What is compulsive overeating? Compulsive overeating: how to deal with it

Obesity is a psychosomatic disease, in the pathogenesis and clinical picture of which both biological and psychological factors and symptoms are combined and interact.

As is known, there is a close connection between anxiety personality disorders, obesity, And depression.

Anxiety disorders lead to obsessive-compulsive overeating disorder, availability anxiety disorder increases the risk of developing obesity, obesity, in turn, causes depression. A vicious circle is formed from which, as it sometimes seems, there is no way out.

However, as recent research has shown, the connection between anxiety disorders, depression and obesity those are as unambiguous as it seems at first glance.

Availability depression in children and adolescents, doubles the risk of developing obesity, but not vice versa. Yes, d depression in girls late adolescence increased the risk of obesity after 5-7 years by 2.3 times; among young men there was no such pattern.

A slightly smaller number of studies have shown the opposite sequence of events. For example, young men, obese both in childhood and adolescence significantly more often had subsequently depression and behavioral disorders than those who were obese either only in childhood or only in adolescence.

In women With body mass index(BMI) > 30 the relative risk of depression was 1.8, and women and men with BMI > 40 it was increased almost 5 times.

In persons over 50 years of age obesity increased the risk depression after 5 years of follow-up approximately 2 times, but the presence of depression did not increase the risk of obesity in the future.

So, depression often precedes the development of obesity, especially in adolescents and young women with major depression, but in some patients, on the contrary, depression develops after many years of obesity. This indicates the possibility of the existence of different pathogenetic variants of the association of obesity with depression.

Depression and compulsive overeating

Classic depression accompanied by insomnia, loss of appetite and body weight(MT), but atypical, erased and somatized depression more often occurs with drowsiness, increased appetite and weight gain.

Both obesity and depression are often accompanied by eating disorders(RPP), eating disorder syndrome(SPE) and bulimia nervosa. A history of depressive disorder is present in 54% of obese patients with FES and only 14% of obese patients without FES.

There are epidemiological and clinical associations between depressive and anxiety disorders, on the one hand, and obesity and associated somatic diseases, on the other.

In many cases, depression and anxiety precede the development of obesity, and the severity of psychiatric symptoms correlates with the anthropometric and biochemical abnormalities associated with obesity. Depression, anxiety and obesity have mutually negative effects on each other.

The connection between obesity and mental disorders (MD) is due to many factors, primarily the commonality of some links in the central regulation of food intake and mood, that is, the serotonin- and noradrenergic neurotransmitter systems of the central nervous system (CNS), as well as the similarity of the functional state of the neuroendocrine system and psychological characteristics.

Back in 1921, psychiatrist E. Kretschmer wrote that people with picnic build(abdominal obesity, in the modern sense) often suffer from depression, stroke, atherosclerosis and gout. In 1932, impaired carbohydrate metabolism, decreased sensitivity to insulin, and autonomic dysfunction were identified in individuals with this symptom complex.

These studies were the first to suggest a link between depression and the syndrome that later became known as "metabolic syndrome" (MetS). It has been proven that pre-, peri-, and postmenopausal women with initially elevated scores of depression, tension, and anger had a significantly higher incidence of metabolic syndrome (MetS) after 7 years.

In both obesity with metabolic syndrome (MetS) and depression, there is a high incidence of the same somatic diseases - arterial hypertension, coronary heart disease (CHD), stroke and type 2 diabetes mellitus.

Compulsive overeating - causes

S. Freud also pointed out that it is on oral stage of development For an individual, eating food is one of the few ways to obtain instinctive satisfaction, which can last a lifetime for certain individuals and comes to the fore when a person feels danger and anxiety, despite the development of the “I.”

The psychodynamic approach to eating disorders is based on the postulate that this phenomenon is based on the child’s frustration with the so-called oral stage of development, and the unconscious basis of pathologically increased appetite is a passionate desire for love and aggressive tendencies to “absorb” or “possess.”

Food represents the first obvious satisfaction of the receptive-gathering desire. In a child's mind, the desire to be loved and the desire to be fed are very deeply connected. Parents often do not understand the reasons for the baby's cry and try to feed him so that he calms down. Demanding attention, the child receives food, as a result, the infant develops a close association between feeding and care.

When, in a more mature age, the desire to receive help from another in solving some of their problems or satisfying their needs causes shame or shyness, which is often in a society whose main value is independence, this desire finds regressive expression in an increased craving for food absorption, i.e. e. stimulates gastric secretion, which leads to the formation of ulcers if a person does not eat, or to obesity if he eats heavily.

Depression and anxiety are accompanied by the same central and peripheral symptoms as long-term stress. In addition, during physical and mental stress, neuropeptide Y concentrations increase, which increases food consumption (“stress eating”).

Stress reactions are triggered by psychosocial and economic problems, depression and anxiety, alcohol consumption and smoking. The risk of the final formation of a protracted stress reaction with the subsequent development of MetS is influenced by personality type, education, social competence, as well as genetic polymorphism.

Among close relatives of obese individuals, the likelihood of depression and bipolar affective disorder, as well as antisocial personality disorder, is significantly higher than among relatives of individuals with normal body weight (BW). A candidate gene for a genetic correlation between MT and depression is located at the ObD7s 1875 locus, next to the obesity gene OB on chromosome 7.

Anomalies common to obesity and depression are increased concentrations leptin, the level of C-reactive protein as a marker of mild systemic inflammation, insulin resistance, atherogenic dyslipidemia and increased visceral fat deposition. Parallels can be drawn between hormonal and metabolic changes in depression, Cushing's disease and MetS; similar abnormalities are found in post-traumatic stress disorder.

Bjorntorp explains the association of obesity with mental disorders (PD) through activation of the limbic-hypothalamic-pituitary-adrenal axis (LHPA) and the sympathetic nervous system (SNS) in response to stress.

The first type of stress response (“fight or flight”) is carried out mainly due to the activation of the SNS and ends favorably: after stress, “successful” animals occupy a higher position, receiving advantages in nutrition and reproduction, and testosterone levels increase in males .

The second type of stress reaction (“defensive”) is characteristic of animals that cannot cope with competition and helplessness and move to a lower level of the hierarchy. They experience activation of the LGGNS - increased cortisol levels, decreased levels of sex hormones, and subsequently - accumulation of visceral fat, insulin resistance, dyslipidemia, hypertension, impaired carbohydrate tolerance and early signs of coronary atherosclerosis, i.e. MetS.

Cortisol levels are affected not only by actual stress, but also by memories of past experiences and anticipation of future stress, as well as by mood.

Compulsive overeating - symptoms

F. Alexander believed that most (including food) behavior patterns are largely determined by psychological defense mechanisms. These mechanisms, in his opinion, are quite rigid and limit human behavior, although they perform an adaptive function and support the integration of the mental “I”, protecting consciousness from traumatic experiences.

Thus, as a result of research, it was revealed that in women who are overweight, compared with women with normal body weight, significant differences are observed on the scales of “denial”, “regression”, “repression” and “reactive formations”. Such a protective mechanism as “repression” simply does not allow into consciousness those thoughts, desires, and feelings that are psychotraumatic due to their social unacceptability.

Obese patients are also characterized by inflated claims, passive aggressiveness, increased, poorly controlled emotionality, and passive forms of behavior.

Symptoms of obsessive-compulsive disorder:

high anxiety (90%);
ritualization of routine daily actions;
obsessive phobias (frequent hand washing, checking door locks, etc.;
inconsistency with one’s ideal and inadequate self-esteem (84%);
presence of a feeling of internal emptiness (vacuum), loss, depression (59%);
tendency to somatization and excessive worry about one’s own health (70%);
difficulties in interpersonal relationships, the desire to avoid social contacts and responsibilities (82%);
“lack of strength,” psychological discomfort, poor health (26%);
presence of strong feelings of guilt after bulimic episodes (24%).

The identified personality characteristics may be one of the reasons why the negative impact of overeating on the body is not noticed for a long time, since patients tend to refuse to recognize the fact that overeating is one of the most important reasons for the occurrence and progression of excess weight.

Characteristic features of thinking and perception, common to both obesity and depressive-anxiety disorders, are rigidity, a tendency to get “stuck” in emotions, “black and white” thinking (according to the “all or nothing” principle), catastrophizing (expecting the worst). all variants of events), a tendency to unfounded generalizations (“I never succeed”), poor tolerance of uncertainty and expectation.

Symptoms of depressive-anxiety disorder with compulsive overeating:

decreased energy, feeling withdrawn and isolated;
obstacle to increasing physical activity;
decreased memory, attention, concentration;
difficulties in understanding, remembering and following recommendations for counting calories, keeping a diary, taking medications, etc.;
depressed mood, anxiety;
overeating, irregular eating, increased consumption of fatty and sweet foods, more active smoking for the purpose of relaxation;
pessimism, unreliability;
low self-efficacy, lack of belief in success;
difficulties with systematic, gradual and steady progress towards the task.

Obese people who consult a doctor for weight loss (BW), as well as women and people with morbid (excessive) obesity, are also characterized by impulsiveness, unpredictability of behavior, passivity, dependence, irritability, vulnerability, infantilism, emotional instability, eccentricity, hysteria, anxiety -phobic and psychasthenic traits.

Impulsivity is reflected in the alternation of overeating and fasting, attempts to reduce body weight (BW) and abandonment of them. Failures to reduce body weight or in other areas of life exacerbate the low self-esteem characteristic of obese people, feelings of inadequacy, and low self-efficacy (lack of confidence in one’s ability to change anything), closing a “vicious circle” of increased depression and anxiety.

Alexithymia and obesity

It turned out that the majority women those who are overweight suffer alexithymia, they have difficulty identifying and describing their own emotions and the emotions of others; difficulties in describing one's own feelings; lack of differentiation of feelings and bodily sensations combined with limited ability to imagine. Internal sensations that characterize emotional life are expressed in terms of irritability, boredom, emptiness, fatigue, undifferentiated excitement or tension.

Some scientists believe alexithymia an important factor predisposing to the development of obesity. Foreign researchers consider alexithymia as a factor complicating the treatment of obesity and note its high prevalence in combination with depression.

Alexithymia is present in approximately 8% of people with normal body weight (BW) and more than 25% of obese people, but usually only in those who have other psychopathological symptoms, such as anxiety. Persons with alexithymia exhibit an exaggerated reaction to stress: against the general background of “inexpressiveness” of feelings, episodes of anger suddenly arise, often “gratuitously.”

Psychological causes of obesity

Pioneer in the study and treatment of obesity, Hilda Brush argues that disturbances in the mother-daughter relationship lead to significant ego deficits in the child (including a lack of independence and control) and to severe cognitive impairment, which together lead to obesity.

Insufficient differentiation of emotional and somatic processes, characteristic of infantile individuals. In the event of the destruction of protective mechanisms under the influence of stress, regression to the physiological level of response occurs, and conditions arise for the formation of various disorders, including obesity.

Particularly pathogenic is upbringing in conditions of lack of acceptance by the mother of the child, when she does not respond to his internal needs and does not distinguish the child’s hunger signals from other emotional states, which causes him to learn a mixture of hunger with other negative states, persisting in the future and leading to subsequent pathology. eating behavior.

Overweight people are characterized by an inability to distinguish between hunger and other emotional states, as a result of which they react to any stress as hunger; the need for food is a reaction to conflict and personal problems rather than to internal physiological stimuli.

Thus, in psychoanalytic literature, the reason for increased food need is considered as a search for substitute pleasures for unsatisfied emotional claims; food is a substitute for absent maternal love, care, and protection against depression.

From the point of view of the psychology of physicality, the process of absorption, digestion and assimilation of food is a generalized metaphor of a person’s relationship with the world. The rhythm of feeding, its consistency with the true state of the child, is internalized into basal trust in one’s own needs, the ability, through initiative and activity, to evoke the appropriate behavior of a significant “Other” that satisfies these needs. Feeding, its regimen, its emotional accompaniment are for the child the primary model of his relationships with other people and the world as a whole.

Possible psychological mechanisms linking obesity and depression include stigmatization of obese individuals, development of low self-esteem, negative self-image, and subsequent anxiety and depression. Thus, in obese children who were subjected to ridicule about their appearance, there was a significant increase in the frequency dysmorphophobia and depression.

Symptoms of anxiety and depression in obese individuals increase in parallel with an increase in the score of psychosocial problems. Psychopathological distress is detected in 26% of obese individuals and worsens the quality of life significantly more than the somatic diseases accompanying obesity. Psychotraumatic childhood events increase the risk of obesity in adulthood by 4.6 times. In children who have experienced sexual, psychological and physical violence or its threat, the risk of obesity increases by 1.46 times, and morbid obesity by 2.5 times. Obese individuals often have a history of early loss or alcoholism of parents, and in adulthood, unsatisfactory family life and sexual relationships, which exacerbates depressive and anxiety symptoms.

Psychoanalytic psychologists interpret obesity as a defense unconsciously formed by the patient against a traumatic situation (“shell”, “wall of fat”). One of the typical variants of such a situation is sexual violence experienced in childhood or its threat, after which the unconscious, as it were, gives the command “if you want safety, be scary, do not arouse the interest of men.” The patient is not aware of this mechanism, and on a conscious level she, as a rule, actively declares

The military goal is to reduce MT and become more attractive.

Compulsive overeating - how to fight it?

In obsessive-compulsive transmission, the decrease in body weight (BW) with initially high scores of depression and personal anxiety is inhibited, regardless of the prescribed diet. Patients with obesity and mental disorders (MD) reduce body weight worse (6.3% of the initial value after 1 year and 1.2% after 1.5 years) than persons without MD (12.6% and 7.8%, respectively).

Another practical aspect of diagnosing depression and anxiety is the ability to identify a risk group for the development of obesity. A prospective study in women of late reproductive age showed that the presence of depression or anxiety doubled the risk of weight gain over the next 4 years, while dietary factors, physical activity, and levels of gonadotropic, sex and adrenal hormones did not affect this. Screening for depression and anxiety helps identify women at greatest risk of menopausal weight gain.

Psychotherapy aimed at reducing anxiety is accompanied by a 7.5% decrease in body weight (BW) over the course of a year, without dieting. If there is a history of serious psychological trauma, especially childhood trauma, then conscious or unconscious sabotage of weight loss attempts is often noted, because obesity has a symbolic meaning of “protection and safety” for such patients.

It has been shown that survivors of sexual violence, on the background of the same weight loss correction program, have a much more difficult time losing weight than individuals who have not been subjected to violence. In such cases, reducing body weight is impossible without long-term psychotherapy, as a result of which the patient understands the cause of obesity, learns to interact differently with threats and build more optimal defenses.

All of the above determines the need for a holistic psychosomatic approach to the management of patients with obesity, combining traditional medical programs for weight correction with psychotherapy aimed at eliminating the psychological problems that caused the development of obesity or arose against its background.

Compulsive overeating - treatment

There is a commonality of pathogenetic mechanisms in obesity and mental disorders. Dysfunction of monoaminergic (serotonin, norepinephrine, dopamine) nerve signal transmission to the central nervous system (CNS), which underlies depressive and anxiety disorders, also plays an important role in the pathogenesis of obesity.

Serotonin accelerates satiety, influences appetite and macronutrient selection, suppressing the desire to consume carbohydrates and fats. It mediates some of the effects leptin to reduce body weight (BW). Shortage serotonin in depression, it increases the craving for carbohydrates, the intake of which reduces the vegetative symptoms of depression, but also increases body weight (BW).

Norepinephrine affects food intake in two ways: stimulation of ag and p2 receptors of the paraventricular nucleus and lateral hypothalamus reduces it, and stimulation of a2 receptors of the paraventricular nucleus increases it. Norepinephrine modulates food intake by influencing neuropeptide Y and leptin.

Stimulation dopamine receptors is accompanied not only by a decrease in the volume and number of meals, but also by a direct effect on energy expenditure. Action dopamine enhances the pleasant sensations of consuming delicious food.

The approach to the treatment of obesity should be differentiated, since it is obvious that individuals with obesity and BD should be treated differently than those without BD. In the presence of clinically obvious depression or anxiety, it is advisable to start with the treatment of the corresponding disorders, and only then begin the actual weight correction program, otherwise the likelihood of a positive result is low.

If symptoms of depression are less pronounced or erased, preference may be given to the management of an obese patient. Sibutramine, if possible, in combination with psychotherapy or its elements.

Anti-overeating pills

There are several groups of drugs that are used for both depression and obesity. Thus, psychostimulants were previously prescribed for the treatment of obesity. amphetamine And Methylphenidate. Currently, they are not used to treat obesity due to the risk of addiction, but in psychiatry they are still successfully used for certain types of depression and other disorders.

Serotonergic anorectics fenfluramine And dexfenfluramine(withdrawn for safety reasons) reduce BW, but also reduce the severity of symptoms in some types of depression and bulimia nervosa.

Psychotropic drugs in the treatment of obesity

Antidepressants

1. Selective serotonin reuptake inhibitors (SSRIs):

Fluoxetine - short-term decrease in BW, disappearance of the effect after 5-6 months of use; in case of obesity + SPE, the effect on MT remains unchanged after 1 year of use;
Sertraline, Fluvoxamine - ineffective; for obesity + SPE - short-term decrease in BW;
Citalopram - ineffective; for obesity + SPE - short-term decrease in BW. Improves neuroendocrine, autonomic and metabolic parameters associated with obesity.

2. Selective serotonin and norepinephrine reuptake inhibitors (SNRIs):

Venlafaxine* - reduces appetite and body weight in patients with depression;
Sibutramine refers to selective serotonin and norepinephrine reuptake inhibitors and was originally developed as an antidepressant. However, its main effect is an increase in the feeling of satiety and a decrease in the need for food intake, leading to a decrease in BW, which persists with long-term use of the drug. (For this reason Sibutramine is the only SNRI registered for the treatment of obesity). Sibutramine recommended for the treatment of obesity caused by mental problems, as a centrally acting drug that, through the serotonin and norepinephrine systems, simultaneously affects both food consumption and the psycho-emotional state of obese patients.

3. Selective norepinephrine and dopamine reuptake inhibitors:

Bupropion* - reduces weight loss and symptoms of depression in depressed patients and obese individuals; reduces BW in obese individuals without depression; effective with long-term use.

Antiepileptic drugs

Topiramate - reduces body weight in obesity, effective with long-term use; not well tolerated

* Not registered in Russia

Table. Psychotropic drugs in the treatment of obesity

The WHO report on obesity lists SSRIs under “drugs not indicated for the treatment of obesity per se”; they are recommended only for the treatment of depression in combination with obesity.

Lydia Yanko

Psychiatrist, psychotherapist, narcologist of the Federal Scientific and Clinical Center of the Federal Medical and Biological Agency of Russia.

Human eating behavior - taste preferences, diet, diet - depends on cultural, social, family, and biological factors. Society's ideas about beauty, especially women's, have a strong influence on eating behavior.

There are several types of eating disorders: anorexia nervosa, bulimia nervosa and binge eating disorder. The latter is often combined with obesity, and anorexia nervosa can lead to death if left untreated.

The main manifestations of these disorders are fear of obesity, self-restraint in food, bouts of gluttony and fasting.

If a person in a state of stress simply awakens, with which he is unable to fight, we are talking about an eating disorder. This is not the norm. Moreover, an attack can be triggered by both serious situations (the death of a loved one, dismissal from work) and minor unpleasant moments that cause negative emotions (the boss raised his voice, a quarrel with a loved one). Unfortunately, the habit of eating up any problem with large amounts of high-calorie food is one of the most common causes of obesity.

Diagnostics

With the problem of compulsive overeating, you need to contact a psychotherapist - he is the one who treats this disease. Since no tests or instrumental research methods can confirm or refute this diagnosis, a regular interview is used and a special test is performed.

According to the Diagnostic and Statistical Manual Diagnostic and Statistical Manual of Mental Disorders for mental disorders, the diagnosis is confirmed if three out of five criteria are met:

The feeling of fullness in the stomach after eating food causes discomfort.
It is even eaten very quickly, almost imperceptibly.
Self-loathing, depressed mood, guilt after overeating.
Eating in the absence of hunger.
Eating alone.

If the patient confirms that he has at least three symptoms, the therapist diagnoses compulsive overeating disorder.

Treatment

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

Firstly, the disorder leads to excess weight gain, followed by obesity, metabolic syndrome, metabolic disorders, excessive stress on internal organs, fatty hepatosis and other associated diseases. All these diseases will have to be treated.

Secondly, it is necessary to eliminate the root cause of overeating, that is, treat depression, reduce depression, and normalize sleep.

Psychotherapy

To overcome compulsive overeating, a psychotherapist can offer several treatment methods, depending on the condition and personal characteristics of the patient.

Cognitive-behavioral, person-centered, group, or hypnosuggestive therapy is used.

Cognitive-behavioral approach- this is a “transformation” of the patient’s thoughts, as well as the circumstances that surround him. For example, the desire to eat another chocolate bar gives way to the opportunity to show it off on the beach. Among the main components of this method are goal setting, self-control, feedback/reinforcement, increased persuasion, incentives.

Person-centered approach in the fight against excess weight - the solution of intrapsychological conflict, that is, mental stress caused by the inability to satisfy one or another need. Initially, to solve a problem, it is necessary to identify the conflict, then understand its essence, identify motives that can be accepted and which should be abandoned.

The last method is hypnotherapy. The therapist identifies experiences that bother the patient and, as a rule, are accompanied by psychosomatics, which is expressed in the appearance of various diseases: for example, bronchial asthma, hypertension, problems with the stomach and duodenum, allergic reactions. During treatment, the psychologist turns the traumatic experience into a resourceful one, cleared of bodily manifestations.

For quick recovery, it is important to find. When choosing a psychotherapist, you must first pay attention to the qualifications of the specialist, as well as the proposed treatment method. On average, therapy lasts about six sessions, between which a certain time must pass so that the body has time to adapt to the changes. This will take at least three months. So doctors who offer you to get rid of the causes of obesity in a week or even a month are most likely charlatans.

Nutrition

In case of compulsive overeating, it is very important to properly organize nutrition: this is part of the therapy. Since the treatment is carried out on an outpatient basis, this falls on the shoulders of the patient himself. Due to the fact that the disorder has psychological causes, it will be difficult for the person, and he will probably need the help of someone close to him so that they can control the meal schedule and portion sizes.

Learn to distinguish psychological hunger from biological. Quench only the last one. Do not neglect the help of family and friends, allow them to take control of meals.
Include at least three full meals during the day: breakfast, lunch and dinner. You can afford a light snack, but here you need to choose natural products - fruits or yogurt. It must be remembered that fasting during compulsive overeating will deal a blow to the entire body, as the body will begin to accumulate fat “in reserve.” Therefore, meals should be regular and healthy.
Find an alternative way to relieve nervous tension (this could be books, sports, music, cinema, dancing, other hobbies).
Eat mostly low-calorie foods. Do not go to restaurants, cafes and fast food establishments. Don't buy a lot of products at once. Do not buy sweets or starchy foods, give preference to vegetables and fruits.
Avoid aimless trips to grocery stores. Don't watch cooking TV shows or flip through recipe books. Do not discuss the topic of food with anyone. Stock up on small dishes that will prevent you from eating large portions.
Don’t sit on and don’t put strict bans on your favorite foods - allow yourself to relax at least once a week (not to the point of gluttony, but one pack of chips won’t hurt). If you push yourself into too strict limits, stress will increase, and with it the likelihood of relapse will increase.

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

It is important to remember that an eating disorder is a psychological problem, so changing your diet without taking into account the psychological aspect can lead to the weight returning back. Only an integrated approach combined with consultation with a competent specialist will allow you to stabilize your weight and avoid overeating in the future. This process takes time and effort, but with proper therapy and an optimal diet, the results will last for many years.

Main symptoms:

Compulsive overeating (syn. gluttony, psychogenic overeating) is a type of eating disorder. With this disease, a person consumes a large amount of food, which has nothing to do with hunger. This means that the pathology acts as a mental disorder and is equated to disorders such as bulimia and anorexia.

This disease belongs to the category of polyetiological disorders, which means that its development is influenced simultaneously by several causes. Provocateurs can be surgical interventions, the loss of a loved one, accidents or violence.

The main clinical manifestation is food consumption not associated with hunger. Against this background, body weight increases, up to obesity, performance decreases and a feeling of a full stomach appears.

The diagnosis is made on the basis of data obtained during a conversation not only with the patient, but also with his relatives. In addition, information from other primary diagnostic measures is taken into account.

Psychogenic overeating is treated using conservative methods – this includes diet therapy and psychotherapy. In some cases, additional medications may be necessary.

Etiology

Often, gluttony is a hyperphagic reaction to. The main difference between this disorder and anorexia or other eating disorders is the absence of taking emetics or laxatives, intense physical activity, or other actions aimed at eliminating the consequences of attacks.

Experts in the field of psychology and psychotherapy identify several groups of predisposing factors that contribute to the occurrence of compulsive overeating:

biological;
psychological;
social.

Today, several genes are known whose mutation can cause the formation of the described disorder, namely:

The GAD2 gene activates the production of gamma-aminobutyric acid in the brain, which, in turn, interacts with neuropeptide Y, which ultimately stimulates appetite.
The Taq1A1 gene is responsible for low dopamine levels. People with a mutation of this gene make decisions more slowly and later experience satiety and pleasure from eating food.
The FTO gene is responsible for a person’s tendency to be overweight and overeat.

Psychological reasons lie in the inability to cope with a particular emotion provoked by internal conflicts or the influence of external negative factors.

The main incentive to consume large amounts of food are emotions such as:

fear and guilt;
anxiety;
own powerlessness;
inability to change the situation.

This leads to the fact that psychogenic overeating in the vast majority of cases is diagnosed in people with low self-esteem.

Another important factor is social pressure. Today, the cult of slimness is widespread, and the absence of excess body weight among female representatives is considered the standard of beauty. This situation further aggravates the feeling of inferiority, guilt, and pushes people to eat large amounts of food to eliminate negative emotions.

The reasons for the formation of this disorder in children:

conflicts in the family;
problems with education;
difficult relationships with adults;
lack of sufficient emotional support;
certain eating habits learned from an early age, for example, eating only fatty foods and sweets, using large plates, eating “for company” or “because that’s how it’s supposed to be when visiting”;
ADHD, also known as hyperactivity disorder, is a neurological-behavioral developmental disorder that begins in childhood.

Symptoms

Compulsive overeating symptoms are multiple and specific, but the main manifestation is eating a large amount of food while the person does not feel hungry.

Other clinical signs are presented:

frequent episodes of uncontrollable binge eating;
feelings of sadness, guilt and depression after overeating;
inability to stop eating and control the amount of food eaten;
quickly eating large quantities of food;
hiding or hoarding food to then eat it secretly from others;
eating normally around other people, but binge eating alone;
embarrassment about how much a person eats;
despair associated with the inability to control eating habits and weight.

Compulsive overeating symptoms mentioned above can lead to the development of a large number of complications.

Nonspecific manifestations of the disease are considered to be:

weight gain;
secretion of a large amount of sweat;
and shortness of breath;
frequent mood changes;
feeling of discomfort and full stomach;
pain in the abdomen;
decreased performance.

Diagnostics

The diagnosis of “compulsive overeating disorder” is made on the basis of information obtained during the implementation of primary diagnostic measures.

These include:

studying family history to establish the fact of burdened heredity;
reviewing the medical history to look for other mental disorders or eating disorders (this is necessary because compulsive overeating very often develops after anorexia);
collection and analysis of the patient’s life history to identify the most likely cause;
a detailed interview with the patient and his relatives is necessary to determine the first time the above symptoms appeared.

General laboratory tests and instrumental procedures are not involved in the process of diagnosing such a problem, but they are necessary to confirm or refute the development of complications.

Psychogenic overeating must be differentiated from that caused by long-term use of medications such as antidepressants and antipsychotics. In addition, the clinician should exclude obsessive-compulsive disorder and various mood and mental disorders.

Treatment

The fight against compulsive overeating is carried out only by conservative methods. First of all, patients are shown psychotherapy, which can be carried out individually or in groups.

The following methods are most effective in treating this disorder:

cognitive psychotherapy;
behavioral psychotherapy;
hypnosis and suggestion.

Treatment for compulsive overeating will not be complete without following a diet.

A gentle diet is compiled personally for each patient, and it must be taken into account that only the attending physician can:

compile a list of permitted and prohibited products;
provide information regarding the method of preparing dishes;
introduce new components to the menu;
create a meal schedule;
determine the duration of diet therapy.

In some cases, you may need to take medications.

Drug treatment involves the use of:

antidepressants;
medications aimed at reducing appetite.

However, such drugs cannot be considered as the main method of therapy. This is due to the fact that the abolition of one or another drug without psychological support will lead to a relapse of the disease.

It is very important to consider that it is not possible to get rid of such an eating disorder on your own. This completely excludes the use of traditional medicine recipes at home, since such treatment can further aggravate the problem.

Possible complications

This pathology can harm not only the figure. Being overweight and eating large amounts of food puts a strain on the entire body.

If the described disease is not cured, then there is a risk of developing a large number of complications, namely: physiological, psychological and social consequences.

Physiological complications include:

metabolic problems;
disordered fat metabolism;
hormonal disorders;
obesity.

Psychological consequences are presented:

anxiety;
loss of interest in life;
decreased sexual desire.

Among social violations it is worth highlighting:

drug and alcohol addiction;
financial problems;
desocialization.

Prevention and prognosis

The development of such a disease can be avoided by following general, simple rules, which is why prevention includes:

building trusting relationships in the family;
maintaining a healthy and active lifestyle;
proper and balanced nutrition;
if necessary, visit a psychiatrist or psychotherapist;
undergoing a full examination in the clinic with mandatory consultations with all specialists, this is especially indicated for people with a genetic predisposition to such a disorder.

Compulsive overeating in the vast majority of cases has a favorable prognosis. This is due to the fact that with the help of the above recommendations it can be completely overcome, and specific symptoms that simply cannot be ignored are the impetus for seeking qualified help, which is why complications and consequences develop quite rarely.

Is everything in the article correct from a medical point of view?

Answer only if you have proven medical knowledge

First of all, you need to define the term. What's happened compulsive overeating In the simplest terms, it is the regular excessive consumption of huge amounts of food, accompanied by feelings of guilt and self-loathing and the feeling that you cannot stop your appetite. Signs of compulsive overeating

You can't stop eating or control what you eat.
You eat a lot and very quickly (as if they could take it away).
You eat even when you feel full.
You eat automatically (for example, you can quickly eat a pack of cookies and not notice how it happened).
Pain in the stomach, disturbances in the gastrointestinal tract.
No matter how much or what you eat, you get, at best, fleeting pleasure, which immediately evaporates.
Food helps you relieve stress.
You eat most often when you are busy with something else (in front of the TV, computer, while reading).
Feeling guilty after overeating.

The presence of half of these signs indicates that you are susceptible to compulsive overeating. Compulsive overeating is not a disease. This is a symptom of the disease. And the disease itself in this case is emotional dissatisfaction. It can have many different sources. Here are some of the possible ones: loneliness, lack of support and satisfactory close relationships, constant stress, unexperienced grief, suppressed strong feelings (anger, resentment, envy), excessive control and self-control in other areas of life. That is, emotional dissatisfaction can mean any discord in the area feelings. It can be situational, passing, that is, a very specific reason led to such an imbalance (breaking up with a loved one, being fired from a job, the collapse of hopes). Or it can be chronic (“dislike” in childhood, low self-esteem, denial of reality). Food in this case is compensation for what is missing. It must be said that our body is generally specialized in compensation. For example, sweating compensates for the possibility of overheating, yawning compensates for the lack of oxygen, and increased hearing and touch compensates for the inability to visually navigate in the dark. With the emotional sphere, the situation is somewhat more complicated. For two reasons:

It is often difficult to understand what exactly I am missing.
Even after understanding what is missing, it is difficult or even impossible to get it.

And then we try to plug this sucking funnel of emotional dissatisfaction in various ways: addictions, constant “jumps” into new relationships, workaholism, etc. Or, as in our case, gluttony. How to help yourself? The most common cause of compulsive overeating is emotional problems. Most often this is depression, suppressed feelings and excessive self-control (for example, a girl obsessed with the idea of being slim). Psychotherapy can help overcome these problems. Long-term and regular. And turning to her is of course the best option. We cannot “cure the disease” ourselves. Even a psychologist cannot cope alone. True, there are cases when it can disappear on its own, if, for example, life circumstances have changed and God forbid everyone. Well, for now, let's talk about what useful things we can do for ourselves. Self-help in this case is control over the symptom itself. Control is constant awareness of what I am doing, why I am doing it and what I want as a result. General recommendations

Minimize the presence of prepared food at home. Try to have just enough ready-to-eat food at home for breakfast, lunch and dinner, plus a few snacks. The principle here is simple: absence of temptations. If you do not live alone, you can ask that food be removed from sight (so that there are no bowls of sweets on the table, bright packages of snacks, etc.). Keep it all tucked away in your kitchen cabinets.
Try to follow a diet. Main meals every day at approximately the same time. Over time, the body will adapt to this regime and at other times you will feel less hungry.
Take any food only at the dinner table. And this is not just a matter of good manners. If your task is to control the process of overeating, then it must be deprived of all additional “conveniences” (not eating on the sofa, in an armchair, in front of the TV, in front of the computer, etc.).
Remember that after eating, the feeling of fullness comes in about 20 minutes.
Occupy your free time with some activity that absorbs your attention and it’s good if it requires your hands to be busy.

Techniques for coping with compulsive overeating

You are full (let's say you recently had lunch) and suddenly feel an urge to eat something. The first control point is to wait 10 minutes. During this time you will not die of hunger. But remove the compulsive nature of the action ( compulsions are unconscious automatic actions). During these 10 minutes, stand up, place your feet shoulder-width apart, and take a few deep breaths in and out. 10 minutes passed and the thought of chewing something returned to you. The second point of control is - instead of going and eating, drink 2 glasses of water (one after the other), but not quickly, in one gulp, but slowly, one sip at a time. This way you indirectly satisfy the need to “absorb” without harm to the body. If we consider compulsive overeating as compensation for emotional hunger (and this is a kind of self-deception), then drinking water is compensation for compensation, that is, a deception of deception.
In front of the TV or in front of the computer, you always feel the urge to gnaw, chew, etc. The biggest danger here is that you don't notice how much you're actually eating. Therefore, we are again engaged in deceiving our harmful addiction. You can chew gum, chew a large fruit pit or lollipop in your mouth. Thus, we "eat" without absorbing. A good metaphor to illustrate how this technique works is a baby's pacifier.
Every time you go to eat, this process should be fully aware. Before you head into the kitchen, ask yourself, “What exactly do I want to eat?” Don't start until you understand what exactly. The answer “I don’t know, something tasty” is not suitable. For example, you realized that you want gingerbread. Then the next question to yourself is: “how many gingerbread cookies do I want to eat now?” Let's say you decide. that two. Then you take not a bag of gingerbread cookies, but a plate. Preferably a beautiful one that you like. Place exactly two gingerbread cookies from the bag on a plate, tie the bag and put it out of sight. It is advisable to divide any food (if possible) into several small pieces. Let’s say you cut these 2 gingerbread cookies into 6 pieces with a knife (this helps convince the “gluttony center” that you ate 6 gingerbread cookies). Eat each piece as slowly as possible, chewing thoroughly, trying to distinguish the slightest shades of taste and aftertaste and your feelings that arise after these sensations. Follow the “sensation scanner” as the chewed and swallowed piece descends down the esophagus and falls into your stomach. All this is done in order to make the process of eating as conscious as possible and allow yourself to enjoy. When nutrition occurs in this way, the body has time to understand that it is being fed and sends appropriate signals to the brain, to the centers responsible for satiety, pleasure and calm. These feelings are the closest to love and it is precisely these (compensatory) that we want to experience by regularly overeating. But the paradox is that when we eat too quickly and unconsciously, we deprive ourselves of why we eat. And then “the wolves are hungry and the hares are eaten.”
Another way to cope with compulsive overeating is to allow yourself to eat, but specifically eat something that tastes bad. For many it suits well, for others it does not suit at all. Individual characteristics play a big role here. When small children are weaned from the bad habit of thumb sucking, a simple method is often used: they smear the finger with mustard. The child develops a conditioned reflex that “thumb sucking is bitter and disgusting” and over time he gets rid of this habit. Our method has the same principle. Choose a product that you do not like, eating which does not give you any pleasure. For example, fresh white cabbage. Every time you experience that familiar compulsive desire to eat, you eat that cabbage. Moreover, you also put the portion on a plate and finish it to the end, even if you don’t feel like it. This is done so that the body develops the reflex we need: it is tasty only at breakfast, lunch and dinner, and the rest of the time it is tasteless. We go for pleasure, but systematically do not receive it. The psyche is designed in such a way that it will have to restructure itself and look for pleasure in something else.
This leads to the fifth method. Take a piece of paper and write on it: “Food for me is...” and then list what food means to you (pleasure, a way to forget, take time, relieve stress, take your mind off boredom, gloomy thoughts, put things off, etc.) d). Then think about each item on this list and ask yourself: How can I satisfy these needs in other ways and write a separate list for each need. (it is useful to use the brainstorming technique here). Many of these things require spending money. And here it will be useful to calculate how much you can save on “extra” food. Conscious expansion of the behavioral repertoire is a solid and thorough step towards breaking out of the vicious circle of compulsions.
Keep a special notebook-diary and write down there every day what pleased you (or you yourself) and gave you pleasure, except for food.
Keep a food diary and note in it each meal (even if it’s just one seed), the time of consumption, the amount of food and, preferably, its cost. This helps to control the frequency of food intake and its quantity, as well as call on your “inner toad” for help. Moreover, when this is presented clearly, it becomes clear where you really overate, and where you just imagined it out of habit. A food diary also makes it easier to track your progress. A The feeling of progress has a powerful positive effect on motivation.
Compensate for every overeating with exercise. If you punish yourself with hunger strikes for bouts of gluttony (as many do), then there is a risk of provoking even more severe attacks in the future (these are so-called “breakdowns”). Remember that you are already emotionally starving and if you suddenly deprive yourself of food as punishment, you will make it even worse for yourself. Exercise is a more mature solution. First, they help avoid the physical consequences of regular overeating (overweight). Secondly, they promote relaxation and calm. Thirdly, they help ease the feeling of guilt that comes after a bout of gluttony. That is, a certain understanding comes: “I worked for a bad deed.” Dealing with feelings of guilt is the most important moment for getting out of the compulsive circle, which in our case looks like this: I feel bad - I eat - I feel guilty - I feel bad. Fourthly, with its regularity (overeating - working the next day), the habit of overeating weakens, because something like this scheme is built in the brain: if I eat, I will feel good, but then I will feel bad because I will have to squat 100 times).
Make it a habit to reward yourself for your success. Track your progress using a food diary and for each successful day (when you effectively managed to control your impulses) reward yourself with something pleasant, but, of course, not food. This could be buying a new thing, going to an interesting event, etc. Behavioral psychology research has shown that In the vast majority of cases, rewards work more effectively than punishments in forming the desired habit. If the basis of emotional dissatisfaction is a lack of love, support and acceptance, then with the help of encouragement we “add” to ourselves what is missing and what we try so vainly to compensate for by regular overeating.

So, the main lever of self-help for compulsive overeating is controlling your symptom. We can do this. The functions of control are to stop destructive behavior and form a new useful habit. Forming a habit over time allows you to loosen your control. Therefore, it will be difficult only at first, but then it will definitely become easier.

Most of us do not mind eating as many attractive dishes as possible during various special occasions or intense mental activity, for example, before important exams. However, this can lead to the consolidation of this habit, and the person begins to eat not only during certain days, but also in his daily routine. This leads to the appearance of compulsive overeating, which affects not only physical health, but also psychological health.

Snack lovers abuse this when it comes to stress and other negative emotions. However, excessive diet only leads to more stress and more food. Lack of an even and balanced diet is much more common than bulimia, and it affects men and women equally. This disease can be cured with the help of a specialist and strengthening one’s own willpower.

This disease is not so much physical as psychological. If people suffering, for example, from anorexia, try to rid their body of a certain amount of food, bringing themselves to the point of vomiting, then in rare cases, overeating can progress unnoticed by others and the patient himself. A person gaining weight is not able to do so as quickly, so it is not possible to diagnose the disease. After some time, when the stressful state becomes almost constant, the primary signs of compulsive overeating begin to appear.

First of all, the disease is formed due to the feeling of pleasure while eating. In a normal state, this does not harm the body, but as soon as depression appears, the illness begins to seem to the patient as a way of calming down and the only refuge from the influence of difficulties on everyday life. Some believe that such problems can begin in early childhood.

When parents present their child only with clothes and food, depriving them of other ways to show attention and love, they forget about many other important things. As a result, a person will believe that when he is in a bad mood, he must cook himself something tasty. It is this stereotype that is considered the main reason for the development of overeating.

There are main reasons for the development of the disease:

Stress and unpleasant situations in various human activities;
Persistent depression and loneliness;
Low level of self-esteem.

It is worth noting the 4th point related to biological anomalies. For example, the hypothalamus, which is a small part of the brain responsible for controlling appetite, is unable to send signals of satiety or hunger.

In addition, a group of researchers recently found a genetic mutation that causes food addiction.

Point 5 is the most common one lately – social pressure. Due to the fact that in today's world only slim and fit people are recognized, eaters feel insecure and depressed, which is why they decide to eat accumulated negative emotions. In addition, loved ones can also influence the patient’s consciousness: constant reproaches about appearance, unsuccessful searches for a soul mate, and so on. It often happens that a child is criticized by others in kindergarten, school and university.

To identify the disease in yourself or your loved ones, just look at the main signs:

Eating a huge amount of food;
The desire to eat faster;
Lack of organization and control over food intake;
An insatiable feeling of hunger;
Eating food hidden from everyone;
After the portion has been eaten, an extra dish is added;
Feelings of guilt arise after consuming an unhealthy diet;
The only source of pleasure lies only in food;
A feeling of excess weight, which is why the patient engages in self-flagellation and tries to get rid of the problem only with the help of food;
Much of the thinking is devoted to food, even when the situation and environment are not related to food;
Endless eating of light snacks at different times of the day.

Many psychologists argue that eating extra food helps cope with decreased psychological and physical discomfort due to negative emotions. In addition, secrecy and a long state of food shortage also result from an overabundance of excess food.

Determining whether you or your loved ones have a disease

Thanks to a few questions, you can accurately determine whether a person suffers from compulsive overeating. If the answer to most questions is yes, then the person is predisposed to or has the disease. If “yes” and “no” are 50% respectively, you should think about a detailed review of your own diet. If your answer is “no”, then there is no need to worry, because overeating does not concern you.

How do seizures manifest?

If a person consumes food in excessive quantities, he feels comfort, but only for a short period of time. As soon as the meal is completed, the patient returns to reality, but with this comes regret and self-hatred, which increases from time to time. A huge flow of food leads to excess weight and the development of obesity, which can ultimately develop into more serious diseases: insomnia, diabetes, osteoarthritis, weight disorder, and so on.

How to overcome yourself and stop the disease?

In most cases, overcoming overeating is not easy. Compared to other addictions, this type of drug serves as a source of life for us, so it cannot be abandoned once and for all.

Therefore, you should independently organize a relationship with food that will not lead to obesity, and there will be no psychological need to resolve problems through frequent snacking.

First of all, it is worth preparing a healthy diet, where the amount of healthy food will prevail in the menu. In addition to healthy foods, a balance must be maintained in which a certain time is allocated for breakfast, lunch and dinner. In addition, you can take various vitamins, but it is better to discuss their dosage with a specialist.

Of course, you can try to cope with the problem on your own, follow all the above tips, but you cannot do it without the help of professionals and treatment. A highly qualified psychotherapist is able to relieve the patient not only of symptoms, but also of destructive habits. First of all, a conversation will be held with the patient, during which the main sources of the problem will be established, certain emotional markers due to which food binge occurs and it becomes difficult for the person to cope with difficulties, depression, anxiety and other unpleasant emotions.

The treatment process itself will seem like hell for people with an advanced stage. As a rule, those suffering from overeating do not talk about their illness, which is why they have to hide the source of obesity.

Psychotherapy as an excellent remedy for illness

Our type of disorder can be treated quite successfully with the help of a psychotherapist. Thanks to several courses of psychotherapy, you will be able to independently cope with overeating, get rid of bad habits, and develop new healthy ones. In addition, you can not only improve your life, but also improve your mood, begin to control your behavior, and be able to cope with any difficulty, regardless of the complexity of the situation.

It is worth noting that there are 3 types of psychotherapy that can effectively treat overeating:

In addition, do not forget about the nutritionist. His recommendations and advice will help optimize your daily menu and create complete control over proper nutrition.

Medicines for therapy

There are medications that can help relieve symptoms, and they can also be used in conjunction with a comprehensive recovery program that includes therapy, relaxation, and self-help techniques. It is worth noting that there are no medications that can completely relieve a patient from overeating.

Drugs to reduce appetite. Thanks to independent groups of researchers on the processes and mechanisms of appetite reduction, it is known that most weight loss pills will reduce bouts of overeating several times. Thanks to this, you can experience weight loss and an improvement in your mood. But there are also side effects:

increased blood pressure;
rapid pulse;
frequent seizures;
nosebleeds;
fatigue;
headaches;
tingling in the abdomen and much more, which can lead to other problems.

One group of British scientists claims that antidepressants can reduce appetite in people suffering from gluttony and bulimia; in addition, they can greatly improve both physical and moral well-being.

At the same time, we should not forget that antidepressants have a high relapse rate. This means that painful symptoms return when you stop taking the drug.

At the same time, do not forget about yourself. You should not delay your meeting with a specialist, because you need to protect your own nerve cells. In addition, further work on yourself and your own body will be filled with various emotions: not only positive, but also negative. However, the results of this struggle will improve the state of life and safely enjoy its fruits.

Tips to improve your condition:

Never sit in one place - move. When people suffer from overeating, they are ready to while away boring moments with a few sandwiches or something similar. When a patient has too much free time, he should go outside, play sports, walk the dog, start feeding pigeons in the park - in general, any of these activities in order to constantly be in action. When a patient sits at home all day and does not want to go out, this indicates the neglect of the disease.
Keep a food diary. Here you can write down everything you eat throughout the day. Thanks to this, you can track how effectively you are fighting the disease. This way you can concentrate on a speedy recovery and your own diet. Observation allows you to discard unnecessary foods and develop the habit of eating the right foods. To make the process systematic and enjoyable, describe your feelings after eating a particular dish. Note whether you eat alone or with someone, what you did before eating and where you were. This way you can identify characteristic problems for further behavior.
Learn to breathe deeply. Thanks to this activity, you can calm down and get rid of an unwanted condition. A few training exercises several times a day are enough to feel how the body begins to cope with certain difficulties more easily. It is advisable to sign up for yoga classes, as they further develop breathing techniques.
Don't forget to go to bed on time. Never go to bed too late, as the substances produced during sleep help normalize your appetite. Create bedtime rituals to help you fall asleep faster. Develop a routine before you go to bed. And you shouldn’t abuse daytime sleep: more precisely, give it up. Because of this type of rest, it is very difficult to go to bed at night, since after waking up the sleepiness will not leave you.

The result of the work that the patient achieves:

Thanks to healing, you can get rid of annoying diets that negatively affect the psyche;
A properly composed menu and consumption of healthy foods can correct obesity not for a few months, but for life;
The patient will be able to recognize hunger and distinguish it from the desire to “eat up difficulties” - and will begin to eat only when the body, and not the emotional state, needs it;
Thoughts about various dishes will disappear - this will help improve your attitude not only towards life and loved ones, but also towards yourself;
As soon as overeating disappears, subsequent diseases will disappear.

You will find personal experience in dealing with compulsive overeating in the following video:

It is possible to cope with overeating, you just need to find a qualified specialist and start working on yourself. Love yourself and your body!