2023-04-23 05:05:55
Obesity is a chronic, multifactorial and complex disease. It doesn’t develop overnight, and it’s also not resolved with a snap of fingers – science even considers that there is no cure. For the rest of his life, the patient will need to watch the scale and deal with the effects of extra fat.
But why do we eat so much and so badly? What explains the difference in sensations between eating a pizza and a salad? And, even though society reinforces that weight loss is just a matter of willpower, how important are emotions when choosing what to eat and how much to put on your plate?
The accumulation of enough fat to trigger health problems is one of the most prevalent conditions in the world, but we are still understanding how obesity operates and what leads to it. Despite the delay, researchers are already starting to point out the main culprits: the biggest one is the consumption of ultra-processed foods, foods high in sugar, sodium and fat, in addition to a long list of preservatives.
In addition to impairing the functioning of the organism, developing diseases such as diabetes and hypertension, super caloric foods also act on the brain, triggering an addictive reward system. The more we eat, the happier we are—but at what cost?
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Hunger or desire to eat
When we put a brigadeiro in the mouth, a traditional sweet made with condensed milk (a combination of sugar and fat), the body immediately undergoes a chain reaction. The pancreas produces and secretes insulin, an essential hormone for processing sugars, which is also transported to the brain. There, the substance stimulates some specific neurons that produce dopamine.
The neurotransmitter is known as the happiness hormone: it activates a series of brain circuits that affect emotions and leave you full of good feelings of reward when eating the candy. Then it’s hard to pick just one.
According to a study by scientists at Yale University, in the United States, published in March 2023, eating excess sugar and fat ends up altering the reward circuits of the brain, making the consumer practically addicted to this type of food. . In a scenario like this, it’s complicated to rely only on willpower.
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In 2019, research published in the scientific journal Journal of Clinical Investigation showed that people who eat a lot of sugar and fat-rich foods can’t even appreciate healthier foods. They also had higher levels of substances that inhibit the action of the satiety hormone: as a result, they eat much more than they need, which, in most cases, leads to obesity. This mechanism is similar to what happens to a person addicted to drugs, for example.
The explanation may be thousands of years old. Scientists studying the subject believe that cavemen had a palate that prioritized more caloric foods, since it was necessary to store fat and energy — they never knew when the next meal would be, and it was essential to keep the organism functioning until there.
Today, this feature is no longer useful, as we live in a scenario of an abundance of food options, many of which are just a few commands away on the cell phone. But our brains still haven’t gotten the memo, and we continue to favor ultra-processed, high-calorie foods.
Fatty and sugar-filled foods also cause intestinal dysbiosis, which is an imbalance in the organ’s microbiota, stimulating the production of toxins that end up going into the blood and reaching the head. There, the substances cause inflammation in the brain, altering the cycle of sleep and wakefulness, in addition to influencing some functions of the organ.
genetic factor
In addition to having to deal with the effects of what we eat on the body, which tends to want what causes weight accumulation and triggers health problems, science has also discovered that there are regarding 200 genes proven to be associated with obesity.
“We know that 70% of the chance of weight gain is genetic, and regarding 80% of the genes associated with obesity are in the brain. With this, the patient is more hungry, more impulsive, more difficult to resist temptations. Having these genes does not depend on people’s choices”, explains endocrinologist Bruno Halpern, president of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (Abeso).
He cites research with identical twins separated at birth that proves the importance of the genetic factor in obesity. The results showed that the two normally have similar weights in adult life despite not having lived the same routine over the years.
Another study, from 1986, carried out by American scientists, analyzed the records of adopted people and compared the height and weight of individuals to those of natural and adoptive parents. When the couple that generated the child was obese, 80% of the children also developed the disease in adult life. When the natural parents were considered normal weight, only 14% of the offspring developed obesity regardless of the diet they followed,
emotions on the scale
When the plate is full of fatty and very sweet options, the body is actively fighting to keep the individual on the unhealthy diet. However, the psychological also has its share of blame, although less than what common sense says.
Psychiatrist Adriano Segal, coordinator of Abeso’s Commission on Psychiatry and Eating Disorders, explains that, as far as we know, emotions are not the main culprits for rampant food consumption.
He says that it is not even the majority of patients who have binge eating. Usually, in cases of less severe obesity, the disorder has a prevalence of regarding 6%. In more serious cases, it can reach 50%.
Although it seems that everyone has it, the diagnosis of binge eating requires that the episode occurs at least once a week for three months and that the patient feels out of control over their own food. In addition, the individual must have at least three of the following symptoms: eating faster than normal; until you feel uncomfortable with being so full; eating huge amounts of food even without feeling hungry; eating hidden out of shame; and feeling nauseous, depressed, or guilty following an episode.
Unlike bulimia nervosa, the person with binge eating does not have compensatory behaviors such as self-induced vomiting, use of laxatives or diuretics, excessive exercise or long periods of fasting.
Other psychic conditions may also be related to being overweight, including depression and anxiety. According to the World Health Organization (WHO), regarding 30% of obese people who seek weight loss treatments have depression at some point in their lives. Science still doesn’t know if one condition triggers the development of the other, or if they are linked in some way.
“But it has already been proven that having a psychiatric diagnosis is a factor that hinders the treatment of any chronic illness. The patient is unable to adhere to therapy proposals with such success. On the other hand, some medications can cause weight gain. Whenever possible, one should choose the option that causes the least problems, and associate it with the treatment of obesity”, explains the psychiatrist.
Fernanda Gonçalves, PhD in psychology, professor at Estácio de Sá University, in Rio de Janeiro, considers that the psychological aspect that triggers compulsive behavior when eating is a phenomenon of multiple origins.
Published studies show that, in addition to being common to use food as compensation for a difficult day, there are many cases triggered by violent events in the body during life. Individuals who have been sexually abused, for example, may have a very strong desire to hide their body shapes, and end up overindulging in food and accumulating fat in this pursuit.
“It is important to understand that it is not a choice, the existence of obesity is not weakness or lack of willpower. There are psychic demands that need specialized monitoring. Although the primary complaint is obesity, in many cases other factors have led to the condition. Each person takes a different path, ”he recalls. In cases of grade III obesity, the most severe, it is more common for the patient to need psychiatric and psychological follow-up.
Segal completes remembering that, unfortunately, it is not just the population that still thinks that the cure for obesity depends only on the ability to resist temptations. According to him, many health professionals still have this type of prejudice, which ends up causing mistreatment at the level of relationship with the obese patient. “It’s not just wanting, just controlling yourself. That’s not it. We need to demystify this notion,” he warns.
multidisciplinary treatment
“For society, obesity is still a disease treated only clinically, with a nutritionist and physical educator. If you only deal with the body, and that’s why we have so many cases of the accordion effect. When motivation is extinguished, if the patient has a psychological complaint, the background trauma remains and the tendency is to return to being overweight. He feels increasingly frustrated and incompetent in dealing with the problem and, somehow, reinforces the belief that there is little possibility of overcoming it”, says Fernanda.
Health professionals specializing in obesity — of which there are still few — advocate that the treatment be multidisciplinary, especially in more serious cases, where the patient has more kilos to lose. That is, in addition to diet, physical exercise, medication use, and investigation of other health issues (hormonal, for example), it is necessary to find out if there is something in the head making the process even more difficult.
If a psychiatric disorder is diagnosed, drug treatment should be started. At the same time, psychological follow-up can help a lot even patients who do not have identified conditions. Fernanda explains that cognitive-behavioral therapy usually has better results in this type of intervention because it has more structured and contemporary protocols. “Some patients manage to have a behavioral change from small insights”, guarantees the psychologist.
Segal also argues that, although physical exercise is not the big star in the weight loss process, it is essential to increase muscle mass, improve communication between the periphery of the body and the brain, encourage the improvement of the intestinal microbiota and even encourage the choosing healthier foods on a daily basis. “It is a central aspect of the treatment”, guarantees the psychiatrist.
Weight loss, when it is intentional and well managed, is also associated with an improvement in psychiatric aspects, in addition to reversing some diseases, such as diabetes, and ensuring a better quality of life for the patient.
In the next article, understand why gordophobia interferes with obesity treatment.
The post Emotions, brain and obesity: what science knows regarding it first appeared on Metropolis.
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