Scrubs
Minimizer
Doctor
Doctor
Doctor

Habitual and Psychological

Eating habits

Kids are playing

Eating habits definitely play a major role in our daily calorie intake. Disregarding actual energy demand, often three square meals per day are eaten plus several snacks throughout the day; many times without an actual feeling of hunger. Very often these habits result from “conditioned behaviors”, in which time of day, for example, may trigger feelings of hunger and thus the urge to eat. Olfactory sensations may have the same effect. A habit of "giving oneself treats" or eating triggered by frustration or stress, having snacks while watching TV in the evening, or just eating out of boredom may be causes for increased calorie intake. The activity of eating itself may revolve around social interactions, getting together, and working off pent-up aggression stemming from a person’s personal life or business. Nutrition involves very complex behavioral patterns, where the boundaries of abnormality are at best blurred.

There is a distinction between malnutrition and actual eating disorders, which are defined as psychogenic disorders of eating behaviors and habits. 30 – 40% of adipose patients suffer from abnormal eating habits with psychological causes. While the first group mainly makes mistakes like eating too fast without fully chewing their food, eating meals which are too large, poorly selected nutritional combinations, or allowing their diurnal rhythm to become disturbed, e.g. for work-related reasons, a deviance in behavior can be documented in the eating disorders group. A summary of the most common eating disorders is shown in Table 6.

  Binge-eating
Uncontrolled ravenous eating attacks or compulsive eating where anything "edible" which is in reach is devoured (e.g. "cleaning out the fridge")
 
  Bulimie
Same as binge-eating, except that after "eating-attacks" deliberate vomiting is induced. Often combined with anorexia, thus patients are mostly very thin.
 
  Night-eating
Ravenous eating attacks at night where the patient will get up at night to eat, often with subsequent diminished daytime appetite.
 
  Stress-eating
Attempt to solve personal conflicts (problems at work, relationship, etc.) by eating.
 
Tab.6: Eating disorders

Psyche

When analyzing adipose patients there are no specific personality characteristics which distinguish them from people of a normal weight. Thus obesity cannot be defined as an addiction. The progressively aggravated personality disorders observed during a developing morbid adiposity are usually not a cause of, but rather are caused by the patients obesity. Damaged self esteem, auto-aggressive behavior due to an unfavorable view of the body, damage to interpersonal relations, work-related problems and reduced mobility often cause these patients to become isolated, which continuously contributes to this vicious circle. In adipose and especially morbid adipose patients, no increased occurrence of mental illness (dysthymia, schizophrenia) can be found.

The depressive disorders in these patients, who all too often appear happy within their social environment, disappear entirely or at least improve after weight-reduction due to successful surgical therapy, and should no longer reappear after 5 years. This has been documented recently in Sweden. Similarly to personality disorders, until recently mental illnesses were generally assumed to be a symptom and not a cause of excess weight. Once excess weight is reduced the mental disorder improves and symptoms can no longer be observed (Cadière,1994).