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Why do we eat too little, too much, the wrong foods, foods at the wrong time? What can be done to get the balance right?
Obesity is a huge problem, in all senses. In 2021, the World Health Organization reported that 1.9 billion adults were overweight, and 650 million were obese. 380 million children and adolescents were overweight or obese. In the UK alone, western Europe’s most obese nation, 63% of adults are obese. The consequences of obesity are severe. Substantially increased risk of type two diabetes, hypertension, coronary heart disease, strokes, cancer, depression, low self-esteem, among others
What causes obesity, in the vast majority of cases, is taking in, by way of food, more energy than is expended. A remarkably small daily excess of 100 kcal can cause a person to put on per 0.5 kg per month, or 6kg per year. That is, a person can become obese from eating just one slice of bread too much per day.
At the other extreme, anorexia nervosa, eating too little, can also be fatal, for different reasons. While cases of obesity are relatively balanced between the genders, 80% of people with anorexia are female. The same figures apply to weight loss as to gain. Being energy deficient by a mere 100Kcal per day can lead to a weight loss of 6kg per year. About 5% of people with anorexia die over a decade. That is a risk factor six times greater than the general population. Approximately 3 million people world-wide are affected.
Bulimia involves binge eating, followed by what is euphemistically called ‘purging’. That is, the person makes themselves vomit to get rid of the food consumed during the binge. Around 3.6 million people demonstrate bulimic behaviours, with women being around nine times more likely to be affected than men.
There are many more types of eating problems, such as OSFED (other specified feeding or eating disorder) and ARFID (avoidant/restrictive food intake disorder). Even an unhealthy diet can be considered problematic, given the long-term health consequences of eating harmful ‘foods’.
What causes the various eating disorders? There is not one cause; the development of eating disorders appears to be a complex interaction of multiple factors, including, trauma, psychological, social, cultural, emotional, biological, genetic, and economic and other causes. There is no known pathogen responsible.
Trying to understand the aetiology of eating problems seems to provide a snapshot of the challenges in fathoming all human problems. When so many variables are involved, it is very difficult to pin down the specific causes, or to separate direct causes from mediating variables, or from consequences. With no agreed causes for the array of eating problems, it is reasonable to ask: why? Probably because there is no one cause; perhaps each person’s route to eating problems is different: ideopathic. Or, possibly all of the above variables can be involved, in some circumstances, but not others; we don’t understand how or why. Maybe some of the listed factors can be triggers, while one of the main causes is something in the thinking or belief pattern unique to the individual.
In healthcare, the word ‘ideopathic’ is used as a cover for: ‘We have no idea what caused this, and are attributing it to unknown factors unique to the individual.’
Some of the general factors that seem to be involved include, having a first degree relative with an eating problem. A history of dieting, unsurprisingly, is associated with binge eating.
In societies and cultures where ‘slim’ is highly valued there is a higher incidence of eating problems.
If I was to place a bet on the causes, I would say that only a tiny handful or eating problems are caused genetically, and that the vast majority of eating problems are caused by a combination of thought, emotional and belief based factors, in response to social, economic and cultural cues or triggers.
A famous comedian once quipped: ‘The only cause of wobble-wobble down here [pointing the the stomach] is gobble-gobble up here [pointing to the mouth].’
Although it is a non-PC joke, it may have some wisdom in it. People do become obese if they eat too much and move too little. At the other extreme, the fear of putting on weight is known to be involved in the development of anorexia, as it is in the emergence of bulimia.
For the vast majority of the world population, eating is done in balance; neither too much, nor too little. In school and at home many young people learn how to eat a balanced diet that sets the pattern of healthy eating for life. In rich countries, having such wealth, easy access to so many delicious foods, seems to result in increasing obesity. That is, even good education in healthy eating has not prevented 63% of the UK population being overweight.
What can we do to eat healthily? Here are some simple approaches.
- When you feel full, stop eating.
- Be aware of the energy level in the food you eat.
- Eat a balanced diet – many different types of food.
- Take at least five a day of fruit and vegetables.
- If you eat too much at one meal, eat less for the next.
- Take enough daily exercise to stay fit – mobility minimises morbidity.
- Try to avoid eating late at night – there is more chance of excess consumption being turned into fat as you sleep.
- Savour your food; stop to really enjoy the taste, the texture, the feel, the colour.
- Eat slowly – it gives your stomach more time to send the ‘enough’ signal.
- Control your eating, lest it ends up controlling you.
If your eating is getting out of control, or harming you in any way, get some help from a professional. The earlier eating problems are addressed the more chance there is of preventing a deterioration.
Professor Nigel MacLennan runs the performance coaching practice PsyPerform.