the intersections of physiology and psychology, we invited a famous psychologist, candidate of psychological sciences, natalia fomicheva to visit us. natalia, hello, hello , actually, the first question is, what is an eating disorder, can eating behavior really be somehow, we can start with what is normal eating behavior, healthy, in general, our body is designed in such a way that we feel physiologically. that is, from the place where a person either feels hunger, but ignores it, or does not feel hunger, or does not feel satiety and overeats, that 's how the basis of the disorders is precisely the failure of this perception of the processes of sensations of hunger, sensations of satiety, and here i add.

to feel hunger, but ignore it, or i will use food in order to regulate some emotions and then i will overeat, that is, here initially , for example, i will limit myself in food, there will be a big story about the fact that you need to look somehow in a special way, you need to somehow influence your own body, this can be done through food, so i, this physiological basis is violated, isn't it normal to limit? in food, well, that is, you understand that you should look normal, feel normal , and for this you should somehow not grab everything, that everything that is at hand, actually, choose somehow, no, that's actually, saturation should work as a limiter, that is, i stop eating when i'm full, and not when i've eaten a certain amount of calories or never i started to worry that tomorrow it will be reflected on the scale, or never i looked at myself in the mirror said a bunch of

nasty things about myself, that is, a limitation that comes from a feeling, it is essentially not a limitation: i've eaten my fill, that's enough for me, here are the limitations because you need to look somehow - this is exactly the foundation that further leads to breakdowns, because people limit themselves, go on diets, and as we all know from research, 95% of people after 5 years of dieting have more weight than they entered this diet, this is the moment, if ... eat very quickly, you will feel full when you have definitely overeaten, than if you eat slowly, and you will have time to eat less, here i would talk in general about the awareness of the process of eating itself, that is, eating, the process of consuming food, in a good way, is a separate type of activity, when we eat quickly, because we are in a hurry, when we are simultaneously scrolling through something on the phone, arguing with a household member.

we prefer sweet food, because it is energy-intensive food, it is food, we need glucose for muscles, for the brain, and this is a rare food in a certain sense, yes, the main problem is that initially, where there was sweet food, there was sugar cane, try to gnaw it, try to get this glucose out of there, fruits, fruits, which still contain fiber, and there is a process of the pancreas reacting to the fact that glucose would come in. much smoother, of course, now that we have industrial sweets, if you overeat just candy, yes or cakes, well, to some extent it will not be very useful for the body, but it is not it means that you need to completely exclude it and sit, and then break down again, here people need some tangible things, why 33, not 48, not 26, because on average, to experience solid food, 33 is a sufficient

amount and here 32 teeth one tongue, and it is easy to remember, yes, when there are some numbers, you can practice a little, as they say, then it ... into a reflex and a person stops counting, but gets used to the fact that food must be chewed, and you know this movement, when this food is pushed straight through, this lump is not chewed, not moistened with saliva, and naturally there is little sense in this food, because nothing can be extracted from it, and so that we do not go too far, in the icd, that same disorder, yes, an eating disorder , it is called, excuse me, the international classification of diseases, thank you, never. do not let me escape into this dark side, there it is called an eating disorder, is it the same thing, or are they different things, a disorder of eating , an eating disorder, are they different things, if we take dsm5, a diagnostic reference book

mental disorders of the latest version, in 2013, avoidant restrictive eating disorder appeared there, and we can say that yeah. we have an eating disorder, this is nervous bulimia, nervous anorexia , overeating syndrome, where concern lies precisely at the basis of this experience of the body, i don’t like my body, and i’m trying to do something through food with my difficult emotions about how i look, eating disorder is a completely different category, these are people who, for example, initially the feeling of hunger is disturbed, they don't...

because only in 2013 it began to be discussed as a separate diagnostic category, research is still underway, so it's difficult to talk about some percentages, but in general i think it will be approximately at the level of nervous anorexia, somewhere around 1-5% of the population, this is probably more associated with people with autism spectrum disorders of the psyche, there are correlations, yes, we really do, firstly, in people with... autism and the autism spectrum we see a disorder of eating in the opposite direction we will also see autistic features, but in general there are three groups that can be distinguished today, these are people who have a very disturbed physiological hunger, plus they have practically no hunger for

tastes, so many of us have this story that we ate something, well, there we ate soup, ate a cutlet, and now we want something sweet, we are full, but the taste buds need something else, but here it is missing, and people can, well , as if eat the same food, the same taste, they are quite happy with it, they eat little, not diverse, and this is one group, the second group of people are people who seem to have very strongly developed papillae, that is , they are such natural tasters, since childhood they do not like. food that has a bright taste for them, and these are children who eat pasta, pasta with cheese and cheese, in my opinion, these are the children who predominate now, that is , they choose food that has a very neutral taste, very understandable, and as

a rule, these are carbohydrates, that is, here we can see the opposite situation, when a person is overweight, because they also have a very unbalanced diet, the third group is people... who in childhood experienced some kind of, well, let's say, trauma in their relationship with food, they choked very badly, got burned, got scared, got poisoned, for them - this experience, it kind of begins to change their eating behavior, that is, food begins to frighten, and the child begins to avoid, he choked on soup, removes all liquid food altogether, or choked on a cutlet and stops eating meat, because it is reminds me, here in essence very... different people can fall under the category of orfit, it is called avoidant restrictive disorder of food intake, with very different such past experience, but it can be harmless, for example, i have a child i know who does not eat red food, he does not eat strawberries, he does not

eat tomatoes, it depends on how limited the diet is, that is, if the diet is so limited that it already has certain consequences for health, then it is dangerous. it is good if a person simply does not eat tomatoes, well, in the end, everyone has taste preferences, this is not yet an eating disorder , it's a relief, yes, thank you, that it is not at all. a device, which is just some kind of well, as you said , yes, how to distinguish - yes, how to distinguish pathology from non-pathology, again, there are quite clear diagnostic criteria, if we are talking about avoidant eating disorder - this is such a continuum, we have a food pyramid, there are complex carbohydrates, there are proteins, vegetables, fruits, fats, sugars, and in severe... an arfit person eats one or two products, in principle, with milder forms, these are

one or two products from each of these categories, from each, from each layer of the pyramid. taste preferences are taste preferences, if this does not affect the functioning of the body, this is a preference, if the question arises that it is impossible to change the structure of nutrition, perhaps a person needs, for example, to add some ... with an autistic spectrum, yes, most likely there will be, and some features of the structure

of the same taste buds, well, rather yes, there is some genetic basis, we will figure out whether mint is so useful or there are some dangers, not only about mint, but about everything most important for life and health, in the program live healthy, tomorrow on the first. "i met a colleague in the lab, he only asked if it was true that you have a psychic serving, and the bosses will get it, oh, you know, how he can do it, look, now, please tell me what my wife needed from you, fortune teller, new episodes, tomorrow on the first." we continue podcast substance deception, we are talking about eating disorders. this is olesya

nosova, with me zukharapavlova, and natalia fomicheva. well, by the way, you said, here is an interesting thing about how some children, but this starts in childhood, prefer to eat pasta, pasta with cheese, cheese and so on, because their taste buds are very strongly developed, they are such potential, as you said, tasters, potential tasters. does this mean that if a person is overweight, if he loves pasta with cheese, then the taster in him dies, that he just needs to pump himself up a little, in fact , we do not rely on the body mass index when we diagnose an eating disorder or an eating disorder, this may coincide, but again, not all people with nervous anorexia are thin, because now, according to the new diagnostic criteria, we say that nervous anorexia. everything is weight loss, this is the dynamics of weight loss, at what weight a person got there, it does not matter,

so here it is like this to say that you weigh so much, therefore you have this - this is too much simplification, and what dynamics should there be for this to look like, this is frightening for nervous anorexia, and 30% of the initial weight in 6 months, this is a lot, well , that is, for a woman 60 kg is 20 kg, a loss of 20 kg, right? almost yes 18, yeah, 20 kg, yeah, well yeah , it is significant, inpatient treatment is always required, with nervous anorexia, yes, this is very desirable, because in fact it is a complex disorder, and a team is needed there, yeah, a psychologist is needed there who specializes in eating disorders, there you need a doctor, a psychotherapist or a psychiatrist, there you need...

hunger as discomfort, that is, they feel that they are hungry, but in general it gives them more activity, lightness, they even like to some extent the experience of hunger, if a girl with such a predisposition, as a rule, these are girls, decides that she needs to lose weight, she will lose weight while she is losing weight, yes, that is, a person who does not have such a predisposition, there will most likely be breakdowns, restrictions will begin, a breakdown, maybe nervous bulimia will develop there, here come in, we call it restrictive

anorexia, when a very narrow corridor of calories is maintained, there are 500-600 calories.

i don't eat the right food all the time, in fact, yes, it is such, uh, taco, such a relationship with food, where there is a lot of anxiety, and a person is constantly worried that if he eats some wrong food, some very serious consequences will occur, therefore, in general , subnervous orthorexia will include different options of eating behavior, where. what will unite them will be precisely this experience of anxiety, an attempt to regulate this anxiety through this is the structuring of food, i exclude gluten, i exclude lactose, and i exclude fats there or vice versa, i exclude carbohydrates, and it becomes easier for me on an emotional level, but you can’t regulate the psyche with food, it ’s a different tool, so in general, raw foodism

can also fall under the criterion of nervous orthorexia, there is the roman scale. intestines, what else is all this done there, and karma, i, yes, i’m trying to regulate all this, essentially cope with my anxiety. yeah. well, i should probably say that, having passed all these tests, having realized that you have problems, you don't need to treat yourself, you don't need to pull yourself together, you need to go to a specialist. and how

different are all these disorders, well, in the sense that, for example, at school, in the class there is a girl who... who begins to protect her figure by inducing vomiting, that is, how likely is it that others can follow her example in the form of induced delirium, yes , in general, we are talking about the fact that we always have three components: we have a body, where there will be some genetic predisposition, some features metabolism, something else, yes, for example, people with nervous bulimia have a reduced aversion to...

maybe the opposite story, there is no genetics here, most likely, yes, by designating that this is superficial and this is erroneous, can a person be returned to normal nutrition, or is it not so easy? it turns out that in general we can say that if a person independently gets out of an episode, for example, nervous anorexia or nervous bulimia, most likely

there was no strong genetic predisposition, yeah, we know such cases, and there are patients they say that at some point i realized that i was doing something wrong with myself, so i really stopped suffering there for a couple of weeks, i talked myself into letting go, most likely there was no... there was a genetic predisposition, but there are those who are one way, and to return everything back, the mortality rate for nervous anorexia is about 13-15%, yeah, this is a very high level for a mental disorder, and what is most effective in a family, let's imagine that a person is somewhere far away, he cannot get to a psychologist, and in a family, that can it be as effective as possible to say that you are beautiful the way you are? we love you and there are no, no problems with your body , or will it all not work, it does not work, if we could cure our loved ones in families, we would be out

of work, i agree, therefore, and there are protocols for organizing nutrition for patients with nervous anorexia, when we teach family members to really build this whole environment in such a way that it is supportive, yeah, but without... specialists in severe cases, of course, it is very difficult, and telling a person that he is beautiful the way he is is possible without an eating disorder , in general, it is necessary, it is necessary, and by gender criterion, it is significant, we have a lot of boys with anorexia nervosa, somewhere around 10 percent, yeah, of the total number, that is , 10, 9 to one, approximately yes, sgulymi is about the same story, yeah, and by age there is a correlation, yes, most debuts are adolescence. age, yeah, that is, puberty, the entrance to puberty, accompanied by a change in the body, the appearance of fatty tissue, the appearance

some emotional experiences about the fact that here i was not loved, here i was rejected, here i was not accepted here and when all this collapses, for adolescence this is the most typical story, but debut in adulthood practically does not happen, nervous anorexia, yeah, there are much fewer of them, yeah. we have cases of nervous anorexia that debit at 25, at 30, and even at 60, but there are significantly fewer of them. and with you again the podcast deception of substances and its permanent host, the editor-in-chief of komsomolskaya pravda olesya nosova, endocrinologist zukhra pavlova. and with us today is a candidate of psychological sciences, psychologist natalia fomyacheva. and what can serve as a trigger, so that at 60 years old, yes... a person stopped accepting himself, here it is rather not that a person stopped accepting himself, he did not accept himself before, it is just that the psyche

coped with it, and here at some point some strong stress can affect, and a loss, for example, yes, happened, the death of a partner, there was a predisposition to this kind of reaction, there was something on... then something happens, so the person begins to go into this idea of ​​losing weight, i wonder, and for pregnant women pregnancy can become a trigger for starting, because the body changes, yes, it grows, again, we pay a lot of attention to how much a pregnant woman weighs, she must always fit into some kind of framework, this can also be very stressful, well, there, probably, the instinct of motherhood helps a lot to hold on, because it is most likely dominant. most likely there is a separate eating disorder, progorexia, this is an eating disorder in pregnant women, yeah, those at risk are those who had episodes of nervous

anorexia, nervous bulimia in adolescence, but in general it can be debited without this, yeah, this is what interested me as an endocrinologist, if there is one boy - yes to nine, there are many girls , then there is some serious endocrinological basis here, here somehow influence... estrogens on all this, so how are you in this, maybe you came across some studies on this? here, firstly, rather a social factor, because boys shouldn't lose weight, our boys should still build up muscle mass more, well , they should, this is about the message of society, and there is - so this is a male version of anorexia, uh, it used to be even called bigorexia from the word big, when men... and they put a lot of effort into having these relief muscles, and their diet is also very distorted, because there is a diet by the clock, a very strict diet.

some of these supplements, in general the content there, it is also anorexic, my body it should look only this way and not otherwise, all my mental psychic activity is directed at this, but since there is no dramatic weight loss, then it seems that it is not so scary, although we also, i think that you as an endocrinologist can perfectly well tell about all the consequences of that diet, yes, which we see in such people, therefore, on the one hand, our society is not so broad.

statistics that this disease used to be five times less common there, now it is five times more, or it was not diagnosed then and we didn't think about this topic at all, something like that, which progresses, like obesity, in the seventy-sixth year now there are four times more people there, firstly, after all, they began to diagnose relatively recently, therefore some part of the people, they simply did not fall, and from those descriptions that we have, we often see something different. content, that is, also a woman, there a girl refuses to eat, weight decreases, but the content, for example, some kind of religious asceticism, yeah, why, yes, this is done, in general, nervous anorexia has become not so long ago differentiate from schizophrenia at all, because it was considered one of the variants of just schizophrenia, when it was singled out as an independent disease, naturally our curve went up, because here

appeared... diagnostics, but in the case of such a voluntary refusal of food with a fatal outcome, they were encountered before, yeah, but now in principle body positive should help a little, still not much, no, it does not help much, it was introduced in vain, that's for sure, no, it was introduced for a reason, but our statistics are not optimistic yet, well, about body positive very... i have a complicated impression about positive, since olesya touched on it, when a person with morbid obesity, with any obesity, is told not to be embarrassed, not to worry about it, and most importantly, not to worry, not to do anything, it is tragic when a person has no arm and they tell him, everything is fine, you are no worse, yes, it happened, that's good, but when a person is unfortunately told, accept everything as it is and do nothing about it, it is terrible, in

essence, in its own way. you understand, if we say specifically about overeating syndrome, the main mechanism for triggering overeating, breakdowns are restrictions, and here for me the same body positivity, it is about the fact that i am rebuilding this attitude towards myself from the position, i am terrible, fat and ugly, i am ashamed, i need to urgently do something about this, punish myself for what i eat, limit myself, and with words... we all know what words people can call themselves, will not lead to recovery, what will lead to recovery is the emergence, acceptance of the fact that yes, i have now it's like this, i don't scold myself for it, i don't punish myself, but i, for example, choose to take care of myself, i take care of myself from a position of care, kindness and accuracy, of course it's a very difficult question, because what you described is an ideal situation, ideal.

only in its infancy, if you are a doctor, then yes, but for some reason we think that overweight people need to be told that they are overweight, every person passing by, i don't pounce on everything that moves, no, i don't doubt it, i mean that body positive it is also about the fact that in general a person has certain personal boundaries, when everyone there, everyone considers it their duty to report that something is wrong with them, but of course, this does not lead to

mental balance at all. once asked when i entered the office, a full man, for a long time, i say, sit down, your complaints about excess weight, he said: "no, i'm fine with that, there was much more than 100 kg." since then i have not asked the question: are you overweight, why did you come here? but then, in my opinion, it is still necessary to explain it is necessary so as not to frighten, but to give a person a general picture, and he could understand, i would really like our listeners today to understand that a disorder - eating behavior - is a problem, it is not treated with care, care for treatment, it is very useful in the family, everything else to a specialist. just let's take the overeating syndrome associated with obesity, yes, that is , a person really, because a person can have overeating, but at the same time the body mass index is normal, so our person overeats, overeats, overeats, then he weighs a lot, he comes to the doctor

, the doctor says: you need to limit yourself in food, or even go for bariatric surgery, yes, do bariatrics, if yes, why did the person overeat before, because? it was his way of regulating emotions, you can't just take it, take it away and give nothing in return, we see very frightening statistics, for example, suicides after bariatrics, depressive episodes, what is bariatrics, so that we do not forget, these are various operations that are aimed at reducing volume stomach so that people who overeat could not overeat, yes or some or less yes... slightly less, yes, here the tool was taken away, the psyche still remains very unstable, and for example, there again studies show that if we take women with a body mass index above

35, who exactly - the body mass index increased as a result of overeating, then 90 there two, 93% of them have a history of severe trauma, usually sexualized, no, rape, well psychological, yes, yeah, and this is their, well, that is, their overeating develops essentially within the framework of post-traumatic stress disorder, you can simply take and forbid them to eat, well, in general, you can with ptsd, what are we going to do, this is always an interdisciplinary problem, i also always resort to the help of psychiatrists, psychologists, psychotherapists, otherwise it does not work, having taken away one, you need to give something else. but overeating can be cured in the end, let's ask this question, for example, to a woman, because it is believed that somewhere around 60%

of patients start again after 5 years to break down, and hypnosis, no, no, now the gold standard is a combination of behavioral therapy with cognitive. emotional , that is, we work with food diaries, we work with identifying triggers that launch episodes of overeating, we work with those emotions, we teach a person to regulate their emotions differently, not through food, we work with post-traumatic stress disorder, we work with all this, hypnosis - that would be great, yes, everyone really wants to come once, it’s better not to come at all, yes, i’ll just call phone the doctor, he will tell me something there, and i will magically stop eating, no, it doesn't work that way, he will dispel the spell, yes, well, that is , it will last for years, yes, well, let's finish our, our wonderful program, with us was a candidate of psychological sciences,

natalya fomicheva, and we talked about eating disorders, natalya, thank you very much, thank you, thank you, thank you. in russian history of the 19th century there were two pavlovichs, first alexander pavlovich, alexander i, then nikolai pavlovich, nikolai i, i would call them, you know, two political fluxes on different sides.

hello, this is the historical podcast russia-west on the swings of history. with you peter romanov and sergei solovyov, today we are talking about alexander i. historians at the end of the reign of alexander pavlovich, and the reign is a quarter of a century from 1801 to 1825, gave him very different characteristics, someone called him an abstract liberal, someone a political altruist, someone a religious conservative, and in my opinion, everyone was right, just at certain stages some character traits dominated in him. and with this split personality did not

occur, somehow it somehow managed to coexist in him, maybe this is the legacy of grandmother catherine, who once said that i will get along perfectly well, both in athens and in sparta, where there are two completely different policies, and the same thing happened with alexander pavlovich, in his younger years he... he could spend the day, the whole day in gatchina, doing, so to speak, marching and military affairs together with his father, as for his upbringing, you and i remember who brought up, this is a republican lagarb, swiss, yes, who later became , among other things, the head of republican switzerland, well, klyuchevsky was very ironic about this, he said that lagarb is such a talkative liberal...

yes, to a certain extent, one can say that both were such mystics to some extent. a very contradictory personality. this contradiction, in my opinion, stems precisely from the need to maneuver in youth, yes, in childhood, then in adolescence, between grandmother ekaterina alekseyevna and, accordingly, father pavel petrovich, because the poles are different, and it was necessary to put on and take off different masks all the time, this... creativity or , according to pushkin, cunning, let's talk about this,

we'll debate, i think, it seems to me, became a distinctive feature of alexander i, it is no coincidence that napoleon once called him a cunning byzantine, yes, there was such a thing as his weakness, you understand, what a deal, if of course we approach this, let's say , he did not order his father to be killed, he did not carry out the necessary reforms in time, he did not decided on them, perhaps, he can be called weak, but on the other hand, well, listen, during... 1812, this same man showed character, that's right, he did not sign peace with napoleon, even after he occupied moscow, that's right, he did not flee from petersburg, he did not flee from petersburg, his relatives, his mother among them, wanted to flee, he insisted on staying, he showed a certain courage, because at that moment, after the burning of moscow, well, there is, witnesses tell an episode, like...

with the murder of his father, because he himself alexander knew about the coup, that it was being prepared, and he actually gave his sanction for it, so he actually did not order his father to be killed, there was such an episode:

he demonstrated also, perhaps not due to some personal courage, but due to some kind of mysticism of his own, because after the war of 812 , this very sharp change occurred in him, but he believed in some kind of divine providence in his special mission, and

he stood very often and more than once this happened, under cannonballs, cannonballs fell right next to him, they begged him to leave.

something, here, well, there was telzit, the first peace in telzit, they were kissing on the raft, hugging , agreeing on something, but at that moment it was a meeting of unequal partners, because napoleon was the winner, after friedland definitely, that's why alexander i of course didn't feel very comfortable, they smiled at him. they smiled, kissed in public, but french troops were standing on the border of russia, yes, yes, yes, here in verfort, i have the impression that alexander behaved differently there, he already disagreed with many things, well it is also known that this phrase about that if you shout there, because at some point napoleon threw his

cocked hat there and almost began to trample it, played out hysterics, well, played out hysterics, played out, he knew how to do it, yeah. began to speak as, partly as a pan-european leader and as the opposition napoleon. finally, well , there are several reasons for the war of 812, but of course, the most important, probably, is the issue of the continental blockade,

yes, it is probably necessary to explain that this is napoleon's policy with the ban on trade with great britain, which was supposed to undermine british power. the ban on europe controlled by napoleon to trade with great britain, which was supposed to undermine british power to bow britain to the french emperor, because napoleon's main opponent from the very beginning of his career to the very end was, of course , great britain, yes, but it turned out that - a blockade is a blockade, if there is at least 1 meter on the free border, then through this meter everything will go, everything will go, but it turned out that since... for russia trade with great britain was extremely important, well, actually the main trading partner, of course. therefore, at a certain stage, russia began to open

the border, so to speak, in one way or another, including english ships under the american flag began to come to russia, so for napoleon, he had a simple choice: either he abandons his entire policy of continental blockade, because it loses its meaning, or it was necessary to force russia to actually join this. blockade to follow this blockade, they were preparing for war both countries before the twelfth year, that is , russia was also preparing for war, it was just that france managed to prepare first, he was the first to gather a great army, alexander was also ready for war, without war there could not be, but here it is necessary to add that there were contradictions and others connected with the eastern question, because since 806 there has been a war with turkey, it has been going on all this time, alexander's russia, led in this case by kutuzov, the appointed commander of the russian army. against the turks, i remind you, before the war of the twelfth year, yes, managed to defeat the turks in the eleventh year in two battles, and napoleon then sadly

noted, the turks have a talent for being beaten, yes, here is the war, kutuzov ended in a month, in may a peace was signed, yes, in a month with napoleon's invasion of russia, and although alexander did not treat kutuzov very well from that time, because then kutuzov warned alexander that he should not give battle to napoleon badly. will end badly, well, i'm exaggerating, of course, but the meaning was this: alexander insisted, he wanted laurels then after all, well, young blood was still probably playing, the laurels of the winner of napoleon, plus there was a numerical superiority in this battle of three emperors, what was there, respectively , the austrian emperor, the russian emperor on one side of the barricades and napoleon on the other, kutuzov's prediction came true, so alexander did not like kutuzov, alexander kutuzov is not...

the architect, in fact, of the final victory, well, there are different versions here, different names are called, but the most common version is that teleran, well, he was also a decent cunning leaf, that's it assessed the situation, in general, he actually went over to the side of the allies and sent to alexander, here is one version of what he sent.

napoleon, when the situation in paris was already such that you can go there, it is less work, you have to take the capital, everything, in the end, finally. the decision was made by alexander himself, and he had to persuade the allies with great difficulty, so to speak, and so on, but nevertheless he insisted on his own, and the coalition went to paris, the battle was short-lived, but bloody, and the russians suffered the most losses because they were on the attack, i think there were only 9,000 soldiers, six of them were russians, they took paris, in the new season. on the first one, today they auditioned us in hort gracheva, great, yura, you

definitely need to.