food addiction: the relationship with food. my story
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ANISA GRANTHAM, LPC, NCACRINCON RECOVERY RESOURCES,
LLC
FOOD ADDICTION: The Relationship With
Food
My Story
• Married• 300 lbs
2001• July- Surgery• 318 lbs• 12-Step on
food
2002
• maintained weight loss
• quit smoking• neck surgery• regain 23
2004-2008
Addiction Overview Obesity Epidemic in America Food Addiction/Sugar Sensitivity The Relationship with Food Therapeutic Considerations Questions
OUTLINE
Overview and Refresher
ADDICTION
SIMPLE DEFINITION
The simple definition of addiction is:
Loss of ControlBehavior becomes
Unpredictable
ADDICTION
Common Aspects of Addiction: Loss of Control
Preoccupation
Increased Tolerance
Heightened Pleasures Increased Cravings
Secrecy
Avoidance of activities with others
Failed attempts at cutting back or quitting
ADDICTION (CONT’D)
There is one key word that can distinguish between someone with or without an issue.
For someone without an issue, the substance does something TO them.
For someone with an issue, the
substance does something FOR them.
EATING DISORDERS
ANOREXIA STARVATION IS A FORM OF CONTROL. TEND TO
BE PASSIVE WITH OTHERS – RESTRICTION INCREASES ENDORPHINS “HIGH”
BULIMIA/ DOUBLE TROUBLE. OVEREATING BINGEING AND SELF INDUCED VOMITTING OR USE OF LAXATIVES - CONTROL
COMPULSIVE THE GOAL IS TO NUMB OUT OVEREATING EMOTION – AVOID AT ALL COST
OBESITY EPIDEMIC IN AMERICA
OBESITY EPIDEMIC IN AMERICA
Body Mass Index (BMI) is a measure of body fat based on height and weight.
2 out of 3 Americans is considered overweight or obese.
(Have a BMI greater than 25) Obese: Over 30
Overweight: 25- 29.9
Healthy Weight: 18.5- 25.9
Underweight: Under 18.5
AMERICAN HEART ASSOCIATION 2013 STATS
Among Americans 20 and older 154.7 Million are overweight or obese. 79.9 Million Men 74.8 Million Women
Of these, 78.4 Million are Obese 36.8 Million Men 41.6 Million Women
THE COST
‘The total excess cost related to the current prevalence of adolescent overweight and obesity is estimated to be $254 billion ($208 billion in lost productivity secondary to premature morbidity and mortality and $46 billion in direct medical costs).’
- American Heart Association
THE DIS-EASE OF OBESITY
Meets the 4 criteria for being classified as a disease:
1. Primary Diagnosis- Not a secondary symptom of something else; independent
2. Progressive- It gets worse over time….
3. Chronic- It does not go away (surgery =remission) There is no Cure.
4. FATAL- It will kill you
LIVING WITH THE DISEASE OF OBESITY Obesity is visible wherever you go Everyone can see your disease (Obesity
walks in the door with you.) Most overweight individuals are
malnourished due to the types of food they consume, most commonly high in fat and sugar and low in nutritional quality
Most obese individuals feel the need to excel in another aspect of their lives (professional, caretaking) in order to compensate for their feelings of inadequacy on a personal level
FOOD ADDICTION – THE RELATIONSHIP
CAN YOU REALLY HAVE A FOOD ADDICTION?
D: Don’tE: EvenN: NoticeI: IA: AmL: Lying
Disease will say “you can not be addicted”
This Idea Fuels DENIAL … If people NEED food to survive….
THE WEIGHT LOSS/GAIN CYCLE
StressorsEmotional problems/
Situations
Diet or Change in Eating
Emotional relief/ reduce
pain / gain control
Return to Old Food/Habits
Weight Regain/restrictio
n
What’s wrong with me?
Restriction
Good Food VsBad Food
‘This time is going to be different’Loss of trust in self
Feelings of guilt and shame
‘said that before’
Why Bother
FOOD AS AN ADDICTION: DOES IT FIT?
The Similarities to Other Addictions
Loss of Control
Preoccupation
Increased Tolerance
Heightened Pleasures
Increased Cravings
Secrecy
Avoidance of activities with others
Failed attempts at cutting back/dieting
NICOLE AVENA: HOW SUGAR AFFECTS THE BRAIN
http://ed.ted.com/lessons/how-sugar-affects-the-brain-nicole-avena
https://s.ytimg.com/yts/img/no_thumbnail-vfl4t3-4R.jpg
THE DESTRUCTIVE EATING CYCLE
Problem/Event Situation
Thoughts of guilt or
inadequacy
Should, Could, Would
Loss of ControlAction: Eat or
restrict
Relief fades and guilt and shame return
THE MISUSE OF FOOD:
Signs and Symptoms• Binge Eating/ Feeling out of Control • Eating Faster than Normal• Low Self Esteem/ Needing to Eat More• Eating Alone (out of shame/ embarrassment)• Shame, Depression, Mood Swings from over eating • Withdrawn from Activities/Outings• Eating Small Amounts in Public• Rapid Weight Gain• Preoccupation with food• Significant Decrease in Mobility• Unsuccessful Diets• Awareness of Abnormal Eating Habits
Emotional and Psychological Aspects
THE RELATIONSHIP
GOOD FOOD VERSUS BAD FOOD “Good” Food: When I eat good food, I am a good
person. Does not taste good Healthy foods, vegetables Organic, expensive
“Bad” Food: When I eat bad food, I am a bad person. Higher in calories and fat Has the ‘yummy’ taste Activates the reward center of the brain These are foods we ‘crave’, setting us up to feel bad
about ourselves and entering the cycle of shame. We enjoy them
HUNGER. APPETITE, AND SATIETY
Hunger- Indicated by the body as an innate need to nourish our bodies.
Appetite- Desire to eat created through the senses of sight, smell, taste, touch, and hear.
Satiety- The state of being full or gratified.
We have difficulty in a society of plenty distinguishing between hunger and
appetite.
For many individuals, the ability to recognize our own satiety has been lost.
HOW DO I KNOW?? Hunger & Satiety Rating
Scale
10= stuffed- feel sick 9= very uncomfortable-
loosen belt 8= uncomfortably full 7= very full-overeaten 6= comfortably full 5= comfortable 4= beginning signals of
hunger 3= hungry 2= very hungry-no
concentration 1= starving/dizzy/irritable
When will I be hungry again?
Simple-Refined Carbohydrates
20 minutes cookies donuts cake popcorn chips fruit juice candy/bars Complex Carbohydrates 30 – 40 minutes cucumbers broccoli apple rice pasta peach green beans grapes Proteins 2 – 4 hours chicken lamb beef soy milkCheese eggs legumes fish nuts
FOOD RITUALS AND SOCIALIZATION
Our exposure and relationship to food includes Sunday Dinners/Brunch Sporting Events Events (celebrations/holidays/losses) Family Reunions/Vacations Eating in front of TV Lunch/dinner with colleagues/friends/church
family Boredom Business meetings
EMOTIONAL AND MALADAPATIVE EATING BEHAVIORS (MESSINA & MESSINA)
Romancing: involves exposing one’s self to activities attached to food. (reading cook books, watching cooking shows, putting self near food related activities)
Stress Reduction: utilizing food to reduce unwanted stress and anxiety. Nervous energy is reduced by eating foods high in sugar and fat.
Comfort Effect: eating invokes a positive psychological effect when one is feeling depressed, angry, bored, out of control, lonely, shamed, or overwhelmed. This becomes your ‘go to’ food.
EMOTIONAL AND MALADAPATIVE EATING BEHAVIORS (MESSINA & MESSINA)
Craving Relief: Food cravings stimulate anxiety, this is reduced by consuming the craving food, generally high in sugar and fat.
Self-Sabotage: successful weight loss, or any successful experience, may create anxiety if one’s self worth is negative. Weight loss and compliments triggers memories. (Personal fear of success- ‘can I maintain this’)
Family of Origin: early childhood experiences, food availability, and family rules all influence eating habits.
EMOTIONAL AND MALADAPATIVE EATING BEHAVIORS (MESSINA & MESSINA)
Binge Eating: short intense episodes of overindulgence of food. Compulsive in nature, subconscious drive to relieve anxiety/fear
Over Eating: continuing to eat after one is full. May develop from use of food to reduce stress and anxiety. May also stem from habits resulting in lack of awareness in satiety.
Mindless Eating: Eating as an automatic response to rituals of daily living (daily routine, snacks, etc)
EMOTIONAL AND MALADAPATIVE EATING BEHAVIORS (MESSINA & MESSINA)
Food Restriction: rigid limits around particular foods or categories of foods can result in a stronger than normal desire to consume these foods. We often romance off-limit activities that we find attractive, creating a fantasy and yearning.
Grazing: impulsive eating throughout the day because food is easily accessible. Usually taking in more calories than intended.
THERAPEUTIC CONSIDERATIONS
ADDRESSING THE RELATIONSHIP WITH FOOD
We tend to go to what is familiar F A M I L Y
Create Food Relationship History relationship history with food - describe memories
related to food as a child, teen, young adult, living independently
meal atmosphere (tension/relaxed) did family eat together / fend for yourself
any food items restricted/prohibited what did you learn about types of food any significant problems
Understanding the connections to certain foods or rituals……
THE WARNING SIGNS OF A ‘BAD RELATIONSHIP’
Pre-eating Identifying a feeling – I eat because I love
food Eating Alone Obsessive thoughts/preoccupation Secret Eating- hiding food/wrappers Dating food Making excuses/minimizing
C O D E P E N D E N C Y
I don’t know where I end and you begin
If you’re happy, I’m happy What if I took care of me first? Doesn’t that make me selfish?
I’m responsible for everything and everyone
I’m afraid or unable to say “No”
Fear of rejection Doing out of obligation and not desire/want
I can swoop in and fix it ALL or NOTHING Mentality
I have no purpose if I’m not taking care of others…..I need you to need me
ADDRESSING THE RELATIONSHIP WITH YOURSELF
Why diets and surgery alone do not work: Accepting self comes separate from weight
loss. The power of a scale Redefine healthy
Family history of obesity- were there comments about body /what was your body image?
“I am good enough”
TREATMENT PLANNING Develop a support system Short term goals How does the client want things to be
different – what are you willing to do? Identify belief systems that do work Self talk – what does that sound like? (+
vs -) Re-define Healthy
stop dieting - develop food plan exchanging habits assignments (benefits
lists)
TECHNIQUES FOR CLIENTS
Keeping a food journal what are you eating how much what time of day what's going on in the
moment what are you feeling FitBit/fitness pal/apps Measuring progress
differently Moving on purpose
Identify trigger food abstinence - get it out
of the house making peace with
food what do you need it to
do for you- trust yourself to do for you
how has it served you how has your weight
served you- protected you from who? from what?
12 STEP PROGRAMS
Eating Disorders Anonymous
Food Addicts Anonymous
Food Addicts in Recovery Anonymous
Over Eaters Anonymous
BOOKS & RESOURCES "Shade's of Hope" - Tennie McCarty “Mindful Eating” - Dr. Michelle May “Breaking Free from Emotional Eating”-
Geneen Roth “Daring Greatly” – Brene Brown, PhD “Gifts of Imperfection” – Brene Brown, PhD “Success Habits of Weight Loss Surgery
Patients” Colleen Cook
Documentary- 90 minutes - Forks over Knives
(2011)
Thank You for your interest and the work you do!
Any Questions?
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