Tarhan: Sudden food restrictions may trigger depression

By Ahmet Taş | Wise News Press
ISTANBUL, TÜRKİYE — Experts at a nutrition congress hosted by Üsküdar University emphasized that obesity and eating behavior should be evaluated not only through physical health but also through psychology.

The “3rd National Congress on Current Approaches in Nutrition and Dietetics” was held at Üsküdar University’s NP Health Campus Ibn Sina Auditorium under the theme “Metabolic Health from Science to Clinic.” The event brought together academics, clinicians, physicians, dietitians and students to discuss obesity, metabolic health, diabetes, cardiometabolic risk, inflammation, microbiota, functional foods and the psychological dimensions of eating behavior.

Speaking at the opening session, Üsküdar University Founding Rector and Chairman of the Executive Board Prof. Dr. Nevzat Tarhan said nutrition treatment should not be based only on prohibitions. He warned that eating habits may carry deep emotional meaning for some patients and that health professionals should understand the patient’s psychology before imposing strict restrictions.

“When a person’s mental health is not in place, they cannot remain loyal to their diet,” Tarhan said.

Eating disorders are not only about hunger

Prof. Dr. Tarhan said Türkiye’s position among countries with high obesity rates was striking. He noted that obesity cannot be explained only by unhealthy eating habits, inactivity or excessive calorie intake. Psychological factors, he said, also play an important role.

According to Tarhan, eating disorders and addiction mechanisms can be related to similar processes in the brain. The brain’s reward system may connect food not only with physical hunger but also with emotional needs such as comfort, pleasure, relief and compensation.

Tarhan said emotional eating is associated with what is described as “reward deficiency syndrome,” which is linked to dopamine deficiency in the brain.

“The reward system in the brain is referred to as ‘reward deficiency syndrome,’ which is actually the neurobiological equivalent and pathophysiology of addiction. In reward deficiency syndrome, there is dopamine deficiency in the brain. Especially in eating disorders, in what they call ‘emotional eating’ or ‘emotional hunger,’ the person eats without being hungry. When they are upset, they eat; when they are happy, they eat,” Tarhan said.

His remarks suggest that eating behavior should not be reduced to willpower or discipline alone. In some cases, food becomes a way to cope with stress, fill emotional emptiness, regulate mood or create a sense of reward. For this reason, nutrition plans may need to take into account the patient’s emotional state, life story, stress factors and the meaning they attach to food.

Emotional eating goes beyond physical appetite

Tarhan said emotional eating is not only related to physical hunger and gave an example from a patient he had encountered years ago. He said the patient, who was overweight and experiencing depression, had almost attached a sense of life meaning to eating.

According to Tarhan, the patient had visited an internal medicine specialist and was told not to eat certain foods. The patient then reacted by asking why his eating mattered so much.

“Doctor, why is it so important for you that I eat this much? If I am not going to eat, why should I live?”

Tarhan said this example shows that eating may represent more than nutrition for some individuals. It may become a source of emotional attachment, consolation or even identity. When such a habit is suddenly removed, the person may feel deprived of something deeply meaningful.

For people who have used food for years as a reward, comfort or emotional refuge, a restrictive diet can create a sense of loss. That loss may trigger depressive symptoms in some cases. Tarhan said this is why diet programs should not be designed only as lists of forbidden foods, but as processes that also protect psychological resilience.

“First the person, then the patient”

Tarhan said dietitians, nutrition specialists and physicians should avoid a purely prohibitive approach. He emphasized that long-standing eating habits cannot always be changed suddenly and that more sensitive methods are needed.

He said telling a person to abandon a habit they have practiced for years for medical reasons may feel like taking away a reward behavior. In some individuals, this can lead to what he described as a “narcissistic injury,” especially when the person has invested emotional meaning in food, body image or eating habits.

“For internists, dietitians and nutrition specialists, the same thing applies: let us not cause the patient to become depressed by simply cutting food. I do not know how you do it, but the patient should be approached in such a way that they are convinced through more skillful methods beyond classic examples like ‘a matchbox-sized piece of cheese.’ It is necessary to understand the patient’s psychology a little. First the person, then the patient,” Tarhan said.

This approach highlights the importance of empathy and behavioral change in nutrition treatment. When a patient is only told “do not eat this” or “do not eat that,” they may feel misunderstood, blamed or deprived of one of the few pleasures in their life. This can weaken diet adherence and make long-term change more difficult.

Tarhan also said young dietitian candidates should consider the addictive dimension of emotional eating. According to him, understanding the emotional background of eating behavior may help professionals develop more effective and sustainable treatment plans.

Obesity and metabolic health require a broader view

Üsküdar University Faculty of Health Sciences Dean Prof. Dr. Arif Aktuğ Ertekin also spoke at the opening session and said nutrition has become a much more critical issue in today’s world. He emphasized the importance of scientific events being sustainable and said such congresses contribute not only to institutions but also to science, the country and the world.

Ertekin said people’s lifestyles had changed significantly, especially after the pandemic. He pointed to increased sedentary behavior, changes in daily routines, stress and the spread of processed food consumption as factors contributing to rising obesity rates.

He also drew attention to global obesity data. Referring to the world population as roughly 8.3 billion, Ertekin said around 30% to 35% of people are described as overweight or obese.

“There are more than 1 billion obese people, and this number is increasing,” he said.

Ertekin said the rise in childhood obesity had reached worrying levels. He noted that more than 177 million children between the ages of 5 and 19 had been identified as obese in recent years. He said this situation should be seen not only as an individual health problem but also as a major public health risk affecting health systems, economies and future generations’ quality of life.

According to Ertekin, the fight against obesity requires scientific research, public awareness and cooperation among professionals working in nutrition and health.

Congress connected science with clinical practice

Üsküdar University Faculty of Health Sciences Department of Nutrition and Dietetics Chair Prof. Dr. Müge Arslan said the congress focused on both the scientific and practical dimensions of nutrition.

Arslan said the congress, organized under the theme “Metabolic Health from Science to Clinic,” aimed not only to share scientific data but also to show how science can be transformed into clinical practice.

She said the event included discussions on diabetes, obesity, cardiometabolic risk factors, functional foods, nutrigenetics, clinical applications and multidisciplinary solution proposals.

Arslan said the congress also hosted a first in Türkiye through the workshop titled “Healthy Transformations in Anatolian Cuisine from Future to Tradition.” She said the workshop addressed Anatolian cuisine through scientific data and aimed to bring traditional flavors together with current knowledge on healthy nutrition.

This perspective underlined that nutrition should not be limited to restrictive diets. Experts at the congress emphasized the importance of culturally sustainable, practical and long-term nutrition models that can be adapted to the individual’s lifestyle, economic conditions, eating culture and psychological needs.

Arslan said the congress brought together physicians, nurses, dietitians, scientists and students, creating an environment for cooperation and stronger scientific connections.

Current scientific data were shared over two days

During the congress, experts addressed a wide range of topics, including obesity, chronic inflammation, personalized treatment, epigenetics, metabolic surgery, GLP-1 analogues, cardiometabolic risk management, lifestyle strategies, diabetes nutrition research, macronutrient balance, plant-based diets and mitochondrial dysfunction.

In the session titled “From Metabolic Risk to Solution: Obesity,” speakers discussed obesity and chronic inflammation, personalized treatment in obesity, surgical interventions in the presence of metabolic disease, and new horizons in obesity treatment.

Another session focused on multidisciplinary approaches in cardiometabolic risk management. Topics included current data on cardiometabolic health, lifestyle strategies to reduce risk and endothelial dysfunction.

On the second day, prominent topics included the relationship between metabolic microbiota and systemic inflammation, nutrition-based approaches to lipedema, inflammation, obesity, anti-aging, cellular aging, longevity and inflammaging. Case presentations were also held on bariatric surgery, GLP-1 use and lipedema.

The congress concluded by bringing together experts, academics, clinicians and students in the field of nutrition and dietetics. The main message that emerged from the opening speeches was that metabolic health should be approached as a multidimensional issue.

According to the speakers, nutrition treatment should not be based only on calories, restrictions and lists. It should also consider psychology, behavioral change, culture, lifestyle and scientific evidence.

Tarhan’s emphasis on “first the person, then the patient” stood out as one of the core messages of the congress. Experts said that when a person’s mental health, motivation and emotional needs are ignored, even the most accurate nutrition plan may become difficult to sustain.

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