Il trattamento dei disturbi alimentari: l'alimentazione meccanica.
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Il trattamento dei disturbi alimentari: l'alimentazione meccanica.

Chi soffre di disturbi dell’alimentazione ha difficoltà a capire quando ha fame o è sazio ed ha pensieri disfunzionali nei confronti dell’alimentazione, del peso e delle forme corporee. 
Una strategia utile per affrontare questi due ostacoli si è dimostrata l’alimentazione meccanica
Mangiare meccanicamente consiste nel cercare di assumere il cibo secondo quanto si è pianificato in precedenza: si dovrebbe considerare ilcibo comeunamedicina.
La pianificazione dei pasti si è dimostrata utile per facilitare l’esposizione al cibo, l’eliminazione della restrizione alimentare e la restrizione del BMI: essa consiste nel pianificare in anticipo quanto, quando, che cosa, dove e in quanto tempo mangiare. La pianificazione dei pasti viene utilizzata nel trattamento dell'anoressia nervosa: una volta pianificata l’alimentazione va consumata utilizzando la tecnica dell’alimentazione meccanica. 
L'alimentazione meccanica è dunque una strategia terapeutica  utilizzata nei programmi di riabilitazione nutrizionale ospedaliera e ambulatoriale per il trattamento dei disturbi alimentari, in particolare per il trattamento dell'anoressia nervosa; attualmente nel trattamento della bulimia nervosa e dei disturbi alimentari atipici si preferisce utilizzare altri tipi di strategie terapeutiche. 
                                   
L'alimentazione meccanica è una tecnica studiata per imparare a ridurre i pensieri riguardanti il cibo, i pensieri legati al controllo del peso, le abbuffate (sia oggettive sia soggettive), a ripristinare i segnali biologici della fame e della sazietà, a ridurre l'ansia e i sensi di colpa connessi all'alimentazione. 
Per riuscire ad alimentarsi meccanicamente è necessario svuotare il pasto di ogni significato; il cibo viene considerato come una medicina da prendere ad orari scadenzati e prefissati (il cibo va assunto negli orari stabiliti e non bisogna assumere cibo al di fuori di essi) e nelle quantità stabilite: quando si segue l'alimentazione meccanica bisogna ignorare i segnali di fame e sazietà (falsati dal disturbo), imparare ad ignorare i pensieri e le preoccupazioni  per quello che c'è nel piatto e per l'adeguatezza delle porzioni, bisogna evitare di rimuginare sul cibo.
Pianificare i pasti e alimentarsi meccanicamente significa decidere in anticipo quando, quanto e cosa mangiare ed attenersi al programma in modo scrupoloso: è importante non saltare mai un pasto, cercare di non mangiare in solitudine e dopo il pasto cercare di distrarsi, in modo da limitare il più possibile i rimuginii riguardanti il cibo assunto. 
L'alimentazione meccanica va proseguita fino alla normalizzazione del peso: a questo punto gli stimoli della fame e  della sazietà saranno più affidabili e le preoccupazioni  per l’alimentazione,  il peso e le forme corporee diminuite.
Quando si utilizza la tecnica dell'alimentazione meccanica è  molto importante cercare di non assumere cibo in difetto o in eccesso rispetto a quanto pianificato: solo così sarà possibile ridurre veramente l’ansia nei confronti del cibo ed il rischio di abbuffate con i conseguenti sensi di colpa e metodi di compenso; ricordiamo a questo proposito che le abbuffate soggettive sono un fattore di mantenimento del disturbo come le abbuffate oggettive e che le prime come le seconde sono in grado di portare a mettere in atto i metodi di compenso che a loro volta rappresentano un ulteriore fattore di mantenimento del disturbo. 

L'alimentazione meccanica permette di:
  • Ridurre l’ansia nei confronti del cibo
  • Rimuginare meno sull'alimentazione
  • Evitare di perdere il controllo sull'alimentazione
  • Ridurre il rischio di abbuffate
  • Recuperare i segnali biologici di fame e sazietà
  • Ridurre i sensi di colpa per aver mangiato.


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