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Obesity and abuse link?

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Old 02-12-2011, 08:48 PM   #1
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Default Obesity and abuse link?

I wasn't sure where to put this if it is the wrong section I apologize.

The article discuses a link between abuse victims and obesity.

I found it fascinating and hopefully this will help someone.

http://www.thepermanentejournal.org/...n-or-both.html
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Old 02-12-2011, 09:39 PM   #2
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Good Link John! A little bit of a tedious read (I swear if they used conterintuitive one more time...!)

But all in all- Rings true for me. I've known it for a few years that that was the reason I'm like this.

But you won't catch me on a 420 cal/day diet!

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Old 02-12-2011, 10:41 PM   #3
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For me, abuse wasn't an issue, but using food for it's "psychoactive" properties was.

I think the reason I never really experimented much with smoking, drugs or alcohol as a teen, was because I never saw the need. Food worked just fine, and it was cheap and legal. I didn't like the effects of alcohol and prescription drugs (never tried illegal drugs at all), because food was a more precise tool. With alcohol and pain medications (prescribed to me for injuries), the results were too intense and unpredictable.

I didn't realize that I was self-medicating with food until much later (probably in graduate school). The book "The End of Overeating" really hit home to me how drug-like foods can be.


One drug-like effect I still have difficulty giving up is eating while reading. I remember in college reading a study that found that students who ate while reading/studying retained more of the information. That eating while reading may fire more neurons, increasing the number of connections (strength of memory).

Maybe I'd intuitively picked that up that connection when I was a kid, but it wasn't nonfiction that I was most likely to want to eat while reading - it was fiction. This may sound weird, but when I eat while watching a movie, or book, I find myself more absorbed in the story. It's as if stimulating the sense of taste boosts the degree to which I can be swallowed up by the story.


(Not so strange if you consider the similar ties made with psychoactive drugs like lsd and literary/artistic creation and/or experience).

Learning to read and watch a movie without food has been difficult, because it's almost like watching a 3D movie without the glasses. I'm working with one less dimension to the process.


Food is so intertwined with my enjoyment of movies/books that I feel like I'm missing something when I don't have the food component. Sometimes I'll chew gum or suck on a breath mint, or drink a diet beverage, just to recapture some of that missing element. Kind of sick, really.
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Old 02-13-2011, 12:58 AM   #4
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I'm a little dubious about that study, although I'm very glad to have read it and thank you for bringing it here. I'm going to get vitriolic, but none of it's directed at you, JohnP.

There are a lot of reasons that people pack on weight, but there's a passage in the "Treatment" section in which the author refers to an "escapist" answer to the question, "why do people get fat?" Apparently it's not reasonable to answer, "Because I really like food." Apparently that's a damned dirty lie, according to the authors.

But there are people who really like food. How is that an escapist answer? Not every large person has a history of terrible trauma or massive sexual dysfunction due to an abusive background. Abuse can lead to obesity, but this article comes perilously close to asserting that obesity automatically implies abuse.

I do get that the authors are talking about people who are greatly obese, not people who have some extra junk in the trunk, and there probably are some differences in the heads and hearts of the person toting around an extra forty pounds and the person carrying an extra four hundred pounds on a similar frame. No one disputes that weight (both over and under the norm) is sometimes a symptom of a greater problem.

But then they turn around and write things like "No one becomes fat out of joy." Really? Just "becoming fat" is enough to reveal your psychological pain to the universe? Even those extra few pounds of junk in the trunk that almost everyone seems to have these days are indicative of a deep-seated psychological problem? Someone who gains sixty pounds in a year when going from an active job to a sedentary one has suddenly developed an emotional dysfunction? The person who--whoops!--managed to gain seventy pounds in her first two years at college because she's eating junky food and thinking of other stuff is emotionally ravaged?

Horsefeathers!

Even if we did assume that the authors' assertions are true and that every person who isn't of average weight is a seething mass of raw nerves and traumatic history, their current method of "treatment" seems profoundly cruel. "You've been horribly victimized in your rotten miserable fat life, so to help you, we're going to kick away the only crutch you've been able to rely upon and give you a tasteless gruel to suck joylessly from its tub five times a day. That'll fix you right up! Oh, and here's some counseling."

There are more reasons why people are overweight or obese than emotional trauma. It's insulting how frequently in that article the authors imply otherwise. I see a ton of speculation and very little rigorous research. In fact, I suspect that they're going off on this "fat people are fat because they're emotionally ruined husks" tangent for the same reason that a man with a hammer sees every problem as a nail: they want their crazy-*** liquid diet to work and therefore those who go nuts on it or run screaming from the program MUST have deep-seated problems.

If I had to drink a freakin' miserable cup o' crap five times a day, I'd probably be profoundly psychologically disturbed after a year of it, too.
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Old 02-13-2011, 03:03 AM   #5
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thanks for posting, JohnP - very interesting read.
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Old 02-13-2011, 03:18 AM   #6
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i haven't read the whole article yet. it's very troubling to think that they were soposed to not eat AT ALL. other than the supplements. and to go down 300 lbs in a year. that's just insane. extremely unhealthy. and extremely.....um just so hard to deal with mentally.

sometimes i can just survive for awhile on just some vitamins and tea and such. but that's the whole dillemma. we can't. this isn't garfield. we don't just take a pill for our meal. food is part of our culture. our pleasure. senses. we should enjoy it at least some of the time.

if we could all just take a pill and not eat, and want to do that, we'd probably all have lost the weight already. that's not why losing is so often difficult. life isn't like that. it's not just calories in, calories out all the time.
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Old 02-13-2011, 09:41 AM   #7
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Quote:
Originally Posted by Nola Celeste View Post

If I had to drink a freakin' miserable cup o' crap five times a day, I'd probably be profoundly psychologically disturbed after a year of it, too.


Agreed. I know quite a few people who have a few extra pounds on them that are not psychologically disturbed. But... I'm not one of them.

Anyway, your post made me think of something else. You said the study said "No one becomes fat out of joy" (I did read the study as well)... but in the same study they do admit to the psychoactive properties of food. Food releases chemicals, etc and make us feel good. So yes. People can become fat out of Joy. Just as people can become fat out of trying to find that joy!

Anyways- I'm actually kinda torn about the merits of this study (for lack of a better word) In one hand, I can see the need for an individual to lose weight rapidly when one is 400 lbs overweight. There are many health risks involved. In the same token, programs like that- I thought- were often strictly supervised by medical doctors... not once a week you come in, we test your blood and vitals and send you on your way until the next week. (And they have the audacity to blame the individual for not loosing weight, or the individual's family for not being supportive)

The supplement they are using is Optifast 70- which is made by Sandoz (Actually a company I work with regularly...I work for a distributor of laboratory equipment)... Anyway, I did a quick google search and Both Optifast and Medifast come up with clinics and programs that are doctor monitored, etc etc. Except you can get Medifast on your own and do it without doctor monitoring, and medifast apparently incorporates some solid food.

I just feel so suprised that this kind of program is something you do with once a week monitoring. I would have thought that this is an inpatient kind of thing.

Anyway, I'm rambling. I appreciate the psychological discoveries they found with these extremely morbidly obese individuals, but I felt the study was written in a way that was "trying" to sound smart, big and profound... And did they ever make mention of teaching these people how to eat once the pounds were off? That would be a shame, for them to go through so much torture, lose 400 lbs, and then gain it back because they have no idea how to eat.

eh... to each their own.

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Old 02-13-2011, 12:32 PM   #8
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It's funny. I don't think the article discusses the link between obesity and victims.

I think the study is more about how physicians don't understand the underlying reasons for obesity and treating patients as though they have a disease glosses over the fact that there may be psychological reasons for being overweight.

In the case of the woman who gained weight after her parents' divorce, I would never say she was a "victim", she simply had an experience that she couldn't resolve emotionally and turned to food to fix it.

But I do think that it's important to recognize that sometimes there are psychological reasons for why people are overweight and those reasons have to be addressed because weight-loss efforts will fail. That's important because so many people wonder why they lose weight and then regain it or why they sabotage themselves and recognizing there's more than just calories in/calories out is important.
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Old 02-13-2011, 04:02 PM   #9
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Yes, I agree that it's important to recognize that sometimes there are psychological reasons for weight issues (not just gain, but drastic and unhealthy losses as well). But the key word there is "sometimes." Maybe it was just poor writing, but the article seemed to imply strongly that any weight excess was a sign of some kind of psychological trauma, and there just is no evidence to suggest that. There was no scientific rigor to their findings.

I'm sure that most of us know there's a psychological component to weight loss as well. If it were as easy as putting down the fork, we'd all be swanning about in size 6 bodies. My disagreement is with the article's implication that distress of some sort is the "cause" of obesity. Obesity doesn't have a single simple cause, and for some people who are pushing an extremely radical diet to proclaim that they've found the root cause of which obesity is a symptom makes me extremely distrustful of that claim.

If you eat a hundred calories more than you need each day, you'll be gaining about ten pounds a year. How easy is that to do without consciously realizing it? Are people who have that kind of weight creep psychologically damaged? How about people who had a more drastic weight gain due to a lifestyle change--going from an active job to a sedentary one, for instance? I gained sixty pounds in a year that way. Trauma? Nope, I just kept eating like I ate when I was constantly on my feet nd whaddaya know, I got fat.

If you poke around in anyone's background, you're going to find pain. It's disingenuous to look at a select subset of the population and uncover their pain, then suggest that they're in that select subset because of it. There are many other people whose weight is unrelated to their pain, though. Yo-yo dieting that adds an extra ten or twenty pounds after each post-diet gain, gaining because of enforced inactivity like injury or a different line of work, even moving to a new place where the food is really awesome can pack on pounds (the Saints' defensive coordinator gained 80 pounds just from moving to New Orleans--yes, the food is that good).

It's bad enough to be saddled with others' assumptions about weight (I'm lazy, I have no willpower, I'm just a heedless slob, blah blah blah). Now according to these diet-drink shills, I'm also too psychologically fragile to handle the problems everyone faces without eating constantly like a big dumb ungulate. Grr, I just find that insulting--not just personally, but for everyone who's had an easier time gaining it than losing it throughout their lives.

Until they take a more rigorous, controlled approach to their research, I'm going to consider that article about as meaningful as a story in "Cosmopolitan" about the connection between how you apply your lipstick and your major personality traits.
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Old 02-13-2011, 04:19 PM   #10
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Quote:
Originally Posted by LightRaven View Post
Anyways- I'm actually kinda torn about the merits of this study (for lack of a better word) In one hand, I can see the need for an individual to lose weight rapidly when one is 400 lbs overweight. There are many health risks involved.

I actually strongly disagree with this. I think the assumption that extremely morbidly obese need to lose rapidly is hooey. I think it's more based on our extreme fear/hatred of fat than reality. Even doctors are under the assumption that fat especially extreme fat is a fate so much worse than death, that risks don't matter. I think the thought is, We need to get that disgusting stuff off you as fast as possible and if it happens to kill you, eh well it's better than living fat right?


Surely being dead is better than being fat. I think that's really the point. Rapid weight loss is risky, and the larger you are, the greater the risks, but even among doctors, very few are willing to suggest slow to moderate weight loss to extremely obese patients, because it's also assumed that slow weight loss is demotivating or impossible. And because we all see it as demotivating and impossible, it becomes a self-fulfilling prophecy. Slow weight loss is failure. If you're losing slow, you suck, you might as well be gaining.

Slow weight loss isn't seen as admirable or remarkable. Try marketing (heck try finding) a slow weight loss book and see how far you get.

I don't think it's the physical risks that motivate doctors and patients to expect and push for rapid weight loss for uber-obese patients, I think it's all the "emotional risks." The impatience everyone has for slow progress. The ridicule and disappointment that slow weight loss inspires.

When I was complaining to my doctor a while back that I wasn't losing "at least 2 lbs a week like normal people," he told me that my assumptions about normal people were wrong (he said "where did you hear that crap - normal people don't lose 2 lbs a week, because normal people give up and lose nothing).

Great doctor, but I've never had a doctor like him before. Either they avoided the subject of weight altogether or they were extremely unimpressed with anything but rocket-fast weight loss. Even a slow month after losing rapidly was pointed out as "what went wrong this month you only lost 5 lbs instead of the 10 you lost last month." That chronic disaproval of anything but rocket-fast weight loss takes a toll on a person. I never gave slow and steady weight loss a try, probably because I neve knew anyone who had. It was all or nothing.

It took a real paradigm shift for me to realize that slow weight loss was not poor weight loss (which is a good thing, because I no longer, even on starvation calories can pull the rapid weight loss that I did in my 20's. Now it's slow weight loss or no weight loss. I'll take the slow weight loss and be happy for it).
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Old 02-13-2011, 04:58 PM   #11
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Quote:
Originally Posted by Nola Celeste
If you poke around in anyone's background, you're going to find pain. It's disingenuous to look at a select subset of the population and uncover their pain, then suggest that they're in that select subset because of it.
I think that's an excellent point!

As for the article. I didn't read it word for word, but as someone who reads a lot of peer-reviewed journal articles in the field of psychology, this didn't really read like one to me. It seemed to be research done to validate a particular program, period.

Best as I can tell, the program being described is run by "the Southern California Permanente Medical Group" which I assume is part of the Kaiser Permanente group, in whose journal the article appears. So, it may call itself a peer-reviewed journal, but it's a jorunal run by the group that is linked to the research...
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Old 02-13-2011, 05:19 PM   #12
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This is in response to the OP's thread title:

Quote:
The striking and frankly annoying conflict between our ability quickly and safely to reduce a personís weight and what patients appeared capable of tolerating emotionally led us to detailed exploration of the life histories of 286 of our patients. Here, we unexpectedly discovered that histories of childhood sexual abuse were common, as were histories of growing up in markedly dysfunctional households. It became evident that traumatic life experiences during childhood and adolescence were far more common in an obese population than was comfortably recognized.
My interpretation would be that the abused were more tolerant of the abusive (?) starvation diet than others and therefore successful in the weight loss effort.

Am I wrong?
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Old 02-13-2011, 06:09 PM   #13
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You know, I hadn't even thought of that, but you're right, DixC. The population they studied was a self-selected one. People who could tolerate that very difficult plan were those who had already weathered great difficulties previously.

It's kind of astonishing to me that the proponents of this "perfectly safe" supplemented absolute fasting plan don't sufficiently acknowledge that anyone would find such a program incredibly challenging emotionally and mentally regardless of their initial emotional and mental state. They mention that after massive weight loss following their program, the people involved had issues with "divorce, anxiety, and sometimes suicidality." They go on to assume that some people "fled their own success" with the program.

How could these people go home and enjoy eating a meal and not realize that denying oneself that basic biological drive for months at a time would cause relationship problems, anxiety, and depression? We have teeth and a tongue and digestive enzymes and all that good stuff for a reason: we're built to eat. Any plan that doesn't acknowledge that is going to be unsustainable at best, unbearable at worst.

But because they're convinced of the rightness of the program, people couldn't be fleeing a program of months-long misery; no, they were "fleeing their own success." Hogwash, poppycock, stuff and nonsense!

Now that I think about it that way, it's yet another example of people in the diet business telling those who haven't lost weight with their "miracle plan" that the fault lies within them; it's dieters' their emotionally fragile states or fear of success, not with the almighty Plan which is the best thing ever created.

I spent so many years believing that I failed at diets, not that most diets failed me. It's sad to think that people who did this extreme plan and broke over or regained after their loss would feel that they'd "failed" again when the plan itself runs counter to millions of years of evolution.
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Old 02-13-2011, 11:21 PM   #14
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For many years I believed the notion that severely obese people almost had to (by definition) be messed up. I think I went into psychology to figure myself out.

I had one counselor suggest that it was "abandonment" issues that were behind my weight, another than I must have repressed memories of sexual abuse (this was when repressed memories of sexual abuse was a very common theory. THen a few years later it was learned that well-intentioned therapists were actually creating false memories in clients, even resulting in innocent parents being sent to prison based on the testimony of the patient and counselor).


I still believe strongly that counseling can help, but I've also learned that I wasn't nearly the basket case everyone, including me assumed.

I learned that high-carb eating actually fuels and creates emotional issues.
Eating junk actually makes me crazy. What I mean is that the better I eat, the fewer mental and physical health issues I have. I actually become less emotional and more in control of my emotions when I eat healthier.

Whenever I ate comfort food in the past, I thought I was doing it to medicate problems. As it turns out it didn't medicate the problem nearly as effectively as it made the problem worse and bigger. Eating carbs for me are like alcohol, drugs, and other "addiction-like" behavors for many people. The behavior/substance seems to solve the problem in the short term, but it only magnifies it in the long term.

Eating a whole food, moderately low-carb diet does much more for my mental health than counseling ever did.

I think obesity is physiological far more often than it is psychological. I didn't always believe that, but I believe it now, and I realize I spent decades trying to solve a problem I didn't have (except as a result of an entirely different problem, a problem I never tried to solve because I didn't know I had it).

I really believed the "a calorie is a calorie" theory to the point that I didn't think what I ate was important. I experimented with different diets, but I never really seriously attempted lower carb eating, because I believed the majority opinion that it was unhealthy and even potentially dangerous. I never would have found success if I had kept looking for it in the wrong place.
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