Obesity: Psychological Factors

Up to this point I have not addressed directly psychological factors that might contribute to obesity, except the psychology of portion size vs. plate size. While I believe by far the major factors contributing to obesity are genetic predisposition related to appetite control and inactivity, psychological factors play a role in some people. I do not really know what the term “nervous eating” means but quite a few overweight people tell me they eat too much because they are anxious or nervous and the food makes them feel better. Another frequent explanation for eating too much is that “I eat when I’m bored.” I have no idea whether these two common reasons for overeating are important independent from appetite centers out of control; maybe the perceptions of anxiety or boredom are really just hunger? I read or heard on the radio the other day that about 20% of people in the U.S. admit to binge eating at least once a week- the binge eating is defined as eating to the point of being uncomfortable. I do not know whether binge eaters are more likely to be overweight than people who do not binge or whether binge eating is always on a psychological basis? Now I’m worried- I love pizza and sometimes I eat more than I should (don’t we all?). Maybe I’m a binge eater too.
Psychological factors as “add-ons” to genes and inactivity

It is clear that once a person is overweight, psychological factors can contribute to the obesity and make it more difficult for a person to trim down. For example, some people deny their obesity and refuse to confront the problem. Denial is a powerful psychological mechanism for relieving anxiety and I suspect this is a fairly common feature, especially in people who are very overweight (i.e., BMIs > 35-40). In other people, it’s more like giving up rather than denial- they may have tried losing weight and maybe even lost a bit but regained all they had lost and then some. There is not much evidence that psychotherapy is a highly effective method of treating obesity. Of course, every person is different and there are certainly some people whose overweight is primarily related to psycholoigical factors. But, let’s not forget that the single common pathway to obesity remains more calories in than are burned up.

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