The title contains a popular search query. But this article will not offer tips like "count to 10 and drink a glass of water". Let's talk about something else: why forcing you 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 to lose weight?
Practical psychologist: If you have a healthy attitude towards diet, then you are in contact with your body - you hear its signals and know how to negotiate with it. If the body signals hunger, satisfy it; satiety you stop eating. The message "don't eat to lose weight" means breaking this contact, facing yourself and showing self-aggression. It turns out that to achieve the goal (weight loss) you take action against yourself. This is not goodOhboring and unhealthyOhin.
Psychiatrist: Most people who have lost weight as a result of a restrictive diet, return it within 1-2 years. Moreover, 2/3 of them gained more than they lost.
endocrinologist:The message that you are forcing yourself not to eat in order to lose weight is irrational. It is important to understand: what happens to the body? Maybe it's not a question of improper diet, but hormonal characteristics.
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 food", diet and calorie counting. And when you allow yourself to enjoy the food.
endocrinologist:It is about treating food as a condition for a fulfilled, happy life. And not as a substitute for joy and satisfaction.
Practical psychologist: That is when you eat from hunger, you stop when you are full, do not focus on the shortcomings of your body that you have to "correct" with food or refusing it, when you do not overeat, do not catch 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 cope with any. She doesn't need food, alcohol, appliances or a TV for this. But there are situations when a person has suffocated 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 resort to this strategy over and over again.
Consultant psychologist:Often people overeat because they lack rest. Let me give you an example. The young woman encountered a problem: she eats a lot in the evening and cannot stop. It turned out that he works for three, because he doesn't know how to reject colleagues. No time for a bite: work all the time. And he can't eat in the evening. That is, the person is exhausted, overloaded, constantly stressed. How to make up for lost energy? Burger, potatoes, chocolate.
It turns out that if a person eats when he is bored, upset, angry, tired or sad, is it wrong?
Consultant psychologist:In itself, this is neither good nor bad: food is unconsciously associated with safety. For a newborn, food is not just food, but the closeness of the mother, calmness, self-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: We satisfy various psychological needs with food. For example, dinner with the 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 disorders (EID) or eating disorders. Psychiatry deals with these problems.
Wait wait! It turned out that if I ate a bar of chocolate after work and felt guilty - is it already a disorder? Should I go straight to a psychiatrist?
Practical psychologist:A complex 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 very hungry - out of boredom or out of company. Maybe it's 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 that. In our country, a psychiatrist deals with this.
endocrinologist:It happens that a person is constantly sad, worried, tired - and he catches those 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 hard to confuse
Psychiatrist: It's not just bulimia and anorexia. Eating disorders also include psychogenic overeating (also called paroxysmal or compulsive), eating inedible foods (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 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).
Practical psychologist: Psychology also distinguishes between overeating syndrome (BOE): when a person does not eat almost anything all day, cannot sleep for a long time or wakes up often and, waking up, goes to the fridge.
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.
Practical psychologist: Yes I agree. There are people with an absolutely healthy diet who are obese. And vice versa - for example, patients with anorexia nervosa.
Have you heard that the problem of RPP is mainly around women, adolescents and models? The truth is?
psychiatrist:Of course not. The disorder can develop at any age in both men and women. For example, selective eating disorders are more common in children - children eat 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, adolescents, models, athletes who practice aesthetic sports (rhythmic gymnastics, figure skating, dance sports), TV presenters, bloggers, actresses - all who are in sight and whose work depends on appearance are endangered. But the problem can affect anyone, including those who are far from the modeling business or beauty blogging.
It is believed that any dietary problems are an attempt to attract attention. The truth is?
Practical 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 his peers. For example, for a 13-15 year old girl, it is important that boys watch her and her friends approve, so she went on a strict diet. It also happens that food problems are the child's attempt to attract the attention of the parents, often unknowingly. But these are quite 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?
Practical psychologist: There are three groups of reasons: biological, psychological and social. Biological - for example, genetic predisposition to RPC - unfortunately, can be inherited. Psychological - domestic violence, prohibition of expressing negative emotions, violation of parent-child attachment (for example, if the child has cold, withdrawn parents). Social - the cult of the ideals of beauty, thinness, harassment.
PsychiatristA: There are certain personality traits that can contribute to the development of EID, such as perfectionism or hyper-responsibility. The characteristics of eating behavior in the family, attitudes towards weight and figure are also influenced. The child could be rewarded with sweets for good behavior and learning, and this stuck to me: since I am good, you can take sweets. Very good? I'll take ten.
Consultant psychologist:Many patients with ECD have experienced physical or sexual abuse. Also for many, food helps to reap secondary benefits from the situation. For example, one of my clients needed weight to protect herself from men. During the therapy, we learned that at school age, the girl got into an awkward situation with an adult man. The client was surprised to remember this: this story seemed "forgotten, " but it continued to influence the girl’s behavior as an adult. They also discovered the belief that men only like slim. If so, being overweight helped her "be safe, " that is, without men.
How common are eating disorders in society?
Psychiatrist: The prevalence of RPC in the world is estimated to be around 9%. The prevalence is higher in risk groups. There are studies on adolescent girls that state 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.
Practical psychologist: It is difficult to give accurate figures, because people with PAD often do not understand at all that they need help. There are numbers for the United States, because it is a center for research and statistics on eating disorders: about 30 million people live with eating disorders. There are twice as many women as men (20 million to 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: Generally speaking, the main symptoms are as follows:
- The person vomits after eating or makes up for what he ate in other ways, for example, excessive physical exertion (physical tyranny), laxatives and diuretics.
- Strong fixation on weight and figure (you can't add / lose a single gram or centimeter! ).
- Numerous attempts to lose weight and swing body weight.
- There are many different rules in the diet (I eat only protein, only vegetables, only red).
- Constant thoughts, fears and feelings of guilt and shame related to food intake and weight. When thoughts and behaviors related to food 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 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 brain pathologies, 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 mellitus.
What if you realize that you or your loved one has RPP?
Practical psychologist: If yes - see 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 break 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. The psychiatrist makes the diagnosis. And treats, depending on the disease, a psychiatrist, psychotherapist, clinical psychologist (prescribed by a psychotherapist). Why is it so important to visit a psychiatrist? 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.
Consultant psychologist:Anorexia and bulimia are treated primarily by a psychiatrist. Emotional overeating - psychologist, counselor psychologist. Obesity - nutritionist-endocrinologist (hormones should be checked, whether metabolism is disturbed) together with a psychologist or psychotherapist.