The title contains a popular query in search engines. But this article will not offer advice like "count to 10 and drink a glass of water. "Let's talk about something else: why forcing yourself not to eat for weight loss is a bad idea and how to deal with your attitude to food.
What's wrong with not eating for weight loss?
Practicing psychologist: If you have a healthy attitude to nutrition, then you are in contact with your body - you hear 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 in order to lose weight" implies breaking this contact, confrontation with oneself and the manifestation of auto-aggression. It turns out that in order to achieve the goal (weight loss), you are taking measures 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 lost.
Endocrinologist:The message to force yourself not to eat in order to lose weight is irrational. It is important to understand: what happens to the body? Perhaps this is not a matter of improper diet, but of hormonal characteristics.
And what is it all about - a healthy attitude to food?
Psychiatrist: This is when regular meals and snacks are not accompanied by anxiety, shame and guilt. Lack of "forbidden foods", dieting and calorie counting. And when you allow yourself to enjoy food.
Endocrinologist:It is about treating food as a condition for a fulfilling, happy life. And not as a substitute for joy and pleasure.
Practicing psychologist: This is when you eat out of hunger, stop when you are full, do not focus on the shortcomings of your body, which must be "corrected" with food or refusal from it, when you do not overeat, do not seize emotions.
Can you give it more details? How and why do we eat up emotions?
Practicing psychologist: There are no good and bad emotions for the psyche, it can cope with any. She doesn't need food, alcohol, gadgets or TV for this. But there are situations when a person drowned out his emotions with food. Upset, I ate a bowl of ice cream - it became easier. His behavior received positive reinforcement, and the person began to resort to this strategy over and over again.
Consultant psychologist:Often times, people overeat because they lack rest. Let me give you an example. A young woman came up with a problem: in the evenings she eats a lot and cannot stop herself. It turned out that she works for three, because she does not know how to refuse colleagues. There is no time to have a bite: business all the time. And in the evening she cannot eat. That is, a person depletes himself, overworkes himself, is in stress all the time. How to replenish the lost energy? Burger, potatoes, chocolate.
It turns out that if a person eats when he is bored, anxious, angry, tired or sad, is that wrong?
Consultant psychologist:In and of itself, this is neither good nor bad: food is unconsciously associated with safety. For a newborn, food is not just food, but closeness to mom, calming, confidence, acceptance, love, communication. Adults also sometimes eat to calm themselves. It’s bad when it’s the only way to deal with anxiety or fear.
Psychiatrist: With food we satisfy different psychological needs. For example, having 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 a 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 an after-hour chocolate bar and feel guilty - is this already a disorder? Should I go straight to the psychiatrist?
Practicing psychologist:Complex issue. There are situations when a person eats on the run, chaotically, does not pay attention to what he eats. Or he eats when he’s not really hungry - out of boredom or for company. It may be just a eating disorder that can be corrected with a nutritionist. But, at the same time, eating outside of hunger is one of the symptoms of RIP. The line is very thin. And only a doctor can determine it. In our country, a psychiatrist is engaged in this.
Endocrinologist:It happens that a person is constantly sad, worried, tired - and seizes these problems. Perhaps this is the result of constant stress. But they are also symptoms of endogenous depression and anxiety neurosis. A psychiatrist is also involved in the diagnosis of such conditions.
But isn't ERP - Bulimia and Anorexia? 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 inedible food (Pick's 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 also attract the attention of psychiatry: selective eating disorder, orthorexia (when the desire for a healthy lifestyle goes beyond all boundaries) and pregorexia (the strictest restrictive diet in pregnant women).
Practicing psychologist: Psychology also distinguishes Overeating Syndrome (BOE): when a person eats almost nothing all day, cannot 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, and a sedentary lifestyle, and hormonal disruptions. It is not possible to equate RPP with obesity.
Practicing psychologist: Yes, I agree. There are people with absolutely healthy eating behavior who are obese. And it happens the other way around - for example, patients with anorexia nervosa.
Heard that the problem of RPP is mainly about women, adolescents and models? It's true?
Psychiatrist:Of course not. The disorder can develop at any age in both men and women. For example, selective eating disorder most often occurs in children - the child only eats certain foods.
Practicing psychologist: Anorexia and bulimia are more common in women. But compulsive overeating - equally in men and women. So it’s impossible to say that RPP is a purely female problem. And yes, adolescents, models, athletes who are involved in aesthetic sports (rhythmic gymnastics, figure skating, sports dancing), TV presenters, bloggers, actresses - everyone who is in sight and whose work depends on appearance is at risk. But the problem can overtake any person, including those who are far from the modeling business or beauty blogging.
It is believed that any nutritional problems are an attempt to attract attention. This is true?
Practicing psychologist: There is such an opinion, but it is not scientifically substantiated. Yes, during therapy, it may turn out that the RPP started when the person was not accepted by peers. For example, for a girl of 13-15 years old, it is important that the boys look at her and that her friends approve, and so she went on a strict diet. It also happens that problems with food are a child's attempt to attract the attention of parents, often unconsciously. But these are rather special cases. It is wrong to think that the need for attention is the main cause of eating disorders.
So what's the reason?
Practicing psychologist: There are three groups of reasons: biological, psychological and social. Biological - for example, a genetic predisposition to RPC - unfortunately, can be inherited. Psychological - domestic violence, a ban on the expression of negative emotions, violation of parent-child attachment (for example, if the child has cold, aloof parents). Social - the cult of the ideals of beauty, thinness, bullying.
PsychiatristA: There are certain personality traits that can contribute to the development of EID, such as perfectionism or hyperresponsibility. The peculiarities of eating behavior in the family, attitudes towards weight and figure also affect. A child could be rewarded with sweets for good behavior and study, and this stuck: since I am good, you can take a candy. Very good? I'll take ten.
Consultant psychologist:Many patients with ECD have experienced physical or sexual abuse. Also for many, food helps to derive secondary benefits from the situation. For example, one of my clients needed weight to protect herself from men. In the course of therapy, we found out that at school age the girl got into an unpleasant situation with an adult man. The client was surprised that she remembered this: this story seemed "forgotten", but continued to influence the girl's behavior in adulthood. They also revealed the belief that men only love slim ones. If so, the extra weight helped her "be 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 about 9%. In risk groups, the prevalence is higher. There are studies of adolescent girls that report that by age 20, about 13% have CRP symptoms. Anorexia is one of the deadly mental disorders, ahead of only chemical addiction.
Practicing psychologist: It is difficult to give exact numbers, because people with PAD often do not understand at all that they need help. There are numbers for the United States, as it is a center for eating disorders research and statistics: 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 consequences of RPE.
What are the symptoms of RPE? Can I diagnose it myself?
Psychiatrist: Generally speaking, 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 cannot add / lose a single gram or centimeter! ).
- Numerous attempts to reduce weight and body weight swing.
- Various numerous rules in nutrition (I eat only proteins, only vegetable, only red).
- Constant thoughts, fears and feelings of guilt and shame related to food intake and body weight. When thoughts and behavior related to food bring a lot of suffering.
- Loss of control over the amount eaten.
But many may have such symptoms to varying degrees. Is there a more accurate diagnosis?
Endocrinologist:RPD is a systemic chronic disease. It causes metabolic changes in systems and organs, changes in human neurohumoral regulation. This is a complex problem that can manifest itself in neuroses, organic pathologies of the brain, organic lesions and depressive disorders.
But first you need to determine the cause of the symptoms. For example, if a person runs to the refrigerator at night, you need to find out the level of glycogen in order to exclude insulin resistance and type 2 diabetes mellitus.
What to do if you understand that you or your loved one has an RPP?
Practicing psychologist: If you have - consult a psychiatrist for diagnosis. If you suspect an RPP in a loved one, it is more difficult: he often refuses, does not want to admit that something is wrong with him. And unnecessary pressure can break trust. Let your loved one know that you are on their side, ready to help and support.
Who Treats ECD? Only a psychiatrist?
Psychiatrist: Not. A psychiatrist diagnoses. And he heals, depending on the disease, a psychiatrist, psychotherapist, clinical psychologist (as prescribed by a psychotherapist). Why is it so important to see a psychiatrist in the first place? Because it can reveal comorbid 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, dialectical behavioral). Family therapy is also recommended.
Consultant psychologist:Anorexia and bulimia are treated primarily by a psychiatrist. Emotional overeating - psychologist, counselor psychologist. Obesity - a nutritionist-endocrinologist (you need to check hormones, whether the metabolism is disturbed) together with a psychologist or psychotherapists.