How to normalize eating behavior. Eating disorders

Human eating behavior is assessed as harmonious (adequate) or deviant, depending on many parameters, in particular, on the place occupied by the food intake process in the hierarchy of individual values, on quantitative and qualitative indicators of nutrition, on aesthetics. The influence of ethnocultural factors on the development of eating behavior stereotypes is significant, especially during periods of stress. An eternal question about the value of nutrition is the question of the relationship between nutrition and life goals ("eat to live or live to eat"), taking into account the role of eating behavior of others for the development of certain personal characteristics (for example, hospitality).

Under eating behaviorit understands the value attitude to food and its intake, the stereotype of nutrition in everyday conditions and in a stressful situation, orientation to the image of one's own body and activities to shape it.

Taking into account the significant influence of transcultural characteristics of a person on the assessment of the adequacy of eating behavior, we point out that the significance of food intake in different cultures and among people of different nationalities differs. So, in accordance with N. Peseschkian's differential-analytical concept, nutrition is one of the main components of the eastern psychological model of values, within which a personal image of body beauty is developed (as a rule, a fat, well-fed person with a good appetite is considered more attractive and healthier) and attitude to how and how much a child or an adult eats. Increased appetite and increased nutrition ("eat first, then we'll talk about problems"), etc., are considered normal behavior in times of stress. the phenomenon of "stress seizing".At the level of domestic relations, the assessment of the highest degree of hospitality is associated with the provision of a large amount of food. In the Western psychological model of values, food in itself is not a value and hospitality does not necessarily include the process of eating. The value is control over food intake, orientation to other standards of beauty and aesthetics - slimness, thinness, athleticism as opposed to fatness within the Eastern model. In connection with such trans-cultural discrepancies, deviant eating behavior must necessarily take into account the ethnocultural stereotype of the eating behavior of the human environment.

The main eating disorders are: anorexia nervosa and bulimia nervosa.Common to them are such parameters as:

Concern about controlling your own body weight

Distortion of your body image

Changing the value of food in the value hierarchy

Anorexia nervosais a disorder characterized by the intentional weight loss caused and maintained by the individual himself. Refusal to eat is associated, as a rule, with dissatisfaction with their appearance, excess, in the opinion of the person himself, overweight. Given the fact that the determination of objective criteria for completeness is largely difficult due to the existence of the aesthetic component, we have to talk about the importance of the parameter of adequacy or inadequacy of perception of one's own body ("body scheme"), orientation to one's own opinion and ideas about it, or reflection and reaction on the opinion of the reference group. Often the basis of anorexia nervosa is a distorted perception of oneself and a false interpretation of changes in the attitude of others, based on a pathological change in appearance. This syndrome is called dysmorphomantes syndrome.However, the formation of anorexia nervosa is possible outside of this syndrome.

Allocate (M.V. Korkina) four stages of anorexia nervosa: 1) initial; 2) active correction, 3) cachexia, and 4) reduction of the syndrome. In the initial stage, the individual expresses dissatisfaction with the predominantly excessive, in his opinion, fullness of either the entire figure or individual parts of the body (abdomen, hips, cheeks). He focuses on the developed ideal, strives to lose weight in order to imitate someone from the immediate environment or popular people. At the stage of active correction, when eating disorders become obvious to others and deviant behavior is developing, the individual begins to resort to different ways losing weight. First of all he chooses restrictive food stereotype,excluding certain high-calorie foods from the diet, he is inclined to follow a strict diet, begins to use various physical exercises and trainings, takes large doses of laxatives, uses enemas, and artificially induces vomiting in order to free the stomach from newly eaten food. The value of food decreases to the maximum, while the individual is not able to control his speech behavior and constantly in communication returns to the topic of losing weight, discussing diets and training. At the stage of cachexia, signs of dystrophy may appear: weight loss, dryness and pallor of the skin and other symptoms.

The diagnostic criteria for anorexia nervosa are:

a) decrease by 15% and preservation at a reduced level of body weight or reaching the Quetelet body mass index of 17.5 points (the index is determined by the ratio of body weight in kilograms to the square of height in meters).

b) distortion of your body image in the form of fear of obesity.

c) the intention to avoid food that can cause an increase in body weight.

Eating disorder in the form of anorexia nervosa syndrome occurs, as a rule, with two types of deviant behavior: pathocharacterological and psychopathological. In the first, eating disorders are caused by the characteristics of a person's character and his response to attitudes from peers; in the second, anorexia nervosa syndrome is formed on the basis of other psychopathological disorders (dysmorphic-phomanic, hypochondriac, symptom complexes) in the structure of schizophrenic or other psychotic disorders.

Bulimia nervosa characterized by repeated bouts of overeating, the inability to go without food even for a short time and an excessive concern with controlling body weight, which leads a person to take extreme measures to mitigate the "fattening" effect of food eaten. The individual is food-oriented, he plans his own life based on the possibility

to eat at the right time and in the amount required for it. The value of this side of life comes to the fore, subjugating all other values. At the same time, an ambivalent attitude towards food intake is noted: the desire to eat a large amount of food is combined with a negative, self-deprecating attitude towards oneself and one's "weakness".

There are several diagnostic criteria for bulimia nervosa:

a) constant preoccupation with food and an irresistible craving for food even in conditions of satiety.

b) attempts to counteract the effect of obesity from the food eaten using such techniques as: induction of vomiting, abuse of laxatives, alternative periods of fasting, the use of appetite suppressants.

c) obsessive fear of obesity.

As seen from clinical descriptions, anorexia nervosa and bulimia nervosa have a number of common features, as a result of which we can talk about a single complex of eating disorders. However, bulimia nervosa, unlike anorexia, may be part of the structure of an addictive type of deviant behavior. If refusal to eat plays the role of a painful confrontation with reality (an essential parameter of pathocharacterological and psychopathological types of deviant behavior), then an irresistible craving for food can reflect both opposition (in particular, the removal of symptoms of anxiety, depression in neurotic disorders) and withdrawal from reality. In addictive behavior, increasing the value of the eating process and overeating becomes the only pleasure in a boring, monotonous life. A person chooses food for himself as an alternative to everyday life with its requirements, responsibilities, regulations. He develops the phenomenon of "thirst for thrills" in the form of changes in eating behavior. For example, such an individual may receive new unusual sensations from the quantity and quality of food, a combination of incompatible ingredients (cucumbers with honey, cake with mustard). The motive is the flight from the "hateful" reality into the world of eternal "food pleasure".

The concept of addictive behavior

The main motive of individuals prone to addictive forms of behavior is the active change of the unsatisfactory mental state, which is considered by them most often as "gray", "boring", "monotonous", "apathetic". Such a person does not manage to find in reality any spheres of activity that can attract his attention for a long time, captivate, delight or cause another significant and expressed emotional reaction. He sees life as uninteresting because of its routine and monotony. He does not accept what is considered normal in society: the need to do something, engage in any activity, observe some traditions and norms accepted in the family or society. It can be said that an individual with an addictive orientation of behavior has a significantly reduced activity in everyday life, filled with demands and expectations. At the same time, addictive activity is selective - in those areas of life that, albeit temporarily, but bring a person satisfaction and pull him out

from the world of emotional stagnation (insensitivity), he [begins] to show remarkable activity to achieve the goal. The following psychological characteristics of persons with dictive forms of behavior are distinguished (B. Segal):

1. Reduced tolerance to everyday difficulties along with good tolerance to crisis situations

2. Latent inferiority complex, combined with outwardly manifested superiority.

3. External sociability, combined with fear of persistent emotional contacts.

4. The desire to tell the truth.

5. Seeking to blame others, knowing they are innocent.

6. The desire to evade responsibility in decision-making.

7. Stereotype, repetition of behavior.

8. Addiction.

9. Anxiety.

The main, in accordance with the existing criteria, the characteristics of an individual with a tendency to addictive forms of behavior is the mismatch of psychological stability in cases of everyday relationships and crises. Normal, usually mentally healthy people easily ("automatically") adapt to the requirements of everyday (everyday) life and more difficult to endure crisis situations. They, unlike those with various addictions, try to avoid crises and exciting unconventional events.

Addictive behavior (from the English, addiction - harmful, vicious addiction) is one of the forms of destructive, deviant behavior, which is expressed in the desire to escape from reality by means of changing one's mental state. (Big Psychological Dictionary, 2003)

The presence of addictive behavior indicates impaired adaptation to the changed conditions of the micro- and macroenvironment. Addictive behavior, as defined by Korolenko and Segal (1991), is characterized by a desire to escape from reality by changing one's mental state.

The definition of addictive behavior applies to all of its many forms. Avoiding reality by changing the mental state can occur using different methods. In the life of every person there are moments associated with the need to change their mental state, which does not suit him at the moment. To achieve this goal, a person "develops" individual approaches that become habits, stereotypes. The problem of addictions begins when the desire to escape from reality, associated with a change in the mental state, begins to dominate in consciousness, becoming a central idea that invades life, leading to a disconnection from reality. A process takes place during which a person not only fails to solve important problems for himself, but also stops in his spiritual development. (Korolenko, Dmitrieva, 2001)

The mechanism of escape from reality is as follows. The method chosen by the person worked, liked it and fixed itself in consciousness as a finally found active means that ensures a good state.

In the future, a meeting with difficulties requiring a decision is automatically replaced by a pleasant escape from the problem with the transfer of its solution "to tomorrow." Gradually, volitional efforts decrease, since addictive realizations "beat" volitional functions, contributing to the choice of tactics of least resistance. Reducing the tolerance of difficulties, avoiding overcoming them leads to the accumulation of unsolved problems.

Each person depends on something or someone. You can argue that you are a completely free person who is not familiar with the concept of addiction. But in reality this is not so, because our existence directly depends on other factors: food, air, water. Physiological dependence is our daily life. But psychological addiction is a problem that needs to be addressed.

Psychological dependence is very multifaceted, especially since so far psychologists have not been able to come to a common opinion on how to describe it. And there are many types of psychological dependence. Many are addicted to smoking or food, although they do not even know it. Others cannot live without some person. For others, the world is not nice without computers and the Internet. As you can see, there is a psychological dependence, where to turn around, because a lot of people are subject to it.

But first, let's still define what constitutes psychological addiction. A full-term description does not always give an exact concept for everyone. Therefore, psychological dependence can be described in this way: a constant return to certain conditions in which life seems easier, better and more colorful. For example, you have a psychological dependence on a person. It manifests itself by the fact that no matter what the reason is, but you always want to be near this person, because you are comfortable with him, all problems fade into the background. And you can't even imagine life without him. Here you have your psychological dependence.

The psychology of addiction is very complex, but doctors know how it is formed. A person in his life experiences various troubles and tragedies. And if some endure them steadfastly, others cannot cope with their problems. These weak-willed people are most susceptible to various addictions. And it all starts with the fact that one day such people, in frustrated feelings, try to escape from reality. So they take drugs, cloud their thoughts with alcohol, or turn their attention to food. In any case, coping with psychological addiction will be very difficult.

The most troublesome people are caused by alcoholic psychological dependence. Inveterate drunkards look into a bottle not because they are drawn to another dose of alcohol, but because they are in a world where they are easy and comfortable. It is almost impossible to cure such an addiction, because after many years no alcoholic will be able to imagine a life where there is not a drop of booze.

Many people try to replace their addiction with something else. So, in an attempt to overcome physiological dependence, say, from smoking, men eat candy or peel seeds. Yes, physiological dependence has been overcome, but psychological dependence on seeds or sweets develops. All this speaks of the wrong approach to the problem and pathetic attempts to cope with it on their own.

But it’s not that bad. Many people realize that their psychological problem prevents them from living a normal, fulfilling life. Therefore, it would be fair to ask the question: how to get rid of psychological dependence? Unfortunately, this cannot be done on your own. Only a psychologist can help to cope with this problem.

The most effective are classes in a group where people with the same problem are gathered. Of course, you can deal with each person individually, but there will be little sense from such treatment, alas. After all, every person, feeling new strength in himself, quickly gets tired of classes and thinks that he can cope himself. The result is exactly the opposite. Psychological addiction returns, and all efforts are wasted. In the group, the opinion of the majority is the authority, so no one wants to look worse in the eyes of other people.

Overcoming psychological addiction is a very long and arduous journey. But at the end of it, you can confidently say that you can start new life, in which there is no place for such a concept as psychological dependence.

Chemical dependence is an obsessive need for a psychoactive substance (surfactant). Addiction will always be an urgent problem in any social order. There is a lot of information about addictions, but nevertheless there are always those who want to try and make their own mistake.

There are as many types of chemical addictions as there are in the world of means that change consciousness. Among them, the most common:

alcoholism (a disease caused by the systematic use of alcoholic beverages)

opium addiction (a disease caused by the systematic use of opium, black opium, heroin, morphine, promedol, omnapone, etc.)

dependence on stimulants (cocaine, phenylpropanolamine, ephedrine preparations: mulka, screw; amphetamine, etc.)

substance abuse (dependence on non-narcotic chemical substances, these are volatile organic solvents, sedative-hypnotics, antiparkinsonian drugs (cyclodol, parkopan))

cannabinol addiction (hash addiction)

hallucinogenic addiction (use of LSD, mescaline, psilocybin, ecstasy, etc.).

The development of all chemical dependencies is strictly staged. The division into stages is due to the dynamics of the development of symptoms and syndromes: a syndrome of altered reactivity - including a syndrome of increased tolerance (tolerance is the minimum amount of surfactants required to achieve a euphorizing effect), a change in the form of intoxication and a reduction in defense mechanisms, a syndrome of physical dependence - a feeling of physical discomfort outside intoxication, mental dependence syndrome - a feeling of psychological discomfort outside of intoxication and a syndrome of long-term consequences - somatic complications due to the use of psychoactive substances and personality changes. Their alternation and development determines the transition from stage to stage.

Let's consider the most common types of non-chemical addiction:

1. Food addiction. A person begins to actively, unlimitedly consume food ("seize problems") to relieve his uncomfortable internal state (mainly anxiety, anxiety). Overeating can lead to obesity and metabolic disorders in the sick person's body. For example, if a person occasionally eats sweets, there is nothing to worry about. However, a patient with this addiction is usually engaged in excessive gluttony - this, in addition to health problems, can further strengthen his process of uncontrollability of life and lead to an inability to constructively withstand stress.

2. Diet addiction - striving for fasting or weight loss. More typical for women. People with this addiction may pay more attention to their appearance (figure) and, accordingly, weight than, for example, their physical health, personal and professional development or their family.

3. Dependence on gambling... Usually, this type of addictive behavior leads to a loss of money comparable to the period of active consumption of psychoactive substances in patients with chemical addiction, and against this background, problems in communicating with loved ones may well develop. The person goes through the same stages of social decline as the alcoholic and / or drug addict. The emergence of these problems can lead a person into serious conflict situations, when the most in a simple way getting out of them may even seem like suicide.

4. Dependence on work - workaholism, constant need for employment. If a person with workaholism is completely immersed in work and does not devote enough time to recover from fatigue, then in the end he will not be able to fully resist stress and solve daily problems. As a result of fatigue, accumulation of stress and problems, a person's condition can deteriorate significantly, and he can develop serious diseases, for example, hypertension or ischemia, the consequences of which can be very life-threatening. And although a workaholic usually really earns quite a lot of money, they do not bring him satisfaction - he does not have time to enjoy spending what he earned on himself. In addition, spending earned money by other family members often causes irritation and conflict.

5. Sex addiction - addiction to sexual relations. As a rule, these are multiple, often promiscuous sexual relationships. With the help of frequent sexual relations, addicted people try to avoid internal conflict, increase self-esteem, etc. Usually, this behavior leads to an increase in confrontation with people around and to a break in the relationship of an addict with his loved ones, infection with sexually transmitted diseases, etc.

6. Addiction to intense sensations ("adventure seeking"). People who are prone to this type of addiction lack vivid emotions. Everyday everyday life does not satisfy them. Getting into stressful situations allows such a person to experience intense emotional experiences. The tendency to get into such situations can lead a person to all sorts of unpleasant situations that can end tragically.

7. Spending - dependence on purchases. Carrying out ill-considered purchases for the momentary improvement of his psychological, emotional state, a person subsequently begins to feel dissatisfaction with such spending of money. An accumulation of dissatisfaction with one's behavior regarding making unnecessary purchases leads to an increase in the level of stress. In the end, a large number of absolutely unnecessary things accumulate in the house, there is no money left for what is needed, and the state of dissatisfaction has not passed.

8. Fanaticism is another type of addiction, the need to have an idol, an object of worship. Fanatical worship of someone or something allows a person to improve their well-being by receiving intense, positive emotional experiences. It's no secret that often fans of artists, singers or athletes travel with them on all tours. What kind of normal life can we talk about in this case? Fanaticism leads to the same negative consequences as all other types of addictive behavior.

Trev-phobic. Russ.

A group of disorders in which anxiety is caused exclusively or predominantly by certain situations or objects (external to the subject) that are not currently dangerous. As a result, these situations are usually typically avoided or tolerated with a sense of fear. Phobic anxiety is not subjectively, physiologically, and behaviorally different from other types of anxiety and can vary in intensity from mild discomfort to horror. Patient anxiety can focus on individual symptoms, such as palpitations or lightheadedness, and is often combined with secondary fears of death, loss of self-control, or insanity. Anxiety is not diminished by the knowledge that other people do not find the situation so dangerous or threatening.

The mere idea of \u200b\u200bgetting into a phobic situation usually triggers anticipatory anxiety in advance. The acceptance of the criterion that the phobic object or situation is external to the subject implies that many fears of having some kind of disease (nosophobia) or deformity (body dysmorphic disorder) are now classified under F45.2 (hypochondriacal disorder). However, if the fear of illness arises and recurs mainly due to possible contact with infection or pollution, or is simply a fear of medical procedures (injections, operations, etc.), or medical institutions (dental offices, hospitals, etc.), in In this case, the heading F40.- is appropriate (usually - F40.2, specific (isolated) phobias).

Phobic anxiety often coexists with depression. Prior phobic anxiety is almost invariably intensified during a transient depressive episode. Some depressive episodes are accompanied by temporary phobic anxiety, and low mood is often associated with some phobias, especially agoraphobia. How many diagnoses need to be made - two (phobic anxiety and a depressive episode) or just one - depends on whether one disorder clearly developed earlier than the other and whether one disorder is clearly predominant at the time of diagnosis. If the criteria for a depressive disorder were met even before the phobic symptoms first appeared, then the first disorder should be diagnosed as the main disorder.

most phobic disorders, apart from social phobias, are more common in women.

In this classification, panic attack (F41.0), which occurs in an established phobic situation, is considered to reflect the severity of the phobia, which should be coded primarily as the underlying disorder. Panic disorder as such should only be diagnosed in the absence of any of the phobias listed under F40.-.

Depressive disorder.

Similar tendencies towards self-blame, self-deprecation, and often self-destructive behavior prevail in another type of mental depression - recurrent (i.e., recurrent) depressive disorder. This disease is also called monopolar depression, since it does not cause manic episodes (unlike manic-depressive psychosis). It is most commonly seen between the ages of 25 and 45, although it can also occur during adolescence. Women get sick twice as often as men. The extended stage of depression is accompanied by painful and gloomy sensations. Family, friends, social activity, professional activities, hobbies, books, theater, company - all these diverse interests lose their attractiveness for the patient. He is seized with one feeling: "Nobody needs me, nobody loves me." Under the influence of this feeling, all ideas about life change. The present seems bleak, the future bereft of hope. Life itself is perceived as a bleak burden. Everyday problems, once subtle or easy to solve, grow to insurmountable proportions. Exhortations to “kick the bad mood” or “pull yourself together” are usually useless. The danger of suicide, as in manic-depressive psychosis, persists as long as the depressive state lasts. The old adage that people who threaten to commit suicide never do so does not apply in this case. No other disease has such a high percentage of patients who attempt suicide.

Eating behavior - these are all components of human behavior that are present in the normal process of eating. Most often, when the ratio is violated, an atypical eating behavior is formed, leading to.

There are three main types of eating disorders: external eating behavior (eating unconsciously, always at the sight of food), emotiogenic eating behavior (hyperphagic stress response), restrictive eating behavior (excessive nutritional self-restraint and haphazard strict diets).

External eating behavior

External eating behavior is an increased response of the patient not to internal stimuli for food intake, such as hunger, filling the stomach, but to external stimuli (set table, eating person, advertising food products). Obese people with an external eating behavior eat regardless of the time of the last meal. The availability of food is of decisive importance (overeating "for the company", snacks on the street, excessive food intake at a party, buying an excessive amount of food). Eating is unconscious.

Emotional eating behavior

Emotional eating behavior, or hyperphagic reaction to, emotional overeating, "food drinking" (according to Shelton): occurs in 60% of cases. The stimulus for eating is not hunger, but emotional discomfort - a person eats not because he is hungry, but because he is restless, anxious, irritable, depressed, offended. This type of pathology of an eating disorder can manifest itself either by bouts of overeating - compulsive eating behavior (occurs in 15-20% of cases), or timed to coincide with the night time - night meal syndrome or overeating at night. ...

Restrictive eating behavior

Restrictive eating behavior is excessive food self-restraint and haphazard strict diets. Periods of restrictive eating behavior are followed by periods of overeating. The emotional instability that occurs during strict diets is called "dietary depression" and leads to refusal to continue dieting, new intense weight gain and relapse of the disease. The patient develops a sense of guilt with a decrease in self-esteem. Periods of food reward alternate with periods of food punishment, and a vicious circle ensues.

Overeating at night or night eating syndrome

Among obese patients, the prevalence of nighttime overeating reaches 9%. The syndrome is manifested by a clinical triad of symptoms:

• morning;
• evening and night;
• sleep disorders.

Mostly this syndrome occurs in obese women prone to depression. Patients with night meal syndrome usually do not take in the first half of the day, obviously reduced, the type of food can be disgusting. In the afternoon, appetite increases, and in the evening there is intense hunger, which leads to significant overeating. Moreover, the stronger the daytime emotional discomfort was, the more pronounced the evening overeating. Sleep problems occur due to not eating enough food. Repeated overeating is possible during the night.

Treatment of eating behavior

The main treatment for eating disorders is behavioral modification. Its main essence is a gradual change in the patient's wrong lifestyle. First of all, this concerns the correction of a disturbed food stereotype, a decrease in the dominant role of food motivation, the elimination of incorrect connections between emotional discomfort and food intake, etc. It is advisable to give the patient new nutritional skills not all at once, but gradually, one or two a week or more slowly.

1. The gradual, rather than one-step, exclusion of high-calorie foods from the diet avoids the occurrence of "dietary depression", which necessarily occurs when a sharp change in the usual style of eating.
2. It is strongly recommended not to eat while walking, out of hand, standing, etc. The patient should be gradually taught to eat at a strictly defined time, at the same convenient location, at a well-served table, in the room, not in the kitchen.
3. You need to eat very slowly. In order for the patient to be able to fulfill this very important recommendation, he should be given specific advice, for example: cut food into very small pieces; chew food slowly and thoroughly until smooth; after eating half of the portion, take a break for three to five minutes and only then continue eating; while eating - thinking about food and enjoying it.
4. In the first months of therapy, when food restrictions are difficult and have not yet become a habit, situations that promote overeating should be avoided. For example, do not go to visit and do not receive guests.
5. All food restrictions of the patient are recommended to be extended to the whole family. At home, in no case should there be foods that are prohibited to the patient. This recommendation allows you to reduce external eating behavior, avoid unnecessary tension in the family and make loved ones not passive observers, but like-minded people and active participants in treatment.
6. It is necessary to try to interrupt the patient's habitual stereotype of "seizing" stress. To reduce the manifestations of emotiogenic eating behavior, the patient should be taught to distinguish between hunger and emotional discomfort; offer ways to relax differently from eating. It can be exercise stress, walks, autogenous training, dancing, breathing exercises, music, knitting, shower, bath. The patient should be helped to choose the most acceptable method of mental relaxation.

TO modern drugsthat are currently used to correct eating behavior in obesity include:

1. Selective serotonergic antidepressants, primarily fluoxetine and fluvoxamine.
2. Selective serotonin and norepinephrine reuptake inhibitor - sibutramine or meridia.

Fluvoxamine it is prescribed in a dose of 50 to 100 mg per day for 3 months. This dose is taken once in the afternoon. The features of the daily distribution of drug intake are associated with a stimulating effect in fluoxetine and a sedative effect in fluvoxamine. These drugs are indicated for obese patients who have decreased satiety, emotiogenic PN, anxiety-depressive disorders, chronic pain syndromes, panic attacks... They are also recommended to be prescribed to those patients in whom decompensation in the mental and psycho-vegetative spheres occurred against the background of diet therapy.

Antibiotic therapy

French scientists have found that eating disorders such as anorexia and bulimia can be caused by the activity of certain gut bacteria that produce protein. The research findings, published in the journal Translational Psychiatry, open up the possibility of using antibiotics to treat eating disorders.

Researchers at the University of Rouen have found that certain types of intestinal bacteria, such as Escherichia coli, produce the protein ClpB, against which the body produces antibodies. This protein is similar in structure to a hormone

Every person, at least once in his life, got up from the table with a full stomach. If this happens rarely and he can control his appetite at such moments (he just allowed himself to relax and enjoy delicious dishes), then there is nothing terrible and pathological in this. An evening walk, an extra hour in the gym, a fasting day will not allow extra calories to be deposited on the body in unnecessary places.

It is quite another matter if this happens unconsciously and every time - after the next endured stress. This is already compulsive overeating - an eating disorder, the main cause of which is negative emotions. Leads to excess weight, and in the absence of proper measures - to obesity.

What it is?

According to the Diagnostic and Statistical Manual of mental disorders, binge eating disorder is a disease, and it is designated as a diagnosis with a separate code - 307.51 (F50.8). If a person in a state of stress awakens simply a brutal appetite with which he cannot fight, we are talking about an eating disorder. This is not the norm. Moreover, an attack can be provoked as a serious situation (death loved one, dismissal from work), and minor unpleasant moments that cause negative emotions (the boss raised his voice, a quarrel with a loved one).

The second name of the disease, common in medical circles, is psychogenic overeating, which most fully reflects its essence. This is an uncontrolled appetite, which is not due to physiological, but mental reasons.

Unfortunately, the habit of seizing any problem with a large amount of tasty and high-calorie food is one of the most common reasons.

Diagnoses. This same diagnosis can sometimes sound like a hyperphagic stress response.

Causes

To overcome binge eating disorder, you need to understand its causes. In fact, there are only 2 of them: stressful situations and experiences. But it's one thing when a person is in a protracted depression and seizes grief from the loss of a loved one. And it is completely different when suspicious and vulnerable girls begin to consume huge quantities of cakes and cakes only because their zipper on their favorite dress broke today or their husband did not congratulate them on their wedding anniversary. In the first case, you will need serious psychotherapeutic help, and in the second, a change in your own worldview.

Sometimes women begin to suffer from it after a diet, thereby nullifying all efforts. The reason for this behavior: dissatisfaction with the results (I expected to lose 10 kg, but in the end I lost only 3 kg).

Despite the fact that overeating is called psychogenic, scientists are actively engaged in the issue of how it affects genetic predisposition... To date, they have already isolated 3 genes, the presence of which leads to obesity as a result of a tendency to overeat. These genes received the following ciphers - GAD2 (stimulates appetite), FTO, Taq1A1 (reduces dopamine levels).

Etymology... The term "compulsive" goes back to the Latin word "compello", which means "to force."

Clinical picture

The main symptoms of binge eating can be noticed both by the person suffering from it and by those close to him. They tend to lie on the surface and are difficult to hide:

• food as the only way to cope with sadness, longing, loneliness;
• unwillingness to show the problem to other people leads to its absorption alone;
• the need to fill up to the dump;
• loss of control over appetite and food intake;
• eating even in the absence of hunger;
• eating an abnormally large amount of food in a short period of time;
• feelings of self-loathing and guilt after seizures;
• pronounced gluttony during stress.

The main thing in clinical picture - inability to control your own appetite. Every time, as soon as a person starts to get nervous, worry, suffer, he drowns out his mental torment with a huge portion of something tasty, and sometimes he himself does not notice that he eats much more than his norm.

Since most often mentally unbalanced people suffer from it, who take everything that happens very close to their hearts, they become prisoners of this disorder for a long time. Young girls and adolescents are most often at risk. Although men who are embarrassed to openly express their emotions can also seize problems with salted fish in the evenings and drink unlimited beer.

Another feature of the disorder is that in a state of stress, the patient rarely eats soups, cereals, fruits or vegetables, the benefits of which would be obvious to his health. Usually they use fast food, something fried, fatty and salty, soda (especially energy) and alcoholic drinks... Accordingly, the result is rapid weight gain. With absence necessary measures to block appetite, everything ends with obesity and concomitant diseases.

Diagnostics

With the problem of compulsive overeating, you can contact a therapist (he will give a referral to the right specialist) or directly to a psychotherapist, since it is he who treats this disease. Since no analyzes and instrumental methods studies cannot confirm or deny this diagnosis, a routine interview is used and a special test is performed.

According to the Diagnostic and Statistical Manual of Mental Disorders, the diagnosis is confirmed if 3 of 5 criteria are met:

1. The feeling of fullness in the stomach after eating is uncomfortable.
2. Even a large portion is eaten very quickly, almost imperceptibly.
3. Self-loathing, depressed mood, guilt after overeating.
4. Eating food in the absence of hunger.
5. Eating alone.

Treatment

If a person wondered how to deal with their abnormal eating behavior, this is already good sign... This means that he realizes the existence of a problem and the need for its speedy solution. Getting rid of binge eating on your own is very difficult - almost impossible. Therefore, you need to start by visiting a specialist - and best of all, a psychotherapist. It is he who will prescribe the correct course of treatment in accordance with the individual characteristics of the patient.

The therapy will be carried out in two directions at once, since the disease is complex. It combines psychological and physiological factors.

First, frustration leads to a set excess weightfollowed by obesity, metabolic syndrome, metabolic disorders, excessive load on internal organs, hepatosis and other associated diseases. This whole bouquet will have to be treated.

Secondly, it is necessary to eliminate the root cause of overeating, that is, to pull a person out of a depressive state, reduce his suspiciousness and constant nervous breakdowns.

Psychotherapy

To combat binge eating disorder, a psychotherapist may offer several methods of treatment, depending on the condition and personality of the patient.

• Group psychotherapy

If overeating is due to insufficient socialization (a person is highly dependent on the opinions of others), special self-help groups are created. Their task is to relieve emotional and nervous tension by increasing self-esteem. The patient begins to communicate with other patients and realizes that he is not alone, that he can be treated well and in fact, everything is not so bad with his communication skills. In 20% of cases, this is enough to cope with the disease.

This also includes family psychotherapy, if uncontrollable gluttony is dictated by problems with one of the family members. This technique is most often used to treat children.

• Cognitive Behavioral Therapy

This course is considered the most effective and ... fastest (and it lasts up to 5 months, so imagine how long it will take for other directions). Here, such tasks are solved as the patient's acceptance of himself, overcoming stress, learning self-control, identifying opportunities to change habitual reactions to events and behavioral stereotypes, and improving the quality of life.

• Interpersonal psychotherapy

Allows to achieve high efficiency in treatment. It is not inferior in this to cognitive-behavioral therapy, but it requires a longer course - from 8 to 12 months. Allows the patient to feel like a part of society, learn to communicate adequately with other people, get out of the closed state. When a person perceives himself as a self-sufficient person, he no longer treats every word from outsiders as a personal grievance. This reduces the degree of anxiety, allows you to be more stress-resistant, which means the end of gluttony.

• Suggestion or hypnosis

A controversial technique, since it allows you to stop the development of the disease only for a certain period. But - quickly and immediately. If all the previous techniques have proved to be useless, they resort to hypnosis. Only 3-4 sessions - and the person recovers. The downside is that he doesn't realize how he got rid of the problem. But he retains the same pattern of responding to stress - overeating. In this regard, relapses are diagnosed in the future.

Going to a psychotherapist, you need to realize that no one will offer magic pills (antidepressants are not). Convalescence is a real fight against the disease, in which the patient himself plays the main role. If he has an irresistible desire to get rid of the disease, if he has patience, then everything will work out. If the course of therapy is violent (relatives insisted), the process may drag on for years, but it will not bring results.

Food

It is very important for compulsive overeating to properly organize food: it is part of the therapy. Since the treatment is carried out on an outpatient basis, it falls on the patient's shoulders. Due to the psychogenicity of the disorder, it will be difficult for him and will probably need the help of someone close to him so that they can control his appetite, meal schedule and portion size from the outside. What recommendations should you follow?

1. Learn to distinguish psychological hunger from biological. Satisfy only the latter. Do not neglect the help of family and friends, let them take control over your meals.

2. Find alternative way relieving nervous tension (this can be a hobby, sports, music, movies, books, dancing). In extreme cases, if there is none, as soon as you feel an irresistible urge to eat something, go outside and breathe as deeply as possible.

3. Eat mostly low-calorie foods. Do not go to restaurants, cafes and fast food establishments. Do not purchase many products at once. Do not buy harmful cakes, pastries, sausages. Let the kitchen have only healthy fruits, vegetables, yoghurts, cottage cheese, etc.

4. Do not go on diets. Refuse aimless grocery shopping. Do not watch cooking TV shows or flip through recipe books. Do not discuss food with anyone. Stock up on small dishes that will exclude the use of large portions.

5. Do not put strict bans on your favorite products - allow yourself to relax at least once a week (not to gluttony, but 1 pack of chips will not hurt). If you drive yourself into too strict limits of limited nutrition, stress will increase, and with it the likelihood of breaking out will increase.

The best option is to consult a dietitian. Depending on the degree of neglect of the disease and the patient's eating habits, he will be able to develop an individual diet and menu. This will facilitate faster recovery.

Medicines

Medical treatment involves the appointment of sedatives. To cope with nervous overstrain and, as a result, to forget about food help:

• antidepressants, especially from the group selective inhibitors - this is Sertraline and Fluvoxamine;
• antiepileptic drugs: Valparin, Benzobarbital, Maliazin, Depamid, Sibazon;
• obesity pills:, Orlistat, Senade, Glucobay, Goldline;
• and there is also a one-of-a-kind drug that has been developed specifically to treat binge eating disorder, Lizdexamphetamine, which was approved by the US Food and Drug Administration in 2015.

Vivance and Elvanse drugs with lisdexamfetamine (English lisdexamfetamine) - psychostimulants from the amphetamine group used in the treatment of binge eating

Lizdexamphetamine is a psychostimulant from the amphetamine group, which is actively used in the West. Contains a natural amino acid. It goes on sale under different names depending on the country:

• Vivanse ( Vyvanse) - in USA;
• Wenwanse ( Venvanse) - in Brazil;
• Elvanse ( Elvanse) - in the UK and other European countries;
• Tivense ( Tyvense) - in Ireland.

Available in capsules of various sizes - from 10 to 70 mg. Often provokes the development of such side effects, as:

• insomnia;
• dizziness;
• diarrhea, constipation, nausea, vomiting, discomfort and pain in the stomach;
• significant weight loss;
• irritability;
• too strong a decrease in appetite up to its complete absence;
• dry mucous membranes;
• tachycardia;
• anxious state.

Lizdexamphetamine is banned in Russia, as it belongs to amphetamine derivatives. This drug is included in the list of narcotic and psychotropic substances under strict control in the Russian Federation.

Folk remedies

Besides organizing proper nutrition, binge eating can be treated at home, including in the diet foods to reduce appetite and, in parallel, have a calming effect. But it is not necessary to independently engage in their selection - it is advisable to discuss such moments in detail with the attending physician. He may recommend increasing your intake:

• pineapple;
• oranges;
• bananas;
• bitter chocolate;
• grapefruit;
• green apples;
• leafy vegetables (cabbage, spinach);
• legumes;
• nuts;
• bran;
• dried fruits;
• cottage cheese;
• and etc.

In the morning (before breakfast) and in the evening (before bedtime), it is advisable to drink 200 ml of infusion from the following herbs and spices:

• marshmallow;
• hawthorn;
• ginger;
• cinnamon;
• nettle;
• burdock;
• alfalfa;
• mint;
• flax seeds;
• cumin;
• fennel.

To cure binge eating disorder, you need complex treatment, which will include psychotherapeutic programs, and the organization of proper nutrition, and drugs, and wise use folk remedies... Only in this case do doctors give comforting forecasts for the future.

Effects

If overeating cannot be overcome for a long time, it may have irreversible consequences not only physiologically. As recent studies have shown, they will also affect human genetics.

Complications:

• hypertension;
• hormonal imbalance;
• blockage of arteries;
• metabolic syndrome;
• obesity;
• weakened immunity;
• high blood sugar;
• diabetes;
• cardiovascular diseases.

Genetics

Binge eating disorder disrupts the genetic makeup. A person suffering from this disorder and refusing to receive treatment will inherit obesity, diabetes and cardiovascular disease to their descendants. The genes responsible for the production of macrophages, which protect the body from infections and other negative factors, are also affected.

Given the structural genetic changes so dangerous for subsequent generations, it is imperative to be cured.

Books

In order to find out more information about the disease, you can read the following books:

Jenin Roth. Feeding the Hungry Heart. The author herself once suffered from this disorder, so her advice will be especially valuable.

Susan Albers. 50 Ways to Soothe Yourself Without Food. It explains in detail how to distinguish physiological hunger from mental and be able to cope with the latter.

Susan Albers. I deserve this chocolate! (But I Deserve This Chocolate!). The writer explains why food cannot be used as a reward.

Binge eating disorder is not just an eating disorder, but a serious medical condition that requires treatment in different directions. Need and nervous system calm, and bring peace of mind back to normal, and eliminate accompanying diseases. Therefore, the next time, seizing another problem with a piece of cake, think: is this not a pathology?

How many times in your life have you tried to lose weight?

Regarding “how many” there is an old joke: The husband asks his wife: “Darling, how many men did you have before me?” The woman frowned and fell silent. The next day, the husband could not resist and asks: "Honey, are you silent because you are offended at me?" "No, I just think!" She replied.

I hope that you are not so running, I mean trying to lose weight 🙂, but I think this is not the first time you are trying to lose weight. What's the matter? Let's figure it out!

Any weight loss program consists of three equivalent elements:

• awareness,
• adequate physical activity,
• changes in eating behavior.

And, if with the first two points of the program, as a rule, there are no special problems, then the change in eating behavior causes the greatest difficulties.

Our eating behavior is largely the result of our eating habits.

What is any habit, including food? This is a way of behavior that takes on the character of a need. In other words, habits are certain behavioral programs that always "work" under certain conditions.

Of course, it is very good when our eating behavior is determined by "healthy" habits for slimness.

A few words about “good eating habits”. I will tell you about an incident that happened to me recently!

As you know, recently all of us were obliged to undergo a medical examination. At the same time, they were strictly warned that it would be necessary to take a blood test, so everyone needs to come for an examination on an empty stomach.

The morning before the examination, I got up and, as usual, had breakfast. I already remembered that it was impossible to eat when I drove up to the clinic.

What happened? The "good" eating habit of having breakfast worked. That is, this is what we have already talked about - a way of behavior that is a need.

For me, the same habit and need is like brushing your teeth. I no longer think about whether I want to have breakfast or not, my body always requires it. And that's great!

Although, at that time, I could not, did not want to have breakfast, and believed that by skipping breakfast, I accelerated the rate of weight loss.

It's big, don't repeat it!

It took me about 1 month to develop the habit of having breakfast, and for more than 5 years it has been a natural need of my body.

But more often than not, things with habits are not so positive.

Wrong eating habits, which ultimately determine eating behavior, are formed in us for more than one day. And it is they who largely determine the problems with excess weight that we have.

When we start, we try to change our eating behavior, but our attempts to change something are faced with the already established stereotypes of nutrition. Which are capable of ruining our undertakings in the bud.

I would refer to the most negative food attitudes for harmony:

• lack of breakfast,
• the habit of eating on the go,
• eating in front of the TV,
• food when bored or anxious
• suffer hunger,
• do not drink water ...

What to do with all this baggage?

Eating Behavior: Developing a New Style

Eating behavior, as we have already found out, determines our habits. Accordingly, rational eating behavior requires new "correct" eating habits.

Changing existing habits is not easy. They have been formed throughout life and have already become an integral part of each of us.

But nothing is impossible for a person who really wants something.

Of course, it is easy to talk about it, but how can this be brought to life, which is filled with stress, worries and problems?

Friends, now I will share with you my vision of this problem, which helped me to change many "wrong" settings.

Changing eating behavior requires:

• faith in the result;
• awareness of the purpose for which you are ready to make efforts;
• sequences;
• patience.

1. When trying to break unwanted habits, don't go overboard. Remember that you can't change everything overnight.
2. Make it a rule to work with one, maximum two "wrong" food settings at a time.
3. On average, it takes us 21 to 28 days to form a new habit. These are, of course, average numbers, and in your case they can change up or down.
4. Start by identifying the negative attitude you want to work with.
5. Next, create an image of your "ideal" behavior and set a deadline by which you plan to achieve it, and do not forget to assign yourself a reward for achieving the desired result.
6. The next stage is the gradual introduction of changes and their consolidation in their behavior.

Let's now try to write a program to change the "bad" habit of not eating breakfast.

So you are not having breakfast now.

However, you know that breakfast within the first hour after waking up accelerates the speed metabolic processes, makes weight loss faster and more effective, helps control attacks of appetite, and guarantees the maintenance of the achieved results in the long term.

With all of these benefits, we come to realize that breakfast is a very good eating habit that will ultimately help us achieve weight loss goals.

Great, the first stage of working with the problem has been passed.

Now let's think about the timing we will define for developing and maintaining the breakfast habit.

The minimum period, as we already know, is 21 days. Let's increase it to 30 days to have a margin of time. So, we give ourselves 30 days to develop a new useful skill.

Any achievement is worthy of a reward. Agree with yourself that if after 30 days, you feel the need for breakfast every morning and, most importantly, you will have breakfast, then you will make yourself a gift.

What it will be - you determine for yourself. Let it be a thing or something else that you would really like, but, as they say, it’s a pity for money. Just not a cake or a cake, but something pleasant for the body, something that will remind you of your achievement.

The process of developing the plan is complete: the goal, timeline, expected result, reward for achievement are defined. It remains to start the implementation of the plans.

Be prepared for the fact that not everything will go smoothly. The first time will require some effort.

Take it easy when things don't go the way you imagined. This is completely normal, life always makes adjustments to our plans.

Think of any challenge as an opportunity for new experiences. You don't have to be perfect in everything, you have the right to be wrong. Potential failure is just your experience, not proof that you are unable to achieve your goals.

Be patient, keep your goal in front of your eyes and move towards it, albeit slowly and gradually, but most importantly, in the right direction. Don't be afraid of mistakes and breakdowns - they are natural!

Friends, try to acquire habits that will make your eating behavior more rational. As a result, your slimness will not be the result of super-efforts, but a natural consequence of your lifestyle and nutrition.

In the next article, we will continue talking about slimness habits. In order not to miss it, and receive new articles in your mailbox.

Eating behavior can be normal, episodically disturbed and pathological (in this case, they speak of). Eating disorders are ways of getting from food what is usually obtained from other sources: caring, distraction, relaxation, etc.

Normally, a person is when he needs to strengthen his body, to get the energy necessary for life. Food also brings pleasure, aesthetic pleasure, promotes communication, but all these are not basic, but accompanying functions. When a person constantly eats to calm down, when he is bored, or just because he is asked to eat, this is an eating disorder.

There are many types of eating disorders, for example, frequent snacking (more than 5 times between meals), pathological hunger (an urgent desire to eat something in between meals).

Another type of eating disorder is carbohydrate thirst, which is expressed in a strong desire to eat something sweet (and preferably at the same time fatty, such as ice cream or chocolate). If you abstain from eating sweets, a person with such a violation begins to mild depression.

There are three types of eating disorders: emotiogenic, external, and restrictive eating behavior.

External eating behavior is associated with a person's habit of eating food, depending not on the feeling of hunger, but on external stimuli. For example, passing by a pastry shop, a person feels the desire to go there and buy something tasty, and then eat it without being commensurate with whether he wants to eat now. Other examples of external eating behavior: the habit of eating what is available, for example, in the refrigerator; food for the company; an urge to eat due to a tasty smell, or appearance food.

Restrictive eating behavior is a haphazard adherence to strict diets and excessive restriction of oneself in food. Due to such restrictions, bouts of overeating occur, when the body begins to absorb food in large quantities, as if trying to catch up during fasting. Restrictive eating behavior is associated with constant stress, both during food restriction and during "food spree" (due to feelings of guilt).

Emotional eating behavior is the habit of eating when feeling psychological discomfort (anxiety, irritation, bad mood, boredom, loneliness). Emotional eating behavior is “eating your emotions”. The reason for its formation is to offer the child food in response to the manifestation of any of his emotional needs, for example, the need for protection, comfort, body contact.

Emocyogenic eating behavior manifests itself in two forms: compulsive eating behavior and night eating syndrome.

Compulsive eating behavior is expressed in clearly limited episodes of overeating (lasting no more than 2 hours), during which food is absorbed in larger quantities than usual and faster than usual. The person feels that they cannot control these attacks until they end on their own. Compulsive eating behavior is usually accompanied by discomfort or even stomach pain and intense feelings of guilt.

Night eating syndrome is a form of emotional eating behavior in which a person usually does not want to eat in the morning, and towards night he feels very hungry, from which he cannot sleep. A night eating syndrome sufferer falls asleep only after eating and may wake up at night to eat more.

You can determine if you have one of the types of eating disorders (external, emotiogenic and restrictive) using.

In addition to eating disorders, there are three types of eating disorders: anorexia nervosa, bulimia nervosa, and binge eating disorder.

Anorexia nervosa is a deliberate restriction of oneself in food, associated with imaginary or overly critical assessment of obesity. Bulimia nervosa is characterized by alternating bouts of binge eating and purging by vomiting, physical exercise, taking laxatives, etc. Binge eating disorder is a disorder consisting in periodic, uncontrolled bouts of binge eating.

Treatment of eating disorders is carried out with the help of psychotherapy and consists in correcting the image of oneself, increasing self-esteem, changing the system of values \u200b\u200band ways to satisfy the need for intimacy, love and security, and correcting relationships with other people.