I’m an obesity medicine specialist who is frustrated. I keep running into the same issue, and it’s time we start discussing the elephant in the room: the need we all have to show love and appreciation with food, especially sugar. It’s never been more problematic than it is right now. As our patients with obesity are sick and dying from COVID-19, we are honoring the front line workers caring for them with sugary treats. Even now, as I write this, a nurse just came and threw some candy on the desk in front of me.
The association between love and sugar is deep-seated and entrenched in our culture. When we are small and fall down, we get a cookie to help us stop crying. We get a lollipop at the doctor after getting a shot. When we have a breakup, it’s a pint of ice cream. When we have a birthday or retire, it’s a cake. We use food as a drug, and we use it to treat every emotion that we have from happiness to sadness and everything in between.
You would think that in a hospital we would know better. And it’s not just my facility; I hear this from medical staff everywhere. Breakrooms are battlefields. My patients say, “I do great until I get to work, and then there is so much junk around, I can’t resist.” When staff does a good job, supervisors reward them with treats. And don’t even get me started about week of the nurse or as I like to affectionately call it, “week of kill the nurse.” Monday bagels, Tuesday donuts, Wednesday pizza, Thursday make your own waffles and Friday, an ice cream party.
With obesity at epidemic proportions and despite millions being spent on treatment, we have made little headway. Two-thirds of Americans have obesity or overweight. Obesity is a major risk factor in most of the chronic conditions we see, including almost 40% of all cancers. Nearly half of Americans have diabetes or pre-diabetes, a condition that was rare only a century ago.
Two of the top conditions that increase the risk for poor outcomes in COVID-19 are obesity and diabetes. Even with this knowledge, we continue to show appreciation to our front-line healthcare workers with sweets, the very thing that increases the risk for these two conditions. Huge ice cream sandwiches, boxes of donuts, cookies, and candy are pushed on carts throughout the hospital. This may seem like an inexpensive way to brighten everyone’s day, but at what cost to their health?
The problem is sugar hijacks our brain biology. The survival instinct that helped protect us in times of famine is now our worst enemy. Most have a hard time resisting, especially when it is right in front of them, and some may even meet the criteria for sugar addiction. If we had co-workers with alcohol use disorder, we would think twice about inviting them to join us at an open bar. But, we don’t give a second thought to baking a tray of brownies and setting it in the breakroom for all to enjoy. Is anyone even stopping to ask themselves the question, is this a good idea?
We are starting to make changes at my institution. There are specific guidelines about what kind of food can be served at meetings, specifically, no desserts and no beverages with sugar. But as a society, we have far to go to change the enmeshed association between love and sugar. We need a cultural shift.
It’s time to tackle the elephant in the room and start discussing these issues and how we can make changes at home, work, and in our communities. We need to show love and appreciation in ways that promote health rather than disease, and we need to set an example in health care.
Susan Wolver is an internal medicine physician.
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