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.

@WindyWindsor

Being very underweight or overweight is not a mental illness or eating disorder in itself.

But these things can however be symptoms and complications from severe and untreated eating disorders. It also may not be caused by an eating disorder at all.

For example, anorexia is a mental illness, it's not being skeletal thin. Being very underweight is a complication of untreated severe anorexia.

There's a lot of ignorance around surrounding stuff like this even with doctors. If you're not very underweight then the treatment for anorexia is mostly non existent. Apparently the illness needs to leave you at deaths door before anyone will do anything about it.

I have a friend suffering from anorexia who is classed as obese. Some may say, well you can't be overweight and suffering from anorexia. Of course you can! She's disabled and is not able to exercise. She is plagued everyday by awful thoughts about her weight has in the past restricted food massively because of this. At some point she was living off water and one meal every other day and tracking her weight religiously. This is anorexia. And it took a giant fight for her to get therapy/treatment for it.

I agree completely that eating disorders, including binge eating, can lead to things like obesity. It's just beyond frustrating that you have to "look" like you have an eating disorder before people take it seriously. If only this could be recognised and treated earlier in life and not have to wait a decade before our bodies face the consequence of mental health issues.

In my opinion the whole attitude to EDs as a whole needs to change. This includes both those with EDs that lead them to lose weight and gain weight.

This is so true about BMI and Anorexia. But that's really in the UK. We had a different experience in another country where my DD was referred within weeks of developing anorexic behaviour, before she was even officially underweight. The longer you wait to intervene with anorexia, the harder the recovery. Our road was hard and long enough and it fills me with dread to think what would have happened if we'd have been in the UK dealing with GPs and CAMHS refusign to do anything based solely on BMI.

I don't doubt that mental health issues play a part for many obese people but I don't think it's the case for the majority. There's a lot of factors in play; a sedentary lifestyle, the convenience of cheap, processed food when you're very busy, aggressive marketing, lack of education etc. What's interesting is obesity rates vary a lot by area. When people talk about 2/3rds it sounds unbelievable. If I think of the parents I see at school drop off I think there's 1 overweight mum out of the 30 in DD's class.

@EmeraldShamrock

Anorexia isn't about food or losing weight to get slim if it a controlling disorder. Aneroxia is a loss of control when you can't get a grip on anything through MH issues food becomes your weapon. I was never fat before I was restricting food it was never about my weight. The warped power you now have over loved ones reinforced the need for this control eventually your stomach closes. It has similar secrets hiding your body shape. Comments on some teenagers weight won't cause aneroxia if they are otherwise NT. I know with my friend she just hasn't got motivation and loves takeaways and sugary foods, wine. She has a 3 y.o on reins because she can't keep up with her, It upsets her a lot but unless she makes a change it'll get harder.

Anorexia is a genetic biological brain disorder, triggered by weight loss for whatever reason.

By its nature, it's a controlling disorder but it is not caused by any lack of control in a person's life. My DD developed anorexia out of the blue, nothing to do with controlling her life. In fact, it causes you to be out of control and controlled by your disorder.

Cahms don’t rely on BMI. It’s in the NICE guidelines I think.My dd has been hospitalised several times and has a lot of support from cahms. Pretty much all they have to throw at it. Her BMI hasn’t ever been horrendous and they’ve carried on treating her whatever ever her wfh is.

What has been a far bigger issue is the lack of resources and expertise re autism. There is a link between autism and anorexia for a section of patients.

@babyblues21

*I took take issue with the assumption that Anorexia is due to body image. I get so tired of this assumption. * It's not an assumption, it's based on my many years of clinical experience working with individuals with mental illness. And a PhD.

Anorexia is reinforced by body images in society and makes recovery more difficult. It is not caused by them. Anorexia is a biological genetic disease. That is the latest research If it were due to body image, how can you explain the genetic component? The fact that identical twins have a higher likelihood of both having anorexia compared with fraternal twins? Why is refeeding the therapy of choice for anorexia (aka the Maudsley approach or FBT) rather than trying to address body image?

@Scr1bblyGum

Cahms don’t rely on BMI. It’s in the NICE guidelines I think.My dd has been hospitalised several times and has a lot of support from cahms. Pretty much all they have to throw at it. Her BMI hasn’t ever been horrendous and they’ve carried on treating her whatever ever her wfh is.

What has been a far bigger issue is the lack of resources and expertise re autism. There is a link between autism and anorexia for a section of patients.

@Scr1bblyGum I'm REALLY glad to hear you've had support from CAMHS. Sadly, I don't think that's been the experience of many others. I've heard too many horror stories from friends and on the different forums I've been active on. Good luck for your DD!

Yes that will be down to the lack of resources and not BMI.

@Scr1bblyGum

Yes that will be down to the lack of resources and not BMI.

I think BMI becomes a filter due to lack of resources.

@ComtesseDeSpair

I dunno. I think obesity is really the inevitable result of what we’re programmed biologically to do - eat when food is plentiful, even beyond the point at which we’re full, so that in times of food scarcity we have fat reserves to keep us alive. We just happen nowadays in the West to never have those times of scarcity and to be surrounded by the type of highly calorific fatty, sugary foods we’re designed to crave, available constantly without the need to hunt or gather them. There’s no moral failing in overreating or putting on weight, it’s what’s kept us alive as a species. Unfortunately it’s become so tied up in social conditioning and conventions.

Anorexia is seen as an illness because it goes directly against what we’re programmed to do: it takes enormous restraint and you need to actively ignore a constant and very loud alarm to be able to literally starve yourself.

That's true to a point but over eating to the point of being morbidly obese is a self harm. And most people won't do that. Because survival is what we're designed to do. So I do genuinely see it as an addiction or mental illness

Our team have told us repeatedly that they don’t rely on BMI. It’s surely based on medical need. My dd has been hospitalised several times with an ok BMI. As soon as she’s medically compromised she’s in, that will vary from patient to patient as to when it’s needed and is separate to BMI.I dread to think what would happen if they didn’t jump in quick each time or support.I’m aware adult services are different though and it’s a massive worry that keeps me awake at night.

In fact I don’t think BMI has every cropped up in discussion. Wfh, heart rate, blood pressure, weight loss, temperature, heart struggling ….. have though. Many times.

I agree to an extent but sugar and fat have a physical effect on the body, insulin spikes and drops etc so it's not just purely a mental addiction

@chickenyhead

I have had BED for years. It isnt treated under mental health services. It isnt treated at all.

At my worst I would eat and eat, whilst crying, because I knew I wasn't hungry, but I couldn't stop. I would stop once I felt sick.

All of my mental health team know and acknowledge that it is eating down and controlling complex PTSD.

Nobody will ever admit fat people could have an eating disorder. Who could they shame and feel superior to then?

Under eating prompts sympathy, over eating is universally seen as disgusting.

Have you heard of BEAT?

www.beateatingdisorders.org.uk/types/binge-eating-disorder

They might have a branch, or group, in your area ..?

I’m slim because fundamentally I just eat when I’m hungry and enjoy feeling fit and healthy. I really do think that for many people who struggle to lose weight it’s not that simple. It’s rather complex to unpick the link between past events and the use of food and I really think it would be helpful to provide more support for people in this situation. Of course some are overweight because they love food and drink and choose that over being slim but could change if they had the inclination to do so.

Binge eating disorder is already a mental illness.

Obesity is just a term for the size of your body, not what causes it. Calling obesity a mental illness would be like saying that being underweight is a mental illness.

It's not, because it doesn't describe a cause, it's a description of a physical body.

The word "Obesity" doesn't tell you anything about causation or what is going on psychologically, so no it will never be a term for a mental illness.

@Scr1bblyGum

In fact I don’t think BMI has every cropped up in discussion. Wfh, heart rate, blood pressure, weight loss, temperature, heart struggling ….. have though. Many times.

Really? But it sounds like your DD is at a weight where it's medically compromising her physiologically which would then be a point where there really should be no question over being treated. I am so sorry you are going through this, I know it is absolutely horrific.

When my DD was being treated, she was fine physiologically but her behaviours were very anorexic and that was what was being treated. She only actually lost about 7 kg from her previous weight at her lowest weight. And restoring her to her target weight was discussed a lot since that was the very purpose of the treatment under FBT.

Restoring target weight is a big trigger for dd so we avoid it in FT. She manages to do it each time anyway, but then restricts back.🙄

@ComtesseDeSpair that's a very good point that maybe explains the different approaches.

I completely identify with the idea the overeating is not a choice / greed / laziness and that it is so often driven by mentally unhealthy behaviours eg loneliness, stress, lack of self worth. But the fact that it is also what we are programmed to do for survival means it's perhaps less extreme than anorexia?

@Kazzyhoward makes the most relevant point I think - we need to reframe it so that the correct treatment can be given. Generally speaking, if you view eating in a 'normal' way but eat absolute shit due to poor food knowledge, you will be very unhealthy but not necessarily obese as your body tells you you're full and without all the attendant mental shit, you put the pie and chips down. So your overall calorie intake isn't that far over what you should be having.

It's the mental issues / addiction that demands we massively overeat which causes obesity.

Disclaimer: I am slim - but I have a seriously fucked up relationship with food including anorexia in my teens but usually bulimia. Which obviously has a massive binge eating element. I'm making huge strides but still regularly binge eat and totally recognise that what I look like has nothing to do with it. It's about changing how I feel and that's what makes it a mental disorder.

Full disclosure: I have an ingrained (thanks mother) programming that says thin is good and fat is bad and therefore have to make an active and conscious choice to NOT judge people on their weight. Even though I KNOW first hand that being obese is not a choice, I can't help my instinctive reaction.

Obesity and society's view on it needs a massive rethink if we are to solve the problem.

It already is and is classified as disordered eating for some individuals. But not all. I shall, take me as an example, if I put on weight and tip into obese it’s not a mental illness. It’s simoly I got lazy and greedy for awhile. Let myself go. Enjoyed myself a bit too much for too long. And many others are the same. However for others it is proper disordered eating and a mental health issue.

@Scr1bblyGum

Restoring target weight is a big trigger for dd so we avoid it in FT. She manages to do it each time anyway, but then restricts back.🙄

I know this isn't the thread but big hugs to you. Anorexia is so devastating for both the sufferer and their loved ones. My DD is weight restored for a couple of years now but I still feel it's never really completely gone away. And we don't have autism on top but we do have ADHD - also linked and poorly understood.

I think we are just starting to really break down the idea that any health condition effects just one area. When we treat mental illness as all in the mind, we do the same disservice as we do when we treat obesity as though it's all in the body. Our Brain can influence the way our hormones work, but our hormones can also influence our brain, our gut can impact on our hormones, and our brain. What we eat effects out gut, our brain, our mental health. Etc. There is no one area effected by anything. Anxiety is a full body state. Obesity is a full body state. Anorexia is a full body state. I really feel that most problems are multi systemic. We should be treating obesity as a condition of mind and body. Arguably more than that, it should also be treated as a social condition, people should not be fighting against an obesogenic environment, we should be living in the right conditions to make it easier to eat well and exercise regularly, reduce stress and sleep enough, and get adequate physical and mental Health care and social support. Not where often everything is working against people, and for many an unhappy life with little money or ways to self improvement, means eating cheap processed food and watching TV all day is the only comfort they get.

I think it’s more like an addiction than a mental illness.

I used to do that bingeing thing OP - it went on for about 10 years. Then I lost my job and I was so stressed that I completely lost my appetite and stopped bingeing. I got another job after a month or two and my appetite came back, but I never craved sugar again. Now, I give pudding a miss and never eat cake or chocolate or biscuits or anything - it just doesn’t enter my head to want them! And if you saw the amount of that stuff I used to gorge on that is really quite amazing!

Anyway, the point I am getting at is that I think I was addicted to sugar. And I got cured of it by going cold turkey for a month or so. I reckon if you can stop for a month - I know it’s not easy but just go all out for a month and eat no sugar at all (other than the naturally occurring sugar in fruit, etc.) the same might happen for you.

Anyway, the point I am getting at is that I think I was addicted to sugar

I’m like this. I generally eat low carb. When I’m eating carbs I can eat so so much and just not feel full. I could eat a huge bar of chocolate and there would be no feelings of fullness, I didn’t binge, just simply I can eat and eat and still want more.

Where as when I cut sugar out my diet, and go low carb, that craving goes totally. I’ve no desire for it at all. I started back about three or so weeks ago and it wouldn’t even occur to me now to eat some chocolate. Where as a month ago if it was in the house, I’d be having it. And it would be playing on my mind till I did. Right now there’s a lot of chocolate, biscuits etc in the cupboard and it simoly doesn’t cross my mind.

I wouldn’t say I was addicted, and as said, I’ve never been a binger, but I think there is something in our bodies chemistry for some of us, where cutting it out completely removes any cravings.

Similar story here about sugar and cold turkey.

I think there is probably something in the MH argument especially when your talking about people morbidity obese and can hardly move.

But from many who are overweight / obese / middle age spread. It can be a lifestyle thing. It's very very easy to gain a few pounds at Christmas then again in Summer holidays. Gaining 4/5 pounds a year do that over a decade and its a couple of stone pushing you into obesity.

The trouble is it's much easier to gain weight than to loose it. The emphasis needs to be on diet rather than on exercise "you can't outrun a bad diet".

I'm not convinced that the Low Fat diet that is pushed is right. I also doubt diet-food, (low fat yoghurt, diet coke,) helps either.

But also sugar is in lots of sauces. So people think they are eating healthy but really they aren't.

My other gripe is time, people are constantly pushed for time, long hours, long commutes, collect kids, feed them, rush to activity, rush home to bed.
And flump on the couch.

Prior to having a car, it was a 15min walk to station, 10mins at the other end, wander to shop for lunch, same in reverse. Add all that up an it's over and hour walk per day. I didn't need to diet.

Now is car everywhere and the fridge is in the next room.