Causes of weight gain and obesity (Psychosocial causes)
It is fundamentally wrong to think that the main reason for the excess weight is that «someone eats too much». The accumulation of excess kilograms and ultimately obesity are due to several factors, ranging from somatic diseases and functional disorders to pharmaceuticals. But even in the case of obvious overeating, the true reasons are far more profound than just an unstoppable love of food.
There are psycho-social reasons why a person is fat, and that’s what we’re going to explain in this article.
Make sure to read carefully until the last page to understand the topic well.
Family, self-esteem, depression… «Roots» excess weight
In general, psychosocial factors of overweight are the subject of numerous scientific studies. They had both a broad and rather narrow focus, in the context of somatic (e.g., endocrinological) and mental illness. However, both studies have shown similarities in the characteristics and mechanisms of eating disorders, overweight, and later obesity.
For example, a study conducted in one of the regions of Russia, the Republic of Buryatia, where excess body weight is fairly common among young people, was aimed at identifying psycho-social predictions of potential obesity.
For adolescents, social factors were found to be the first to be such predicants:
- Eating behavior and eating habits in the family, such as food at night or rare meals;
- The modified mother’s body mass index;
- part-time family
Psychological factors are more important for younger children:
- High level of personal anxiety;
- Low self-esteem (low self-esteem is a symptom of depression, but in this case, children do not show signs of depression, and their self-esteem is reduced);
- Introversion (i.e. isolation, self-affection);
- emotional distance from the child in the family or emotional rejection.
According to other studies, and in adults, similar personality psycho-social characteristics are found: high level of anxiety, isolation, temper, impulsiveness which are the predictors of weight problems so When looking at social or psychosocial factors, these are different stressors experienced in the last year before a person seeks help for overweight. He has depressive symptoms, negative affect, depression, sadness…
Given a person’s psycho-emotional background, food has a different meaning and ceases to be only a source of energy and nutrients.
The food consists of:
- for relaxation/pleasure;
- as a reward/compensation;
- Means of communication/self-assertion;
- to protect.
At some point, food becomes the only acceptable way to get rid of grief, sadness, anxiety, and other negative emotions.
In this case, it is almost certain that a person has a compulsive eating disorder, psychogenic overeating, which in English literature is called Binge Eating Disorder (from binge – drinking).
The main characteristic of compulsive eating disorder is the loss of control over appetite. In the sphere of loss of control, there are many disorders (for example, addiction to alcohol, where the loss of control over the amount of alcohol consumed is in the first place). Similar things happen to humans when they develop compulsive eating disorders. He realizes that the amount of food he eats in a short time, the abnormally large portions, the quality and composition of the food, all fall short of dietary standards, so he often eats alone, often at night. Stress forces a person to regularly experience overeating even when there is no physical need for food, i.e. even without being hungry. Sometimes overeating episodes occur outside of the immediate context of stressful events. And it does not have to be a negative experience, it can also be positive stress (successful exam, promotion, etc.).
In compulsive eating disorder, stress-related overeating is a separate problem of eating behavior. First of all, stress can be close to the episode of overeating, or it can be removed. In other words, childhood experiences of sexual abuse, aggression, bullying, psychological trauma, etc. can be the main cause of overweight and obesity in adulthood.
There is much talk today about trauma in particular, and the traumas of society in the broader sense. Survivors of violence are at risk of compulsive overeating and of developing overweight and obesity.
Therefore, early intervention by people who have experienced physical, sexual abuse in childhood or later is a preventive factor for eating disorders, overweight, and obesity. Overeating is also closely associated with the development and the presence of depressive symptoms in humans. Accordingly, the detection of depression, timely psychotherapy, and anti-depressive therapy are some of the ways to overcome stress-related overeating.
The relationship between depression and obesity is primary and requires adequate therapy.
as we said, Low self-esteem, high levels of anxiety, unstable emotional state, depressive symptoms are characteristics that studies have found to be common to most overweight people.
Some studies show that approximately half of the cases of compulsive eating disorders are among those experiencing or having experienced depression. Whether depression causes compulsive eating disorder or vice versa is not well established. However, low self-esteem, high levels of personal anxiety, isolation, which in childhood are the precursors of potential obesity and persist thereafter in adulthood, effectively negate the treatment of overweight per se. At the same time, the prescription of antidepressants for diagnosed mild or moderate depression has a positive effect not only on an individual’s emotional state but also on his eating behavior, leading to a decrease in excess body weight.
Pharmacotherapy – pill treatment – is not a priority for eating disorders. In the first place, psychotherapeutic methods are used which show high efficiency in correcting eating disorders, including obesity.
- Cognitive-behavioral therapy. It can be both individual and group.
- Self-help groups: anonymous gluttons, anonymous anorexics, anonymous bulimia, etc. The work of such groups is based on the famous 12-step program, which has proved effective for people suffering from alcoholism. The program is adapted to the problems of people with eating disorders.
- Managed self-help programs. As an example of such a program, one can recall Allen Carr’s book «Easy Way to Quit Smoking», reading which a person applies to himself non-pharmacological methods of not smoking. Similar programs addressed to people with eating disorders are available in the form of printed publications as well as electronic gadgets.
Antidepressants for depression and obesity
As for pharmacotherapy of eating disorders, among the medications, one can name antidepressants, some anticonvulsants, and so-called «special means». There is a group of drugs that have a significant influence on dietary behavior and therefore weight, but they are not currently medications. By «special means» I mean preparations that have a pronounced effect in reducing appetite, but as medicines in Belarus are not registered. It should also be noted that no medicinal agent is used to correct eating disorders as a monotherapy. Pharmacotherapy of excess weight in complex therapy makes it possible to achieve special results when a patient has depressive symptoms, obsessive-compulsive disorder, and anxiety.
In this context, antidepressants are of particular interest. Some of them, while coping well with depression, induce weight gain. Uncontrolled administration of antidepressants was once even cited as one of the key causes of large numbers of overweight and obese people in America.
and we think that the cause and the effect are confused. On the other hand, it is difficult to say for sure whether the primary or the secondary is depression or obesity. Fortunately, there is a group of preparations that provide the optimal level of serotonin («happy hormone» or «good mood hormone») and through the influence on food craving (irresistible desire is), on impulse and compulsion, help in the treatment of depression and the correction of eating disorders.
Little serotonin, lots of food drive. It’s scientifically proven. Serotonin deficiency triggers a compulsive desire to eat, bulimia, compulsive overeating. Accordingly, modifying serotonin levels with serotonin antidepressants prevents these risks. In addition, antidepressants encourage people to remain physically active longer, increase their endurance and ability to work, i.e. not to relax and not to be hyperdynamic, but to have a stimulating effect.
Why it is important to prescribe antidepressants in cases of depression and obesity is illustrated by a study conducted by American scientists over five years (2005-2010) involving large numbers of obese people. They were assessing the severity of depressive symptoms, which were high enough. The signs of depression were more common in women than in men, and their expression was moderate and severe. Despite some gender differences, the fact remains that people who are obese often suffer from depression that requires prescription of pharmacotherapy. The effect of antidepressants is twofold: on the one hand, they treat depression, and on the other, during a four-week course of therapy, patients typically experience the desired and desired weight loss.
In addition, serotonin antidepressants have been shown to have a positive influence on compulsions (obsession). Although there is no compulsive overeating or bulimia, there is reason to believe that antidepressants can be effective against these forms of compulsive disorder.
Today, the trend towards invigorating thinking – the perception of body mass and imperfect forms in a positive way – is being actively promoted throughout the world. And it’s a good trend. But if the main emphasis is not on «bodywork», but on «positive», the expert believes it fits well in the context of prevention of bio-psycho-social causes of excess weight. The formula is simple: there’s a good mood, there’s a positive – there’s no depression, so there’s less risk of obesity.
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