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  • 6/28/2013

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    FoodAddiction:AnOverlookedCauseofPersistent

    OverweightandObesity

    LaVeraJ.Forbes,PhDCenterforFoodAddictionFreedomlavera@FoodAddictionFreedom.com

    6787639266

    Goals

    Explainrecenttheoreticaladvancementsinobesityresearch

    Identifysymptomsoffoodaddictionscientifically

    Providenewtoolsandresources

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    TherapyMedicationSurgery

    SustainedWeightLoss

    WeightBias

    Theinclinationtoformunreasonablejudgmentsbasedonapersonsweight

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    WeightBiasinAmerica Common

    Acceptable

    Hardtoignore

    Happensin:

    Education

    Employment

    PersonalRelationships

    HealthCare

    ComplexityofObesity

    Neurological

    BlamethePerson

    Itstheirfault. Personwontchangebehavior.

    Figureitoutthemselves.

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    WHATWILLYOUGIVEUP? 46%ofsubjectsreportedthattheywouldbewillingtogiveup

    atleast1yearoflife 5%reportedthattheywouldgiveup10yearsormoreoftheir

    life. 30%ofrespondentsreportedthattheywouldratherbe

    divorced 25%reportedthattheywouldratherbeunabletohave

    children 15%reportedthattheywouldratherbeseverelydepressed 14%reportedthattheywouldratherbealcoholic. Thequestiontheresearchersdidnotask:Weretheywillingto

    abstainfromdessertsandothercomfortfoods?Obesity,2006(OBESITYVol.14No.3March2006)

    ImpactofPhysicianWeightBias

    Jeopardizepatienthealth CorrelationbetweenhighBMIandfewerexams

    Delayoravoiddoctorvisits

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    OtherCopingResponses

    Isolation Depression SocialWithdrawal

    AMAStrategiesforReducingBiasAgainstOverweightandObesePeople

    Recognizethatobesityisachronicmedicalcondition

    Improveyourknowledgeofnutrition,multidisciplinarytreatments,andcommunityresources

    Createafriendlyofficecultureandatmosphere

    Treattheoverweightandobesepopulationwithrespectandsupport

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    MostcommonstrategyusedbyWellnessProviders

    WhatPeopleWant

    Howtostopthecravings

    Whytheyovereat

    Whytheyeatthewrongfoods

    Howtomanageemotionaleating

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    WhyPeopleOvereat

    AccessibilityAvailabilitySedentarylifestyleCheapfoodEmotionaleating

    WhyDoPeopleOvereat?

    Despiteeffortstoloseweight

    Despitetheconsequences

    FoodAddictionFood

    Addiction

    ChronicOvereatingChronic

    Overeating

    BingeeatingBingeeating

    ObesityObesity

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    NegativeBeliefs

    Lazy Noncompliant Undisciplined Lowwillpower

    BrookhavenFindingsU.S.DeptofEnergy,BrookhavenLab

    Sightandsmelloffoodelevatesdopamine Affectsthepleasureandrewardcenters Biochemicalprocessinducesintensecravingsandlossofcontrol

    Increaseindopamine=increasedhungeranddesireforfood.

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    Foodcravingssimilartodrugcravings. Dopaminecanbetriggeredwithouteating. Reasonpeopleeatwhenfull Reasonpeoplelosecontrol

    RushUniversityMedicalCenter2006

    Environmentalcluestriggercravings Modulatefoodseekingandfoodintake Appetizingfoodschangethebrain Promotesincreasedhunger Notallfoodsproducetheresponse

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    WhatMakesFoodAddictive?

    Processed(Palatable)Foods

    HighConcentrationsof:SugarFlourFatSaltCaffeine

    CausesOverConsumption

    Enhancesrewardneurochemistry

    Increasesdesiretoovereatthesefoods

    Resultsinaddictivelossofcontrol

    Foodcompaniesareaware

    RefinedVS.Unrefined

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    UnrefinedFoods

    Foundinnature Notaddictive

    RefinedFoods

    Thefoodspeoplecrave Refinedbyanindustrialprocess Notaddictiveuntilextractedandconcentrated Refiningenhancesaddictivepower

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    Food - RewardCertainfoodsenhancetherewardneurochemistry:

    Serotonin:warmmilk,pasta,potatoes,bananas,turkey

    Dopamine:sugar,whitestarches Opiates:chocolate,sugar,dairy,spicesAddictionsUnPlugged

    Addictivelossofcontrol Majorimplicationsforassessmentandtreatment

    TheFindings

    Cannotgenerallyattributeobesitytofoodaddiction

    Allobesepeoplearenotfoodaddicts Palatablefoodsdonothavethesameeffectoneveryone

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    FactorsContributingtoObesity

    Foodaddiction Poordigestion Hormonalissues Oxidativestress Inflammation Lowimmunesystem Chronicstress

    Toxinsinthebody Anobesogenicenvironment

    Genetics Ageandgender Emotionaleating

    FoodAddiction

    Achronicrelapsingproblemcausedbyvariousfundamentalfactorsthatencouragecravingforfoodorfoodsubstancessoastoobtainastateofheightenedpleasure,energyorexcitement.

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    Carbohydrates PotatoChips Pastries Pasta FrenchFries

    Sugar Cookies Cake Candy Sodas

    HighestIncreaseinConsumption

    Highfructosecornsyrup

    Softdrinks Flour

    ImpactofRefinedCarbohydrates

    IncreaseinType2Diabeteswithincreasedconsumptionofcornsyrup

    IncreaseinType2Diabeteswithincreasedcarbohydrateintake

    IncreaseinType2Diabeteswithincreasedconsumptionofrefinedgrains readytoeatcereals

    Increaseofobesitywithincreasedcarbohydrateintake

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    Peopleovereatcarbohydrates Unawareofdopaminerelease

    SugarAddiction

    Dr.NicoleAvenas Research

    Studiedsugaraddiction Eatingstyleencouragesaddictiveeating Restrictionandbingeing Promotesaddictiveeatingbehaviors

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    PrincetonUniversity

    Palatablefoodsalsoreleaseopiods Excessivesugarcausebehavioralandneurochemical signsofdependency

    Causesopiod withdrawal Withdrawalfromsugarsimilartowithdrawalfromnicotineandmorphine

    FoodAddictionHypothesis

    Peoplecanbecomeaddictedtopalatablefoods

    Addictioncreatesdependence

    DSMIVTRdefinition Substancedependencethat

    meets3of7criteria Occurringwithinoneyear

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    SubstanceDependenceCriteria

    Tolerance WithdrawalSymptoms Takinginlargeramountsorforalongerduration Attemptstocutdownorcontroluse Excessivetimespentpursuing,using,orrecoveringfromuse

    Reduction/discontinuationofimportantactivitiesbecauseofuse

    Continuedusedespiteconsequences.

    Neurochemical Response

    Food Activatemesolimbic

    dopaminerewardsystem Significantlylower

    dopaminereceptorlevels Decreasedsensitivityinthe

    rewardsystem Causeslossofcontrol

    Drugs Activatemesolimbic

    dopaminerewardsystem Significantlylower

    dopaminereceptorlevels Decreasedsensitivityinthe

    rewardsystem Causeslossofcontrol

    NIDAStudy

    Obesepeoplemayneedtoovereattogetgratification

    Foundsimilaritiesbetweencompulsivedrugabuse,overeating,andgambling Brainchanges Rewardcircuitsdisrupted Involuntarybehavior

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    LowerLevelsofD2Receptors

    DopamineandSerotonin

    Obesepeoplehavelowerlevels Obesepeopleanddrugaddictshavesimilarlevels

    Peoplecanbeaddictedtofoodlikedrugoralcoholaddictions

    IfFoodAddictionExists

    Anaddictionmodelshouldbeused Avoidtriggerfoods Followanabstinentbasedfoodplan UsethesameapproachasAA Abstinencemaybeharderwithfood

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    FoodAddictionIntervention

    Motivation(Mentoring/Coaching)

    CognitiveBehavioralTherapy

    12StepPrograms

    AbstinencefromTrigger/BingeFoods

    Expectlongtermcare

    12StepProgramsReferralSources

    FoodAddictsAnonymous

    FoodAddictsInRecoveryAnonymous

    OvereatersAnonymous CenterforFoodAddictionFreedom

    FoodAddictionInstitute

    CenterforFoodAddictionFreedomwww.FoodAddictionFreedom.com

    6787639266

    Assessmentandtreatment Detoxification Teleclasses Coaching SupportGroups Abstinentbasedmealplans

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    SampleAbstinentBasedMealPlanFAABasicFoodPlan

    Breakfast Lunch(4hrs afterbreakfast)

    Dinner(5 hoursafterlunch)

    MA(MetabolicAdjustment)(4hrsafterdinner)

    1Protein 1Protein 1Protein 1Dairyor2ozProtein

    1Dairy 1Cooked Vegetable 1CookedVegetable 1Fruit

    1Fruit 1FreshVegetable 1FreshVegetable

    1GrainorStarchyVegetable

    dailyoil 1Grain orStarchyVegetable

    Menadd1fruitor1grain,or1starchyvegetable

    dailyoil

    YaleFoodAddictionScale

    Validatedinstrument AssessfoodaddictionusingDSMIVTRcriteria 21itemselfscoringmeasure Identifiessignsofaddictiontopalatablefoods Easytoadminister

    Summary

    Peoplenoticeweightbias Foodaddiction maybethecauseofchronicovereatingandobesity

    Triggerfoodsstimulateneurochemicalsandheightensrewardinthelimbicsystem

    Dietandexerciseadvicealoneisnotenough Helppeopleunderstandandmanagetheirfoodcravingsinstead

    Assessforfoodaddictionandrefertoareliablesource Abstain,Abstain,Abstain!

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  • Yale Food Addiction Scale Gearhardt, Corbin, Brownell, 2009

    Contact: ashley.gearhardt@yale.edu

    This survey asks about your eating habits in the past year. People sometimes have difficulty controlling their intake of certain foods such as:

    - Sweets like ice cream, chocolate, doughnuts, cookies, cake, candy, ice cream

    - Starches like white bread, rolls, pasta, and rice

    - Salty snacks like chips, pretzels, and crackers

    - Fatty foods like steak, bacon, hamburgers, cheeseburgers, pizza, and French fries

    - Sugary drinks like soda pop

    When the following questions ask about CERTAIN FOODS please think of ANY food similar to those listed in the food group or ANY OTHER foods you

    have had a problem with in the past year

    IN THE PAST 12 MONTHS: Never Once a month

    2-4

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