Sunday , January 24 2021

To lose weight, what happens in the head is as important as what is on the plate

Monitoring what you eat is far from enough to lose weight, say, a neuroscience researcher and an endocrinologist.

Fabien Dworkac, Ph.D., is a researcher in neuroscience and public policy at the National Institute of Health and Medical Research (Inserm). This article was written in collaboration with Lelia Bracco, an endocrinologist. He relies heavily on his book "Conversation" under a Creative Commons license. Read the original article.

Until 10 years ago, infectious diseases such as tuberculosis, HIV / AIDS and malaria were the largest public health problems in the world. But today there is another threat: non-communicable diseases, such as diabetes or cardiovascular diseases. This is currently a health emergency, both in high-income and low-income countries. However, only 2% of the total funding from international health partners is dedicated to combating these diseases.

To combat them, combating an obesity epidemic that is spreading across the globe is a priority.

The report is alarming: obesity is growing across the globe, affecting both rich and developing countries. In particular, childhood obesity is alarming in 2014, 41 million children under the age of 5 years who are overweight or obese. According to Gill Fumi, professor of geography at ESPE-Paris and author of the book Food geopolitics, "More than 1 billion people are overweight worldwide with a body mass index (BMI> 25) and at least 300 million people are obese (BMI> 30), and overweight and obesity 3 million deaths per year,

The consequences of these weight problems are worried because they cause many diseases that decrease life expectancy and lower the public health budget. These include not only metabolic diseases, such as diabetes, high blood pressure, high cholesterol, heart disease, and atherosclerosis, but also osteo-articular diseases, lung diseases, and an increase in the frequency of certain types of cancer.

Unfortunately, despite its commonplaceness, the problem of overweight remains without any real solution on a global scale because of its great complexity.Lelia Bracco and Fabien Dworkac

Indeed, obesity is due to very diverse social factors: excessive consumption, unhealthy foods, sedentary lifestyles, accelerated rates of urban life, stress, social isolation … These factors add genetic, neurohormonal and psychological factors, as well as phases of restrictions. bidirectionally to the central nervous system. This dialogue is especially reflected in the place occupied by the pleasure in eating. Pleasure awaits the brain, sensed feelings, in connection with the emotional environment, but also with memory, as evidenced by the famous anecdote prolust Proust.

Pleasure also allows hormonal modulation of feelings of appetite and satiety, which for each person depend on the sensitivity of brain areas involved in the reward and self-control system. This neurohormonal cascade, which is caused by a complex mixture of emotions, stress and diet, is unique to all. It is located at the intersection of genetic and epigenetic susceptibility, psychological parameters and personal environmental influences.

Understanding how these various factors influence oneself can help to better deal with obesity, in particular, avoiding the stigma associated with blame or negative judgments. Many people who want to lose weight actually experience psychological pain. However, anxiety, like the pleasure of eating, can stimulate food without real physiological need.

The detrimental effects of obesity on health are not limited to "physical" medical problems that require weight loss. Another consequence, regardless of the level of obesity, is mental suffering. The complexity of managing the latter is due to multiple reasons (multiple self-esteem disorders, obsessive thoughts …) as support. Mental suffering can, paradoxically, be exacerbated by the measures taken to lose weight, and therefore they should be treated regardless of nutritional issues.

In long-term nutritional monitoring, a sense of failure and guilt is omnipresent …Lelia Bracco and Fabien Dworkac

Managing obesity and overweight requires the elimination of many existing practices in the face of the recognized rejection of simple dietary advice. Today, since none of the approaches have shown strong efficacy, health authorities should remain attentive to the individual and offer full body care support, taking into account the contradictions of society. The latter pushes consumption, creates needs, desires … And, thus, besides, frustration and dependence. We are the happy victims of large surfaces with countless rays, filled with industrial products, with irresistible packaging, full of calories!

This industrialization of food has led to the enrichment of fat and sugar in order to improve palate pleasure and, consequently, increase sales. This is a major factor in diseases such as diabetes. These dietary changes have led to high-calorie foods in small amounts. This physiological regulatory ability is deceived by this industrial product. The feeling of fullness is based on the expansion of the stomach, which is interpreted as a signal that food needs have been met.

In addition, excessive food consumption leads to addiction to addiction. In addition, already undernourished by food, our physiological balance also has to adapt to changes associated with the modern lifestyle, more sedentary.

It is easy to assume that the emergence of obesity in the country correlates with the level of economic and industrial development. This favors urbanization and primarily affects disadvantaged social classes. Therefore, at the economic level, the question arises of finding a complex balance between profits related to agribusiness sector profits and mass distribution, as well as losses caused by the exponential increase in health care costs caused by obesity and degradation of nutrition quality.

At the moment, to lose weight, the most effective solution is gastric surgery (bariatric surgery). Given its intrusive and irreversible nature, it remains restrained for severe or complex obesity. Therefore, weight changes and lifestyle changes, such as struggling with a sedentary lifestyle, are necessary for weight loss.

Easier said than done: after they followed a lot of medical, social or friendly advice and made a long hard work, struggle, loss of control and self-confidence, many people end up cracking and giving way to a paradoxical increase in food intake and weight . Lelia Bracco and Fabien Dworkac

To avoid a deadlock, understanding the vicious circles that lead to this resistance to weight loss is important. This requires the study of both neurobiological and psychological plan.

A person suffering from obesity in itself is not an unexpected resource. A new understanding of the ability of the brain to remodel involves the possibility of changing habits and a favorable transformation at any age.

And for those who want to live with excess weight, then the question of free will and the opportunity for everyone to live differently.Conversation

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