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What’s Strategic Science Got to Do With Eating Disorders Prevention? Just About Everything

S. Bryn Austin, ScD

In the world of public health prevention, we have an idea called “strategic science.” Basically, the idea is that when we set out to design a new study, we ought to be thinking about how the study findings could be used by policymakers and communities to make change happen to benefit people – real people, like you or your children, your friends and neighbors, or the people in a neighborhood across town. It’s a simple idea, but it demands a pretty radical departure from the more typical way that study ideas get out of the gate. Here’s how it usually goes: A researcher reads what other scientists have published, goes to a few conferences, and then sits down with some colleagues to come up with a new study that will generate results to fill a gap in what has been published so far. They may succeed in making some new discovery to fill in that gap in scientific knowledge, but that doesn’t mean they will be any closer to filling the gap in action to make meaningful change in the lives of real people. Not only is this process frustratingly slow, it’s not even on the right track to get us where we need to go.  

That’s where strategic science comes in. Public health luminaries Kelly Brownell and Christina Roberto explain that the goal of strategic science is to fill not just any gap in what’s known, but instead to fill “gaps in knowledge important to policy decisions” that will result in positive action. This should happen based on the free flow of ideas across scientists, policymakers, and community advocates at all phases of the research, especially at the beginning before a study is designed. There is a lot to like about strategic science. One, it’s a way to vastly increase the chances that study findings will be relevant and can point to feasible, public health law and policy changes that decision makers can champion to have large-scale effects for a whole city or state or even the whole country. Two, because a strategic-science study’s findings are by design relevant and feasible to act on, they can be used to catalyze change in the near term. Yes, near term. Not in some distant 30 years from now. In three years, or who knows, maybe this year.

We have every reason to want to get the prevention train moving much faster. Thirty million Americans will struggle with an eating disorder in their lifetimes, and far more are affected by serious and debilitating eating disorder symptoms. Like all significant public health problems, we can’t treat our way out of this. The demand is just too great for our healthcare system. And we wouldn’t want to depend on treatment alone anyway. If we can prevent eating disorders on a large scale – on the scale that public health prevention efforts usually focus -- we will also be preventing an ocean of suffering, healthcare and other costs to individuals, families, and society, and lives lost.  

So let’s say you buy my argument so far that we should be using strategic science to accelerate public health impact on eating disorders prevention. What are some examples of large scale public health prevention efforts that led to massive improvements in health? Think policies that bring us clean water and sanitation, laws requiring lifesaving seatbelts and airbags in cars, bans on indoor smoking in workplaces, and more. What are our equivalent targets in the world of eating disorders prevention? Here are some ideas: diet pills and the dieting industry’s ubiquitous weight-loss messages and products; the fashion industry and its drive for “size zero” regardless of the consequences; widespread weight-based discrimination that creates a hostile environment for all of us, especially those of us living in larger bodies, and with no protections on the books almost anywhere in the country. These may seem like Goliath-sized battles to take on, but that’s the beauty of strategic science: When we all work together -- scientists, policymakers, and community advocates -- we make a powerful trifecta for catalyzing change for prevention. 

Wondering what you can do? Here are a few examples of strategic science in action where you can join in or maybe be inspired to get something started in your community:

We can’t just keep waiting for prevention to move forward at the snail’s pace with business-as-usual science. We – and that means all of us: scientists, policymakers, and community advocates together – need to get those wheels turning. Strategic science is our ticket on the bullet train. 

Ed's note: Eating disorders, such as bulimia, binge eating disorder, and anorexia, are serious illnesses that involve extreme emotions, attitudes, and behaviors surrounding food, exercise, and body image. Though not diagnostic, this video outlines the basic warning signs and symptoms and will give you an idea of what to look out for.

Dr. Austin is Professor of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health and Professor of Pediatrics, Harvard Medical School and Boston Children’s Hospital, Division of Adolescent and Young Adult Medicine. She is the Director, Strategic Training Initiative for the Prevention of Eating Disorders (www.hsph.harvard.edu/striped), President of the Eating Disorders Coalition, and Secretary of the Board of Directors of the Academy for Eating Disorders.