Food Addiction - Compulsive Food Behaviours

[BlueArmy]

Richard Osman's recent discussion desert island disc's regarding food addition got me thinking

Richard Osman opens up to Desert Island Discs about food addiction

The author and TV host speaks about the "shame" behind his lifelong struggle with overeating.

www.bbc.co.uk

First of all, I sadly recognised much of what he was talking about. Second, obesity is an underlying factor with T2 diabetes, and my own experience of the NHS is that they go straight after treating the problem, not digging into the cause. I am convinced I have some form of eating disorder. I can go for months with everything under control, but then go through binge stages, more recently driven by yet another lockdown clashing with that over consuming part of the year known as xmas. Even though I know its bad for me, even though I know I shouldn't do it, even though I have been able to demonstrate to myself for months on end I can do, even though my libre is telling me its hurting, I can still go through binge eating phases. People might say just get a grip man, but its deeper than that. You know your doing it, you know you shouldn't do it, but you almost black out mentally and do it anyway, kidding yourself for a brief moment it will be ok.

Has anyone here had issues with the mental side of weight management and have you had any treatment for it and what did you do to get that treatment plan in place?

 

[AndBreathe]

Richard Osman's recent discussion desert island disc's regarding food addition got me thinking

Richard Osman opens up to Desert Island Discs about food addiction

The author and TV host speaks about the "shame" behind his lifelong struggle with overeating.

www.bbc.co.uk

First of all, I sadly recognised much of what he was talking about. Second, obesity is an underlying factor with T2 diabetes, and my own experience of the NHS is that they go straight after treating the problem, not digging into the cause. I am convinced I have some form of eating disorder. I can go for months with everything under control, but then go through binge stages, more recently driven by yet another lockdown clashing with that over consuming part of the year known as xmas. Even though I know its bad for me, even though I know I shouldn't do it, even though I have been able to demonstrate to myself for months on end I can do, even though my libre is telling me its hurting, I can still go through binge eating phases. People might say just get a grip man, but its deeper than that. You know your doing it, you know you shouldn't do it, but you almost black out mentally and do it anyway, kidding yourself for a brief moment it will be ok.

Has anyone here had issues with the mental side of weight management and have you had any treatment for it and what did you do to get that treatment plan in place?

In my 20s I spent a number of years anorexic. I did have treatment, and thankfully moved on from it. Fortunately my treatment helped me understand what was at the root of my issues, and equally thankfully, I am now able to recognise if/when a trigger point could be in play.

In terms of yourself, BlueArmy, have you heard of Dr Jen Unwin? She is a psychologist who has done a lots of work on food addiction. She recently published a book called "Fork in the Rood". (All profits from the book go to the Public Health Collaboration to support it's aims. I see it's free with Kindle Unlimited:

Amazon.co.uk : fork in the rood

Jen also runs a weekly group, on a Wednesday evening, on Clubhouse where food and eating challenges are discussed. Anyone can join in with it.

https://www.clubhouse.com/club/fork-in-the-road

I do wish you well. Disordered eating isn't a happy place to be.

 

[Bloden]

Hi there @BlueArmy. 🙂 I had binge eating disorder for ten years. I didn’t get professional help cos I didn’t realise I had an illness as such. I read every food, diet, fad book going. Eventually I read “Overcoming Overeating” by Jane Hirschmann...Wow! It turns out I was eating my emotions instead of feeling them. I worked thru the book (there are exercises, etc to do) and haven’t looked back. (I seem to remember writing a piece about the book for this forum’s Books section).

There isn’t an instant fix, and dealing with my issues wasn’t easy, but I’m so relieved I found the book and sorted myself out! 🙂 Good luck.

 

[everydayupsanddowns]

Thanks for sharing your experiences @BlueArmy - it’s a really important topic.

I’ve heard more than one clinician say that a diagnosis with diabetes is more or less a recipe for disordered eating (even if your relationship with food up to that point had been fine), so I think as people with diabetes we are always going to have to keep a close eye on food / weight management / eating behaviours from a mental health perspective, both where we are now, and also anything in our past that may have led us to this point.

 

[rebrascora]

I’ve heard more than one clinician say that a diagnosis with diabetes is more or less a recipe for disordered eating (even if your relationship with food up to that point had been fine)

I think it can work both ways. For me, I have struggled with undiagnosed disordered eating for many years.... perhaps stemming from working rotating shifts for a lot of years.
My diabetes diagnosis seems to have actually helped me to find a way to live with it. Certainly not cured but under control and having control is bliss. For me low carb is the answer. It has stopped the knuckle gnawing cravings. The occasional times I have strayed into eating a more normal diet (bread particularly seems to knock me off the rails), the cravings have come back with a vengeance and taken weeks to regain control. Once I am back on track with my low carb way of eating, I find it relatively easy to maintain, even though I need the odd jelly baby to treat hypos most days, that seems to be OK and not trigger me. I still don't follow an ordered way of eating, ie have 3 meals a day..... sometimes just 1 or mostly 2 meals and some days I graze rather than having meals, but as long as I keep the carb intake low and avoid the high carb foods, I don't feel hungry or suffer cravings or be tempted to over eat.

 

[Bloden]

Thanks for sharing your experiences @BlueArmy - it’s a really important topic.

I’ve heard more than one clinician say that a diagnosis with diabetes is more or less a recipe for disordered eating (even if your relationship with food up to that point had been fine), so I think as people with diabetes we are always going to have to keep a close eye on food / weight management / eating behaviours from a mental health perspective, both where we are now, and also anything in our past that may have led us to this point.

I agree @everydayupsanddowns. I said in my post “I haven’t looked back” but, as you say, I do find HAVING to eat when I’m not hungry (to boost my BG before exercise, eg) hard sometimes. 🙂

 

[joner847]

@BlueArmy I can identify what you're going through as I have this problem too!! I have no short-term memory, discovered as part of an ADHD diagnosis, having spent a few days with an educational psychologist to find out why I'm unable to perform tasks that require memory recall....taking exams, public speaking where prompts are not allowed (e.g. Interviews!).

I'm told that I have no "executive" control; so at the moment I can sit here and rationally think of the foods in the cupboard that I shouldn't eat, but give it a couple of hours and, with the raging "munchies" will demolish most of that list!! I also think that I should simply "man-up" as that is how I was brought up....but can't help these binges...why do I do it? Get really annoyed to the point of slapping yourself around the head. So you're not alone here.

 

[Eddy Edson]

I recommend checking out this thread: https://forum.diabetes.org.uk/boards/threads/guyenet-on-weight-loss-meds.95831/

It talks about how the new class of weight loss meds ("GLP-1 receptor agonsists") like semaglutide came to be. Thekey effect of these seems to be the reduction of addictive behaviour in general:

Not only are people who take semaglutide less hungry, they’re less easily seduced by tempting, calorie-rich foods. Research from two independent groups suggests that semaglutide causes food cravings to fade quite substantially. You might be tempted to attribute this to the reduction in hunger, which after all is “the best sauce.” That’s probably part of the story, but not all of it. In Macklin’s patients, semaglutide reduces the drive to engage in a wide spectrum of dopamine-fueled behaviors, including drinking alcohol and shopping. “People say they’re on Amazon way less,” observes Macklin.

The animal research backs this up, reporting that semaglutide and similar drugs reduce alcohol intake in alcoholic monkeys and the use of a variety of dopamine-spiking addictive drugs in rodents. So one reason why semaglutide is so effective may be that it curbs food intake from two angles: our brain’s perceived need for calories (hunger), and our tendency to be seduced by food even when we aren’t hungry (reward). “They are no longer subject to the prime symptom of obesity,” observes Macklin of his patients, “which is this motivational drive to eat, triggered by external cues around them, modulated by stress and fatigue.”

Seeley believes semaglutide and similar drugs act in another important way: they directly or indirectly affect the brain circuits (mostly in the hypothalamus) that regulate the size of the body’s fat stores, making the body “want” to be leaner.

To understand this possibility, we must first understand something fundamental about obesity. Body fatness isn’t just the haphazard result of however much we decide to eat and how often we go for a jog—it’s actively regulated by the brain, with strong genetic influences. And the brain’s “setpoint” for body fatness is higher in people with obesity.

And so on. The key message of the underlying research is that the human bod & brain have design flaws: for many people, exposed to the "obesogenic" modern food environment, this desgin flaw will make you eat a lot when you're stressed, bored, whatever. "Willpower" probably doesn't cut it. If you're seriously affected, as many people obviously are, you may well need meds like these to compensate for nature's crappy design work.

There will be more & more drugs of this class - several in Phase 3 trials at the moment - hopefully bringing down costs & reducing side effects.

 

[AndBreathe]

I recommend checking out this thread: https://forum.diabetes.org.uk/boards/threads/guyenet-on-weight-loss-meds.95831/

It talks about how the new class of weight loss meds ("GLP-1 receptor agonsists") like semaglutide came to be. Thekey effect of these seems to be the reduction of addictive behaviour in general:

Not only are people who take semaglutide less hungry, they’re less easily seduced by tempting, calorie-rich foods. Research from two independent groups suggests that semaglutide causes food cravings to fade quite substantially. You might be tempted to attribute this to the reduction in hunger, which after all is “the best sauce.” That’s probably part of the story, but not all of it. In Macklin’s patients, semaglutide reduces the drive to engage in a wide spectrum of dopamine-fueled behaviors, including drinking alcohol and shopping. “People say they’re on Amazon way less,” observes Macklin.

The animal research backs this up, reporting that semaglutide and similar drugs reduce alcohol intake in alcoholic monkeys and the use of a variety of dopamine-spiking addictive drugs in rodents. So one reason why semaglutide is so effective may be that it curbs food intake from two angles: our brain’s perceived need for calories (hunger), and our tendency to be seduced by food even when we aren’t hungry (reward). “They are no longer subject to the prime symptom of obesity,” observes Macklin of his patients, “which is this motivational drive to eat, triggered by external cues around them, modulated by stress and fatigue.”

Seeley believes semaglutide and similar drugs act in another important way: they directly or indirectly affect the brain circuits (mostly in the hypothalamus) that regulate the size of the body’s fat stores, making the body “want” to be leaner.

To understand this possibility, we must first understand something fundamental about obesity. Body fatness isn’t just the haphazard result of however much we decide to eat and how often we go for a jog—it’s actively regulated by the brain, with strong genetic influences. And the brain’s “setpoint” for body fatness is higher in people with obesity.

And so on. The key message of the underlying research is that the human bod & brain have design flaws: for many people, exposed to the "obesogenic" modern food environment, this desgin flaw will make you eat a lot when you're stressed, bored, whatever. "Willpower" probably doesn't cut it. If you're seriously affected, as many people obviously are, you may well need meds like these to compensate for nature's crappy design work.

There will be more & more drugs of this class - several in Phase 3 trials at the moment - hopefully bringing down costs & reducing side effects.

Eddy, whilst I think it's wonderful that something has been found to help with weight loss and reducing addictive behaviours, I think it is a very sinister path if all that happens for those requiring help is the provision of a little tablet to fix it all, because let's face it what is being addressed is the symptom, not the root cause.

Like almost everything, semagultide isn't without potential side effects, which the BNF lists as:

Side-effects​

Common or very common​

Appetite decreased; burping; cholelithiasis; constipation; diarrhoea; dizziness; fatigue; gastrointestinal discomfort; gastrointestinal disorders; hypoglycaemia (in combination with insulin or sulfonylurea); nausea; vomiting; weight decreased

Uncommon​

Pancreatitis acute; taste altered

What many people really need is time and therapies to help understand the cycles and root causes.

Finally, not all food addictions involve obesity.

 

[nonethewiser]

Everyone can over binge especially round special occasions like xmas birthdays anniversaries, that is normal human behaviour.

If it's more that that then counselling will help, just avoid books videos that alienate food groups as that will only make issue worse, book & methods that Bloden mentioned earlier sounds like good starting point.

 

[Elenka_HM]

I’ve heard more than one clinician say that a diagnosis with diabetes is more or less a recipe for disordered eating

I was quite worried about that when I got diagnosed. I had always associated counting calories and such with people doing extreme diets or suffering from eating disorders. I also tend to obsess over food. So not very excited about carb counting. I know it will be important for my Diabetes management, so when time comes I will share my concerns with the diabetes team and try to approach it in a mentally healthy way.

 

[Eddy Edson]

what is being addressed is the symptom, not the root cause.

I think you will find this is increasingly a minority view amongst the experts. In other words, the mismatch of the gut/brain feedback system and the food environment is the common driver of eating-too-much disorders, and if you try to deal with it just through behaviour modification or whatever it won;t produce anything better than the rather dismal results such approaches do in fact approach. I think increasingly these behavioural approaches are being seen as the adjunct, not the core therapy.

 

[Mrs Mimoo]

I have ADHD which means I'm continally seeking stimulation. Food was one of those stimulants. I now look for other ways to keep me interested. I would like some treatment for ADHD but private is over a grand and the NHS does not want to know.

 

[Deleted member 21371]

I think you will find this is increasingly a minority view amongst the experts. In other words, the mismatch of the gut/brain feedback system and the food environment is the common driver of eating-too-much disorders, and if you try to deal with it just through behaviour modification or whatever it won;t produce anything better than the rather dismal results such approaches do in fact approach. I think increasingly these behavioural approaches are being seen as the adjunct, not the core therapy.

You are right.
My daughter is a psychiatric nurse specialising in eating disorders in children.
There are some excellent treatments being developed, the old school thought of treating through talking therapy doesn't address the issue of an actual physical problem, and there is good evidence this is becoming more commonly found.

 

[AndBreathe]

I think you will find this is increasingly a minority view amongst the experts. In other words, the mismatch of the gut/brain feedback system and the food environment is the common driver of eating-too-much disorders, and if you try to deal with it just through behaviour modification or whatever it won;t produce anything better than the rather dismal results such approaches do in fact approach. I think increasingly these behavioural approaches are being seen as the adjunct, not the core therapy.

I believe that only a minority of those with eating disorders receive treatment at all; whether because they themselves don't realise their behaviours represent an eating disorder, partly because those living in an overweight state, without being massively obese are just told to eat less and move more and partly because there simply aren't enough resources to give the care really required.

Eating disorders, and disordered eating are often well hidden.

 

[Hardy]

Blue Army - I have struggled with binge eating disorder or bulimia all my adult life (now in 50's), morphing from one to another and back again. My diabetic control is better when the eating disorder is less acute. I have had treatment from an eating disorders service, which has helped but it will no doubt be a life long struggle for me.

I choose foods at times which some would say are not a good choice as a diabetic (for example a regular size chocolate or single ice cream) BUT the risk of the the eating disorder and impact on my mental health is greater than the diabetes. Avoiding chocolate or ice cream or crisps, for me, leads to eating disorder behaviour of binging on that food.

GP's aren't always good at identifying eating disorders, so its good to go prepared. A helpful website is BEAT (beat eating disorders) it has really useful information, and offers a support service too. Eating Disorder services often require a referral from the GP, and they offer a service if you meet the criteria for services that they are commissioned for.

It can improve for you, Blue Army but its hell when things are bad.

As Bloden said, its often the emotional side that needs to be addressed (whilst at the same time being nourished). Which is where self help books or finding a service that can offer treatment can assist.
Good luck

 

[Bloden]

Eating disorders, and disordered eating are often well hidden.

My problem was a secret - how could I put something into words when I didn’t understand what was going on? It was a very lonely experience.

 

[AndBreathe]

My problem was a secret - how could I put something into words when I didn’t understand what was going on? It was a very lonely experience.

If agreeing 10000% made sense, I'd agree that much. Secret and very complex in the experience of many, I'd say.