Obesity: psychological factors involved in overweight
Obesity is considered a pandemic in Western countries. Unhealthy habits, stress, sedentary life and poor diet are the most frequent causes of excess weight. It is a disease that comes from the hand of a work context that forces us to be sitting in an office and to pay little attention to our health.
Of course, There are several disorders that can also be the cause of obesity . Medical problems such as endocrine or hormonal imbalances. These are separate cases that should be treated from a mainly medical perspective.
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Scientific researches have focused on this disease, obesity. In the United States, more than two thirds of adult women and up to 75% of men are overweight.
Overweight and obesity: differences
It is useful to differentiate between overweight and obesity , since they are related but not identical concepts. Both have in common that they refer to excess accumulated fat. However, overweight people are considered to have a Body Mass Index (BMI) from 25 to 29'9, being people who should reduce their weight in order to be healthier.
Obesity is a problem quantitatively and qualitatively more serious. Obese people surpass 30 BMI points, and their health is at significant risk.
Treating obesity from Psychology
The causes of obesity are several and, in many cases, comorbid. This means that the treatments to overcome this problem must be multifactorial : from the medical and endocrinologist field, to psychology and psychiatry can help people suffering from this problem.
Throughout the last decades, a large number of therapies and treatments have been developed against this disease, mainly focused on improving eating habits and promoting physical exercise. These two factors are closely linked to the reduction in body volume.
However, professionals who treat obesity have been realizing that it is necessary to intervene in this problem with more specific and personalized approaches, through medical, nutritional, psychiatric and psychological intervention. This deployment of professionals to tackle this problem is motivated by the human, social and economic costs generated by obesity.
Risks of obese people
Obesity is a disease that not only affects the quality of life of affected people, but also entails other important problems:
1. Comorbidity
Obesity is a risk factor for the development of other pathologies: hypertension, heart disease, cancer, sleep apnea, and so on.
2. Social stigma
Unfortunately, people who suffer from this health problem are strongly stigmatized both at school and in the workplace. This leads to the diminution of self-concept, increasing anxiety and worsening personal relationships.
3. Psychological and psychiatric disorders
Obesity has a high index of comorbidity with psychopathologies, such as anxiety, addictions, depression, eating disorders, among others.
Relevant psychological aspects
As I said before, obesity has biological, psychological and cultural causes. Regarding the psychological aspects associated with excess weight, there are different approaches and studies that point out certain possible causes, although none with a high degree of consensus.
For example, from Psychoanalysis, obesity is usually attributed to the symbolic act of eating, and overweight is usually associated with an externalization of neurosis, associated with depression, guilt and anxiety. It is also common to associate obesity with certain emotional conflicts in the background, or with another previous mental disorder.
The psychological etiology of obesity is confusing, so the efforts in the intervention focus on assessing and re-educating certain beliefs of patients, in addition to knowing the affective variables (emotional management) and environmental variables (food habits, habits, etc.). . This variety of psychological processes involved in obesity raises the need to address the situation of each patient individually, assessing their personality and their environment.
Psychological evaluation
Psychologists and psychiatrists can investigate intervene in the beliefs and emotional states of obese patients with the aim of improving their quality of life . It is important that the therapist creates an environment conducive to the patient to express and express their affective and cognitive conflicts.Usually, obese people experience low self-esteem and have a bad image about their own body.
Self-esteem, eating habits and intake perception
In short, the therapist must not only promote changes in the level of eating habit and lifestyle, but must also find a way to reinforce the self-concept to focus on the achievement of losing weight. In this sense, it is important to emphasize the importance of offering the patient tools for the control of emotions, impulses, as well as anxiety management techniques.
It is noteworthy that patients with obesity tend to underestimate their caloric intake compared to people without weight problems. Minimize the amount of food they eat, not being fully aware that their intake is excessive. This is a common feature with people who suffer from other types of addictions. To control this, the psychotherapist must accompany the patient and perform live records to show what amounts should be acceptable for each meal.
In short, therapy should focus not only on weight loss, but the process of psychological maturation that allows awareness of the problem, improving the quality of life and establishing healthy habits, such as physical activity, a better self-concept and perception of one's own body and healthier eating habits. It is also key concienciar to the patient that the obesity is a disease , and stress that you should strive to avoid relapses. One of the treatments that has shown the most success is cognitive-behavioral therapy.
Psychiatric aspects to consider
The role of the psychiatrist is also relevant in the treatment of people with obesity . Psychiatrists are responsible for deciding which patients are eligible to undergo surgery, and which are not. Traditionally, it has been considered that patients with psychotic symptoms are not suitable to undergo surgical procedures, nor are those with a history of abuse or dependence on alcohol or other drugs.
Another group of patients who have serious difficulties to follow a psychiatric treatment linked to excess weight are those who have a personality disorder.
Approximately 30% of obese people who come to therapy express having bulimic impulses. In addition, 50% of patients with bulimic inmates also have depression, unlike only 5% of patients without this type of impulses.
Treating affective disorders such as anxiety or depression in obese people is key to a good prognosis. It is the necessary basis for the patient to commit to perform the treatment and change their lifestyle.
Concluding
Definitely, patients with obesity require global treatment: doctors, psychiatrists, nutritionists and psychologists must intervene to diagnose and treat each person correctly and in a personalized way. Although there is not a broad consensus on the psychological causes of obesity, we find some points in common in many obese patients: low self-esteem, poor self-concept, poor eating habits and comorbidity with other psychopathologies.
This should make us assess the relevance of the role of mental health professionals to improve the quality of life and the chances of recovery of these patients.
Bibliographic references:
- WHO. (2014). Descriptive note No. 311
- Banegas, J.R. (2007). The challenge of obesity for public health. I NAOS Convention. Spanish Agency for Food Safety and Nutrition. Madrid, March 27, 2007.
- Strategy, N. A. O. S. (2005). Strategy for nutrition, physical activity and prevention of obesity. Ministry of Health. Spanish Agency for Food Safety. Madrid.
- Stunkard, A. J. (2000). Determinants of obesity: current opinion. Obesity in poverty: a new challenge for public health, 576, 27-32.
- McRoberts, C., Burlingame, G. M., & Hoag, M. J. (1998). Comparative efficacy of individual and group psychotherapy: A meta-analytic perspective. Group Dynamics: Theory, Research, and Practice, 2 (2), 101.
