Who doesn’t know Dr. Nowzaradan? The elderly American doctor who treats the very obese and the protagonist of a successful TV docu-reality TV, Lives to the Limit: Nowzaradan receives people with exceptional body mass and somewhat disastrous lives in his hospital in Texas, wanders them when the scale does not go down, it encourages them when they make progress. In between is the everyday life of these patients and their families, their efforts and their failures. Spectacularizing the always questionable disease. But it must be recognized that Lives at the limit (as well as its Italian version, The clinic to be reborn) shows some important aspects about life, discomfort and, in general, the complexity of a pathology that (fortunately to a lesser extent) concerns the 12, 6 percent of Italians.
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The data of the problem
Starting with a fact: obesity does not heal by itself. We need to change lifestyle and for this reason the support of those close to us is crucial, that is, the person who shares meals with us: the parent, the partner, the child explains Stefano Erzegovesi, psychiatrist and nutritionist, head of the Center for disorders food of the San Raffaele hospital in Milan. Also because we are talking about a course of treatment that lasts for years and that concerns the whole environment of the patient.
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Complex pathology
First, don’t judge Obesity is a chronic and complex disease that does not have a single cause (overeating), but has genetic and environmental components. To treat it you need a specialist who acts on several fronts: nutritional, psychological and relational says Erzegovesi. Yes, but how to make it clear to an obese family member or friend (or on the road to obesity) that their health is in danger and that the time has come to consult a doctor? The severe judgment, statements like “but can’t you see yourself?” or “you have to stop eating so much” are ineffective, indeed, often, deleterious. The urge to eat linked to ancient and profound motivational drives; the patient under treatment must, first of all, learn to recognize his emotions, unhinge the mechanisms that lead him to eat.
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Awareness
Then, the family member counts to ten before triggering a reprimand. And abandon the judgmental attitude. And what, then, would be the right attitude? It is necessary to understand the level of awareness that the patient has of his problem, says Erzegovesi. Is he sending out signs that he suffers from his condition? That his life is not what he would like? He can’t put on shoes with laces because he can’t tie them, he doesn’t go to the swimming pool or the sea because he is ashamed to be seen in a bathing suit…. Here, faced with these signs, a family member can say: I’m sorry that your quality of life has deteriorated, but you can improve it and I can help you do something. We have gone from the level of the judge to that of help.
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Shared path
And helping an obese means sharing a path: We do something other than do something. Similarly, say: from tomorrow you eat a plate of salad before dinner different to say from tomorrow we will eat a plate of salad together. Sharing works for all ages and for all problems: for children who do not want to eat vegetables and for the overt obese. And let’s not forget that in these cases, sharing also means adopting healthy behaviors for the whole family. Sharing also translates into simple gestures of solidarity.
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Concrete examples
An example? Preparing vegetables in ready-to-use single-serving bags to keep in the refrigerator should be a task everyone in the family takes turns. Also, an important act of love: let’s not forget that about half of the very obese are people who have suffered traumatic events, such as physical or sexual abuse. Or they are people in the past victims of neglect for whom food has become a kind of general anesthetic that is used impulsively.
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Sense of failure
In the stories told on TV it happens to see mothers who cook for their son, often stuck in a bed victim of his own weight, unhealthy meals like dozens of fried chicken legs. They love their son, they know it’s wrong and yet they do it. Because they are people with low self-efficacy, or the awareness of having the resources to succeed in something. The thought: “why fight to give him the salad, nothing will change”. They take failure for granted, explains Erzegovesi. The self-efficacy of a family member (as well as of the patient, of course) is the key to facing a long and tiring path of treatment and weight loss. If the situations we see on TV are really at the limit, that of the low self-efficacy of the family member is a trait that we also review for us, for example, in many parents of children with a tendency to obesity who are unable to not satisfy the requests for food of their parents. sons.
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Lifestyle
Not only the sick but the whole environment that heals: the clan or family member who changes lifestyle together with the patient. And not just at the table. That environment that we define as “obesogenic” must change, that is, where we tend to consume processed (processed and packaged) foods at low cost, where we do not do physical activity and where there is a culture of low emotional awareness, explains Erzegovesi. So, if you want to help a loved one you have to change the environment and their lifestyle forever: review all behaviors starting from how I arrange the food in the pantry, how I shop, accompany the patient in his efforts to move , which must be accessible and persistent over time: it is useless to force anyone who has never entered the gym to enroll in the gym, better still, take simple walks around the house every day.
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22 December 2020 (change December 22, 2020 | 09:43)
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