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INVENTION
Russian Federation Patent RU2244569

METHOD FOR THE TREATMENT OF FOOD addiction, accompanied by obesity

METHOD FOR THE TREATMENT OF FOOD addiction, accompanied by obesity

Name of the inventor: VY Semke (RU); Krasnopyorov OV (RU); Panchenko AL (RU); Bohan NA (RU); Krasnoperova NY (RU)
The name of the patentee: Research Institute of Mental Health, Tomsk Scientific Center of the Siberian Branch of the Russian Academy of Medical Sciences (RU); Ltd. Psychosomatic Center "Dream"
Address for correspondence: 634014, Tomsk, pos. Pine Forest, NII PP TSC SB RAMS, LA Stepanova
Starting date of the patent: 2002.01.22

The invention relates to medicine, namely to the psychiatry and psychotherapy. The method comprises performing a diet therapy and psychotherapeutic influence on the collective group sessions. Thus the basic psychotherapeutic influence is carried out for the two sessions of eight hours each method marathon in asthenia conditions, failure of biorhythms, and behavioral stereotypes. Produce motivation for healthy eating, self-confidence and faith in success. Form a weight loss program, visualize and concretise treatment. Keep a diary of eating behavior, exercise psychological protection in the event of a situation diet violation. After the main session is conducted psychotherapeutic influence in a single session lasting three hours later one and three months. At the sessions, fix the results, discuss the situation and eliminate that trigger relapse obesity. The method allows to increase the length and durability of remission.

DESCRIPTION OF THE INVENTION

The invention relates to medicine, particularly psychiatry and can be used for the treatment of food addiction, accompanied by obesity.

There are treatments for bulimia nervosa and binge eating, which leads to overweight (BMI), which are used in complex combination, where the fore often act diet therapy and physiotherapy in combination with drug therapy (E.A.Beyul, YP Popov, 1990). It offers a variety of treatment regimens based on different theoretical concepts. Thus E.A.Markova et al. (1986) pay considerable attention to diet therapy and change primarily eating disorders and suggests the following guidelines for treating obesity mandatory restructuring psychotherapeutic eating; regulation of energy intake of substances; increase the body's energy costs (physiotherapy, physical methods of influence); the use of pharmacological agents; the use of medication and fasting only in case of failure of dietary treatment; Surgical treatment of alimentary-constitutional obesity with failure of conservative therapy; relapse prevention.

This position is shared by many Russian and foreign authors (R.H.Kadyrova et al 1986, 1987;. E.A.Beyul with Soave 1987;. S.F.Konev, T.A.Zykova, 1988; V.A.Oleneva , Yu.P.Popova, 1992). A.A.Gadzhiev et al. (1996) suggests the use of acupuncture.

A number of other authors (A.M.Veyn et al, 1979;. E.I.Marova et al, 1981;. I.V.Tereschenko, 1993; M.M.Ginzburg, G.S.Kozupitsa, 1996; and others. ) believe the main method of treatment of exogenous constitutional obesity medication.

Diet therapy. According to many authors, this type of therapy is the leading (E.A.Markova et al, 1986;.. E.A.Beyul et al, 1986). It proposed the appointment of a reduced diet with sufficient protein and limiting animal fat and carbohydrate. The diet should contain the required amount of vitamins and minerals. The Institute of the USSR Academy of Medical Sciences power developed the basic principles of the diet for obese. These include: 1) Appointment of a reduced energy value of the diet (reduced), balanced across all indispensable nutritional factors and contains enough protein; 2) Adherence 5-6 - full board without increasing the total energy value of food; 3) systematic control of the amount of food eaten; 4) Complete abstinence from alcohol, which, in addition to a substantial increase in energy value of the diet, drastically weaken self-control over food intake; 5) The limited introduction of carbohydrates, especially mono- and oligosaccharides, which are the main suppliers of energy and easily turning into fat in the body; 6) The restriction of animal fats and vegetable oils consumption increase (up to 50% of total fat); 7) Reduction of salt intake to 5-6 g per day; 8) Control of fluid intake (not more than 1.5 liters).

Separately, you can select fasting. Fashion trends, an active supporter of which was an American scientist P.S.Bregg (1997), author of "The Miracle of Fasting," and found support in the scientific community, at this point in time almost lost its appeal for a number of objective reasons. When the body is forced full starvation except fat expend structural proteins of cells and tissues, especially muscle. Particularly high protein during periods of fasting (15 days) according to E.A.Beyul et al. (1986). The authors believe that fasting becomes severe stress, which leads to a deepening of the already impaired in patients with substance exchange. During starvation very quickly spent glycogen stores in the liver and as a result suffers from its function of depositary. Fasting puts the body at a disadvantage even when higher demands for immunity. Any banal infection may take a prolonged duration. At full fasting there is some risk of cardiovascular disorders (De Carvalho S. 1988).

According Eriksson LS et al. (1988), Kral JG, Heymsfield S. (1988), in obese patients in the treatment of starvation recovery does not occur, or a radical improvement.

G.G.Zhdanov et al. (1994) propose a method of short-term (10-14 days) nutritional deprivation for preoperative preparation of patients who are obese, as the prevention of surgical complications. We agree with this position and T.G.Voznesenskaya et al. (1990), and I.V.Tereschenko et al. (1994). Physiotherapy. It is believed that physiotherapy has wide indications for use in obesity (E.A.Markova et al., 1986). Exercises include work all parts of the nervous system - from brain cells to the peripheral receptors and humoral and endocrine mechanisms; accelerate the oxidation processes by increasing the gas exchange; enhance the secretory function of various organs and vigorously promote the allocation of metabolic products, an increase in energy consumption (E.A.Beyul et al, 1986, P.P.Kuziv, Yu.I.Slivka., 1998; et al.).

P.Ya.Grigorev et al. (1989) argues that the role of physical activity in the pathogenesis of obesity is greatly exaggerated, especially in the prevention and treatment of obesity. I.V.Tereschenko (1993) believes that the increase of physical activity should be included in the complex treatment of obesity, but it should be borne in mind that improper increase in physical activity in obese patient creates a stressful situation, ie stress in the hypothalamus - pituitary - adrenal cortex and overproduction of adrenocorticotropic hormone, cortisol.

Pharmacotherapy. There are currently a lot of pharmacological methods of obesity treatment, but there is no specific common methods and schemes. Drugs used in the treatment of exogenous constitutional obesity can be divided into means of reducing the need to use food, and dosage forms that contribute to the normalization of the functional state of the organism, accelerates the process of weight loss, the evacuation of the adipocyte fatty tissue, etc.

Tools that reduce the feeling of hunger can be divided:

1 of pharmaceuticals operating its mass;

2 funds, which have a direct influence on the excitability of the alimentary center.

It is known that a certain degree of food filling of the stomach leads to reflex inhibition of the food center. On this principle is based the use of drugs in Group 1, its current weight. These include various types of dietary fiber, the most pronounced effect of which has methylcellulose.

More than 40 years known for such pharmacological agents that reduce the feeling of hunger as amfepramone, Fepranon, dezopimon and others. However, due to the mandatory side effects of existing drugs (agitation, insomnia, palpitations, increased blood pressure, the development of drug dependence), the search continues for new anorectics .

I.V.Tereschenko (1993) believes that the anorectic drugs to which they were not treated group, no significant effect on the result of the treatment of obesity, because they are only symptomatic therapies views.

From the point of view of the author are the pathogenetic treatment measures that increase thermogenesis.

Since eating disorders are often accompanied by psychopathological disorders (depression, anxiety), antidepressants are used to treat these conditions. For this purpose, selective serotonin reuptake inhibitor (fluoxetine - Prozac, sertraline - Zoloft), which reduce appetite (Smulevich AB, 1997). E.A.Markova et al. (1986) argues that the medical treatment of obesity is a mandatory tool etiotrop and pathogenic effects on the body. At the same time, these same authors note a number of serious side effects of pharmacotherapy.

For the treatment of patients with a BMI of acupuncture technique is used on VG Vogralik et al. (1985), based on the impact on the biologically active points located on the ears and other parts of the body. To suppress the feeling of hunger, thirst and appetite normalization applies an inhibitory effect on auricular points hunger - 18, thirst - 17 stomach - 87, oral - 84, the hypothalamus - 26, pancreas - 96. To stimulate fluid removal and restoration of water-salt metabolism It uses a tonic effect on the point of the ear 95, 26 and 9 corporal IM, 67 V, 7R, 6R, 25-27 V.

E.A.Beyul et al (1986) believe that the drug therapy plays a secondary role. The authors propose to differentiate patients with obesity and release: 1) - people with "normal" energy consumption that can reduce the energy value of food without the aid of drugs; 2) - those with "normal" energy consumption, are unable to reduce food intake without the help of anorectic drugs; 3) persons with "normal" energy consumption, which can not resist the excessive food even with drugs; 4) - persons with reduced energy consumption, requiring them to increase.

Thus, a number of Russian and foreign authors considered symptomatic medication, do not affect the fixation and support achieved by the treatment of the normal body weight (E.A.Beyul et al, 1986, 1990;. I.A.Koreshkin, 1998; JEMitchell et all, 1993). At the same time difficult to make a choice in determining treatment strategy between the effectiveness of a drug and its side effects.

Psychotherapy. Hyperalimentation. stratifying on constitutional predisposition to the development of obesity in the future leads to the exchange dysfunction, which in turn leads to secondary somatic disorders (diseases of the musculoskeletal system, the cardiovascular system, etc.). Based on this provision, etiotropic treatment exogenous constitutional obesity, above all it should be aimed at eliminating the causes of eating disorders. Data reasons can act intrapersonal and social conflicts. Stressful factors related to the social sphere, in the opinion of many authors, quite subjective. Therefore, the main focus in the treatment of overweight patients should be on the normalization of interpersonal well-being and ability to optimally and to respond adequately to exogenous psycho-emotional stress.

Psychotherapeutic treatment aimed at changing eating behavior when exogenous constitutional obesity, applies, as a rule, in addition to the other above-mentioned types of treatment of this disease (M.Grabovska, V.A.Oleneva, 1968; E.S.Kreslavsky V. I.Loyko 1984; I.V.Tereschenko, 1993; E.A.Markova et al, 1986, etc.)..

E.A.Beyul (1986) attaches great importance to the suggestive psychotherapy, hypnosis is considering a measure not only symptomatic but also pathogenetically directed method of treatment, because with the help of hypnosis you can achieve adjustment obese psyche of the patient and eliminating unhealthy eating habits, which, according to essentially linked to the main cause of the disease.

Kreslavsky ES Loikaw and VI (1984) proposed a scheme of the rehabilitation program of patients with obesity (partnership, diversity efforts, the unity of psychosocial and biological methods of influence), much of which is accompanied by psychotherapeutic techniques such as gipnosuggestiya, rational psychotherapy. Later Kreslavsky ES (1985) reports on the need to combine psychotherapeutic methods with drug treatment aimed at correction of emotional disorders such as anxiety, depressed mood, irritability.

According Donelly J., Duncan David F., Procaccino Anthony T. (1993) in patients undergoing treatment for a group of overweight, there is a decline in both reactive and personal anxiety when completing the questionnaire of personal and reactive anxiety Spielberger.

There is evidence of the use behavioral approach to reducing excess body weight in obese patients, accompanied by coronary heart disease (Hramelashvili VV, 1990). A significant role is given to a method of psychotherapy group (B.D.Karvasarsky, 1985).

In general, research on psychotherapeutic method of treatment, disjointed and contradictory. Data on the dynamics of the psychosocial status of patients, reducing weight, and its correlation with the effect achieved in the treatment of developed insufficiently for practical use. Definitively not defined the role of psychotherapeutic interventions and strategic techniques of treatment in individual patients. In recent years, more and more authors declined to dispensary carrying excess body weight correction, as a more favorable follow-up. Outpatient treatment is often associated with the development of correct dietary habits, not only the patient but also his family that plays a significant role in achieving stable treatment outcomes (Kadyrov AD et al, 1986;. E.A.Markova et al. 1986 ; Zamotaev IP et al, 1988)..

The increasing severity of the problem requires the active continuation of the search of the most effective directions and methods of weight loss in obese and fixing the results.

The object of the invention is to increase the efficiency of food addiction treatment, accompanied with obesity, and increase resistance and remission duration.

The problem is solved by the application of psychotherapeutic effects and dietetics, with the main psychotherapeutic modality are intensively during two sessions of 8 hours each, then spend supportive psychotherapeutic effects of a single session of 3 hours and after one and three months after the main psychotherapeutic influence.

The process is carried out as follows:

The main therapy techniques used in the treatment of obesity are:

1) Rational psychotherapy

2) hypnosuggestive methods (policy-hypnosis, Ericksonian hypnosis)

3) Self-regulation and self-hypnosis

4) Emotional-stress therapy

5) Neuro-Linguistic Programming

6) Positive Psychotherapy

7) Music therapy

8) Behavioral therapy

Mandatory conditions that take into account and change the psychology of eating disorders in the process of psychotherapeutic effects are as follows:

1) Development of motivation to healthy eating.

2) A clear statement of the formation and weight loss program - how much time and how many kilograms need to lose weight.

3) Visualization and concretization of goals required making a plan.

4) Maintain a food diary.

5) Rapid or gradual change in dietary habits.

6) The mood on the belief in the success and development of self-confidence.

7) Psychological protection in the event of situations of possible violations of the diet (the situation of temptation or emotional stress).

Stages of treatment

Methods of providing psychotherapeutic care for patients with excess weight provides some phasing. Each stage includes their tasks and psychotherapeutic effects differ in shape, pattern and content.

The first stage (preparatory) is characterized by the use of indirect (mediated) suggestion. It turns out promotional activities, advisory work therapists, other patients who have undergone treatment (human billboard), doctors somatic profile, making referrals for treatment, acquaintance with the results of treatment of patients presented an album with photos and videos. Before treatment is conducted psychological and psycho-physiological examination of patients.

The second phase (therapeutic) includes collective-group session for 4 meetings. Two meetings to 8 hours by marathon (preferably, but not necessarily, when one of the two meetings held at night) and two control-support session for three hours in a month and three months after the main action. marathon method has the following specific mechanisms and benefits:

1) the intensity and concentration of psychotherapeutic influence exceeds the intensity of the same total exposure "classical" (90 minutes) sessions through time savings on "heating" and the structuring of the group;

2) increasing asthenia and biorhythms failure, behavioral patients reduces drag, facilitates the emergence of altered states of consciousness, the development of new experiences;

3) the continuity of the group experience contributes to the integration of a variety of exercises and experiences in a single batch process.

Number of group members is usually not more than 12-15 people. The increase in their numbers is impractical because it is difficult to contact a doctor with patients, monitoring them, deprive him of the possibility of introducing elements of self suggestion, keep for a class of all patients in the field of view, to support the activity of their attention. Individual treatment would be less effective as a joint activity of patients in the group of actively involving patients in the treatment process, develops communication skills, promotes the exchange of experiences on the treatment and individual experience, it helps to overcome the unconstructive fixation on disbelief in achieving this goal.

After the formation of the group, its members love each other and psychotherapists carried rational psychotherapy. During the conversation, the therapist repeatedly emphasizes that the most effective way of losing weight and keeping optimal weight is to change eating habits, reduction in the frequency and quantity of meals in accordance with the needs of the individual weight normalization program, restructuring the psychological motivations of man in relation to food and their own physical activity. At this stage we discussed indicators of normal body weight for each group member. It is possible to calculate using the tables or formulas.

The advanced formula of Broca:

M P = 100-10% of this difference,

where M - a normal body weight, kg, P - height in cm.

Indicator Breitman:

M = P * 0,7-50

In English literature widely used BMI - Body Mass Index (BMI)

VMI = M / P 2 (m)

Body weight in kilograms divided by height in meters squared. Indicator 25 indicates not more than about normal body weight, BMI in the range 25-27 corresponds overweight, over 27 indicates obesity.

Dysregulation of food intake is one of the major causes of excess adipose tissue. For most people with a normal body weight is usually not required any special participation of consciousness in determining the amount and quality of food. A significant part of the fat people to achieve energy balance income and expenditure of energy requires constant conscious control.

For a proper understanding of human behavior must be food to touch concepts such as "hunger", "appetite", "saturation".

Hunger - a set of unpleasant sensations in the form of emptiness and stomach cramps, feeling instinctively the need of food intake. It occurs when the body's nutritional reserves fell below the level needed for energy balance.

Appetite (with lat -. Aspiration, desire) - general feeling of pleasant emotional feelings that are associated with the human desire to receive certain foods. It is based on the desire to receive pleasant sensations that accompany the reception of one or the other food. In contrast to the appetite of hunger occurs when sufficient nutrient reserves of the organism.

Saturation - the lack of desire to eat, due to food intake. It is the opposite of hunger, being the reverse side of the same coin.

During the conversation, the therapist emphasizes the need to listen to changes in sensations that usually occur during or after treatment (eg, saturable increase, loss of appetite, change in taste, indifference or aversion to the previous favorite high-calorie, sweet or fatty foods, etc.) and gives the task is not to take food without feeling hungry that often make many obese people. But if there is still wanted, you have to eat right, abandoning the "empty calories", well reaching your diet, using dietary recommendations proposed.

1) Reduce caloric intake by limiting carbohydrates, especially easily digestible (sugar, chocolate, sweets, pastries, pasta, white bread, pastries, cakes, etc.). Because carbohydrates can leave cereals, which are cooked in the water (rice, buckwheat, oatmeal, barley), no more than 100 grams of wholemeal bread (bran, black, rye), which contains fat, more protein and B vitamins, and is less nutritious. Excluding honey, jam and sugar from your diet, in tea and coffee can be added sweetener ( "Milford", "Zucly" et al.).

2) Exclude from the diet of animal fats (lard, butter, fatty meats, cream and fatty cheeses). In a small number (1-2 tablespoons) should be left in the diet of vegetable oil for filling vegetable salads.

3) Observe the correct methods of cooking food (decoction, quenching in water, steaming, etc.).

4) Compulsory inclusion in the diet of protein. The mistake many people wanting to lose weight, is the neglect of protein food. But proteins are digested into amino acids are the "building material" for the cells of the body, they are low-calorie and give a feeling of satiety food field. So be sure to include in your diet the animals (lean meat, poultry, lean fish, boiled eggs - no more than 1-2 per day) and vegetable (peas, beans, beans, mushrooms, soy products) proteins.

5) Dairy products (skim milk, cottage cheese, yogurt, kefir, yogurt, sour cream 2-3 tablespoons for salads) can be used as a source of protein and calcium.

6) Fruits and berries can be everything except bananas. They are sources of vitamins, minerals, fiber, but they need only have to "main" meal or a separate reception. In the winter and spring to include in the diet of dried fruits (apricots, raisins, prunes), which are the source of potassium and stimulate the bowels.

7) Vegetables (raw, boiled, steamed) without restriction, except potatoes, which is due to the high caloric content of starch, but soak peeled potatoes in cold water for 10-12 hours, it is possible to reduce the caloric content.

8) Avoid beer and other alcoholic beverages.

9) Limit consumption of salty foods (salted and smoked fish, cooked and cured, salted sauces and seasonings), because salt retains fluid in the body, it promotes the formation of edema, thus slowing down the process of digestion of adipose tissue.

10) Right to organize a drinking mode, to use without restriction only filtered or mineral water. Listening to your own feelings, only drink if you want to, without overloading the body of excess fluid.

11) Exclude from the diet of herbs and spices that can stimulate appetite.

To lose weight, you should use the following guidelines and recommendations.

1) Adopt a diet diary in which every day to mark the amount of food eaten in kilocalories.

2) Use a diary to learn how to regulate the body's energy balance. Any type of obesity, in the end, is provided with excess energy intake over energy expenditure with food. A person with a normal body mass quantity of consumed food calories roughly corresponds to the amount expended in the process of life. The body regulates the balance automatically. Fat man, whose regulation of energy metabolism processes are violated, in order to lose weight, you must very strictly regulate the flow and power consumption. Therefore, counting Entries using the calories and energy expenditure tables proposed tables for various activities its energy balance, it is possible to achieve the desired energy deficit. In order for an effective weight loss process has started, the energy deficit should be about 500-1500 kcal per day.

3) On the day of the food does not receive more than 600 kcal.

4) Independently create a better diet. Using the above dietary recommendations, the individual characteristics of the body's own tastes and habits of each patient can make for themselves the most effective and optimal diet.

5) Regularly monitor your weight on the same scale at the same time, but also to monitor the changes in the volume of the different areas of the body. More often than not the weight decreases gradually and stepwise, so you should be prepared to ensure that the process of weight loss will be followed by periods of "stop" weight loss. The main thing is not losing weight speed and change of habitual harmful stereotypes of power, changes in the quantity and quality of food.

6) Eat slowly, carefully chewing. Usually the feeling of fullness comes after 15-20 minutes after starting a meal, so this is the minimum time that should be spent on food. If there quickly, before the onset of saturation of a person eats more than you need to satisfy your hunger.

7) Apply fasting days 1 time per week. For example:

A. Milk-kefir diet: 1 liter of milk or yogurt

B. Fruit and vegetable diet: 1 kg of apples or tomatoes or cabbage-carrot salad.

B. Complete abstinence from food: only use 1.5 liters of mineral water or herbal tea.

8) There is only a small spoonful of the small plates, which subjectively increases satiety.

9) When the desire to eat, to distinguish hunger from appetite, to try to escape by 10-15 minutes, if the desire is saved, you can go to the kitchen. But to start the process of making food should always be a liquid (a glass of water, tea or juice in small sips) or low-calorie foods (fruits, vegetables, salads), carefully listening to the sensations in the body.

10) Stop there for hours, under the TV, to eat up for home.

11) In order to increase the motivation to lose weight, you can buy an expensive dress or suit that size, to which the patient seeks and hung it in a prominent place, presenting its "svelte image" in this outfit.

12) Use a steam room or sauna for skin cleansing, removal of toxic substances from the body get rid of excess fluid, accelerate the process of digestion of adipose tissue.

13) The use of self-regulation and self-hypnosis at home.

During treatment, patients are taught the basics of autogenous training and auto-suggestion to yourself at home to work on their own feelings, reducing appetite, increasing satiety, strengthening willpower, etc. Activity meditating opposed to some negative sides of hypnotherapy in its classic model - a passive attitude of the patient in the process of treatment, depending on the doctor. The main elements of the methodology are training muscle relaxation, self-hypnosis and self-education. The therapeutic effect of anger management, along with the development as a result of relaxation trophotropic reaction characterized by increased tone of the parasympathetic part of the autonomic nervous system and helps neutralize the stress state, based on the weakening of activity of the hypothalamic and limbic regions, which is accompanied by a decrease in the overall development of anxiety and anti-stress trends. In recent years, the physiology of an increasing number of works, which testifies to the fact that the signal saturation starts the complex reactions of the hypothalamic-pituitary axis and the limbic system, a part of which is associated with positive emotions. If emotional stress on the background of the rise of anxiety satiety and emotional responses associated with it may act as a compensatory mechanism. According to psychiatrists who have been emotionally immature persons giperfagicheskaya response to stress, which is a maladaptive, but do not blame the social form of protection for any emotional and psychological discomfort (I.S.Korosteleva, 1994). Several authors have noted that bulimia may be a sign of hidden depression. The presence of such indicators as anxiety and depression are characteristic of obese patients as a symptom of mental distress (V.I.Krylov, 1994). Therefore, it is advisable to educate patients with overweight, anger management elements: 1) a lower level - relaxation training with exercise, aimed at evoking the feeling of heaviness, heat, to master the rhythm of cardiac activity and respiration; 2) the highest stage - the creation of trance states at various levels. The lower level consists of six standard exercises that are performed by patients in one of three postures (sitting in a "posture coachman", lying down or reclining). Exercises are performed by the mental repetition of 5-6 times of auto-suggestion formula that tells the therapist and are aimed at evoking the feeling of heaviness in the arms and legs, the heat sensation in hands and feet, the regulation of heart rate, respiratory rate and the normalization of the regulation, evoking sensations of heat in the area of ​​the abdominal cavity sensation of coolness in the forehead to prevent loosening and headaches of vascular origin. An indicator of the assimilation of the next exercise is a generalization of sensations. The second stage uses the exercise of imagination and self-affirmation plot developed by domestic authors (Panov AG Belyaev GS, Lobzin the BC, IA Kopylov, 1980), which are based on techniques of deliberate emotion regulation. The aim of exercise is self-conscious modeling of a given emotional state, but the essence is the reproduction of emotive representations, images and dynamic situations. self-affirmation exercises is mental rehearsal thrilling significance of the situation in the light of how it wants to see the patient. These exercises are best done in the morning, have not yet woken up completely, ie while in natural autogenous immersion. Self-hypnosis or autosuggestion - a process of suggestion, addressed to himself. It allows patients to call at one or another of sensation, perception, control the processes of attention, emotional and somatic reactions. The essence of self-hypnosis at IP Pavlova It is concentrated stimulation of a particular area of ​​the cerebral cortex, which is accompanied by a lockup of the remaining cortex, representing the interests of the whole organism, its integrity and existence. Self-hypnosis does not require special special training. Suffice it twice a day, after waking up and before going to bed 3-4 times myself to repeat the formula of auto-suggestion. It is made arbitrarily, it consists of a few short phrases. As an example we present one of the possible options:

1) I have a good mood and health.

2) I like the process of losing weight.

3) Every day, the more I try to lose weight, the less my appetite.

4) The longer I keep a diary, the slimmer and lighter becomes my body.

5) I am indifferent to sweet, fatty food and flour.

6) The faster saturation increases, the faster splits fat tissue.

7) Reduction of weight and volume improves health and makes you feel better.

Much attention in the overweight psychotherapy paid trance techniques - psychotherapeutic techniques using modified (split) of the state of consciousness in the therapeutic or prophylactic purposes. In our work we use the techniques of hypnosis not only classical, but also Erickson, who, having absorbed all the positive experience of classical hypnosis differs from it by the following criteria:

1) Use sanogennykh patient resources

2) All patients considered hypnotizability

3) Medical vague wording of (generalized), high-resolution connectivity subjective reality of the patient.

Examples of psychotherapeutic texts are listed below (O.V.Krasnoperov, 1996).

Text №1.

Before you enter into a state of trance, I will ask you to get comfortable. And you may notice that as soon as you relax, inside you there is a state of trance. And you can note that you are a good hear my voice well hear the music, feel like you're sitting in a chair, and you can feel like your hands touch your feet, relaxing. And you can feel the temperature of your hands, the weight of your hands and continuing to listen to my voice and music, you can continue to relax, sinking further and further into this state. And feeling as your feet touch the floor, and the back of the backrest concerns, you can feel relaxed and safe, and by continuing to relax, sinking deeper and deeper into this state, we can afford to learn about the condition even more. Hearing my voice will help all who wish to improve their health, get rid of bad habits, solve many psychological problems. And your consciousness can be far away in some nice place for you, where you can relax and unwind, and those memories or representations are activated in a certain direction Your subconscious mind, which in turn produces a body precisely those changes that are necessary for you. You do not have to believe in them or not believe. Just listening to my voice and my words, you at once or gradually begin to find his body in those or other useful to you changes. It is not necessary to understand the meaning of all the proposals, improving your well-being will occur without it. Maybe, sometimes, listening to these phrases, you'll catch myself thinking, what do you think about something else, or do nothing and do not want to delve into their meaning. And that's good ... And if you want, you can continue to listen and listening to my voice, relieve fatigue, improve your mood, increase alertness, activity and performance. Since each of us in varying degrees of fatigue tests: someone constantly, the other - by the end of each working day, and the third - only occasionally, after the hard work. Similarly, subject to fluctuations and our mood. Sometimes you after a long time of trouble can be depressed, but sometimes you may experience an increase in vitality and improvement of mood, without knowing why. All depends on your subconscious.

And each of you now can recall one or more instances of his life (perhaps from childhood or adolescence, or from the recent past), when even seemingly after the hard work you were still active, cheerful and workable and would "collapse mountain "... I do not know at what point you can return to that feeling of cheerfulness and good humor from your past. Each is necessary for this time (someone - minutes, someone - hours). But I know that your subconscious mind is capable of a lot better than you do, review your past and find it exactly the resources, the energy that you need.

I wonder how you'll learn about these useful changes. Maybe you feel the ease and flexibility of muscles or physically feel that you can walk, climb stairs or to operate without fatigue much longer than before, and maybe you'll hear from others that look good, or to see in the mirror of his joyful smiling face.

And the more you smile, the more you will be surprised that you have really improved mood and increased efficiency.

Text №2.

This treatment session will help all who wish to get rid of excess weight, and, no matter how much you have extra padding, sixty or two. But if anyone thinks that all those extra kilos will disappear by the end of the session, then he is mistaken. Weight reduction will be gradual. Someone will need to do a few weeks, someone a few months depending on your initial weight. And your mind can doubt this, while your subconscious is already beginning to explore your inner mysterious world and begins to identify ways and means of normalization of weight. And maybe some of you listening to my words, make a deep breath, and the others will start to sink in some state or even go into a trance, while others, on the contrary, to feel more refreshed and even more activated their consciousness.

Generally trance - this is not a special phenomenon, it is often found widely distributed condition. Everyone many times in my life have been in this state. And you, too, several times during the day come into this state and get out of it. Since trance - that standing in line and listening to lectures, and driving a car, and all the other states, when you are immersed in himself, in his thoughts, in his feelings. And, listening to me, some of you may already be immersed in a trance of the depth that you need here and now. And it's interesting that everyone, though intuitively knows what the depth and duration of the trance necessary to him at one time or at another time, in one or another state.

And you can change quickly or slowly. Similarly, once or gradually you will start to appear necessary therapeutic effects. Someone today, tomorrow or in the coming days will observe that decreases or completely disappears appetite. The other markedly accelerate satiety after meals: for complete saturation and overflow of the stomach will miss two or three spoonfuls of food, or even any piece of food will cause expansion and swelling in the abdomen. The third change first taste - formerly favorite food becomes less tasty or even indifferent. Someone all these sensations appear at the same time, another will appear one after another - sequentially or alternately. And the more your mind right now is resisting, the faster you will lose weight. And I do not know how you listen to me carefully, or surfactants, seriously or with a smile, but I know that after a while everyone who need it will find that its weight has decreased, although, perhaps, he did not pay attention, that it decreased appetite, accelerated saturation and perverted tastes and smells of food. This is because it is difficult to note that the increased metabolism of your body's metabolism and accelerate the disintegration of adipose tissue, and it happens to everyone who inhales and exhales, sitting in this room. And before you agree, what will be said next, I'd like to recommend to you today is always before eating to pay attention to your feelings and do not have, if you do not want. And if you really want to lose weight, then, sitting down at the table and starting eating, you think it's a state of trance and feel surprised to find that already ate, or mark, that food today is not so tasty and even resembles the mouth, mixed with saliva, something unpleasant.

Text №3.

I know that some of you have long been embarrassed to go to the beach and swimming in the reeds or no swimming; others do not like the mirror of bathrooms; others dream of wearing clothes that they want (shorts, short skirts, etc.), rather than the one that causes the figure to wear; fourth tired of diseases, which are always accompanied by excess weight: headaches, shortness of breath, pain in the joints and spine, hypertension, gallstones and kidney, and many others. But I know that the one who really wants to can become slim, beautiful, healthy, and therefore happy.

And the closer you will be to listen to my words, the next will continue to go to your healing process. And before you feel a significant reduction in weight again, you two, three or even four times a day will remember our treatment. And, smiling, you may recall that the process of weight reduction you precede the reduction and disappearance of appetite, the most rapid saturation, increase metabolism, and other personally your individual feelings.

Our existence - is a chain of continuous change. The universe itself is constantly changing. Times change, the alternate ebb and flow, the leaves fall off the trees and bloom again. Even in our body is a constant process of cell death and the emergence of new ones. Even the mighty cliff collapse and fade with time. Because so naturally the expectation of change in ourselves. And the more you concentrate on this idea and realize that the achievement of these changes within your capabilities, the more success you will achieve in life. From the beginning to adjust themselves to the fact that you will certainly achieve the desired changes with the help of these texts ...

And you can imagine the warm winter day. Can you remember yourself as a child in the winter ... or my children or grandchildren ... or just children playing in the street in the winter. And you can imagine, it is easy or difficult as you or they build snowmen of wet snow. Take a small ball of snow and rolled on the snow lying. And on a small lump begins to adhere to the soft, fluffy, white snow. And the lump increases, it becomes more and more. And ready the first ball. Then roll out the second and third. Mounted on one another, it is possible to attach the hands to stick a carrot instead of a nose, and a snowman is ready. And all winter this large, white, heavy snowman stands unchanged. But spring comes, the sun warms, and he suddenly begins to melt, reduced eyes. With each passing day it becomes less and less, getting thinner and thinner, lighter and lighter. And there is only one carrot. And I do not know when spring will come in your life. It can occur even in the winter and, of course, in the spring, and maybe by the summer all your loose white "snow" has melted, and perhaps before you type in your diet useful carrot or come up for themselves something else better. But every day, winter, spring, summer or autumn, remembering our treatment, you will be surprised to find everything new and useful in his new body, which will help you to get rid of complexes, improve your health and fully cope with being overweight.

At the end of the treatment, at the final stage, it discusses the program and time control and support meetings, which are necessary to secure the effect of the treatment, but also to answer questions that may arise in patients in the process of further self-slimming. The doctor strongly emphasizes the need to be especially careful with the successful completion of treatment. Many patients after treatment are very satisfied with their appearance and well-being, forgetting about the possibility of recurrence of the disease in non-diet regime and exercise. Therefore, to discuss the situation that can cause obesity relapse: nervous tension, stress, situations of temptation, which helps to avoid errors.

To test the effectiveness of the treatment used 4 groups of patients:

1. Diet therapy (without therapy) - 15 people

2. Psychotherapy individual sessions for two weeks (without nutrition) -12 people

3. Psychotherapy individual sessions for two weeks in conjunction with a nutritionist to control meetings at one and three months - 18 people

4. Psychotherapy marathon in conjunction with a nutritionist, followed by support sessions one and three months - 80 people (the proposed method).

All patient groups were measured by the following indicators: body weight before treatment, body weight at 1 and 3 months after treatment and the results of SUN test (subjective assessment of well-being, activity and mood on a ten-system), respectively. Patients of all groups were tested according to the procedure of multilateral study of personality: no significant differences between the groups in terms of all the scales of this technique is not revealed. Patients of all groups - women (average age - 34 years).

The results are shown in the table. Analysis of these data shows that the best result was obtained using psychotherapeutic marathon in conjunction with a nutritionist (Group 4 patients) for the first month, they lost an average of 9,68 ± 0,2 kg. (11.4% of the initial weight), and 3 months after treatment the average weight loss was 17.4 ± 0.2 kg, which was 20.2% of the initial weight. In second place on the effectiveness of weight loss was a group №3, when to use the classic version of psychotherapy - individual sessions 1-1.5 hours a day for 2-weeks in combination with diet: weight loss after 1 and 3 months after treatment was 7.4 ± 0.35 kg and 11.0 ± 0.3 kg (8.6% and 12.8% of the original), respectively. Even fewer have reduced their body weight, patients groups №2 (when used in the classic version of psychotherapy for 2-weeks without diet), who lost weight for 1 and 3 months to 5,8 ± 0,4 kg and 7,6 ± 0,4 kg (7.0% and 9.2%), respectively. The worst results were obtained in patients in Group 1, which received only diet therapy: a month after the treatment of their body weight decreased by only 3,9 ± 0,3 kg (4.8% of the original) and at 3 months remained almost at this same level - 4,3 ± 0,4 (5,3%). These differences in weight loss between the speed of all the groups were statistically significant (P <0.05). Moreover, patients in Group 4, this rate after 3 months of treatment retained, while the 3rd and 2nd groups of patients is significantly reduced, while the 1st - practically stops.

Analysis of SUN test revealed a steady increase in the level of health, activity and mood from the start of treatment and at 3 months after treatment, only group 4 patients who underwent psychotherapy marathon in combination with diet. Subjectively, they noted a decrease in appetite, accelerate the saturation process and painless (without much effort) reduction in body weight. While the patients in the other groups only the first month of being marked increase in the level, activity and mood (but to a much lesser extent than in patients of group 4), and at 3 months after treatment began the decline of these indicators. Patients also Group 1 held only diet therapy without therapy immediately after treatment began a significant reduction in the mood, they explained containment amount of calories and food intake by only willpower, while conversely increased appetite.

From the above it can be concluded that the proposed method for treating food addiction can improve treatment efficiency, and to stabilize the results obtained by the integrated use psychotherapeutic methods as psychotherapeutic marathon help change dietary strategies and psychological motivating patients in combination with diet, which allows to optimize power mode.

Thus, the proposed method of treating patients with food addiction, obesity accompanied allows:

1. Increase the efficiency of the treatment of patients with food addiction, obesity is accompanied by the integrated use of psychotherapeutic techniques as a psychotherapeutic marathon, changing their relationship to food (decrease appetite, accelerate the saturation process, etc.) and improvement of the subjective psychological background - being, activity mood.

2. Stabilize the results and increase the duration of remission through the use of self-regulation and self-hypnosis techniques in combination with diet.

3. Optimize the psychotherapeutic process - to work in a short time (2 marathon eight-hour psychotherapy), without drug exposure.

CLAIM

A method of treating food addiction, accompanied by obesity, including diet therapy and psychotherapeutic influence during collective-group sessions, wherein the main psychotherapeutic influence is carried out for the two sessions of eight hours each method marathon conditions asthenia, failure of biorhythms, and behavioral stereotypes, while generate motivation for healthy eating, self-confidence and faith in success, form a weight loss program, visualize and concretise treatment, keep a diary of eating behavior, exercise psychological defense conducted psychotherapeutic influence in case of the situation violations of diet, after the main sessions during one session three o'clock duration at one and three months aimed at consolidating the results, discussion and exclusion situations that provoke a recurrence of obesity.

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Publication date 06.01.2007gg