Transcript No Slide Title

ANISA GRANTHAM, LPC, NCAC
RINCON RECOVERY RESOURCES, LLC
FOOD ADDICTION:
The Relationship With Food
My Story
2001
• Married
• 300 lbs
2002
• JulySurgery
• 318 lbs
• 12-Step
on food
20042008
•maintained
weight loss
•quit
smoking
•neck surgery
•regain 23
OUTLINE
Addiction Overview
 Obesity Epidemic in America
 Food Addiction/Sugar Sensitivity
 The Relationship with Food
 Therapeutic Considerations
 Questions

ADDICTION
Overview and Refresher
SIMPLE DEFINITION
The simple definition of addiction is:
Loss of Control
Behavior 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
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

ANOREXIA
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
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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?
Disease will say “you can not be addicted”
This Idea Fuels DENIAL … If people NEED food to survive….
D:
E:
N:
I:
A:
L:
Don’t
Even
Notice
I
Am
Lying
THE WEIGHT LOSS/GAIN CYCLE
Why Bother
Stressors
Emotional problems/
Situations
Feelings of guilt and shame
Weight
Regain/restriction
What’s wrong with me?
Restriction
Diet or Change in
Eating
Good Food
Vs
Bad Food
‘said that before’
Return to Old
Food/Habits
Loss of trust in self
Emotional relief/
reduce pain /
gain control
‘This time is going to be different’
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-affectsthe-brain-nicole-avena
 https://s.ytimg.com/yts/img/no_thumbnailvfl4t3-4R.jpg
THE DESTRUCTIVE EATING CYCLE
Problem/Event
Situation
Relief fades and
guilt and shame
return
Action: Eat or
restrict
Thoughts of guilt
or inadequacy
Should, Could,
Would
Loss of Control
THE MISUSE OF FOOD:
Signs and Symptoms
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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
THE RELATIONSHIP
Emotional and Psychological Aspects
GOOD FOOD VERSUS BAD FOOD

“Good” Food: When I eat good food, I am a good person.

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Does not taste good
Healthy foods, vegetables
Organic, expensive
“Bad” Food: When I eat bad food, I am a bad person.

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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.
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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

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Proteins
2 – 4 hours
chicken lamb beef soy milk
Cheese 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
FA M I L Y
 Create Food Relationship History
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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

I’m responsible for everything and everyone
I’m afraid or unable to say “No” I can swoop in and fix it
ALL or NOTHING Mentality
I don’t know where I end and you begin
CODEPENDENCY
Fear of rejection
Doing out of obligation and not desire/want
I have no purpose if I’m not taking care of others…..I need you to need me
If you’re happy, I’m happy
What if I took care of me first?
Doesn’t that make me selfish?
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”
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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
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 stop
dieting - develop food plan
 exchanging habits assignments (benefits lists)
TECHNIQUES FOR CLIENTS
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Keeping a food journal
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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
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Identify trigger food
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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
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Food Addicts in Recovery Anonymous

Over Eaters Anonymous
BOOKS & RESOURCES
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"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?