Beating Overeating

It is easy to overeat – especially when we are not paying attention. Have you ever mindlessly noshed away on potato chips or some other munchies at a party without noticing how much you have eaten? That can easily happen. Especially in a social situation when there is socializing with other people.

We live in an eating and drinking society – many social situations are centered on food and alcohol. It is very rare that there is healthy low fat food at social gatherings. As one of my healthcare colleagues says, “You can go out to a party or dinner and yet, there can be nothing to eat!” – meaning nothing healthy or  nourishing. He suggests either eating before going or bringing a healthy snack of your own.

In my counseling work with clients, in West Chester and Philadelphia, PA, I routinely hear how difficult it is to maintain healthy eating habits – Mostly due busy and rushed schedules with little time for homemade meals. This type of lifestyle can turn into a runaway train – get totally out of hand. “On the fly” food is often high in fat, salt, sugar and carbs. They create cravings.

Mark Hayman, MD, author of Ultra Wellness uses this example - if a person was presented with a bowl of chips and a bowl of broccoli, what are the chances that the broccoli will be over-consumed? Right…no chance! Natural foods just don’t ignite addictive eating.

So, what might happen if you could change your palate? To rectify your sense of taste to what you find is pleasing, satisfying and good? Do you believe that is possible? It is.

Modern day foods are often processed and genetically engineered. They can distort the sense of taste and confuse the palate. Salt, sugar, chemicals, alcohol, dairy, food additives and overly processed foods are notorious for distorting taste. We get used to intensely flavored foods which are not real, but enhanced. Then something like a fresh salad no longer tastes good enough and seems bland. We grow distant from what is natural and seek out artificially flavored and altered “food substitutes.” Our taste buds get worn down and turn bland. They take a lot to be stimulated – making way for low nutrition flavored and presentation enhanced food products.

In a way, these foods can be viewed as synthetic drugs. After all, food is a substance that can be abused, and addiction is about high stimulation and intensity.

Cutting down on these “foods” is a start, but giving your palate a breather and cleansing to re-focus on real, pure taste can be of most help. A confused palate can make it difficult for your body to recognize true hunger verses a “hankering.” True food cravings for greens, protein, water, fruits, and other foods which hold the building blocks of health can go unnoticed or misinterpreted. Junky – fatty, salty, sugary foods can creep in as replacements and fuel powerfully addictive food cravings. There is an easy way to re-center your palate and recreate how you eat – restructure your mindset.

Make it a point to get more connected to your food. Next time you eat fruit, such as an apple, first look at it. Notice the color and variation of its skin. Smell it. Then bite into it noticing the juiciness, and the depth of the flavor – sweet and tart. Eat slowly – take in the detail. Feel the consistency on your tongue.

This is more mindful eating – getting back in touch with our senses and coming back to the moment experiencing what is, pure and simple – And, of course, learning to love it.

This is the way we reclaim what is natural and healthy.

Understanding Obesity & Food Addiction

Something that I have learned over the years in my work as a Behavior Therapist and Addictions Specialist is that issues with food and eating are often lurking in the shadows of other problems, including alcohol dependence, drug abuse, problems with anger and impulse control, and difficulties with overwhelming emotions.

When I assess a new client in my Philadelphia or Chester County based office, I find it immensely important to understand their daily habits of living as they generally complete the picture in understanding the presenting issue and what is keeping it going. Lack of proper sleep, exercise and nutrition exacerbate mental and physical health concerns making them worse.  Energy drinks, take-out food, protein bars, pizza and coffee are not staples of a healthy diet. They do create poor eating and food habits and distance from what is normal and healthy via reinforcing impulsive and “on the fly” eating.

Most people want to be healthy, but struggle with making the changes needed to establish balance in their relationship with food and eating.  First, a person must understand their own tendencies with food along with how they deal with stress, emotions and people, as well as making sure there are no medical concerns (endocrine, etc.) which may be negatively impacting ones’ behavior with food.
I have found that obesity and food addiction are related much of the time.  I also find it curious, however, that issues with weight – obesity are not challenged and inquired about as much as one would think, despite the increase in health risks- That many people silently suffer food addiction.

Obesity
Obesity is at the forefront of today’s health concerns and warrants focus, because it is linked to many health problems. Did you know that that approximately 65% of adult Americans are overweight and 30% are obese? It is also estimated that roughly 80% of obese adults have at least one of more conditions such as: cardiovascular disease, diabetes, hypertension, sleep apnea, arthritis, and cancer. There is then another tier of problems which includes depression, substance abuse, and chronic pain that can develop as a result of those issues. Studies show that 25-50% of obese individuals binge eat and that there is a 75-95% recidivism rate to obesity among formerly obese individuals who have undergone treatment. Obviously, this points to a significant epidemic. It also raises a question, “What happened to our relationship with food?” “What went wrong?”

Food Addiction?
The medical community, insurance and food industries all encourage consumers to exercise “personal responsibility" when it comes to preventing obesity, addiction, and chronic health problems. Self-control, better choices, avoidance of over-indulging/over-eating, and staying away from packaged, high fat, carbohydrate, sugary foods is emphasized and encouraged. Seems simple, right? Being informed and then choosing? No!

Food, like alcohol and drugs, is biologically addictive. Food is a substance.

There are specific biological mechanisms that drive addictive behavior. Addictive behaviors are fueled via primitive neurochemical reward centers in the brain that override one’s ability to exert reason, self-control, manage cravings, stop eating and to recognize biological signals of true hunger, appetite, and satiation.

Liking vs. Wanting.  Research shows that obese individuals are similar to non-obese individual in their “liking” of foods, but that they have a stronger “wanting” / desire/ drive for the foods they want. They are also willing to go to great lengths to obtain and consume them. It is noted that this may be due, in part, to neurological changes that cause a blunted psychological reward response to food – Much like how a drug addicted person might crave their drug or “want” it very strongly, long after they stopped enjoying or “liking” it.


Craving vs. Addiction. We all crave certain foods from time to time. Women are notorious for craving chocolate.  Some other common cravings include fat, sugar, or carbs. Food cravings are important because they play a role in over or compulsive eating – as they serve as “trigger foods.” It is said that our industrialized society ripens the opportunity for obesity, due to the availability and exposure to addictive food substances: sugar, fat, sweeteners, refined carbohydrates, salt and caffeine -- eroding at self-control and ability to regulate consumption of these foods.  “Loss of control” is both a term and behavior associated with addiction.

Do You?...
* Eat when you're not really hungry or eat as a result of emotional triggers
* Feel guilt or shame after eating
* Eat alone, in secret or hiding the amount of food your eat from others
* Feel out of control and/or can't stop eating
* Crave certain foods only as part of binge eating
* Get a feeling of relief from emotions when eating certain foods

Evidence in Support of Food Addiction
According to a report from the National Center on Addiction and Substance Abuse (CASA) at Columbia University, up to one half of individuals with eating disorders (including bingeing) abuse alcohol or illicit drugs, compared to 9% of the general population. Conversely, up to 35% of alcohol and illicit drug abusers have eating disorders, compared to 3% of the general population.
A direct correlation has also been established between the dramatic increase of obesity and overweight population and the aggressive marketing, increased availability, and consumption of foods over the same period (similar to tobacco).

• People who are addicted to food tend to exhibit many of the same characteristics as those addicted to alcohol and drugs:Exhibit behavior in times of transition or stress
• Common family history
• Common brain chemistry (decreased sensitivity of dopamine-reward system)
• Low self-esteem, depression, anxiety, impulsivity
• History of sexual, physical, or emotional abuse
• Obsessive preoccupation, cravings, and secretive rituals
• Experience mood altering effects from use of substance

- National Center on Addiction and Substance Abuse (CASA) at Columbia University
There is help available – One does not need to suffer.  Counseling for eating disorders coupled with professional nutritional guidance and self- help programs such as Overeaters Anonymous and Eating Disorders Anonymous are the basis of a well-structured plan.  If you are concerned about your relationship with food and eating but not sure if you are addicted and or not quite sure if you are ready to make any big changes, help is still available. Effective counseling allows room to sort through issues and make new choices.

Mending our Relationship with Food – Problem & Addictive Eating

Mending our Relationship with Food – Problem & Addictive Eating

America's Food & Weight Problem

Memorial Day has passed and the launch of summer season has occurred here in the Philadelphia area – the opening of swimming pools, barbeques, and the start of trips to the beach. Last week, I had overheard two women talking over lunch at a restaurant at the King of Prussia Plaza about their dread of having to deal with “the bathing suit issue.” Summer seems to bring increased awareness to weight, shape and body type, as there is less room to hide in warm weather clothing. Curious, however, that as a culture obsessed with thinness, we are the most overweight country in the world with 65% of adults being overweight and 30% obese. And, we often don’t understand the difference between having a few extra pounds on us, and being overweight or obese. This lack of understanding can get in the way of addressing food and weight issues, for as we know a solution to any given problem is only as good as our understanding of the problem.

As a licensed counselor, behavior therapist and certified addictions specialist, I work with people to help them change problem behaviors.  When I see clients in my Chestnut Hill, Philadelphia and West Chester, PA office I often hear about food problems - Especially, when working with addictive behaviors with substances or problems with emotions, overwhelm and distress. Overeating, bingeing and unhealthy food choices are often a part of the issue are generally part of the addictive picture. A lot of time one addictive behavior, such as alcohol goes into remission and another surfaces or takes precedence. Food and eating issues are often lurking in the background.

Getting it Right with Our Relationship with Food 

Food is our most significant relationship in life. It is our sustenance – our survival; equally important as the air that we breathe. Eating is the way we attached to our mothers bonding with and being soothed and nourished as completely dependent beings when we entered the world – eating provided a way of feeling safe connected and whole.  Growing up, specific foods and the traditions around them become rituals: a means of celebration, mourning, managing feelings and emotions, reward, as well as being with one another in a social sense. Food can also be used as a “social lubricant,” much like alcohol, sports, and related activities.

Ultimately, food is powerful - Eating is not a habit to be broken nor is abstinence an option when we have a problem with food or eating, whether it involves, overeating, bingeing, or restricting. Understanding why we eat or don’t eat, and why we choose the foods we choose, are necessary in order to stabilize this critical relationship. 

Our relationship with food is a relationship that we need to get right.

In order to get or stay healthy we must identify eating patterns and potential problems that can lead to abuse of food, addiction, and chronic health conditions. My practice, Integrated Treatment Solutions, located in Chestnut Hill/ Mount Airy Philadelphia and West Chester / Newtown Square, PA areas does not provide medical treatment, but does work with the behavior factors which influence human health and well-being. We know that problem behavior does not improve over time without proper intervention.

As we learn in life, solving a problem is not just about finding the “one factor” or cause, but the many factors involved which play against and feed off one another fueling the problem. Mending our relationship with food is no different.  We need to understand the biological, social and mental/ emotional drivers which form and sustain the habits and patterns we have with problem eating.

Living Well Weekly’s next topic:  Understanding Obesity & Food Addiction

The Relationship Between Storms, Change and Counseling

Last week, an unexpected hailstorm, blew through Chester County hitting the towns of Exton, Downingtown and West Chester very hard. It was a lovely sunny afternoon then all of a sudden there were thunder and lightning in the midst of the clear blue sky. It grew darker and the wind picked up speed blowing new summer leaves off the trees. Then the ice came down pummeling newly sprouted plants. By the end of it all, spring blooms were no more and carefully mulched and mowed lawns tattered with leaves and debris. Nothing was spared.

We have so little control of many things in life; nature being one of them. Nature is non – negotiable. Nature has its’ own patterns of balancing itself. Things can get interrupted or even destroyed – It is neither personal nor discriminatory. Something is lost and something new emerges. This is the essence of change and balance – The cycle of life.

As a Chestnut Hill, Philadelphia and West Chester, PA based counselor, I work with people moving through their own personal storms involving changes that were not wanted, including divorce, job loss, death of a loved one, addictions, etc. These experiences often bring up strong emotions, which can feel overwhelming. If vulnerable to reactivity, situations like these can trigger self-defeating behavior, including bingeing on food or alcohol, excessive spending, raging on a loved one, quitting a job without a plan and many other unproductive actions.

Just like a major storm, where opposites intersect via cold meets heat resulting in a powerfully fueled storm system, our human conflicts can meet and when opposite they can clash and create crisis. When we do not know how to deal with the situation and put it off or minimize its’ importance, tension from repressed emotions builds beneath the surface. Time passes and when a stressor occurs - Wham!

Maybe a person realizes that they are tolerating poor treatment after years of telling themselves it is okay, or awareness is reached that their career is not fitting and they have been trying to force it, or a person realizes that they are not compatible with their mate. These are tough situations to realize and accept.

We need to let something go to have something else grow and replace it – Sometimes it is a skewed perception or outlook – Sometimes it involves making a tangible change. Making changes like these are uncomfortable for most of us. It can feel immensely unsettling when in “limbo like state” of the in between.

Effective counseling and behavior therapy provides an opportunity on how to manage and even thrive in the in between times and helps with becoming more flexible in response to the winds of life – Growing more resilient and stress hardy. We can then live in less fear and resistance understanding and remembering that the flowers and plants will grow back again, maybe not until the next year or perhaps looking a bit different, but according to nature's order.

Recovery - Healing: Forbearance and Resulting Gifts - Part #4

Recovery & Healing: Turning “Crisis into Opportunity"

Part #4: Forbearance and Resulting Gifts

Our world has become fast, furious and bottom line oriented. Technology tools like texting, emailing, Face-Time, SKYPE, on-line shopping and others set an expectation that we are all accessible 24/7 with no "wait time." Our expectations for quick response can be almost addictive and our dependency on these technologies an addiction. Regardless, we have become "trained" to expect immediate response - It is easy to lose sight of process and that all things take their own time.

Healing is a process not an event. Recovery and healing from addiction, depression, chronic pain, distress/ burnout and other medical issues take time. These issues tend to take longer in the making and therefor are not quick to resolve -- Paying attention to the nuances of these conditions and healing is important to be able to recognize progress and sustain motivation. This is where forbearance comes into play.

Forbearance is a form of patience - tolerance or self-control, especially in not responding to provocation. Forbearance requires refraining from action: the fact of deliberately not doing or saying something when you could do or say it. This is not the same as shutting down or repressing one self, but consciously choosing to suppress action in favor of the overall good of the situation. Forbearance is necessary in life and a quality that comes with maturity and wisdom. As we get older we often come to see that we have little control over many things that happen, and that we need to find other ways to cope which go beyond "grinning and baring" or resisting and pushing through circumstances. Through forbearance we often learn more about ourselves and the process of life.

Forbearance is another learning that sounds simple but is not easy! But it is worth developing as we learn to understand ourselves, our behavior patterns, assumptions, and motivations. We also learn about others, and the overarching process of how things work in the world and how the pieces come together in their own timing. This helps with learning to be more relaxed and present in the moment and not be over-focused on the future at the expense of living more fully right now. We also learn to be more patient and accepting of ourselves and others, and be the kind of people with whom others feel safe and enjoy spending time. And, of course, our efforts and goals have more opportunity to be completed.

In order to get and to stay well staying centered, in the moment, organized and balanced is required. This may sound immensely simple but again, not easy! In behavior therapy we learn how to develop skills to focus and be more mindful (less reactive), process difficult emotions, tolerate and cope with distress and to advocate for ourselves in a graceful and effective manner. By increasing our life skills in these areas we decrease the stress and pressure on our bodies, freeing up energy for improved functioning and well-being. We establish the roots of health and wellbeing - http://myintegratedtx.com/our-philosophy/ .  

Getting Well - Staying Well: Healing vs. Cure - Part #3

Recovery and Healing: Turning “Crisis into Opportunity"

Getting Well - Staying Well: Healing vs. Cure - Part #3

As a Philadelphia and Chester County - based therapist, certified addictions counselor and co occurring disorders/ dual diagnosis specialist, I see clients in my practice who have been trying to work through tough health, mental health and addictions challenges for a long time.

"When am I going to feel better?" "When are things going to change?" These are questions that my clients in my practice in Chestnut Hill and West Chester, PA ask when feeling uncomfortable or when life presents an illness, disability, or loss - some sort of crisis that was not asked for but happened.

There are times in life when we want change and often need change to happen in order to establish or restore well-being. However, as adults who have been around a while, perhaps we know that change is a process not an event. That there is no real "cure" to our problems or conditions - But, our desire for things to be fixed can keep us searching for immediate solutions and attached to false expectations, reinforcing and prolonging our discomfort.

I listen closely to people's life experiences. I hear about the adversity and struggle that people have endured and survived.  Although such wear withal is a sign of strength, such rallying can certainly take a toll over the long term. When help is long overdue is only natural to want to be done and better. So, it is important to be aware of expectations and to have a sense of the difference between curing and healing.

"Cure" is intermingled in the definition of healing, healing means something very different than merely "curing" or eradicating illness or disease, but restoring to balance, repairing, and returning to soundness. Healing often has more to do with emotions and a sense of safety; fostered by self- respect and control, and having positive people and conditions in one's life. Healing requires the deeper work of change involving reflection, self-examination and acceptance of what was and is. This type of settlement prepares the foreground for health and life-long well-being, the type of inner comfort and satisfaction that most of us long for and see in others who we deem "enlightened," but often do not know how to attain for ourselves. Healing is necessary for any lasting change to take place.

Starting with "what is" and accepting "what is" is the starting point - developing a willingness and capacity for being and staying in the moment and noticing what is real as compared to the mental fiction of our minds is necessary if we wish to develop inner resilience and strength.  Being able to follow and notice the moment to moment changes within ourselves, including our thoughts and emotions and how we respond to other people and our environment is part of regaining control of ourselves, behavior and improving our lives.

One of my favorite as well as being a client favorite books for teaching mindfulness and how it is linked to our health and well-being is The Power of Now, by Eckhart Tolle. His teaching on the "Pain Body" is helpful in understanding the mind-body connection.

https://www.youtube.com/watch?v=gcgSYC3h1ew

Join us next week to read about: Recovery - Healing: Forbearance and Resulting Gifts

Recovery and Healing: Crisis Meets Opportunity - Part #2

Crisis Meets Opportunity

What can be more traumatic than addiction? To become aware of being out of behavioral control and attached to a substance and or process to the point of sheer destruction of one's life? Sounds pretty scary - Not to mention the "ripple effect" of such a crisis, on others connected to the individual, family, workplace, etc. This can make for a highly complex issue leaving people feeling confused, overwhelmed and powerless. However, whether one is dealing with addiction, depression, pain issues or the like, deep within the situation there is a way through it - solutions, and a gem of opportunity waiting to be discovered.

The Chinese have been aware of this phenomenon for thousands of years. In Chinese the word for crisis consists of two characters: one meaning danger, and one meaning opportunity. Why? Because crisis always feels dangerous and can indeed be dangerous. However, it is often our response to sudden or unwanted events which impact outcomes and the future; but that can be tough to see in the moment when paralyzed by fear. Our fear of danger may be necessary for self-protection in some cases, but can distract us and impair our ability to see through presenting situations and identify important information and solutions. We often miss themes and patterns that are embedded in such circumstances which are clamoring for our attention and trying to provide guidance for us to find our way. Hence, the interpretation of the Chinese proverb also says that it is the rare person who can see the opportunity within a crisis.

In talking health and wellness, we need to recognize that our symptoms are messages communicating our needs, fears and wants. As a trusted mentor once said, "It is easy for human beings to mislabel experiences as symptoms." It is natural to not want to be uncomfortable and when we do feel uncomfortable we may be apt to view our unwanted experiences as symptoms to be cured. But, when this type of thinking occurs, we miss the learning and information we need to create more productive conditions to move forward, to learn about ourselves and our needs.