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Tackling Obesity: Part 4: Exploring the Intersection Between Body and Mind 7.06.04 Source: Andrew Schwartz, for CHC exchange Whatever the biochemical and genetic causes, few doubt that psychosocial factors also play a role in proper regulation of the body's energy-food balance. The interaction of behavior and psychology within an individual occurs in the context of family, community and environmental factors (see diagram). Among those factors, stress is rapidly emerging as a significant concern. In fact, there are some intriguing links between stress and eating habits in animals and biochemical factors. Recent research by UCSF's Mary Dallman supports the idea that stress and fat metabolism are regulated by the same biological mechanisms. Dallman's study found that animals subjected to greater chronic stress increased their consumption of sweet or fatty food and developed greater visceral fat deposition. Visceral fat is buried beneath the muscles and is stored centrally, in the abdomen. It is the type of fat associated with heart disease and other serious health problems. Consequently, it is not only how fat you are that is important, but where that fat is stored. Psychologist Elissa Epel has long studied the links between stress, as measured by the release of cortisol, and where and how fat appears in the body. "We know that stress is a pathogenic factor in weight control and we believe that cortisol and insulin are each half of the picture of stress-induced obesity," she says. "Insulin alone promotes obesity; cortisol and insulin together promote visceral obesity." Epel's current project examines in humans what Dallman has found in rats. "In looking at the eating habits of chronically stressed caregivers, we are trying to see if we can replicate the stress reaction in humans. Will the stress eaters (those who eat more under stress) show an increase in cortisol, insulin, and visceral fat over time? Our theory is that they will." In another recent study of medical students, Epel did find that stress eaters develop higher cortisol, insulin, and adiposity during exam times, as compared to those who report they eat less during stress. Laurel Mellin has found similar links. Mellin, a nutritionist who has written numerous books on weight loss and who directs the Institute for Health Solutions, has observed a vicious emotional cycle wherein stress and depression lead to hormonal changes that then lead to decreased energy needs, increased appetite and increased fat storage. "The people I work with eat for the same reasons we smoke or drink," says Mellin, "because we have emotional needs that are not fulfilled. We feel something missing, we can't identify it, and so we eat ice cream. We've found that the eating response is tied to parenting that fails to nurture or to provide limits. It is the absence of those two skills - nurturing and limit setting - that sustain our compulsion to overeat." Mellin offers workshops and programs that teach nurturing and limit setting skills. She has surveyed people who have used her method and found a large percentage resolved their overeating problem, with many sustaining their improvement six years later. She has also served as the Director of UCSF's Pediatric Obesity Clinic. In doing so, she created something called the Youth Evaluation Scale (YES), a computerized questionnaire that creates a bio-psychosocial profile that identifies the contributors to obesity and recommends reasonable care options.
Part 2: Genetics Provides Clues, Not All the Answers Part 3: "Our Biology Is a Mismatch for Our Environment" Part 4: Exploring the Intersection Between Body and Mind Part 5: A "Toxic" Environment Part 6: One Size Does Not Fit All |
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