Tuesday, September 11, 2007

Obesity - maybe your stomach is depressed?

This has to be one of the most ridiculous comments I've read in a long time to describe obesity and it comes from Dr. Nora Volkow the director of the U.S. National Institute on Drug Abuse.

Dr. Volkow, in an editorial published in May in the American Journal of Psychiatry says that,

"some forms of obesity are driven by an excessive motivational drive for food and should be included as a mental disorder in DSM-V"
She then goes on to compare obesity with drug addiction with food of course being the drug.

Yes, let's add one more stigma to obesity and label it a mental illness and compare the obese to drug addicts. Brilliant! Helpful! Oy!

You know what should be included in the Diagnostic and Statistical Manual V (the bible of psychiatric disorders) as a mental disorder? Quobesity.

Quobesity occurs when a person, just because they eat, believes that they are experts in all things obesity related. Side-effects include ridiculous editorials and quotations that often manifest as blog entries here.

The comparison of eating behaviours and drug addictions is certainly not a new one, but it does have a fatal flaw - how many folks do you know whose addictions only exist from 4pm onwards?

The vast majority of food addicts (chocoholics, carb-addicts etc) will report that their addictive behaviours and struggles with food only manifest from the mid to late afternoon onwards. It is an exceedingly small proportion of these folks who struggle all day long. The all day long folks, if they meet certain criteria, may indeed have a diagnosable psychiatric condition entitled binge eating disorder, however to reiterate, in my experience, the vast majority of bingers tend to only do so from the afternoon onward.

Those same folks, when taught to eat frequently, not skip meals or snacks and include foods helpful with hunger prevention tend to see their binging disappear, in many cases literally overnight.

If Dr. Volkow is keen to make changes for the up and coming new Diagnostic and Statistical Manual V (the bible of psychiatric disorders), might I suggest an exclusion criteria for binge eating disorder whereby the diagnosis cannot be given to an individual who skips any daytime meals or snacks.

For food addicts or binge eaters who might be reading this post - try this recipe to see if it helps minimize your addictive type behaviours. Worst case scenario you prove me wrong and you may indeed be a truly food addicted binge eater. Best case scenario, you regain control over what is most certainly a very frustrating and potentially demoralizing behaviour:

  • Breakfast within 30 minutes of waking, at least 350 calories with at least 15grams of protein
  • Eating every 2.5 hours with between meal snacks of 100-200 calories a piece with at least 8 grams of protein
  • Lunch of at least 300-400 calories with at least 15 grams of protein
  • Dinner of at least 400 calories with at least 15 grams of protein
  • For every hour of sustained exercise add an additional 100-150 calories that are primarily carbohydrate based.