3 ways community creates a healthy life | Olivia Affuso

**Elise Hu** (0:00)
I've been thinking a lot about what makes a good life, and when I dig into this question, it really comes down to the people around us, neighbors, teammates, the friends and family we share a meal, a game, or a group chat with. It turns out our health and happiness may depend on them so much more than we realize. So for August's TED Talks Daily playlist, we've gathered five of our favorite talks on finding our people, our community, whether it's at a dinner table, in a video game, or in a garden growing in the middle of the city. Happy listening.
You're listening to TED Talks Daily, where we bring you new ideas to spark your curiosity every day. I'm your host, Elise Hu. Context matters, especially when it comes to maintaining our weight. In today's talk from a TED salon in 2021, physical activity epidemiologist Olivia Affuso makes the case that weight loss and maintaining a healthy weight is not your personal responsibility. Instead, she says, social environments, systems around us, are harming our health, and we can do things to try and fix them. But first, a quick break to hear from our sponsors.
And now, our TED Talk of the Day.

**Olivia Affuso** (1:21)
Making lifestyle changes to not only lose weight, but to maintain a healthy weight long term, is hard. Ask anyone who has ever tried. So let's consider my mom, for instance. She is 77 years old and has struggled to maintain her weight in order to achieve good blood sugar control over the past 30 years. You see, good blood sugar control requires maintaining a delicate balance between diet, exercise, and insulin injections. So early in the COVID-19 pandemic last year, my mom came to stay with me, which led to a change in her usual dietary intake away from meals provided to the elderly to more healthful home-cooked meals.
What could possibly go wrong?
Well, overnight, her blood sugar dropped dangerously low, and she was incoherent and nearly unconscious. Imagine having to inject your mom with a giant horse needle of glucagon to boost her blood sugar until she could take in calories on her own. I was terrified that she would not be okay or that I might need to call for emergency medical treatment during the pandemic.
Luckily, she responded to the emergency injection and was able to consume enough calories to bring her blood sugar back up. But of course, this led to a high blood sugar, and she needed even more insulin, which is a fat-storing hormone to get her blood sugar to a normal range. Although it took a coordinated effort with her doctor to find balance between her diet, exercise, and insulin regimen, I was happy to be social distancing with my mom. And she was able to lose some weight, even though she sometimes complained that I was acting like the food police. Nonetheless, I was grateful to have my biggest fan and run streak motivator with me during the lockdown. We became a village of two.
Each day, she would ask me, did you go run yet? You see, she would ride her stationary bike while I was working during the day and running at almost 10 p.m. each night. It was a tough year to say the least. But at least this arrangement allowed us to create a healthy and supportive environment together. So the problem is, we often think of weight control as an individual challenge. And of course, to some extent, it is. But we know that the environments in which we live, learn, work, and play affect our ability to engage in healthful behaviors. When the world around us is what we might call an obesogenic environment, in other words, systemically and perpetually geared towards creating obesity, acting like weight loss or maintaining a healthy weight is a personal responsibility is simply not helpful nor effective. To put this in simple terms, I can't blame you for being overweight if restaurants and grocery stores, or at least all of the ones you can afford, sell an abundance of high sugar, high calorie processed foods at low prices. And then if you don't have access to good health care and fitness options and work multiple jobs, you don't have time to exercise anyway. That's like tying your hands behind your back, pushing you into a pool and yelling at you to swim.
And if you have a genetic propensity towards excessive weight gain, long-term weight maintenance may simply be unattainable given the current treatments available. Although individual health behaviors are important for positive health outcomes, these behaviors are driven by the contexts in which we as individuals find ourselves. Imagine what we could do if we optimize systems, policies, and practices for our physical, not to mention mental health. There are a lot of things that need to change, but that won't happen overnight, such as our work schedules, wages, the availability of healthy, affordable foods in every community, and public spaces that make walking, biking, and hiking safe, accessible, and inviting.