The title contains a popular query in search engines. But this article will not give advice like "count to 10 and drink a glass of water. " Let's talk about something else: why it's a bad idea to force yourself not to eat for weight loss, and how to handle your attitude towardsfood.
What's wrong with not eating for weight loss?
Practicing psychologist: If you have a healthy attitude towards nutrition, then you are in touch 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 oneself and the manifestation of autoaggression. It turns out that in order to achieve the goal (weight loss), you are taking action against yourself. It is not goodISLANDboring and unhealthyISLANDin.
Psychiatrist: Most people who have lost weight as a result of a restrictive diet take it on again within 1-2 years. In addition, 2/3 of them win more than they lost.
Endocrinologist:The message of forcing oneself 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 question of improper diet, but of hormonal properties.
And what is it about - a healthy attitude towards 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 of a fulfilling and happy life. And not as a substitute for joy and pleasure.
Practicing psychologistThat is, when you eat out of hunger, stop when you are full, do not focus on the deficiencies in your body, which must be "corrected" with food or rejection of 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 feelings for the psyche, it can handle any. She does not need food, alcohol, gadgets or TV for this. But there are situations where a person drowned his emotions with food. Sorry I ate a bowl of ice cream - it got easier. His behavior received positive reinforcement and the person began to resort to this strategy again and again.
Consulting psychologist:Often 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 reject colleagues. There is no time to get a bite: business all the time. And in the evening she can not eat. That is, a person exhausts himself, overexerts 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 upset, is it so wrong?
Consulting psychologist:In itself, this is neither good nor bad: food is unconsciously associated with security. For a newborn, food is not just food, but closeness to mother, calm, self-confidence, acceptance, love, communication. Adults also sometimes eat to soothe 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, it's intimacy to have dinner with your family. 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 treats these problems.
Wait wait! It turns out that if I ate a chocolate bar after class and felt guilty - is this already a disorder? Should I go directly to the psychiatrist?
Practicing psychologist:Complex issue. There are situations where a person eats on the run, chaotic, not paying attention to what he is eating. Or he eats when he's not really hungry - out of boredom or for company. It can only be an eating disorder, which 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 determine that. In our country, a psychiatrist is engaged in this.
Endocrinologist:It happens that a person is constantly sad, worried, tired - and grasps 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 diagnosing such conditions.
But is ERP not - 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 that are part of the International Classification of Diseases (ICD). However, there are disorders that are not included in this list, but which also attract the attention of psychiatry: selective eating disorder, orthorexia (when the desire for a healthy lifestyle goes beyond all limits) and pregorexia (the most restrictive diet in pregnant women).
Practicing psychologist: Psychology also distinguishes between overeating syndrome (BOE): when a person eats almost nothing all day, can not sleep for a long time, or often wakes up and, wakes up, goes in the fridge.
Is obesity also an ERP?
Psychiatrist: Not always. There can be many causes - these are genetics, and a sedentary lifestyle and hormonal disorders. It is not possible to equate RPP with obesity.
Practicing psychologist: Yes I agree. There are people with absolutely healthy eating behaviors who are overweight. And it happens the other way around - for example, patients with anorexia nervosa.
Heard that the problem with RPP is mainly about women, young people and models? It is 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 eats only certain foods.
Practicing psychologist: Anorexia and bulimia are more common in women. But compulsive overeating - just as much in men and women. So it is impossible to say that RPP is a purely female issue. And yes, young people, models, athletes involved in aesthetic sports (rhythmic gymnastics, figure skating, sports dancing), TV hosts, 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 industry or beauty blogging.
It is believed that any nutritional problems are an attempt to attract attention. It is true?
Practicing psychologist: There is such an opinion, but it is not scientifically substantiated. Yes, during therapy, it may turn out that RPP started when the person was not accepted by peers. For example, for a girl of 13-15 years, it is important that the boys look at her and that her friends approve of it, and therefore she went on a strict diet. It also happens that problems with food are a child's attempt to attract parents' attention, often unknowingly. But these are quite special cases. It is wrong to think that the need for attention is the main cause of eating disorders.
So what is the reason?
Practicing psychologist: There are three groups of causes: biological, psychological and social. Biological - for example, a genetic predisposition for RPC - can unfortunately be inherited. Psychological - domestic violence, a ban on expressing negative emotions, violation of parent-child attachment (for example, if the child has cold, backward parents). Social - the worship of the ideals beauty, thinness, bullying.
PsychiatristA: There are certain personality traits that can contribute to the development of EID, such as perfectionism or hyper-responsibility. The peculiarities of eating behavior in the family, attitudes to weight and figure also affect. The child could be rewarded with candy for good behavior and studies, and this stuck: since I'm good, you can take a candy. Very good? I'm taking ten.
Consulting psychologist:Many patients with ECD have experienced physical or sexual abuse. Also for many, food helps to get secondary benefits of the situation. For example, one of my clients needed weight to protect himself from men. During the therapy, we found out that the school-age girl got into an uncomfortable 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. In that case, the extra weight helped her "be safe", ie 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 young girls who report that about 13% at the age of 20 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 disorder research and statistics: There are approximately 30 million people living with eating disorders. There are twice as many women as men (20 million against 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: In general, the main symptoms are as follows:
- A person causes himself to vomit after eating or compensates for what he has eaten in other ways, such as 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 swing.
- Various numerous rules in nutrition (I eat only proteins, only vegetables, only red).
- Constant thoughts, fears and feelings of guilt and shame related to food intake and body weight. When thoughts and behaviors related to food bring a lot of suffering.
- Loss of control over the amount eaten.
However, 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 fridge at night, find out the level of glycogen to rule out insulin resistance and type 2 diabetes mellitus.
What if you understand that you or your loved one has an RPP?
Practicing psychologist: If you have - consult a psychiatrist for a diagnosis. If you suspect an RPP in a loved one, it's harder: he often refuses, will not admit that there is something wrong with him. And unnecessary pressure can break trust. Let your loved one know that you are on his side, ready to help and support.
Who treats ECD? Only a psychiatrist?
Psychiatrist: Does not. A psychiatrist diagnoses. And he cures, 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 detect 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.
Consulting psychologist:Anorexia and bulimia are treated primarily by a psychiatrist. Emotional overeating - psychologist, counseling psychologist. Obesity - a nutritionist-endocrinologist (you should check hormones, if your metabolism is disturbed) together with a psychologist or psychotherapists.