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Comedores Compulsivos Anónimos  (OA por su traducción en inglés Overeaters Anonymous) es un programa de 12 pasos para personas con problemas relacionados con la comida, incluyendo pero no limitándose a  personas con el síndrome del atracón, Bulimia y Anorexia. Cualquier persona con una relación problemática con la comida es bienvenida ya que la Tercera Tradición dice que el único requisito para ser miembro de OA es el deseo de dejar de comer compulsivamente.

OA fue fundada por Rozanne S. y otras dos mujeres en Enero de 1960. La sede de la organización u Oficina de Servicio Mundial está localizada en Rio Rancho, New Mexico. Comedores Compulsivos Anónimos estima tener 54,000 miembros en 6,500 grupos en más de 75 países. .

OA ha desarrollado su propia literatura para aquellos que comen compulsivamente, también usa los libros de Alcohólicos Anónimos, Alcohólicos Anónimos y Doce pasos y Doce Tradiciones. El primer paso de OA consiste en aceptar la impotencia ante la comida, los once pasos restantes tienen como objetivo proporcionar sanación "física, emocional y mental" a sus miembros.

Definiciones
OA define una compulsión como "cualquier impulso o sentimiento de ser lanzado incontrolablemente hacia la realización de alguna acción irracional." Además, OA define el comer compulsivo como una enfermedad adictiva y progresiva. OA considera el comer compulsivo como una condición crónica y como parte de un intento de aliviar estrés psicológico.

Como los otros programas de 12 pasos, en OA se piensa que el comer compulsivo tiene tres componentes, considerando que la estructura humana tiene tres dimensiones: física, mental y espiritual. La enfermedad se manifiesta en cada una de estas dimensiones. Un libro que se describe a sí mismo como basado en métodos de OA, enuncia que en la dimensión mental, un comedor compulsivo no se come sus sentimientos, si no que está expresando un "hambre interior".

Para ayudar a miembros potenciales a decidir si necesitan el programa, OA tiene un cuestionario que pregunta  cosas como: "¿Gasta mucho tiempo y pensamientos en la comida?", si se contesta afirmativamente a tres o más preguntas, se considera un indicador de que OA puede ser de ayuda.

Abstinencia en OA
"El significado de Abstinencia para OA es la acción de evitar el comer compulsivo o los comportamientos compulsivos asociados a la comida mientras se alcanza o mantiene un peso corporal saludable." Este concepto de abstinencia ha sido criticado por no ser específico. Mientras que para AA abstinencia significa no tomar alcohol, en la experiencia de OA no es posible quitar específicamente ciertos alimentos ya que diferentes personas tienen diferentes alimentos que desencadenan el comer compulsivamente.

Se dice frecuentemente que los alcohólicos no tienen que beber, pero los comedores compulsivos necesitan comer, Comedores compulsivos anónimos responden que los alcohólicos tienen que tomar pero que no pueden tomar alcohol, de la misma manera, los comedores compulsivos tienen que comer pero no pueden comer aquellos alimentos que despiertan la compulsión por comer.

En la literatura de OA, se define "compulsión" de la siguiente manera: 'compulsión' significa 'un impulso o sentimiento de ser irresistiblemente arrastrado hacia la acción de un acto irracional.' Por lo tanto, "comer compulsivamente" y "comportamientos compulsivos asociados a la comida" (como los términos usados en la definición de abstinencia) signigican comer irracionalmente o tener comportamientos irracionales asociados a la comida, resultado de un impulso o sentimiento irresistibles. Entonces para OA, "abstinencia" es el acto de evitar "el comer compulsivamente" y los "comportamientos compulsivos asociados a la comida", mientras se alcanza o se mantiene un peso corporal saludable. Esta definición puede ser descrita como matizada y sujeta a interpretación personal (i.e., la definición de un "peso corporal saludable") o que se requiere de un análisis personal (i.e., determinar los desencadenantes u orígenes de ciertos comportamientos) pero no es vaga.

El objectivo de la definición de abstinencia de OA es que el comedor compulsivo evite el comer compulsivo o los comportamientos compulsivos asociados a la comida, no que se abstenga de comer. OA recomienda a los comedores compulsivos que sigan su propio plan de alimentos que les permitirá evitar los comportamientos destructivos mientras se alcanza o se mantiene un peso corporal saludable.

El programa sugiere a los miembros que identifique aquellos alimentos que desencadenan el comer compulsivo. Dado que cada individuo es responsable de definir su plan de alimentos, este lo puede cambiar si sus necesidades o su comprehensión de sus compulsiones cambia, sin quebrantar su abstinencia. Se alienta a los miembros a buscar consejo en sus compañeros de OA y más importante, en su "poder superior", antes de hacer cualquier cambio en el plan de alimentos para validar que las razones son de peso y no una decisión basada inadvertidamente en la subyacente compulsión.

Herramientas y estrategias de recuperación
El programa de OA está basado en los 12 pasos y las doce tradiciones de alcohólicos anónimos. Se han ralizado pequeños cambios para hacer el programa aplicable a los desórdenes alimenticios pero tal adaptación ha sido mínima. Para llevar a cabo los doce pasos y practicar las doce tradiciones, la literatura del programa de OA recomienda usar las nueve herramientas de recuperación que incluye un Plan de Alimentos, Apadritamiento, Juntas, Teléfono, Escribir, Literatura, Anonimato, Servicio y Plan de acción. Estas herramientas se consideran críticas para obtener y mantener abstinencia.

Las juntas ofrecen una validación consensual y sirve para disminuir sentimientos de culpa y vergüenza. El padrino provee una guía a través del programa y apoyo cuando es necesario, pero gradualmente alienta una autonomía en el ahijado

Plan de Alimentos
En OA, abstinencia es "la acción de evitar el comer compulsivo o los comportamientos compulsivos asociados a la comida mientras se alcanza o mantiene un peso corporal saludable". Por definición, para OA, 'compulsión' es 'un impulso o un sentimiento de ser irresistiblemente lanzado a realizar una acción irracional'". OA tiene una historia larga y compleja con los "planes de comida" y no respalda o recomienda ningún plan de alimentos específico, ni excluye algún plan de alimentos personal. OA recommends that each member consult a qualified health care professional, such as a physician or dietitian. OA publishes a pamphlet Dignity of Choice which assists in the design of an individual food plan and also provides six sample plans of eating (reviewed and approved by a licensed dietitian) with which some OA members have had success.

Individual OA meetings and sponsors may make more detailed suggestions. Some of these caution against foods containing excessive sugar, alcohol, and wheat. A qualitative analysis of bulimics recovering in OA found bulimic OA members with excessively rigid plans are less likely to remain abstinent. The researchers conducting the analysis suggested new members start with a somewhat rigid plan that becomes increasingly more flexible approaching the end of a year in the program.

An individual's plan of eating may call for the exclusion of certain triggering behaviors. For example, a person who knows that eating after a certain time in the evening creates compulsive food behaviors might well include in his or her plan of eating a commitment to abstain from eating after that time of night; or a person who knows that snacking between meals creates compulsive food behaviors would probably include in his or her plan of eating a commitment to abstain from chewing or sucking between meals.

Demographics
In 2002 a dissertation compared the results of a survey of 231 OA members in the Washington area of North America undertaken in 2001 with the findings from surveys of OA members taken in 1981, twenty years previously. The 2001 survey showed that 84% of OA members identified as binge eaters, 15% as bulimic, and 1% as anorexic. The 1981 survey had found that 44.5% of OA members identified as binge eaters, 40.7% as bulimic, and 14.8% as anorexic. The survey also found an increase in the percentage of males in OA from 9% in 1981 to 16% in 2001. Both figures are generally inline with estimates made by the American Psychological Association that the male to female ratio of those with eating disorders ranges from 1:6 to 1:10. The researcher stated that the typical OA member in Washington was white and highly educated. The typical OA member surveyed in 2001 worked in a full-time capacity and homemakers only comprised 6% of the 2001 OA population, in contrast to 30% of those surveyed in 1981. This reflects the trend for increasing numbers of females to be employed outside of the home. Further, 80% of the 2001 participants had attained a college degree, compared to 59% of those surveyed in 1981. The percentage of OA members who were divorced or separated had risen from 10% in 1981 to 21% in 2001, also reflecting trends amongst the general population.

Correlations with maintaining abstinence
Research has identified a number of OA practices significantly correlating with maintaining abstinence in OA: adherence to a food plan (including weighing and measuring food), communication with other members (specifically sponsors), spending time in prayer and meditation, performing service work, completing the fourth step, completing the ninth step, writing down thoughts and feelings, attending meetings, and reading OA/AA literature. Researchers have therefore concluded that application of OA practices might directly help promote abstinence and reduce the frequency of relapse in those with binge eating disorder and bulimia nervosa.

Honesty
Though not found in research to be significant, a number of OA members responded that honesty was a very important OA practice. Researchers have noted the high level of honesty at OA meetings and pointed out that working the Twelve Steps reinforces this quality.

Spirituality
Some researchers have found that in spite of its perceived high importance to the program that spirituality does not correlate with measures of weight loss, while others have found somewhat contradictory conclusions. In particular an increased sense of spirituality was correlated with positive gains in eating attitudes, fewer body shape concerns, and positive psychological and social functioning. However, measures of religiosity and particular religious affiliations have never been found to correlate with treatment outcomes.

Demographic abstinence differences
Some research has found the average length of abstinence for bulimics in OA was significantly higher than the average length for binge eaters. Paradoxically, bulimics were also found to attend fewer meetings, and had less of a commitment to write their thoughts and feelings down daily. However, the frequency of relapse for bulimics and binge eaters was not significantly different. The differences may be explained by the predictable nature of the bulimic cycle. Other research has found binge eaters in OA had better success than bulimics. Most OA members who have reported negative experiences in the program are anorexic. This could be caused by OA's focus on problems of eating too much rather than too little. Some OA practices, such as refraining from eating certain kinds of foods, are antithetical in the case of anorexics. Though, most anorexics have a previous history of bulimia.

Results
The average weight loss of participants in OA has been found to be 21.8 pounds. Survey results show that 90% of OA has responded that their lives have improved either "somewhat, much, or very much" in their emotional, spiritual, career, and social lives. OA's emphasis on group commitment and psychological and spiritual development provided a framework for developing positive, adaptive, and self-nurturing treatment opportunities.

Since excessive weight gain or loss is viewed as a symptom of underlying issues, OA focuses on these issues. No one reports on weight gain or losses but on their personal spiritual and emotional progress. A statement read at the beginning of each meeting states that ..."we are not a diet and calories club."

Changes in worldview
Changes in worldview are believed to be critical for individuals in the recovery process, as they are generally accompanied by significant behavioral changes. Accordingly, several researchers have identified world view transformation in members of various self-help groups engaged in addiction issues. Such research describes "worldview" as having four domains: (1) experience of self; (2) Universal Order/God; (3) relationships with others; and (4) perception of the problem. In OA, members changed their beliefs that (1) "it is bad to eat" to "one must eat to stay alive and should not feel guilty about it"; (2) "one is simply overweight and needs to lose pounds" to "one has underlying psychological and interpersonal problems"; (3) "one must deprecate oneself, deprive oneself, please other people" to "it is okay to express positive feelings about oneself and take care of one's needs"; (4) "food is the answer to all problems, the source of solace" to "psychological and emotional needs should be fulfilled in relationships with people"; "I am a person who eats uncontrollably" to "I am someone who has limitations and does not eat what is harmful for me."

Understanding of control
The act of binging and purging provides bulimics with the illusion that they can regain a sense of control. Binge eating has been described as a "futile attempt to restock depleted emotional stores, when attempts at doing everything perfectly have failed." The self-destructive behavior of injecting intoxicating drugs parallels overeating in that it permits the user not only to experience comfort, but to feel deservedly punished when through.

In relationships, many OA members attested to trying to obtain absolute control of their own lives and those of others. Paradoxically, OA member's experience of themselves was also characterized by strong feelings of personal failure, dependence, despair, stress, nervousness, low self-esteem, powerlessness, lack of control, self-pity, frustration and loneliness. As part of these feelings, the self was perceived as being both a victim of circumstances and a victim of the attitude of others. Many members viewed this lack of self-esteem as deriving from their external appearance. Harsh self-criticism is a typical characteristic, accompanied by feelings of "I don't deserve it," and "I'm worth less than others." Such feelings were found to have a dominant influence on the structure of relationships with others.

The members describe their sense of relaxation and liberation and the concomitant growing value of restraint and modesty in their lives. Their testimonies show that, paradoxically, it is by becoming aware of their powerlessness and accepting the self's basic limitations that they start to feel the recovering self's growing power. At the same time, personal responsibility replaces self-pity and the expectation that others will act for the good of the individual. In this attitude, egocentricity and exaggerated, false self-confidence perpetuate the problem that led them to join OA. While eating disorder was active many OA members claimed that their experience of self was composed of an obsessive aspiration for perfection that concealed their sense of worthlessness.

Comparisons
A significant difference between Twelve Step work and cognitive-behavioral therapy is the acceptance of a Higher Power and providing peer support. A large study, known as Project Match, compared the two approaches as well as motivational enhancement therapy in treating alcoholics. The Twelve Step programs were found to be more effective in promoting abstinence. However, some researchers have found that cognitive-behavioral therapy is the most effective treatment for bulimics. The two approaches are not mutually exclusive.

Each OA group has its own character and prospective members are encouraged to sample several groups before deciding if OA is for them.

Criticism
OA is different from group therapy in that it does not allow its participants to express their feelings about and directly to each other during meetings. OA meetings are intended to provide a forum for the expression of experience, strength and hope in an environment of safety and simplicity.

Feminist
OA has been the target of feminist criticism for encouraging bulimic and binge eating women to accept powerlessness over food. Feminists criticize that the perception of powerlessness adversely affects women's ongoing struggle for empowerment. Similarly, teaching people they are powerless is liable to encourage passivity and prevent binge eaters and bulimics from developing coping skills. These effects would be most devastating for women who have suffered oppression, distress, and self-hatred. In these criticisms Twelve Step programs are described as inherently male organizations that force female members to accept self-abasement, powerlessness, external focus, and rejection of responsibility inherent — qualities attributed to male religion and politics. Surrender is described as invoking images of women passively submitting their lives to male doctors, teachers, and ministers. Alternatively, they suggest that women would do better to focus on pride rather than on humility.

Fanaticism
Opponents of Twelve Step programs argue that members become cult-like in their adherence to the program, which can have a destructive influence, isolating those in the programs. Moreover this kind of fanaticism may lead to perception that other treatment modalities are unnecessary. Surveys of OA members have found that they exercise regularly, attend religious services, engage in individual psychotherapy and are being prescribed antidepressants. This is evidence that participants do not avoid other useful therapeutic interventions outside of Twelve Step programs.

Literature
OA also publishes the book Overeaters Anonymous (referred to as the "Brown Book"), The Twelve Steps and Twelve Traditions of Overeaters Anonymous, For Today (a book of daily meditations), the OA Journal for Recovery, a monthly periodical known as Lifeline, and several other books. The following list is not comprehensive.