Pastorini, obesity and mental health

«People with obesity are constantly oscillating between the illusion of getting out of a difficult situation and the frustration of not managing to do it. And this frustration leads people to disillusionment and shut down their social life»

Marco Pastorini, psychologist and psychotherapist, expert in eating disorders

Mental health and self-image are two concepts that go hand in hand with obesity, one of the most common diseases of the modern age. 13% of the world population suffer from obesity, and each of these people has a specific problem that can only be solved with the help of a personal journey that can lead them to self-acceptance. Marco Pastorini, psychologist and psychotherapist, expert in eating disorders and in sexual issues, has been working for a long time together with other specialists to help obese people retrieve their self-image.

Obesity and mental health

Obesity is a complex disease, and it is difficult to clearly define all its causes and symptoms. In general, it is a pathology that heavily impacts the body and forces those who suffer from it to modify their lifestyle and their social life. «Obesity compromises general functions, such as sleep and couple life, and simple functions tied to autonomy, from tying one own’s shoes to playing with the kids at the park» the psychologist explains. «The body, which normally should be a source of well-being, becomes an obstacle and a source of many physical problems.»

Obesity also undermines the positive image that each has of their own body, a problem that slowly forces people to isolate themselves from society. «A person affected by obesity does not easily show their body, feeling uncomfortable in some situations such as going to the beach. But in severe cases, discomfort can be caused by a mere look in the mirror» Pastorini continues. This lack of self-esteem is a stepping stone towards other mental health problems such as depression.

«If I find no one who can help me or understand me, then food becomes an ally and a refuge» he says. And a diet without a strategy lacking the support of professionals can aggravate the situation. «When someone with obesity tries to diet down, there is the risk that the diet fails and becomes an illusion, bringing disappointment that reactivates the vicious cycle. There is a lingering sense of inadequacy».

The importance of self-image

A positive relationship with one’s own self-image is pivotal to having a fruitful life. Obesity deteriorates this relationship, and this is something that many overweight people have in common. «When we have a complex relation with our body, then lack of faith may arise» Pastorini explains. «We need the body to explore the environment and to talk and interact with others. If we are ashamed of it, then we lack one of the most important aspect of our sociality.»

To retrieve the lost self-esteem, people with obesity need to follow a psychological plan to see food and the body as allies again. «From enemies they need to become friends. The role of the psychologist is to guide the patient through a process of personal change and of exploration of their own body to see food differently.»

During this process, people usually find the roots of their discomfort. They may suffer from obesity since they were children, and have a distorted self-image different from the one had by those that became overweight during adulthood. In both cases it is important to understand what caused the condition. «Why did I suddenly lose control over my relationship with food? What broke me? We need to look into the past to understand what went wrong, so we can avoid it coming back in the future.»

The role of the psychologist to treat obesity

When talking about how to cure obesity, usually people think about the help that dieticians or, in severe cases, surgeons can provide. Truth is, treating people with obesity is a long and complex work that has to be carried out on multiple levels to guarantee serenity and consistency to patients. «As every food-related problem, obesity is a disease that must be tackled with a team of specialists: a psychologist, a dietician, a nutritionist and if needs be a bariatric surgeon» Pastorini says. And if bariatric surgery is on the table, then a therapist has to treat the patient and understand if the operation is what they really need.

Furthermore, the help of a psychologist helps patients with obesity to trace back the causes of the disease and keep them in check, especially when dealing with eating disorders such as BED (Binge Eating Disorder). «Food and eating voraciously represent a way to control anger, frustration and other tiring emotional states». In fact, during the pandemic, cases of obesity spiked because being confined in a single place exacerbated this kind of “escape”. «We should never forget that food is something we use not only to nurture ourselves but also to interact with others» Pastorini continues, and if these interactions are negative, then eating disorders may occur.

Finally, a therapist is important to help the patient set reasonable expectations. From managing time and emotions to providing a progressively difficult physical activity that is easy to follow throughout the years, each overweight person can improve their lives. «However, the self-image that a patient has and the image that they want to obtain must be grounded in reality» Pastorini explains, to avoid painful realizations that the image they are trying to achieve is, in fact, unachievable. «They need to work on their emotions, on their ability to manage time and to make time for themselves, on their self-image to actualize and give value to their own body.»