Obsessive Workouts and Protein Powders: How Concerned Should We Be?

Reactions to the NY Times article and the Pediatrics study on teens and muscle-enhancing behaviors.

I'm bothered by something I read. "Compared with a sedentary lifestyle of video games and TV, an obsession with working out may not quite qualify as a health hazard", as stated in last week's NY Times article. While the article brought to light the silent struggle many boys deal with—or rather, don't deal with—their obsession with weight training, dietary modification and steroid use to achieve the 'perfect' body—it failed big time in educating readers about when to be concerned, and what we can do to prevent this unhealthy trend. But this is not just about boys—the Pediatrics article identified that girls, too, are taking steroids and more frequently protein shakes to increase muscle mass while pushing activity.

Yes, teens, both boys and girls, have become more focused on increasing their muscle mass. "Strong is the new skinny" is a current sentiment; neither being healthy nor slim is good enough. The bar has been raised necessitating increased muscle mass to change one's appearance. And the price they pay is far greater than suggested in the Times' quote above.

Lean and muscular, yes, but nor much of a sex drive!

But how big a deal is it if a teen—or an adult—takes a supplement or pushes their training to change their appearance? The actual study, in my humble opinion, did little to differentiate unhealthy disordered behaviors from more innocuous ones. What's the issue with weight training to increase muscle mass, any way? What's the harm in your taking a protein shake to bulk up your muscle a bit? (Steroid use is another story, and that is well addressed in the Times article.)

If you're like twenty-three year old Nathan, it's quite a big deal. He relied on the gym-endorsed protein powders, "to promote muscle growth". All things high in protein were considered safe—if they were also very low fat. Despite my urging to reduce his exceedingly high protein intake, and to liberalize his intake of fats and carbohydrate, his kidneys began to fail, struggling to filter the extraordinarily large load of protein waste products. His thoughts were all consumed with when he'd be able to get to the gym and when and what he'd be eating next.

But this is not solely a male thing, as the Pediatrics study shows. Girls, though, are more likely to modify their diet, while boys will increase their gym training to 'meet their needs'.

And what if it were high in carbs?

Like Karen, you may be spending more and more time at the gym while restricting your intake, ultimately finding it too stressful to live life with school and work demands, along with your rigid workout regimen.

Certainly, drinking protein supplements is not itself a cause for alarm. But relying on shakes in lieu of real food is. It impacts our ability to socialize, to be flexible in eating situations and to get all that we need nutritionally. A diet devoid of fats and carbohydrate will be deficient in much-needed nutrients, and typically in calories. A sense of deprivation often results, accompanied by obsessive thinking about food and eating and weight.

As for the workouts, where do we draw the line about what is healthy and safe, and what is excessive? If you're in a community of triathaloners, marathon runners or iron men/women, a few hours at the gym will seem inconsequential. 

But is it driven by a preoccupation and distortion that anything short of a few hours will leave you fat or unfit? Many of my patients believe falsely that working out is always a good thing. Nothing can be further from the truth. When intake is inadequate, working out not only won't build muscle mass, it will help break down muscle to convert it to fuel! And when net intake is substantially less than need (either because of very high activity or low intake) metabolic rate slows down, so you burn fewer calories 24/7. Certainly not what you intended!

Surprisingly, there was no mention of the low testosterone levels that result in males, similar to the drop in hormones seen in females with anorexia. Tell this to those boys and it might motivate for change. Sex drive drops, facial hair diminishes and risks to bone density increase as well. For boys in their growing years—which might last until 18 or 19 years—the consequence may be stunted growth. And the opportunity for catch up is lost once the bone growth plates have closed. Most boys and girls do care about their height, but do they realize this may result?

And what messages are we conveying to our kids with their school BMI screenings? Are we faulting them for their high BMI (which will remain high as muscle mass increases and height fails to increase)? Or are we fairly looking at an increasing BMI percentile for that individual as a possible marker for unhealthy behaviors—be it steroid use resulting in rapidly increasing muscle mass or binge eating? Are we presenting being obese as so horrific that even if their behaviors are healthy, we tell them they need to lose weight? Is a drop in BMI in an overweight child healthy if they starved themselves or compulsively exercised to get there? 

Shouldn't we be screening with questions about thoughts and behaviors, not just BMI?

Are we reinforcing their interest in fitness because we perceive it as healthy—no matter what? Do we share the same distorted views about all things protein-rich being "good" while villainizing carbohydrate-rich grains and fat-rich foods, too? Are we contributing to the misinformation they hold fast to? Why don't we recognize that there is sometimes pathological thinking and behaviors that drive extended workouts and dietary changes?

I don't have the answers.  But I do know that we are influenced by cultural standards of beauty, and that these images have become more and more unattainable. Yes, without steroids, you can't possibly bulk up like many of your weight-lifting role models, nor can you be both healthy and low weight as the air-brushed magazine pics would lead you to believe.

Something has to change. And it can start with you. Add your comment. Share this piece. Counter misinformation and acknowledge unhealthy behaviors—even when society fails to.

Consider these older posts for more information on topics covered in this post:

http://dropitandeat.blogspot.com/2010/07/daily-exercise-is-must-or-so-you-think.html

http://dropitandeat.blogspot.com/2012/03/protein-new-black.html

Cupcakes for control—A healthy strategy for weight management

No need to wait until the holidays for a slice of pie.

What if you ate what you liked? No, not just ate what you liked but accepted it as ok, too? And what if you allowed yourself to eat enough of it? What if you ate as much as you needed to satisfy your hunger?

Imagine you actually notice your hunger. The signal becomes clear to you as your stomach begins to growl. Then you get annoyed, angry with yourself for feeling. You want to deny the hunger.  You start counting down until the right hour has arrived to eat, to justify the fuel your body begs for. You're angry that your body is fighting with you, telling you that you should eat, that you need to eat, while your thoughts fight back. I shouldn't need to eat—I ate yesterday! I ate too much earlier today! I didn't exercise! I don’t want to gain more weight. I don't deserve to eat.

Well I'll tell you what I argued back, in a session earlier this week: "Don’t expect that you can have it both ways; that you can easily stop eating when you've had enough, while not eating when you haven't had enough! Don't expect that you can deny yourself food and still feel well fueled over time. No, that's just not going to work for you." Ultimately, we need to respect our hunger and to get enough.

"But I should choose healthy foods, right?"

If you only eat what you think you should eat, omitting what you'd truly love to eat, you will keep yearning. You'll have the popcorn, then the fruit, then a yogurt and ultimately the cookies. And not just one cookie. And not just a comfortable amount of cookies. Because even though you're eating them, you're thinking and believing you're not supposed to be. So you shovel them down. You neither taste them nor enjoy them. You'd rather not even feel them. Then you set the unrealistic goal that tomorrow (and the day after, and the day after that) you will not eat sweets, or carbs, or white flour, or fill-in-the blank.

It looked beautiful—the low-fat chocolate soufflé that my husband decided to make, prompted by the professionally photographed image on the cover of my nutrition magazine on our kitchen table. But the taste? Yuck. So after one or two bites, I left it. It made me yearn for the rich, satisfying, molten chocolate desserts my friend Amy makes. What a disappointment. (Now that's not to say there aren't great, satisfying yet reduced calorie desserts, mind you. I've got some really good ones in a soon-to-be-released recovery cook book, in fact).

A patient of mine recently said, "No spray paint supermarket cupcakes for me—if I'm gonna have them, they're going to be good ones from a great bakery." Yes, even full fat desserts can be a let down at times. Last Thursday I was served some of those tasteless, mass-produced brownies at a function, and I couldn't get past a single bite. I came home, still hungry after the yummy vegetarian entrée I had there, and ate a small bowl of dark chocolate chips, peanuts, and raisins—my go-to when there's no fabulous baked items available. And that hit the spot. I sat at the table, and I enjoyed them.

I'm bragging a bit; I want you to know that it's ok to eat what you like, and to taste it, and truly enjoy it. And that you can leave what you don't like—as long as you're still meeting your needs. (And that doesn't mean leaving what's not 'safe'—that's a very different story. You know who you are.) When I hear patients describing how fabulous something tasted—how much they enjoyed a particular dish or meal—I know they've made progress. That is, if they allowed themselves more that just a bite in a pathological restrictive way that's far from healthy.

Waiting patiently for a satisfying dinner.

When I came home from that 'brownie-evening' out, I noticed that Mica, my dog, had not touched his food. And then I realized. I had placed dry chow in his bowl earlier that afternoon, but had not mixed in his usual and preferred wet food. He was hungry for sure—but you know, dry food alone just doesn't cut it. So he waited patiently for me to return and feed him what he really wanted. And you know what? He even left some food over when he had had enough!

Sometimes when we're hungry we eat for the pleasure, while sometimes it's just for the fuel. When my son was a nursing infant I experienced for the first time eating to live. I often ate simply for the fuel. I got hungry frequently as a new mom juggling my infant's needs and my own and I needed to eat whatever was convenient. I got hungry and I ate anything. Similarly, when I'm hiking or biking I eat to fuel. I'm just looking to get enough, and it's not for the pleasure of eating, but strictly for function. While most other times I eat, in part, for the experience.

Moving forward.

Visions of cupcake vans? Time to allow yourself to eat some!

Does this post resonate? Start noting when you get hungry, and how you respond. Do you honor your hunger and eat? Do you count up your calories to see if you're allowed to eat? Do you check the clock to see if it's acceptable? Put aside those rules and work on responding to your hunger before it gets extreme or you miss your 'window of opportunity'.

Make a list of what you like to eat. And make a list of what you allow yourself to eat. Then start moving things over from one list to the other.

But don't just eat it. Eat it mindfully. Eat it peacefully. Eat it with all your senses. See it. Feel it—the creaminess in your mouth, the granular sugar on the surface. Smell it and hear it. Yes, note the crunch of the chips, the chewy sound of the chocolate caramels. 

And of course taste it. Really taste it and enjoy it. Because honestly? It's going to be fine.

You Can Pull It Off--But It Won't Be Pain Free

What Nobody Tells You About Eating Disorder Recovery

Ever have a bad wound that you covered protectively with a large Band-Aid? Then you decide to just pull it off and ouch it hurts! There's that darn adhesive that clings tenaciously to your skin and mini hairs. And there's the sensation of being exposed; the injury is fresh and even small bangs or temperature changes impact it—it’s just so sensitive—and the sensation of clothes brushing against it feels awful. And don’t you hate the way the wound can look?

Well, in many ways, this analogy applies to removing your eating disorder behaviors.

Perhaps with the Band-Aid, you've come to expect that there's some discomfort, and you know at some point the bandage no longer works and has to be forcibly removed. Peeling off this layer may leave your injury exposed, but over time it allows you to heal. But your eating disorder? Did anyone warn you that it might not feel so good to remove it, to move in a healthy direction?

It's time to come clean. Yes, pulling away the protective layer of eating disorder behaviors doesn't necessarily feel so great. In fact, it can feel like crap. In part, because you start to feel—emotions, positive and negative—as well as physical sensations. 

And feeling things you'd rather not experience is no picnic. If you've been restricting and now begin nourishing your body, you'll start to be more present. You'll notice your hunger again, and that increased hunger may be rather scary. You may feel that you have no ability to manage this hunger, that it will simply spiral out of control, getting stronger and stronger. And starting to eat again after a restrictive mode can cause physical discomfort, as food takes longer to move through your digestive tract compared to when you were eating normally.

But it gets better. Really it does.

You may be surprised to find yourself feeling sad, or even more depressed than you’d been when actively engaging in eating disorder behaviors. No surprise. It’ll take some work with a good therapist to learn to sit with those feelings, and to discover that they too shall pass.

But it gets better. Really it does.

Why bother recovering, then, if it’s a painful process? How do you get yourself to do something that may feel so bad—at least at the start?

It may help to remember that it also feels terrible on many levels to maintain the unhealthy place you’re at, and that the risks are quite high. Need a reminder?

The physical ones include risk of sudden death, regardless of where your weight is at. You can be bulimic and have a shift in your electrolyte balance causing sudden heart problems and death. (I kid you not). If you’re the restricting type, it may be a longer, slower move toward permanent damage, with a decrease in your immune function, making you more susceptible to infections, a slowed heart rate, low body temperature and decreased kidney function, to name a few. It may take a great deal of effort to move through your day, although you likely have forgotten just how much better you can feel—since this is what you’ve come to view as normal.

The cognitive changes include the challenges of processing information and difficulty working, studying, and parenting. Your thinking becomes distorted with food restriction and you’re more likely to start ruminating with obsessive thoughts.

Need I describe the mood changes? Ask any loved one and they’ll describe the irritability, self-loathing and isolation that result from your tortured relationship with food. Depression and anxiety may have preexisted, but they worsen. And of course hopelessness overcomes you.

Is it really better to stay where you're at, patched with your Band-Aid, out of fear of feeling, or fear of failing at recovery?; to live life as an out of body experience?; to not fully enjoy the company of loved ones and close friends?; to not be there for your beloved pet?

Eating enough, and moving from binging is neither painless nor easy. But improving your quality of life, and realizing that there’s more to you than your eating disorder is something worth doing. And if you need help pulling off the Band-Aid, reach out for a hand. If things have gone too far, it just might be time to allow others to start lifting up the corners.

This post is dedicated to an old patient of mine who recently resurfaced and asked for help. At her first visit, she pulled out a quote she had typed up and attached to her recovery binder—a statement I made to her several years back when she was struggling. “I’m still not giving up on you”, it said. And I’ll say the same to you. It’s not yet too late to turn things around, unless you refuse to reach out and ask for help.

Let me know how it goes.

Record Keeping to Change Your Perspective--And Your Eating

I'd LOVE to eat your food record, but I'm really not that hungry!

“My dog ate my food record.” “Oh, I left it at work.” “I know what I eat, I don’t need to write it down.” And finally, the very honest and most insightful comment I’ve heard, “I just couldn’t bring myself to do it. Because if I don't write it down, then maybe it didn't happen." This, perhaps, sums up why, in spite of knowing that food record keeping is recommended, it is often not done. But of course you know I can't just let it go at that! 

First, let me clarify. A food record, generally speaking, is a journal of what you ate including the quantity of food, and when you ate it. A valuable food record also includes some other critical information—your perceived hunger when you begin eating, your thoughts and your feelings—both physical and emotional. Noting where you ate is also quite useful, as we’ll discuss in a bit. Oh, and if food was consumed but eating disorder behaviors followed, that should be noted as well.

And calories? In my view, these have no place in your food record. “But don’t they count and impact my weight?” Absolutely. Yet counting them is not my idea of a healthy way to change your relationship with food and normalize your weight. We are trying to get out of your head—away from your over-analyzing what's acceptable to eat—and into your body, aware of its signals to eat and to stop eating. A goal of record keeping is to help you learn to rely on these signals so you can trust your body—I know you're not there yet—but this is a great way to start.

Why all the fuss about keeping a food record? Why do Dietitians like me recommend it and why do so many struggle against doing it? 

Accountability, compassion and shifting perspective

If you know that someone is going to be looking, you certainly think twice about what you eat. Now you may think that you already are painfully aware of what others think about your eating. And that recording only makes you obsess more about what you're eating. But writing it down in the way described below does something different. It allows you not to hyper focus on the meal you overate or the fact that you ate when you think you didn't need to. Rather it allows you to look at the bigger picture. Truthfully, this is where having another set of experienced eyes makes all the difference. 

Just saw this in NYC--can you imagine?!

Most of my clients find that my perspective on their eating  helps them to be less critical of their eating. They see that their overeating followed too long a span of time, or that their recurring hunger makes perfect sense, given the large volume of food devoid of adequate calories they were consuming.

Recording allows you to distinguish between physical hunger vs other eating triggers. Recognizing that you weren't hungry helps you to realize that something else contributed to your eating. Seeing that you were hungry but didn't eat, forces you to ask yourself what your intentions of restricting were.

Recording the food you've eaten also takes it out of the closet, so to speak. It legalizes eating. And hearing someone like a Dietitian react not in the way you'd expect—rather, acknowledging how delicious the brownie might have been, or that you only had 3 versus the whole package of cookies, or that you seemed to have needed to eat when you did and it was great that you entitled yourself to do so—get the idea? These messages help to counter the negative assumptions you have about your eating, and may help you feel more justified to eat in a balanced way. No, not the way you think you should be eating—full of restrictions and deprivation, but a more human way of enjoying food.

Would you sleep or do other things on your kitchen table?
(Ok, you don't need to answer that.)

Identifying the location you eat in is also quite important. Do you only eat when driving—where no one can see—not even you? Do you do a lot of eating in your bedroom late at night? Must you eat your food alone, out of the watchful eye of family members?

And what do you choose to eat? Do you limited your selection to diet foods, light in calories and in satisfaction? Do you include a range of nutrients including fats, carbohydrate and protein—or tend to shy away from one or more of these groups? Do you allow yourself to really eat what you like—not just to eat it, but to see it and take it in with all your senses?

Sure, there are some of you that feel so overwhelmed that recording feels like just another chore—which it is. And some of you feel you just can't get organized to remember to write things down. But largely most readers may prefer not to know—not to see it, not to acknowledge what you've eaten—at least on the days you didn't think you ate as you should have—and so you don't record.

If you're serious about shifting your relationship with food, get yourself a notebook you can keep in the kitchen. Or do you live with your smart phone at your side? Check out a fabulous free app, Recovery Record, which leaves off the nutrition details common to so many apps, but appropriately includes the thoughts, feelings and behaviors that so influence your eating, and how you feel about yourself. Then get started. And be sure to share this info with a professional experienced in this area—not the gym trainer who may have a slightly different way of seeing things.

And do start by moving your scale out of site. It is much more challenging to begin to trust yourself when you are being jerked around by that object on your bathroom or bedroom floor constantly.

Thoughts? Comments? I'd love to hear from you.

What’s the Point? I’ve Already Blown It. Breaking the Cycle of Restrictive & Binge Eating.

What bothered Stacey most was the binging. Sure, the restrictive eating made her feel lightheaded and made it difficult to function. And yes, she was tired—but that was to be expected—it was what she was used to. The preoccupation with her weight, her eating, her food rules—that was all she knew. But then the binges soon followed, along with the need to purge and as this increased in frequency, she began to panic. Which brought her to seek my help.

We began with a behavior chain—a mapping of the sequence of events that Stacey experiences, the link between her thoughts, feelings and actions, which keep her stuck in her disorder. It shows how one link in the chain leads to the next, then the next, to keep the cycle going.

They have no idea how she's suffering.

Her pattern began, like it does for many of you, with deprivation—or simply not eating enough. She often fools herself into thinking that she is having enough—eating regularly, yet consuming insubstantial amounts or very low cal items; or limiting her intake because of not feeling hungry—perhaps because of the large volume of water and coffee she relied on to take the edge off. 

Maybe it seems justified—I mean, she did binge the night before—so it seemed reasonable to her to "get back on track" with her diet mentality. And sometimes even her anxiety makes it challenging to notice her hunger and rely on it. At this point, she simply doesn’t trust her body or herself.

Next, she tends to get quite hungry. Sometimes she actually allows herself to eat enough—knowing she needs the fuel—while other times she overeats. But when she does eat a reasonable amount, she feels so guilty and not entitled to it that she later attempts to restrict.

Patterns can be nice, but not this pattern she's
stuck in.

But once Stacey crosses the line, guess what? She figures “why bother?” and so initially she decides to continue to overeat, thinking she’d already blown it. This leads her to feel disgusted with herself and to lose hope. She continues this cycle for a while until much damage is done—to her intake, to her mood, and to her sense of self-worth. Eventually this leads her, once again, to restricting her intake—to make up for the damage from the day before, to punish herself, to “get on track and take control”.

The scale compounds the problem. Focusing on the number prevents her (and you) from really looking at the problem behaviors. Your weight's climbing? This only increases your panic and impulse behavior to try to seize control--without thinking rationally about what your body truly needs. Your weight’s stable? Perhaps you minimize how damaging your thoughts and behaviors have become, and simply accept them as normal. No, it is not acceptable to spend 90% of your thoughts on food, and eating, and weight. 

And your drop in weight? It may reinforce your unhealthy behaviors, as weight loss can be seen as a positive—even if it is anything but healthy—especially in the manner it is achieved. To me, weighing is generally a lose-lose situation (and I’m not talking about weight) in this situation, before you have learned to trust your body and its ability to self regulate; until you have learned to view your weight as just one variable in the big picture of your health. (So please stop weighing yourself if this applies to you!)

See the problem? In Stacey’s case, as she's eaten less, even with the periodic binging, her weight has been stable. So of course she fears what might happen if she does eat more. In her mind, more food must equal more weight. Yet in reality, there are a couple of explanations for this stable weight despite lower daytime intake. She may be making up the calorie difference when binging (although in her case this did not appear to be happening). 

Or more likely, her metabolic rate decreased to accommodate her low intake. So now she eats less, her body slows the rate at which it burns calories—she feels tired, preoccupied with dieting and sometimes out of control when she overeats—and she fears changing this situation will result in her doubling in size. But this is wrong, wrong, wrong! Because her metabolism will in fact increase again as she normalizes her food intake!

It seems we have a selective memory regarding eating. We focus on the fact that we overate—but we ignore that there was restriction that preceded it; we simply blame ourselves for our "lack of control", or failure to have “willpower”. If we binge and then purge, our memory stays fixed on how much we binged on, so we get annoyed when later on we get hungry and need to eat. How quickly we forget that we have gotten rid of a large part of our food intake, and that feeling hunger makes total sense.

Stacey has a long way to go. But here’s what she is working on. Rather than blaming herself for her seeming inability to take control, she's working on acknowledging that restricting keeps her stuck in the vicious cycle. And now she is beginning to liberalize her daytime intake, to prevent this unhealthy chain of events from continuing.

She further needs to join the “Clean Slate Club”. Yes, that's the Clean Slate, not clean plate, club. Overate? Binged? What's done is done. Trying to compensate with restricting will ensure you (and she) stay stuck—and that needs to change.  Starting with a clean slate mentality can help. It is more damaging to keep going on the destructive eating path, than to stop now and lessen your losses. It is worse to purge then to sit with the discomfort of overeating. And it is senseless to begin again with restricting, because it is quite clear where that will lead.

A typical breakfast prepared and eaten on my vacation:
fruit, yogurt, honey, baguette and butter and pastries. 

Perhaps you identify with Stacey—who is actually a composite of several patients I have seen this week.  Or maybe you haven't (yet) experienced the rebound binging—and purging—that may result from continued restrictive eating. It is not too late to change, to prevent the potential rebound overeating that deprivation can cause.

Why not start to break the cycle now?

Trying to Change your Relationship with Food? A Letter to your Loved Ones May Help

I frequently describe the chat that needs to happen—between those of you struggling to normalize your eating and move away from compulsive overeating or binge eating, and your loved ones. I spend so much time talking about this in patient sessions that I decided to write it down in a letter form, so all of you in this position can use it.

Why such a conversation, you ask? Because in order to start to change your relationship with food, you need to let go of the fear and the shame you’re all-too-familiar with. To do so, it helps to put it right out there to those who will be seeing you eat and may be surprised by what they see. The last thing you need is more judgment—you’re critical enough of your own eating, you don’t need anyone else’s judgment! So read on and test it out at home!

Dear All-who-really-care about me,

While I know you are worried about my health and my eating please realize that you are not alone. Just because I don’t talk about it with you doesn’t mean I am not concerned. In fact, I am actively working to try a different approach to change my relationship with food, so I thought I’d let you in on it.

Remember all those diets you’ve watched me start and stop, those failed attempts to take control with rigid, senseless rules? Those days are over. “What now?” you’re wondering? “You’re giving up again?” you’re thinking? Think again! Here’s what you can expect to see, so brace yourself.

You know those foods you think I shouldn’t be eating? The foods you and I really like to eat? It’s time to make peace with them, to legalize them. Because now they feel forbidden, and when something feels prohibited I want to eat more of it—just like anyone would. Yes, that’s normal. What isn’t normal is thinking I will never eat cupcakes again—or ice cream, or chocolate, or bread or ‘white carbs’. No, that’s absurd, unrealistic and quite frankly, unnecessary. 

What I’ve been learning from an experienced Registered Dietitian who deals with helping people like me is that it’s not the food that causes the weight gain. No, not the carbs themselves, nor the sugar, nor the fats, but rather how much we eat of them. And I’m learning how to start to take control of my portions of such foods.

First, I’ve got to welcome them back into my diet. You see, when I feel I’m not allowed to eat them, it sets me up for trouble. I feel ashamed if you and others see me eat things, so I’m more inclined to eat them quickly, mindlessly, just because there’s no one around. And trust me, I do. And this goes against what I need to do—to eat them mindfully whenever I’m hungry and choose to eat them.

But I fear the reaction from everyone. So I’m giving you this letter so you won’t be surprised when I sit down at the table and have a couple of cookies. I’ll eat them without distraction and I’ll really enjoy them this way—as opposed to just shoveling them in. Please recognize that I am doing this because I care to feel better and be healthy, so be open-minded. Realize that the diets and restriction have only set me up for problems.

So when you see me at the table eating something you think is ‘bad’, think again. Perhaps you’ll join me and we can normalize our eating together.

Be patient with me--this is a process.  It's not going to get better over night.

Thanks for supporting me and for understanding.

PS: Learn more about my struggle from http://www.dropitandeat.blogspot.com/2012/09/what-ive-learned-about-food-addiction.html

Let me know how it goes!

What I've Learned About Food Addiction

This post applies to all so read on.

I'm addicted to desserts and I can't keep them in the house. They just call to me. I can't simply eat a piece or a small portion—no, not me.  Once I start I can't stop and I have to eat them until their gone or I need to throw them in the trash—although sometimes, I’m embarrassed to say, I dig them out of the trash because I just can't let them slip away. And I never know when I'll get to eat them again. Avoidance—total avoidance seems like the only way—yet it never seems to work. I just have no willpower.

No, that's not me speaking—although these statements were certainly true for me at some point in my life. Yes, that time in my early twenties when my eating was emotionally driven and I had no idea what hunger and comfortable fullness felt like.  Rather, the comments above were spoken by many patients that walk into my offices—by the overweight who have unsuccessfully struggled to lose some weight with rigid diets and deprivation, and by those of average weight and below who now approach food in a black and white way, seeing food as the enemy. 

And why wouldn’t they, and you, feel that there is no hope, that you must be addicted to food in the way others are addicted to drugs? The debate about food addiction has again emerged, with media distortions and outrageous researcher conclusions on rat studies and MRI findings. And it will leave you feeling hopeless—unless you see how you are being manipulated and left to believe you are powerless.

Yum! Salted caramel.

The Wall Street Journal put out a rather balanced piece on food addiction. Yet the NY Times article on this subject is an embarrassment.  "Can Food Be Addictive?" makes reference to several studies suggesting that overeating is an addiction, perhaps not much different than addictions to drugs and alcohol. The examples cited?

"...Princeton University and University of Florida researchers have found that sugar-binging rats show signs of opiate like withdrawal when their sugar is taken away — including chattering teeth, tremoring forepaws and the shakes. When the rats were allowed to resume eating sugar two weeks later, they pressed the food lever so frantically that they consumed 23 percent more than before", they tell us. 

Well, I’ve never had my paws shake and my canines never chattered, but this sounds like sugar dependency is a serious culprit! That’s what they’re leading us to believe. But a more detailed review of this 2011 study sheds a whole different light on things. We learn that rats were first deprived, going 12 hours without food to eat, prior to being given the sugar solution. And, this binging was dependent upon the timing of the feeding. One blog describes how "... rats who had received only the food chow on this intermittent schedule, or had unrestricted access to food and sucrose, did not show these effects." That's right—not depriving the rats and actually allowing them access to food including sugar prevented binge eating. The blog reporting on this study appropriately summarizes:

I don't wait for special occasions to eat these!

“This means that after being deprived of the food or drug the rat will self-administer extremely large quantities of the substance once it is available again. This behavior tapers off once the animals are sated, but these binges will consistently occur after each period of deprivation.”

Ok, so they binged when given sugar. But more importantly the research actually confirms the very problem with food deprivation and the resulting out of control eating that we see in our clients who feel trapped in this cycle. No, there was no problem when they could freely feed on food and sugar as desired. Rather, the problem with binging resulted from the withholding of food for long periods, which set the rats and sets my rat-like readers up for trouble.

Might I add that we are not rats in our ability to step in and change our situation. We are not limited to our cages—we can choose to step out of our environment and to control our triggers. And we can certainly avoid deprivation—the biggest trigger for binge eating. You didn’t need a rat study to tell you that, though!

Another study referenced by the NY Times article to support the food addiction theory drew equally absurd conclusions. Researchers at Oregon Research Institute surveyed 151 teens who were in a healthy weight range about their eating habits and food cravings. Then they did brain-scan studies on them while the kids looked at pictures of chocolate milkshakes—more activity in the brain was considered to be linked with greater cravings. Next, they gave them a milkshake to drink while they were having an MRI scan. The kids who'd reported eating the most ice cream over the past few weeks prior to the MRI scans registered lower activity in their reward centers from the milkshake—in other words, less craving for the milkshakes. To me that’s a good thing. Those very kids who had access and consumed these items regularly did not have their brains light up as if they were getting some big reward when offered a milkshake—no, it was no big deal to them.

Yet the NY Times states that these findings "suggest that just as drug abusers and alcoholics need increasingly larger doses over time, children who are regular ice-cream eaters may require more and more ice cream for the reward centers of their brains to indicate that they are satisfied."   One study author similarly concludes that not having as great a response to eating the food (based on MRI) is problematic—that “over consumption of these foods down regulates reward processes. That may, in turn, make you eat more." Really? That's quite a strange conclusion to draw, in my opinion, especially as these kids were not overweight. (in spite of their more frequent ice cream consumption.

Further, this study attributes possible addictive-like qualities of ice cream shakes, made with Haagen Daz ice cream, to the high fat content.  But if it is about the fat, why don’t we have addictions to such high fat items as prime rib or deep fried chicken? Or whole milk, even? No, this just isn’t seen. 

High fat and satisfying!

So maybe it's not the nutrient, the fat or sugar (as implicated above) content at all but the conditions under which we eat. Is it any surprise that those reward centers of the brain would light up in MRIs, similar to what occurs with other addictions, when these very food items are used in our culture as rewards? You know, you had a hard day, so you indulge yourself with an ice cream, ironically just as the old Haagen Daz ads suggested? Or as a young child, you scrape your knee and your mom gives you some cookies to feel better. If we could only allow ourselves to enjoy such pleasurable foods as ice cream without the value judgment we add to it!

The take home message.

What's not in question is how you feel. Clearly, when you experience out of control eating you feel as if your are addicted to food—that you have no control over certain food items or types and that it therefore must be out of your hands to seize control. And with the recent studies I referenced, you might be convinced this is true. But the only clear link with what feels like food addiction is food deprivation. 

This is not a meal!

Continuing to use food as a reward for a hard day or for eating healthy all week is a huge mistake. 

If you’re feeling like you’re addicted to food, consider changing your relationship with food and move from black and white thinking, giving yourself permission to eat those foods you enjoy but think are forbidden. 

Eat in a balanced way--and I don't mean by following the My Plate way. Rather, make the foods you eat enjoyable. Sure, include satisfying less processed foods, too--but not at the exclusion of other foods. 

And take charge of your environment—focus on mindfully eating and truly enjoying your food so you know when you have eaten just enough.

Read more about this approach in some older posts below: 

http://www.dropitandeat.blogspot.com/2012/04/0-false-18-pt-18-pt-0-0-false-false.html

http://www.dropitandeat.blogspot.com/2010/06/you-dont-understandi-cant-have-just-one.html

http://dropitandeat.blogspot.com/2011/12/following-vegan-diet-and-gluten-free.html

http://dropitandeat.blogspot.com/2010/12/recovering-from-slip-coping-with.html

http://dropitandeat.blogspot.com/2010/11/twinkies-for-weight-control.html