I've been meaning to write for days, but somehow I just did not get around to it. This week has been a bit crazy--another post on that later, and my emotions are beginning to wear on me.
But first I want to write this post. I had this knock on the door on Thursday night at 11pm. I'm thinking who could be knocking at my door this late? In walks my neighbor, the one who went through detox. She came in and gave me a big hug and said she felt great! I was thrilled for her, though a part of me was slightly stunned at how "high" she seemed, sober but high. Even she admitted, she was on a pink cloud.
Truly, this seemed to be really good for her. She said she felt like she is in a better place. I think she really enjoyed rehab as it felt like a bit of a vacation for her. She had a few ups and downs, like breaking her glasses and not being able to see well, but overall, she loved the people there, said they fed her well, and got her head back, etc.
There were two things B. said that stuck out to me. One was about her experience with the people at rehab. There were a variety of ages--some with alcohol issues, others with drug dependency issues. She explained that she and several other older persons were trying to get through to some young people who were heroin addicts. She said, it was like they just didn't get it--that they could not see how much they were wrecking their lives. They tried to tell them that they did not want to have these addictions years on end. She said she and several of the other older women felt like they got through to them, and that felt good to her.
The other thing B. said was how reading the Big Book (this is the AA book) this time around was different. She had read it a number of times before, but it just didn't make sense to her or was meaningful. But now, being sober, she felt like she finally understood it. It made sense, and she could put value in it. This reminded me of the weight restoration stage for many with eating disorders. Prior to that, therapy or anything else won't be as effective if at all. It's a testament to how we have to be a bit clear-headed both physically and emotionally in order to fully grasp real treatment.
B. still has a lot of work ahead of her, but I think she will get there step by step. She will have IOP 3x/week plus her AA meetings. She's beginning to learn what her triggers are and is trying to find other means to cope. She says her family is backing her and willing to help, so I hope that happens.
As for me, I'm the neighbor and friend to be there, supporting her along the way.
Showing posts with label addictions. Show all posts
Showing posts with label addictions. Show all posts
Monday, June 27, 2011
Wednesday, June 15, 2011
Detoxing
Monday was an ironic day. I finished up the bartending school and passed the final exams. I was really happy with myself and excited to call my parents and let them know. I also wanted to let my neighbor B. know, except that she told me her news first. She decided to go into rehab for her drinking problem. (I discussed this in a post here)
This surprised me, but I was also quite proud of her for taking this additional step. The day before we were chatting about her and her family's trip to New York. There were some interesting stories like almost losing one of her sons to the Canadian border while they were visiting the Niagra Falls. She had told me that she knew she needed to stop drinking and that when her dad's inheritance estate was finalized, and there was more money, she would go.
That Monday morning, her hands began shaking, and she needed a beer. I guess for whatever reason, it clicked with her. She called her sponsor who was thrilled with her decision, and then basically said she should just have all the beer she wanted that night, because she never would again.
B. asked me to come over and hang out. I did hang out with her from like 8:30pm - 1:30am. It was a long night and by midnight, I was asking her if she planned on going to bed soon. But at the same time, I knew she was more nervous than she let on about going.
We chatted quite a bit. It was essentially the same conversation we had almost a year ago when we had talked about this. I think during this time, she slowly got worse. She's lost a bit of weight substituting beer for food. Her memory has also been affected. I watched last night as the more she drank, the more forgetful she would become, telling me the same story over and over. Then, I'd see her stagger to find wood for the fire pit. It was difficult to watch.
When I asked her what made her decide to go to rehab now, she said she wasn't sure other than she knew she needed to go. For many people around her, with the exception of her family, most did not realize she had that big of a problem, simply because she is a functional alcoholic. She has not had some of the typical losses an addict might have--a career (she did lose her job but that was not through fault of drinking--it became a reason later however to drink later), a house, going into debt, etc. I told her that some people do not hit a rock bottom, but that they simply get to a point of being sick and tired of being sick and tired. Her eyes lit up with a "yes, that is exactly it."
During the past year, she has continued to go to AA meetings, but it was obvious, this was not enough and she needed a higher level of care. I think part of the problem too was that she saw a lot more people worse than her, so it undermined the what the severity of the problem though she knew she had one.
Although I do not completely agree with the entire AA philosophy, I've always felt that everyone has to do whatever feels right and will suit them for treatment. For her, she feels she has just not surrendered herself to God/a higher power. Personally, I think it is a lot more than that, but if that is what she needs/believes, then certainly, it can be helpful.
She will be in an inpatient program detoxing for 10 days, though she could be there for 30 days. I'm hoping she will take the 30 days, so she can at least begin some therapy. She's had limited experience with any kind of therapy for herself other than a psychiatrist who didn't even think she needed rehab at all.
B. said she was kind of excited to be going (she left yesterday morning), because she was finally doing something for herself. Like many, she fell into the caretaker role. There's also a lot of low self-esteem issues too. Though I do not know everything that goes on behind closed doors, I can see how she would have come to feel that way. Words hurt.
So how does her family feel? Actually, they are thrilled she is going. However, I get the sense from them that they want her to change but are unwilling to change themselves. Perhaps, this will be an incentive for them as I do not think they want to watch their mother continually get worse. Or maybe by them hearing it from someone else, that will make a difference. All I can do is hope.
I hope for B. this will be the step she needs to kick this for good. On the down side, I think there is a chronic depression, unresolved past issues, low self-esteem, communication issues, etc. But on the up side, there is no denial of a problem, there is motivation to get better, a yearning to be able to feel emotions again, and a belief system.
Though I consider myself to be more in a sense spiritual than religious, I do pray for people. And I pray for B. she can get through this, that she can learn to love and accept herself, and mostly to begin to heal. Recovery doesn't happen overnight, it is a process--one that can be long and difficult but in the end, for the better.
Lastly, I have to say it feels a bit odd being on this side of the fence. It wasn't like I didn't know this before, but it is weird, it's like knowing something beforehand than someone else--knowing there is an ability to come out on the other side. I did point out to B. I tell her these things not because I am wise beyond my years but rather through experience. I did not go into specific details nor talk about my ED, more depression, having a short stint in an inpatient unit in my teens, being a bit suicidal, etc. I don't know how much she will remember of what I said, but I hope there is some part she can hold onto.
p.s.--There was one thing that astounded me--how she had no qualms with her insurance company and they accepted her to go the very next day. I was floored honestly. And her insurance isn't that great. It just reminded me how much easier it is for someone with an alcohol problem to get extensive treatment than it is for an eating disorder person. I know it has gotten better overall, but still, I just couldn't believe it, especially with such a fast turn around time for the insurance company making a decision.
This surprised me, but I was also quite proud of her for taking this additional step. The day before we were chatting about her and her family's trip to New York. There were some interesting stories like almost losing one of her sons to the Canadian border while they were visiting the Niagra Falls. She had told me that she knew she needed to stop drinking and that when her dad's inheritance estate was finalized, and there was more money, she would go.
That Monday morning, her hands began shaking, and she needed a beer. I guess for whatever reason, it clicked with her. She called her sponsor who was thrilled with her decision, and then basically said she should just have all the beer she wanted that night, because she never would again.
B. asked me to come over and hang out. I did hang out with her from like 8:30pm - 1:30am. It was a long night and by midnight, I was asking her if she planned on going to bed soon. But at the same time, I knew she was more nervous than she let on about going.
We chatted quite a bit. It was essentially the same conversation we had almost a year ago when we had talked about this. I think during this time, she slowly got worse. She's lost a bit of weight substituting beer for food. Her memory has also been affected. I watched last night as the more she drank, the more forgetful she would become, telling me the same story over and over. Then, I'd see her stagger to find wood for the fire pit. It was difficult to watch.
When I asked her what made her decide to go to rehab now, she said she wasn't sure other than she knew she needed to go. For many people around her, with the exception of her family, most did not realize she had that big of a problem, simply because she is a functional alcoholic. She has not had some of the typical losses an addict might have--a career (she did lose her job but that was not through fault of drinking--it became a reason later however to drink later), a house, going into debt, etc. I told her that some people do not hit a rock bottom, but that they simply get to a point of being sick and tired of being sick and tired. Her eyes lit up with a "yes, that is exactly it."
During the past year, she has continued to go to AA meetings, but it was obvious, this was not enough and she needed a higher level of care. I think part of the problem too was that she saw a lot more people worse than her, so it undermined the what the severity of the problem though she knew she had one.
Although I do not completely agree with the entire AA philosophy, I've always felt that everyone has to do whatever feels right and will suit them for treatment. For her, she feels she has just not surrendered herself to God/a higher power. Personally, I think it is a lot more than that, but if that is what she needs/believes, then certainly, it can be helpful.
She will be in an inpatient program detoxing for 10 days, though she could be there for 30 days. I'm hoping she will take the 30 days, so she can at least begin some therapy. She's had limited experience with any kind of therapy for herself other than a psychiatrist who didn't even think she needed rehab at all.
B. said she was kind of excited to be going (she left yesterday morning), because she was finally doing something for herself. Like many, she fell into the caretaker role. There's also a lot of low self-esteem issues too. Though I do not know everything that goes on behind closed doors, I can see how she would have come to feel that way. Words hurt.
So how does her family feel? Actually, they are thrilled she is going. However, I get the sense from them that they want her to change but are unwilling to change themselves. Perhaps, this will be an incentive for them as I do not think they want to watch their mother continually get worse. Or maybe by them hearing it from someone else, that will make a difference. All I can do is hope.
I hope for B. this will be the step she needs to kick this for good. On the down side, I think there is a chronic depression, unresolved past issues, low self-esteem, communication issues, etc. But on the up side, there is no denial of a problem, there is motivation to get better, a yearning to be able to feel emotions again, and a belief system.
Though I consider myself to be more in a sense spiritual than religious, I do pray for people. And I pray for B. she can get through this, that she can learn to love and accept herself, and mostly to begin to heal. Recovery doesn't happen overnight, it is a process--one that can be long and difficult but in the end, for the better.
Lastly, I have to say it feels a bit odd being on this side of the fence. It wasn't like I didn't know this before, but it is weird, it's like knowing something beforehand than someone else--knowing there is an ability to come out on the other side. I did point out to B. I tell her these things not because I am wise beyond my years but rather through experience. I did not go into specific details nor talk about my ED, more depression, having a short stint in an inpatient unit in my teens, being a bit suicidal, etc. I don't know how much she will remember of what I said, but I hope there is some part she can hold onto.
p.s.--There was one thing that astounded me--how she had no qualms with her insurance company and they accepted her to go the very next day. I was floored honestly. And her insurance isn't that great. It just reminded me how much easier it is for someone with an alcohol problem to get extensive treatment than it is for an eating disorder person. I know it has gotten better overall, but still, I just couldn't believe it, especially with such a fast turn around time for the insurance company making a decision.
Tuesday, February 9, 2010
Intervention-Marquel
I caught last night's episode of Intervention with the story of Marquel, an exercise addict and alcoholic. Although there have been a number of episodes on eating disorders on Intervention, there were a few unique aspects I appreciated about this one: 1) The show represented a minority. I know they have in the past, I just don't recall any with eating disorders but perhaps I'm wrong here. 2) The individual refused treatment despite all the actions of her family and friends. I don't think this has happened in many episodes, but I haven't been watching Intervention on a regular basis lately. I remember a few episodes of people having huge lash-outs or escaping the premise, but all eventually went to treatment. With Marquel, she suspected the intervention and flat out refused, walking away and not speaking to her family and friends for 4 1//2 months as of this date.
A brief synopsis of Marquel: Marquel is a 30 year old Hispanic woman with two young children and a roommate in South Beach Florida. She was an elementary school teacher after college for several years but is now a fitness instructor. Her family feels she is an exercise addict, but Marquel does not, viewing exercise as "therapeutic:" She questions her exercise addiction (up to many hours per day) but does not feel like it has taken over her life.
Marquel also has a history of bulimia and alcoholism with symptoms of restriction and amenorrhea. On several occasions, she has passed out, been hospitalized for alcoholic poisoning, and was pulled over for a DUI and hit and run. Marquel does not view her alcoholism as a problem but says as many addicts do she has control over it and "I can stop drinking when I feel like it, I just never feel like it."
Growing up Marquel's family was a typical close-knit Hispanic family. When Marquel was 15 years old, her mother died of breast cancer which was very difficult for her, feeling like she never got a chance to mourn her death. Her father began dating soon after which was also hard on Marquel, wanting his affection.
When Marquel moved a way to college in FL, that was when her heavy binge drinking appeared. She found love, got married, and had two children. She presented herself as a "perfect" mom, but eventually that took its toll. She began to party, consume a high amount of alcohol, and neglect her kids. Five months ago, she separated from her husband and moved to South Beach with her children and began as a fitness instructor.
Marquel's entire family is very concerned for her and especially worried about her children. When the family tried the intervention, Marquel suspiciously picked up on it (possibly by her roommate who her family felt like enabled Marquel) and walked out, chased by her father who desperately tried to convince her to get help. She eventually agrees to come back to talk to her family which was not very productive. In the end, despite what everyone thought, Marquel did not agree to go to treatment.
As I said before, I liked the fact that this episode featured a Hispanic individual struggling with addictons and an eating disorder. In recent years, there has been an increase in Hispanics with eating disorders, making researchers realize they are not immune as once thought with better body image and different cultural expectations. And I have to admit that I don't think it is helpful that many live in South Beach which adheres to a similar lifestyle of "lookism" as Los Angelos.
In terms of treatment, it is obvious that Marquel needs help. She is at risk of hurting herself, others, and her kids. But like most addicts, will she have a rock bottom, will she get tired of the lifestyle she is living, tired of missing her kids enough to stop, or the lack of communication with her family? I think whenever many of us watch this show, we always hope that the individual will decide willingly to go to treatment. In many of the shows, it seems like it takes just a few minutes of tears, and then they decide to go (we really don't know how long this takes due to editing). But in reality, unless there is absolutely no other option, it usually takes awhile and with multiple attempts. Everyone is different when it comes to treatment and when they decide to get help. We hope that when they do decide, it is not too late.
I'll be interested to see whether Intervention will do a follow up story if Marquel does decide to enter treatment.
Related posts on Intervention:
Emily
Nicole
Sonia and Julia
A brief synopsis of Marquel: Marquel is a 30 year old Hispanic woman with two young children and a roommate in South Beach Florida. She was an elementary school teacher after college for several years but is now a fitness instructor. Her family feels she is an exercise addict, but Marquel does not, viewing exercise as "therapeutic:" She questions her exercise addiction (up to many hours per day) but does not feel like it has taken over her life.
Marquel also has a history of bulimia and alcoholism with symptoms of restriction and amenorrhea. On several occasions, she has passed out, been hospitalized for alcoholic poisoning, and was pulled over for a DUI and hit and run. Marquel does not view her alcoholism as a problem but says as many addicts do she has control over it and "I can stop drinking when I feel like it, I just never feel like it."
Growing up Marquel's family was a typical close-knit Hispanic family. When Marquel was 15 years old, her mother died of breast cancer which was very difficult for her, feeling like she never got a chance to mourn her death. Her father began dating soon after which was also hard on Marquel, wanting his affection.
When Marquel moved a way to college in FL, that was when her heavy binge drinking appeared. She found love, got married, and had two children. She presented herself as a "perfect" mom, but eventually that took its toll. She began to party, consume a high amount of alcohol, and neglect her kids. Five months ago, she separated from her husband and moved to South Beach with her children and began as a fitness instructor.
Marquel's entire family is very concerned for her and especially worried about her children. When the family tried the intervention, Marquel suspiciously picked up on it (possibly by her roommate who her family felt like enabled Marquel) and walked out, chased by her father who desperately tried to convince her to get help. She eventually agrees to come back to talk to her family which was not very productive. In the end, despite what everyone thought, Marquel did not agree to go to treatment.
As I said before, I liked the fact that this episode featured a Hispanic individual struggling with addictons and an eating disorder. In recent years, there has been an increase in Hispanics with eating disorders, making researchers realize they are not immune as once thought with better body image and different cultural expectations. And I have to admit that I don't think it is helpful that many live in South Beach which adheres to a similar lifestyle of "lookism" as Los Angelos.
In terms of treatment, it is obvious that Marquel needs help. She is at risk of hurting herself, others, and her kids. But like most addicts, will she have a rock bottom, will she get tired of the lifestyle she is living, tired of missing her kids enough to stop, or the lack of communication with her family? I think whenever many of us watch this show, we always hope that the individual will decide willingly to go to treatment. In many of the shows, it seems like it takes just a few minutes of tears, and then they decide to go (we really don't know how long this takes due to editing). But in reality, unless there is absolutely no other option, it usually takes awhile and with multiple attempts. Everyone is different when it comes to treatment and when they decide to get help. We hope that when they do decide, it is not too late.
I'll be interested to see whether Intervention will do a follow up story if Marquel does decide to enter treatment.
Related posts on Intervention:
Emily
Nicole
Sonia and Julia
Thursday, May 7, 2009
High-functioning, still eating disordered
There is an interesting piece in the NY Times called "High-functioning, but still alcoholics." In it, Sarah Allen Benton, author of Understanding the High-Functioning Alcoholic, says,
" high-functioning alcoholics are able to maintain respectable, even high-profile lives, usually with a home, family, job and friends. That balancing act continues until something dreadful happens that reveals the truth — to themselves or to others — and forces the person to enter a treatment program or lose everything that means anything."
This description reminded me of the similarities of what I've always called the "high-functioning" eating disordered person. These are the individuals who continue to excel in academics, careers, sports, hobbies, motherhood, etc. despite actively engaging in their eating disorders. It's actually quite a paradox, as one would think the opposite--that these individuals could not function.
The problem with this success (for however long that might be) is that it provides a sense of illusion that there really isn't a problem. Because again, the logic would be the eating disorder would not allow them to function, so how is it they are still functioning? As Peter Hamill, author of A Drinking Life, says "If I was able to function, to get the work done, there was no reason to worry about drinking. It was part of living, one of the rewards."
Or as Benton says, "Having outside accomplishments led me and others to excuse my drinking and avoid categorizing me as an alcoholic. My success was the mask that disguised the underlying demon and fed my denial."
I guess I bring up this whole point of the "high-functioning" eating disordered person, because I think a lot of us fall or have fallen into this trap at one time or another. We may not completely flat and out deny we have a problem, but there is still the idea we can somehow be both. While it is true, this can work for awhile, eventually our bodies and minds will catch up to the deprivation. And by that time, sometimes it becomes too late to fix the existing damage.
The take home message is to not be fooled by "high-functioning." Because in the end, it's still an eating disorder. Or as Benton says, "It’s not the number of drinks that defines an alcoholic. It's what happens to you when you’re drinking." In this case, it would be, "it's not the number of calories (or weight) that defines an eating disorder, but rather what happens you when actively engaged in your eating disorder."
Note--*For further reading about the "functional alcoholic," Caroline Knapp's Drinking: a love story is excellent. I actually found myself significantly relating to this book more than other eating disorders ones.
" high-functioning alcoholics are able to maintain respectable, even high-profile lives, usually with a home, family, job and friends. That balancing act continues until something dreadful happens that reveals the truth — to themselves or to others — and forces the person to enter a treatment program or lose everything that means anything."
This description reminded me of the similarities of what I've always called the "high-functioning" eating disordered person. These are the individuals who continue to excel in academics, careers, sports, hobbies, motherhood, etc. despite actively engaging in their eating disorders. It's actually quite a paradox, as one would think the opposite--that these individuals could not function.
The problem with this success (for however long that might be) is that it provides a sense of illusion that there really isn't a problem. Because again, the logic would be the eating disorder would not allow them to function, so how is it they are still functioning? As Peter Hamill, author of A Drinking Life, says "If I was able to function, to get the work done, there was no reason to worry about drinking. It was part of living, one of the rewards."
Or as Benton says, "Having outside accomplishments led me and others to excuse my drinking and avoid categorizing me as an alcoholic. My success was the mask that disguised the underlying demon and fed my denial."
I guess I bring up this whole point of the "high-functioning" eating disordered person, because I think a lot of us fall or have fallen into this trap at one time or another. We may not completely flat and out deny we have a problem, but there is still the idea we can somehow be both. While it is true, this can work for awhile, eventually our bodies and minds will catch up to the deprivation. And by that time, sometimes it becomes too late to fix the existing damage.
The take home message is to not be fooled by "high-functioning." Because in the end, it's still an eating disorder. Or as Benton says, "It’s not the number of drinks that defines an alcoholic. It's what happens to you when you’re drinking." In this case, it would be, "it's not the number of calories (or weight) that defines an eating disorder, but rather what happens you when actively engaged in your eating disorder."
Note--*For further reading about the "functional alcoholic," Caroline Knapp's Drinking: a love story is excellent. I actually found myself significantly relating to this book more than other eating disorders ones.
Wednesday, November 19, 2008
"Insight deficit" and denial
Eurekalert posted an interesting article about "insight deficit" and denial. Although the article is about substance abuse and addiction, I think it could easily pertain to eating disorders.
Much like with other addictions, denial can play a very strong role in keeping an individual in their eating disorder illness. The Society of Neuroscience meeting in Washington, D.C. held their annual meeting this past weekend where researchers discussed this impaired insight as well as other neuroscience topics related to addictions. Rita Goldstein, a psychologist who led the presentation, explained that the insight impairment were in many of the same regions of the brain that addiction symptoms seem to appear. She further said:
It is therefore possible that these core clinical addiction symptoms — craving and compulsion and the chronic relapsing nature of addiction — may be a consequence of compromised insight. Such impaired insight might help explain why drug-addicted patients often have a hard time recognizing, accepting, and/or acknowledging their own signs and symptoms of addiction, as well as the need for treatment. It could also help explain these patients' failure to comply fully with treatment regimens — and their tendency to relapse
Now, I'm sure we can chalk some of the denial thinking into pure starvation and malnourishment, but at the same time, there is evidence of the similarities between addiction and eating disorders in both biological mechanisms and psychobiology. An older article in Psychiatric Times explained it nicely. Also, this abstract by Walter Kaye about the neurobiology of anorexia and bulimia nervosa gives another good explanation of these mechanisms.
Whatever your opinion is about the addiction model and eating disorders, this is good food for thought. It's interesting to think that the "denial" so many of us have had at one point or another may be more than just about refusal to completely admit our illness.
Much like with other addictions, denial can play a very strong role in keeping an individual in their eating disorder illness. The Society of Neuroscience meeting in Washington, D.C. held their annual meeting this past weekend where researchers discussed this impaired insight as well as other neuroscience topics related to addictions. Rita Goldstein, a psychologist who led the presentation, explained that the insight impairment were in many of the same regions of the brain that addiction symptoms seem to appear. She further said:
It is therefore possible that these core clinical addiction symptoms — craving and compulsion and the chronic relapsing nature of addiction — may be a consequence of compromised insight. Such impaired insight might help explain why drug-addicted patients often have a hard time recognizing, accepting, and/or acknowledging their own signs and symptoms of addiction, as well as the need for treatment. It could also help explain these patients' failure to comply fully with treatment regimens — and their tendency to relapse
Now, I'm sure we can chalk some of the denial thinking into pure starvation and malnourishment, but at the same time, there is evidence of the similarities between addiction and eating disorders in both biological mechanisms and psychobiology. An older article in Psychiatric Times explained it nicely. Also, this abstract by Walter Kaye about the neurobiology of anorexia and bulimia nervosa gives another good explanation of these mechanisms.
Whatever your opinion is about the addiction model and eating disorders, this is good food for thought. It's interesting to think that the "denial" so many of us have had at one point or another may be more than just about refusal to completely admit our illness.
Saturday, January 5, 2008
Obesity as a brain disorder
As the new year has begun and many people have vowed to lose weight as their resolution, the topic of weight loss and obesity are up there. But then again, do they ever go away? I can't count how many ads I've heard on the television and radio about joining this gym or that gym, trying this weight loss plan, etc. However, on a completely different slant, I came across an interesting editorial in The American Journal of Psychiatry, entitled "Should obesity be included as a brain disorder" by Drs. Nora Volkow and Charles O'Brien. They were addressing this question as an inclusion into the new DSM-V proposed to be published in 2011.
Drs. Volkow and O'Brien propose "that some forms of obesity are driven by an excessive motivational drive for food and should be included as a mental disorder in DSM-V. DSM-IV recognizes eating disorders such as anorexia and bulimia as mental disorders with severe impairments and serious adverse outcomes but does not recognize obesity despite its devastating medical and psychological consequences. Obesity is characterized by compulsive consumption of food and the inability to restrain from eating despite the desire to do so. These symptoms are remarkably parallel to those described in DSM-IV for substance abuse and drug dependence (Table 1), which has led some to suggest that obesity may be considered a "food addiction" (5).
They go on to talk about the similarities of the brain regions of those with obesity and substance abuse dependency which is essentially the drive for rewarding properties. That in effect affects dopamine, though in different ways from the substance abuser. They also point out how the medications used for both substance and obesity often overlap.
In their conclusion, they do point out that this classification is a component at looking at obesity as a mental health disorder which is not completely inclusive to everyone.
I think this is an interesting take on obesity and could be true for some people. Dr. Volkow is likely to take this approach since she is an addictions specialist. She was featured in the excellent HBO documentary "Addiction." I thought her explanation about how addiction works was very educational. If you haven't seen this, I highly recommend it.
This editorial was written last May, and in the current issue a psychologist rebutted her thoughts. She also had some interesting things to say, including how from her experience the "health at every size approach" has worked in her practice. This approach is about not dieting, tuning in to your hunger signals, and accepting your size. Drs. Volkow's and O'Brien's also addressed the psychologist and defended their editorial in this issue.
Personally, I think it is an interesting way to look at obesity. I do not think all people who are obese would fall into this category as Dr. Volkow suggests, but it does give explanations into the "drive to eat" just as those with anorexia nervosa have a drive to restrict their food intake or not to find food as pleasurable as some recent studies have proposed. I think with addiction, there is a lot of overlap whether it is to food to illegal substances to an eating disorder if you believe an eating disorder can also be classified as an addiction, etc.
My only issue with so much studying of the brain going on and different illnesses is that people will just blame their brain and forget accountability and responsibility. Don't get me wrong, science is really in its infancy of studying the brain and how it works, but there has to be balance. But the more information we have, the more society can be helped educationally.
Just to point out, there is also an article about binge eating disorder and treatment as well in this current issue.
Drs. Volkow and O'Brien propose "that some forms of obesity are driven by an excessive motivational drive for food and should be included as a mental disorder in DSM-V. DSM-IV recognizes eating disorders such as anorexia and bulimia as mental disorders with severe impairments and serious adverse outcomes but does not recognize obesity despite its devastating medical and psychological consequences. Obesity is characterized by compulsive consumption of food and the inability to restrain from eating despite the desire to do so. These symptoms are remarkably parallel to those described in DSM-IV for substance abuse and drug dependence (Table 1), which has led some to suggest that obesity may be considered a "food addiction" (5).
They go on to talk about the similarities of the brain regions of those with obesity and substance abuse dependency which is essentially the drive for rewarding properties. That in effect affects dopamine, though in different ways from the substance abuser. They also point out how the medications used for both substance and obesity often overlap.
In their conclusion, they do point out that this classification is a component at looking at obesity as a mental health disorder which is not completely inclusive to everyone.
I think this is an interesting take on obesity and could be true for some people. Dr. Volkow is likely to take this approach since she is an addictions specialist. She was featured in the excellent HBO documentary "Addiction." I thought her explanation about how addiction works was very educational. If you haven't seen this, I highly recommend it.
This editorial was written last May, and in the current issue a psychologist rebutted her thoughts. She also had some interesting things to say, including how from her experience the "health at every size approach" has worked in her practice. This approach is about not dieting, tuning in to your hunger signals, and accepting your size. Drs. Volkow's and O'Brien's also addressed the psychologist and defended their editorial in this issue.
Personally, I think it is an interesting way to look at obesity. I do not think all people who are obese would fall into this category as Dr. Volkow suggests, but it does give explanations into the "drive to eat" just as those with anorexia nervosa have a drive to restrict their food intake or not to find food as pleasurable as some recent studies have proposed. I think with addiction, there is a lot of overlap whether it is to food to illegal substances to an eating disorder if you believe an eating disorder can also be classified as an addiction, etc.
My only issue with so much studying of the brain going on and different illnesses is that people will just blame their brain and forget accountability and responsibility. Don't get me wrong, science is really in its infancy of studying the brain and how it works, but there has to be balance. But the more information we have, the more society can be helped educationally.
Just to point out, there is also an article about binge eating disorder and treatment as well in this current issue.
Thursday, November 8, 2007
Confessions of a Cracker Addict
Keeping with this topic of obesity, I was listening to a podcast the other day about a book called Waistland by Deidre Barrett, a Harvard psychologist in their behavioral medicine department. I have not read the book yet, but only listened to an interview of her about the book. The book looks at the obesity problem from an evolutionary standpoint with scientific research. She also talks about how to "reprogram" your body/mind in terms of biologically. I didn't agree with everything she said in the interview. For example, she believes that there is only a grain of truth in genetics and becoming fat and some others that I can't think off the top of my head. However, there were a few interesting things she did say which I think are in fact true.
One thing she mentioned was that people really need to do more of a radical approach in order to stop their "food addiction." This is in the sense of what they are eating in terms of sugary, fattening foods. Her theory is that if you let's say eliminate a certain food that is high in sugar and fat, essentially over time, your body is going to stop craving it. This is completely opposite of what many health professionals tell you, ie. make small changes. Barrett's thinking is that 1) those small changes are not enough to truly make a difference, 2) that by continuing to "feed" your body this way only throws your body off. An example would be glucose levels or cortisol. I think in some ways this can work for some people. The problem is that many people have a hard time with continuance over time which can lead to the yo-yo dieting.
Her approach is more about breaking the pattern and developing good habits. Supposedly, it takes what 21 days to develop a habit. I decided to try to take on this type of approach and see what happens.
See, even though I've had an eating disorder for many years, mostly eat all natural and organic foods, my one "refined" substance is crackers, mainly wheat thins and animal crackers. They are my addiction. I've always considered them "safe" foods, and I can eat quite a lot of them. I think it's due to never really feeling "full." I also think besides the psychological value of them, I think there is something biologically driven as well. Even when I was in the hospital for non-epileptic seizures (long story), I remember asking my parents to bring me wheat thins. One thing I can say about wheat thins is that by eating so many of them, it probably kept my iron levels at bay since there is some fortification in them.
I know there could be worse things in life to eat, but I don't know, I guess maybe it just feels really "unbalanced" or something. Literally, if I don't eat them, my caloric intake is drastically reduced. In a sense, it's a good challenge for me to try to eat other things.
I've tried many ways to reduce my cracker consumption--putting them in servings, only buying the small bags, always telling myself this was the last time, etc., you get my drift. The last time I completely eliminated wheat things, it was like three weeks without eating them. That was like a record for me. My parents think it is funny how these crackers have basically become another food group to me and often times when they come, they bring me a whole bunch.
Anyway, what I do notice after eating so many is that my blood sugar takes a nosedive, and I'm often tired in the late afternoon. So I'm trying hard not to buy any crackers even though I know Wal-Mart currently has the 14 oz box of reduced fat wheat thins (I really prefer the low sodium ones) for 2/$5 and the 2 lb. bag of animals crackers priced at 2/$3. Since Sunday, I have not eaten any and actually there is a difference in terms of blood sugar level. I still get a little tired but not the same as before. I know I could easily just add a protein source to the crackers, but then that just messes with my head in terms of calories and fat. I'm hoping to make 21 days and see if I have really developed a "habit" from it. I'll keep you posted.
One thing she mentioned was that people really need to do more of a radical approach in order to stop their "food addiction." This is in the sense of what they are eating in terms of sugary, fattening foods. Her theory is that if you let's say eliminate a certain food that is high in sugar and fat, essentially over time, your body is going to stop craving it. This is completely opposite of what many health professionals tell you, ie. make small changes. Barrett's thinking is that 1) those small changes are not enough to truly make a difference, 2) that by continuing to "feed" your body this way only throws your body off. An example would be glucose levels or cortisol. I think in some ways this can work for some people. The problem is that many people have a hard time with continuance over time which can lead to the yo-yo dieting.
Her approach is more about breaking the pattern and developing good habits. Supposedly, it takes what 21 days to develop a habit. I decided to try to take on this type of approach and see what happens.
See, even though I've had an eating disorder for many years, mostly eat all natural and organic foods, my one "refined" substance is crackers, mainly wheat thins and animal crackers. They are my addiction. I've always considered them "safe" foods, and I can eat quite a lot of them. I think it's due to never really feeling "full." I also think besides the psychological value of them, I think there is something biologically driven as well. Even when I was in the hospital for non-epileptic seizures (long story), I remember asking my parents to bring me wheat thins. One thing I can say about wheat thins is that by eating so many of them, it probably kept my iron levels at bay since there is some fortification in them.
I know there could be worse things in life to eat, but I don't know, I guess maybe it just feels really "unbalanced" or something. Literally, if I don't eat them, my caloric intake is drastically reduced. In a sense, it's a good challenge for me to try to eat other things.
I've tried many ways to reduce my cracker consumption--putting them in servings, only buying the small bags, always telling myself this was the last time, etc., you get my drift. The last time I completely eliminated wheat things, it was like three weeks without eating them. That was like a record for me. My parents think it is funny how these crackers have basically become another food group to me and often times when they come, they bring me a whole bunch.
Anyway, what I do notice after eating so many is that my blood sugar takes a nosedive, and I'm often tired in the late afternoon. So I'm trying hard not to buy any crackers even though I know Wal-Mart currently has the 14 oz box of reduced fat wheat thins (I really prefer the low sodium ones) for 2/$5 and the 2 lb. bag of animals crackers priced at 2/$3. Since Sunday, I have not eaten any and actually there is a difference in terms of blood sugar level. I still get a little tired but not the same as before. I know I could easily just add a protein source to the crackers, but then that just messes with my head in terms of calories and fat. I'm hoping to make 21 days and see if I have really developed a "habit" from it. I'll keep you posted.
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