In this episode of Talks with Health, I leave you an interview with Andrea Arroyo about obesity psychology . Andrea is a dietitian-nutritionist as well as a general health psychologist . She is a professor at the Open University of Catalonia among other entities. She coordinates the working group Eating Disorders and Psychological Treatment of Obesity of the College of Psychologists of Catalonia, in addition to being very active in the media and blogs. She specializes in psycho-nutrition, eating disorders and obesity. I am pleased to have Andrea on my team at the Júlia Farré Nutrition Center.
– Hello Andrea, thank you very much for giving us your time to do this interview
Thanks to you Júlia, it is a pleasure to be able to leave the consultation today to visit such a beautiful place and to be able to talk for a while.
Obesity beyond an energy balance problem
For many years obesity has been understood simply as a problem of energy expenditure . In other words, the energy balance was out of balance. A person ingests more calories than he spends and therefore gains weight and the solution lay in following a hypocaloric diet, combining it with physical exercise… Even so, there are many people who cannot lose weight, others who lose it and regain it again …
Is explaining obesity really as easy as an unbalanced energy balance? What do you think about it?
At first glance, it is not that simple by any means. The result of this balance that you named now between what we eat and what we spend, is not something so simple, obesity is something much more complex. In consultation and in our day to day we can observe that simply people’s intake depends on many factors and is the result of multiple interactions. It is not only what we eat but how we eat it , the trends we have as consumers, hormonal factors … It goes much further, that is, we cannot only reduce diet and exercise to remedy a problem as complex and as global as obesity is.
We cannot just reduce diet and exercise to remedy such a complex and global problem as obesity. #centrojuliafarre @aarroyof Click To Tweet
How can a person become obese?
We know that there is a genetic component that is present and can predetermine, also many biological factors that science has not yet delved into. Regardless of this, a person can become obese due to an interaction of multiple factors. In other words, obesity is considered a multifactorial and multicausal problem , therefore we must take into account all these factors that cause it to appear in a person’s life.
– What we are seeing is that obesity is increasing in all ages and in different links of society. Nutritionists dietitians tend to criticize the food industry a lot for the type of products they produce and promote.
Is the food industry really a major cause or should we also take individual responsibility for obesity?
I think it’s a hybrid between the two. We cannot be one hundred percent responsible for everything, since the context, advertising, entertainment, this entire food industry that every day focuses its efforts on us to buy these more processed and unhealthy products has a part of responsibility. It is often not easy to deal with all these stimuli that we encounter every day. There are also factors such as living in an urban environment that does not invite you to do physical activity or a work environment where they do not make it easy for you not to spend more than eight hours sitting.
What impediments on an emotional or psychological level does an obese person find that they cannot> lose weight?
This is something that we have discussed many times in our clinical sessions, exchanging opinions about all the patients we have. I would tell you that I find myself very hopeless. The fact of trying everything and not being able to do anything, is something that from psychology we call learned helplessness. Learned helplessness appears when you behave in a passive or indifferent way because according to you you have already tried everything or you believe and accept that you can no longer do anything or there is no remedy for your situation.
The learned helplessness appears when you behave in a passive or indifferent way because according to you you have already tried everything or that you believe and accept that you can no longer do anything or there is no remedy for your situation.
– Would they be the prototype of people who come to the nutrition or psychology consultation and say “Let’s see if you can lose weight”? As a professional responsibility is passed to you.
If what you mention is something we call Locus of Control. In other words, where is the control of your life, in your nutritionist or psychologist or in yourself? At this point we must return responsibility to the person , arguing what we can do for her, but also what she can do herself, who is at the helm of her life.– I would like you to tell me a little about the stigma of obesity .
– Well, let’s get to the most important thing
What solutions are there to treat obesity?
The reality is that we do not have a definitive solution, but this does not prevent us from taking action. In other words, with all the tools and knowledge that we have today, it is possible to work and get down to work. Health professionals must be very aware that there are many things that can be done and others that are beyond our control.
How do you approach the treatment of obesity from the psychological point of view?
From the psychonutrition we must make a good assessment of each case, collecting as much information as possible and above all taking into account specific aspects that are linked to the psychological context of obesity. We ask questions in aspects such as body dissatisfaction or possible eating disorders that appear. Also in the way in which they behave with food, if they have forbidden foods, if they do not have them. Questions about physical limitations or family are also important. From here, when you have an assessment of the case as complete as possible, you set yourself therapeutic goals.
What kind of therapeutic goals could they be, could you give me an example?
Well, for example, we often find ourselves with guilt feelings . People may feel guilty for having eaten a certain food, for skipping their diet or even with their body. These are very common and important points that in many cases end up becoming therapeutic targets. Work on guilt, acceptance of the body and negativity linked to the figure.
What would you say to another psychologist who is working with her team
Well, that they incorporate it, because we know that obesity needs this interdisciplinary team . Within each of its functions, there is the doctor, the endocrinologist, the dietitian-nutritionist, the personal trainer, but there must also be the health psychologist who is able to address this problem from a psychological point of view.
Obesity treatment needs an interdisciplinary team. Dietitian-nutritionist, personal trainer, endocrinologist and also a health psychologist.
– To finish
What would you say to those people who have obesity and do not see how to remedy their problem?
Don’t give up , just because someone tells you that it is a chronic problem. That they seek professional and specialized help. We are many professionals happy to help you, we work on this every day.
When an obese person loses weight, will he psychologically always have to maintain an internal fight against obesity?
It depends on the personal resources you have, it depends on the personal work you have done, the growth you have faced. Ultimately it depends on many factors that on a psychological and internal level he has faced. Often times when there is weight loss this also leads to body dissatisfaction. Each person is unique, so the case would have to be reassessed to see how this person is now facing his life from this new reality.
– Finally, I don’t know if you want to add any question that we have not discussed and that you would like to comment on.
I would like to end by emphasizing that people with obesity are not a simple number of weight. Despite the fact that in many contexts they insist on evaluating them based on their weight. I encourage you not to give up on them and to be much more resilient, as they are worth much more than a figure on the scale.