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Corso di Laurea in Discipline Psicosociali
Psicobiologia del comportamento umano
IPOTESI D’ INTERVENTO PREVENTIVO
SUL SOVR...
CHE COS’È L’OBESITÀ?
L’obesità è considerata e descritta clinicamente come una condizione
somatica, definita, su base morf...
DATI EPIDEMIOLOGICI
DATI EPIDEMIOLOGICI
STIMA Organizzazione Mondiale Sanità (OMS) in riferimento al 2008 :
• 1,5 miliardi di individui nel mo...
OBESITA’ E PATOLOGIE (in crescita)
Da studi empirici risulta che:
> Le persone obese riportano maggiori compromissioni e l...
• Il dato più allarmante ci proviene da alcuni studi di follow-up
a lungo termine sul trattamento dell’obesità che indican...
QUALI
FATTORI POSSONO
CONTRIBUIRE AL
SOVRAPPESO E
ALL’OBESITA’?
ABITUDINI MENTALI
• Secondo le condizioni diagnostiche dell’asse I (disturbi clinici,
caratterizzati dalla proprietà di es...
SOCIALI E AMBIENTALI
•L’“Ambiente obesogeno”
• L’obesità è prevalente nelle
nazioni con economie di mercato
stabili (Seide...
EMOZIONI
•Il 60-90% degli eccessi alimentari avvengono
come conseguenza di stati emotivo-affettivi
negativi (Kolotkin et a...
E’ CAMBIATO IL
NOSTRO MODO
DI CONSUMARE
I CIBI
STRATEGIE D’INTERVENTO
• La terapia cognitivo-comportamentale (TCC) mira ad identificare le
credenze disfunzionali, consid...
CONCLUSIONI
Legge di Muir: quando si cerca di isolare qualcosa si scopre che
aveva addentellati in tutto l’universo.
(A. B...
IPOTESI D’ INTERVENTO PREVENTIVO SUL SOVRAPPESO E
SULL’OBESITA’ IN UNA PROSPETTIVA PSICO-SOCIO-
BIOLOGICA
GRAZIE PER L’ATT...
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Ipotesi d'intervento preventivo sul sovrappeso e sull'obesita' in una prospettiva psico-socio-biologica - claudio lombardo

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L’obesità è stata definita dall’OMS come malattia multifattoriale e riconosciuta come epidemia globale (globesity).
Vari fattori incidono su questa condizione morfologica e sul suo stato iniziale: il sovrappeso.
Pressioni ambientali, fattori di rischio personali, sociali e familiari, relazionali e comportamentali, genetici e biologici, possono concorrere alla genesi del sovrappeso e dell’obesità.
La seguente tesi si propone di analizzare tutti i differenti fattori coinvolti al fine di convergere in una più ampia prospettiva che tenga conto dell’importanza non solo degli aspetti psicologici ma anche di quelli relazionali, socio-ambientali e organici.

Publié dans : Sciences
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Ipotesi d'intervento preventivo sul sovrappeso e sull'obesita' in una prospettiva psico-socio-biologica - claudio lombardo

  1. 1. Corso di Laurea in Discipline Psicosociali Psicobiologia del comportamento umano IPOTESI D’ INTERVENTO PREVENTIVO SUL SOVRAPPESO E SULL’OBESITA’ IN UNA PROSPETTIVA PSICO-SOCIO-BIOLOGICA Candidato Claudio Angelo Lombardo Relatrice Prof.ssa Elsa Addessi Correlatrice Dr.ssa Chiara Mastropasqua
  2. 2. CHE COS’È L’OBESITÀ? L’obesità è considerata e descritta clinicamente come una condizione somatica, definita, su base morfologica, come un eccesso di massa grassa (Cuzzolaro, 2002). Le definizioni dell’Organizzazione Mondiale della Sanità (OMS) sono: > sovrappeso = IMC da uguale o superiore a 25 fino a 29,99 > obesità = IMC uguale o superiore a 30.
  3. 3. DATI EPIDEMIOLOGICI
  4. 4. DATI EPIDEMIOLOGICI STIMA Organizzazione Mondiale Sanità (OMS) in riferimento al 2008 : • 1,5 miliardi di individui nel mondo in sovrappeso • 200 milioni di uomini e 300 milioni di donne erano obese. Tali stime secondo l’OMS sono destinate a crescere di anno in anno. In Italia: • Il sovrappeso riguarda il 42,5% degli uomini • Gli obesi rappresentano invece il 10,5% • Nelle donne il sovrappeso è meno presente (26,6%) • Ma il tasso obese di rimane alto (9,1%) La Società Italiana dell’Obesità (S.I.O.) afferma che nel 2025 il tasso di obesità fra gli adulti arriverà al 14%. L’OMS : LA PIÙ GRAVE EMERGENZA SANITARIA DEL VENTUNESIMO SECOLO !
  5. 5. OBESITA’ E PATOLOGIE (in crescita) Da studi empirici risulta che: > Le persone obese riportano maggiori compromissioni e limitazioni fisiche rispetto agli individui normopeso (Doll, Petersen, Brown, 2000; Fine, Jennifer et al., 1999; James et al. 2004)  Le persone obese in cerca di un trattamento per la riduzione del peso percepiscono livelli di compromissione fisica significativamente maggiori rispetto ai soggetti obesi che non stanno cercando di perdere peso (Fontaine et al., 2000)  Gli individui obesi percepiscono significative riduzioni del funzionamento psicosociale, del benessere psicologico e, in generale, della salute mentale (Fontaine, Barofsky, 2001; Kushner, Foster, 2000; Wadden et Stunkard, 1985)
  6. 6. • Il dato più allarmante ci proviene da alcuni studi di follow-up a lungo termine sul trattamento dell’obesità che indicano come il 90-95% di coloro che perdono peso lo riacquistano entro pochi anni (Garner, Wooley, 1991) a volte con gli interessi (Sarlio-Lahteenkorva et al., 2000) •La sola restrizione calorica può essere in grado di peggiorare la condizione del paziente obeso in quanto i livelli di ormoni dello stress potrebbero gravare sul suo stato psicopatologico (Lattimore, Maxwell, 2004), qualora fosse presente OBESITA’ E PATOLOGIE (in crescita)
  7. 7. QUALI FATTORI POSSONO CONTRIBUIRE AL SOVRAPPESO E ALL’OBESITA’?
  8. 8. ABITUDINI MENTALI • Secondo le condizioni diagnostiche dell’asse I (disturbi clinici, caratterizzati dalla proprietà di essere temporanei o comunque non strutturali), e disturbi in asse II, (disturbi di personalità e ritardo mentale) del DSM-IV rientrano i comportamenti dannosi per la salute e, l’obesità, può essere definita una condizione somatica profondamente influenzata da comportamenti inadeguati (Cuzzolaro, 1993) • Williams James affermò che la più grande scoperta della mia generazione è che gli esseri umani possono cambiare le loro vite cambiando le loro abitudini mentali
  9. 9. SOCIALI E AMBIENTALI •L’“Ambiente obesogeno” • L’obesità è prevalente nelle nazioni con economie di mercato stabili (Seidell, 1997). GENETICI E BIOLOGICI • Obesità materna (Strauss, 1999) • Leptina • Neuropeptide Y •Ormoni dello stress (cortisolo) FATTORI DI RISCHIO PERSONALI E COMPORTAMENTALI a) bassa autostima; b) insoddisfazione corporea; c) difficoltà nella gestione delle emozioni; d) perfezionismo; e) bassa autoefficacia; f) instabilità affettiva (Sirigatti, 2009); g) abitudini e preferenze alimentari (food preference); h) scarsa attività motoria (Iaia, 2009); ecc. RELAZIONALI E FAMILIARI La famiglia può influenzare atteggiamenti, credenze sull’alimentazione nonché sulla percezione del proprio aspetto esteriore. Correlazione tra auto- immagine e influenza familiare (Schwartz, Phares, Tantleff- Dunn,Thompson, 1999). Riequilibrare l’attività serotoninergica alterata (Manuk, et al., 2005). I DCA possono quindi essere considerati come soluzioni auto terapeutiche atte ad arginare l’angoscia (Bruck, 1997).
  10. 10. EMOZIONI •Il 60-90% degli eccessi alimentari avvengono come conseguenza di stati emotivo-affettivi negativi (Kolotkin et al, e Ganley). • Emotional eating. • Sobal et al., come conseguenza di stati emotivi positivi. PERSONALITA’, AUTOIMMAGINE E AUTOSTIMA Disturbi di personalità bordeline e incremento BMI (Sansone et al., 2001). Gli adolescenti obesi hanno problemi di autostima e di depressione principalmente in relazione ad una negativa immagine del corpo (Mond et al., 2011). SESSUALITA’ E SOVRAPPESO Aumenta, in relazione all’aumento dell’IMC, anche la problematicità relativa alle aree che riguardano l’interazione di coppia, i rapporti sessuali, l’erotismo immaginativo e i ruoli di coppia (Ackard et al., 1999; Friedman et al., 1999; Boyes et al., 2007; Quirk, 2009; Pinehiro et al., 2010; Markey et al., 2001; Jeansen et al., 2007; Brody, 2003). INFLUENZE SOCIO- ECONOMICHE Correlazione negativa altamente significativa tra SSE nell’infanzia e obesità in età adulta (Charney et al. 1976; De Spiegelaere et al., 1998). ABITUDINI COMPORTAMENTALI L’alimentazione viene considerata una funzione corporea non innata ma che contiene degli elementi di apprendimento e di cui ci si può servire per ottemperare a bisogni non legati alla nutrizione (Bruch, Hebb). MODELLAMENTO I figli tendono ad imitare le pratiche dietetiche dei genitori ed anche gli atteggiamenti e i comportamenti legati ai disordini alimentari (Cutting et al., 1999).
  11. 11. E’ CAMBIATO IL NOSTRO MODO DI CONSUMARE I CIBI
  12. 12. STRATEGIE D’INTERVENTO • La terapia cognitivo-comportamentale (TCC) mira ad identificare le credenze disfunzionali, considerate alla base di determinati disturbi e comportamenti, con lo scopo ultimo di sperimentare un cambiamento cognitivo-emotivo e comportamentale, attraverso la modificazione di tali pensieri disfunzionali in altri più funzionali. • Nel trattamento dell’obesità infantile la TCC si pone l’obiettivo di modificare i processi cognitivi, emotivi, relazionali ed ambientali che condizionano il comportamento alimentare e le abitudini di sedentarietà. • La terapia non è focalizzata alla riduzione del peso corporeo ma alla modifica dello stile di vita attuabile attraverso il raggiungimento di piccoli obiettivi graduali, sia nell’ambito dell’alimentazione sia dell’attività fisica.
  13. 13. CONCLUSIONI Legge di Muir: quando si cerca di isolare qualcosa si scopre che aveva addentellati in tutto l’universo. (A. Bloch, 1980) • Il tasso di obesità non è esclusivamente ascrivibile a caratteristiche o comportamenti individuali, ma è correlato ampiamente al contesto ambientale, economico e socioculturale (Monteiro et al. 2004). • E’ quindi opportuna una maggior sensibilizzazione – soprattutto da parte dei professionisti del settore – sulle possibili cause del sovrappeso e dell’obesità al fine di poter intervenire nella loro valutazione mediante una prospettiva psico-socio-biologia.
  14. 14. IPOTESI D’ INTERVENTO PREVENTIVO SUL SOVRAPPESO E SULL’OBESITA’ IN UNA PROSPETTIVA PSICO-SOCIO- BIOLOGICA GRAZIE PER L’ATTENZIONE Candidato Claudio Angelo Lombardo Relatrice Prof.ssa Elsa Addessi Correlatrice Dr.ssa Chiara Mastropasqua

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