Obesophobia

Obesophobia or pocrescophobia is a persistent, abnormal fear of gaining weight, particularly in cultures that value thinness. This phobia was listed as a rare disease by the Office of Rare Diseases of the National Institutes of Health.^{[1][2][3][4][5][6][7]}

The word obesophobia comes from the Latin obesus, meaning "fat" and Greek φόβος, phóbos, meaning "fear" or "morbid fear". The term has been around since 1997.^[8]

Individuals with this phobia originally start with a major desire to lose weight^{[1][2][3][4][5][6]} which turns into a compulsive desire to avoid all things that could result in weight gain.^{[1][2][3][4][5][6]} The more these things are avoided, the more they are feared.^{[1][2][3][4][5][6]} A habit of avoidance can lead to a sense of failure if weight is gained. Gaining weight is seen as a failure to those with obesophobia and therefore they experience an abnormal fear toward anything that will cause them to fail.^[9] Obesophobia is also known as weight phobia, a term created by Arthur H. Crisp regarding perceptions that sufferers of anorexia nervosa, an eating disorder characterized by an obsessive fear of gaining weight, may have regarding weight gain.^[7] Some psychologists (Hsu & Lee, 1993)^[10] have stated that a subject having weight phobia is a necessary precursor for a diagnosis of anorexia nervosa.^[10]

Causes

The etiology is similar to that of most phobias in general, namely environmental, evolutionary, and neurobiological. Phobias arise from a combination of internal predispositions (heredity, genetics, and brain chemistry) and/or external events such as trauma and can usually be traced back to an early age.^[11] Specifically obesophobia is associated with an obsession with weight loss. It can be triggered by negative media perceptions, children comparing themselves to other "popular, skinny" kids, parents who struggle with weight or die of complications from weight, and parents conveying to their children a negative attitude regarding weight.

Media perceptions

The media plays a large role in people's opinion of what a perfect person is to look like. Media portrayals of models, celebrities, and athletes with "perfect" bodies paints a false picture of what bodies are supposed to look like. The media has also put a major emphasis on calorie counting, dieting, and weight watching, causing many women (and men) to become obsessed with being thin, dieting and watching their weight.^[12]

Cultural issues

In the United States, society is set on the notion that "thin is in" and that being fat is a cultural liability. Those who suffer from obesity issues are then discriminated against in accessing education, economic opportunity, social networks, and other forms of capital. Documentaries such as Super Size Me paint a grotesque picture of what our society values as far as fat is concerned and the need for change that is associated with it. This film persuaded McDonald's to eliminate the Supersize option, though its image as an unhealthy fast food restaurant persists.^[13]

Symptoms

People who struggle with obesophobia often place restrictions on aspects of their daily lives. This can include things such as going to school, changing jobs, buying stylish clothing, dating, enjoying sexual relationships, and sometimes even seeking medical care. They also suffer from things such as an obsession with weight and weight loss techniques, feeling they always eat too much, denying hunger, only seeing themselves as fat and panicking over food, especially if they believe that they have eaten too much. Some of these symptoms can occur as a result of the attitudes in believing that one can function well off of a minimum amount of calories, that there is an ideal weight for each height, and that fat distribution can be controlled.^[14] They also may believe that if you eat and enjoy fat others view you as disgusting and they feel that something is the matter with you. People suffering from obesophobia may restrict their fat intake in their diet as well. This person may suffer from malnutrition from not getting enough fat in the diet. They also may then suffer from things such as irritability, depression, and anxiety.

Mental

• Obsessive thoughts
• Difficulty thinking about anything other than the fear
• Corrupt mental images of weight gain
• Knowledge of fears being unreasonable or exaggerated but feeling powerless to control them
• Obsession regarding body weight and weight loss programs^[15]
• Distorted self-image^[15]
• Body dysmorphism^[15]

Emotional

• Anticipatory Anxiety: Persistent worrying about upcoming events that involve weight gain
• Uncontrollable Anxiety: Feeling the need to do everything possible to avoid weight gain
• Terror
• Inability to function normally
• Elevated levels of anger, sadness, fear, hurt, and guilt when thinking about weight gain

Physical

• Not feeling hungry to abnormal levels^[15]

Behavioral

• Going to the restroom/toilet to force out and empty stomach contents via vomiting or laxatives.^[15]

Complications

Anorexia

Anorexia nervosa is associated with obesophobia. It is an eating disorder characterized by excessive food restriction, irrational fear of gaining weight, and distorted body self-perception. It typically involves excessive weight loss. A person with anorexia often initially begins dieting to lose weight. Over time, the weight loss becomes a sign of control. When an anorexic gains weight, it causes anxiety, and losing weight helps to reduce this anxiety.^[7] The diagnostic criteria for 307.1 Anorexia Nervosa as outlined by the DSM-IV-TR:

• Refusal to maintain body weight at or above a minimally normal weight for age and height, for example, weight loss leading to maintenance of body weight less than 85% of that expected or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected.
• Intense fear of gaining weight or becoming fat, even though underweight.
• Disturbance in the way one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
• In postmenarcheal females, amenorrhea, i.e., the absence of at least three consecutive menstrual cycles. A woman having periods only while on hormone medication (e.g., estrogen) still qualifies as having amenorrhea.^[16]

Bulimia

An illness in which a person has regular episodes of overeating (binging) then uses various methods such as vomiting (purging) or laxative abuse to prevent weight gain. Many people with bulimia have anorexia as well. The diagnostic criteria for 307.51 Bulimia Nervosa as outlined by the DSM-IV-TR:

• Recurrent episodes of binge eating characterized by both
  1. Eating, in a controlled period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
  2. A sense of lack of control over eating during the episode, (such as a feeling that one cannot stop eating or control what or how much one is eating).
• Recurrent inappropriate compensatory behavior to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, enemas, or other medications, fasting, or excessive exercise.
• The binge eating and inappropriate compensatory behavior both occur, on average, at least twice a week for three months.
• Self-evaluation is unduly influenced by body shape and weight.
• The disturbance does not occur exclusively during episodes of Anorexia Nervosa.^[16]

Compulsive exercise disorder

Extreme repeated exercise beyond the requirements for good health. Instead of getting moderate exercise, these people are compelled to exercise excessively every day. They feel compelled to do so and struggle with guilt and anxiety if they don't work out. Exercising starts to take over a compulsive exerciser's life because life is planned around it. Those who compulsively exercise are at risk for developing eating disorders as well.^[17]

Obsessive–compulsive disorder

A type of anxiety disorder characterized by repetitive obsessions (distressing, persistent, and intrusive thoughts or images) and compulsions (urges to perform specific acts or rituals).

Laxative abuse

Can lead to intestinal paralysis, irritable bowel syndrome, pancreatitis and liver failure.^[18]

Treatment

Ways to treat obesophobia is through intervention and therapy treatments dealing with anxiety and phobias. It is sometimes hard to make one do that since most anorexics and others who struggle with weight disorders don't think that they have a problem. Some therapy interventions may be useful as well as medications.

Medications

• Beta blockers work by blocking the stimulating effects of adrenaline on the body, such as increased heart rate, elevated blood pressure, pounding heart, and shaking voice and limbs.
• Antidepressants called selective serotonin reuptake inhibitors (SSRIs) are commonly used in the treatment of phobias. These medications act on the chemical serotonin, a neurotransmitter in the brain to influence mood
• Sedatives like benzodiazepines help you relax by reducing the amount of anxiety that you feel.^[19]

Hypnoanalysis or hypnotherapy

Hypnoanalysis (hypnotherapy) is a type of therapy used to teach the mind to attach different feelings to feared items. When the subconscious is spoken to directly, it may be possible to find the issue triggering a person's phobia and introduce new ideas and positive suggestions. These positive suggestions may then be used to help make the desired changes. Hypnoanalysis has been approved as a method of therapy since 1958 by the American Medical Association.^[20]

Behavior/exposure therapy

Desensitization or exposure to the phobia focuses on changing the subject's response to the object or situation that they fear. Gradual, repeated exposure to the cause of the phobia may help a person learn to conquer their anxiety.

See also

• Fat Phobia Scale

References