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1 PSYCHOLOGY MODULE 2 Eating Disorders Food Addiction OVERVIEW EATING DISORDERS Transforma$onal Nutri$on Inc. 1

2 WHAT WE WILL COVER IN THIS SECTION What Is It? Introduction Statistics Growing Problem Younger Adults Growing Issue For Adults Not Enough Research Why Eating Disorders Develop Specific Eating Disorders And Treatment WHAT IS IT? Serious disturbance in everyday diet or body perception May have started out as Just less food More food than usual Spirals out of control INTRODUCTION Often begins during teen or young adult years Living in Westernized countries increases risk Most common in adolescence and young adulthood Rising incidence in adults Transforma$onal Nutri$on Inc. 2

3 STATISTICS Affects 30 million Americans 1/3 are male Eating disorders can happen to anyone Same prevalence in all races Except more anorexia in non-hispanic white individuals STATISTICS Children Lifetime prevalence 2.7% 3.8% female 1.5% male Age % Age % Age % STATISTICS Average woman in America is 5 4 and 165 pounds Miss America on average is 5 7 and 121 pounds BMI averages of winners of Miss America decreased 22 in (underweight) in 2000s Transforma$onal Nutri$on Inc. 3

4 GROWING PROBLEM Prevalence has increased over the past 60 years Closely mirrors rising obesity rates Anorexia has increased every decade since 1930s in year olds Bulimia tripled between 1988 and 1993 in year olds GROWING PROBLEM FOR YOUNG ADULTS Children hospitalized with eating disorders increased between 1999 and 2006 by 119% 81% of 10 year olds fear being fat 42% of girls in grades 1-3 desire to be thinner GROWING PROBLEM FOR YOUNG ADULTS 35-57% of girls Use compensatory methods to avoid weight gain Crash dieting Fasting Vomiting And others (excessive exercise, diuretics, etc.) Compensatory behaviors Any behavior someone engages in to try to compensate for extra calories or weight gain Transforma$onal Nutri$on Inc. 4

5 GROWING PROBLEM FOR YOUNG ADULTS 25% of elementary aged girls diet regularly Frequent dieting makes girls 12 times more likely to binge than those who don t 35% of average dieters become pathological eaters 1/4 develop into an eating disorder (full or partial diagnosis) GROWING ISSUE FOR ADULTS Eating disorders in adult populations Increasing in recent years Approaching half of all treatment seekers Programs traditionally for adolescents opening up to adults NOT ENOUGH RESEARCH Only $.93 spent for each individual with an eating disorder Spending compared to other illnesses Illness Prevalence NIH Funding Eating Disorders 30 million $28,000,000 Alzheimer's 5.1 million $450,000,000 Autism 3.6 million $160,000,000 Schizophrenia 3.4 million $276,000,000 Transforma$onal Nutri$on Inc. 5

6 WHY EATING DISORDERS DEVELOP Biological causes Coexisting mental health issues Perfectionism Chaos at home Difficulty expressing emotions Low self-esteem Feeling helpless Impulsivity Teasing about body Trauma Cultural views about body Media Photoshop Pro-ana culture Body changes BIOLOGICAL CAUSES A wide variety of biological issues can influence or cause eating disorders Including Genetics/Epigenetics Biochemical imbalances Hormone imbalances Auto-immune issues Brain tumors, calcifications, lesions Obstetric complications COEXISTING MENTAL HEALTH ISSUES Depression Half of all individuals with binge eating disorder have depression history Eating more than usual One of the symptoms of depression Depression can be cause or effect of eating disorders Brain changes in anorexia can cause depression and issues with decision making Transforma$onal Nutri$on Inc. 6

7 COEXISTING MENTAL HEALTH ISSUES Anxiety Anxiety prior to the development of the eating disorder Eating disorder as a way of coping with and managing anxiety Building anxiety before disordered eating episodes 13.5% of those getting treatment for anxiety have an eating disorder as well COEXISTING MENTAL HEALTH ISSUES Anxiety Those seeking treatment for eating disorders 69% reported that the anxiety preceded the ED 65% have at least one anxiety disorder May have social anxiety about how perceived by others Most frequently occurs with ED at 42% COEXISTING MENTAL HEALTH ISSUES Bipolar Disorder 24% have symptoms of eating disorders 44% have difficulty controlling eating Transforma$onal Nutri$on Inc. 7

8 COEXISTING MENTAL HEALTH ISSUES ADHD Research has shown girls with ADHD have higher incidence of eating disorders Substance Abuse Alcohol and drug abuse 4 times more likely in those with eating disorders PERFECTIONISM Feel worth is dependent on being perfect May become obsessed with obtaining perfection Perfectionistic aims used to fight feelings Never feel good enough Anxiety and depression often underlie this feeling Have often experienced emotional trauma CHAOS AT HOME Mental health or substance abuse issues of others in the home Dysfunctional family Anger issues in the home Parent had disordered eating Girls from foster homes are more likely to develop bulimia Transforma$onal Nutri$on Inc. 8

9 DIFFICULTY EXPRESSING EMOTIONS Unexpressed emotions Alexithymia Difficulty with Determining what one is feeling Expressing feelings Can be the result of childhood trauma and neglect Will sometimes eat their emotions rather than express them LOW SELF-ESTEEM Low self-esteem highly associated with eating disorders Research has supported this relationship May include Negative self-image and body image Feelings of inadequacy Excessive concern over others evaluations Doubt own self-discipline FEELING HELPLESS Negative events occur Feel like there is nothing they can do to improve their situation Feel backed into a corner Coping mechanisms may be inadequate Resort to food or restriction for comfort Transforma$onal Nutri$on Inc. 9

10 IMPULSIVITY Highly associated with binging Individuals with bulimia Show higher levels of recklessness Individuals with problems inhibiting their responses Harder time holding back automatic response to binge TEASING ABOUT BODY Parents Child given the message Their body or food is bad Weight and body shape determine Worth Approval Affection Support TEASING ABOUT BODY Peer pressure and bullying Begin to feel ashamed of body Want to change body to conform to peer pressure Prevalent in athletic culture Transforma$onal Nutri$on Inc. 10

11 TRAUMA Traumatic events can set off eating disorders Domestic Violence Child abuse victims Eating disorder as way to gain control Research shows Sexual abuse related PTSD These girls at higher incidence for eating disorders CULTURAL VIEWS ABOUT BODY Cultural value placed on thinness Idealized body stereotype isn t usually attainable Primarily in westernized societies Higher socioeconomic status correlated with higher levels of eating disorders Higher incidence for men in the LGBTQ community MEDIA Constant influx Narrow definitions of beauty Images often use Photoshop Elementary school girls reading magazines 69% report that magazines affect their ideal body shape 47% reported pictures make them want to lose weight Transforma$onal Nutri$on Inc. 11

12 PHOTOSHOP Photoshopping is a general term for photo manipulation Produce and distribute images of perfection UK has harsher standards for honesty in advertising Often see headlines about UK rejecting ads using Photoshop that are in publication in the US PRO-ANA CULTURE Pro-Ana means pro-anorexia Websites and other information focused on how to be anorexic 460% increase from 2006 to 2007 PRO-ANA CULTURE Thinspiration Pictures For inspiration Of gaunt individuals Often with bones showing Some websites ban these types of tags Tumblr in 2012 Transforma$onal Nutri$on Inc. 12

13 BODY CHANGES Puberty Weight gain Many body changes Giving birth Weight gain Role change BODY CHANGES Physical disability Chronic pain, loss of mobility, etc. Getting older Slower metabolism, more difficulty keeping weight off Easier to see physical defects SPECIFIC DISORDERS AND TREATMENTS Anorexia Nervosa Bulimia Nervosa Binge Eating Disorder Other Eating Disorders Transforma$onal Nutri$on Inc. 13

14 ANOREXIA NERVOSA 0.6% lifetime prevalence (0.9% female, 0.3% male) Severe restriction of food and low weight Those with anorexia 50 times more likely to commit suicide 20% develop chronic anorexia ANOREXIA NERVOSA Anorexia has highest death rate of all psychological disorders Nearly 6% of those with anorexia will die Anorexia is a chronic illness 3 rd most common in adolescents SIGNS Repeatedly referring to self as fat even at normal weight Fear of gaining weight Guilt for eating Body image distortion Transforma$onal Nutri$on Inc. 14

15 SIGNS Over focus on calories, weight, food Refusal of meals or reporting that they just ate to get out of meals Withdrawal Compensatory activity Laxatives, diet pills, exercise DIAGNOSTIC CRITERIA Body weight below normal For weight and height Weight 85% of what would be normal Even though underweight, fear of gaining weight or getting fat DIAGNOSTIC CRITERIA Distorted body image Body weight/shape have severe impact on self-evaluation Denial how serious low body weight is Miss at least 3 consecutive periods Transforma$onal Nutri$on Inc. 15

16 SIDE EFFECTS Short term effects Dizziness Confusion Lightheadedness Lack of coordination SIDE EFFECTS Short-term side effects Mood swings Fatigue Fainting Pale, yellowish, or gaunt skin color SIDE EFFECTS Long-term effects Osteoporosis Growth of fine hair over body and face Constipation Anemia Yellow dry skin Transforma$onal Nutri$on Inc. 16

17 SIDE EFFECTS Long-term effects Brittle nails and hair Low blood pressure Drop of internal temperature, feels cold all the time Fatigue, lethargy Infertility EXTREME RESTRICTION When the body doesn t have enough calories coming in Mental Effects Thinking becomes unclear Decision making compromised Perpetuates disordered eating EXTREME RESTRICTION When the body doesn t have enough calories coming in Physical effects Severe dehydration Kidney failure The body begins to consume itself Heart damage Brain damage Multi-organ failure Transforma$onal Nutri$on Inc. 17

18 TREATMENTS Key components Restoring healthy weight Change thoughts and behaviors related to disordered eating Treat psychological issues related to the disorder TREATMENTS Diet Work with a trained nutritionist Make plan to get full nutrition and sufficient calories Build comfort with eating Medication Antidepressants Anti-anxiety medications Others TREATMENTS Therapy Cognitive Behavior Therapy Focus on changing thinking about food and body Create more accurate and logical perceptions Challenge myths and core beliefs about Food Body Eating Exercise Requirements for love, attention, affection, etc. Transforma$onal Nutri$on Inc. 18

19 TREATMENTS Therapy Cognitive Remediation Therapy Helps correct issues related to anorexia Attentional Bias (Over focus on bad parts of food and body) Lack of cognitive flexibility (Feeling there is one right way to eat, or for body to look) TREATMENTS Therapy Family Therapy Family seen as unit that needs equilibrium Often disordered eating is to refocus attention from real problems within the family Or as a reaction to problems within the family Communication is key TREATMENTS Therapy Acceptance and Commitment Therapy Mindfulness Based Cognitive Therapy (MBCT) Both focused on More accurate self-appraisal Acceptance of self in the here and now Transforma$onal Nutri$on Inc. 19

20 CARE AND SUPPORT METHODS Self-care Get plenty of sleep Treat illness Develop a good support network Discuss problems or journal Discuss what is going on with family Help them understand the issue and how to help CARE AND SUPPORT METHODS Try to keep busy to reduce obsessing about food or body Self-soothe Activate the 5 senses when feeling stressed or emotionally vulnerable Find ways to soothe or distract from emotions that cause restricted eating CARE AND SUPPORT METHODS Keep a food journal Make sure meet minimum calorie requirements daily Exercise regularly Unless this is a compensatory strategy Releases natural endorphins Improves mood and depression Transforma$onal Nutri$on Inc. 20

21 CARE AND SUPPORT METHODS Practice self-compassion and self-kindness Stop judging yourself or food Control is a major issue with anorexia Feel if can control body can control life This is a myth CARE AND SUPPORT METHODS Let go of control Thinking of foods as good or bad is another way of maintaining control But control is an illusion Let go of judging Sets up failure If don t perform perfectly (eating all good or approved foods) then end up feeling like a failure BULIMIA NERVOSA 0.6% lifetime prevalence (0.5% female, 0.1% male) Binging on large amounts of food and compensating with some other behavior (vomiting, laxatives, etc.) 19% of women in college have bulimia Transforma$onal Nutri$on Inc. 21

22 SIGNS Negative view of self Severe self-criticism Low self-esteem Guilt about eating and weight SIGNS Binging Preoccupation with food Guilt after eating Constant thoughts about food pound weight fluctuations SIGNS Purging Sore throat Calluses or wounds on the back of the hands Swollen neck glands Staining of teeth Transforma$onal Nutri$on Inc. 22

23 Visits the bathroom after meals Food missing Eating secretly SIGNS SIGNS Other compensatory behavior Diuretics Diet pills Laxatives Excessive exercise DIAGNOSTIC CRITERIA Binge eating and compensation occur at least 2 times a week for 3 months consecutively Self-evaluation strongly impacted by body shape and weight The disordered behavior doesn t occur only during episodes of anorexia Transforma$onal Nutri$on Inc. 23

24 DIAGNOSTIC CRITERIA Recurrent binging and purging Compensatory behavior for preventing weight gain Vomiting Laxatives Starvation Compulsive exercising Diuretics DIAGNOSTIC CRITERIA Binging and purging in addition to one of the following Feeling out of control when eating Eating an amount of food larger than what an average person would see as normal (2,000-15,000 calories or more) in a very short amount of time (2 hours) SIDE EFFECTS GI issues Edema Purging Tooth decay or damage Stomach or esophagus damage Transforma$onal Nutri$on Inc. 24

25 SIDE EFFECTS Deficiencies Vitamins Minerals Electrolyte imbalance SIDE EFFECTS Dehydration Kidney problems Dizziness, lightheadedness, nausea Constipation TREATMENTS Diet Skilled Nutritionist Education about diet and nutrition Medication Antidepressants Transforma$onal Nutri$on Inc. 25

26 TREATMENTS Therapy Dialectical Behavior Therapy Mindful Eating DBT courses teach: Mindful eating and attention to emotions motivating binging and purging behavior Identifying and productively coping with emotions Interpersonal problem solving and conflict resolution Dealing with strong emotions and negative events without binging and purging TREATMENTS Therapy Cognitive Behavior Therapy Examine and understand thoughts that stimulate binging and purging Challenge automatic thoughts Challenge myths and underlying beliefs Create new behaviors Track binging, purging, and emotions Experiment with trying out new behaviors TREATMENTS Therapy Interpersonal Psychotherapy Primarily addresses patterns in relationships Use of the therapeutic relationship to mend wounds Preferred by doctors and especially clients Less like school then CBT More practical than psychodynamic approaches Transforma$onal Nutri$on Inc. 26

27 CARE AND SUPPORT METHODS Self-care Get plenty of sleep Treat illness Develop a good support network Discuss problems Find ways to treat yourself that don t have anything to do with food Develop a prize closet for adults Candles, lotions, nail polish, etc. CARE AND SUPPORT METHODS Discuss what is going on with family Help them understand the issue and how to help Try to keep busy and reduce thinking about food Self-soothe Activate the 5 senses when feeling stressed or emotionally vulnerable Find ways to soothe or distract from emotions that cause binge eating CARE AND SUPPORT METHODS Keep a food journal Exercise regularly Unless this is primary compensatory strategy Releases natural endorphins Practice self-compassion and self-kindness Get out of the cycle of guilt and shame Transforma$onal Nutri$on Inc. 27

28 CARE AND SUPPORT METHODS Stop judging yourself or food Judging sets you up for failure Often if have acted bad or binged will scrap eating well for the rest of the day See things as all bad or all good Let go of control Eating disorders are often ways to reassert control over a chaotic environment But control is an illusion and trying to have it constantly only causes suffering BINGE EATING DISORDER 2.8% lifetime prevalence (3.5% female, 2% male) Eating a small amount of food in a brief amount of time without compensating for it Most common eating disorder in the US 10%-15% of overweight dieters have binge eating disorder SIGNS Gaining weight quickly Eating large amounts of food regardless of hunger Late night eating Overeating causes guilt and shame Transforma$onal Nutri$on Inc. 28

29 SIGNS Hiding food Self-medicating with food No purging to get rid of food Eating to the point of pain and discomfort SIGNS Hiding evidence of binging Depression or anxiety Out of control feeling around food Weight fluctuations DIAGNOSTIC CRITERIA Recurrent binge eating AND Eating an amount of food greater than is normal for an average person in a short amount of time (2 hours) Feeling out of control while eating Transforma$onal Nutri$on Inc. 29

30 DIAGNOSTIC CRITERIA Binge eating is associated with at least 3 of the following Eating very quickly Eating until uncomfortable Even when not hungry eating large quantities of food Eating alone due to embarrassment Feeling disgusted with oneself Feeling guilty after overeating, depressed DIAGNOSTIC CRITERIA Binging occurs 2 times a week over 6 months Distress about binge eating Not associated with compensatory behaviors SIDE EFFECTS Binge eating Usually binge on unhealthy foods Can cause weight gain and obesity Obesity plus unhealthy diet may result in a slew of side effects Transforma$onal Nutri$on Inc. 30

31 SIDE-EFFECTS Obesity has a myriad of side-effects including - Diabetes - High blood pressure - Heart disease - Joint and muscle pain - Osteoarthritis - High cholesterol - Cancer - Gallbladder disease - Kidney problems - GI problems SIDE-EFFECTS Mental health effects From being obese From being socially isolated From withdrawal and failure to come through with work and family obligations These include: Depression Anxiety TREATMENTS Diet Skilled Nutritionist Education about diet and nutrition Education about what binge eating does to body Medication Antidepressants Transforma$onal Nutri$on Inc. 31

32 TREATMENTS Therapy is almost identical to techniques used with Bulimia Nervosa Commonality between both Binging Feeling out of control around food TREATMENTS Therapy Dialectical Behavior Therapy Mindful Eating DBT courses teach: Mindful eating and attention to emotions motivating binge eating behavior Identifying and productively coping with emotions Interpersonal problem solving and conflict resolution Dealing with strong emotions and negative events without binging TREATMENTS Therapy Cognitive Behavior Therapy Examine and understand thoughts that stimulate binging Challenge automatic thoughts Challenge myths and underlying beliefs Create new behaviors Track binging, significant events, and emotions Experiment with trying out new behaviors Transforma$onal Nutri$on Inc. 32

33 TREATMENTS Therapy Interpersonal Psychotherapy Primarily addresses patterns in relationships Examine social anxiety Use of the therapeutic relationship to mend wounds Preferred by doctors and especially clients Less like school then CBT More practical than psychodynamic approaches CARE AND SUPPORT METHODS Self-care Get plenty of sleep Treat illness Develop a good support network Discuss problems Reduce environmental vulnerability CARE AND SUPPORT METHODS Find ways to treat yourself that don t have anything to do with food Figure out what is rewarding for the individual and use that instead of food (It s different for everyone) Adult prize closet Pleasant activities Tokens Every time you avoid a binge put a token in a jar When you get to a certain amount give yourself a big reward (Vacation, clothing, new technology) Transforma$onal Nutri$on Inc. 33

34 CARE AND SUPPORT METHODS Discuss what is going on with family Help them understand the issue and how to help Help them understand trigger foods and importance of staying away from them Try to keep busy and reduce thinking about food Pay attention to times you are least likely to binge and do more of that Example: If you binge less when other people are around don t let yourself be alone for a while CARE AND SUPPORT METHODS Self-soothe Activate the 5 senses when feeling stressed or emotionally vulnerable Find ways to soothe or distract from emotions that cause disordered eating Keep a food journal CARE AND SUPPORT METHODS Exercise regularly Unless this is primary compensatory strategy Releases natural endorphins Help reduce obesity, increasing energy and reducing physical pain Practice self-compassion and self-kindness Stop judging yourself or food Transforma$onal Nutri$on Inc. 34

35 OTHER EATING DISORDERS There are many other eating disorders Most are not official diagnoses Treatments are similar to other diagnoses Many of these are recent additions Increasing incidence of some of these disorders Particularly Body Dysmorphia, Orthorexia, Pregorexia, and Drunkorexia OTHER EATING DISORDERS EDNOS Body Dysmorphia Orthorexia Bigorexia Night Eating Disorder Pregorexia Drunkorexia Purging Disorder Anorexia Athletica Diabulemia OTHER EATING DISORDERS A note about treatment Specific treatments for these eating disorders generally mirror therapies for the primary eating disorders Care and support methods are similar too Most of these eating disorders are so new that there has not been enough research to provide recommended treatments Transforma$onal Nutri$on Inc. 35

36 EDNOS Many people have variations that don t met diagnostic criteria for one of the big 3 eating disorders All fall within the diagnostic umbrella of Eating Disorders Not Otherwise Specified (EDNOS) Even though these issues may not meet traditional criteria for an eating disorder doesn t mean they aren t serious and potentially life threatening EDNOS Some examples Meet all symptoms of anorexia except Missing menses Weight is currently in the normal range Meet all symptoms of Bulimia except Compensatory behavior after smaller amounts of food Binging and purging occurs less than 2 times a week Chewing and spitting out food BODY DYSMORPHIA Obsession with a perceived physical defect May be a slight imperfection May be completely imagined Past normal level of concern with appearance Transforma$onal Nutri$on Inc. 36

37 BODY DYSMORPHIA Diagnostic Criteria Obsession with defect in appearance, real or imagined Distress is significant from obsession over defect May also impair functioning in other areas of life BODY DYSMORPHIA Fears of rejection Due to imagined ugliness Low self-esteem Recognition that defect is distorted Yet still experience compulsion to think about it ORTHOREXIA Righteous or healthy eating obsessed Obsesses about choosing the right foods As much obsession about food as other eating disorders May not be obsessing over calories May be obsessing over healthy foods Or how food is processed prepared, etc. Tends not to eat out since doesn t trust food prep Transforma$onal Nutri$on Inc. 37

38 ORTHOREXIA Often begins with honest attempts at healthy eating Leads to an elimination of a particular food group Has the potential to morph into anorexia ORTHOREXIA May develop in response to Recent illness Negative news about food type or group Family habits Economic problems Society trends BIGOREXIA Obsession about being underdeveloped, underweight, or too small Usually are muscular Will obsess about having a perfect physique Feel muscles inadequate Distorted self-image Transforma$onal Nutri$on Inc. 38

39 BIGOREXIA Men are most susceptible 10% of obsessive gym rats Extreme workout methods Also known as muscle dysmorphia Type of Body Dysmorphic disorder Related to OCD BIGOREXIA Maintain strict diet May abuse steroids, get plastic surgery May cause depression and anxiety May feel inadequacy in other areas of life NIGHT EATING DISORDER Pattern of binging late at night Person may not be aware of actions when eating Sleep eating Eating is not usually in short period of time Transforma$onal Nutri$on Inc. 39

40 NIGHT EATING DISORDER Affects 1-2% of the population, 6% of obese people in treatment, and 28% of gastric bypass seekers More common in young women NIGHT EATING DISORDER Insomnia Higher propensity for sleepwalking More than half of daily calories consumed at or after dinner Binges consist of carbs and sugary foods NIGHT EATING DISORDER Skips breakfast or postpones eating after waking Eating pattern causes Stress Depression Anxiety Guilt Shame Transforma$onal Nutri$on Inc. 40

41 PREGOREXIA Extreme exercising and dieting while pregnant Wish to avoid gaining doctor recommended pounds More pressure for pregnant women to look thin Tabloid and media scrutiny of pregnant celebrities Can result in very serious health problems for mom and baby DRUNKOREXIA Reduction in calorie intake in order to spend calories on drinking Saving calories for binge drinking 30% of female college students show this behavior Upping chances of negative effects of alcohol Intoxication Alcohol poisoning Poor judgment PURGING DISORDER Recurrent compensatory behavior Purging Diuretics Laxatives Enemas No binge eating episodes Not underweight Signs include trips to the bathroom following every meal Transforma$onal Nutri$on Inc. 41

42 ANOREXIA ATHLETICA Compulsive exercising Extreme exercise regimen Beyond what is normal or healthy Compensate for calorie intake through exercise Feel guilt, shame, or anxiety When routine disrupted DIABULEMIA Type I Diabetics Manipulating insulin Lower levels to lose weight Lower insulin puts body into starvation mode Begin breaking down muscle and fat YOUR ROLE IN EATING DISORDERS Serve as a guide and a coach Encourage clients to seek professional help National Eating Disorders Association Transforma$onal Nutri$on Inc. 42

43 FOOD ADDICTION WHAT WE WILL COVER IN THIS SECTION What is it? Ads and processed foods Signs Signs Addiction and food Why food addiction develops Dopamine reward pathway Side-effects Like other addictions Treatment Addiction and food Care and support Obsessive compulsive with food WHAT IS IT? Also called compulsive overeating Addiction to junk food Uncontrolled eating Eating impairs other parts of life Transforma$onal Nutri$on Inc. 43

44 DOPAMINE REWARD PATHWAY Dopamine is one of the key neurotransmitters in the brain involved with addiction Dopamine is released when we complete activities necessary for life Food, sex, social bonding The dopamine release begins the addictive cycle LIKE OTHER ADDICTIONS The dopamine released from eating Same brain activation we see in other addictions Heroin, Nicotine, Cocaine Food addiction is accompanied by many of the hallmarks of any addiction Drug seeking behaviors, tolerance, withdrawal ADDICTION AND FOOD Food triggers pleasurable feelings Releases dopamine in the brain Foods most eaten when addicted to food are Salt, sugar, fat Once something triggers the pleasurable dopamine release We seek it out again Chase the dragon May need to consume more to achieve the same effects Transforma$onal Nutri$on Inc. 44

45 OBSESSIVE COMPULSIVE WITH FOOD Food addiction often results in an obsessive compulsive relationship with food Obsess about food, what to eat, what shouldn t eat, etc. The only compulsion that makes you stop thinking about food is eating ADS AND PROCESSED FOODS Food advertisements push mostly processed foods Constant barrage of advertisements Many are focused on children Ads often focused on link between processed food and fun, friends, or family Reduce awareness of what healthy foods and healthy eating are ADS AND PROCESSED FOODS Many food products seem to be designed to stimulate this addictive process Filled with fat, sugar, and salt Processed foods can become physically addictive Mood dips when don t get fix Transforma$onal Nutri$on Inc. 45

46 SIGNS Eat so much you feel sick Keep eating after are full Even when it causes physical pain Eat more than plan to SIGNS Particularly specific foods that the individual abuses Comfort foods Fatty, sugary, salty foods Go out of the way to get certain foods SIGNS Try to cut out certain foods Or worry that you can t find them Like other addictions the person will have difficulty stopping their eating Negative consequences when can t stop eating Weight gain Disrupted relationships Social withdrawal Transforma$onal Nutri$on Inc. 46

47 SIGNS May also begin to show another hallmark of addiction Tolerance Eat more, but food is less and less satisfying Repeated attempts to stop eating end in failure SIGNS Impact on relationships Eating or desiring to eat causes neglect to Job Friends Family Recreation SIGNS Impact on relationships Eating or food get in the way of effectiveness at School Job Fear of overeating keeps you from attending certain events Weight gain from overeating keeps you from wanting to expose yourself Don t want to swim, etc. Transforma$onal Nutri$on Inc. 47

48 SIGNS Withdrawal Experience symptoms of withdrawal that are characteristic of other addictions Emotional Agitation, anxiety, other mood symptoms Physical Headaches, GI issues, cold sweats SIGNS Feelings of guilt, shame, and depression when eating or when others discover that they binge Tolerance Reducing pleasurable effects of food Takes more food to feel good than it used to SIGNS Large amounts of time spent Thinking about food Planning meals Obtaining desired foods Plans to eat alone Transforma$onal Nutri$on Inc. 48

49 SIGNS Not all food addicts are obese or overweight Can be a grazer Snacking throughout the day Eat between 5,000 and 15,000 calories a day SIGNS Relief from stress, depression, or other difficult emotions when eating Addictive high Food addicts that primarily binge are diagnosed with binge eating disorder If food addicts purge or complete compensatory behavior they likely have Bulimia Nervosa WHY FOOD ADDICTION DEVELOPS Many of the same reasons contributing to eating disorders Other reasons Metabolism of endorphins is abnormal Triggers the addiction process In line with other theories linking issue to the brain s reward center Trigger foods causes serotonin release Physical withdrawal Smell or sight of food causes insulin release Transforma$onal Nutri$on Inc. 49

50 SIDE-EFFECTS Obesity and gaining weight Eating disorders Huge amounts of money spent on food A lot of time thinking about food and planning binges SIDE-EFFECTS Isolation and withdrawal Not eating very much in public But still remains overweight Low self-esteem Negative feelings about food and body TREATMENTS Recovery can be difficult Unlike other addictions we have to eat to live Cannot completely avoid food or food related events AA has alcoholics avoid alcohol and alcohol related events Transforma$onal Nutri$on Inc. 50

51 TREATMENTS Food addiction has an excellent overall recovery rate 80% have reduced or removed symptoms Nutritional counseling with a trained nutritionist Education about food, diet, and the process of addiction with food TREATMENTS There are several successful 12 step programs for food addiction Food Addicts Anonymous Food Addicts in Recovery Anonymous Overeaters Anonymous TREATMENTS Therapy Getting to the root of the emotional issues related to food addiction Most treatments for eating disorders also work for food addiction Transforma$onal Nutri$on Inc. 51

52 TREATMENTS Therapy Behavioral strategies Fill up on healthy foods Don t let yourself get too hungry Detox from sugar and processed foods Discover and ban trigger foods from the home CARE AND SUPPORT METHODS Self Care Get plenty of sleep Eat enough Don t let yourself get too hungry Treat illnesses Self-soothe difficult emotions CARE AND SUPPORT METHODS Practice self-compassion and self-kindness Stop judging yourself or food Keep a food journal Transforma$onal Nutri$on Inc. 52

53 CARE AND SUPPORT METHODS Reinforcement and pleasure without food Adult prize closet Pleasant activities Tokens Every time you avoid a binge put a token in a jar When you get to a certain amount give yourself a big reward (vacation, clothing, new technology) Figure out what is rewarding for the individual and use that instead of food (It s different for everyone) CARE AND SUPPORT METHODS Do things to stop obsessing about food Distract Pleasant activities Volunteering Get involved in helping others takes the mind off problems, food, body Begin to foster new hobbies CARE AND SUPPORT METHODS Talk with friends and family Set up a support network Be open about feelings and difficulties Have support available for when addictive feelings strike Help in avoiding triggers Foods Other people Certain events Transforma$onal Nutri$on Inc. 53

54 END OF PSYCHOLOGY MODULE 2 Please submit your test questions by the due date on your Session Calendar. Transforma$onal Nutri$on Inc. 54