treat and help others, or the action of giving to charitable causes–such as donating to the PJCC. Yes, we can instruct people how to eat better, teach ethics in our classrooms, but the strongest determinant of optimal conduct may be with whom we surround ourselves. My 2-year-old granddaughter aped the behavior of her mother. This primal trait of emulating behavior appears in children, as well as adults as described above, but often beneath our cognitive awareness when it comes to making healthy choices. The challenge is to be more mindful. The habit of saying a blessing before and after eating a meal may have helped my religiously observant ancestors be more aware of what they were consuming. Except before Shabbat dinner, I don’t usually reflect about the sanctity of my food. Think again when you are the first to order in a restaurant or ask for seconds. Our behavior not only affects our health personally, but also the health of our children, our friends, and all those around us. What we do matters. We are all connected.

Jerry Saliman, MD is a volunteer internist at Samaritan House Medical Clinic in San Mateo. He retired from Kaiser South San Francisco after working there more than 30 years. While at Kaiser SSF, Dr. Saliman was also Chief of Patient Education. He received the 2012 “Lifetime Achievement Award” given by the Kaiser SSF Medical Staff.

Editing acknowledgement: Ellen Saliman

Neither the PJCC or our guest columnists provide medical advice, diagnosis, or treatment. Please make your health care decisions in partnership with your health care provider.

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