The title contains a popular query in search engines. But this article will not offer tips like "count to 10 and drink a glass of water". Let’s talk about something else: why force yourself not to eat for weight loss is a bad idea and how to deal with your attitude towards food.
What's wrong with not eating for weight loss?
Practical psychologist: If you have a healthy attitude towards nutrition, then you are in contact with your body - listen to its signals and know how to negotiate with it. If the body signals hunger, you satisfy it; satiety, you stop eating. The message "do not eat to lose weight" means the cessation of this contact, coping with self and the appearance of autoaggression. It turns out that to achieve the goal (weight loss), you are taking action against yourself. This is not goodOdull and unhealthyOin.
Psychiatrist: Most people who have lost weight as a result of a restrictive diet regain it within 1-2 years. Moreover, 2/3 of them gain more than they lose.
Endocrinologist:The message of forcing yourself not to eat in order to lose weight is irrational. It is important to understand: what happens to the body? Maybe this is not a matter of improper diet, but of hormonal characteristics.
And what is it about - a healthy attitude towards food?
Psychiatrist: This is when regular meals and meals are not accompanied by anxiety, shame and guilt. Lack of "forbidden foods", diet and calorie counting. And when you allow yourself to enjoy the food.
Endocrinologist:It is about treating food as a condition for a full and happy life. And not as a substitute for joy and pleasure.
Practical psychologist: This is when you eat from hunger, stop when you are full, do not focus on the shortcomings of your body, which should be "corrected" by food or rejection of it, when you do not overdo it, do not capture emotions.
Can you give more details? How and why do we eat emotions?
Practical psychologist: There are no good and bad emotions for the psyche, it can withstand any. She does not need food, alcohol, equipment or TV for this. But there are situations when a person suffocates his emotions with food. Upset, I ate a bowl of ice cream - it got easier. His behavior received positive reinforcement and the person began to turn to this strategy over and over again.
Consulting psychologist:Often times, people eat too much because they lack rest. Let me give you an example. A young woman came up with a problem: in the evening she eats a lot and can not stop herself. It turned out that she works for three, because she does not know how to refuse colleagues. No time to bite: business all the time. And in the evening she can not eat. That is, a person impoverishes himself, exhausts himself, is under stress all the time. How to replenish lost energy? Burger, potatoes, chocolate.
It turns out that if a person eats when he is upset, anxious, angry, tired or sad, is it wrong?
Consulting psychologist:In itself, this is neither good nor bad: food subconsciously relates to safety. For a newborn, food is not just food, but intimacy with mom, solace, trust, acceptance, love, communication. Adults also sometimes eat to calm themselves. It's bad when it's the only way to cope with anxiety or fear.
Psychiatrist: With food we meet different psychological needs. For example, eating dinner with your family is intimacy. Going out to a restaurant with friends closes the need for social interaction. The problem arises when food becomes the crutch for our negative experiences. This brings us to the topic of an eating disorder (EID) or eating disorder. Psychiatry deals with these problems.
Wait wait! It turns out that if I ate a chocolate after hours and I feel guilty - is this already a disorder? Do I have to go directly to a psychiatrist?
Practical psychologist:Complex issues. There are situations when a person eats on the run, chaotically, not paying attention to what he eats. Or eat when he is not really hungry - out of boredom or for company. It may be simply an eating disorder that can be corrected with a nutritionist. But, at the same time, eating out of hunger is one of the symptoms of RIP. The line is very thin. And only a doctor can prescribe it. In our country, a psychiatrist is engaged in this.
Endocrinologist:It happens that a person is constantly sad, anxious, tired - and catches these problems. Maybe this is the result of constant stress. But they are also symptoms of endogenous depression and anxiety neurosis. A psychiatrist is also involved in diagnosing such conditions.
But is not ERP - Bulimia and Anorexia? The symptoms are difficult to confuse
Psychiatrist: It's not just bulimia and anorexia. Eating disorders also include psychogenic overeating (also called paroxysmal or compulsive eating), eating inedible food (Pick disease), and psychogenic loss of appetite. These are disorders included in the International Classification of Diseases (ICD). However, there are disorders that are not included in this list, but that also attract the attention of psychiatry: selective eating disorder, orthorexia (when the desire for a healthy lifestyle goes beyond any limits) and pregorexia (the strictest restrictive diet in womenpregnant). .
Practical psychologist: Psychology also distinguishes overeating syndrome (BOE): when a person eats almost nothing throughout the day, can not sleep for a long time or often wakes up and, waking up, goes to the refrigerator.
Is obesity also an ERP?
Psychiatrist: Not always. There can be many reasons - these are genetics, a sedentary lifestyle and hormonal disruptions. It is not possible to equate RPP with obesity.
Practical psychologist: Yes I agree. There are people with absolutely healthy eating behaviors who are obese. And it happens the other way around - for example, patients with anorexia nervosa.
Have you heard that the problem of RPP is mainly related to women, teenagers and models? It's true?
Psychiatry:Certainly not. The disorder can develop at any age in both men and women. For example, selective eating disorder is more common in children - the child eats only certain foods.
Practical psychologist: Anorexia and bulimia are more common in women. But compulsive overeating - equally in men and women. So it is impossible to say that RPP is a purely female problem. And yes, teenagers, models, athletes doing aesthetic sports (rhythmic gymnastics, figure skating, sport dancing), TV presenters, bloggers, actresses - all those who are visible and whose work depends on appearance is in danger. But the problem can be overcome by any person, including those who are away from the modeling business or beauty blogs.
It is believed that any food problem is an attempt to attract attention. This is true?
Practical psychologist: There is such an opinion, but it is not scientifically proven. Yes, during therapy, it may turn out that the RPP started when the person was not accepted by peers. For example, for a 13-15 year old girl, it is important that boys watch her and her friends approve of her, and so she continued a strict diet. It also happens that food problems are the child trying to get the attention of the parents, often unconsciously. But these are quite special cases. It is a mistake to think that the need for attention is the root cause of eating disorders.
So what is the reason?
Practical psychologist: There are three sets of reasons: biological, psychological and social. Biological - for example, a genetic predisposition to RPC - unfortunately, can be inherited. Psychological - domestic violence, prohibition of expressing negative emotions, violation of the parent-child relationship (for example, if the child has cold and restrained parents). Social - the cult of ideals of beauty, weakness, bullying.
PsychiatristAnswer: There are several personality traits that can contribute to the development of EID, such as perfectionism or over-responsibility. The characteristics of eating behavior in the family, attitudes towards weight and figure are also influenced. The child could be rewarded with cakes for good behavior and study, and that stalled: since I'm fine, you can get some candy. Very good? I will take ten.
Consulting psychologist:Many patients with ECD have experienced physical or sexual abuse. Also for many people, food helps to derive secondary benefits from the situation. For example, one of my clients needed weight to protect herself from men. During therapy, we discovered that at school age the girl got into an uncomfortable situation with an adult man. The client was surprised to recall this: this story seemed "forgotten", but continued to influence the girl's adult behavior. They also discovered the belief that men love only the weak. If so, being overweight helped her to "stay safe", that is, without men.
How common are eating disorders in society?
Psychiatrist: It is believed that the prevalence of RPC in the world is around 9%. In risk groups, the prevalence is higher. There are studies of teenage girls reporting that by the age of 20, about 13% have symptoms of CRP. Anorexia is one of the deadliest mental disorders, ahead of only chemical addiction.
Practical psychologist: It is difficult to give accurate numbers because people with PAD often do not realize that they need help. There are figures for the United States, as it is a center for research and statistics on eating disorders: there are approximately 30 million people living with eating disorders. There are twice as many women as men (20 million versus 10 million). And every hour in the world at least 1 person dies from the effects of RPE.
What are the symptoms of RPE? Can I diagnose it myself?
Psychiatrist: In general, the main symptoms are as follows:
- A person makes himself vomit after eating or compensates for what he has eaten in other ways, for example, excessive physical exertion (physical tyranny), laxatives and diuretics.
- Strong fixation on weight and figure (you can not add / lose a single gram or centimeter! ).
- Numerous attempts to reduce weight and body weight fluctuate.
- Numerous different rules in nutrition (I eat only protein, only vegetables, only red).
- Persistent thoughts, fears and feelings of guilt and shame associated with food intake and body weight. When food-related thoughts and behaviors bring a lot of suffering.
- Loss of control over the amount eaten.
But many can have such symptoms to varying degrees. Is there a more accurate diagnosis?
Endocrinologist:RPD is a chronic systemic disease. Causes metabolic changes in systems and organs, changes in human neurohumoral regulation. This is a complex problem that can occur in neurosis, organic brain pathology, organic lesions and depressive disorders.
But first you need to determine the cause of the symptoms. For example, if a person runs in the refrigerator at night, you should detect glycogen levels in order to rule out insulin resistance and type 2 diabetes mellitus.
What if you found out that you or your boyfriend has an RPP?
Practical psychologist: If you have - consult a psychiatrist for diagnosis. If you suspect an RPP on a loved one, it's harder: he often refuses, unwilling to admit that something is wrong with him. And unnecessary pressure can break trust. Let your loved one know you are on his or her side, ready to help and support.
Who treats ZHF? Just a psychiatrist?
Psychiatrist: Jo. A psychiatrist makes the diagnosis. And he cures, depending on the disease, a psychiatrist, psychotherapist, clinical psychologist (as described by a psychotherapist). Why is it so important to visit a psychiatrist in the first place? Because it can detect accompanying conditions such as depression or anxiety disorder, which are found in about 80% of cases in people with RPD. Treatment depends on the severity of the disease. It can be drug therapy in combination with psychotherapy (group, cognitive-behavioral, behavioral dialectical). Family therapy is also recommended.
Consulting psychologist:Anorexia and bulimia are mainly treated by a psychiatrist. Excessive emotional eating - psychologist, counseling psychologist. Obesity - a nutritionist-endocrinologist (you should check hormones if metabolism is disturbed) along with a psychologist or psychotherapist.