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Psychological roots of lose weight therapy


BINGE-EATING DISORDER

  • Compulsive or emotional eating is characterised by recurrent episodes of binge eating. An episode of binge eating is characterised by both of following:

1. Eating, in a discrete period of time (e.g. within any 2-hour period), an amount of food that is definitely larger than the most people would eat in a similar period of time under similar circumstances.

2. A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating).

An indicator of loss of control is the inability to refrain fron eating or to stop eating once started.

  • The binge-eating episodes are associated with three (or more) of the following:

1. Eating much more rapidly than normal

2. Eating until feel uncomfortably full

3. Eating large amounts of food when not feeling physically hungry

4. Eating alone because of feeling embarrassed by how much one is eating

5. Feeling disgusted with oneself, depressed, or very guilty afterward.

  • Marked distress about binge eating is present.

  • The binge eating occurs, on average, at least once a week for three months.

  • Binge-eating disorder is associated with increased body fat, weight gain, and may represent a prodromal phase of eating disorders for some individuals.

  • Dieting follows the development of binge eating in many individuals.

  • Binge-eating disorders appears to run in families, which may reflect addictive genetic influences.


BODY DYSMORPHIC DISORDER

BDD relates to preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others.

The individual performs repetitive behaviours (mirror checking, excessive grooming, reassurance-seeking behaviour, camouflaging) or mental acts (comparing his or her appearance with that of others) in response to the appearance concerns. The behaviours and mental acts are typically time-consuming and not pleasurable but difficult to resist or control.

The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The individual may recognise that the body dysmorphic beliefs are probably not true (BBD with good or fair insight) or they might be completely convinced that the BDD beliefs are true (BBD with absent insight/delusional beliefs).

The individuals with BDD believe that the defects or flaws in their physical appearance make them look ugly, unattractive, abnormal, or deformed. Concerns range from looking "not right" to looking "like a monster".

Preoccupation can focus on one or many body areas, most commonly on the skin (e.g. perceived acne, scars, wrinkles), hair (excessive body or facial hair), nose (e.g. size, shape), breasts, body weight, teeth or lips.


BODY DYSMORPHIC DISORDER - PREOCCUPATION WITH BODY WEIGHT

Many individuals presenting for weight-loss treatment report that they engage in eating for emotional reasons. Body image is an important aspect of quality of life for many individuals. Body image dissatisfaction is common for individuals who are overweight, as it is for individuals with average weight. The degree of dissatisfaction seems to be directly related to the amount of excess weight person has and the body image dissatisfaction is believed to play an influential role in the decision to seek lose weight treatment. People who are overweight are frequently subjected to discrimination in several settings including educational, employment, and personal life.

Improvement of health and appearance are likely a central motivation for weight loss treatment. Weight loss also is associated with significant improvement in psychological status. Most psychological characteristics (including anxiety, depression, self-esteem, body image, and sexual functioning) improve with weight loss. There are a growing number of studies that suggest that behavioural and psychosocial interventions can reverse the weight gain.


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