Obesity and psychology

Preface

This topic mainly deals with the psychological aspects from being overweight. Permanent weight reduction can only be achieved if the mechanisms that lead to obesity are understood.

Synonyms in a broader sense

Medical: obesity

Overweight, fat, fat, fat, stout, corpulent, full figured, plump, obesity per magna, obesity, ideal weight, normal weight, underweight

English: overweight

Definition of obesity

The term Obesity (Obesity) describes a condition in which a person is more weight than the normal value (normal weight), which is considered optimal for his body size, and is thereby exposed to increased health risks.
The degree of obesity in need of treatment (overweight) is calculated using the so-called Body mass index.
You can find more information about the calculation at: Body mass index.

The body mass index

General classification of the body mass index (BMI = kg (body weight) / (height in) m2)

• Underweight: below 18.5
• Normal weight: 18.5 to 24.9
• Overweight: 25.0 to 29.9
• Obesity grade I: 30.0 to 34.9
• Obesity grade II: 35.0 to 39.9
• Obesity grade III: over 40.0

In most cases there is only one BMI greater than 30 need treatment. Of course, the level of the treatment is not the only factor BMI decisive, but in particular the distribution of the fat. E.g. known that with the fat distribution in the abdomen, which is typical for men, there is a much higher risk of myocardial infarction than with the hip fat accumulation which is more common in women.
Not to be forgotten, of course, are psychological stress, as well as high psychological stress, from which, regardless of BMI (Body Mass Index) a need for treatment can arise.

Secondary diseases

Typical illnesses caused or partly caused by obesity:

Obesity is associated with a variety of direct and indirect health risks. The following are the most important:

• Diseases from Cardiovascular system (Heart attack, high blood pressure = arterial hypertension)
• diabetes mellitus (Sugar disease)
• Joint diseases (arthrosis)
• Sleep disorder
• Breathing disorders (sleep apnea)
• Diseases of the veins (varicosis / Varicose veins)

Also there are related to Obesity / overweight clear for the sick “Psychosocial” consequences. This describes the worries that arise when dealing with the environment.
Often times, self-esteem and life satisfaction are severely impaired. Anxiety disorders and depressive moods are not uncommon.

Please also read our topic on this Consequences of being overweight.

Frequency (epidemiology)

Occurrence in the population
About every 5th adult and every 20th adolescent in Germany suffers from obesity that requires treatment (overweight).
The likelihood of becoming overweight clearly increases with age. Women in particular are at risk as they get older.

diagnosis

In addition to determining the BMI (Body mass index) and the distribution of fat, medical laboratory tests are necessary in order to assess the risk of the diseases mentioned above.
Furthermore, a so-called "Weight curve" to be created. The patient draws the previous course of his weight in this and discusses with a doctor / therapist whether he can assign certain fluctuations in weight to certain life events. In this context, the patient should also create a desired curve from which his target weight can be read.
Furthermore, so-called. Food diaries proven, in which all food and drinks that the patient consumes are noted for a week.
This tool is particularly important to any Binge eating disorder or other unfavorable eating behavior (e.g. frequent consumption of sugary lemonade or particularly high-fat food, etc.).

causes

In contrast to the popular opinion that obese / overweight patients simply eat too much, science in recent years has shown that various influencing factors play a role in the development of overweight (obesity).

1. Genetic aspects:
   In twin studies it could be shown that so-called genetic factors play a role in the development of obesity / overweight.
   There were e.g. Cases of adoptions in which pairs of twins were separated and showed the same weight development despite completely different environments.
   There also seem to be some very clear differences in how people “metabolize” the food they are offered.
   Equal amounts of Calories can thus lead to very different weight developments.
   
2. Psychological aspects:
   Many people know very well whether you are a good or a bad "calorie processor"; they know whether you are putting on fat quickly or not.
   Accordingly, these people often experience only very limited food intake.
   Something similar can be found in people who are subject to certain social rules (e.g. young women). They are taught that only a slim body is a beautiful body, so that they too limit and rein where they can.
   The problem with this pulling together is that it is a pure "head ban", i.e. the head dictates and all other needs have to obey. So it does not matter whether I am still hungry or if I would like to eat another piece. My head (my mind) forbids me.
   Most people are now so designed that absolute bans can often have the opposite effect.
   Example: Ms. M. resolves not to eat any more cake. She loves cake, but I know that she “only has to look at cake to gain weight”. So she forbids it. After a few “cake-free” days, Ms. M. has a lot of trouble at work and meets with a friend in the afternoon to talk about it. Of course, the friend bought cake because she knows how much Ms. M. loves cake. Ms. M. is so upset because of the anger that the voice of her reason can no longer be heard, so that the desire for cake in her rage virtually takes control. After the first piece, however, she pauses again when she realizes that she has broken her command. Instead of stopping now, however, she now lapses into a kind of “black and white thinking” in which she says to herself “It doesn't matter now !!” and gives in to further enjoyment.
   
   In the group of bulimia - Sick people, one finds this change from great control and total breakdown of the control system in sometimes extreme form.
   
3. Physical aspects
   Large-scale studies have shown that obese (overweight) people in many cases do not consume as many more calories as those of normal weight. It was found, however, that obese patients usually had a clear shift towards fat in that they consumed more fat with the same amount of calories. This led to a rethink in the therapy of obesity (overweight).
   Previously it was assumed that simply reducing the amount of food was the key to success, today it is assumed that the amount that an overweight patient consumes is not of great importance as long as it is kept as "low-fat" as made possible.
   Contrary to previous opinions, carbohydrates (such as bread, potatoes, pasta) are not “forbidden” foods in the case of weight reduction (weight loss).

Therapy overweight

The modern therapeutic approach to treating the Obesity must take into account today's knowledge of this disorder. It just isn't enough to stop eating an obese patient and scare them with stories of high blood pressure and heart attacks. Today's therapy should be carried out in different stages, which ideally build on one another.

1. Education of the patient about the causes of his disorder
2. Realistic goals
3. Eating habits
4. Eating habits
5. Move

enlightenment

Most obese (overweight) people carry around with them a picture of themselves and their disorder, in which they usually see themselves as the culprit for their disorder.
As mentioned above, however, this is by no means fully applicable. Of course, it is by no means beneficial for a patient to eat exclusively junk food and avoid any kind of exercise, but it is just as wrong to label an overweight person as lazy wolverine per se. The truth lies (as is so often the case in our beautiful world, which is neither entirely black nor entirely white) in the middle.
The therapist's task is to explain the whole range of causes to the patient in order to work on his attitude towards himself. The message here should be that much of what constitutes obesity (overweight) is through no fault of our own, but that we do not simply have to accept this fate.
Most obese patients who come into such therapy have already had a large number of failed diets and have therefore often left the mark of failure on themselves. The honest and scientific explanation of the disorder should now lead to a rethink and give a new motivation boost.

Realistic goals

If the patient should have developed a motivation for a therapy through this first step, the next step is to determine the goals of the therapy. Unfortunately, in many cases, motivation or over-motivation leads to the motivated person setting unachievable goals at which he will almost certainly fail. (E.g. the weight reduction from 120 to 70 kg within half a year)
Such a failure can destroy the newly created motivation and ultimately lead to weight gain (black and white thinking) by completely giving up the attempt to lose weight.
Regarding the target weight, there are guidelines that assume that it makes sense to initially reduce the starting weight by around 15%.

Eating habits

As already mentioned, it is usually only annoying to forbid a person to eat.
For this reason, it is important not to consider the food itself, but its composition in the therapy. In concrete terms, this means, for example, that animal fats should be replaced by vegetable fats and that around half of the food consumed should consist of carbohydrates.
Fat should generally not make up more than 30% of the diet.

Eating habits

Eating habits
This important step is ultimately about applying what you have learned. E.g. Most people have certain rituals when buying food, according to which they buy certain things and not others.
There are also rituals, e.g. how a person a bread smeared.
This often does not work very consciously (ask yourself how many times in your life you have made bread for yourself), but is often "trained" over many years.
Aim of therapy must now be retrained this behavior. When you become aware of new foods (which are not so dissimilar to the "old" ones) if you have tried it, sooner or later you will certainly find some that are both tasty and lower in fat than the usual ones. It should be emphasized once again that it is not about bans (sweets are also allowed), It is about the responsible use of the knowledge that has been imparted to the patient about obesity.

Move

It cannot be avoided to say that any weight loss efforts will be greatly enhanced by regular exercise.
Here, too, it is not about Olympic-level performance, but about the responsible handling of the knowledge imparted.
Every change in behavior, even small ones (e.g. small ways on foot and not by car, etc.) will have a lasting and positive effect on the patient. Here, too, it is important to set realistic goals, as there is otherwise the danger of destroying the motivation to continue the therapy.