1. You say that understanding food addiction educates us. What does food education look like to you?
I assume you are asking what food addiction looks likes to me (not food education). In simplistic terms food addiction looks like an inability to stop eating to the point that one’s life is being impacted in unhealthy ways, even though one truly wants to be able to stop.
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For example, a food addiction may be present if a person’s weight has resulted in serious health issues (hypertension, diabetes, high cholesterol, sleep apnea, need for knee/hip replacement, etc.), the doctor has said losing weight is imperative in order to improve those health conditions, but the person is unable to stop eating in unhealthy ways, in spite of a strong desire to do so.
Or, if a person’s focus on food, weight, diets, etc. is causing difficulties in their relationships with family or friends, but they continue to make their weight, their talk of dieting or the time they spend away from the people in their life due to food/weight-related behaviors to the ongoing detriment of those important relationships, there may be food addiction present. Without the ability to recognize an addiction, a person is unable to deal with/get treatment for it. That is why it’s important to have the education about food addiction.
2. Why do you think its important to educate ourselves and our families on the realities of food addiction?
I jumped the gun in question number one, I see! We have to know what an addiction looks like if we are going to get help for it. It seems to me a great number of people describe themselves as “food addicts,” and yet may not truly understand that addiction is a disease that needs treatment. Addiction is a chronic disease that is not “cured,” but can be treated.
In addition, like all chronic diseases, meaning the disease does not ever go away completely, but can be remitted, addiction affects every person in the family. Therefore, all family members need to understand the disease, how it affects the person afflicted by it, and how it affects all members of the family.
3. We are seeing an increase in the cases of children with food addictions and body image issues. How much of a role do we play in shaping our children’s perspective on living a healthy lifestyle?
Primary caretakers play a tremendous role in shaping our children’s perspective on living a healthy lifestyle. Typically, children ‘learn what they live’ in the home. When they become adults, they often repeat the patterns and ‘live what they learned.’ Clearly, that is not always the case, although it often turns out to be the way things play out. Therefore, how adults choose to eat (cooking versus eating out, choosing well-balanced meals versus carbohydrate-laden snacking, drinking soda and sugar-filled drinks versus water, etc.) have a large impact on the way children are taught to eat.
The ways adults talk about their own body acceptance (or lack thereof) has a powerful impact on how children learn to be critical or accepting of their own bodies.
Whether adults are critical and judgmental toward people who are overweight/obese will also influence how their children will think about, and behave toward those who struggle with their weight. Yes, we adults play a very significant role in our childrens’ perspectives on living a healthy lifestyle.
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4. Fad diets and weight loss programs are everywhere. We see books written about them, documentaries on Netflix, our friends talking about them. How much of what we see and hear in the media should we take at face value and how much of it should we take upon ourselves to learn more about?
The answer to this question could be a book in itself! There are SOOOO many books, so much information and so many programs out there. It can be daunting to dig in and know where to start.
I struggle with some of the reality shows as they can favor “hype” over reality. In fact, I have heard, although I don’t know for sure, that some of the “reality” shows are completely scripted. There are, of course, some good reality-type programs that do help educate the public in some ways, at least. Regardless of whether one reads something in the media, hears about something on a television show (even established news programs), always investigate.
Even the most prominent “recovery programs” don’t agree on some things. I read a lot on the topics I am most interested in. What I hear and see in the majority of the books and articles is what I considered to be the most “tried and true.”
In other words, if many of the “top” authors on a subject are saying a lot of the same things, I figure there must be some truth to it. The bottom line, however, particularly in regard to healing from addictions, is to sort through the many tips and tools and figure out what works for you! Strive to live a life clean and sober from all mood-altering substances and behaviors and to learn to live life fully! Get the professional and lay person support necessary and gather as many tools as you need to be successful.
5. Addiction can be caused by both physical and emotional problems. Do you see therapy as a response to working to treat our addictions?
Personally, I can’t even imagine trying to successfully treat addictions without the benefit of therapy. That being said, “therapy” can come from many sources, including recovery support groups (12 Step groups, Celebrate Recovery groups, Smart Recovery, etc.), spiritual leaders, mentors and sponsors. Formal therapy with a licensed professional who understands addictions and the underlying issues oftentimes accompanying addictions (trauma, unresolved loss/grief, etc.) is always, in my book, a wise thing in which to participate!
6. There is a lot of stigma attached to getting therapy when it comes to addiction. How do you ensure that patients feel safe to be able to overcome their challenges and medical conditions?
I say if those who “support” a person oppose therapy, but the person believes therapy would help, then get the therapy regardless of what others think! You can tell others or not, but get the professional help you need. Therapists are bound to keep patient information confidential (with a few exceptions). A therapist is someone who wants to help and will put forth effort to help the patient feel safe. All therapists, as well as medical providers, can only help their patients to the degree the patient wants help and is willing to put forth effort for themselves.
I tell patients that I will do everything I can possibly do to help them overcome their challenges (within legal and ethical constraints), but I cannot and will not work any harder for them than they are willing to work for themselves. I am willing to believe in them until their self-esteem and self-efficacy increase. Yet, they need to show up and put forth some degree of effort if their medical and/or psychological challenges are to be overcome.
7. Why do you think some people wait until they have reached to the point of getting weight loss surgery before they take matters into their hand?
Obesity is a very complicated disease, on both emotional and physiological levels. Patients who struggle with obesity have often been criticized and judged by health care professionals, ranging from nurses, to doctors to therapists. They are often times reluctant to even go for professional help for fear of being chastised once again.
Persons who have the disease of obesity often have a great deal of shame and therefore do what they can to avoid inviting more. Many patients have “tried and failed” in terms of weight loss efforts for so long, they have, in some cases, “given up” and/or “given in.” Many people tell me they have been diligent in terms of eating well and exercising but lose so little weight that they give up on their efforts.
Others have taken matters into their hands over and over and over, trying nearly every diet they hear about. For some, dieting becomes a way of life, which may represent a fear of dealing with other, more “real,” potentially emotionally painful issues.
Chronic dieting keeps one focused on food, calories, scales, points and recipes. Chronic dieting, and the amount of thought, time and effort that goes into it can also help one avoid a painful marriage, difficult family dynamics, and ultimately, to avoid one’s self. I don’t know that I would find it fair to say that patients wait until they are seeking weight loss surgery to take matters into their hands.
I have conducted over 5000 pre-surgical evaluations and can’t think of any patient who hasn’t made some attempts to deal with their disease prior to seeking bariatric surgery. For those bariatric patients who are also dealing with the disease of addiction in addition to the disease of obesity, they may have no awareness that addiction is sabotaging their efforts to lose weight or remain on a weight loss program that has been successful for them. Medical and mental health professionals, as well as patients, need more awareness of how addiction may be undermining weight loss efforts for a great many patients.
8. What are the misconceptions about weight loss surgery that you are actively trying to dispel?
I love this question as there are a number of misconceptions about weight loss surgery… and I vehemently work to dispel them! First, it is not true that after bariatric surgery, a person can “eat whatever I want… just less of it.” While that may appear to “work” for a time, it is simply not the case. “Going back to my bad habits” is what has led to weight regain following prior weight loss efforts. A return to habits of eating a steady diet of unhealthy foods will lead to weight regain, for almost anyone, even after bariatric surgery.
Another misconception is that all patients will experience the “dumping syndrome” and therefore will be unable to consume sugar and/or too many simple carbs without getting sick. Only a percentage (40 – 50 percent) of people will experience “dumping,” an unpleasant physiological response to eating too much sugar or too many simple carbohydrates.
A number of patients want to experience dumping as they believe this will be a deterrent from eating foods with sugar/too many carbs. While fear of dumping may detract some people from eating foods that can trigger the symptoms of dumping, including nausea, chills, sweats, cramps and diarrhea, quite a few people resume the consumption of sugar and carb-rich foods.
An additional misconception is the notion that only a “very small percentage” of people develop alcoholism, pain medication addiction, or other addictions following bariatric surgery. Although the numbers of patients who develop addictions following bariatric surgery may not be large, neither it is “very small.”
9. How is self-esteem and self-confidence tied to accepting ourselves as we are yet recognizing that we are not a 100% perfect and we may have work to do?
Self-acceptance is difficult for most people. We are emotionally protective beings and will therefore, shy away from recognizing and dealing with our imperfections. In working with patients who suffer from obesity, self-acceptance can be even more difficult. The majority of people who suffer from obesity have experienced ridicule by others, from loved ones to strangers to health care professionals. In addition, many people heap ridicule upon themselves in the way of negative self-talk.
For people who have made numerous unsuccessful attempts to lose weight, self-esteem, self-efficacy and self-confidence are lacking. Emotional pain related to their weight is often a daily experience, whether it originates from an external source or from within self. Human nature is to protect one’s self, both physically and emotionally.
Therefore, we minimize or deny the emotional pain we experience. Acceptance of self is a process. Perfection is a myth, an unattainable human condition. Accepting that perfection is not the goal and learning to be grateful for our working parts is a start!
10. How much of food addiction is internal stressors and how much of it is external?
According to Gabor Mate, a physician who is an addiction expert, two things are required for addiction to manifest: “a susceptible person and stress.” I agree. Many addicts have dealt with external stressors, particularly in their early years, to include abuse and neglect. Addictions develop as a way to avoid the pain of such stressors. Addictions help people emotionally numb themselves.
Addictions can be thought of, in many cases, as the symptom of other, more “real” problems that need to be addressed. Internal stress may be the result of being ill-equipped to deal with external stressors. As for what part internal vs external stressors have to do with addiction, I couldn’t begin to answer except to say that both types of stressors contribute to using food or other addictive substances or behaviors as an unhealthy way of attempting to cope with the stress.
That is why learning stress reduction techniques to include breathing skills and mindfulness skills are beneficial to the treatment of addictions.
11. In your words, please share with our readers your experience, if any, with food addictions, how you overcame them and how you are using your experience to help others overcome theirs.
I became aware of “body image” in middle school. I began exercising at that time on a regular basis. When I left home for the first time to live on my own at college, I developed a very serious eating disorder. I was extremely anorexic, which for me, was a form of a food addiction. I overcame that in a very unhealthy way. I started drinking a lot and became a functional alcoholic throughout the last couple years of college. I then got married and discovered that codeine had fewer side effects and no one could smell it, like they could alcohol.
At the age of 28, with my marriage and family at stake, I finally entered an outpatient treatment program. It was then that I began my journey into recovering from addictions. I am so very grateful to have spent the next three years in various forms of therapy to include individual, couples, family and group therapy. It was then that I returned to school to obtain both my Master’s degree and PhD.
Since that time I have worked to help others deal directly with whatever problems they have in life, without the use of addictive substances or behaviors. It is extremely rewarding work and I am grateful to be able to have the job that I do. My experiences with addiction benefit me in my work with others as they know I understand what they are dealing with.
12. There is one message that you never fail to share with others. What is it?
In terms of my work with food addiction: If you have the disease of addiction as well as the disease of obesity, you need to actively address both diseases or the addiction is going to trump the obesity. The result will be weight regain and/or the development of other problematic, addictive behaviors.
In general my overall message regarding addition and healing from addictions is this: We each need to heal the relationship with ourselves (address unresolved issues related to shame and learn to utilize our individual gifts) in order to live our fullest, most authentic lives possible.
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I hope this interview was informative, helpful for everyone and thanks for Dr. Connie for taking the time to talk to us.