Public and health professionals' misconceptions about the dynamics of body weight gain/loss

Human body energy storage operates as a stock-and-flow system with inflow (food intake) and outflow (energy expenditure). In spite of the ubiquity of stock-and-flow structures, evidence suggests that human beings fail to understand stock accumulation and rates of change, a difficulty called the stock-flow failure. This study examines the influence of health care training and cultural background in overcoming stock-flow failure. A standardized protocol assessed lay people's and health care professionals' ability to apply stock-and-flow reasoning to infer the dynamics of weight gain/loss during the holiday season (621 subjects from seven countries). Our results indicate that both types of subjects exhibited systematic errors indicative of use of erroneous heuristics. Indeed 76% of lay subjects and 71% of health care professionals failed to understand the simple dynamic impact of energy intake and energy expenditure on body weight. Stock-flow failure was found across cultures and was not improved by professional health training. The problem of stock-flow failure as a transcultural global issue with education and policy implications is discussed.