TRABAJOS PRESENTADOS POR EL DR. ALBERTO CORMILLOT Y COLABORADORES EN CONGRESOS INTERNACIONALES

 

OBESITY AS HOMEOSTATIC BIOPSYCHOSOCIAL SYSTEM

 

Cormillot, J. Luxardo, R. Zukerfeld, Instituto Argentino de Nutrición, Buenos Aires. Argentina.

8th International Congress on Obesity, Paris, France. 29 August- 3 Sept., 1998

Obesity is a chronic disease of considerable comorbidity and its outcomes have been greatly frustrating over the past decades. The aim of this study is to introduce two concepts we have considered useful to understand and approach the problem: planned crisis (PC) and reverse assertivity (RA). PC is defined as the cognitive-behavior style by which the subject generates explicative or justificative situations of his/her eating behavior and RA as the cognitive behavior style by which the subject induces behaviors in other people in order to explain or justify his/her own eating beahvior. Our hypothesis is that there is internal homeostasis in obese people that is not only biological but also, psychosocial in nature. Such homeostasis would tend to maintain itself by PC and RA mechanisms which are independent of the psychopathological conditions, expressed as “I-cannot-comply”. Otherwise, PC- and RA-dependent mechanisms are of the “I-do-not-want-to-comply” type. More than 30 years of clinical observations of different types of obesity provide paradigmatic examples of PC ("I went shopping, found no size for me, I got anxious and set myself to eat”) and of RA (“my husband told me not to eat. I went mad and ate”) both typically involving relapses. Conclusions: It is important to diagnose these mechanisms properly and design treatment programs that will focus on the development of new homeostatic conditions compatible with the reduction of risk factors by means of: (a) a psychoeducational approach and realistic goals; (b) developing strategies in which the concept of compliance is replaced by that of empowerment as done in modern treatment programs for chronic diseases.

Acknowledgments: M.Argüello.