Hello, my name is Dr. Rachel Green. I am an eating disorder counseling specialist. Today I would like to talk with you about two forms of eating disorders, obesity and anorexia nervosa. In our discussion, I would like to be able to give you a new perspective on food, hunger and satiety hoping that it may benefit those who live with these disorders.
Obesity is defined as when a person has maintained a body mass index (BMI) of 30 or higher. People with obesity have many health risks which include hypertension, Type 2 diabetes, heart disease, bone health problems in addition to many other health complications and illnesses.
Anorexia nervosa is defined as a mental illness because it refers to individuals who refuse to keep their weight within 85% of the standard weight for their age and height. Those who live with anorexia express deep anxiety about gaining any weight in addition to their body image being dramatically distorted. These individuals refuse to eat and have a habit of going on eating binges, which they follow with vomiting. Their excuse for this is that they have to do this to keep what they view as an acceptable weight. This illness is very severe and is life threatening in most cases. It can result in heart failure, kidney failure and damage to the brain.
Both anorexia and obesity are studied in depth. Several new theories have brought new light to the treatment of these conditions. We will also discuss numerous hunger and satiety myths as well as facts about the maintenance and development of these disorders. We will have a chance for Q&A in the later part of the program.
There are a wide variety of theories that attempt to address why we choose to eat or not to eat. Hunger and satiety have bio-psychosocial factors that are detailed in theories relating to obesity and anorexia.
From an evolutionary perspective, we can see that periods occurred in which shortages existed in our food supplies. These may have contributed to obesity as a part of our genetic predispositions as a means of storing food when it became available so that those calories would be available to us later for our use when food supplies became scarce. This relates also to the desire to eat great quantities of high calorie foods. Consumption of high calorie foods leads to fat storage of that food’s energy. We also know that we require at least 3 solid meals daily to maintain our normal weight. This social connection to normality can be carried forward into social interactions that take place when consuming foods that are more palatable due to high fat content or high sugar content. This carries forward into our understanding of the motivations for eating.
Such factors do influence our eating patterns. Additional factors play into the choices that we make that may conflict with our ability to maintain a healthy and ideal body weight. Calories are burned during exercise and if we do not balance our caloric intake well with our exercise levels then we will not be in balance. People also have different rates of metabolism, which affects their ability to burn or store fat. Thermogenesis, which is a non-exercise activity where energy is dissipated, is also relevant to this discussion.
Studies in Biopsychology have shown that we do not eat due to the need to fuel the body, but eat because of our learned, embedded responses. Studies show that people tend to eat larger quantities in social settings than when alone. This factor alone would be a significant contributor to obesity if we correlate socializing with food.
Satiety has shown to be related to the types of food we eat. We need certain nutrients and minerals. Candy doesn’t include these nutrients and minerals, and so our bodies do not feel satisfied or full when we eat them. Meals that contain the proper mix of nutrients and minerals yield a more complete satiety. Some foods contain more of the nutrients required to allow us to actually feel full.
Anorexia includes some of the same issues of social factors that influence our views of acceptable healthy weight and eating. The inclination to eat in social situations can be skewed in the opposite direction for some individuals. They can be so insecure that they do not meet their body’s needs due to their feelings about others’ perceptions of them.
Anorexia involves a great fear of weight gain and the individual displays starvation habits of eating or alternate binge and purge cycles of eating. These patterns are learned eating behaviors. Binging is an aspect of anorexia that can help us to see how hunger and satiety are related to mind over matter because the mind is overtaking the body’s need for nutrition in this disease. The binge is meeting the body’s need, but the purge that follows is catering to the corrupted ideal as the individual sees it, so satiety no longer has a positive value.
The start and development of anorexia is specific to the individual because external factors contribute to the development and beginning of this disease. The most common onset factor is dieting. Dieting is generally undertaken in response to socially perceived and abnormal expectations. There seems to be a connection between weight gain and food intake that defies the positive motivation that is normally connected to satiety and healthy eating habits. The value of the food incentive is lost in the negative contribution of feelings for weight control.
In this discussion today we have reviewed a number of myths and facts relating to these two diseases. What questions do you have about anorexia or obesity?
Question 1: I want to know if my parents’ obesity is the cause of my own obesity.
Answer: Your parents’ obesity may have given you a genetic predisposition that affects your ability to maintain an ideal weight but isn’t the only factor. The Bio-psychosocial theory gives us the evidence to understand that you have the willpower to control your own weight in a healthy manner. You can learn to rehabilitate yourself with regard to your expectations and eating behaviors. This will give you greater satiety and a healthier prognosis.
Exercise is also a critical factor in controlling your weight. A proper, regular practice can help you to burn calories. The combination of proper intake and proper exercise can give you a healthy weight. Overeating is not the response to need, but is a continuance of values and habits about food that are not healthy.
Question 2: I eat the same foods and amounts as my girlfriend, but she does not gain weight and I do. What makes this happen?
Answer: This would be because her basal metabolism and differs from yours significantly. She has a higher rate allowing her to digest foods more efficiently.Consumption is not the only factor in weight gain. You have to look at your own physical activity/exercise levels as well.
Question 3: My family feels that I have become anorexic in response to my exposure to women’s images as portrayed in magazines and on TV. This may be true, but I do not have any cravings for food. Why would that be so?
Answer: It may be true that you initially learned to connect extreme thinness with success and beauty and you chose to work toward that slanted ideal. Your dieting then contributed to this skewed viewpoint when you were able to lose weight in the beginning of your new eating patterns. You may have found yourself more beautiful due to the exposure to such idealized images and then failed to recognize later the health problems that this began to cause for you.
I would attribute the feeling that you do not crave food at all to the negative value this skewed view placed on food. You look at food as a negative element in your life since you connect it only with weight gain instead of with nurture and health. Rehabilitation of your mind and body require you to nurture your body with healthy foods and exercise. It is possible to re-establish healthy eating patterns that can give you back your desire for and enjoyment of food.
Question 4: I feel sick each time I eat, so I have taken to not eating. Can you tell me why this is?
Answer: I believe this relates to incentive values of food. You may have taught yourself that food will make you gain an unhealthy amount of weight and now you connect food only with negative things. If you begin by eating foods that you know are healthy for you then you can begin to view food as a positive thing again. Eating healthy foods and staying away from high sugar and high fat foods is a way to let your body respond well to what you eat. If your focus is on weight control rather than on health, you will be punishing your body for eating even healthy things.
Pinel, J. P. J. (2011). Biopsychology. (8th ed.). Allyn & Bacon.
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