food addiction: the relationship with food. my story

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?