Heart Attacks at the Heart Attack Grill: Fast Food and Bad Decisions

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Editor's update: ABC News reports that a second person has suffered a heart attack at the Heart Attack Grill this past weekend. The woman is recovering after "eating a double bypass burger, smoking cigarettes and having a margarita," according to ABC. -- Julie

Without reverse-engineering our habits, the likelihood of success is that
much lower. We need that self-awareness to improve our lives. At the end of the day, our success over our own habits will determine our quality of life as a nation, not a lawsuit or fine leveled against one vendor or even a whole class of restaurants.

If you've been online in the past 24 hours, you've heard about the man who had a heart attack at the Heart Attack Grill in Las Vegas, Nevada, while enjoying one of the burger joint's so-called "Triple-Bypass" burgers.

Heart Attack Grill ambulance
Image: KJGarbutt via Flickr

The Heart Attack Grill, which opened in Las Vegas in October, is known to locals and tourists alike as a place to indulge in uninhibited gluttony. Their motto is "Taste Worth Dying For." They offer 8,000-calorie burgers -- which involve several beef patties, American cheese, and bacon -- fries deep fried in lard, and provide any patron over 350 pounds who walks in the door with an unlimited supply of free bacon burgers.

It's easy, given the situation, to ask ourselves whether such a health-averse place should be held responsible for what happened to the man dinning there over the weekend. But as BusinessWeek's Teddy Wayne rightly points out, "To be fair to [Heart attack Grill owner Jon] Basso, more than 785,000 people have their first heart attack per year in the U.S., and this is the first to occur in his restaurant; better-known and less honestly named fast-food franchises have likely caused exponentially more coronary events over the years."

The knee-jerk reaction to hold a restaurant responsible for the health choices that we make every day misses the point. This isn't about one restaurant or even fast food restaurants -- this is about the choices we make. Despite being faced with the dire statistics resulting from poor heart health, high blood pressure, high cholesterol and obesity, human beings haven't proved to be very good at estimating long-term risk.

Deep Fried in Pure Lard
Image by sql_samson via Flickr

We tend to focus on immediate problems, the things are right before our eyes. Failing health ten or even five years down the line isn't an immediate problem. Hunger is. Unfortunately for us, our choices can and often do become habits, and these habits, in turn, can have disastrous long-term consequences.

Understanding habits

In The Power of Habit, Charles Duhigg outlines the habit cycle, a simple three-step process that defines a lot of our choices, both good and bad: cue, routine, and reward. In order to tackle our bad habits, we have to analyze the corresponding habit cycle and identify the routine. He writes:

As an example, let's say you have a bad habit, like I did when I was researching this book, of going to the cafeteria and buying a chocolate chip cookie every afternoon. Let's say this habit has caused you to gain a few pounds. In fact, let's say this habit has caused you to gain exactly eight pounds, and that your wife has made a few pointed comments. You've tried to force yourself to stop -- you even went as far as to put a Post-It on your computer that reads "NO MORE COOKIES." But every afternoon, you manage to ignore that note, get up, wander toward the cafeteria, buy a cookie and, while chatting with colleagues around the cash register, eat it. It feels good, and then it feels bad. Tomorrow, you promise yourself, you’ll muster the willpower to resist. Tomorrow will be different.

But tomorrow, the habit takes hold again. How do you start diagnosing and then changing this behavior? By figuring out the habit loop. And the first step is to identify the routine. In this cookie scenario -- as with most habits -- the routine is the most obvious aspect: it's the behavior you want to change. Your routine is that you get up from your desk in the afternoon, walk to the cafeteria, buy a chocolate chip cookie and eat it while chatting with friends.

Next, some less obvious questions: What's the cue for this routine? Is it hunger? Boredom? Low blood sugar? That you need a break before plunging to the next task? And what's the reward? The cookie itself? The change of scenery? The temporary distraction? Socializing with colleagues? Or the burst of energy that comes from that blast of sugar?


Images from the Heart Attack Grill menu.

What's the reward?

Duhigg's suggestion is to undertake a series of little experiments. First, you need to identify the reward that drives your habit. In the cookie scenario he posed, a reward may be the change of scenery, a burst of sugar, hunger, friends or any distraction from work. To test which, one can choose to go on a walk and eat nothing instead of going to the cafeteria and having a cookie. Or one can go to the cafeteria and buy a cookie but eat it back at one's desk. Or go to the cafeteria, buy something sweet other than the cookie and stick around and chat. Or go and buy an apple and stick around to chat. Or buy a coffee and stick around and chat. Or drop by a friend's office and stay there, without eating, and chat.

Changing up specific variables will enable you to understand what is driving your habit. If it's hunger, an apple will do as well as a cookie. If it is a jolt, the coffee will do as well as the sugar. If it's some conversation with friends, dropping by a friend's office should work as well as wandering over to the cafeteria. If a change of scenery is what you need, a stroll around the block will do the trick.

Duhigg suggests keeping notes on your experiments. After you are finished trying each new reward every day, sit down and write three things that come to your mind. They can be anything: emotions, thoughts, something you noticed while changing up your routine. This is both to force a moment of clarity and to help you remember later what you were thinking and feeling at this moment. Next, set an alarm for 15 minutes. When that alarm goes off ask yourself whether you still crave whatever you identified as driving your habit (in Duhigg's case, the cookie). If the answer is yes, you will know that whatever reward you attempted that day is not the one that drives your choices.

What's the cue?

Isolating the reward is a big step toward changing bad habits in our lives. But that's not the end of it. Cues -- the things that trigger our habit loops -- are important to identify as well. While on your way somewhere, have you ever realized that you were going to work or home instead of the intended destination? Going to work or home are habits that have their own individual cues. Something on the way to that other place triggered your habit, and that's why you absentmindedly changed destination. This is how powerful habits are.

But we're not helpless. If you have identified your routine and your reward, you're already that much closer to being able to alter your loop. The next step is figuring out what the cue is. According to Duhigg, almost all habitual cues arise from one of five categories: location, time, emotional state, other people, and the action that immediately preceded the craving. In your notes, as soon as the craving arises, write down answers to these five questions:

  • Where are you?
  • What time is it?
  • How do you feel?
  • Who is around?
  • What did you just finish doing?

Answering these questions will enable you to understand what is triggering your habit. With this information, you will be able to anticipate the cue and prepare a plan. In Duhigg’s cookie scenario, he isolated the reward in his habit loop as the need to a moment to socialize and the cue as the time frame between 3:00 and 4:00PM. To change this habit, he made a plan to walk over to a friend's desk every day at 3:30PM to have a ten-minute chat.

He admits that it wasn't easy -- he set an alarm to remind himself to go visit with a friend, but sometimes he ignored it, which invariably led him to fall off the wagon. Sometimes, it seemed easier to just go get a cookie than actively look for someone to talk to. But by and large Duhigg discovered that sticking to his plan left him feeling much more satisfied at the end of the workday. After a few weeks, he hardly gave the routine any thought -- he just did it. Six months later, he no longer wears a watch, yet somehow, at around 3:30PM every afternoon, he gets up and spends the next ten minutes chatting up a colleague.

His is but one example and without a doubt, some habits are more deeply ingrained and die harder than others. Some may even refuse to allow us to break them down into their nuts and bolts at first. We can't give up. The first step in changing what we do so that we can lead healthier lives is to make the time to analyze these habits that have hijacked our days and nights and start breaking them down.

Without reverse-engineering our habits, the likelihood of success is that much lower. We need that self-awareness to improve our lives. At the end of the day, it is our success over our own habits and not a lawsuit or fine leveled against one vendor or even a whole class of restaurants that will determine the improvement of health and quality of life as a nation.

AV Flox is the section editor of Love & Sex and Health on BlogHer. You can connect with her on Twitter @avflox, Google Plus +AV Flox, or e-mail her directly at av.flox AT BlogHer.com

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