Another good question from Dr.Fox a.k.a. The Lifting Dermatologist. He noticed that quite often when he makes comments about someone's diet they react very emotionally and Dr.Fox wonders why it happens. My most general answer would be "it depends" as there are different people, with different histories, upbringing, metabolic situation and mindset. But at the same time, there are certain common themes that I've spotted too and today I'd like to talk about them. I think that the best way of addressing it would be to the psychodynamic approach, which is based on Freudian psychology.
The Freudian Model (Structural):
As most of you know, Sigmund Freud proposed a model of human psyche and described the three main structures in it - Id, Ego and Superego. We can illustrate these concepts using their relationship to nutrition and fitness. Id is the most primitive part of our psyche - it is responsible for drives such as hunger, sexual drive, desire to have things in general. In relationship to our question, Id would be creating the drive to devour things, to have as much food as we can, purely out of hedonistic motives. Superego represents the voice of reason, a set of rules, both rational and moral, that we should follow. It's quite an idealistic concept so in many cases these rules are tough or even impossible to follow to a tee. In our case, this would be some sort of our own nutritional guidelines - what we could and what we should and shouldn't eat, in what quantities and frequency, how much we should work out etc. Notice that there is a lot of "should" statements here - that's the nature of Superego. And finally, we have Ego, which, in Freudian model is the place where the conflict happens between primitive drives of Id and the wisdom and morals of Superego. This conflict is quite taxing on our psyche and thus Ego employs specific defenses to preserve our mental faculties. There are lots of different defenses, but I'd like to name a few here:
1. Denial - person simply doesn't register a problem. For example, they don't have the understanding of them being overweight or unfit or unhealthy. I really don't want to give examples here, but there is plenty of denial around us.
2. Projection - person doesn't register a problem with themselves, but definitely sees it in others. Good example would be the subject of one of my previous Q&As when Dr.Fox' colleagues were making comments about his vascularity at a conference.
3. Displacement - likely the one we're looking for here - when a person who struggles with their diet and redirects their unhappiness with themselves to others (like lashing out on some smart and fit doctor who makes comments on their diet).
Again, there many of these mechanisms described, we don't have to go over them in much detail, but I think it's important to highlight that pretty much everyone lives in their own bubble created as a compromise between the objective reality, the drives of Id and the rules of Superego rather that in a pure representation of objective reality.
And here comes my second point - our bubbles are our world, literally, and they are very fragile, so when you make comments about someone's diet, you effectively do more that just offering an opinion or medical fact, you are damaging the fabric of their existence. And the fact that you're a doctor, someone with a high socio-economic status, apparently a smart and successful person, who also seems to be very fit makes this perceived damage much more profound. Effectively, people react to this as to a loss, they literally go through the stages of grief as described by Elizabeth Kübler-Ross:
The Kübler-Ross stages of grief:
Denial - people deny the fact that they are wrong and that you are right, or more precisely, they refuse to believe that their dietary approach may be incorrect or ineffective.
Anger - people get angry at you, they act out, tend to blame you for their misfortunes and, as it's hard to do on a rational level, they might become quite emotional.
Bargain - at this stage people normally start patching their mindset by finding a new compromise. In our situation they might partially accept your approach and give up some aspects of their approach, but they still hold on to theirs to a great extent.
Depression - that's the moment of deep emotional understanding of the fact that their approach is not working and it usually comes with another wave of being emotional.
Acceptance - in the end of the day people do accept the fact that their old model didn't work. That's the time to create a new one and I think that if you have withstood the previous 4 stages, it's the perfect moment for you to help with your advice.
So, this is my educated guess on why people get emotional when we make comments about their diets, whether we are right or wrong. It's up to you what to do with this knowledge. My take would be to be careful with comments in general and to offer advice only when asked for and when you feel that people are ready to receive it, namely, when they understand themselves that their model is not working the way they'd wanted it to. If they aren't aware of it, you can use some motivational interviewing to help them move in the direction of better understanding of their situation. Also, if their model works for them there is no point in trying to convince them otherwise. Just wish them good luck and support if you can.
These were my thoughts and I would like to thank Dr.Fox for another amazing question. I hope it was helpful and, as always, feel free to ask questions, to make comments and to explore my website and to subscribe to my YouTube channel for updates.
Sincerely Yours,
Dr.Sam
Video: Inspirational Q&A #5: Diet, Emotions and... Sigmund Freud?