Obese people should be allowed to satisfy their desire for foods like chocolate and ice cream, according to Australian psychiatrist George Blair-West. Permitting people to eat the energy dense food they crave will ultimately help them lose weight, Dr Blair-West told an audience of HealthWEST PHO members.
The Director of Psychophysiology at the Obesity Rehabilitation Unit at Brisbane's RiverCity Private Hospital says some people's emotional attachment to certain foods is so strong, trying to break it will only trigger "rebellious overeating". His work is based on the extensive research into what has become known as 'Restraint Theory'.
Dr Blair-West, author of Weight Loss for Food Lovers: Understanding the Psychology and Sabotage of Weight Loss, says, in a society where every major social event is celebrated with food, it is unsurprising some people develop such a strong dependence on it.
"Food becomes the currency with which you deal with negative and positive emotions," he says. This explains why educating the obese about the dangers of being overweight is generally a waste of time, Dr Blair-West says. Many obese people are well informed about nutrition but are compelled to eat fattening foods, and deprivation of those foods usually results in an even greater desire to consume them.
Instead, obese people should be encouraged to reduce overall calorific intake by cutting out the fattening foods they do not have an attachment to, ie, "low sacrifice" foods. For example, a person who craves fast food hamburgers might retain them in the diet, preferably via the drive through, but refrain from also ordering fries and sugary drinks, Dr Blair-West says. The next step is to reduce the intake of emotionally charged or "high sacrifice" foods.
This can be achieved by eating more mindfully and savouring the food's taste, texture and smell, he says, adding many people overeat when they are not paying attention to their meal. People should also be encouraged to wait 20 minutes after a meal before reaching for more food, given this is how long it takes for the brain to register satiety.
An emotional attachment to weight is another important factor in the obesity equation, especially in cases where the obese person has been sexually abused, Dr Blair-West says. For some obese victims of sexual abuse, excess weight serves as a "suit of armour", making the person stronger, less attractive and less of a target to would-be abusers.
Dr Blair-West told New Zealand Doctor he is sympathetic to the plight of GPs who are frequently faced with obese patients but have little effective training to treat them, describing their predicament of feeling overwhelmed by the obesity epidemic as "therapeutic nihilism".
