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3 Types of Eating Dysregulation Underlying Patients’ Higher Weights




A major reason for the failure of current medical treatment for “overweight” is that “weight” problems often are actually eating problems. Higher weight may be due to genetic loading, metabolic or hormonal conditions, neurotransmitter imbalances, chronic dieting and weight cycling, or other causes, but it often occurs because people are eating in ways that are out of sync with appetite cues for hunger, pleasure and satiation. To resolve this problem, eating disorders’ therapists have been successfully using psychology of eating approaches for more than three decades and it’s time for other health care professionals to follow their lead.

Dysregulated eating comes in several varieties, including emotional eating, mindless eating, and binge-eating. Usually patients have more than one form of eating dysfunction and often engage in all three types. Underlying them all is anticipated or actual distress (generally felt as anxiety or bodily tension) lessened by the act of eating, which prevents or reduces it. Discomfort might come from obsessing all evening about the leftover lasagna in the refrigerator and keeping busy to refrain from eating it, then finally scarfing it down in one fell swoop before falling exhausted into bed. Or, distress might arise in a flash, driving someone to mindlessly polish off three cookies in a four-pack, in spite of having reached satiation after having consumed only one. In broader clinical terms, this dysregulated dynamic could be called obsession (intrusive thoughts about eating or distress about refraining from eating) followed by compulsion (the act of eating), which reduces the anxiety caused by the intense food craving. Thus, is habit formed, for who wants to experience ongoing internal angst when it could be made to disappear in a delicious twinkling. This dysfunctional dynamic overrides “normal” eating appetite cues: to eat when hungry, choose foods that are enjoyable, eat with awareness and an eye toward pleasure, and stop eating when full (quantity) or satisfied (quality).

Here is how dysregulated eating plays out in emotional, mindless or binge-eating:

1. Emotional eating is done to avoid, prevent or reduce emotional distress which may be caused by internal or external stress, memories, or simply experiencing mildly unpleasant or uncomfortable feelings. Emotional eating is meant to cheer you up or calm you down. Eating a pint of Ben and Jerry’s ice cream might act as a pick-me-up and be the highlight of a boring Saturday night alone or, alternately, help soothe rattled nerves after your boss chews you out in front of your entire department or you finally mail in your taxes minutes before the federal tax deadline. Such eating has a distinct, specific purpose: to re-regulate emotional dysregulation by tuning it up or toning it down. It also can serve as a prophylactic to unwanted feelings such loneliness, anger or disappointment. Why feel bad when you can, instead, eat something that tastes good? 

2. Mindless eating is just that—snacking or grazing through what’s in your food cabinets or refrigerator on auto-pilot. Or it could play out as overeating because you’re not paying attention to fullness or satisfaction cues. Mindless eating is done as if you’re in a trance and is usually not driven by any one specific discomfiting emotion, unless it’s boredom or the desire to avoid tasks. It’s done because there is food somewhere to be had. You think of it or see it and you eat it. It’s that simple, no thinking required. Unconscious eating is also born of habit: before you flop down on the sofa to watch TV, you automatically gran a bag of chips or you keep eating simply because the food is in front of you. Overeating is another form of mindless eating. When it’s all gone, you’re done, and not before.

3. Binge-eating is classified as a Feeding and Eating Disorder in the Diagnostic and Statistical Manual of Mental Disorders. It involves eating an excessively large amount of food in a short period of time—often rapidly, with little awareness, to well beyond full—“on average, at least once a week for 3 months” without the ability to control intake, followed by feelings of guilt, shame, or disgust (1). Bingeing is a self-driven activity that takes on a life of its own, an act accompanied by feelings of frenzy, madness and desperation. In its aftermath, the stomach feels distended and aches and you are wracked with guilt, shame and remorse.

To understand patients’ specific eating problems, health care professionals need to ask questions about their state of mind before, during and after eating. Moreover, patients need to hear that they are not bad, permanently defective or societal outcasts because of their dysfunctional eating patterns, and that they can resolve them by obtaining emotional and psychological support via therapy and intuitive-eating or health coaching, as well as through groups, workshops, books, blogs, podcasts and videos tailored to healing dysregulated eating.

Endnote
(1) American Psychiatric Association, ed. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (Washington, DC: American Psychiatric Association, 2013), 350.


Disclaimer: Please note that this article is intended for informational and educational purposes only. It is not intended as a substitute for the medical or psychological assessment, advice and individualized care from your personal health care provider or mental health professional. Please consult with your personal health care professional regarding your individual situation and concerns. For health care providers, the information contained herein may not be applicable or appropriate for every patient. Paige O’Mahoney, M.D. and Deliberate Life Wellness LLC specifically disclaim any and all liability arising directly or indirectly from the use of any information or products contained in these materials. Mention of products, techniques, methods, resources, approaches, or other entities in our materials is for informational purposes only and does not indicate endorsement.






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3 Facts About Food Addiction




As the obesity epidemic continues to grow, more and more physicians are considering treatment. Obesity is recognized as a chronic disease by the American Medical Association, and even binge eating, which can lead to obesity, has been officially classified as an eating disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V).

As doctors work to find more effective ways to treat obesity, the underlying causes of weight gain are also being considered. While societal factors and lack of education on exercise and dieting certainly play a role, physicians should also consider even deeper causes of excessive weight in the individual, including food addiction.

Recent studies have begun to show that the pattern of weight loss and regain, combined with the inability to control eating habits, clinically presents like an addiction. The clinical presentation and symptom profile between substance abuse and food addiction is
well documented.

To learn a little more about food addiction, take a look at this infographic and download our free white paper on food addiction by clicking here.


Blog written by Vanessa Ramalho/Robard Corporation

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Relating Mental Health & Behavior to the Weight Loss Journey




In my experience working at the Dr. Rogers Centers, a provider of fitness, wellness and weight loss services in San Antonio, Texas, behavioral techniques are introduced to help participants modify eating and exercise habits. Weight loss program participants have access to a Licensed Professional Counselor/Licensed Chemical Dependency Counselor to receive cognitive behavioral therapy to help treat their symptoms and how to think differently about food and their lives.

What is Cognitive Behavioral Therapy?
According to the National Association of Cognitive-Behavioral Therapists, Cognitive Behavioral Therapy is a form of psychotherapy that emphasizes the importance of thinking about how we feel and what we do. Much of this therapy involves changing our thoughts about different aspects of our lives. This therapy also utilizes mindfulness therapy to keep the participant in the present moment to help relieve anxieties about past experiences.

Cognitive Behavioral Therapy techniques can help controlling cravings and primitive impulses. Cravings and other addictive behaviors that trigger pleasure are controlled by our limbic system, sometimes called the “lizard brain.” Our primal instincts are managed in this part of the brain as well. During mindfulness therapy, breathing techniques are used to reengage the frontal cortex. The frontal cortex supports impulse control and is also responsible for decision making. Weight loss program participants can make clearer, conscious decisions about their cravings through this simple therapy.

The Reciprocal Relationship
Many weight loss program participants suffer from co-occurring disorders — typically obesity and depression, or obesity and anxiety. With Cognitive Behavioral Therapy, healthcare professionals are able to treat both problems. It is important to treat both issues simultaneously as they are in a reciprocal relationship and will feed off of each other. Learning what our triggers are and recognizing our disordered eating patterns is the key to success. There must be an understanding that food is not the problem; rather, food is fuel for our bodies. The problems lie in our lifestyles, are emotional, and can even involve negative feelings towards certain foods or exercise.

Healthy Supplementation
In addition to Cognitive Behavioral Therapy and understanding the relationship between obesity and mental health issues, a professional counselor may recommend supplements to support mental health. Exercise is one example of a “supplement.” It increases dopamine, which is the “feel good” chemical in our brains. Instead of increasing dopamine from unhealthy cravings or other addictions, exercise can be used to achieve this “high.”

Other vitamins and nutrients that are commonly recommended are:

• Vitamin D3: Important for all body functions. For brain health, it helps to release neurotransmitters that affect brain function and development.
• 5-HTP: Converts into two important chemicals: Melatonin and serotonin. Melatonin supports sleep and wake cycles. Serotonin is known for being a “happy chemical” and supports positive mood and outlook.
• Calcium: Essential for healthy brain function. Deficiencies can lead to anxiety and moodiness.

For medical professionals interested in turnkey weight loss programs that incorporate all of the elements for behavioral change for long-lasting results, you can request more information here. Also, take a look at Robard’s upcoming webcast on “Brain Systems Underlying the Munchies.” To register for this webcast, please click here.


Blog written by Gabrielle Harden, Guest Blogger



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