Treating obesity a different way
Admittedly armchair science
I’ve been obese much of my life.
My mother, who had become alarmed at my weight-gain, took me to the doctor. When we left his office my mother had hope and I had a brochure that explained the standard 1100 calorie diet that they hand out to adults with diabetes. To my eyes, it looked like dry toast and water for the rest of my life.
I was 10 years old.
Fast forward a century or two
I had gastric bypass surgery several years ago and since then I have been able to pass for normal. This experience formed a component of the idea I present below. They can do surgery to fix your body, but they can’t fix your brain. I was still a compulsive overeater but I couldn’t act on it effectively. I started doing a few other things compulsively, but it was pretty weak tea compared to devouring an entire bag of Oreos.
Fast forward another century and a half
I toughened up. I got better. I lost a lot of weight and only gained back about 10% of it. I’m still a compulsive overeater but it’s minuscule by comparison to The Old Days. I should just shut up and take “yes” for an answer but I keep wanting to defeat that demon that’s now the size of a pebble in my shoe.
So I’ve spent a millennium or two thinking about obesity and its causes and cures.
Obesity as a form of OCD
I looked up the treatment for OCD because I suspect obesity is a form of it. I suspect that because of my experience the year after the gastric bypass. I was exposed to hunger but couldn’t act on it. Sometimes I would feel full and hungry at the same time and there was nothing I could do but sit there and experience it.
I think the ideation that accompanies OCD and obesity is extremely similar. In fact, I think almost any substance abuse issue may be a form of OCD and could possibly be treated the same way.
OCD is a way to relieve anxiety. Repetitive quasi-magical rituals ensure safety. After a while, you sort of forget the anxiety because the repetitive behavior keeps it in check.
With food, this means you are never hungry which keeps anxiety at a minimum.
And how it’s treated.
People with OCD are usually treated with SSRIs. When it works (and it may take shopping around to find the right one), it reduces but doesn’t eliminate anxiety. Even when an SSRI works, the behavior intended to reduce anxiety remains. We/he/she/they still believe a catastrophe will happen without the ritual. Medication needs to be accompanied by Exposure and Response Prevention (ERP) in order to retrain the impulses.
For a person with OCD this can mean being exposed to crowds, to open or closed spaces, to noises, spiders, thunderstorms, etc.
For an obese person, it would mean to eat sensibly … and then stop. This exposes the obese person to the catastrophe — hunger.
Rationally, everyone knows you can’t suffocate to death in an elevator and that going without food for 12 hours won’t kill you. It takes weeks to starve to death. Not hours.
But this is not about hunger or spiders. This is about fear.
Why is hunger a terrifying catastrophe? Who knows? You may never know what that fear is about, exactly. Whatever caused it historically may be interesting and helpful to know but it’s not necessary. That was then. This is now.
The bottom line is, it’s not a catastrophe and you have been acting like it is.
I read somewhere that you should do one courageous thing every day. For some people keeping it to only one won’t be enough. Sorry, those are the cards you were dealt.
“I want to be brave with my life. … We can choose courage or we can choose comfort, but we can’t have both. Not at the same time.” — Brene Brown
Being exposed to your fear and not responding or acting upon it takes courage. Pay attention to the word “acting.” When the fear comes, don’t act. Don’t do the ritual.
The fear will seize hold of you.
Sit there and let it
Imagine Pandora sitting there next to an unlidded box watching evil things flying up and out. Pandora slammed the lid shut and that is also your impulse. Don’t act.
Don’t do it. Leave the lid off and eventually, the box will empty and be just a box.
Research has shown that Exposure and Response Prevention can rewire your brain. In other words, you can actually heal.