Friday , December 4 2020

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

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

Fabien Dvorcak is a research associate in the field of neuroscience and public policy at the National Institute of Health and Medical Research (Inserm). This article is co-written with Lilia Bravo, an endocrinologist. He pays special attention to his book "The Talk" under the Creative Commons license. Read the original article.

Until 10 years ago, infectious diseases such as tuberculosis, HIV / AIDS and malaria are the greatest concerns for public health around the world. But today a new threat arises: non-communicable diseases such as diabetes or cardiovascular disease. These are emergencies for health, both in high-income and low-income countries. Only 2% of the total funding allocated by international health partners is dedicated to fighting these diseases.

To combat them, the fight against the obesity epidemic spread across the planet is a priority.

The report is worrying: Obesity is increasing everywhere across the planet, affecting both rich and developing countries. Childhood obesity, in particular, is alarming, and in 2014 41 million children under the age of 5 are overweight or obese. According to Gilles Fumie, Professor of Geography at ESPE-Paris and author of the book The geopolitics of food, "More than 1 billion people are overweight globally with a body mass index (BMI> 25) and at least 300 million people are overweight (BMI> 30), overweight and obese 3 million deaths each year,

The consequences of these weight problems are disturbing because they cause many diseases that reduce life expectancy and burden public health budgets. These are not only metabolic diseases such as diabetes, high blood pressure, high cholesterol, cardiovascular disease and atherosclerosis, but also osteoarthritis, pulmonary diseases and increased incidence of some cancers.

Unfortunately, despite its banality, the problem of overweight remains unrealistic in the world because of its great complexity.Lilia Bracco and Fabian Gorcek

In fact, obesity is the result of many different social factors: overconsumption, unhealthy food, sedentary lifestyles, accelerated rates of urban life, stress, social exclusion … These factors add genetic, neurohormonal and psychological factors but also phases of constraints . bi-directional to the central nervous system. This dialogue is particularly relevant to the place of pleasure of food. Pleasure is expected from the brain, sensed by the senses, in connection with the emotional environment, but also with memory, as illustrated by Proust's famous anecdote of the moon.

Pleasure also allows for hormonal modulation of appetite and saturation sensations that depend on each individual for the sensitivity of the brain regions involved in the reward system and self-control. This neurohormonal cascade, which stems from a complex mix of emotions, stress and diet, is unique to everyone. It is at the intersection of genetic and epigenetic sensitivity, psychological parameters and the personal influences of the environment.

Understanding the way these different factors affect themselves can help fight obesity better, especially by avoiding stigma related to guilt or negative judgments. Many people who want to lose weight are actually in mental pain. However, anxiety, like eating pleasure, can encourage food without a real physiological need.

The harmful effects of obesity on health are not limited to "physical" medical problems that require weight loss. Another consequence, regardless of the level of soreness, is mental suffering. The complexity of managing the latter comes as many causes, multiple (self-esteem, obsessive thoughts …) as his support. Mental illness can be paradoxically worsened by the measures taken to lose weight and should therefore be dealt with regardless of nutritional problems.

With long-term nutrition, the feeling of failure and guilt is ubiquitous …Lilia Bracco and Fabian Gorcek

Managing obesity and overweight requires the disclosure of many current practices in the face of the recognized failure of the ordinary nutrition council. Until now, since no approach has shown lasting effectiveness, health authorities need to continue to be attentive to the individual and offer comprehensive support for the body and the mind, taking into account the public's contradictions. The latter directs consumption, creates needs, desires … And thus, in the same way, disappointments and dependencies. We are the happy victims of large surfaces with countless rays filled with industrial foods, with irresistible packs full of calories!

This industrialization of food has led to fat and sugar enrichment in order to improve palate pleasure and hence increase sales. This is the main factor for diseases such as diabetes. These dietary changes have resulted in foods with high caloric levels in small volumes. Our physiological regulatory capacity is deceived by this industrial food. The feeling of completeness is due to stomach dilatation, which is interpreted as a signal that food needs are met.

In addition, excessive intake of food leads to addiction. In addition, already undernourished by eating, our physiological balance must adapt to the changes due to the modern lifestyle that is more sedentary.

It is not uncommon for the occurrence of obesity in a country to be related to the level of economic and industrial development. It benefits from urbanization and affects first and foremost disadvantaged social classes. At the economic level, therefore, is the question of finding a difficult balance between profits linked to agribusiness profits, mass distribution and losses due to the exponential increase in healthcare costs caused by obesity and deterioration in nutritional quality.

Currently, to lose weight, the most effective solution is gastric surgery (bariatric surgery). Given its intrusive and irreversible nature, it remains preserved for heavy or complex obesity. Therefore, food modification and lifestyle changes, such as the fight against sedentary lifestyles, are essential for weight loss.

Easier to say than to do: after having followed many medical, public, or friendly advice, and after a long period of hard effort, struggle, loss of control and self-esteem, many people eventually cracked and led to paradoxical increase in food intake and weight. Lilia Bracco and Fabian Gorcek

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

The person suffering from obesity has unsubstantiated resources on his own. New insights into the ability of the brain to remodel suggest the possibility of changing habits and favoring transformation at any age.

And for those who want to live overweight, then the question of free will and the opportunity for everyone to live in a different way.The conversation

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