Psikososyal Faktörlerin ve Beslenme Müdahalesinin Yeme Bozuklukları Üzerindeki̇ Rolü

Abstract

Yeme bozuklukları, karmaşık ve çoklu faktörlü etiyolojiye sahip olan psikiyatrik bozukluklardır. Yeme bozukluklarının etiyolojisinde aile içi ve çocukluk dönemi deneyimleri, toplumsal ve kültürel baskı, medya standartlarının dayatılması gibi sosyokültürel faktörlerin yanı sıra düşük benlik saygısı ve beden memnuniyetsizliği, stres, kaygı, duygu durum bozuklukları, travma ve mükemmeliyetçilik gibi psikolojik faktörler bulunmaktadır. Yeme davranışının normalleştirilmesini içeren bir beslenme müdahalesi sağlamak için yeme bozukluğuna sahip bireylerin hastalığının altında yatan psikososyal yönlerin anlaşılması gerekmektedir. Çünkü bir bireyin psikiyatrik bir hastalık olan yeme bozukluğuna dair semptomlarını ilk tanıyan kişi veya bir hastanın bu durum için başvurduğu ilk sağlık uzmanı diyetisyen olabilmektedir ve diyetisyenler bu hastaların tedavi ekibinin kritik bir üyesidir. Beslenme müdahalesinin planlanması sırasında; tıbbi veya fiziksel durumla ilgili beslenme sorunlarının tanımlanması, antropometrik ölçümlerin ve biyokimyasal verilerin değerlendirilmesi, davranışsal ve çevresel faktörlerin incelenmesi, enerji ve makro besin ögesi gereksinimlerinin hesaplanması, tüketilen gıdaların miktar ve çeşitliliğinin arttırılması, açlık ve tokluğun normal algılanmasına ilişkin öneriler verilmesi gibi uygulamalar, uygun ağırlık restorasyonu ve sağlık hedefleri doğrultusunda planlanan beslenme müdahalesinin temel süreçlerini oluşturmaktadır. Bu süreçte bireyin değişen ihtiyaçları gözetilerek psikososyal destek ve olumlu pekiştirme sağlanması sürece olan bağlılığını arttırmaya yardımcı olabilmektedir. Tedavi süresince tedaviye dahil olan sağlık uzmanları ve bireyin ailesi ile sürekli bir iş birliği ve iletişim içinde olmak iyi yönetilen bir tedavi sürecinin ayrılmaz parçasını oluşturmaktadır. Bu açıdan tedavi ekibi içinde yer alan sağlık profesyonellerinin yeme bozukluğunun etiyolojik faktörlerini dikkate alarak ekip içerisindeki diğer üyeleri bilgilendirmesi ve ortak karar alma ortamı sağlaması tedavi sürecine oldukça büyük bir katkı sunmaktadır.

Keywords

• yeme bozuklukları
• psikososyal faktörler
• beslenme müdahalesi

The Roles of Psychosocial Factors and Nutritional Intervention on Eating Disorders

Abstract

With a multifaceted and intricate etiology, eating disorders are classified as mental diseases. The etiology of eating disorders includes sociocultural factors such as family and childhood experiences, societal and cultural pressures, imposition of media standards, as well as psychological factors such as low self-esteem and body dissatisfaction, stress, anxiety, mood disorders, trauma, and perfectionism. To provide a nutritional intervention that includes the normalization of eating behavior, it is necessary to understand the psychosocial aspects underlying the illness of individuals with eating disorders. Because a dietitian may be the first person to recognize the symptoms of an individual's eating disorder, which is a psychiatric disorder, or the first healthcare professional to whom a patient applies for this condition, and dietitians are a critical member of the treatment team of these patients. During the planning of nutritional intervention; practices such as defining nutritional problems related to medical or physical condition, evaluating anthropometric measurements and biochemical data, examining behavioral and environmental factors, calculating energy and macronutrient requirements, increasing the amount and variety of foods consumed, and giving recommendations regarding the normal perception of hunger and satiety constitute the basic processes of nutrition intervention planned in line with appropriate weight restoration and health goals. In this process, providing psychosocial support and positive reinforcement by considering the changing needs of the individual may help to increase their commitment to the process. Being in constant cooperation and communication with the healthcare professionals involved in the treatment and the family of the individual during the treatment period constitutes an integral part of a well-managed treatment process. In this respect, the health professionals in the treatment team informing the other members of the team by considering the etiological factors of the eating disorder and providing a joint decision-making environment makes a great contribution to the treatment process.

Keywords

• eating disorders
• psychosocial factors
• nutritional intervention

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