Dear Clients and Colleagues: Spring flies by.

We are already in the month of May, which brings Memorial Day and the launch of summer season the opening of swimming pools, barbeques, and the start of trips to the beach. Over the weekend I had overheard two women in a department store talking about their dread of having to deal with the bathing suit issue. Summer seems to bring increased awareness to weight, shape and body type, as there is less room to hide in warm weather clothing. Curious, however, that as a culture obsessed with thinness, we are the most overweight country in the world with 65% of adults being overweight and 30% obese. And, we often dont understand the difference between having a few extra pounds on us, and being overweight or obese. This lack of understanding can get in the way of addressing food and weight issues, for as we know a solution to any given problem is only as good as our understanding of the problem. This issue of Living Well News is focused on Our Relationship with Food, identifying eating patterns and potential problems that can lead to abuse of food, addiction, and ill health. Being able to identify risk factors and problem behavior is both a preventative measure as well as an intervention. Integrated Treatment Solutions does not provide medical treatment, but does work with the behavior factors which influence human health and well-being. We know that problem behavior does not improve over time without proper intervention. We hope you find this issue useful and encourage you to forward it onto a family member or a friend who might be struggling with food, eating, and weight. For more information or to schedule an appointment, contact us today by phone at 610.692.4995 or email info@MyIntegratedTX.com Warm regards, Paula Tropiano, M.A., L.P.C., CCDP-Diplomate Director Food: Our Most Important Relationship Food is our most significant relationship in life. It is our sustenance our survival; equally important as the air that we breathe. Eating is the way we attached to mother, forming that symbiotic bond of soothing and nourishment as completely dependent beings when we enter the world a way of feeling safe, connected and whole. Growing up, specific foods and the traditions around them become rituals: a means of celebration, mourning, managing feelings and emotions, reward, as well as being with one another in a social sense. Food can also be used as a social lubricant, much like alcohol, sports, and related activities. Ultimately, food is powerful - Eating is not a habit to be broken nor is abstinence an option when we have a problem with food or eating, whether it involves, overeating, bingeing, or restricting. Understanding why we eat or dont eat, and why we choose the foods we choose, are necessary in order to stabilize this critical relationship. As we learn in life, solving a problem is not just about finding the one factor or cause, but the many factors involved which play against and feed off one another fueling the problem. Mending our relationship with food is no different. We need to understand the biological, social and mental/ emotional drivers which form and sustain the habits and patterns we have with problem eating.

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Obesity Obesity is at the forefront of todays health concerns and warrants focus, because it is linked to many health problems. Did you know that that approximately 65% of adult Americans are overweight and 30% are obese? It is also estimated that roughly 80% of obese adults have at least one of more conditions such as: cardiovascular disease, diabetes, hypertension, sleep apnea, arthritis, and cancer. There is then another tier of problems which includes depression, substance abuse, and chronic pain that can develop as a result of those issues. Studies show that 25-50% of obese individuals binge eat and that there is a 75-95% recidivism rate to obesity among formerly obese individuals who have undergone treatment. Obviously, this points to a significant epidemic. It also raises a question, What happened to our relationship with food? What went wrong? Food Addiction? The medical community, insurance and food industries all encourage consumers to exercise personal responsibility" when it comes to preventing obesity, addiction, and chronic health problems. Self-control, better choices, avoidance of over-indulging/over-eating, and staying away from packaged, high fat, carbohydrate, sugary foods is emphasized and encouraged. Seems simple, right? Being informed and then choosing? No! Food, like alcohol and drugs, is biologically addictive. Food is a substance. There are specific biological mechanisms that drive addictive behavior. Addictive behaviors are fueled via primitive neurochemical reward centers in the brain that override ones ability to exert reason, self-control, manage cravings, stop eating and to recognize biological signals of true hunger, appetite, and satiation. Liking vs. Wanting. Research shows that obese individuals are similar to non-obese individual in their liking of foods, but that they have a stronger wanting / desire/ drive for the foods they want. They are also willing to go to great lengths to obtain and consume them. It is noted that this may be due, in part, to neurological changes that cause a blunted psychological reward response to food Much like how a drug addicted person might crave their drug or want it very strongly, long after they stopped enjoying or liking it. Craving vs. Addiction. We all crave certain foods from time to time. Women are notorious for craving chocolate. Some other common cravings include fat, sugar, or carbs. Food cravings are important because they play a role in over or compulsive eating as they serve as trigger foods. It is said that our industrialized society ripens the opportunity for obesity, due to the availability and exposure to addictive food substances: sugar, fat, sweeteners, refined carbohydrates, salt and caffeine -- eroding at self-control and ability to regulate consumption of these foods. Loss of control is both a term and behavior associated with addiction. Do You or Someone You Know Have a Food Addiction? The CAGE Questionnaire is a tool used to diagnose alcoholism, and can be adapted to identify people with food addiction. Answering Yes to 2 or more items below, may indicate a problem with food addiction. 1. Have you ever felt the need to Cut down on your eating? If you dont ration yourself, you will lose control? 2. Have you ever been Annoyed by criticism of your eating? If you get upset when people bring up your eating, you may be too attached to eating. 3. Do you feel Guilty about your eating? It builds up, because every time you say you are going to control yourself you fail. 4. Have you ever needed an Eye-opener? You wake up in the morning and are compelled to consume.

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Evidence in Support of Food Addiction According to a report from the National Center on Addiction and Substance Abuse (CASA) at Columbia University, up to one half of individuals with eating disorders (including bingeing) abuse alcohol or illicit drugs, compared to 9% of the general population. Conversely, up to 35% of alcohol and illicit drug abusers have eating disorders, compared to 3% of the general population. A direct correlation has also been established between the dramatic increase of obesity and overweight population and the aggressive marketing, increased availability, and consumption of foods over the same period (similar to tobacco). People who are addicted to food tend to exhibit many of the same characteristics as those addicted to alcohol and drugs: Exhibit behavior in times of transition or stress Common family history Common brain chemistry (decreased sensitivity of dopamine-reward system) Low self-esteem, depression, anxiety, impulsivity History of sexual, physical, or emotional abuse Obsessive preoccupation, cravings, and secretive rituals Experience mood altering effects from use of substance National Center on Addiction and Substance Abuse (CASA) at Columbia University

Integrated Treatment Solutions provides counseling and group work geared towards identifying, understanding and breaking the cycle of over- eating. We apply an eclectic approach emphasizing education, skill building and stress reduction strategies. Our clients gain an understanding of their relationship with food and identify trigger foods and stressors which prompt cycles of over-eating and poor food choices. Goal: for our clients to become more conscious of their relationship with food and gain behavioral control with eating. Quote: "Never trade what you want most for what you want at the moment" Unknown

We invite you to sign up for the monthly issue of Living Well News please on the Integrated Treatment solutions homepage www.myintegratedtx.com .

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