Obese Persons Have Less Internal Body Awareness
There are been many reasons given over the years and among many studies as to why people become fat. Some are genetics, environmental factors, family dynamics, drugs, metabolic disorders, modern lifestyles of sedentary lives, emotional coping, and self-soothing behaviors. Food is used to numb emotional pain in the last two cases (Goodspeed Grant & Beoersma, 2005). An new factor is that obese persons have lower body awareness than most people (Herbert & Pallotos, 2012, 2014).
Body awareness is an amalgam of two states: exteroception which is the awareness of what is present at the body’s external boundary and interoception which is the awareness of internal changes within the body. Interoception is composed of two substates: visceroception which is the awareness of sensations from inside the body and proprioception which is the awareness of the physical state of the body including joint positions, muscular sensations, and posture. Exteroception and interoception are a kind of two-way flow creating our experience of being embodied and, at a deeper level, balancing our homeodynamic states. Exteroception guides us through external reality while interoception informs us about our internal reality. Interoceptive states govern emotional body experience which underlie our thinking and decision-making (Herbert & Pollatos, 2012).
Neuroscientific advances in the past 20 years have revealed an ‘‘interoceptive neural network’’ in the brain made up of the:
- somatosensory and somatomotor cortices
- cingulate cortex
- prefrontal cortices (ventromedial prefrontal cortex, dorsolateral prefrontal cortex)
- insular cortex
Most people should be familiar with the functions of these cortical areas. The somatosensory and somatomotor centers process incoming stimuli and respond with physical movements. The cingulate cortex is part of the limbic system and is involved in emotional processing. The prefrontal cortices deal with thinking, communication, emotional experience, intuition, and volition. The right insula may be thought of as the central actor within this system as it creates a second-by-second “snapshot” of our immediate neural states which are then combined to give us the feeling of having a body (Craig, 2002, 2009, 2019a, 2019b). The insula is the primary organ of embodiment. The insula is also involved with body movement, music and rhythm, emotional awareness, self-recognition, and time perception, and subjective feelings (Craig, 2009). In short, the interoceptive system monitors visceral changes, emotional states and responses, and self-regulates feelings and behavior.
Obesity and Body Awareness
It is now known that obese persons have limited body awareness. One example comes from the a systematic review of 104 studies with 32,883 subjects comparing interoceptive sensitivity with disordered eating habits. The results strongly indicate that body awareness plays a key role in eating disorders. While this applies to all types of eating problems, the focus here is on the obese and there are several key aspects to consider. First, they have difficulty in perceiving bodily signals of hunger and satiety. This seems to be a matter more of being sensitive to body signals and their meaning versus not having body awareness (Herbert & Pollatos, 2014). Second, they are far less accurate in estimating body sizes as compared to healthy weight controls. The current theory is that obese persons have an impaired sense of spatial cognition which affects their ability to judge the spatial properties of a body including the distance between parts and those parts in space. This problem may also relate to obese persons lack of motivation for physical exercise and subjective feelings of fitness. The brain areas potentially involved are the inferior parietal lobule, intraparietal sulcus, primary somatosensory cortex as these are all involved in processing the neural representations of body structure (Tagini, Scarpina, & Zampini, 2021).
Closing Thoughts
Future research into body awareness and weight control will give further insights into the exact interoceptive deficits associated with disordered eating and hopefully lead to the development of improved therapies. Working with body awareness will naturally be the key tool. Using the focusing and refinement of body awareness as a treatment tool for the obese and anorectics appears to be a good approach given their chronic state of limited body consciousness. Some potential methods are mindfulness meditation and here I am thinking specifically of Vipassana meditation with its emphasis on body sensations (see Treves et al., 2019 for an overview). Other candidates would be yoga (e.g., Neukrich, Reid, & Shires; Ostermann et al., 2018) and Sensory Awareness (e.g., Tophoff, 2004). Dance therapy (e.g., Virtanen et al., 2022) and clinical somatic psychotherapy, such as Hakomi Method (Fallon-Cyr & Fallon-Cyr, 2002) and Gestalt Therapy (Kepner, 2008) also come to mind.
Consciously practicing body awareness can be both very easy and very difficult. It becomes difficult from what some theoreticians call psychological inertia. That is, our attention and focus tend to stay in areas that are comfortable and habitual. We spend our time obliviously riding along on automatic. Sometimes it is hard to break through this condition. When we resolve to become more attentive and alert, we then enter into a state of mindfulness (Kodish, 2004). And this one is often difficult to maintain for any period of time due to mind wandering and distractions. Next is related the accuracy and sensitivity of interoception and these take time and practice to develop.
I have written several other pieces here on the nature of body awareness and with all bodymind phenomenon it is often, if not always, a key component of the healing and recovery process. See Dimensions of Body Awareness blog-lecture for a list of many other contemporary health problems related to changes in body awareness as well as the blogs on subjective and objective views of body awareness.
Paul Shane, Ph.D., LMT
Director, Academic Content
References
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