Tag Archives: eating

Take One

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It was another brisk afternoon. Similar to the ones she knew to grow up with her whole life. Sitting there with a mug of cold black tea– she wasted time. That’s what the days have come to be for her, just another waste of time. Perhaps she’d read a book, perhaps she’d journal, maybe work on the 12-steps or just fiddle around on Facebook. What to do? For now she just listens to the clock tick for a while. She didn’t remember the clock ticking so loudly before. But then again she hadn’t been in her dad’s house for over a month– it must be new. They were always buying little things for the house. Although they swore they would sell the place and move to Oregon when they retire; creating that picture perfect home was still a high priority.

What’s with the world, she thought. What’s with all this material stuff? We can’t even necessary prove our immediate existence. There goes the ringing in her ears. It seems to arise every time she delves too deep with these questions on reality. Just live, just move along, she tells herself. But what to do when your just some bored human that has been fighting with addiction, bipolar one and an eating disorder. God, she is so screwed up.

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Addiction and the Eating Disorders

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Although comprehensive theories of addiction recognize the etiological importance of environmental and cognitive factors, it has been widely accepted for many years that addiction is also a brain disease and that individuals differ in their susceptibility to this condition (Leshner, 1997; Wise and Bozarth, 1987). Explanations of the eating disorders have tended to eschew biological models in favor of those that focus on psychosocial and family influences-the most prominent models arising from psychoanalytic, feminist and cultural theory. It is not surprising, therefore, that although clear parallels exist between the abuse of substances and disturbances in eating, there has been a reluctance to accept that the two may share a common etiology. It is also probable that their similarities were obscured by dramatic differences in the social profile of the stereotypic drug addict and the patient with an eating disorder-the former typically associated with male criminality and social deviance and the latter with female submissiveness and social conformity.

In the past decade, however, there has been a growing paradigmatic shift in eating disorder research, with a movement away from explanations that rely solely on psychosocial factors, to a belief that disturbances in the function of brain neurotransmitter pathways are also highly relevant (Kaye, 1999). One outcome of this change in orientation has been an emerging and increasing interest in the links between eating disorders and substance abuse disorders.

Clinical and Biological Traits

It is generally agreed that the commencement of addictive behaviors can take two motivational routes: either the seeking of positive sensations or the self-medicating of painful affective states. While current research documents a substantial lifetime comorbidity between the eating disorders and other forms of addiction, there is less agreement on the reasons for this link (Holderness et al., 1994; Wiederman and Pryor, 1996). Some researchers have suggested that a common set of personality traits predispose an individual to a range of behaviors that have the potential to become excessive (Koob and Le Moal, 1997; Leshner, 1997). Support for this idea comes from evidence that anxiety and depression are frequent premorbid characteristics both of addicts (Grant and Harford, 1995; Kessler et al., 1997) and of patients with eating disorders (Deep et al., 1995; Vitousek and Manke, 1994). Our own research has also found that among eating-disordered patients, irrespective of diagnostic category, scores on a measure of addictive personality characteristics were comparable to those reported for drug addicts and alcoholics (Davis and Claridge, 1998). Complementary to this viewpoint, an addiction to one behavior reinforces a certain style of coping pattern that leaves the individual vulnerable to developing another type of addiction (Holderness et al., 1994).

Others have suggested that the eating disorders are, themselves, a form of drug addiction since their characteristics satisfy all the clinical and biological criteria for conventional addictions such as smoking, alcoholism and cocaine abuse (Davis and Claridge, 1998; Davis et al., 1999; Marrazzi and Luby, 1986). Foremost among these is the progressively compulsive nature of the behavior, even in the face of adverse consequences to health and safety (Heyman, 1996; Robinson and Berridge, 1993). Moreover, with continual exposure, individuals typically require more of the behavior to produce the same reinforcing effect (Berridge and Robinson, 1995). They also tend to experience an obsessively increasing craving for the behavior that can persist even after a long period of abstinence. Presumably that accounts, at least in part, for the fact that addicts have a strong tendency to resume the addictive behavior after treatment and for the chronic relapsing nature of addiction (Robinson and Berridge, 1993). These characteristics find direct parallels in the core eating-disorder behaviors such as dieting, over-exercising and binge eating, all of which tend to become increasingly excessive over time. Patients also report a strong compulsion to continue these behaviors despite serious medical complications, which is reflected in their prolonged morbidity and the high rate of relapse (Herzog et al., 1999; Strober et al., 1999).

At the biological level, similarities are also evident. We know, for instance, that strenuous exercise and starvation activate the dopaminergic (DA) reward pathway of the brain (Bergh and Sodersten, 1996; Casper, 1998). The resulting biological events underlie the auto-addiction opioid theory, which proposes that a chronic eating disorder is an addiction to the body’s production of endogenous opioids and therefore is identical to the physiology and psychology of substance abuse in general (Huebner, 1993; Marrazzi and Luby, 1986). In other words, starving, bingeing and exercise all serve as drug delivery devices since they increase circulating levels of -endorphins that are chemically identical to exogenous opiates, and these endorphins are as potentially addictive because of their ability to stimulate DA in the brain’s mesolimbic reward centers.

Via a different route, self-starving may have other biologically rewarding properties, albeit as a negative reinforcer. For example, in certain individuals, food restriction is reported to reduce anxiety. It has been suggested this might occur because of reduced serotonin activity in those with overactivity in this neurotransmitter system (Kaye, 1999).

– See more at: http://www.psychiatrictimes.com/articles/addiction-and-eating-disorders#sthash.UckhnDog.dpuf

Diet in Recovery

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“According to Medline Plus, an addicts diet prior to recovery not only effects ones overall health but can lead to many diseases and disorders of the body and mind.”

The impact of different drugs on nutrition is described below.

OPIATES

Opiates (including codeine, oxycontin, heroin, and morphine) affect the gastrointestinal system. Constipation is a very common symptom of abuse. Symptoms that are common during withdrawal include:

  • Diarrhea
  • Nausea
  • Vomiting

These symptoms may lead to a lack of enough nutrients and an imbalance of electrolytes (such as sodium, potassium, and chloride).

Eating balanced meals may make these symptoms less severe (however, eating can be difficult due to nausea). A high-fiber diet with plenty of complex carbohydrates (such as whole grains, vegetables, peas, and beans) is recommended.

ALCOHOL

Alcoholism is one of the major causes of nutritional deficiency in the United States. The most common deficiencies are of pyridoxine (vitamin B6), thiamine, and folic acid. A lack of these nutrients causes anemia and nervous system (neurologic) problems. Korsakoff’s syndrome (“wet brain”) occurs when heavy alcohol use causes a lack of enough thiamine.

Alcohol intoxication also damages two major organs involved in metabolism and nutrition: the liver and the pancreas. The liver removes toxins from harmful substances. The pancreas regulates blood sugar and the absorption of fat. Damage to these two organs results in an imbalance of fluids, calories, protein, and electrolytes.

Other complications include:

  • Diabetes
  • High blood pressure
  • Permanent liver damage (or cirrhosis)
  • Seizures
  • Severe malnutrition
  • Shortened life expectancy

Laboratory tests for protein, iron, and electrolytes may be needed to determine if there is liver disease in addition to the alcohol problem. Women who drink heavily are at high risk of osteoporosisand need to take calcium supplements.

STIMULANTS

Stimulant use (such as crack, cocaine, and methamphetamine) reduces appetite, and leads to weight loss and poor nutrition. Abusers of these drugs may stay up for days at a time. They may be dehydrated and have electrolyte imbalances during these episodes. Returning to a normal diet can be hard if a person has lost a lot of weight.

Memory problems, which may be permanent, are a complication of long-term stimulant use.

MARIJUANA

Marijuana can increase appetite. Some long-term users may be overweight and need to cut back on fat, sugar, and total calories.

Nutrition and psychological aspects of substance abuse

When people feel better, they are less likely to start using alcohol and drugs again. Because balanced nutrition helps improve mood and health, it is important to encourage a healthy diet in people recovering from alcohol and other drug problems.

However, people who have just given up an important source of pleasure may not be ready to make other drastic lifestyle changes. It is more important that people avoid returning to substance abuse than that they stick to a strict diet.

“We can take back our health and our life by following some simple guidelines…”

  • Stick to regular mealtimes
  • Eat a low-fat diet
  • Get more protein, complex carbohydrates, and dietary fiber
  • Vitamin and mineral supplements may be helpful during recovery (this may include B-complex, zinc, and vitamins A and C)

People with substance abuse are more likely to relapse when they have poor eating habits. This is why regular meals are so important. People who are addicted to drugs and alcohol often forget what it’s like to be hungry and instead think of this feeling as a drug craving. They should be encouraged to consider that they may be hungry when cravings become strong.

During recovery from substance abuse, dehydration is common. It is important to get enough fluids during and in between meals. Appetite usually returns during recovery. People in recovery are often more likely to overeat, particularly if they were taking stimulants. Eat healthy meals and snacks and avoid high-calorie foods with low nutrition (such as sweets), if possible.

The following tips can help improve the odds of a lasting and healthy recovery:

  • Eat nutritious meals and snacks.
  • Get physical activity and enough rest.
  • Reduce caffeine and stop smoking, if possible.
  • Seek help from counselors or support groups on a regular basis.
  • Take vitamin and mineral supplements.