MYTHS AND TREATMENT OF OBESITY

Most of the information we have today about obesity concludes that DIETS DO NOT WORK.  So, what else can we do to stem the tide of morbid obesity?

According to Albert Ellis, creator of the REBT model of therapy, obesity is deeply misunderstood.  I'm sure most people with a weight problem would agree!  (This is my response every time I hear some jerk say that losing weight is simple:  just burn off more calories than you eat!  Grrrrr.....)

The following is a simplified point-by-point construct to explain and treat what is becoming known as Overeating Disorder (OED).  Although not listed in the current diagnostic manual, it can still be diagnosed as Eating Disorder Not Otherwise Specified (NOS).  Does everyone who is overweight have a disorder?  Absolutely, not.  Below you will find a set of criteria for meeting the diagnosis (OED).

Overeating from a behavioral standpoint is explained as follows:

BEHAVIORAL:

 

Overeating results from inappropriate use of food as a reward and defective system of learning regarding food.

Here are some myths not guaranteed to make you feel better about your weight.

Myths Of Obesity:

 

Excess weight results from:

1. Poor control;
2. Not eating the right way or the right foods;
3. Maintaining weight loss becomes easier with time.  (That last one really bums me out!)

A CHART TO HELP YOU GAUGE YOUR WEIGHT

COGNITIVE THERAPY (specifically:  Rational Emotive Behavioral Therapy “REBT”) CHALLENGES SOME BELIEFS AND EXPLAINS MORE ABOUT OBESITY:

1. OVEREATING DISORDER (OED) IS THE RESULT OF SOME UNDERLYING PERSONALITY PROBLEMS

Depression is common in overweight people, however, other disorders occur at same rate as they do in slim people.  Studies showed that after weight was lost, depression decreased.

They have different issues from slim people, but those issues abate after weight loss (due to being more accepted by other and having a better self-image).

2. A “Fat Personality” does not exist.

3. Fat people are not less intelligent than slim people.

4. Locus of control is a determining factor on who will lose weight.  If the power to lose weight is perceived as coming within the person, good results are more likely; if the fault and solutions are perceived as outside oneself, bad results are usually expected.

5. Obese people tend to generate greater quantities of endorphins that makes ingestion of sugary, fatty foods positively reinforcing. The person gets an “eater’s high.”  Endorphins block feedback mechanism that signals satiety (that they are full).  Bad news:  Endorphin levels do not change after obese person has lost weight.

6. Information, appropriate thinking and feelings control weight—not diets.

OBESE PEOPLE USE IRRATIONAL BELIEFS (Thinking Errors) that fall into 4 main categories:

1. Demandingness (or shoulds);
2. Awfulizing;
3. Low frustration tolerance;
4. and Self-downing (putting themselves down).

 

 OTHER POINTS TO CONSIDER:
 

• Symptoms of emotional eating increases with body weight.
• Emotionally aroused obese eat more when they cannot identify distressing emotions.
• Many obese are depressed.  They focus on depression caused by negative thoughts associated with their weight.  They do not try to lose weight when severely depressed.
• Dieting increases depression because it deprives the body of serotonin.
• Diets themselves cause a type of eating that causes obesity.  (In other words, chronic food restriction leads to binging.)
• People struggling with obesity may be afraid to lose weight because of changes that it brings. (It disturbs comfort levels.)

SYMPTOMS OF OED:
 

*Similar to criteria for alcohol addiction*

1. Continued use despite disruption in major areas of functioning
2. Physical & psychological symptoms of withdrawal
3. Binging/gorging/fast eating
4. Triggered by allergy to certain foods (sugar, refined, fats)
5. Loss of control
6. Compulsion/cravings
7. Preoccupation/obsession
8. Feelings of guilt & shame
9. No usual regurgitation

GENERAL REBT TREATMENT RECOMMENDATIONS:

1. Don’t assume that if you are 10-20 lbs. overweight, you have an eating disorder. (Compare against the norm of your culture and the fatness that tends to be in your family, your individual set-point.)

2. If you are 50 or more lbs. overweight, check to see if you have specific medical problems (thyroid or metabolism deficiencies).

3. Find people who will accept you. 

4. Eat the right foods and exercise. (As you might have guessed, this is more complicated than it appears!)

5. Notice your thoughts; gain insights into your eating patterns; challenge your irrational thinking.

DON’T EAT TO SOLVE PROBLEMS, BUT SOLVE THEM!

Much more info, of course, can be found in Ellis' book.

Of course, different books appeal to different people.  (If you learned anything at all from reading my blog, you will probably understand that I do not absolutely advocate only one way on anything.)

Try to choose a book that talks about feelings, the psychology of, and healthy eating, though.  Any method or program is rarely as simple as it looks--that is my experience.

 

 This woman died soon after this picture was taken

Sorry to leave you on such a downer, but in case you take this subject "lightly", I want to emphasize--this is serious stuff!

 

KNOW THAT THERE IS HOPE AND TREATMENT FOR OBESITY!!!