Bariatric clinicians at The American Association of Bariatric Counselors have identified a frequently undiagnosed shame based dysfunctional psychological disorder that is pervasive amongst many obese patients that can help explain relapses: AVOIDANT PERSONALITY DISORDER DSM-5 30
As the diagnosis suggests, the main coping mechanism of those with avoidant personality disorder is avoidance. This chronic disorder is so deeply rooted, that shame riddled obese patients will avoid the pain of confronting anything that conjures up their obesity shame.
Feelings of shame triggers avoidant behaviors; interruption of self-monitoring, scale use, exercise, mindful eating, weight gain and especially not keeping appointments at your office/clinic This can explain how a minor weight gain can become a full blown relapse.
How Avoidant Personality Disorder Leads To Avoidance Syndrome and Dysregulated Eating Behaviors
The best way we can explain how the Avoidance Syndrome leads to dysregulated eating behaviors and weight gain is by telling by a real story. There are many ways that this story can begin but this is the version that most patients identify with and how the story was told to me by a patient.
This completes part three our three part best practices series:
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Part 1: Why Would Somebody Lose All The Weight and Then Gain It Back?