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Health:饮食不规律 家庭大问题

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核心提示:Dr. Kathryn Zerbe, professor of psychiatry at Oregon Health and Science University and a longtime expert on eating disorders, recently took readers' questions on anorexia, bulimia, binge eating and related problems. Here, she responds to questions o

    Dr. Kathryn Zerbe, professor of psychiatry at Oregon Health and Science University and a longtime expert on eating disorders, recently took readers' questions on anorexia, bulimia, binge eating and related problems. Here, she responds to questions on the role of in-laws and other family members in promoting disordered eating.

    An Over-Controlling Mother-in-Law?


    Dear Dr. Zerbe,

    When my husband and I were between homes, we stayed with his parents for two months. His mother became extremely controlling of our eating habits (mine in particular.)

    I was not allowed to help myself to anything in the fridge or kitchen except bread and sometimes yogurt. We had to sneak out to the grocery store and "hide" our food in the refrigerator (way in the back) and eat when she was not there.

    Eating normally was not allowed in the house. It was only when her husband came home that she began preparing dinner and then everything appeared normal. (By then I completely starving.)

    I found myself losing weight at an astonishing rate and dropped down to 105 lbs after about six weeks of this. When I found myself hiding food in the closet of the room we were staying in I realized how unheathy this was and moved out.

    Is there a name or term for someone who tries to control the eating habits of others in this way, or might this behavior simply be an eating disorder that is imposed upon others?

    Thank you,



    Dr. Zerbe responds: There is no particular term for a person who tries so hard to control the habits of another, but it is fairly common to see someone who has an eating issue of their own impose it on others. Sometimes this is very direct, as your own case illustrates. At other times, the attempt to have impact is more subtle, and the person being targeted simply feels bad, or ashamed or guilty, when eating in front of the family member or friend. Psychologists refer to this phenomenon as projection.

    There are plenty of instances of women, for example, who go to lunch with an old friend and come home feeling miserable about themselves when nothing overtly derogatory or controlling has been said about food or body image. The person becomes somewhat preoccupied with her own diet, body image or weight for a while, only to learn later that the friend had an eating problem or struggle with body image. That person was, indeed, having negative thoughts and feeling about their own, and possibly their friend's, weight or body image, and the sensitive, empathic friend picked up on it. This is sometimes called in mental health circles "the contagion effect" because it's so much like catching a virus from another person.

    Fathers, Kids and Self-Image


    When I was 16, my dad began to make snide comments about my weight. I had put on about ten pounds since my early teens but I stayed a healthy weight, ate right and played sports.

    He'd say, "are you sure you want to eat that?" if I ever reached for a cookie. He told me I'd never be as athletic as some of my friends, and he said he wouldn't have to say these things if I weren't "so fat."

    I'm 19 now and have since learned not to stand for this. My dad has gotten better but still says things along these lines. A strong support system and self-image kept me from considering an eating disorder.

    But I worry for other women whose fathers and husbands are the same or worse. How can we teach others, who may have the best of intentions, to encourage us to eat healthy and stay active instead of hurting and demeaning us?



    Dr. Zerbe responds: You raise many important issues in your post, including the role of fathers and other significant male figures in the positive or negative development of sense of self in young men and women.

    So often in the past psychiatry tended to "blame the mother," but we now understand that so many factors - genetic, biologic, the role of father and siblings, and environmental - all play their part. That is what needs to be addressed in treatment, and this stance of blaming anyone is not helpful when trying to overcome a mental health concern.

    If you want to read more about the role of fathers and father figures in the development of eating problems, I suggest my colleague Margot Maine's accessible book, "Father Hunger: Fathers, Daughters and Food."

    In my book "Integrated Treatment of Eating Disorders: Beyond the Body Betrayed," I have a list of "do and don't" tips for family members and concerned loved ones that encourage staying active and coping with eating issues. One critical step is to not place so much emphasis on weight or appearance and instead to have more useful dialogues at home about healthy eating and exercise. It's also important to avoid using terms like "going on a diet" or derogatory statements of any kind.

    It is certainly O.K. for you to continue to develop your assertiveness skills by saying, "Dad, that statement hurts my feelings" or "That remark is not helpful." If he does not seem to listen or "get it," tell yourself (as hard as this is to do) that that is his issue and you are only responsible for your own attitudes.

    Set a no-tolerance policy at home for teasing about weight or body, and increase awareness of the impact of mass media. Make discussing weight at mealtime a taboo subject and keep emphasizing that you are working hard to develop sources of self worth that do not depend on appearance.

    Finally, I will quote the father of one of my students who advised her, when she was going off to start college, to remember that "No!" is a complete sentence. That "no" can be applied to many situations in life, but in this case you could say, "No. Stop talking about this stuff." In other words, keep the communication lines open but maintain appropriate interpersonal and generational boundaries.

    俄勒冈医科大学心理治疗专业教授、营养饮食专家卡斯琳·泽比(Dr. Kathryn Zerbe)最近解答了许多读者来函中关于厌食、挑食、暴饮暴食等问题。以下是她对家庭关系引起个人饮食失调问题的解答。




















    如果你想多了解父亲在孩子建立良好生活习惯方面,应该给予哪些帮助的话,我建议你可以看看我同事马国特·梅恩(Margot Maine)写的《爸爸饿了:亲子与美食》(Father Hunger: Fathers, Daughters and Food)这本书。

    我在《饮食失调的治疗方法:从心理上来看》(Integrated Treatment of Eating Disorders: Beyond the Body Betrayed)这本书里,列出许多给患者及家属的建议,鼓励患者积极对待和解决饮食失调的烦恼。关键的一点,不要把体重和美貌看得过于重要,多与家人聊聊健康和运动的话题。尽量避免用"越吃越胖"之类话取笑和打击别人。




关键词: Health 饮食 家庭
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