For some people with overeating disorders, the treatment plan consists mainly of complete avoidance of trigger foods, such as highly sugary, fatty, or fried foods. Others in the nutrition field debate the viability of this strategy, since patients ultimately have to come to terms with having healthy relationships with all types of food. What do you think? Tell us in the comments section below.
In the final instalment of our three-part series on food addiction, Cleveland Clinic director of nutrition Jennifer Sygo examines the two most commonly adopted treatment methods for chronic overeaters and those who believe they suffer from food addiction. Please share your thoughts or experiences in the comments section at the end of the story.
If you or someone you care about is addicted to food, how exactly does one go about treating it? You might argue that treating food addiction makes as much sense as treating someone for a predilection to air or water or shelter, but with mounting evidence that the brains of some individuals — whether by nature or nurture — are more susceptible to addictive-type responses to certain foods, this is a question that is increasingly being asked by clinicians, researchers, and those who feel they are suffering from this as-yet-undefined condition. Last week, we looked at the triggers of food addiction, as well as the lack of clarity in diagnosis (the condition is currently not part of the Diagnostic and Statistical Manual of Mental Disorders). This week, we’ll take a closer look at some of the methods used to manage this controversial condition.
Read the first instalment in our Food Addiction series
Read the second instalment in our Food Addiction series
TREATMENT OPTION 1: TRASH THE TRIGGERS
While there is no consensus treatment for food addiction, most methods fall into two main categories: avoidance of triggers, or management of one’s relationship with food. The first option tends to follow the classic addiction model, insofar as the foods that are known to trigger the most intense cravings are eliminated indefinitely. Based on the growing body of research, the most common addictive triggers seem to be foods that are sugary or made from refined carbohydrates (white bread and pasta, baked goods, ice cream, candy or chocolate), fatty foods (burgers, cheese), or high in salt (chips, french fries). Not only do these foods possess various elements that seem to trigger stronger-than-average cravings, there is also evidence suggesting we can become habituated to them. In other words, the more sugar or salt we eat, the more we crave. By that logic, taking them out of the diet should lead to a decreased desire for the foods over time.
The great challenge with this treatment method, of course, is the need for a significant self-discipline. Much like going on a diet, avoiding a particular food or foods requires constant attentiveness, and eventually, psychological fatigue can set in. Evidence also suggests that all-or-nothing mindset can and even lead to binge-type behaviours over time, especially when one gives up on the plan, for example, by eating a trigger food at a party, or as an emotional response after a bad day. This simple act of letting go tends to trigger more feelings of guilt and shame, themselves common triggers for compulsive overeating. To help support individuals in this ongoing battle, self-help groups, such as Overeaters Anonymous, are an increasingly popular method to help learn coping mechanisms.
TREATMENT OPTION 2: MIND YOUR FOOD
The second, and more complex method of managing food addiction is to work to improve the individual’s relationship with food. Through a process known as mindfulness, there is some hope to at least curb the cravings, and potentially alter the brain’s response over time.
At its simplest, mindfulness means being aware of one’s habits and behaviours, but without judgment. Championed by the likes of Jon Kabat-Zinn, author of Full Catastrophe Living, or in the food world by Dr. Susan Albers, author of Eating Mindfully, mindfulness involves becoming more self-aware through all aspects of one’s life, while mindful eating focuses specifically on the thought process that surrounds eating.
To get a better idea of what the process of mindfulness involves, one can take a very small amount of food — say, three raisins or almonds, and spend what might seem inordinate amount of time considering, tasting and eventually eating the food. For example, you can start by holding the food item in the palm of your hand, noting its colour, shape and texture, how it looks in the light, and how it feels to the touch. Putting the food in your mouth, the initial sensation on your lips and tongue, the taste and texture on your tongue and against your cheeks should all be attended to. Eventually, when you do take a bite, note the flavour and texture of each bite. While it may be impractical to engage in such an intensely focused process while in the middle of one’s workday, at its simplest, this exercise can be used by mindfulness practitioners to bring a sense of awareness to the eating process itself, something that many of us have disassociated from in our busy world.
From there, mindfulness training can teach an individual to observe his or her eating behaviours passively, and perhaps most importantly, without judgment. Simply observing oneself when on the brink of (or in the midst of) a binge, for example, by asking yourself what is going on (am I sad? Lonely? Angry?) — can help to bring the focus back to both yourself and the food you are eating.
Beyond the more philosophical elements of mindful eating, other concepts that can help almost any individual include taking a slower approach to eating, sitting down at a table whenever possible (not at a desk, in the car, or in front of the TV), and eating meals and snacks at fairly regular times. Ultimately, no food is forbidden: If you want the chocolate cake, you can have it, but be sure to sit down at the table, savouring every single bite. As you can imagine, mindfulness is a process that requires emotional investment, and might feel a bit too esoteric for some. But for those battling a seemingly overwhelming feeling of being addicted to food, it can be the welcome respite from all of the stress and negativity that they have long associated with every bite of food.
• Jennifer Sygo is a dietitian in private practice at Cleveland Clinic Canada, which offers executive physicals, prevention and wellness counselling and personal health care management in Toronto.
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