The title contains a popular search engine query. But this article will not offer advice such as "count to 10 and drink a glass of water. " Let's talk about something else: why forcing yourself not to eat to lose weight is a bad idea and how to deal with your attitude to food.
What's wrong with not eating to lose weight?
Practitioner 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 to lose weight" implies breaking this contact, confrontation with yourself and self-aggression. It turns out that to achieve the goal (weight loss), you take action against yourself. This is not goodOhdull and unhealthyOhin
psychiatrist: Most people who have lost weight as a result of a restrictive diet regain it within 1-2 years. In addition, 2/3 of them gain more than they lose.
endocrinologist:The message of being forced not to eat to lose weight is irrational. It is important to understand: what happens to the body? Maybe it's not a matter of poor nutrition, but of hormonal characteristics.
And what is it 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", diets and calorie counting. And when you allow yourself to enjoy the food.
endocrinologist:It is about treating food as a condition for a full, happy life. And not as a substitute for joy and pleasure.
Practitioner psychologist: This is when you eat from hunger, stop when you are full, do not focus on the shortcomings of your body that need to be "corrected" with food or giving it up, when you do not overeat, do not grab emotions.
Can you give more details? How and why do we eat emotions?
Practitioner psychologist: There are no good or bad emotions for the psyche, it can handle all kinds. She doesn't need food, alcohol, gadgets or TV for that. But there are situations when a person suppresses his emotions with food. Upset, I ate a bowl of ice cream - it became easier. His behavior received positive support and the man began to resort to this strategy again and again.
Psychologist Consultant:Often people overeat because they lack rest. Let me give you an example. A young woman faced a problem: in the evening she ate a lot and could not stop. 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 he can't eat in the evening. That is, a person is exhausted, overloaded, constantly stressed. How to replenish lost energy? Burger, potatoes, chocolate.
It turns out that if a person eats when he is bored, anxious, angry, tired or sad, this is not right?
Psychologist Consultant:This in itself is neither good nor bad: food is unconsciously associated with safety. For the newborn, food is not just food, but closeness to mom, calmness, confidence, acceptance, love, communication. Adults also sometimes eat to calm down. It is bad when it is 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 eating disorder (EID) or eating disorder. Psychiatry deals with these problems.
Wait wait! It turns out that if I eat chocolate in an hour and I feel guilty - is it already a disorder? Should I go straight to a psychiatrist?
Practitioner psychologist:A difficult question. 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 can be just an eating disorder that can be corrected by 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 determine it. In our country a psychiatrist deals with this.
endocrinologist:It happens that a person is constantly sad, worried, tired - and get caught up in these problems. Maybe it's 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 isn't 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 junk food (Peak disease) and psychogenic loss of appetite. These are diseases 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 exceeds all limits) and pregorexia (the strictest restrictive diet in pregnant women).
Practitioner psychologist: Psychology also distinguishes between overeating syndrome (BOE): when a person eats almost nothing all day, can not sleep for a long time or wakes up often and, waking up, goes to the refrigerator.
Is obesity also ERP?
psychiatrist: Not always. There can be many reasons - these are genetics, and sedentary lifestyle, and hormonal disorders. It is not possible to equate RPP with obesity.
Practitioner psychologist: I agree to. There are people with absolutely healthy eating behavior who are overweight. And the opposite happens - for example in patients with anorexia nervosa.
Did you hear that the problem of RPP is mainly for women, adolescents and models? True?
psychiatrist:Of course not. The disorder can develop at any age in both men and women. For example, selective eating disorder is most common in children - the child eats only certain foods.
Practitioner psychologist: Anorexia and bulimia are more common in women. But compulsive overeating - the same for men and women. So it is impossible to say that RPP is a purely female problem. And yes, teenagers, models, athletes who engage in aesthetic sports (rhythmic gymnastics, figure skating, sports dancing), TV presenters, bloggers, actresses - all who are in sight and whose work depends on appearance are exposed torisk. But the problem can overtake anyone, including those who are far from the modeling business or beauty blogs.
It is believed that all kinds of eating problems are an attempt to attract attention. This is true?
Practitioner psychologist: There is such an opinion, but it is not scientifically substantiated. Yes, during therapy it may be that the RPP started when the person was not accepted by peers. For example, for a girl aged 13-15, it is important that boys watch her and her friends approve, so she goes on a strict diet. It also happens that food problems are an attempt by the child to attract the attention of the parents, often unknowingly. But these are very special cases. It is a mistake to think that the need for attention is the main cause of eating disorders.
So what's the reason?
Practitioner psychologist: There are three groups of reasons: biological, psychological and social. Biological - such as genetic predisposition to RPC - can unfortunately be inherited. Psychological - domestic violence, prohibition to express negative emotions, violation of parent-child attachment (for example, if the child has cold, distant parents). Socially - the cult of the ideals of beauty, weakness, harassment.
psychiatristA: There are certain personality traits that can contribute to the development of EID, such as perfectionism or over-responsibility. The peculiarities of the eating behavior in the family, the attitude to the weight and the figure also influence. The child could be rewarded with sweets for good behavior and learning, and that remained: since I am good, you can take candy. Very good? I'll take ten.
Psychologist Consultant:Many ECD patients have experienced physical or sexual abuse. Also, for many, food helps to reap the secondary benefits of the situation. For example, one of my clients needed weight to protect herself from men. In the course of therapy we learned that at school age the girl was in an unpleasant situation with an elderly man. The client was surprised to remember this: this story seemed "forgotten", but continued to influence the girl's behavior in adulthood. They also revealed the belief that men love only the weak. If so, the extra pounds helped her "besafe ", ie without men.
How common are eating disorders in society?
psychiatrist: It is estimated that the prevalence of RPC in the world is about 9%. In the risk groups the prevalence is higher. There are studies of adolescent girls who report that by the age of 20, about 13% have symptoms of CRP. Anorexia is one of the deadliest mental disorders, ahead of only chemical dependence.
Practitioner psychologist: It is difficult to give accurate figures because people with PAD often do not even 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. Women are twice as many as men (20 million vs. 10 million). And every hour in the world at least one person dies from the effects of RPE.
What are the symptoms of RPE? Can I diagnose it myself?
psychiatrist: Generally speaking, the main symptoms are as follows:
- A person is forced to vomit after eating or to compensate for eating in other ways, such as excessive physical activity (physical tyranny), laxatives and diuretics.
- Strong fixation on weight and figure (you can't add / lose a single gram or centimeter! ).
- Numerous attempts to reduce weight and weight swing.
- Various numerous dietary rules (eat only protein, only vegetables, only red).
- Constant thoughts, fears and feelings of guilt and shame related to food intake and body weight. When you think and behave related to food, you bring a lot of suffering.
- Loss of control over the amount eaten.
But many of them 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 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 your glycogen levels to rule out insulin resistance and type 2 diabetes.
What if you find out that you or your loved one has RPP?
Practitioner psychologist: If you have - consult a psychiatrist for a diagnosis. If you suspect RPP in a loved one, it's harder: he often refuses, unwilling to admit that something is wrong with him. And unnecessary pressure can undermine trust. Let your loved one know that you are on his side, ready to help and support.
Who treats ECD? Just a psychiatrist?
psychiatrist: No. A psychiatrist diagnoses. And treats, depending on the disease, psychiatrist, psychotherapist, clinical psychologist (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 occur 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.
Psychologist Consultant:Anorexia and bulimia are mainly treated by a psychiatrist. Emotional overeating - psychologist, counselor psychologist. Obesity - nutritionist-endocrinologist (you need to check hormones for metabolic disorders) together with a psychologist or psychotherapist.