Psychogenic overeating – the disorder of food behavior which is shown uncontrolled absorption of a large number of food against the background of a stress. Is a multifactorial disease, it can be provoked by accidents, surgeries, a divorce, loss of the loved one, problems in the relations and negative emotions. The psychogenic overeating is followed by a set of excessive weight. The main symptom are gluttony episodes during which the patient accepts a large number of food in the absence of feeling of hunger. Episodes come to the end with sense of guilt or shame. The diagnosis is established on the basis of a conversation with the patient. Treatment – psychotherapy, a diet, in some cases pharmacotherapy.
Psychogenic overeating (compulsive overeating, gluttony, giperfagichesky reaction to a stress) – violation of food behavior, uncontrolled reception of a large number of food in stressful situations. Is a mental disorder, along with anorexia and bulimia enters into group of frustration of meal. Expressiveness of a psychogenic overeating can significantly differ – from separate episodes of a moderate overeating to the regular impulsive gluttony adjoining on bulimia. Unlike bulimia and anorexia the psychogenic overeating is not followed by reception emetic and laxative, the intensive physical activities and other actions designed to eliminate consequences of attacks. Treatment of this pathology is performed by experts in the field of clinical psychology and psychotherapy.
Reasons of development of a psychogenic overeating
Experts allocate three groups of the factors promoting development of a psychogenic overeating: biological, psychological and social. As the major biological factor consider hereditary predisposition. Now three genes which are responsible for a set of excessive weight as a result of systematic reception of a large number of food are revealed and increase probability of development of a psychogenic overeating.
GAD2 stimulates production of gamma aminooleic acid in a brain. Reacting with Y neuropeptid, gamma aminooleic acid stimulates appetite therefore carriers of more active form of this gene have a tendency to an overeating. The gene of Taq1A1 "is responsible" for the low level of a dopamine. Carriers of this gene slowly make decisions, feel saturation later, feel pleasure from meal later. The gene of FTO causes tendency to excessive weight and an overeating even in the absence of feeling of hunger. In development of a psychogenic overeating hereditarily the caused features of character and the personality and existence of predisposition to some mental disorders (depressions, disturbing frustration) also have a certain value.
Inability to cope with the unpleasant emotions caused by the internal conflicts or external adverse circumstances is the main psychological reason for development of a psychogenic overeating. Such emotions as fear, alarm, wine, offense or feeling of own powerlessness and impossibility to change a situation become a direct incentive to the use of a large number of food. The patients suffering from a psychogenic overeating often have the underestimated self-assessment, feel defective, incapable to meet expectations of people around.
In the childhood patients with a psychogenic overeating quite often suffered from the conflicts in a family, problem education or difficult relations with significant adults. Many patients since the childhood got used "to jam" negative emotions as they did not get sufficient emotional support from parents. In emergence of a psychogenic overeating the eating habits got since the childhood have a certain value, in particular – a habit to eat a lot of greasy and sweet food, to use big plates, to eat food in the absence of feeling of hunger "for the company" or "because it is necessary". Similar stereotypes of food behavior break ability of a brain to control feeling of saturation and with other risk factors increase probability of development of a psychogenic overeating.
One more significant factor is social pressure. The symmetry cult reigns in modern society. Lack of excess weight quite often is considered as the main sign of female beauty. It aggravates feeling of own inferiority, wakes up sense of guilt and pushes patients with a psychogenic overeating to the use of food for elimination of negative emotions. The vicious circle is so formed. A set of various factors "feed" and supplement each other. Inability to adjust own eating habits involves continuous decrease in an emotional background and increase in level of uneasiness that, in turn, aggravates a problem of a psychogenic overeating even more.
Symptoms and consequences of a psychogenic overeating
Characteristic sign of a psychogenic overeating is absorption of a large number of food in the absence of feeling of hunger. Patients eat when they are nervous, feel offended, humiliated, helpless, guilty or disappointed. They jam bad mood, grief or boredom. The attack of a gluttony can proceed about two hours, at the same time patients lose ability to control amount of the eaten food and do not feel saturation. The episode comes to an end with feeling of the crowded stomach, sense of guilt, shame and disgust for itself. Regular reception of large numbers of food provokes a set of weight. Attempts to get rid of eaten are absent.
Violations of food behavior at a psychogenic overeating are shown only alone. In the presence of other people patients eat normal amount of food and do not experience special difficulties with control over quantity of eaten. Patients have constantly a bite during the day, postpone, hide or reserve food to eat it later when nobody sees. Attempts to regulate quantity and frequency of meals of strong-willed effort are inefficient. It becomes the reason of decrease in a self-assessment, disappointment in itself and feelings of helplessness.
The psychogenic overeating increases probability of emergence of a number of mental disorders and somatic diseases. Patients with this pathology suffer from a depression more often. Development of frustration of a disturbing range is possible. In certain cases, trying to cope with fault, shame and helplessness, patients begin to take alcohol and soothing medicines that can lead to development of alcoholism or dependence on medicinal substances. Because of a set of weight at a psychogenic overeating the risk of development of a hypertension, diabetes, coxarthrosis, a gonartroz, a zhelchekamenny disease and some other diseases increases.
Diagnostics and treatment of a psychogenic overeating
The diagnosis is established on the basis of a conversation with the patient. Differential diagnostics is carried out with the obesity which is a consequence of long reception of antidepressants, neuroleptics and some other medicines. In the course of diagnostics of a psychogenic overeating exclude violations of mood and the mental disorders provoked by excessive weight, but not connected with pristupoobrazny loss of control over quantity of eaten. Among such frustration – the disturbing and depressive frustration which arose owing to experiences concerning loss of attractive appearance, change of the relations with people around, lack of the desirable results at observance of diets, etc.
The main method of treatment of a psychogenic overeating is the psychotherapy. Cognitive and behavioural therapy, interpersonal therapy and dialectic behavioural therapy is used. During cognitive and behavioural therapy the psychologist helps the patient to learn to reveal the thoughts provoking a psychological impulse to a gluttony attack. The patient has an opportunity to monitor communication between the emotional condition and episodes of an overeating, and then learns to interrupt this communication at the initial stage, using various receptions and technology of relaxation.
The main objective of interpersonal therapy at a psychogenic overeating is identification of problems in the interpersonal relations and elimination of these problems by improvement of communicative skills. This technique allows to reduce amount of negative emotions in the course of communication and, thereby, to minimize quantity of impulses to an overeating attack. Dialectic behavioural therapy represents a combination meditative the technician and methods of cognitive and behavioural therapy. During therapy of the patient a psychogenic overeating studies to control the emotions and to quickly eliminate stress consequences.
The individual psychotherapy is combined with occupations in group. During the group occupations patients learn to form a healthy diet, get support of people with the same problems and impart experience fight against a disease. The psychologists and psychotherapists specializing in treatment of a psychogenic overeating work in close cooperation with nutritionists. In the course of therapy work on change of a diet, establishment of the accurate schedule of meal etc. is carried out. In some cases the psychotherapy and a dietotherapy are supplemented with medicamentous therapy.
Sometimes at a psychogenic overeating use medicines for appetite suppression, however, scope of these medicines is limited because of heavy side effects. In the presence of disturbing and depressive frustration appoint antidepressants. Medicines of this group not only influence mood, but also reduce quantity of attacks of a gluttony. At the same time, antidepressants cannot be considered as the main way of treatment of a psychogenic overeating as cancellation of medicines without psychological support often involves a recurrence. The psychogenic overeating will usually well respond to treatment, the forecast favorable.