RU2734910C1 - Weight reduction method - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to psychotherapy. Hunger awareness skill is formed. For this purpose, the patient uses cards of a single plate of food, into which he enters the names of products of a single portion of food, which he eats per one meal. Interval between single meals makes 3.5–4.5 hours, while a single portion of the food taken by patient till 6 o'clock in the evening contains vegetables, protein and carbohydrates in ratio of 50:25:25. One portion of food taken by patient after 6 o'clock in the evening contains vegetables and protein in ratio of 50:50. Single portion of food has a weight of not more than 200 grams and consists of 2–3 kinds of products and is consumed from utensils, into which only such portion of food is stored. Patient consumes food in portions weighing not more than 10 g. To develop skills of awareness of hunger, satiation or overeating, a hunger rating scale is used, wherein division 5 of the hunger assessment scale corresponds to feeling of satiety in the patient's stomach, division of 0–4 hunger assessment scale corresponds hunger, 6–10 hunger assessment scales - overeating. Patient sits at the table, puts his/her right hand on the stomach and assesses on the hunger assessment scale his or her hunger, and if it corresponds to 0–4 grades of the hunger assessment scale, then one proceeds with eating. Patient eats not more than 50 % of the food in dish during 2–3 minutes, gets up from the table, switches his attention to any activity and does not start eating during 3–5 minutes. Patient again sits at the table, puts his/her right hand on the stomach and assesses on the hunger assessment scale his/her hunger feeling and if it corresponds to scale divisions 0–4 of the hunger assessment scale, then he/she starts eating and slowly and deliberately eats not more than 10% of portions of food which is in dishware. Then he gets up from the table, switches his attention to any activity and does not start eating for 3–5 minutes. Patient again sits at the table, puts his/her right hand on the stomach and assesses on the hunger assessment scale his hunger, and if hunger corresponds to division of 5 famine assessment scale, the patient stops eating. If it corresponds to scale grades 0–4 of the hunger assessment scale, then one begins eating and slowly eats the food until the bottom of the dishware appears. Between meals the patient drinks water according to organism needs. Bites are absent. Additionally, during the interview, the patient is evaluated by means of a questionnaire on depression, wherein the Zung scale is used to assess the depression. In addition, the patients assess themselves by an anxiety scale, wherein the anxiety scale is a Zung anxiety self-assessment scale for measuring stress resistance and anxiety. And if patient's anxiety level is more than 5, patient performs exercises for stress and relaxation of body muscles - straining and relaxing fists, arms, shoulder girdle, abdomen, hips, legs, face. Additionally, the patient forms a table of positive effects in his or her life that occur during weight-loss, which is accompanied by positive effects throughout the period of losing weight. Plate of the single plate of food contains a stylized image of the plate which is divided into parts with names of products included into a single portion of food. Tea cup or a tea saucer is used as a dish for a single portion of food. One portion of food is eaten with a teaspoon. Activity involves physical activity, physical exercises and physical labor. Water used is pure, non-carbonated, unsweetened, unsalted water. Conscious control of the process of food intake and formation of skills of awareness of hunger, satiation or overeating in the stomach is performed in the form of two sessions, each of which consists of a rational part and sessions of indirect suggestions. During the session of indirect suggestions, the patients are immersed into a trance state and a session is performed, repeating the formulated formula using categories of visual images, auditory impressions, by sensations, using neurolinguistic programming and metaphors. Sessions of conscious control of the process of food intake and formation of habits of awareness of hunger, satiation or overeating in the stomach are performed in the afternoon or in the evening. Patients count the caloric content of a single portion of food, conduct a food diary and daily weight is measured.

EFFECT: method allows to reduce the weight by the required number of kilograms for a long period and independently to maintain the achieved weight.

10 cl, 1 tbl, 3 ex

Description

The invention relates to medicine, in particular to psychotherapy, and can be used to reduce the weight of the human body.

In modern conditions, obesity is one of the most common forms of pathology among the population, contributing to the manifestation and development of many diseases that worsen health and shorten a person's life expectancy. Along with the increased consumption of high-calorie foods and reduced physical activity, there is another reason: the lack of effectiveness of methods used to reduce weight, lack of nutritional culture. Therefore, it is advisable to start losing weight only with the normalization of nutrition. The mainstay of treatment for overweight and obesity is currently diet therapy or nutritional correction. Along with diet therapy, correction of eating behavior should be carried out, since most patients have violations of psychological forms of eating behavior, which contribute to an increase in craving for food.

The well-known Healthy Eating Plate, created by nutrition experts at the Harvard School of Public Health, is a guide to healthy, balanced eating (see https://www.schiborschi.online/blog/garvardskaya-tarelka-pitaniya). The Healthy Eating Plate (health plate) is a reminder of the necessary foods for human nutrition during the day. This is a very simple way to remember the correct ratio of foods in a healthy diet, so that you can follow it anywhere, anytime. The advantage of the "health plate" is that consumers may not be on a strict diet, but enjoy all the usual types of food, since, having an idea of a healthy diet, people will be able to eat fewer foods and some more. For example, in the British "health plate" about 35 percent are fruits and vegetables, another 35 percent are starchy foods (potatoes, bread, rice, pasta). The share of dairy products (milk and derivatives) in the "health plate" accounts for 12 percent; the same amount is occupied by proteins - meat, eggs, fish, beans. The remaining six percent are foods high in sugar and fat, seafood).

It is known that a plate of health is the optimal ratio of food intake components during breakfast, lunch and dinner (see, for example, http://profilaktica.ru/tarelka-zdorovya/). A plate of 20-24 cm is divided in half. Then one part of the plate is divided again. Most of the plate should be vegetables and fruits. 1/4 of a plate - carbohydrates (pasta, whole grain bread, cereals, potatoes), 1/4 - proteins (fish, meat, eggs, nuts, seafood). It is necessary to consume 3 such "plates" a day. A couple of snacks from 2-3 servings of fermented milk products are also allowed (1 serving - with your fist, about 80 grams). If the goal is to lose weight, then an evening plate of health is 1/2 vegetables and 1/4 proteins, no carbs.

It is known that hunger is a physiological need of the body. The feeling of hunger is in the stomach.

The hunger scale is known (see https://helpiks.org/3-96244.html):

1. Overeat - a feeling of painful bloating, nausea, it is difficult to move, it seems that you will never want to eat again in your life.

2. Fed up with riding - you have to unbutton the top button on the belt or loosen the belt, a feeling of heaviness, fatigue, drowsiness.

3. Full - you feel food in your stomach, you feel full, perhaps even a little discomfort - although there is still room in the stomach. You feel you are full.

4. Slightly full - you begin to feel satisfaction, the first signs of fullness.

5. Neither hungry nor full - neutral state, balance, balance of energy in the body. You do not feel food in the stomach, do not feel the urge to eat. You don't think about food at all.

6. Slightly hungry - you experience the first signs of hunger - a slight sucking sensation in the stomach, a slight, easily tolerated discomfort that is easy to ignore and continue what you are doing.

7. Hungry - you experience palpable signs of hunger - your stomach rumbles, the sucking sensation intensifies. You understand that you want to eat and that you will have to eat soon.

8. Very hungry - you are irritable, you feel strong hunger cramps. Hands tremble, fatigue grows, at this moment you are ready to eat anything.

9. I am dying of hunger - dizziness, extreme fatigue, consciousness may become indistinct.

Eat at the points of the scale “well-fed”, “overeat” - it means that you are guaranteed to eat after satiety and get from food, instead of pleasure, feeling unwell and guilt Points of the scale - “Sated” and “Hungry” - are alarming states, but not necessarily fraught overeating Scale points - "Neither hungry nor full" - this is a state of balance. It means that the body has enough energy, enough nutrition.

In fact, there are only three indicators of true hunger: a bodily sign (emptiness in the stomach), temporary (3.5-4.5 hours from the last meal), behavioral (low selectivity in food).

According to doctors, 75% of overeating cases are caused by emotions. Emotional hunger usually causes overeating. Most people reach for a snack when stressed, upset, or anxious about something. Often people take comfort in food and are already accustomed to eating when they are not hungry, and often it is junk food with a high content of carbohydrates and sugar. It raises serotonin levels, which helps us feel better, calms and relaxes. An overweight person usually continues to eat even after they have consumed enough food to satisfy their hunger.

A known method for correcting weight using suggestions in a state of wakefulness and an altered level of consciousness with the formation of negative emotions ("feeling of nausea") to abuse food with increased energy value (see patent RU No. 2019996, "Method for correcting human weight" op. 30.09. 1994). However, a single session of psychotherapy is far from always able to create a solid attitude towards rational eating behavior of a person.

A known method for correcting excess weight (see, for example, patent RU No. 2264232, op. 10.06.2005). The known method provides for the analysis of anamnesis, diet therapy with the exclusion of high-calorie foods and rational psychotherapy for weight loss without disrupting health, while analyzing the anamnesis and by questioning, identifying eating disorders, conducting rational psychotherapy to understand the problem by the patient, form an active positive emotional-volitional motivation for achievement of the final goal - weight loss according to the program for a given period of time by the recommended number of kilograms, determine the main representative system of information perception by the patient: visual, auditory or kinesthetic, make up in the waking state a formula for changing the eating behavioral stereotype, aimed at normalizing eating behavior, after this patient immersed in a trance state, and conduct the first session of indirect suggestions. In the second session, the patient is immersed in a trance state and an early satiety stimulation session is conducted to prevent overeating. However, the known method is quite lengthy. Treatment is carried out in a course of 3-4 sessions, sessions in 3-5 days, repeated maintenance treatment 1 session per week for 3 months, repeating the first.

Known methods for correcting excess weight (see, for example, patents RU No. 2264232, op. 20.11.2005, No. 2264233, op. 20.06.2005, No. 2314783, op. 20.01.2008, No. 2493885, op. 09/27/2013, No. 2257406, op. 02/10/2016). Known methods include the analysis of anamnesis, identification of eating disorders by questioning. Immediately before the session, rational psychotherapy is carried out in the form of a group conversation. Then, several psychotherapeutic sessions are carried out with the patient, involving the immersion of the patient in a trance state and conducting sessions of suggestion using neurolinguistic programming. The methods described above are highly effective, however, they often target the patient at rapid weight loss (which in itself is fraught with complications for the patient) without proper focus on changing the entire future lifestyle.

The known "Method for weight loss" (see patent Ru No. 2632777, op. 09.10.2017). The known method of weight loss includes psychotherapeutic techniques of conscious control of food intake with fixation in the stomach and in the body. Classes can take place in an individual or group format, followed by control meetings. A preliminary interview with each patient is mandatory, at which the presence of food addiction and the specifics of eating disorders are determined. The technique of focusing attention during a meal on bodily sensations, including in the region of the stomach, which is gradually filled with chewed food, is used. This method is chosen as the closest analogue.

On a national scale, the problem of overweight is a social evil, since it leads to the development of numerous diseases, reduces labor productivity and leads to a significant reduction in the life expectancy of people. The applicant had to solve the following tasks:

- to acquaint participants with the concepts that characterize life in a lean body (hunger, appetite, drinking regimen, food diary, weighing, etc.)

- to develop new eating habits;

- reduce the calorie content of the diet;

- lose weight by the required number of kilograms, intensively, without sagging skin;

- maintain the achieved weight;

- teach patients to lose weight on their own.

The technical result of the claimed invention consists in a comfortable, stable weight loss by the required number of kilograms for a long period, by changing eating behavior due to the formation of sustainable nutritional skills, as well as in the restructuring of eating habits due to a personalized approach to the choice of diet and composition of products , and in self-maintenance of the achieved weight.

The achievement of the specified technical result is provided by the fact that in the method of weight loss, including the conscious control of the process of eating, the formation of the skills of awareness of the feeling of hunger, satiety or overeating, the use of a set of cards according to the invention, as a set of cards, the patient uses cards of a disposable plate of food in which he enters the names of the products of a single serving of food that the patient eats at one meal; the interval between single meals is from 3.5 to 4.5 hours, while a single serving of food, which the patient takes up to 18 hours, contains vegetables, protein and carbohydrates in a ratio of 50:25:25, and a single serving of food, which the patient takes after 18 hours contains vegetables and protein in a ratio of 50:50; a single portion of food weighing no more than 200 grams consists of 2-3 types of products and is used from dishes into which only such a portion of food is placed; food is consumed in portions, the weight of which is not more than 10 g; for the formation of the skills of awareness of the feeling of hunger, satiety or overeating, the hunger assessment scale is used in points, and division 5 of the hunger assessment scale corresponds to the feeling of satiety in the patient's stomach, 0-4 divisions of the hunger assessment scale correspond to hunger, 6-10 of the hunger assessment scale - overeating; the patient sits down at the table, puts his right hand on his stomach and assesses his feeling of hunger using the hunger rating scale, and if it corresponds to the 0-4 divisions of the hunger rating scale, then starts eating; the patient eats no more than 50% within 2-3 minutes, the food in the dishes gets up from the table, switches his attention to any activity, and does not start eating for 3-5 minutes; the patient sits down at the table again, puts his right hand on his stomach and assesses his feeling of hunger on the scale of hunger assessment, and if it corresponds to the divisions of the 0-4 scale for assessing hunger, then starts eating and slowly and consciously eats no more than 10 servings of food that is in the dishes, then gets up from the table, switches his attention to any activity, and does not start eating for 3-5 minutes; the patient sits down at the table again, puts his right hand on his stomach and assesses his feeling of hunger according to the hunger rating scale, and if the feeling of hunger corresponds to division 5 of the hunger rating scale, then the patient stops eating; if it corresponds to the divisions of the 0-4 scale of the hunger assessment scale, then starts eating, and slowly eats food until the bottom of the dishes appears; between meals, the patient drinks water according to the needs of the body; no snacks; and, additionally, during the preliminary interview, the patient is assessed using a depression questionnaire, while the Tsung scale is used to assess depression; additionally, patients assess themselves on the scale of anxiety, while using the Tsunga self-assessment scale of anxiety as a scale of anxiety to measure resistance to stress and anxiety, and if the patient's anxiety level is more than 5, then the patient performs exercises for tension and relaxation of body muscles - straining and relaxing his fists, arms, shoulder girdle, abdomen, thighs, legs, face; additionally, patients form a table of positive effects in their lives arising from weight loss, in which they enter positive effects throughout the entire period of weight loss.

At the same time, the card of a one-time plate of food contains a stylized image of a plate, which is divided into parts with the names of products included in a single portion of food.

At the same time, a tea cup or tea saucer is used as a dish for a single portion of food.

In this case, a single serving of food is eaten with a teaspoon.

In this case, the activity includes physical activity, physical exercise and physical labor.

At the same time, pure, non-carbonated, unsweetened, unsalted water is used as water.

At the same time, the conscious control of the food intake process and the formation of the skills of awareness of the feeling of hunger, satiety or overeating in the stomach are performed in the form of two sessions, each of which consists of a rational part and sessions of indirect suggestions.

At the same time, during the session of indirect suggestions, the patients are immersed in a trance state and the session is conducted, repeating the compiled formula using the categories of visual images, auditory impressions, through sensations, using neurolinguistic programming and metaphors.

At the same time, the conscious control of the food intake process and the formation of the skills of awareness of the feeling of hunger, satiety or overeating in the stomach are carried out in the afternoon or in the evening.

At the same time, patients calculate the calorie content of a single serving of food, keep a food diary and measure their weight daily.

Distinctive features of the claimed method are the following features:

- the patient enters into the cards of a single plate of food the names of products of a single portion of food that the patient eats at one meal; the interval between single meals is from 3.5 to 4.5 hours, while a single serving of food, which the patient takes up to 18 hours, contains vegetables, protein and carbohydrates in a ratio of 50:25:25, and a single serving of food, which the patient takes after 18 hours contains vegetables and protein in a ratio of 50:50;

- a single serving of food weighing no more than 200 grams consists of several types of products and is used from dishes into which only such a portion of food is placed; food is consumed in portions, the weight of which is not more than 10 g;

- to form the skills of awareness of the feeling of hunger, satiety or overeating, the hunger assessment scale is used in points, and division 5 of the hunger assessment scale corresponds to the feeling of satiety in the patient's stomach, divisions 0-4 of the hunger assessment scale correspond to the feeling of hunger, 6-10 of the hunger assessment scale - overeating ;

- the patient sits down at the table, puts his right hand on his stomach and assesses his feeling of hunger according to the hunger rating scale, and if it corresponds to the 0-4 divisions of the hunger rating scale, then starts eating; the patient eats no more than 50% within 2-3 minutes, the food in the dishes gets up from the table, switches his attention to any activity, and does not start eating for 3-5 minutes;

- the patient sits down at the table again, puts his right hand on his stomach and assesses his feeling of hunger according to the hunger scale and if it corresponds to the 0-4 scale of hunger scale, then starts eating and slowly and consciously eats no more than 10 servings of food that is in the dishes, then gets up from the table, switches his attention to any activity, and does not start eating for 3-5 minutes;

- the patient sits down at the table again, puts his right hand on his stomach and assesses his feeling of hunger according to the hunger rating scale, and if the feeling of hunger corresponds to division 5 of the hunger rating scale, then the patient stops eating;

- if it corresponds to the divisions of the 0-4 scale of the hunger assessment scale, then starts eating, and slowly eats food until the bottom of the dishes appears;

- between meals, the patient drinks water according to the needs of the body; - no snacks;

- additionally, during the preliminary interview, the patient is assessed using a depression questionnaire, while the Tsung scale is used to assess depression;

- additionally, patients assess themselves on the scale of anxiety, while the Tsunga self-assessment scale of anxiety is used as an anxiety scale to measure stress resistance and anxiety, and if the patient's anxiety level is more than 5, then the patient performs exercises for tension and relaxation of body muscles - straining and relaxing his fists , arms, shoulder girdle, abdomen, thighs, legs, face;

- in addition, patients form a table of positive effects in their lives arising from weight loss, in which they enter positive effects throughout the entire period of weight loss.

In the prior art, there is no information about the possibility of obtaining a technical result due to the above distinctive features. In this case, the mentioned features can be called a new means for obtaining the above technical result, since this result has not yet been obtained using such features.

The essence of the proposed method of weight loss is as follows.

A group of patients is preliminarily formed. The number of people in a group is usually no more than 40. It was experimentally determined that an increase in the size of the group is inappropriate, since it is the joint activity of the psychotherapist and patients that makes it possible to create a positive emotional state and business atmosphere. The impact on the patient's eating behavior begins with a conversation with the psychotherapist, who must find out for the patient's lifestyle, his eating habits. Many patients themselves notice their inaccuracies in nutrition: an improper diet, an excess of fatty and sweet, automatic, imperceptible overeating, eating for the company or to distract from problems, eating for pleasure, etc. Most patients feel a great desire to change their eating behavior towards a rational one (diet, set of foods and their quantity), but they are not able to do it (“I know what is needed, but I cannot”). This is due to persistent eating habits that are formed over the years and are fixed in a dynamic stereotype. Patients answer the psychotherapist's questions “what”, “where”, “when”, “how” and “why”:

- When and why did the problem of excess weight appear?

- What did you do to reduce excess weight?

- How much did you lose weight, and how much did you keep it?

- Why did you decide to tackle this problem?

- What do you want to achieve?

The psychotherapist also evaluates patients using a depression questionnaire and uses the Tsung scale to assess depression (material Psylab.info - an encyclopedia of psychodiagnostics).

Based on the information collected, the psychotherapist draws a conclusion about the causes of obesity, and also identifies those for whom this method of weight loss is contraindicated or may be ineffective (acute psychotic illnesses, exacerbation of chronic somatic diseases, etc.).

Next, the psychotherapist conducts anthropometry of the patients (measuring height, chest circumference, waist and hip circumference, calculates body mass index - BMI, where BMI = weight (kg) / height (m)). The psychotherapist informs that patients will need daily morning weighing on an empty stomach, after using the toilet, without clothes, and also every three days it will be necessary to measure volumes - chest, waist, hips. A clear reduction in volumes - chest, waist, hips gives the patient positive emotions and encourages further work on himself.

The method of weight loss is carried out during two group 7-8 hour sessions, which are carried out in the afternoon or in the evening. Moreover, the second lesson is carried out 36-48 hours after the first. It is envisaged, at the request of patients, to meet with a psychotherapist after 1 month (meetings are possible after 6 months and after 12 months) and the patient's online support, which helps to adjust nutrition during discussion and monitor the results of weight loss.

The claimed method is based on methods of active listening, homework, teaching visualization, positive thinking, fighting anxiety, relaxation techniques, and the formation of new eating habits.

On the first day, rational psychotherapy with motivated suggestion is carried out in the waking state. They form an active positive emotional-volitional motivation to achieve the final goal - weight loss by the desired number of kilograms. The patient is asked to explain the motives that prompted him to decide to start losing weight. This information is necessary to find an individual psychological mindset for losing weight, to conduct psychotherapy and to draw up formulas aimed at changing eating behavior. Determine the main representative system of information perception by the patient: visual, auditory or kinesthetic. The psychotherapist forms each patient's weight loss goals and helps each patient create their own visual image after losing weight, which patients describe on a piece of paper. Patients write down the information given by the therapist. According to the patients' answers, the psychotherapist controls the assimilation of the material given to him. Assimilation of information also occurs due to the visual-motor response of patients. It is the joint activity of the psychotherapist and patients that allows you to create a positive emotional state and a business atmosphere in the classroom.

It is known that hunger is a physiological need of the body. The feeling of hunger is in the stomach. It is known that the size of the stomach of different people is significantly different. In those who often overeat, the stomach walls are distended. The psychotherapist focuses the attention of patients on methods of reducing the volume of the stomach and achieves the formation in the consciousness and subconsciousness of patients of the dominant idea of reducing the volume of the stomach. It is known that one portion of food needed to satisfy true hunger is the size of a person's fist or two palms collected in a handful by a boat. It is this amount of food that will reduce the volume of the stomach. The patient needs to use such a cup or plate to accommodate just such a portion of food.

Then the therapist tells the patients about the hunger scale, which the patients will use in the future. To do this, he offers a 10-point scale for assessing hunger. Division 5 of the scale for assessing hunger corresponds to the feeling of satiety in the patient's stomach - neither hungry nor satiated, neutral state, balance, balance of energy in the body. Food is not felt in the stomach. There is no urge to eat. Doesn't think about food. Scale divisions 0-4 correspond to hunger, 6-10 - overeating.

An overweight person usually continues to eat even after they have consumed enough food to satisfy their hunger. To determine whether the body really has a physiologically justified need for food at a particular moment, patients place their right hand on the stomach area.

The psychotherapist talks about the health plate and the disposable plate of food.

The health plate defines the food to be eaten during the day for 3 meals. The health plate is divided into several parts (three or four parts), which the patient fills himself three times a day. It is necessary to take a plate and conditionally divide it into parts. Then you need to fill parts of the plate with vegetables, fruits, carbohydrate part (pasta from durum wheat, whole grain bread, cereals, potatoes), protein part (fish, meat, eggs, nuts, seafood).

The therapist also talks about portions of food. Large portions provoke fast and frequent biting of food in large chunks, incomplete chewing, which leads to a decrease in the length of time food is in the oral cavity and reduces the satiety effect due to the effect on taste and olfactory receptors (lack of "sensory satiety"). Small pieces of food provide all these effects. The psychotherapist forms in patients the skills of conscious control of food intake with fixing the patient's attention on the bodily sensations of hunger and satiety.

A single meal plate contains a single serving of food that the patient eats in just one meal. Usually, a person takes food (as recommended by the World Health Organization) with an interval between meals of 3.5-4.5 hours. The patient has as many single plates of food per day as he takes food once a day. For one meal, the patient eats a single portion of food weighing no more than 200 g, which consists of 2-3 types of food. The psychotherapist draws the patient's attention to the fact that when a single portion of food is taken up to 18 hours, it should contain vegetables, protein and carbohydrates in a ratio of 50:25:25, respectively, and when a single portion of food is taken after 18 hours, it should contain vegetables and protein in ratio of 50:50, respectively. As the dishes from which the patient consumes a single portion of food, they use dishes that can hold no more than 200 g of food, for example, a teacup or a tea saucer. And they consume a single serving of food with a teaspoon. Snacks are not allowed during the day. Pure, non-carbonated, unsweetened, unsalted water is consumed by the patient as his body needs.

It is very important to teach the patient to control the moment of saturation. This can only be done if the patient begins to eat when the feeling of hunger occurs. To develop the skills of awareness of the feeling of hunger, satiety or overeating, a scale of hunger assessment is used. The patient mentally imagines that this scale runs along his spine in such a way that division 5 of the hunger scale corresponds to the feeling of satiety in the patient's stomach, which is fixed in physical sensations, the division of the scale 0-4 corresponds to the feeling of hunger, 6-10 - overeating. The patient sits down at the table, puts his right hand on his stomach and assesses his feeling of hunger, and if it corresponds to the divisions of the 0-4 scale, then he starts eating. Within 2-3 minutes, the patient eats no more than 75% of the amount of food that is, for example, in a tea cup or on a tea saucer, gets up from the table, switches his attention to physical exercise, physical activity or physical labor, and not starts eating within 3-5 minutes;

the patient sits down at the table again, puts his right hand on his stomach and assesses his feeling of hunger and if it corresponds to the divisions of the 0-4 scale, then he starts eating and slowly and consciously eats no more than 10 servings of food that is in a teacup or on a tea saucer , then gets up from the table, switches his attention to physical exercise, physical activity or physical labor, and does not start eating for 3-5 minutes;

the patient sits down at the table again, puts his right hand on his stomach and assesses his feeling of hunger, and if the feeling of hunger corresponds to the division of the scale 5 of hunger (stomach fullness has come), then the patient stops eating;

if the feeling of hunger corresponds to the divisions of the 0-4 scale, then he sits down at the table again, starts eating, and slowly eats the food until the bottom of the dishes appears.

It is very important that the process of weight loss is as convenient for the patient as possible, otherwise, the patient will experience psychological discomfort and stop following the recommendations. It takes a long time to lose weight, so it is very important to individualize weight loss recommendations for each patient, so as to ensure a high patient commitment to weight loss. The psychotherapist individually determines the amount of daily kcal for each patient, but not more than 1500 kcal. The calorie content of meals consumed by the patient daily should be maintained in such a way that the daily amount of kcal per day does not exceed 1500 kcal. The patient himself chooses and maintains the calorie content of a single plate of food. The psychotherapist also gives the patients three cards - red, yellow, green, as well as a food calorie card, and suggests that each patient compose their own “food traffic light”. At the end of each day, the patient writes on these cards the foods that he ate during the day and uses these cards later when filling out the cards for one-time plates of food for his daily diet, taking into account the selected daily calories. By weighing himself daily, the patient analyzes what foods eaten the previous day gave an increase in his weight. If the patient's weight has increased by more than 500 grams, then these products are entered on the red card. If the patient's weight has increased by less than 500 grams, then these products are entered on the green card. All other products are entered on a yellow card. "Food traffic light" cards help the patient to immediately find foods that give weight gain, do not affect weight, and help to lose weight. The patient uses these cards in the future when drawing up his daily diet, taking into account the selected daily calories. At the same time, every day, the patient keeps a diary, where he writes down the calorie content of each single plate of food he takes.

Also, the patient fills in stylized disposable food plates for the next day. Stylized disposable food plates are sheets of paper with a circle divided into several parts. In each of the parts, the patient writes down the name of the products that the patient will consume during a single meal. This allows the patient to create a menu for the next day, evaluate this menu and see it clearly. At the same time, the patient plans his daily menu, guided by the products available to him, as well as the interchangeability of products, food prices, and his taste preferences.

Next, patients are immersed in a trance state and a session of indirect suggestions is performed, repeating the formula for reducing the stomach using the categories of visual images, auditory impressions, through sensations, neurolinguistic programming and metaphors.

Further, patients are given homework:

- keep a diary and write down everything you ate in it (eat according to the idea of a proper and balanced diet) with calorie count;

- take measurements of weight and volume;

- change the dishes to a small plate and mug (for example, a tea cup or tea saucer) and eat consciously;

- use clean, non-carbonated, unsweetened, unsalted water only as the body needs;

- think over non-food ways of your reward.

At home, after the first day, patients form a table of cons of life in an obese body and pluses in the body with weight loss, for example:

In the process of losing weight, patients add at least five positive effects in their lives to the "pluses" column every day throughout the entire period of weight loss. Daily review of this table and filling in the "pluses" column contributes to the formation of incentives in patients to self-control and change in eating behavior, the transition to images of harmony.

On the second day, at the stage of rational therapy, the therapist receives feedback from patients on the results of the first day and on the homework performed by the patient. Patients tell the psychotherapist what they have learned on the first day, the psychotherapist continues to work with patients, analyzes and corrects the main mistakes in the patients' eating behavior. Conducts the consolidation of a rational form of eating behavior.

A psychotherapist tells patients what anxiety is and what a person's level of anxiety is. The psychotherapist reports that a person can assess anxiety on a scale of anxiety (for example, the self-reported anxiety scale developed by Tsung, which is a tool for measuring stress resistance and anxiety, material Psylab.info - an encyclopedia of psychodiagnostics). Patients rate their level of anxiety on a scale from 0 to 10, and the therapist tells and demonstrates exercises for tension and relaxation of body muscles (fists-arms-shoulder girdle-abdomen-thighs-legs-face). Describes how to tighten and relax the muscles of the body. And it says that with a high level of anxiety, the patient must perform these exercises at least 3 times a day. Further, the psychotherapist talks about a person's emotions, teaches patients positive thinking, and tells patients how important it is for a person to be in a good mood. Next, patients are immersed in a trance state and a session of indirect suggestions is performed, repeating the formula for reducing anxiety and a calm attitude to food using the categories of visual images, auditory impressions, through sensations, neurolinguistic programming and metaphors.

During the second day, the psychotherapist also considers with patients the correct eating behavior in non-standard situations, meal planning, that lunch should be more than dinner, that it is necessary to buy healthy foods, prepare food in a healthy way, that food should be varied, that it is necessary to learn from the breakdowns, to distinguish between hunger and appetite and different stages of hunger, that patients need good and adequate sleep, that patients should see their achievements and reward themselves for them.

Below are examples that illustrate the described method.

Example 1. The method is carried out as described above.

A 35-year-old woman, presented on May 30 with a weight of 94 kg and a height of 170 cm. Anamnesis revealed that a child was born, at the time of treatment she was 2 years old and breastfeeding was over. Desired weight - 79-80 kg. The number of daily calories was determined to be 1350. I used 4 meals a day as per the guidelines for the main food categories. On August 30, a weight of 79 kg was reached. Thus, over a period of 3 months, there was a decrease in weight by 15 kg, on average 200 g per day, which is physiological. During the observation period, a decrease in the level of anxiety was revealed from 51.5 on the Tsung scale initially, to 30.5 - which is a characteristic of the health norm. Achieved by following the relaxation exercise recommendation 3 times daily. Normalization of the general condition, improvement of mood, appearance was found - waist volume - 10 cm, hips 12 cm, chest 6 cm from the initial one. Notes the acquisition of the skill of satiety, the ability to assess the level of satiety and to push back - to throw out the remains of food, at the first appearance. It was noted that nectarines were included in the red list, which give a sharp increase in weight over 500 g. Changes in taste preferences in favor of healthy food were noted, obsessive cravings for sweets (ice cream, sweets) were completely gone, thanks to a balanced diet of complex carbohydrates, as well as following the recommendation to enjoy the taste of food, not the amount.

Example 2. The method is carried out as described above.

Male 48 years old. On examination, weight 130 kg, height 175 cm, abdominal circumference 126 cm. Complaints of rapid fatigue, decreased physical activity, mood, is under the supervision of an endocrinologist, sugar level 8.4-8.0 mmol / l, it is recommended to reduce weight. The patient mastered the method of weight loss and during the next month was on the online support, which helped to adjust the diet, give up sweet, high-calorie foods, as well as exclude alcohol and check the implementation of recommendations. A month later, on control weighing, the weight was 118 kg, a decrease of 12 kg per month. Abdominal circumference 112 cm, which was -14 cm per month. Notes an improvement in mood, general well-being, and a decrease in blood sugar levels during the control study to normal values of 4.6-5.4 mmol / l. Meals - five single plates of food. The number of daily calories was determined as 1500. Fully mastered the techniques of visualization and relaxation, the daily plate consists of all the recommended products, a single serving does not exceed 200 g. The feeling of fullness is achieved quickly and lasts the recommended amount of time, every 4.5 hours, that is , keeping pauses between meals. Snacks and a constant desire to eat something to relieve internal stress are completely gone.

Example 3. The method is carried out as described above.

Woman 29 years old, height 175 cm, weight 189.8 kg. The number of daily calories was determined as 1400. Over 18 months, the weight decreased by 67 kg and is 122.8 kg. The diet for the period of weight loss consisted of all the recommended foods, I used 4 meals a day, according to the recommendations for the main food categories. Portion 200 g. Rapid training in calorie counting in a single plate of food. Scheduling one-off meals for tomorrow every day has made it easier and faster to lose weight. The client is under the supervision of gynecologists for the implementation of the IVF procedure, which is the main motivational component in the formation of a dominant to follow the recommendations in the process of forming normal eating behavior.

The inventive method has been tested. The claimed method, weight loss was carried out in 300 patients of various ages and sex. The claimed method of weight loss is as gentle as possible, feasible and comfortable. The study of the dynamics of weight loss in patients, the clinical condition of patients revealed the high efficiency of the proposed method. In patients, weight loss occurred by 5-10 kg monthly.

Weight loss is a lot of work and you can successfully complete it, if you do not limit yourself only to a reduced calorie regimen, but also correctly formulate your goals, track the feelings behind appetite, introduce new pleasures into life, take better care of yourself and realize the disadvantages of being overweight and overeating. Then the work will progress successfully. The inventive method makes it possible to lose weight independently and naturally. The inventive method has a double effect (weight loss and health improvement), since most diseases are known to be based on unhealthy diet. Therefore, by rationalizing their diet and losing weight, people improve their health. The claimed method helps everyone: those who are trying to lose weight for the first time, and those who have already tried everything and are desperate.

The result has been achieved, which consists in a comfortable, persistent weight loss by the required number of kilograms for a long period, by changing eating behavior through the formation of sustainable eating habits, as well as in the restructuring of eating habits due to a personalized approach to the choice of diet and composition products, as well as in self-maintenance of the achieved weight. In the future, patients independently apply the acquired new knowledge and skills to maintain their new eating behavior.

The inventive method allows not only to change the patient's eating behavior and to consolidate the achieved result, but also gives an unexpected result - it contributes to an increase in the society of people whose quality of life has improved. Diseases recede, vital energy rises, the emotional state improves, pleasures that are not associated with food are found.

Claims (10)

1. A method of losing weight, including conscious control of the food intake process, the formation of the skills of awareness of the feeling of hunger, satiety or overeating, the use of a set of cards, characterized in that as a set of cards, the patient uses cards of a one-time plate of food, in which he enters the names of products of a single portion food that the patient eats at one meal; the interval between single meals is from 3.5 to 4.5 hours, while a single serving of food that the patient takes up to 18 hours contains vegetables, protein and carbohydrates in a ratio of 50:25:25, and a single serving of food that the patient takes after 18 hours, contains vegetables and protein in a 50:50 ratio; a single portion of food weighing no more than 200 grams consists of 2-3 types of products and is used from dishes into which only such a portion of food is placed; food is consumed in portions, the weight of which is not more than 10 g; for the formation of the skills of awareness of the feeling of hunger, satiety or overeating, the hunger assessment scale is used in points, and division 5 of the hunger assessment scale corresponds to the feeling of satiety in the patient's stomach, divisions 0-4 of the hunger assessment scale correspond to the feeling of hunger, 6-10 of the hunger assessment scale - to overeating; the patient sits down at the table, puts his right hand on his stomach and assesses his feeling of hunger according to the hunger rating scale and, if it corresponds to the 0-4 scale divisions of the hunger rating scale, then starts eating; the patient eats no more than 50% of the food in the dishes within 2-3 minutes, gets up from the table, switches his attention to any activity and does not start eating for 3-5 minutes; the patient sits down at the table again, puts his right hand on his stomach and assesses his feeling of hunger according to the hunger scale and, if it corresponds to the 0-4 divisions of the hunger scale, then starts eating and slowly and consciously eats no more than 10 servings of food, which is in the dishes, then gets up from the table, switches his attention to any activity and does not start eating for 3-5 minutes; the patient sits down at the table again, puts his right hand on his stomach and assesses his feeling of hunger according to the hunger rating scale, and if the feeling of hunger corresponds to division 5 of the hunger rating scale, then the patient stops eating; if it corresponds to the divisions of the 0-4 scale of the hunger assessment scale, then starts eating, and slowly eats food until the bottom of the dishes appears; between meals, the patient drinks water according to the needs of the body; no snacks; and additionally, during the preliminary interview, the patient is assessed using a depression questionnaire using the Tsung scale to assess depression; in addition, patients assess themselves on the scale of anxiety, while the Tsunga self-assessment scale of anxiety is used as an anxiety scale to measure stress resistance and anxiety, and if the patient's anxiety level is more than 5, then the patient performs exercises for tension and relaxation of body muscles - strains and relaxes his fists, hands , shoulder girdle, abdomen, thighs, legs, face; additionally, patients form a table of positive effects in their lives arising from weight loss, in which they enter positive effects throughout the entire period of weight loss. 2. The method according to claim. 1, characterized in that the card of the disposable food plate contains a stylized image of the plate, which is divided into parts with the names of the products included in the single serving of food. 3. The method according to claim 1, characterized in that a teacup or a tea saucer is used as a dish for a single portion of food. 4. The method according to claim 1, characterized in that a single serving of food is eaten with a teaspoon. 5. The method of claim. 1, characterized in that the activity includes physical activity, exercise and physical labor. 6. The method according to claim 1, characterized in that pure, still, unsweetened, unsalted water is used as water. 7. A method according to claim 1, characterized in that the conscious control of the food intake process and the formation of the skills of awareness of hunger, satiety or overeating in the stomach are performed in the form of two sessions, each of which consists of a rational part and sessions of indirect suggestions. 8. The method according to claim 7, characterized in that during the session of indirect suggestions, the patients are immersed in a trance state and the session is conducted, repeating the compiled formula using categories of visual images, auditory impressions, through sensations, using neurolinguistic programming and metaphors. 9. The method according to claim 7, characterized in that sessions of conscious control of the food intake process and the formation of the skills of awareness of hunger, satiety or overeating in the stomach are carried out in the afternoon or in the evening. 10. The method according to claim 7, characterized in that the patients calculate the calorie content of a single serving of food, keep a food diary and measure their weight daily.