Dear Clients and Colleagues: Summer has officially begun!

The pools are open, the aroma of barbeque is in the air, and the ice-cream man has started making his rounds ringing that well-known bell after dinnertime! With the warm weather and relaxed attitudes that come with summertime, there is much temptation to indulge in foods that may not be healthy for us and certainly not on any routine basis. When struggling with food, weight, and impulse control, there is even more of a need for awareness, information, and support in not reinforcing and enabling destructive behavior with food. The last issue of Living Well News focused on Our Relationship with Food, and examined problems with eating habits, food choices, and introduced food addiction. This issue of Living Well News is focused on Mending Our Relationship with Food helping us understand our behavior, the influence of emotions, and steps to prevent and treat food addiction. There is also a skill building opportunity using mindfulness to help you with reorienting yourself and gaining back behavioral control in the moment. And, let us know how you made out in using it! 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 Making Change - Making a New You Reflecting back on the statistic 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 -- tells us that something was amiss in the change process. Working with harmful health habits, including addictive behavior with food, is a process not an event. These are lifestyle changes requiring self-awareness, preparation, and the willingness to be uncomfortable. Social support and having a solid plan for ongoing maintenance is paramount, as most people relapse into old behavior during the maintenance phase, after the crisis passes. Quick changes or adaptations are often confused with lasting change. It seems to be that we humans believe, or want to believe, that once we get a quick win on the board that we are done or that we get to reward ourselves, usually with permission to indulge ourselves in the very behavior that presented problems in the first place! Lasting change involves new ways of living, and decision-making which need to become ingrained automatic responses, as opposed to requiring large amounts of willpower and energy directed towards desired outcomes in order to sustain new behaviors. Having a process allows us to integrate and adjust to new ways of living and, believe it or not, start to connect to the new identity that change brings. Perhaps you have heard a formerly obese person share that although they had achieved weight loss, that they continued to see themselves as fat? This, of course, led them to relapse because they did not change their relationship with themselves, their thinking, and self-concept from being obese to being at a healthy weight and being a person who makes healthy choices. Essentially, the inner person who was struggling with

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food does not go away but needs continual encouragement, redirection, and reinforcement concerning new lifestyle behaviors. Understanding Behavior Most of us consider behavior as what we can observe. However, the larger part of behavior is actually deeper and goes unseen, including our thoughts and emotions which drive our actions in the attempt to resolve feelings, moods as well as to sooth sensory discomfort. This is how we are structured as creatures with a brain that thinks, emotes, and prompts us to take action structured to survive under any circumstance. Its just that our brains are not necessarily structured for modern life where there is a need for both short and long-term planning, while operating according to socially acceptable norms. The odds are that there are no creatures lurking in the bushes waiting to pounce on us - We may NOT need our brain stems to scan for the ongoing dangers of environmental predators as our early ancestors did in order to stay alive. However, the brain continues with its original programming without retraining, it goes where ever it needs to in order to avoid discomfort, unwanted feelings, and what it interprets as danger. In order to change our behavior we need to understand our behavior, including: how we perceive ourselves, others, the way we think, the types of feelings, and their intensity that surfaces in response, and then identifying the action we use in order to cope and self-manage. The Role of Emotions Whether we are aware or not we are always feeling something. The purpose of body sensation and emotions are to get us to act. If we did not feel hungry we would not eat If we dont eat, we will perish. If we didnt have taste then we would not be attracted to food, etc. However, the way we respond to our bodys cues can impact our health and well-being, either in a positive and/or negative way. Cues and emotional triggers drive overeating by stimulating our mental ghosts (representations of past sensory and emotional associations with food that we have stored in our brains). When we expect food will give us pleasure or relief from distress, that expectations amplifies the rewarding value of food. Expecting something to be rewarding stimulates pursuit of that reward. If eating alleviates negative emotional states then, over time, that cognitive memory with become stronger and more salient. It becomes the way we cope and handle our inner experiences. People who dont acknowledge or talk about feelings are at high risk for problem behavior, and often have difficulty identifying their emotional needs and exercising behavioral control. The no emotions, I dont cry or be vulnerable rule tends to get people into trouble -- fueling tension, rigidity, frustration, and impulse control problems. Conversely, those who over-emote and who may be labile, meaning emotionally up and down or lacking stability, are also at risk in their ability to assert true behavior control as they tend to be hypersensitive or emotion-phobic. Essentially, we need to understand our behavior patterns, including identifying the emotions and sensations that are most difficult for us to experience. In doing so, we also need to assess the basis for our thinking and appraising what we believe to be true. It is important to remember that we are not our thoughts and that feelings are not facts. The most common emotions which present difficulty include: sadness, anger, emptiness, stress, and anxiety. We tend to judge these emotions as negative, although they are part of a being human and alive.

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Prevention & Treatment of Food Addiction Just like in any other relapse prevention plan, it is important to: #1: #2: Avoid risky situations. Increase your awareness of where you are or where you are going. What will you be exposed to? Reduce likelihood of craving by reducing the likelihood of cures to unhelpful behavior. Refuse invitations. Eliminate the possibility of being exposed to trigger foods, those that put you at risk for overeating or binging. Stay based in reality What can you really expect when you expose yourself to temptation? Resist the urge. Urges are common and normal. It is when we give into urges that we make way for more of them. They can be intense and tend to get stronger each time we give into them. Helpful coping can include: Find a distraction. (15 minutes can be a magic number!) Talk about the urge with someone supportive. Talk yourself through the urge. Surf the urge ride it out. Remind yourself of negative consequences.

#3:

Remind yourself of your goals and that you wish to feel positively about yourself keep that in mind when confronting trigger foods (pastries, carbs, sweets, etc. most common). Push yourself away from what is no longer wanted. Planning your response to these foods will be key to your success putting together a plan to remove yourself from the environment or refuse the food. Practice, over and over, until it becomes a habit. Structure is also the key to health. Make sure that you are not hungry and are well fed. Eat a protein-based breakfast and have small healthy snacks throughout the day -- including nuts and fruit, and drink plenty of water. This will reduce cravings and emotional vul\nerability. Skill Building: Mindful Eating Part of healing destructive eating and food patterns is to heal the body and become in tune with its needs. Knowing natural hunger signals is the most effective way to maintain healthy weight. This means knowing the difference between a stress response and real hunger. Hence, quieting and slowing down is necessary to be able to listen to, learn, and trust the bodys cues -- and to, perhaps, reshape old reactive, addictive conditioning to more conscious choices based on real needs. The next time you sit down to a meal: Make sure that you actually have time to eat the meal in a paced manner. Be aware of your hunger. Listen to what your body is feeling tune into hunger, strength, mental energy, and focus. Know what you are about to eat and assess whether you are going to gain nutritional value from the meal. Notice colors, textures, and even being aware of the food origin. . Be aware of portions eat on a smaller plate, especially if you tend to over portion your food.

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Slow down before you eat. Drink a glass of water and breathe. Eat slowly, one small bite at a time, taste the food, chew thoroughly, and swallow. Take time eating and digesting the meal. Most of us eat too fast!

Obviously, there is more to the eating and food equation But, understanding our behavior with food is a powerful and necessary place to start. While the food industry with its additives makes for craving and problem eating, we still need to take control. Seeing an integrative physician can be helpful, as well to assess to food allergies or other health concerns with may fuel the problem. We invite you to sign up for the monthly issue of Living Well News please on the Integrated Treatment solutions homepage www.myintegratedtx.com .www.myintegratedtx.com .

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