Dr. Ralph E. Jones, Special to the STar
By Dr. Ralph E. Jones, Special to the STar
February is Eating Disorder Awareness Month; a time when we raise awareness to the problems arising from addiction to food and the associated conditions of it.
We are a nation of peoples with obsessions and compulsions, more so than any country in the world. Although for most people, the obsessions and compulsions they have are not pathological (they do not create psychological or physical problems); for a growing number of individuals obsessions and compulsions create major life problems; among them being alcohol and other drug dependency for example.
Yet, even in this age, there exists an addiction of compulsive and obsessive behaviors at its core that consumes approximately 6 percent of our population, and that kills around 500,000 individuals each year; one that only in the past 25 years has been brought to the forefront: Food Addiction.
Food Addiction is the loss of control over food. Food is used as “medication” to control and suppress negative feelings such as sadness, anger, anxiety, depression, boredom and loneliness.
A major contemporary concern is our relationship with food. Terminology in vogue, such as being a “foodie,” has permeated our culture. We take pictures on our cell phones of food, we describe our relationships with others surrounding their likes and dislikes of food, food is usually involved in our social interaction with family members and others, we “quiet” and reward our children with food…food as never before in history permeates our culture.
And, as it has done so, there are now an increasing amount of negative consequences. A primary example is the growing rise in Obesity in our nation, in which, the Rio Grande Valley is now deemed to have the “most obese individuals in the nation.”
But obesity is not the only problem associated with food addiction. There are many more that are not less serious.
Besides the obvious reason for eating food, there are a variety of other reasons as well; which do not necessarily lead to problems. We eat in celebration, for enjoyment, for social acceptance, or to relieve boredom. We also eat to win affection, and often ritualistic (such as hot dogs at sporting events, popcorn at movies, snacking in front of the TV, etc.)
Ritualistic eating can often result in over-eating, such as that occurring at Thanksgiving or other holidays. Eating patterns also vary; some may eat when they feel stress or to avoid painful feelings, while others may restrict their intake under the same circumstances. Most all of us eat for reasons other than to survive.
But it is our preoccupation with food and its relationship with success that has often been cited as a cause of the increase in the incidence of eating disorders.
Food addiction is the loss of control over food consumption; it is the craving that centers on food. Although food addiction is not considered to be a pathological problem with the psychology and medical community, the associated diseases, classified as “Eating Disorders” are (this is to change however with a revision of the Diagnostic and Statistical Manual of Mental Disorders that is being considered now).
Like addiction to alcohol and other drug substances, there are foods that are high in salt, sugar, and/or fat that can trigger the pleasure neurochemical receptors in the brain (serotonin, dopamine, endorphins, etc.), creating strong feelings of pleasure and satisfaction.
When a person becomes addicted to the “high” that results from eating particular types of food, the person suffering from the addiction will continue to eat even when they are no longer hungry…thus the ensuing addiction, not unlike the cocaine or heroin addicted person continuing to use the drug in order to feel the high.
Food addiction is the most complicated form of addiction, as the major source of the addiction, food, is necessary for survival; one cannot just go without food for any length of time. It, unlike alcohol and other addictive chemical substances, is necessary for survival; and subsequently the hardest form of addiction to treat and takes the form of many diagnosis; Chronic Obesity, Chronic Binge-eating, Anorexia Nervosa, and Bulimia Nervosa.
Chronic Obesity occurs when one is over 20 percent of the desired weight for their height for prolonged periods of time. There are mild, moderate, and severe degrees of obesity. According to researchers in the field, obesity in American males and females of all age groups and ethnicities is on the rise; clearly two thirds of our population are overweight, and half of those meet the criteria for obesity; more than 72 million people.
Chronic Obesity and the subsequent over-eating arises as a result of “stuffing” ones feelings or to relieve painful feelings; and is associated with high, uncontrollable anxiety coupled with available food. The issue of loss of control is most apparent with this person as with all those with food addictions, and like the drug addicted person, the food addicted person will continue to engage in the destructive behavior with their “drug of choice,” food.
Chronic Binge-Eating most usually occurs among individuals who seem to have a higher incidence of low self-esteem, have problems managing stress, exhibit higher levels of anxiety when in social situations, and are relatively less assertive than non-binge, obese individuals.
Over 50 percent of individuals with a binge eating disorder are food addicts.
In addition, and perhaps most importantly, binge eating is often accompanied by difficulty in distinguishing between negative feelings and hunger, so eating becomes a response to emotional distress. They do indeed “eat their feelings.”
Anorexia Nervosa and Bulimia are conditions often associated with women and their body image (albeit about 10 percent of this population are males); and societal pressures placed on women that promote eating-disordered behaviors by emphasizing perfection,
competition, and physical attractiveness. Anorexia involves restricting food intake, dieting, and over exercising to lose weight, bulimia through purging (purposeful vomiting). Anorexia Nervosa is an increasingly common and complex disorder that overrides the person’s physical and psychological well-being; pursuing a thin body becomes an isolated area of control in a world in which the individual feels ineffective, the dieting provides and artificially dangerous sense of mastery and control.
As the weight loss progresses, a starvation state ensues, which eventually develops a life of its own, leading to features of anorexia nervosa. Thus, this addiction becomes most life threatening and fatal if not treated. Thus was the case of Karen Carpenter, of the singing duo The Carpenters of the 1970s 80s era. Karen Carpenter died of heart failure due to anorexia nervosa.
Of all the individuals with food addiction that I counseled with, none is so remembered as Mary. Mary was in her 40s, and had recently gone through divorce. She was approximately 120 pounds overweight. She suffered high blood pressure, was recovering from uterine cancer, was diabetic, and had clinical depression.
She was informed by her doctor that if she did not lose weight she would die of heart failure. Her self-described problem was food…she could not control her diet or food intake. She often engaged in binge eating; especially food containing a lot of sugar and flour. She presented with all of the psychological symptoms associated with Chronic Obesity; she had extremely low self-esteem. Mary was in serious trouble, and though the Psychiatrist could only “band aid” her associated depression, he referred her to a gastric specialist and she had lap band surgery which limited the amount of food she could consume. As I knew that the surgery would not treat the root causes of her addiction, and after completing her surgical recovery, I referred her to Shades of Hope Treatment Center in Buffalo Gap, Texas; the most renowned treatment center for treatment of eating disorders in the state…food addiction.
Mary went on to lose 125 pounds, her blood pressure was under control, and she no longer presented with diabetes. She became very strict with her diet and is currently living a very productive life.
While working in State Residential psychiatric services, I remember the individuals with Anorexia Nervosa and other food addiction concerns that we treated.
Once the person’s physical health was stabilized and began on a healthy diet, and prescribed medication, they were afforded Group and individual Cognitive Behavior Therapy to facilitate changing their thinking about their self-image and self-concept. Upon discharge they were referred primarily to the local out-patient mental health authority for xtensive after-care and support groups.
Some eventually died from their addiction like Karen Carpenter, but there were others who succeeded in getting their addiction and lives under control. Yes, Food Addiction is real. It is the “Silent Addiction” which hopefully in the near future may be more productively addressed. If you, a loved one, or a friend is suffering with food addiction, remember that help is only a telephone or keyboard away.
Stay Healthy my Friends!