Search Results for "food addiction"
How To Tell If You May Be A Food Addict
Following the recent guest posts by Drs Vera Tarman and Pam Peeke on food addiction, many readers have left comments about how this notion rings true to them and how the ideas of treating their “eating disorder” as an addiction has helped them better control their diet and often lose substantial amount of weight. Others have asked how to tell if they might be food addicts. For them, I am reproducing the following list of 20 questions taken from Food Addicts in Recovery Anonymous. Although it is important to note that “food addiction” has yet to be officially recognized as a medical/psychiatric condition and the following questions are by no means “diagnostic”, I would still support the idea that the more of these questions you answer with yes, the more likely you may benefit from discussing this problem with someone who has expertise in addictions (rather than simply going of on another diet or exercise program). 1. Have you ever wanted to stop eating and found you just couldn’t? 2. Do you think about food or your weight constantly? 3. Do you find yourself attempting one diet or food plan after another, with no lasting success? 4. Do you binge and then “get rid of the binge” through vomiting, exercise, laxatives, or other forms of purging? 5. Do you eat differently in private than you do in front of other people? 6. Has a doctor or family member ever approached you with concern about your eating habits or weight? 7. Do you eat large quantities of food at one time (binge)? 8. Is your weight problem due to your “nibbling” all day long? 9. Do you eat to escape from your feelings? 10. Do you eat when you’re not hungry? 11. Have you ever discarded food, only to retrieve and eat it later? 12. Do you eat in secret? 13. Do you fast or severely restrict your food intake? 14. Have you ever stolen other people’s food? 15. Have you ever hidden food to make sure you have “enough?” 16. Do you feel driven to exercise excessively to control your weight? 17. Do you obsessively calculate the calories you’ve burned against the calories you’ve eaten? 18. Do you frequently feel guilty or ashamed about what you’ve eaten? 19. Are you waiting for your life to begin “when you lose the weight?” 20. Do you feel hopeless about your relationship with food?… Read More »
Guest Post: Food Abstinence for Food Addicts: Deprivation or a New Freedom?
Today’s guest post comes from Dr Vera Tarman, addictions specialist and Medical Director of Renascent, Canada’s largest drug and alcohol rehabilitation facility. She has spoken internationally on the subject of food addiction and is the co-author of Food Junkies: The Truth about Food Addiction (reviewed here). Her website is addictionsunplugged.com. Countless times during my public talks, the question comes up: “You have to eat! If food is addictive, what can you eat?” “Yes”, I agree. “ You do have to eat, but not desserts, bagels, pastries, or any junk food. You don’t need sugar, honey, maple syrup or molasses to survive.” How about vegetables, fruits, meats and fish? For most people, even end-stage food addicts, these foods are not addictive. Food abstinence is not about being on a diet, restricting calories, counting points, eating specially packaged foods – it is a recommendation that we eat the foods our body was metabolically designed to eat and enjoy with satisfaction. Our evolutionary hormonal and neurochemical “checks and balances” have been designed for the natural foods of our ancestors. In other words, we are programmed to desire food when we are hungry and are satisfied when we have sufficient energy reserves from that food. In a perfect nutritional ecosystem, most people can stop with satisfaction when they are full. Willpower, the front-lobe strongman of the brain, is actually quite short-lived and fragile, but works sufficiently well under normal conditions. The food industry has created foodstuffs that provide an highly efficient delivery system to our brain’s reward center. This manipulation gives us a copious amount of delight immediately: the quick fix. The fiber from fruit and vegetables has been peeled away, the hovering bees that discourage an overly eager hand from taking gobs of honey have been removed, the bark of a maple tree or sugar cane that would have made it impossible to get more than a lick of sap or sugar have been stripped. Our primal brain which is accustomed to moderate pleasure is overwhelmed with the euphoric bliss of highly palatable foods. Willpower sags under the strain. This is why you choose the apple cheese cake over the apple. Foods have become irresistible, even to a normal eater. To a food addict, they are the kick-start of a downward spiral to endless overeating, misery and self-loathing. The question that typically follows is, “If you restrict your foods, aren’t you encouraging abnormal… Read More »
Bariatric Surgery Reduces Response to Food Cues?
One of my favourite sayings to patients asking me about bariatric surgery is, “If you think surgery is a quick fix – don’t do it”. That said, one of the consistent messages I hear from patients, who have undergone successful surgery, is about how it appears to affect their appetite, cravings and response to food. This is particularly impressive, when you hear patients tell you how their previous obsession and desire to eat (many liken this to a addiction) before surgery, has been replaced with a surprising disinterest, not to say, indifference to foods that they previously found most tempting and rewarding. This anecdotal report from post-surgical patients may well have a sound biological basis, according to a study by Christopher Ochner and colleagues from St. Luke’s Roosevelt Hospital, New York, NY, published in a recent issue of the Annals of Surgery. The researchers used functional magnetic resonance imaging (fMRI) and verbal rating scales to assess brain activation and desire to eat in response to high- and low-calorie food cues in 10 female patients 1-month pre- and post-Roux-en-Y bypass surgery. Following surgery, there was a distinct decrease in the activation of key areas of the brain known to be involved in the mesolimbic reward pathways in response to high-caloric highly palatable food cues (pepperoni pizza, fudge sundae). These changes in brain imaging were mirrored by the participant’s subjectively reduced desire to eat in response to these cues, suggesting that the surgery may have resulted in substantial changed in the neuronal response mechanisms to such cues. Thus, this study provides further evidence that bariatric surgery owes its success to neuronal (and hormonal?) mechanisms that go beyond simplistic notions of ‘restriction’ or ‘malabsorbtion’. Indeed, as the authors point out, these findings are in stark contrast to previous findings in patients losing similar amounts of weight without surgery, who regularly report an increase rather than a decrease in their appetite and desire for highly palatable foods. Clearly, as the researchers conclude, elucidation of exactly how gastric bypass surgery affects the brain’s reward system, may point to novel pharmacological targets that could lead to new medications that may ultimately reduce (or completely abolish?) the need for obesity surgery. I would certainly be curious to hear from my readers how, in their experience, bariatric surgery affected their (or their patients’) appetite and cravings for highly palatable foods. AMS Edmonton, Alberta Ochner CN, Kwok Y, Conceição… Read More »
How Your Gut Feeds Your Fat Addiction
Have you ever wondered why it is almost impossible to only eat one potatoe chip or French fry? Regular readers may recall a previous post on the discovery that we have specific oral sensory receptors that allow us to sense the ‘fattiness’ of food – a function that makes a lot of sense, given that dietary fat provides the densest source of caloric intake. Now, Nicholas DiPatrizio and colleagues from the University of California, Irvine, have discovered that these oral dietary fat sensors activate a powerful ‘addiction-type’ mechanism in your gut that serves to promote further fat intake – their study is published in a recent issue of the Proceedings of the US National Academy of Science. For their studies, the researchers used a well established ‘sham feeding’ model in the rat, where liquid diets eaten by the animal can be drained from the stomach via a chronically implanted gastric cannula, thereby preventing them from reaching the small intestines. Using this model, the researchers showed that ‘sham feeding’ of a high-fat diet resulted in the potent activation of endocannabinoids in the early part of the small intestine by altering enzymatic activities that control endocannabinoid metabolism. The endocannbinoids (cannabis-like compounds produced in the body) are well known to play an important role in regulating ‘rewarding’ feeding behaviours. This effect was abolished by surgical transection of the vagus nerve showing that the stimulation of these changes in the gut is driven through a centrally mediated neuronal pathway. Furthermore, the local application of cannabinoid type 1 receptors blockers (e.g. rimonabant) in the small gut, reduced increased sham fat ingestion. In other words, this study shows that oral sensing of fat sends a signal to the brain, which in turn sends a signal to the gut leading to formation of endocannabinoids, which in turn re-enforce fat eating. This is probably why, just eating one piece of fatty food (say one potatoe chip or French fry) is so hard – simply eating one makes you want to continue eating till the whole bag or plate is empty. Unfortunately, the drug rimonabant, used to effectively block this effect in this study, is no longer available for obesity management (it was withdrawn due to its negative impact on mood), but it may well be that other CB-1 inhibitors that do not enter the brain may prove to be effective to reduce fat intake. Or, in the words… Read More »
Gender Differences in Trauma and Addictions
This week, I am attending a Scientific Symposium called “Recovery From Addiction“, organised as part of the Alberta Family Wellness Initiative of the Norlien Foundation. My interest in this meeting (where, for once, I am not a speaker on the program), comes from the close links between mental health, addictions and obesity that I regularly note in my patients. As someone with no formal training in diagnosing or treating addiction disorders, this symposium is turning out to be most interesting. Yesterday, much of the program focussed on the link between trauma and addictions; on how addictive behaviours (including food addictions) can result from a wide range of traumatic experiences. I was particularly interested in the presentation by Stephanie Covington from the Institute for Relational Development at the Center for Gender and Justice, La Jolla, CA, who talked about the important differences in both the nature and behavioural impact of trauma between genders. Some of these differences are profound and should be noted by anyone dealing with trauma in men and women. For example, while much of the mental, physical or sexual trauma in men is often inflicted by strangers, women often experience these traumas from very people they love and want to be close to. Perhaps not surprisingly, women often have a history of domestic violence, something men are far less likely to have experienced. This perhaps explains the very different responses that men and women have to trauma: while men tend to respond to trauma with destructive actions (aggression, violence, rages), women tend to respond more often with retreat (isolation, dissociation, depression, anxiety). Interestingly, both genders can respond with self-destructive action (substance abuse, eating disorder, deliberate self-harm, suicidal actions). Overall it appears that women are more likely to respond to trauma with depression than with classical PTSD as defined in DSM IV. While men will use addictive behaviours to escape and distance themselves from the realities of their lives, women will often manifest addictive behaviours in order to maintain a relationship, to fill a void of what is missing in a relationship, or to self-medicate the pain of abuse or betrayal. These important differences have a direct relevance for addressing addictions (or obesity) in group settings, which is why Covington made a strong case for running separate groups for men and women. Overall, Covington made a strong case for using a trauma-informed gender-responsive intervention for women in addiction treatments. Thus,… Read More »
