to think that in the future obesity will be a mental illness

[postitgirl]

ok , bear with me....
I've been watching a few programmes about anorexia, I don't know why, they've just 'popped up' on netflix and amazon, and it's so interesting how even though people with anorexia are literally starving themselves, they still don't eat. So I started thinking, I've been trying to lose weight for years and year and years, and it's so bloody hard, because there is a thing in my brain that equates pleasure with over-eating crap. I go on a diet, and my willpower lasts for a few days, if I'm lucky, and then this overwhelming urge to break the diet, to binge, to eat chocolate and all the bad things, not just a small square of chocolate, like a bar, plus ice-cream etc etc. Any of us who struggle know what i'ts like. And it's getting worse as I get older. I'm becoming more attached to that feeling of 'release' when I do overeat... I'ts like a stress reliever to my brain - I'm suddenly a nicer person to my kids, I feel chilled, I feel satisfied, I feel happy, but of course i'ts a vicious cycle of self-hatred etc etc.
So it just occurred to me that in the future, maybe the treatment for obesity will be similar to that of anorexia, with the blame being taken out of the equation, that it will be treated literally as a mental disease - a disease where your mind is taken over, in a similar way to the way anorexia takes over. just the way some of the young girls were talking about how it was the "anorexia talking" even thuogh they knew they were making themselves ill, and could even die, the anorexia wouldn't let them eat.
Just as someone who has struggled mentally with my weight for all these years - i'ts like the "fat" talking. Cos when I'm "sane" of course I want to stop doing it, I want to get fit, and slim etc etc. And I know what I should be eating and what I shouldnt I could probably get a degree in nutrition at this stage I've done so much research on what I should eat and not eat.
What do you all think - can anyone relate.

@DazzlePaintedBattlePants

I don’t disagree that there are some (many?) people for whom obesity has its roots in mental ill health, but I reckon there are far more people for whom being overweight is just a direct consequence of it being so damn easy to consume more calories than you need. Not everything is a mental health issue.

Morning break used to be a cup of tea and a biscuit, now it’s a latte and a croissant. Lifestyles have changed so much since the 1970s and it’s never been easier to eat crap and be as inactive as possible. Hell, you don’t even have to walk to the chippie, Just Eat will deliver your junk food to your front door.

I do think you're right. Lots of people are overweight because it has never been easier to be overweight (or harder not to be), especially in cultures like ours.

I do also think that obesity can be caused by mental illness - as I said upthread I was diagnosed with BED, I eat compulsively and excessively. For me it's not making the unhealthy choice at lunchtime every day because Maccies is easier than making a salad, it's eating 4 packets of biscuits in the evening because sugar gives my brain a tiny dopamine hit and then the resulting shame and self-hatred leads me into a spiral of eating more to make me feel 'good' that lasts about as long as the mouthful does.

It's a bit like how recurrent headaches could be because you're always forgetting to drink enough water or it could be a symptom of a serious illness - the outcome looks the same on the surface, but the cause is very different.

This debate reminds me very much of the opioid debate in the States. Is the epidemic of addiction caused by the influx of easily obtainable drugs or the wide-open arms of the users that welcome it? Surely living in a healthy society based on community and connection is a great preventative to addiction in a population? This is what I believe. You need the drugs (ultraprocessed food) to satiate the desire (to feel good) but ultimately with no desire the drugs are harmless.

Whilst I think there’s a huge psychological element, I think it’s more than that.

I say this because previous generations have endured much greater trauma than us yet largely remained slim. For example, think how many women lost partners/sons/brothers/fathers in the world wars. How many men experienced the horrors of trench warfare. Feet rotting off from trench foot whilst mortars exploded around them, and having to scoop up the flesh and dismembered limbs of their friends. And that’s before we even get to the blackout and bombing raids - pretty bad even without all the above if you reflect on how our society has reacted to lockdown etc.

And then there’s the aftermath. Men coming home a shadow of their former selves with PTSD and their partners having to live with this. All this trauma and yet they didn’t turn to the bakery/sweet shop for relief. I think a lot has to do the availability of crap food, the normalisation of fatness, and hugely reduced physical activity. I say this as somebody with ADHD who can eat shedloads and was almost obese before I took up lifting weights 3x a week and tracking calories.

I don't think its necessarily true.
Obesity isn't just a mental health issue, it's also a by-product of food industry, advertising and more.
How come an orange juice is considered healthy when its nothing but sugar?
How come food industry get away by claiming that cereals are perfectly suitable for a breakfast?

A lot of kids are overweight now, not because of mental health, but because of processed food laced with sugar, and constant snacking culture.

We can't just shrug it off by saying "ha...that's poor mental health".

I think the problem with things like OA is that many people lack the emotionally literacy / are unable to talk honestly about their eating habits. Weight and food intake has become so tied up in moral concepts of greed, laziness, selfishness.
If alcoholics and drug addicts are able to manage to lay it all out among similar people who have an understanding of their situation, there is no shame in aa/na/oa only support.
Your post would put people off and unless they can afford private rehabilitation and one 2 one therapy its the best option.
I think it is an addiction, addiction brings on mh issues.
No-one with a peaceful happy mind self harms through substance destroying their loved ones.
Doctors should be referring patients to support groups that deal with the willpower and emotional side not low calorie diets.
If you're an addict you're an addict whatever the vice.

People do know OA is a nutty evangelical Christian organisation don’t they!?

@fat13

People do know OA is a nutty evangelical Christian organisation don’t they!?

I do yes

Agree with morbid obesity.

I guess it is on a scale. Anorexia is extreme one end. Then within not mental illness but not being particularly healthy is constant crash diets, going to extreme lengths to stay thin and being controlling with food- which to be honest is a lot of people. Similarly, being overweight, binge eating a bit, not having great self control etc is not healthy but uncontrollably binging, waking in the night to eat, not being able to stop at any cost is mental illness.

Just like full blown depression vs negative thinking, being down and not helping yourself in anyway and unhealthy habits which don't help your mind. One is Illness and one is unhealthy.

People do know OA is a nutty evangelical Christian organisation don’t they!?
I'm sure there are non religious groups- I'm not religious at all I attended NA there was no holy/moly stuff, I assumed there would be, it put me off joining for ages.

I completely agree.

As a teen, I had anorexic and bulimia. As an adult, I'm overweight. The root of all of this is the same - childhood trauma.

And the prevalence of unhealthy foods exacerbates it.

@babyblues21 I disagree - while body dysmorphia is a feature of anorexia it’s not the core or the cause

It's a combination of things rather than a mental illness I think: a hormonal unbalance, a gut flora unbalance and an ultra processed western diet. Things like binge eating are in the realms of mental illness for sure (and not all people who binge eat are obese), but there are various reasons why people become and stay obese which differs from person to person. As pp have said good books on this matter are The Obesity Code and Why We Eat (too much).

Biochemical/epigenetics. I think methylation plays a big role actually. Not many people know enough about it.

@therocinante

I agree. There's been some movement on e.g. sugar addiction and binge eating disorder being more widely recognised, but overeating is still seen as a lack of self control rather than an illness.

I was diagnosed with binge eating disorder a couple of years ago at the same time as being diagnosed with ADHD. I've not told anyone about the BED because so few people believe it's a real disorder.

A few years ago I needed to look up the statistics on BED and similar eating disorders. I was shocked that I must know so many people who are living with this and yet the stigma is so great that I'd no idea it's as common as it is.

I think dopamine and MH issues are a big factor here, but I’m also wary of it becoming regarded as an illness as many people undoubtedly just eat too much and it’s too easy just to write it off as something beyond their control. Losing weight isn’t easy for most and does require a lot of willpower, especially once bad habits have been formed.

I would agree with everyone on here who has said that obesity needs to be treated as a comorbid health problem. It has so many physical problems that need managing, but a lot of it either stems from MH problems or the obesity itself has created MH problems. I would also add that education about nutrition and health needs to be thrown into the mix as well, as a lot of this involves “family culture”, too. There is so much to unpack that you can’t tie it all up in one basket. (I can say this from experience - I have lost 65kg and maintained it. It involved a very integrated approach, and I had to sort all that out myself.)

I agree it is a combination factor with overeating. Of course the problem is you can't completely stop the addiction of eating like you would be able to eventually completely stop taking drugs/drinking alcohol/smoking because you still need food to live.

babyblues21 I took take issue with the assumption that Anorexia is due to body image. I get so tired of this assumption.

Also eating disorders take many forms as outlined by BEAT.

www.beateatingdisorders.org.uk/types

Binge eating, bulimia and OSFED are just as big concerns but I guess urgency is less because death comes a lot slower if at all if not treated. Unlike Anorexia. Funds are very limited.

ChubbyLittleManInACampervan

Sorry but you are wrong re other eating disorders not bring deserving of psychiatric intervention.

I speak as somebody with an anorexic child who has been hospitalised several times and another who binge eats. The latter exacerbates his mental health, is tied up with it and a huge concern. They are both receiving psychiatry and therapy.

I agree. Addiction to food is probably the worst type of addiction, because there is absolutely no getting away from it. You can't completely cut it out of your life like alcohol, drugs, gambling etc. You need the stuff to live. Also most people don't help when you are dieting. We have a few drug addicts in the family, I don't offer them some smack when I see them, but if your on a diet people don't see it as important, and tent to encourage you to eat the things you shouldn't.

Tend, not tent.

Obesity is a complex problem that can't be classified simply as a mental health issue any more than it can be called simply a metabolic issue or anything else. It's a combination and each person with obesity will have a different balance of factors.

I was obese for years. I've been not-obese (bit still overweight and gradually losing more) for about the last 9 months.

Reading about the gut-bacteria biome is very interesting - your gut bacteria are genetically not "you" at all but they control your hunger impulses and the gut bacteria of naturally slim people are measurably different from the bacteria of obese people. There has been some research on giving gut-bacteria transplants to try to reset the metabolism but I don't think that work has reached a point of having a proven treatment pathway yet.

The "affluenza" thing is also an issue. A twinge of peckishness which evolutionarily would be "intended" to prompt an individual to go out hunting or on a foraging expedition to spend a couple of hours being active in search of a meal, is instead instantly sated with a bag of crisps. Learning to be ok with being "a bit peckish" for a couple of hours before eating was the biggest factor in being able to lose weight and it really wasn't easy to achieve that as I had serious mental issues with tolerating that sensation without replacing it with an actual self-harming urge due to the stress of resisting the call to snack.

Even if it is a "self discipline" issue, impulse control and executive function can often be part of a wider issue with a broader diagnosis like ADHD.

Yanbu OP.

You can’t compare war time trauma to today, they had no food, it was rationed and scarce and personally I think that’s where it began. My mother grew up on rationed food and scarcity, in relative poverty. She was always slim then as there was nothing bad to over eat. She had a lot of trauma (abusive marriage) and turned to food and is obese. I am also obese because I grew up around her sugar addiction, an abusive father and didn’t learn self coping methods. I’ve had lots of counselling and CBT and over eating isn’t seen as self harming in the same way, yet I am still doing it.

I am trying to lose weight now and it is so hard I feel set up to fail sometimes. You can’t eat out. The shops are absolutely laden with false advertising - no wonder people who are less literate than me struggle because half of Tesco’s is full of sugary ‘healthy’ bars (KIND, belvita, raw bars, protein things) which you have to read and inspect to understand nutrition labels correctly which not everyone does. There is now even diet ice cream which leads people into over eating when trying to eat low calorie it’s capitalising. Every time I’ve been to slimming world they have tried to flog you sugary bars as meal replacements (Hifi bars) and most women there live on them and muller lights! Even diet ‘aids’ are not really out to help you!
I’m obese and at a hospital appointment I was expecting to be told I was too fat, they weighed me and said ‘oh that’s ok’ here have some ice cream for your hospital dinner

FYI your gut biome is different because you treat it badly. I have ‘IBS’. When I cut out sugar I can go to the toilet properly, often daily. When I eat a lot of sugar I can’t go for 2 weeks then have explosive D that lasts a whole day!

Lots of people can have lots of opinions but usually people who are obese will tell you that they feel mentally unwell, depressed, anxious and like they are self harming. They will beat themselves up for what they eat, eat for comfort etc. So you can’t just post it’s not mental illness when lots of people are telling you that it’s not just their hormones

Oh I think that's so simplistic OP,YABU .

It's a multi-facetted issues, as so many.
Undoubtedly, eating creating things can have a calming and comforting effect.

However, there are people who stuff themselves with shit food, shop bought cakes and god knows what and are stick thin, that's genes.

Other people have always been slim, not thin but after having children their hormones take a hit and they never get back to what they were, no matter how sensibly they eat.

Different ethnicities have different body types and some put on weight more easily in less hideable places.

Food is also a cultural thing, not just individual and don't get me started with the disgusting food design from food manufacturers who want people to get hooked.

When people go through a stressful period, it's a good idea to use to food to comfort yourself every now and then, it's not crack cocaine just a home made cake.

The way you phrase puts blame on the individual and sounds quite self loathing.

Obesity is multi-facetted. Unless poverty, too is a mental illness?

28% of British population is obese, not 2/3, says Google.

I've been flamed on MN for saying that many maybe most obese people basically have a mental illness. Be careful what you say -- some people strongly do not want to hear this. They find it deeply offensive. There is much more stigma when deemed mentally unwell than being simply fat, I guess.

re only 3.6% of Japanese rarely being obese: they have different prevalences of other mental illnesses, don't they. Agoraphobia, computer game addiction, Overwork, anxiety, etc.