RU2019996C1 - Method for correcting weight of a person - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: single psychotherapeutic session is combined with two-month dieting. First, the patients are divided into groups according to identical suggestibility, then subjected to rational psychotherapy in the alert state, then, against the background of increasing relaxation they are subjected to heterosuggestive treatment for developing negative attitude to overeating the high-calory food. EFFECT: higher efficiency.

Description

 Obesity is one of the most common diseases, which, according to researchers, is based on primary and secondary metabolic disorders. The most significant etiological factor is recognized as a disorder of the mechanisms of regulation of fat metabolism, which can occur in any part of the regulatory apparatus - both at the level of the central and autonomic nervous system, and at the level of intimate metabolism of fatty tissue. The most significant factor contributing to the development of the disease is recognized as a violation of the diet in the form of its redundancy and disorder.

 Two forms of obesity are typologically distinguished: obesity as an independent disease and as a symptom complex reflecting pathology in the central nervous system and the endocrine system. The insufficiency of motor activity, which was previously considered as the main reason for the occurrence of obesity, today plays the role of an additional, but not decisive factor.

 The most common variant of obesity is alimentary obesity, which accounts for more than half of all cases of the disease (55-60%). Currently, a sufficiently large number of methods and tools have been developed used in the treatment of obesity. However, as practice shows, not all of them are effective and affordable for a wide range of patients with obesity. So, for some methods, this is due to the need to mobilize emotional-volitional efforts for a long time (fasting, diet therapy); for others (surgical methods, physiotherapy exercises) with limited use due to concomitant somatic diseases, and finally, for the third (pharmacotherapy) with the possibility of side effects and complications. A well-known exception in this series are non-medicated physiological methods for the prevention and treatment of obesity, in particular reflexology based on a reflex method of normalizing central and peripheral regulatory mechanisms.

 In recent years, the treatment of obesity with methods of psychotherapy has become widespread. They are based on special techniques aimed at the formation of a concentrated focus of excitation in the cerebral cortex, which, according to the law of negative induction, causes a braking zone around itself, which determines the dominant importance of this region or point of the cerebral hemispheres against the background of a decrease in the tone of the cortex. In this case, the word-order acquires the meaning of a specific code isolated from all influences and becomes an effective stimulus that can cause inhibition of motivation processes.

 Important components of the mechanism of the therapeutic effect of psychotherapy are its focus on the patient’s personality, taking into account its individual characteristics, the ability to influence the level of motivation and emotional response, to form a new structure of the attitude system. An important role in the course of treatment is given to the achievement of the patient's awareness and understanding of the causal relationship between the disease and the characteristics of its relationship system.

 This disease can be attributed to those forms of pathology, which are based on functional disorders in the processes of motivation, in particular, in the food center system.

 As the data of the conducted studies show, the concept of the food center includes structural formations of different levels of the systemic organization of the central nervous system, where the cerebral cortex and the subcortex play an important role. Among the brain structures, the nerve formations that make up the medial bundle of the forebrain formed by the structures of the limbic system are most closely related to motivational reactions. The neurophysiological basis of various motivations is made up of specific cortical-subcortical systems. And the nervous mechanism, which differs from the humoral one in greater flexibility and plasticity, is the fastest way to form motivation and the corresponding functional system. To understand the mechanisms of the therapeutic effect of various psychotherapy options, it is also important that the food center, like the centers of other drives, can be subjected to various influences both from the afferent nerves (i.e., reflexively) and from other centers, thanks to the established intercentral relationships. These reflex and intercentral influences are capable of exerting influence on various parts of the functional system of food motivation, which take part in the implementation of complex behavioral reactions, in their emotional and vegetative support. Indeed, acquired and conscious skills, behavior motives changed during psychotherapy, strong emotions, especially negatively colored ones (anxiety, fear) can cause a decrease or suppression of the functional activity of the food center, as well as other drives.

 An exceptional feature of emotional states is their ability to cause instant integration of all body functions. Moreover, encompassing the whole organism, emotions themselves can act as an absolute signal of the usefulness or harmfulness of one or another impact before a specific response mechanism of the organism is determined. This is especially important to take into account when developing methods and means of treating those diseases that are associated with impaired attraction and, in particular, obesity. Without exception, all vital needs and desires, including manifestations of intellectual activity, are accompanied by an appropriate emotional tone, due to which various functions of the body are authorized or rejected on the basis of the principle of compliance with the formed emotional state. It is this circumstance that makes emotions an important link in the mechanism of therapeutic action of many methods and means, including various types of psychotherapy, due to the possibility of influencing emotional reactions and human behavior.

 A known method of reducing a person’s weight using an autogenic training (Lindemann H. Autogenic training, M .: Med., 1985, p. 325). However, the method has the disadvantages of any autogenic training applied in isolation.

 An analogue of the proposed method is a method for the complex treatment of obesity (Psychotherapy in the system of rehabilitation of patients with the alimentary-constitutional form of obesity Ter. Archive, 1984, v. 56, N 10, pp. 104-107), including multi-stage complex treatment using at each stage of diet therapy, physiotherapy exercises, drug therapy, physiotherapy, psychotherapy. At the preparatory stage, the psychotherapeutic effect included learning the techniques of autogenic training with the aim of mastering the methods of self-regulation of sensations of hunger and thirst, activation of the motor sphere, and a decrease in the level of psychological tension; at the second stage - also teaching methods of self-regulation using certain formulas, conducting rational psychotherapy in relation to diet, physical activity, at the third stage - conducting rational group, family psychotherapy, various types of club work.

 This type of psychotherapeutic effect is in the nature of supportive psychotherapy. But such tactics of psychotherapy in the treatment of obesity, as shown by practical experience, are ineffective, because patients need a long-term mobilization of emotional-volitional efforts, and most of the patients are not able to adhere to food restrictions and increase motor activity over a long period of time.

 The purpose of the proposed method for correcting a person’s weight is to increase the effectiveness of weight loss by using the method of stress psychotherapy.

 The difference of the proposed method lies in the fact that the psychotherapeutic effect is not carried out in stages, but once in a state of relaxation and in the form of a heterosuggestive effect with the aim of forming negative emotions for food abuse with increased energy value; diet therapy is prescribed for a period of 8 weeks with an energy value of 800-900 kcal per day.

 The method is based on the principle of mobilization of the self-preservation reflex due to the formation of negative emotions of fear (motivated emotional suggestion). As you know, the emotion of fear is one of the strongest emotions of a person, and it is precisely fear, fear of disrupting the diet that is offered during treatment sessions that allows you to get a high therapeutic effect. In the process of verbal heterosuggestive influence, a negative psychological attitude is created for the use of products with high energy value - carbohydrates, fats, not overeating. After the session, if this regimen is violated, when “forbidden” foods are consumed, discomfort occurs: dizziness, nausea, stomach pain, vomiting. As a result, the patient does not enjoy eating, and most importantly, he feels a fear of disrupting the proposed regime and therefore limits his diet. This makes it possible to succeed even in non-suggestible patients. The effectiveness of the method of stress psychotherapy is also associated with a one-time patient meeting with a doctor. The subsequent re-session, which is carried out in some cases (with a weight loss of up to 10% of the initial one) 6-7 months after the first, is more of a securing nature. The disadvantages of a long-term phased course of psychotherapeutic treatment are associated with the effect of getting used to the doctor: the patient begins to consider the doctor as his friend, which reduces the effectiveness of psychotherapy. A huge role in stress psychotherapy is played by the psychotherapeutic ritual itself, including the patient’s anxious waiting for the session to begin, its mystery, the knowledge that the doctor is using a new unknown method, that a certain “code” is being put into the mind, so that the patient can do what is required to weight loss.

 The method is as follows.

 48 hours before the session of stressful psychotherapy (coding), alcohol is excluded from the patients ’diet, and 24-hour high-calorie foods (carbohydrates, fats) are excluded. Patients are divided into groups of 10-15 people on the basis of identical suggestibility, which is evaluated, for example, according to the well-known method of "suggested errors." Immediately before the session, rational psychotherapy is carried out in the form of a group conversation. In this case, a motivated suggestion is made in the wakeful state and already at this stage the formation of negative emotions of fear of overeating and eating high-energy food begins with the appearance of a feeling of anxious expectation before the session, which also contributes to the success of the treatment.

 Then, a session is conducted in which the patient first creates a state of relaxation using the methods of verbal and non-verbal suggestion, and then the state of relaxation is deepened with the help of electric sleep to the stage of superficial hypnotic sleep, because the effectiveness of motivated suggestion against the background of hypotaxia increases hypnability, and it is in this state that a post-hypnotic realization of suggestion is possible. The use of electrosleep has proven itself in conducting hypnotherapy sessions and allows for deeper inhibition of brain cortex cells. When carrying out a heterosuggestive imperative effect against the background of electric sleep, a final installation is created for the formation of negative emotions for food abuse with increased energy value. Further, hypnothesia is carried out by commonly used methods. The average duration of a session is about 20 minutes.

 External conditions during the session include a calm environment, a darkened room, the absence of extraneous noise, the presence of a monotonous variable sound tuning fork, etc., i.e. such factors that contribute to increasing the effect of heterosuggestion on the background of a hypnotic state.

 After the session, patients are prescribed a diet for 8 weeks with an energy value of 800-900 kcal per day. After 6-7 months, a repetition of exposure is possible with a weight loss of up to 10%.

 The proposed method of weight correction was carried out in more than 1000 patients of various ages and sexes. Patients were followed up to 3 years. The study of the dynamics of their weight, clinical condition revealed a high efficiency of the method in patients with alimentary-constitutional and endocrine forms of obesity of varying degrees with a weight loss of 10 to 40% of 5-10 kg per month. Contraindications for the application of the method are chronic diseases in the acute stage, cancer, taking corticosteroids. No complications were noted.

 PRI me R. Patient A.V. N.V., born in 1947, economist. Seek help for obesity. Upon admission, he complains about a decrease in working capacity that appeared in the last year, a feeling of weakness, shortness of breath, dizziness when walking, physical exertion. On the maternal side, both grandmother and mother were distinguished by increased completeness.

 He worked as an economist. Neither at the institute nor at work was the excessive completeness of particular troubles and troubles. The work was mostly not very interesting, characterized by sedentary mobility and required perseverance and attention. In 1979 he entered graduate school, which he graduated in 1983, after which he defended his thesis. In the adult state, the weight remained stable within 97-100 kg with an increase of 174 cm. I began to notice that in the morning there was a "wolf appetite", which lasted for 1-2 days. According to the patient, during these periods he constantly had a desire to eat something. Attempts to keep themselves within the framework of a relative diet were not particularly successful. Since that time, he began to note that he began to gain weight, which in a relatively short time reached 120-125 kg. He drew attention to the fact that he began to tire quickly, decreased performance, worsened memory, frequent attacks of apathy, drowsiness, unwillingness to do anything, poor sleep, appetite nonetheless remained good. All this contributed to a decrease in mood, the appearance of irritability, emotional lability, and the difficulty to restrain oneself. He was hospitalized at the Institute of Nutrition, where he was prescribed diet therapy, physiotherapy procedures, physiotherapy exercises. Within a month, it was possible to reduce weight from 125 kg to 102 kg, which was accompanied by an improvement in well-being. Nevertheless, despite the ongoing treatment, a sense of increased appetite persisted. In the first 1-2 months after discharge, he continued diet therapy, although over time it became more difficult to do this. The desire to give up everything and eat well was almost always present to a greater or lesser extent. He began to pay attention that the more he restrains himself, the more he wants to eat. According to the patient, he was tired of fighting with himself and returned to his previous lifestyle. The weight began to grow again, and concomitant deterioration of the general condition began to appear slowly and not so pronounced. The latter circumstance again forced him to turn to doctors for help. The treatment was carried out by the method of unloading and dietary therapy (dosed fasting). The treatment was difficult. During treatment, the weight decreased by 18 kg. After the treatment was carried out for two months, the condition remained satisfactory, returned to work again and throughout this period I tried to comply with the recommended diet. However, after starvation, he began to notice sleep disturbances in himself, manifested by plentiful dreams, when he dreamed that he had “lost his temper” and was eating again without restriction, he saw himself in a dream as he was eating everything and could not get enough. Often woke up in sweat and could not fall asleep for a long time. There was a feeling of fear that he would never become the same as before. For him, his whole life turned into a constant struggle with himself.

 Physical condition upon admission. A patient of average height, increased nutrition, with a predominant distribution of subcutaneous fat on the lower abdomen, trunk, thighs. With a height of 174 cm, weight 112 kg. The borders of the heart are not sharply increased to the left, the tones are muffled. Blood pressure 150/90 mm RT. Art. In the lungs, visicular breathing. Abdominal organs without features. From the side of the nervous system, unsharp soreness of the upper trigeminal points. The abdominal reflexes are sluggish, knee and Achilles somewhat lively.

 Blood and urine without pathological changes. During the review craniography, bone-structural changes from the skull were not detected. The Turkish saddle has clear contours. The fundus is normal, the field of view is not limited.

 The treatment according to the proposed method.

 After treatment using the coding method, the patient followed the recommended diet without any effort. The feeling of hunger almost disappeared, he guarded the indifference to previously beloved dishes. Completely refused to drink alcohol. Within a month, the weight decreased to 95 kg, while the patient did not experience the difficulties that were present after previous methods of treating obesity. At the same time, the general condition noticeably improved, a feeling of self-confidence and self-confidence appeared. Significantly improved performance, mood, emotional mood. Subsequently, he was re-observed for 3 years for follow-up examination. He did not make complaints to his state, continued to observe the diet without volitional efforts, maintaining weight characteristics within the required limits.

Claims (3)

 METHOD OF HUMAN BODY WEIGHT CORRECTION, including psychotherapeutic effect and diet therapy, characterized in that alcohol is eliminated from the diet before 48 hours of psychotherapeutic effect, high-calorie products are excluded in 24 hours, and the effect is performed once, with the patient being grouped by 10-15 people at first on the basis of identical suggestibility, then rational psychotherapy is carried out with motivated suggestion in a wakeful state, after which patients are introduced into a state of relaxation using techniques verbal and non-verbal suggestion, deepen relaxation with the help of electric sleep to the stage of superficial hypnotic sleep and continue to have a heterosuggestive effect with the aim of forming negative emotions for abuse of food with increased energy value followed by hypnotization, a diet is prescribed for 8 weeks with an energy value of 800 - 900 kcal per day .  2. The method according to claim 1, characterized in that the heterosuggestive effect is carried out for 20 minutes  3. The method according to claim 1, characterized in that when reducing weight to 10%, the effect is repeated after 6 to 7 months.