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Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying @greenlakenutrition.com www.greenlakenutrition.com Copyright © 2012

Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 [email protected]

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Page 1: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Emotional Eating:An Integrative Perspective

By Ying Yu, MS, CN, CHCJanuary 10, 2012

(206)[email protected]

Copyright © 2012

Page 2: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Learning Objectives:

• Remove stigma around emotional eating

• Identify biochemical factors that contribute to emotional eating

• Assess for amino acid and nutrient deficiencies that contribute to neuro-chemical dysregulation.

• Recognize the emotional and psychological factors that contribute to emotional eating

• Help clients move from emotionally-avoidant eating to emotionally-attuned eating

Page 3: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Definition

• Commonly accepted definition: • EE is any eating that is done in

response to an emotion rather than to physical hunger.

Page 4: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Evolution

• Pleasure from eating is built into our DNA for survival. Otherwise we wouldn’t eat.

• Powerful neurotransmitters and endorphins are released every time we put something in our mouths.

• This process starts from birth the minute we are fed by a caregiver – we are instantly soothed.

• Impossible to separate food from emotions.

Page 5: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Complex Relationship

with Food• Food chronicles our lives from birth till death

• Part of our identity on the individual, familial, cultural, racial, and spiritual/religious levels.

• Food affects our emotions, and we make emotional decisions about food we eat

• We are what we eat AND we eat what we are.

• It connects us with nature and the seasons.

Page 6: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

“Emotional Eating” Label

• This is misleading and carries a negative connotation:• Implies that emotions should be

separate from eating.• Assumes that it’s all about will-power

and discipline, leading to guilt, shame, self-blame.

• Instills a fear of pleasure and hunger, both are normal processes in the body.

Page 7: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Remove the Stigma

• Normalize • We are all emotional

eaters (and food addicts)

• We’re designed to love food

• Remove “good” / “bad”

• Encourage learning, curiosity, self-awareness, and experimentation.

Page 8: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

So when did this

relationship go awry?

Page 9: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Our Changing Food Supply

• When our environment changes, and we are no longer connected with our natural rhythms and those of nature, our health and appetites go awry.

• Historically, what was available were whole foods eaten locally and seasonally. Refined and rich foods were associated with the wealthy.

• Today, due to cheap food processing methods and food transport systems, junk food is affordable and available to all socioeconomic levels.

Page 10: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Our Changing Food Supply

• We simply eat what’s available to us.

• No one is exempt from addictive, imbalanced eating.

Page 11: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Our Changing Food Supply

Eating whole foods is in harmony with our evolution:• Our hunger-satiety signals and pleasure-reward system are

designed to respond to food in its whole form, balanced in macro- and micronutrients essential to our health.

• Eating naturally stimulates release of pleasure-generating neurotransmitters without causing imbalance.

Eating refined Foods is not:• Once food becomes refined, we are all vulnerable to food

addiction. (Joel Fuhrman, 2011)• Modern processing creates food with concentrated levels of

refined carbohydrates and unhealthy fats without redeeming levels of proteins, fibers, micronutrients, and phytonutrients.

• Consumption of large quantities of these foods hijacks the brain’s reward system, causing systemic functional dysregulation.

Page 12: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Our Changing Culture

Since the 1950s:

• We spend more time in cars, at our desks, in front of our computers.

• We watch on average 4 hours of tv per day, replete with tempting tv commercials for processed foods.

• We feed ourselves and our children fast and convenience foods, out of cans, boxes, and microwaves.

• There are more two-income households, leaving children to feed themselves with whatever is available.

Page 13: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Finding the Root Cause

• U.S. Statistics:• Early 1900s - Only 1 in 150 people were obese• 1950s – 9.7% obese, 33% overweight• Today – 34% obese (17% age 2-19), 75% overweight

• Is it really that we’re intrinsically “lazy,” “incompetent,” “ignorant,” and “undisciplined?”

• Or could our changing food supply be changing how our brains and bodies work?

• Could it be that we haven’t fully understood and respected how powerful food can be as a psychotropic chemical?

Page 14: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Food Addiction

Page 15: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Addiction Model to EE

• Growing body of scientific studies (over 1000 in the past decade) confirming that the brain reacts to some foods the same way it reacts to drugs or alcohol.

• Today, there is little doubt that food powerfully affects our brain chemistry.

Page 16: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Addiction Model to EE

“Fatty Foods Addictive as Cocaine in Growing Body of Science.” (Nov 3, 2011, Bloomberg Publications)• An article summarizing research from 28 scientific studies

published in 2011 alone. • Study: Brain scans of obese people and compulsive eaters

reveal disturbances in brain reward circuits similar to those experienced by drug abusers.• 26 overweight young women were given MRI scans as they

got sips of a milkshake made with Haagen-Dazs ice cream and Hershey Co.’s chocolate syrup. Six months later, the women who had gained weight showed reduced activity in the striatum, a region of the brain that registers reward, when they sipped milkshakes the second time. (Journal of Neuroscience).

Page 17: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Addiction Model to EE

• Refined and fatty foods can over-stimulate our reward center, thereby• Desensitizing the brain’s circuitry • Depleting our neurotransmitter reserves• Depleting key nutrients and cofactors needed for

neurotransmitter biosynthesis

• Blunted reward system and systemic depletion are exactly what happens in drug and alcohol addiction.

• This leads to depression, anxiety, impaired cognition, learning and memory, intense cravings and food addiction.

Page 18: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Legal Implications

Mortality rates of legal addictive substances (according to the CDC):

• Cigarette Smoke: ~443,000 deaths / year• Alcohol Use: ~38,000 deaths / year• Obesity-related Diseases: ~162,000 deaths / year

“This could change the legal landscape…If fatty foods and snacks and drinks sweetened with sugar and high fructose corn syrup are proven to be addictive, food companies may face the most drawn-out consumer safety battle since the anti-smoking movement took on the tobacco industry a generation ago.” (Bloomberg article)

Page 19: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Understanding How the Brain Works

Page 20: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

The Neuroaxis

Page 21: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

1. Brain Stem

• Sends neuromodulators such as dopamine and norepinephrine to ready one for action

• Keeps one energizes to reach goals, and rewards you with pleasure when they are reached

Page 22: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

2. Diencephalon

• Thalamus and hypothalamus

• Switchboard for sensory information

• Directs automatic nervous system (SNS, PNS, ENS)

• Regulates endocrine system through HPAA

• Regulates primal drives (e.g., food, sex, water) and primal emotions (terror rage).

Page 23: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

3. The Limbic System

• “The Emotional Brain;” central to emotion and motivation

• Includes basal ganglia, amygdala, hippocampus

• Basal Ganglia – involved in rewards, stimulation seeking, and movement

• Hippocampus – forms new memory, differentiates between real vs. perceived threats

• Amygdala – “alarm bell” that responds to charged emotions or negative stimuli

Page 24: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

4. Cortex

• “New Brain;” higher level executive functions of organization, self-monitoring, and impulse control; can have inhibitory effect on the limbic system.

• Prefrontal Cortex (PFC) – sets goals, makes plans, directs action; shapes emotions, in part guiding and inhibiting the limbic system

• Anterior Cingulate Cortex – steadies attention and monitors plans; helps integrate thinking and feeling

• Insula - perception, motor control, self-awareness, cognitive functioning, and assessment of interpersonal experience.

Page 25: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Key Neurotransmitters

• Primary neurotransmitters:

• Glutamate – excites receiving neurons

• GABA – inhibits receiving neurons

Page 26: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Key Neurotransmitters

• Neuromodulators – influence primary neurotransmitters• Serotonin – regulates satiety, mood, sleep, digestion;

most antidepressants aim at increasing its effects

• Dopamine – involved with rewards and attention; promotes approach behaviors

• Norepinephrine – alerts and arouses; “fight or flight”

• Acetylcholine – promotes wakefulness, learning, and focus

Page 27: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Key Neurotransmitters

• Peptide neuromodulators

• Opioids – reduce pain and stress, produce pleasure (e.g., runner’s high); include endorphins

• Oxytocin – promotes nurturing behaviors toward children and bonding in couples; associated with blissful closeness and love; triggered by touch and food; women have more oxytocin than men.

Page 28: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Key Neurotransmitters

• Other neurochemicals:

• Cortisol – released by adrenals during fight-or-flight; stimulates the amygdala and inhibits the hippocampus.

• Estrogen – brains of both men and women contain estrogen receptors which affect libido, mood, and memory

Page 29: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Brain’s Reward System

• Purpose:• Facilitates learning of behaviors that

enhance the chance survival by producing pleasure

• Drives the avoidance of actual and potential threats through providing pain

Page 30: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Brain’s Reward System

Two-part process:

1. Dopamine – released when pleasure or reward is anticipated based on past experience

• Levels stay elevated if reward arrives• Levels drop if meet disappointment or discontentment,

and cravings ensue to restore previous high

2. Endorphins, oxytocin and norepinephrine – creates the pleasant feeling tones associated with actual/anticipated rewards

1. Released to strengthen behaviors that lead to attainment of reward (e.g. toddler learning to eat with a spoon)

Page 31: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

The Effect of Food on

Brain Functioning

Page 32: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Food & Normal Brain Chemistry

• When we see food, dopamine is released in anticipation of pleasure

• Dopamine and endorphins are released when food is eaten

• Serotonin is released when we’ve had enough

• All these reinforce our eating behavior

Page 33: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Addictive Foods & Brain Chemistry

• These foods includes refined sugar and carbohydrates, unhealthy fats, caffeine, alcohol, food additives, food sensitivities, etc.

• Trigger over-arousal of the brain stem, diencephalon/SNS, and limbic system.• Floods the body with feel-good neurotransmitters and

cortisol• Eventually this leads to desensitized receptors and

diminished neurotransmitter pool

• Inhibits neural pathways in the cortex.

• Because these foods are very low in nutrient-density, there’s a deficiency in neural supportive micronutrients.

Page 34: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Cortisol & Energy Modulation

• Increases energy availability to cells

• Mobilizes glycogen and fat stores for fuel

• Conserve fat around abdomen

• Intensifies cravings for calorically dense foods

emotional eating.

Page 35: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Food, Cortisol, & The Brain

• Repeated SNS/HPAA activity sensitizes the limbic system, leading to hyper-arousal and anxiety

• Over-stimulates the amygdala, which reinforces implicit memories (subconscious impressions of threat), leading to generalized anxiety (ongoing anxiety regardless of the situation).

• Inhibits activation and new neuron formation in hippocampus, which encodes explicit memories (clear records of what actually happens).

Page 36: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Result?

• These foods numb parts of our brain and skew our perception of reality, thereby preventing us from forming new memories to replace old fears.

• In other words, these foods keep us stuck in old maladaptive patterns and coping behaviors; impedes us from adopting and maintaining healthy new behaviors.

• It is no wonder that we experience:• Reduced motivation• Decreased pleasure from food and activities• More depression, anxiety, and physical pain• More pleasure seeking behavior / addiction

• We know what to do but just can’t seem to do it.

Page 37: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Breaking the Vicious Addictive

Cycle

Page 38: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Breaking the Vicious Cycle

Goal is to quiet the SNS and nourish the PNS.

Parasympathetic Nervous System:• Normal resting state of body, brain, and

mind• Enables cool, calm decision-making• Fosters tranquility and enables insight• Restores a more natural rise and fall in

pleasure neurotransmitter levels• Enables more activity in the cortex

Page 39: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Breaking the Vicious Cycle

1. Eating in harmony with nature and balance blood sugar

2. Manage detoxification and withdrawal symptoms to restore true hunger

3. Replenish amino acids and micronutrients needed for healthy neurotransmitters modulation

Page 40: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

1. Eat in Harmony

Eat nutrient-dense foods in the right ratios - healthy plate model

• Roughly 20g lean protein at each meal with 1-2 cups of colorful vegetables

• Eat food in its whole form• Eat locally and seasonally whenever

possible

Page 41: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Balanced Macronutrients

15%

55%

30%

Macronutrients - Recommended Percentage of Daily Calories

Lean ProteinsComplex Car-bohydratesHealthy Fats

Page 42: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Current Trends

62.00%25.50%

12.50%

U.S. Food Consumption by Calories

Refined and processed foodsDairy and animal foodFruits, vegetables, beans, nuts, seeds, and whole grains

Page 43: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Optimal Micronutrients

• Health = Nutrients/Calories (Eat to Live, Dr. Joel Fuhrman)

• Food loses nutrients every step of processing.

• Continuum:• Unrefined/Whole • Partially Processed • Fortified • Refined

• The more refined a food is, the higher its addictive potential.

Page 44: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Anti-inflammatory Plate

2/3

1/6

1/6

Food Groups by Surface Area of Plate

VegetablesProteinGrains

Page 45: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

“What if all Americans…

• ate a large bowl of green salad daily

• had a large serving of steamed greens daily

• ate a cup of beans daily

• had at least an ounce of raw seeds and nuts daily

• ate at least three fresh fruits daily

• had some tomatoes, peppers, onions, mushrooms, herbs, and garlic daily”

Source: Fuhrman, Joel (2011). Eat to Live: The Amazing Nutrient-Rich Program for Fast and Sustained Weight Loss (p. 165). Hachette Book Group.

Page 46: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

2. Detoxification / Restoration of True

Hunger• “Toxic Hunger” - the experience of

detoxification & withdrawal symptoms that leads us to eat when we’re not truly physically hungry. (Furhman, 2011)

Page 47: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Fear of Hunger /The Need To Feel

“Full”• Body goes into detoxification and repair as soon as we

are no longer digesting.

• Uncomfortable withdrawal symptoms lead us to eat more food to feel better, as eating retards detoxification and withdrawal.

• The more low-micronutrient meals we consume, the greater the toxic buildup in our body, and the more intolerable the withdrawal symptoms will feel.

• We eat continuously, and choose heavy, hard to digest meals to avoid onset of detoxification symptoms.

• This inevitably leads to weight gain, leptin/insulin resistance and emotional eating.

Page 48: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Leptin Resistance

• Traditionally believed to be produced by adipose tissue to control satiety signals in the hypothalamus.

• More recent research shows low plasma leptin levels / leptin resistance results in:• obesity, hyperphagia, neuroendocrine dysfunction,

depression, dysregulation of the brain’s reward circuitry, hyperglycemia and insulin resistance, impaired learning and memory

• Leptin receptors have been found in hypothalamus, hippocampus, brain stem, cortex, amygdala, and cerbellum.

Citation: Leptin regulation of neuronal excitability and cognitive function. Harvey, J. Curr Opin Pharmacol, 2007 Dec;7(6):643-7

Page 49: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Symptoms of “Toxic Hunger” /

Withdrawal• Headaches

• Fatigue

• Nausea

• Weakness

• Mental confusion and irritability

• Abdominal and esophageal spasm

• Fluttering and cramping in the stomach.

Symptoms can last from a couple of days to a few weeks.

Page 50: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

True Hunger

• Comes on after glycogen stores have been depleted, when gluconeogenesis begins

• Protects against muscle breakdown

• Different from hypoglycemia, as glucagon naturally activates gluconeogensis

• When eating according to true hunger, not toxic hunger, we learn that we need a lot less food than we think.

Page 51: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Appetite Regulation

Source: Fat, Sick and Nearly Dead, a Joe Cross film.

Page 52: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

How to Achieve True Hunger

1. Do not eat when not hungry.

2. Snack only when it’s true hunger

3. Do not overeat. Don’t eat until you feel full or stuffed

4. Do not eat a big dinner

5. Don’t eat after dinner. Instead, clean the kitchen, brush and floss, and stay away from food. Look forward to how good food will taste the next morning when you are hungry again.

6. Discontinue or wean off caffeine, salt, alcohol, sweets, butter, cheese, processed foods, soft drinks, smoking, and illegal and legal drugs (if safe to do so).

Source: Fuhrman, Joel (2011). Eat to Live: The Amazing Nutrient-Rich Program for Fast and Sustained Weight Loss (p. 166). Hachette Book Group.

Page 53: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Principles of Detoxification

• Optimize:• Digestion• Absorption• Elimination

• Eat:• Clean & fresh • Fiber-rich • Anti-inflammatory• Antioxidant-rich

• Drink:• Water• Herbal Teas• Vegetable broths

• Avoid:• Sugar• Caffeine• Dairy• Wheat• Red meat• Alcohol and drugs• Artificial flavors, colors,

preservatives• Pesticides, hormones etc• Most processed foods• Other food sensitivities

(e.g. soy, eggs, fructose, grains, etc.)

Page 54: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Clients see 50-80% reduction in emotional eating behaviors and cravings

Page 55: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

3. Functional Nutrients for Brain

Health• High potency multivitamin and mineral complex

• Dose: should contain most minerals and 100% or more of the daily value

• B Complex – B6, Folate, and B12 are all needed for methylation, which plays a critical role in neurotransmitter synthesis• Dose: 10-25 times the daily value of all B vitamins; at least

800mcg of folic acid (Marz 1999)

• Omega 3s – EPA and DHA are powerful anti-inflammatory fatty acids for the brain; DHA is the main structural fatty acid in CNS. • Dose: at least 500mg DHA and 500mg EPA (Hyman 2009)

• Vitamin E as Gamma Tocopherol – gamma tocopherol has proven to be more neuro-protective than alpha and other tocopherols (Morris et al. 2005). • Dose: 400 IU with at least 50% in gamma form. (Hyman 2009)

Page 56: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Folate

• Deficiency linked with depression in studies dating back 30 years. About 1/3 of all depressed patients are deficient in Folate.

• 60% of the US population has a genetic polymorphism in MTHFR, which converts 5,10-MTHF to 5-MTHF, the active form

• 5-MTHF is critical for methylation, as well as the regeneration of Tetrahydrobiopterin (BH4), which is the rate limiting step in monoamine neurotransmitter synthesis.

• Effective for people who do not respond well to SSRIs due to low levels of neurotransmitters.

• Source:

• E. Huskisson et al. 2007. The Influence of Macronutrients on Cognitive Function and Performance. The Journal of International Medical Research 35:1-19.

• A. Coppen. 2005. Treatment of Depression: Folic Acid and B12. Journal of Psychopharmacology 19 (1):59-65

Page 57: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com
Page 58: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com
Page 59: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Nutrient Support for Neurotransmitters

Serotonin: • Precursors: 5-HTP, L-tryptophan• Supportive Nutrients: Iron, B6, niacin, folate,

B12, inositol • Dose: 50-200mg 5-HTP in am or 500-1500mg Trp

HIS; 12g/d Inositol (Gelber et al. 2001)

Dopamine & Norepinephrine:• Precursors: L-phenylalanine, L-tyrosine

• Dose: 500-1500mg per day, empty stomach (Hyman 2009)

• Supportive Nutrients: iron, B6, niacin, folate, B12

Page 60: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Nutrient Support for Neurotransmitters

Achetylcholine: • Precursors: choline, acetyl-L-carnitine• Supportive Nutrients: Phosphotidylserine, niacin

• Choline Foods: egg yolks, beef, liver, dairy fat• Dose of acetyl-L-carnitine: 500-1000mg/d empty stomach in am (Hyman

2009)• Dose of Phosphoditylserine: 100-300mg/d (Hyman 2009)

GABA:• Precursor: L-Glutamine • Cofactor: B vitamins, Mg, Inositol

• Dose: 500mg-1500mg L-Glutamine tid; 100-500mg GABA tid (Ross 2004)

Hyperzine-A: a Chinese club moss extract that slows breakdown of achetylcholine

• Dose: 50-200mcg/d (Hyman 2009)

Page 61: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Dopamine & NE Synthesis

Page 62: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Serotonin Synthesis

Page 63: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

GABA Synthesis

Page 64: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Other Considerations

• Endocrine disorders (PCOS, diabetes, hypothyroidism, leptin/insulin resistance, etc.)

• Microbial infections (Candida, EBV, etc.)

• Sunlight/vitamin D

• Exercise

• Water

Page 65: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

When Chemically-Balanced…

• Fewer cravings

• Eat when hungry, stop when full

• Better energy

• Greater mental clarity and emotional resilience

• Less food and body image obsessive thinking

• Fewer negative thoughts and emotions (quieter amygdala)

Page 66: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Cultivate Emotional

Coping Skills

Page 67: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Dealing with Suffering

“Life is suffering.” ~ The First Noble Truth taught by Buddha

“In a world of tension and breakdown it is necessary for there to be those who seek to integrate their inner lives not by avoiding anguish and running away from problems, but by facing them in their naked reality and in their ordinariness.”

~ Thomas Merton

Page 68: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Avoiding Suffering

“It is not the feelings themselves that cause...the compulsive eating... It is our attempt not to feel the feelings.”

Source: Eating in the Light of the Moon, by Anita Johnston, Ph.D.

Page 69: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Pain vs. Suffering

• Buddhist Psychology - • Pain is inevitable• Suffering is not. It is optional

Page 70: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Relationship to Suffering

Attachment Theory:

• How we respond to our feelings and needs is shaped In infancy by our primary caregiver(s).

• How we treat ourselves, in times of distress (typically from unmet needs), is modeled after how they treated us and how they treated themselves.

Page 71: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Attachment Styles

Secure (55-65% of the population)• When a parent is consistently available and able to

meet the needs of a child in a sensitive and attuned manner.

• Child has greater self-esteem, emotional health, and ego resilience; comfortable with intimacy in relationships; has internal sense of security and worthiness

Anxious/Pre-occupied• When a parent is inconsistent in h/her ability to meet a

child’s needs in a responsive and appropriate manner.• Child exhibits greater anxiousness and insecurity; pre-

occupied with approval seeking

Page 72: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Attachment Styles

Avoidant• When a parent consistently fails to be available or

able to meet a child’s needs.• Child is more independent and isolated. Avoids

people or pushes them away.

Disorganized• When a parent is experienced as a source of danger

and safe haven. • Child exhibits learned helplessness; lacks a coherent,

organized strategy for coping

Children with insecure attachment styles have higher measured cortisol levels.

Page 73: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Emotional Hunger

Hunger as a metaphor:

“Longing for food is longing for emotional and spiritual nourishment. It is often a longing for the ideal mother, the archetypal Good Mother who nourishes us, soothes us, and loves and accepts us just the way we are.”

Source: Eating in the Light of the Moon, by Anita Johnston, Ph.D.

Page 74: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Basic Human Needs

• Love

• Connection

• Safety

• Physical well-being

• Honesty

• Play

• Peace

• Autonomy

• Meaning

• Hope

Source: http://www.cnvc.org/Training/needs-inventory

Page 75: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

When Needs Are Met

• Affectionate

• Engaged

• Hopeful

• Confident

• Excited

• Grateful

• Inspired

• Joyful

• Exhilarated

• Peaceful

• Refreshed

Source: http://www.cnvc.org/Training/feelings-inventory

We feel:

Page 76: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

When Needs Are Unmet

• Afraid

• Annoyed

• Angry

• Confused

• Aversive

• Disconnected

• Disquiet

• Embarrassed

• Fatigue

• Pain

• Sad

• Tense

• Vulnerable

• Yearning

Source: http://www.cnvc.org/Training/feelings-inventory

We feel:

Page 77: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Re-parenting Ourselves

• Our parents did the best they could. We have to pick up where they left off.

• We must learn to nourish and sooth ourselves in a consistent, sensitive, attuned, and appropriate manner.

• In other words, we have to become our own secure base to which we can return in times of need.

Page 78: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Food as Surrogate Mother

• Until we learn to parent ourselves, food serves as a surrogate mother who is always there, promising to consistently and reliably provide comfort.

• “Food is the only thing I can count on in life to…• …always be there for me.”• …make me happy.”• …not disappoint me.”

Page 79: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Counselors Role

• Model a healthy compassionate relationship, teaching the client how to appropriately self-sooth.

• Help clients more accurately interpret their physical sensations, emotions, and needs.

• Teach them appropriate coping for different needs.

• The client will then eventually internalize and integrate the counselor’s voice as her own.

Page 80: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Ideal Nurturer

Qualities include:• Patient• Good listener• Compassionate• Empathic• Understanding• Forgiving• Strong• Reliable• Responsible• Clear boundaries

Page 81: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Two Types of EE

• Emotionally Avoidant Eating• Eating to not feel

• Emotionally-Attuned Eating• Eating that is attuned to underlying

feelings and needs

Page 82: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Emotional Attuned Eating

• Step 1 – Pause

• Step 2 – Tune in

• Step 3 – Feel

• Step 4 - Respond with self-compassion

• Step 5 – Provide

• Step 6 – Receive

Page 83: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Step 1 - Pause

• Breaks automatic behaviors

• Allows us to connect with the voice of our inner nurturer

• This is where awareness and change can come in

• Strategies include:• Deep breathing• Leaving the room• Drinking water• Counting to 100• Walk around the block…

Page 84: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Step 2 – Tune In & Listen

As an ideal mother would for her child, help to name and interpret the experience.

Ask yourself:• What am I feeling (physically, emotionally)?• What am I needing/yearning for?• What am I believing about my experience? (pain vs. suffering)

• Is this feeling familiar? How old do I feel when I feel this? What memories from the past come to mind? (Tapping into implicit memory encoded in our amygdala)

Stay present and receptive. Listen to the whole story, without judgment or fixing (this accesses our hippocampus and cortex, strengthens higher executive functioning; enables new, explicit memory to form)

Page 85: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Step – Tune in & Listen

• “Can you imagine how your life would have been different if each time you were feeling sad or angry as a kid, an adult said to you, ‘Come here, sweetheart, tell me all about it?’ If when you were overcome with grief at your best friend's rejection, someone said to you, ‘Oh, darling, tell me more. Tell me where you feel those feelings. Tell me how your belly feels, your chest. I want to know every little thing. I'm here to listen to you, hold you, be with you.’”

~ Geneen Roth

Page 86: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Step 3 – Feel Fully

• As with mindful eating, approach the feeling as if you’ve never experienced it before.

• Give yourself 20 min in which you won’t be disturbed.

• Sense your body. Feel the surface you’re sitting on.

• With total curiosity and objectivity, notice where you feel the emotions in your body.

• Describe your sensations – shape, volume, texture, color, intensity, temperature, etc.

• Soften instead of contract around the sensations. Move towards rather than away from them. Breath deeply into them until they subside and pass.

Page 87: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

The Wisdom of Emotions

• Powerful way for our body and psyche to communicate.

• They not only lead us to safety and away from potential dangers, they also let us know when we are living in or out of alignment with who we really are and how we want to live.

Page 88: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

The Wisdom of Emotions

• Anger: determination, strength to stand our own ground, energy and focus to let the world know what is and is not okay.

• Fear: opportunity to learn trust and gain courage. Discover what we really need to feel safe. Denying it is paralyzing, sends us into panic and stagnation.

• Loneliness: gift of self-awareness, may learn why you keep others at a distance and how you do it.

• Sadness: gift of healing and cleansing past wounds with tears. Compassion for ourselves and others. Feeling oneness with the human race as none of us are exempt from suffering.

• Jealousy: gift of making us awareness of what we truly desire.

Page 89: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Step 3 – Feel Fully

• “All any feeling wants is to be welcomed with tenderness. It wants room to unfold. It wants to relax and tell its story. It wants to dissolve like a thousand writhing snakes that with a flick of kindness become harmless strands of rope.”

~ Geneen Roth

Page 90: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Step 4 – Self-Compassion

• Identify and disengage from inner critical voices, such as:

ED,

The Perfectionist,

The Workaholic,

The Minimizer,

The Victim,

The Child,

The Rebellious Teen, etc…

Page 91: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Step 4 – Self-Compassion

• Be warm and understanding towards ourselves when we suffer, fail, feel inadequate, fear the unknown, etc.

• Recognize that suffering, vulnerability and imperfection are part of being human.

Resources: • Radical Acceptance by Tara Brach

(book) • Self-Compassion by Kristen Neff (book)• The Power of Vulnerability by Brene

Brown (TEDtv)

Page 92: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Step 5 - ProvideWhat kind of nourishment would best meet your needs?

Page 93: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Step 5 - Provide

• How are you providing for yourself?• With a loving Intention?• With a punishing Intention?

• Who are you feeding?• Self-compassionate voice?• Self-critical voice?

(Which part of your brain are you strengthening? Old brain or new brain?)

Whatever we feed, grows.

Page 94: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Step 6 - Receive

“To take in the nourishment that’s offered…we have to believe that we are valuable and worthy to receive.”

~ Hale Sofia Schatz

• Physically: Whatever you decide to eat, say “I choose to have this,” then chew well, savor, and enjoy it fully. Allow time for digestion.

• Emotionally: Give yourself full permission (and as much time as you need/can) to rest, play, do nothing, vent, grieve, etc., without guilt.

• Mentally: Give yourself time to reflect on and integrate your experience. Often, clarity, insight and understanding come after feeling fully.

• Without receiving, we remain emotionally starved. (“snack” vs. a “full meal”)

Page 95: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

What does freedom look like?

Page 96: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

What does freedom look like?

• Becoming our own ideal nurturer is a lifelong process.

• There is no end point but there are many rewards along the way.

• Discipline - Roaming free in a small meadow• Eat mostly clean, stabilizing fuel for the brain & body• Regularly listening and responding to our feelings/needs• Valuing our strengths and respecting our limitations

• Conscious choices based on knowledge of:• Biochemical costs and benefits• Emotional costs and benefits

• Aligning with a loving intention for our body, mind and spirit, so we can grow to be the fullest expression of ourselves.

Page 97: Emotional Eating: An Integrative Perspective By Ying Yu, MS, CN, CHC January 10, 2012 (206)729-5111 ying@greenlakenutrition.com

Q & A