The title contains a popular search engine query. But this article won't offer advice like "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 towards food.
What's wrong with not eating to lose weight?
practicing psychologist: If you have a healthy attitude towards nutrition, then you are in touch with your body - you 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 "don't eat to lose weight" implies the breaking of this contact, the confrontation with oneself and the manifestation of self-aggression. It turns out that in order to achieve the goal (weight loss), you are taking action against yourself. this is not goodTHEdull and unhealthyTHEinside.
Psychiatrist: Most people who have lost weight as a result of a restrictive diet regain it within 1-2 years. Also, 2/3 of them earn more than they lost.
Endocrinologist:The message to force yourself not to eat to lose weight is irrational. It is important to understand: what happens to the body? Perhaps this is not a matter of inadequate diet, but of 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 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.
practicing psychologist: This is when you eat hungry, stop when you're full, don't focus on your body's deficiencies, which must be "corrected" with food or refusal, when you don't overeat, don't apprehend emotions.
Can you give more details? How and why do we consume emotions?
practicing psychologist: There are no good and bad emotions for the psyche, it can handle either. She doesn't need food, alcohol, gadgets or TV for that. But there are situations when a person has smothered 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 repeatedly.
Consulting Psychologist:People often overeat because they have no rest. Let me give you an example. A young woman came up with a problem: at night she eats a lot and can't stop. Turns out she works for three, because she doesn't know how to turn down colleagues. No time for a bite: business all the time. And at night she can't eat. That is, a person is exhausted, overloaded, stressed all the time. How to restore lost energy? Burger, potato, chocolate.
It turns out that if a person eats when they are bored, anxious, angry, tired or sad, is that wrong?
Consulting Psychologist:By itself, this is neither good nor bad: food is unconsciously associated with safety. For a newborn, food is not just food, but closeness to the mother, soothing, trust, acceptance, love, communication. Adults also eat sometimes to calm down. 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 eliminates 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! Turns out if I eat a chocolate bar after work and feel guilty - is that 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 could just be an eating disorder that can be fixed 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 involved in this.
Endocrinologist:It happens that a person is constantly sad, worried, tired - and he takes advantage of 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 isn't ERP - Bulimia and Anorexia? Symptoms are hard to mistake
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 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). ) .
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, upon waking, goes to the fridge.
Is obesity also an ERP?
Psychiatrist: Not always. There can be many reasons - they are genetics, 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 behavior who are obese. And the opposite happens - for example, patients with anorexia nervosa.
Heard that the RPP problem is mostly about women, teenagers 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 occurs most often 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. Therefore, it is impossible to say that RPP is a purely female problem. And yes, teenagers, models, athletes who play aesthetic sports (rhythmic gymnastics, figure skating, sports dance), TV presenters, bloggers, actresses - everyone in sight and whose job depends on their looks is at risk. But the problem can overtake anyone, including those far from the modeling business or beauty blogging.
Any nutritional issues are believed to be an attempt to get attention. That's true?
practicing psychologist: There is such an opinion, but it is not scientifically based. Yes, during therapy, it can happen that RPP started when the person was not accepted by peers. For example, for a 13-15 year old girl, it is important that the boys look at her and that her friends approve, so she followed a strict diet. It also happens that problems with food are an attempt by the child to attract the attention of the parents, often unconsciously. But these are very 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, prohibition of the expression of negative emotions, violation of parent-child attachment (for example, if the child has cold and distant 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. The child could be rewarded with candy for good behavior and study, and that stayed: since I am good, you can take a candy. Very good? I'll take ten.
Consulting Psychologist:Many patients with ILD have experienced physical or sexual abuse. For many, too, 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 it continued to influence the girl's behavior into adulthood. They also revealed the belief that men only love thin men. If so, the extra weight helped her to "stay safe", i. e. no men.
How common are eating disorders in society?
Psychiatrist: The prevalence of PRC in the world is believed to be around 9%. In risk groups, the prevalence is higher. There are studies of adolescent girls that report that, by the age of 20, about 13% have symptoms of CPA. Anorexia is one of the deadly mental disorders, second only to chemical dependency.
practicing psychologist: It is difficult to give exact numbers, because people with PAD often do not understand anything that they need help with. 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 consequences of EPR.
What are the symptoms of ERP? Can I diagnose myself?
Psychiatrist: Generally speaking, the main symptoms are as follows:
- A person vomits after eating or makes up 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't add/lose a single gram or centimeter! ).
- Numerous attempts to reduce weight and body weight balance.
- Various nutrition rules (I eat only protein, only vegetables, only red).
- Constant thoughts, fears, and feelings of guilt and shame related to food intake and body weight. When food-related thoughts and behaviors bring a lot of suffering.
- Loss of control over the amount ingested.
But many may have these symptoms to varying degrees. Is there a more accurate diagnosis?
Endocrinologist:RPD is a chronic systemic disease. It causes metabolic changes in systems and organs, changes in human neuro-humoral 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, you need to find out the glycogen level 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 - see a psychiatrist for diagnosis. If you suspect an RPP in a loved one, it's more difficult: he usually refuses, doesn't 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? Just a psychiatrist?
Psychiatrist: No. A psychiatrist diagnoses. And he heals, depending on the disease, 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 comorbidities like 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 primarily treated by a psychiatrist. Emotional excesses - psychologist, counselor psychologist. Obesity - a nutritionist-endocrinologist (you need to check hormones, if metabolism is disturbed) together with a psychologist or psychotherapist.