Saturday , October 16 2021

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

Monitoring what you eat is far from enough to lose weight, says a neuroscientist and endocrinologist.

Fabien Dworczak, PhD, is a researcher in neuroscience and public policy at the Institute of Health and National Medical Research (Inserm). This article was written together with Lélia Bracco, Endocrinologist. He is very interested in his book, The 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 biggest public health problems in the entire world. But today another threat arises: non-communicable diseases, such as diabetes or cardiovascular disease. Now it is a health emergency, both in high-income countries and low-income countries. However, only 2% of the total funds allocated by international health partners are aimed at combating these diseases.

To fight them, the war against the obesity epidemic that spreads across the planet is a priority.

The report is alarming: obesity is increasing across the planet, affecting rich and developing countries. Childhood obesity, in particular, is growing alarmingly, in 2014, 41 million children under 5 years were overweight or obese. According to Gilles Fumey, professor of geography at ESPE-Paris and author of this book Food geopolitics. "More than 1 billion overweight people worldwide with a body mass index (BMI> 25) and at least 300 million people are obese (BMI> 30), and overweight and obesity cause 3 million deaths every year..

The impact of this severe problem is worrying because they cause many diseases that reduce life expectancy and burden the public health budget. This is not only a metabolic disease, such as diabetes, high blood pressure, high cholesterol, heart disease and atherosclerosis, but also osteo-articular disease, lung disease and increased frequency. certain cancers.

Unfortunately, despite the banality, the problem of overweight remains without real solutions on a global scale, due to its enormous complexity.Lélia Bracco and Fabien Dworczak

Indeed, obesity results are from very heterogeneous social factors: excessive consumption, fast food, sedentary lifestyles, increased speed of urban life, stress, social exclusion … For these factors genetic, neurohormonal and psychological factors are added, but also the limitation phase. bi-directional to the central nervous system. This dialogue is mainly reflected in the place occupied by food pleasure. Enjoyment is anticipated by the brain, felt by the senses, in relation to the emotional environment, but also with memory, as illustrated by the famous anecdote from Madeleine Proust.

Enjoyment also allows hormonal modulation of sensations of appetite and satiety, which depend, for each individual, the sensitivity of the area of ​​the brain involved in the system of reward and self-control. This neurohormonal cascade, which comes from a complex mixture of emotions, stress and diet, is unique to everyone. This is at the intersection of genetic and epigenetic vulnerability, psychological parameters and the influence of the personal environment.

Understanding how these factors affect yourself can help fight obesity better, especially by avoiding the stigma attached to guilt or negative judgment. Many people who want to lose weight are, in fact, in psychological pain. However, anxiety, like the pleasure of eating, can encourage food without real physiological needs.

The dangerous consequences of obesity on health are not limited to "physical" medical problems, which need weight reduction. Another consequence, independent of the level of satiety, is psychological suffering. The complexity of the second management occurs for many reasons, many (disruption of self-esteem, obsessive thoughts …), as support. Psychological suffering can, paradoxically, be exacerbated by the steps taken to lose weight and must therefore be treated independently of nutritional problems.

In long-term nutritional monitoring, feelings of failure and guilt are everywhere …Lélia Bracco and Fabien Dworczak

The management of obesity and being overweight requires many practices that are not recorded today in the face of recognized failures from simple dietary advice. Until now, because there was no approach that showed lasting effectiveness, health authorities must continue to pay attention to individuals and offer comprehensive body-mind support, taking into account the contradictions of society. The latter puts forward consumption, creates needs, desires … And thus, by, the same frustration and dependence. We are happy victims of a large surface with countless rays full of industrial food, with unbearable packaging, full of calories!

Industrialization of this food has resulted in enrichment of fat and sugar, to increase the enjoyment of the ceiling and, therefore, increase sales. This is a major factor in diseases such as diabetes. This change in diet has produced foods with high levels of calories in small volumes. Our physiological regulatory capacity is deceived by this industrial food. The feeling of fullness lies in gastric dilatation, which is interpreted as a signal that food needs have been fulfilled.

In addition, excessive food intake causes addictive behavior. In addition, nutritional deficiencies by nutrition, our physiological balance must also adapt to changes due to modern, more sedentary lifestyles.

It is not trivial that the emergence of obesity in a country correlates with the level of economic development and industry. This is favored by urbanization and influences in the first place of disadvantaged social classes. At the economic level, because it is a question to find a difficult balance between profits associated with the benefits of the agribusiness sector and mass distribution and losses due to the exponential increase in health costs caused by obesity and degradation of nutritional quality.

At present, to lose weight, the most effective solution is stomach surgery (bariatric surgery). Given its disturbing and irreversible nature, it is still provided for severe or complicated obesity. Changes in diet and lifestyle changes, such as the fight against lifestyle, are therefore important for reducing weight.

It's easier said than done: after following a lot of medical, community, or friendly advice, and having made difficult efforts for a long time, struggle, losing control and confidence, many people finally "cracked", and gave up on increasing food and weight paradoxical. Lélia Bracco and Fabien Dworczak

To avoid deadlock, understanding the vicious circle that causes rejection of weight loss is very important. This requires exploring both neurobiological and psychological plans.

Obese people have unexpected resources. New insights into the brain's ability to remodel show the possibility of changing habits and transforming them well at any age.

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

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