Author: psychologyofobesity

bariatric medicine, depression, mood disorders, obesity, psychology, Uncategorized

The True Cost of Comfort Eating


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In society, the use of food is far more than just to meet your nutritional needs.  We even have specific foods, to mark specific occasions.  Food brings people together.    The giving of food is the expression of love from one to another.   Like that old song “Sweets for my Sweets, Sugar for my Honey”.

We eat to heal and grow our bodies, and but also to feed our emotions.  Whether we are joyfully celebrating with cake, nourishing cold symptoms with soup, or mindlessly eating a box of chocolates in our efforts to get through a relationship break up. Food is there, within reach to cure our ills, whatever they may be.

Emotional eating  occurs when we are stimulated to eat because of experiencing negative emotions or mood disorders such as stress, anxiety and depression.  We attempt to bring ourselves comfort when doing so.  However, this action can lead to the development of eating disorders, such as Binge Eating Disorder or Bulimia.  Anorexia Nervosa is another eating disorder when someone feels compelled to lose weight, and attempts to avoid or reduce intake of calories and exercises excessively.  However, it is the high calorie food intake that I am focusing on.

Our tongue is equipped with taste buds, which detect sweet, sour, bitter and salty tastes.  Sweet and high fat foods are more pleasurable to eat, and we are driven to eat these as a source of energy.  Our tongues ability to taste bitter and sour tastes, enables us to detect any food which may be poisonous, or decayed, and therefore not useful for our nutritional.   In nature, sweet foods include berries, honey, fruits, sugar beets, sugar canes amongst others.  They have calories for energy and also important vitamins, minerals and proteins.  Our processed foods is a different matter.

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By combining sugars, fats and even salt in food manufacturing, foods become more pleasurable to eat.  The term ‘bliss point’ is used when a product has just the right amount of sugar, fat, and salt to optimise its palatability.  In other words, to optimise your eating pleasure.  This pleasure is experienced in your brain, but is a short lived experience.  Overeating occurs, when we seek to prolong that experience.  Especially in our attempts to ease emotional pain.  The problem is, that what you’re eating is likely to cause more emotional pain in the long run. Namely in the form of mood disorders such as stress, anxiety and depression.

Aside from the additional weight gain and self-directed negative thoughts about the weight,  which can lead or be a consequence of mood disorders, studies have shown that there is a link between an unhealthy diet and mood disorders.

When overeaters experience stress or anxiety, the behaviour to overeat will be stimulated (Macht 2008). The consumption of high fat/sugar foods does reduce symptoms of stress and anxiety, but only provides short-term relief (Mariam and Morris 2010).  Low levels of polyunsaturated fatty acids have been found to be linked to an high incidence of depressive symptoms (Peet et al 1998), although other studies have found that increasing Omega 3 intake, leads to a decrease in human depressive symptoms (Lin & Su 2007).  On the other hand, high levels of saturated fat intake not only increases abdominal obesity, but have been found to be a causative factor in neurological impairments (Weber-Hamman et al 2002, Van Reedt Dortland et al 2013).

The increase in abdominal obesity and/or neurological impairments can lead to an increased vulnerability to stress/anxiety/depression (Novic et al 2005, Sharma & Fulton 2013),  which leads to overeating and so the cycle continues.

Unfortunately,  mood disorders are under diagnosed in obese people.  Or an assumption is made by the health care professional that the obesity is the cause of the mood disorder and treats the obesity instead.   It is also in the healthcare organization’s interest to deal with the obesity issue due to the cost of diabetes medication.

You will see one example of this if you watch the movie on Netflix “The Man Who Ate Himself to Death”.  In it you will see the story of Ricky Naputi.  A man in his late 30’s who weighed 900lbs at his heaviest. You will see the story unfold of others trying to get help for Ricky to lose weight.  You will hear the frustration of his partner.  You will hear the irritation from his doctor who is about to give up on Ricky for his lack of effort on his weight loss journey and who in fact berated Ricky for restarting his antidepressant medication instead.  You will also hear the neutral but someone judgemental tone of the narrator, as Ricky seemingly is not ‘pulling his weight’ in dealing with his weight loss.  If you listen really carefully, you will also hear Ricky say how he feels better taking the antidepressants and his cravings are reduced.  somehow, everyone misses this.  The wife leaves him, and by the end of the movie, Ricky is dead.  He didn’t eat himself to death as the title of his story suggests, he actually took an overdose of pills and committed suicide.  Unfortunately, many bariatric patients are doing the same post-surgery,  as their underlying mental health condition goes undiagnosed, even if they have successfully lost a large amount of weight.

If you are obese and experiencing stress, anxiety and/or depression, speak to your healthcare professional.  If you would prefer to talk to someone else about this but are housebound, please either contact a mental health support helpline or feel free to email me at elevationpdc@aol.com. I am in the process of creating a webinar and course which will assist you in overcoming the topics I raise in this blog.  But, I do advise you to seek local help so that these issues can be addressed.

Whatever size you are, you are worth your weight in gold and much more!

Best wishes,

Antoinette Niles Bsc (Hons) Psychology

PS:  Please forgive my two month absence.  I moved home twice and had to catch up on my Masters Degree in Mental Health Sciences. But, everything I’m learning I hope to pass on to you.

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October 2010 11st 10lbs
obesity, Uncategorized

Why Doesn’t She Just Stop Eating?


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Rudd Center
Rudd Center

This question is often asked by an observer watching an overweight or obese person eat something considered calorific.  Maybe you’re the one doing the observing, or perhaps unknown to you, you are the observed? As mentioned in my previous blog, this fat shaming is not appropriate.  But, on this occasion, I will be discussing the possible answer to the question asked above.  This being another factor which is thought of as a cause of obesity.

Welcome to the Obesogenic Environment!

First, let’s look at how eating has changed over the years.

As a child growing up in a Caribbean household, we mainly ate home cooked meals.  On Saturdays, we would often have Mum’s homemade Caribbean soup.    On Sunday’s we would have a large meal of meat or poultry, rice and peas, and vegetables.  Which would be filling the air with lovely aromas by the time we returned from church and Sunday School.  This would be followed either by my then favourite, tutti-frutti ice cream, or fruit salad with evaporated milk.  During the week, local businesses would close at 5pm, banks closed at 3pm and if you forgot to buy something form the shops on Saturday, you would have to wait until Monday before replenishing that forgotten item. Throughout the rest of the week, we would continue to have home cooked meals, but on a Friday we often had a takeaway meal consisting of fish & chips once a week.   This was a routine in many Caribbean families.  The only other takeaway food I knew of as a child was the deliciously golden pastry wrapped well seasoned beef or chicken pattie or my treasured 99 Flake from the ice cream van.  Which my parents were certain that I could hear coming from a mile away, as I ran up to them screaming “ice creeeeeeam”

As I got older, I had pizza, Chinese food or Indian food only with friends outside of the home environment.  I had my first McDonalds at 16 when they opened in branch in my local area of Harlesden.  KFC was a staple after raving as a young adult, as they remained opened until 2am.

Nowadays, we are seeing our High Streets are filled with eateries, restaurants, coffee shops, burger restaurants, and fried chicken outlets. Many of us succumb to these tempting choices even when we are not hungry.  Somehow, almost by magic, we can be triggered to eat.  This is caused by Food Cues.

Food Cues

We can experience food cues which trigger us to eat when we are hungry, or by seeing or smelling food, listening to others talk about food or eating in front of us, feeling emotional or stressed and even doing certain activities.  When we are cued to eat food, regardless of the reason, it can lead to overeating or at least poor eating choices.   We have created links between our activities and our eating behaviours.  For example, going to the cinema and eating a large bucket of popcorn, eating in front of the TV, having chocolate when stressed, having a cake with a particular cake eating friend etc.  And we can also be triggered by food cues to eat through advertising.

And companies give a great deal of thought around how to entice you into eating their food.

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Advertisements and even slogans are used to catch our attention.  Chocolate companies very much like the cigarette companies in the past, would use healthy looking attractive slim active people to market their chocolate, or burger or other calorific foods. There’s nothing wrong in that.  After all, calorific items can be eaten in moderation as part of a healthy lifestyle.

Mmmmmm I’m Loving It!

Over the years, advertising has changed from talking about the qualities of the food product, to adding emotional qualities or behavioural instructions. For example, Coca Cola’s current advertising slogan is “Taste the Feeling!”, but from 1886 to 1920, their most popular slogan was “Delicious and Refreshing”. While KFC continues to be “Finger Lickin’ Good!”, Kit Kat suggests that you should “Have a break, Have a Kit Kat!”.   Mars used to say “A Mars a day, will help you Work, Rest or Play!”, which focussed more on the energetic boost you can have after eating their product.  They changed their slogan in order to focus more on the ‘mental upliftment’ you can have through having a fun experience after eating their product.  More recently, the Mars company was successful in winning £1 million of free advertising during the Paralympics to market their more lighter caloried product Maltesers while celebrating diversity by using disabled actors retelling true stories.  Hopefully, it may have an impact on those who enjoy a fried deep fried Mars bar from their local chippy.

Advertisers also use cute baby animals to catch and hold your attention, while promoting their high sugar, high calorific items.  A study completed in Japan’s Hiroshima University, found that images of baby animals including puppies and kittens can powerfully effect attention and concentration ( source: Public Library of Science aka PLOS One).

Out of the Mouth of Babes!

Recently, food adverts aimed at children during children’s TV viewing times have been banned.  However, in a recent study by Cancer Research UK (CRUK), children participants responded to questions asking them how familiar they were with TV advertising, when they watched it and what effects it had on them.  Most respondents were exposed to the food adverts during 7-9pm, when  watching TV with their families.

Unlike gambling adverts which suggest that you “Gamble Responsibly” in the small print, or the warning on cigarette packets informing you that they can harm your health, we do not have such warnings in food advertising.  Occasionally, you may notice the advice that their product can be consumed in small amounts as part of a healthy lifestyle.  But unfortunately, that seems to be written on a family sized packet of some calorific item, which you are supposed to eat in smaller portions.  And until recently, only the small portion information will be shown on the nutritional label.  It is useful to know how many servings the product should yield.  However, if you are anything like me, my idea of a portion often differs from that of the manufacturer. I do not take the time to weigh the recommended portion of cheese puffs before eating them.  Admittedly, when I’m in weight gaining mode, the kitchen weighing scales are the furthest thing from my mind when I’m in the snack cupboard. Although, the bathroom weighing scales will soon torment me with the inevitable weight gain from my night feast.

Just Eat!

There are now businesses which have collated all your local restaurants together for your eating pleasure.  Now we don’t even have to leave our homes to get a restaurant quality meal.  It can be order with a few swipes and taps on our mobile devices and delivered to our doors within minutes.

Food and Your Brain

In David Kessler’s book “The End of Overeating”, He explains how companies use food engineering in order to create food products which are so delicious, that they activate the neurotransmitters in your brain which are responsible for the feeling of pleasure.  Such as dopamine and serotonin. When we have a surge of serotonin or dopamine, we will seek that same experience over and over again.  We can get this effect from many foods, but mainly those which are sugar and/or fat laden. For some, like myself, this becomes a way to cope with stress.

In fact, the BBC reported on a study conducted by Dr David Lewis, in which couples had electrodes attached to their heads to measure the neuronal activity when they kissed or ate a piece of chocolate.  The findings showed, that eating chocolate created more intensity and lasted four times the duration than kissing passionately.  It also increased the heart rate significantly.  http://bbc.in/2fETUWc But, don’t kick out your partner yet, as he/she can help you burn off the extra calories in a very fun pleasurable way!

Overall, we are bombarded by messages to eat 24 hours a day, and we often eat when we are not hungry because those messages or our feelings/stress levels seem to compel us to.  Leading to weight gain, and judgement from others who are often affected in exactly the same way!

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11st 4lbs –  2005   This was taken when I was just 8lbs away from my target BMI 25.  I was thrilled at being size 12 for the first time in my life.  But,  my spine vertebrae was visible through my skin, along with my hips bones and I lost all the volume in my breasts. My skin sagged everywhere leading me to have a tummy tuck at a later stage.

I apologise for the delay in posting this new blog.  I hope to post on a weekly basis in future.  Thank you for the feedback I receive on my first posted blog.

How are you affected by the obesogenic environment?

Do you have a favourite place you like to buy food from even when you’re not hungry?

Let me know your thoughts?

Best Wishes,

Antoinette Niles Bsc (Hons) Psychology

 

obesity

Just Look at the Size of Him!


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Weight Bias & Stigma

Have you ever noticed whenever there is media coverage on the topic of obesity, they always show obese people from the neck down?  They also show obese people just milling around, sitting down (implying their sedentary lifestyle) or even just eating?  I often wonder, do these people know they are being filmed?  And that their image (at least below neck level) is shown to portray the issue of the increasing obesity “crisis” (their term not mine!).  This is fat shaming, also known as weight bias and stigma.  Something, not only the media is guilty of doing.

©World Obesity
©World Obesity

However, slim people do not experience stigma or bias about their weight and are not fat shamed.  Negative assumptions about obese people are so entrenched in society, that even some obese people themselves hold these assumptions.  For example, have you ever seen an obese person eat in a public place, and assume, that they must’ve been eating all day long? 

Or perhaps, you’re carrying a few extra pounds yourself and pass someone larger in the street thinking “well, at least I’m not as big as HER!”  Other assumptions are that they are actually slim people who are getting fatter, whereas that person may actually be losing weight at a steady recommended pace of 2lbs a week, therefore becoming slimmer.  Or that they are out of control in many if not all the areas of their life and that this is evident by their size.

Fat shaming can also occur in intimate and familial relationship settings. Where a loved one attempts to help their obese beloved lose weight by verbal bullying. It doesn’t work, and in fact can make the situation worse.  Worse for the relationships, and worse for weight loss motivation.

What about being considered “fat and stupid”?  Although, various earlier research findings showed a link between obesity and intelligence, a more recent study found that contrary to earlier research conclusions, it is more likely that low intelligence from childhood leads to obesity and weight gain in adulthood, as opposed to obesity causing a reduction in intelligence. ((http://personal.lse.ac.uk/kanazawa/pdfs/COEDO2014.pdf Intelligence and Obesity:  Which Way Does the Causal Direction Go?).  But is it reversible after weight loss?

A small study with 171 participants, found that most had a mild cognitive impairment (MCI) regardless of age.  Their results also showed a decrease in the MCI of most of the patients after having bariatric surgery (Rochette et al 2016 Mild cognitive impairment is prevalent in persons with severe obesity. Obesity, 24: 1427–1429. doi: 10.1002/oby.21514).

Weight stigma could be a factor in the increase in the super morbid obese group with a BMI>50 who are becoming housebound.  Unfortunately. we only hear of the cases where a super obese person needs medical care, and had to have a wall taken down by the local fire service in order to get taken to hospital.  Or even have part of their home demolished and airlifted out of their home.  Such as in the case of Khalid Mohsin Shaer who at 20 years old weighed 1344lbs/610ks/96stone.  As an humanitarian gesture, he was ordered to be taken to hospital in 2013 by King Abdullah.  A special bed was made for him in the US, so he can be  transported safely.  He went on to lose half his body weight by 2014 after having bariatric surgery at King Fadh Medical City in Riyadh. But even in a healthcare environment, the overweight or obese patient may still experience weight stigma. 

Dr Sean Phelan from the College of Medicine, Mayo Clinic lectures and has also conducted research on the topic of weight stigma. He found that in the field of healthcare, not only are obese patients’ victim to discriminatory comments by healthcare staff, but overweight and obese medical students also experience perceived and internalized weight stigma, which may contribute to worsen their well-being. In a survey conducted with his colleagues, Dr Phelan suggested that this may be due to the healthcare culture is which obesity is considered preventable (http://bit.ly/2dqdHD2).  Unfortunately, as a result, this bias may impact the interaction you have with a healthcare professional. 

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©World Obesity

Whether from nurses, doctors or consultants, it results in the obese patient feeling that they are judged as being lazy, undisciplined and responsible for their predicament. Unfortunately, this may act as a deterrent in obese people seeking medical help whether for obesity or other health problems.  The resulting shame felt when obese, then often becomes a factor in  increasing poor eating behaviours.

The awareness that this is a sensitive topic, has resulted in some doctors changing their approach in discussing obesity with their patients.

Dr. Arya M. Sharma, MD, DSc (hc), FRCPC is Professor of Medicine & Chair in Obesity Research and Management at the University of Alberta, Edmonton, Canada. He is also the Clinical Co-Chair of the Alberta Health Services Obesity Program.  He teaches doctors a new approach which he calls  the 5 A’s of Obesity Management:

  • Ask patient for permission to discuss excess weight.
  • Assess patient completely before offering any advice
  • Advise by focusing on behavioural goals, not on weight loss.
  • Agree a treatment plan with the patient
  • Assist the patient in accessing treatment options e.g. Professional (psychological, bariatric etc.), community resources etc.

Give them a chance to help you before a treatable health issue becomes a bigger problem.  Alternatively, you may want to approach someone in the weight loss industry who can support you  on your weight loss journey.

In my personal experience,  I did believe in the past that I was considered ‘fat and stupid’ by many others, including health professionals.   Even, if my belief was accurate, it was something I had to change in myself in order to take the first steps in reducing my weight. This along with other self-directed negative beliefs led to my feeling depressed.  My depression fed my hunger for food, and the resulting extra weight gain ‘fed’ my depression. I decided to educate myself on the topic of diet and nutrition and also anatomy & physiology.  This self education, led to my having a fuller understanding of what I was doing to my body.  And at that point, I was able to start a weight loss journey which was successful, long term, for the first time in my life.

 My cognition and indeed my IQ did change after my weight loss.  This happened primarily because my confidence and self-esteem improved, enabling me to enrol at university and do a psychology degree.  During my studies, I had to learn study skills, exam revision skills, critical thinking, research skills and much more.  Although, I had done many qualified courses before while obese, losing weight enabled me to release all of my negative self-directed fat thoughts I held about myself and my level of intelligence.  My anxiety about being a fat (and ‘stupid’) student also lifted in the absence of my obesity.  Allowing me to feel that I at last, rightfully belonged in the classroom environment along with the rest of my mature student peers. 

In addition, my exercise routine, enabled me to release stress from my body and mind leaving me to focus on other things.  Also, my limitation of brain dulling foods and alcohol, was replaced with water, water rich foods, fruits and vegetables, which left me with a clear mind and body.  I found that eating better, actually made me feel better physically and mentally.  Through my job working with clients wanting to lose weight, they also found these benefits. 

But, don’t just listen to me, you should be your own judge on this.  I know you’re smart and ready to make a decision about your life. Get smart about what you eat, and why you are eating it. You can change your mind and change your behaviour as a result. Weight Stigma exists, Yes.  But it’s easier to change your mind about how you feel about yourself, than it would be to change a mass of ignorant people!

In other words, what other people think of you is none of your business, what matters is what YOU think of YOU Don’t let your excess weight stop you exercising, changing your life or leading an active full life. 

Me at 18st 7lbs 2003
Me at 18st 7lbs 2003

Do you feel fat shamed in your personal or professional life? 

Have you ever experienced it in a healthcare setting? 

 Let me know your thoughts.

Best Wishes,

Antoinette Niles Bsc (Hons) Psychology