This is a blog post more than a bit off-topic for me, though why I would write about it will eventually make sense; it's all about people's behavior and why I find it interesting.
It starts with me stumbling into this because my insurance company launched a new app and some kind of rebrand. Since my bronze insurance is rather sucky, I was going to take every free offering that came with it to try and get something out of my ever-increasing premiums.
Omada and Learn to Live were two apps I could access completely free. So I did. Why wouldn't I?
What Is Omada?
Omada describes itself as a "virtual care program that gives you personalized support to get to a healthier you." It provides a real person who serves as a health coach for the cohort you're assigned to (people from your area who signed up around the same time as you). Each week, there are lessons you can read/listen to, goals you can set based on those lessons, and food and fitness tracking.
Food tracking is very different; instead of calculating amounts, calories, and macros, it simply asks that you track your meals and snacks and then tag them as to whether they were mostly healthy, somewhat healthy, or not at all healthy. Then, you tag them based on the general macros (healthy fat, lean protein, fruits, vegetables, whole grains) and the situation and motivator that led you to eat. That makes you think about what and why you're eating. Omada sometimes comes with a scale that automatically sends the data to the app.
It doesn't come with harsh rules, crash diets, 30-day challenges, or anything like that. It is focused on gradually and slowly changing behavior towards food.
What Is Learn To Live?
Learn to Live is about mental health care, focusing on cognitive behavioral therapy and, from what I can gather, changing the way you think. Neuroplasticity and changing how I think about life and situations are on my list this year, and so I'm finding it interesting to have this "free" online class to supplement both Omada and what I've been reading in books.
It has some good material and homework and could be treated almost like online learning.
I'd been looking for an app to help me make some new changes, but I didn't want to be locked into constantly logging everything that crossed my mouth and my mind and assigning it a numerical value. For that reason, I've been enjoying these two apps. I just got a FitBit and have it connected to Omada and I'm off to the races (as much as you can be in cold February in North Dakota). Interesting note: when FitBit reminds you it's time to get your 250 steps in, you can walk along to Dpak's "Trumpty Dance," and you'll hit 250 perfectly. You might also find some dance moves you didn't know you had.
By the time you finish reading this blog post, you'll see why both of these apps, a health tracking app and a mental health app, have been packaged together.
Insurance Companies, Omada Participation, And GLP-1
A few days into Omada, I noticed a lack of participation in my group chat and discussion, as well as much participation beyond weighing in, the least challenging thing you can do since you simply stand on a scale, and it sends the info automatically. I've checked back; some have done a few days of other tracking, but the majority are doing a minimal amount of participation.
In my opinion, when you have a structured curriculum or program, you work the program. Maybe it won't work, but it definitely won't if you don't.
I joined some of the extra groups in Omada dedicated to different topics like cooking or walking. A tiny handful of people seemed to be participating, and some even put in some heartbreaking personal stories that make you want to give them a hug and encouragement, but I saw quite a few complaints about their insurance company requiring Omada for their meds. I wondered why so many of the comments I was seeing were a mix of "my stupid insurance company" and "I'm losing tons of weight using Ozempic/Mounjaro/Zeptitude/Whatever."
I went to Reddit to do a search on Omada, trying to figure out why so few were fully participating when so many people were in the app. Unfortunately, much of what I found about Omada on Reddit was disappointing. It wasn't the app's fault, but the users' attitudes. It turns out that insurance companies required people to use Omada (though each company differed in requirement) to maintain insurance coverage of the meds.
"My doctor already provided a PA. Why is my insurance company making me do this stupid app in order to get my prescription filled?"
"I already know all of this health information. I've tried it before, and it doesn't work, so why do they make us do this?"
"This is so patronizing, these stupid healthy eating lessons in Omada. I just click through without reading and make it count as one of my four interactions for the month so I can get the meds."
"They don't make people who get insulin/statins/name-a-disease jump through these hoops, so why us?"
Posts abounded on ways to be sneaky and how to do as little participation as possible in Omada and still make your insurance company think you were working the program ("Just log in, and then close the app, because that counts as an interaction!") according to their requirements.
As a short and chubby/fat/fleshy/rounder/rotund person myself, I know what it is to deal with all the stuff that comes with it. I also know the feeling when you lose a bunch of weight and feel physically and emotionally on top of the world (and it comes back, and then the cycle starts again). I get the joy of a monthly injection, helping the pounds melt away without having to fight to change habits and cravings.
But those shots are expensive.
They're also lifelong.
If you stop them and haven't changed anything about your lifestyle in your head space, it's likely the weight will come back completely. There are potential side effects of those shots, some serious (and expensive). And if your insurance is paying for all of this, from the shot to what might follow, then I am paying for them.
I want people to do Omada, just because it's a structured program and it won't hurt; it might help. It's not too much to ask. I'm not saying people can't or shouldn't have their shot. I'm just wondering if they could work the program. Of all the health tracking apps I've used, it's pretty low-hassle. I've come to enjoy it, and I've found the lessons really interesting, with some neat health tips that aren't overbearing or requiring huge changes immediately.
Changing Your Thinking, Change You
I'm tired of being mentally weary.
I'm interested in what we're learning about neuroplasticity and, in general, what happens when you purposefully change how you think. This shouldn't be so surprising; the Bible repeatedly tells us to control our thoughts, but we don't really do it or we think it's only referring to keeping our thoughts PG or better. It's more than that.
Neuroplasticity goes beyond a fluffy "think positively!" and refers to how the brain can reorganize and adapt its structure and connections. It's an interesting area of study for recovering from injury, adapting to new challenges, improving learning, and so on. Changing our thinking purposefully, whether truly delving into neuroplasticity, can still reverse depression and how we respond to stressful situations. It can change how we view failure or success.
"Why am I doing this? Why am I thinking this? Is this really the situation or am I getting it wrong?" I often ask myself these days.,
Eating has a lot to do with our thinking and our decisions, and as tempting as an injection to melt away the pounds is to get to the solution of the physical issues (which are real, and I do understand that), that does not change our thinking and relationship with food. The broken thing is still broken. It is true that GLP-1 shots affect the brain, helping some beat addictions not associated with food, while others have excessively vivid dreams or have emotional issues develop where they don't quite feel like they're the same person they used to be in their head.
Heart, mind, soul. God wants it all. What we love, what we think, and who we serve.
Why are we eating what we do? What can we do to develop a good personal food culture? How is eating and drinking fitting into the things I'm struggling with, acting as a substitute? What part of my mind am I simply not able to control? What automatic habit did I allow to take root that is tied to my weight? Is food the only joy I have?
Like many things in life, we let ourselves get behind the curve, always playing catchup. We're too busy to do anything but grab a quick snack bar or run through the coffee place, pressed for time. It feels like we're working so hard at change because the mental load in our head from the feelings of guilt, failure, and "I'll start tomorrow" wears us down.
Trying Everything But Changing Nothing
"I've tried everything, and nothing works, but this does, so why would they keep it from me?" is a common comment I saw in my Omada research, and I know that feeling. But the key word is "tried."
I suspect I'd say more accurately that I've tried diets, quick-fixes, severe and abrupt habit changes and self-control, strange cleanses, excessive exercise that can't be sustained for a lifetime, borderline disordered eating coming awfully close to eating disorders—it feels like I've tried everything because I've tried so many things with varied success but always a return to where I was and then some.
This is why a controlled and planned program is beneficial. Work the program and see where it takes you over time. It's not a harsh start, but a gradual entrance into changed behavior. At the very least, it removes the decision load from your mind and frees up mental energy because you don't have to decide; the program is leading you to a goal.
Don't try Omada. Do Omada. Even if it doesn't work, it wasn't a waste, and it definitely won't harm your health.
Knowing What To Do Isn't The Same As Doing It
Another common comment I saw was, "I already know what healthy eating is. It's so patronizing that they think I don't know it and have to listen to it in order to get my meds. "
I also know I shouldn't eat candy, sugar, chips, crackers, and other such things, but I do it anyway. Knowing the right thing is not the same as doing it. Knowing is not what starts the action.
And, to my delight, I have learned some new things in the Omada weekly lessons I wasn't aware of, plus tips on simple ways to start the habit of putting them into place. Maybe it will all work, and maybe it won't. But I decided I would try, and I'd work the program as best I could and see what might happen. Perhaps I'll find I've changed my thinking. Perhaps the number on the scale will change. Perhaps nothing will change. I don't know until I try and work the program.
I'm not saying do or do not take weight-loss medication; I'm not a doctor. I'm simply suggesting that whatever you decide to do, would it be so bad to also learn things that can change the way you think in life, things that might have a positive impact on more than just weight but also emotions and relationships and creativity? It's a great opportunity that you're already paying for when you pay your insurance premium. Why not take advantage? Why not just work the program? Regarding the medication, we don't know what tomorrow holds, what side effects might develop, or what insurance companies will and won't cover in the future. Wouldn't you be better off, someday, having changed your way of thinking should you ever need to go off of the shot?
Recommended Reading:
The Upward Spiral: Using Neuroscience to Reverse the Course of Depression, One Small Change at a Time by Alex Korb
Hardwiring Happiness: The New Brain Science of Contentment, Calm, and Confidence by Rick Hanson
Dressing on the Side (and Other Diet Myths Debunked): 11 Science-Based Ways to Eat More, Stress Less, and Feel Great about Your Body by Jaclyn London