Emotions, Comfort and Food

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Parents who have unresolved issues with their own parents are ill-equipped to protect their children from obesity, as we discussed yesterday. Another comment on that same study and that particular brand of poor parenting comes from Vanishree Bhatt, writing for ScienceWorldReport.com:

It was found that insecure parents were more likely to be distressed by their children’s negative emotions when punished. Children are unable to handle all the emotional turmoil and feelings and turn to comfort eating of junk food, sugary drinks and salty treats. These eating and behavior patterns increase risks of obesity.

A study published by The American Journal of Clinical Nutrition and reported on for MedicalDaily.com by Samantha Olson illustrates one way in which parents can undermine their children’s health. Olson describes the elaborate experiment showing that stressed kids consume more calories, but this is the gist:

They found those parents who said they had used a reward system with food between the ages of 3 to 5 were more likely to have kids at risk of eating more calories.

University at Buffalo public health researcher Marc Kiviniemi wondered why, regardless of the fact that most Americans have tried to lose weight, most Americans are still overweight. He perceived a “disconnect” and, together with Carolyn Brown-Kramer of the University of Nebraska, set out to discover what was behind it.

The things that people take into account when making a diet plan are not the same factors that influence actual behavior. Kiviniemi is quoted on his institution’s website:

The crux of the disconnect is the divide between thoughts and feelings. Planning is important, but feelings matter, and focusing on feelings and understanding their role can be a great benefit… Planning is an effort that demands mental energy, but feelings happen automatically. Deprivation or anything that demands a high degree of self-control is a cognitive process. If you put yourself in a position to use that energy every time you make a food choice that energy is only going to last so long.

Dr. Billi Gordon writes often about the compulsive overuse of food, alcohol, and drugs. He asks his readers to remember that many processed food products are actually more like drugs, and to be conscious of when we are using food for drug-like purposes. Some behaviors that help us to “survive now” are quite damaging in the long run, and we need to replace them with better “survive now” strategies. This brief extract gives an idea:

In the case of negative emotions generated by social cues, your brain’s response will be to take the lid off of the neurochemical cookie jar for some dopamine… To protect us from the neurochemical deficits caused by negative emotions, one of the brain’s immediate solutions is to increase dopamine (the brain’s happy dance drug)… When you are bingeing, your brain is surviving now by reaping the neurochemical rewards of eating to obviate the immediate threat of negative emotional states.

Reddit contributor “hamplanet_boogie2988” once wrote:

I am the ‘perfect storm’ of bad eating habits.

I eat when I am sad because it makes me happy. I eat when I am happy to celebrate. I eat when I am bored. I eat when I’m depressed.

I am a compulsive eater. I am an over eater. I binge. I also am unable to purge.

I am obsessive about it. I get angry about it. I get sad about it.

I have gone to the store to get a food I didn’t really want and ate it while crying.

I’ve eaten huge meals while not even thinking about it, but thinking about what I was going to eat next.

This litany of misery ends with a final declaration that we won’t repeat on a family webpage, but which translates as, “I’m all kinds of messed up.”

Your responses and feedback are welcome!

Source: “Poor Parenting Linked to Childhood Obesity: Study,” ScienceWorldReport.com, 02/11/14
Source: “Stressed Out Kids More Likely To Overeat; How Parents Train Their Kids In Emotional Eating,” MedicalDaily.com, 05/03/15
Source: “Thoughts drive dieting plans but feelings drive dieting behavior,” Buffalo.edu, 05/05/15
Source: “We Break Our Own Hearts,” PsychologyToday.com, 04/07/15
Source: “FatPeopleStories,” Reddit.com, 2014
Photo credit: cogdogblog via Visualhunt.com/CC BY

Emotions and Food, a Sad Legacy

i-am-bored
“Associations Between Adult Attachment Style, Emotion Regulation, and Preschool Children’s Food Consumption” is the title of a study published by the journal of Developmental & Behavioral Pediatrics, which attempts to better understand the roots of childhood obesity. The questions that drove the researchers’ curiosity are explained by Prof. Kelly Bost:

We wanted to discover the steps that connect attachment and obesity. Scientists know that a person’s attachment style is consistently related to the way he responds to negative emotions, and we thought that response might be related to three practices that we know are related to obesity: emotion-related feeding styles, including feeding to comfort or soothe; mealtime routine; and television viewing.

Routine is another word word for habit, which Childhood Obesity News recently discussed as one of the pillars on which the house of sustained weight loss is built. Because humans revert to habit in times of stress, the importance of establishing useful habits in small children is paramount.

In the matter of feeding styles, “secure attachment” is similar to “unconditional positive regard,” in that both phrases are science-speak for a word that seemingly is unsuitable for scientific papers: love. Here, secure attachment is defined by the availability and responsiveness of the caregiver(s). In other words, someone is with the child, and not just physically present but emotionally available enough to interact.

Responsiveness is a double-edged sword. It is a psychological truism that a child finds even negativity, criticism, and punishment preferable to being ignored. As millions of tragic case histories throughout the ages can attest, painful attention is better than no attention at all.

If the primary care physician were free to explore that path, strewn with emotional landmines, many children who are now obese might not have been. How many families are likely to have the opportunity of full-blown therapy for all members? Or the willingness to undertake it? But those are questions for another day.

Insecure attachment

This University of Illinois study broke some new ground by showing a multi-generational dynamic that had not previously been defined. We take the liberty of personalizing the premise by inventing a fictitious character, Norma. In childhood, the emotional base that supported her was shaky. Her hard-working parents were rarely seen, and she was raised by a series of baby-sitters, au pairs, and nannies. Consequently, Norma was always anxious and uncertain in close relationships.

Norma grows up, has a child, Sandy, and instantly begins a career of ineffective parenting. One day, Norma hears about an academic study, and volunteers to answer questions about how she deals with Sandy’s negative emotions. The researchers want to know if she and the other participants use “emotion-related, pressuring feeding styles known to predict obesity.”

Norma answers all the questions honestly. She cops to using food treats to reward or bribe Sandy, and quite a few other counterproductive activities. Like many other parents in her situation, she becomes overwhelmed by stress and takes the easy way out. The very idea of trying to enforce a set mealtime is exhausting. If Sandy doesn’t want to eat at regular times, fine. Meanwhile, Sandy is the biggest kid in the class.

One thing that parents do is to punish or dismiss the sad or angry feelings of a child, which only leads to more sad and angry feelings, and eventually, to some kind of crisis. This is Prof. Bost again:

The study found that insecure parents were significantly more likely to respond to their children’s distress by becoming distressed themselves or dismissing their child’s emotion…

Clinicians can help address children’s obesity by giving parents practical strategies to help kids deal with negative emotions like anger, sadness, and boredom. That means helping them describe what they’re feeling and working on problem-solving strategies with them.

The researchers’ ultimate question is, will Norma’s relationship with her own mother increase Sandy’s chance of obesity? Sadly, it looks like the answer is yes.

Your responses and feedback are welcome!

Source: “Could your relationship with your mom increase your child’s chances of obesity?,” EurekAlert.org, 01/30/14
Image by Internet meme

The Quit Smoking, Quit Sugar Drugs

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Recently, Childhood Obesity News mentioned the recent discovery that drugs like varenicline, which have been used to help people quit smoking, also seem able to help people who are hooked on sugar, by treating the sensory addiction component of eating addiction. As Dr. Pretlow has written, eating addiction results from a mixture of sensory and behavioral addiction components in varying ratios. Anything that approaches the problem from either angle should be examined for potential usefulness.

Apparently, varenicline and related drugs also affect lab animals that are habituated to artificial sweeteners like saccharin. Prof. Selena Bartlett, the Queensland University of Technology neuroscientist who did the research, hopes that this class of pharmaceuticals will provide a “novel new treatment strategy to tackle the obesity epidemic.”

Unfortunately, humans are likely to experience disturbing side effects. Varenicline, sold under the proprietary name of Chantix, has been found to produce stomach pain, indigestion, nausea (that may persist for several months), constipation, vomiting, gas, and blood in the urine or stool — and that’s just the digestive system. Farther up, at the digestive system’s receiving end, patients have reported dryness and an unpleasant taste in the mouth.

There have been reports of sleep disturbance and insomnia, unusual dreams, mental confusion, severe headaches, weakness, and fatigue. When treatment with this type of drug is initiated, the patients is warned to be on the lookout for chest pain and shortness of breath; vision, speech, and balance anomalies; blistering skin rash; easy bruising; and coughing up blood. Additionally:

Patients may experience psychiatric symptoms such as behavioral changes, agitation, depressed mood, and suicidal behavior while using Chantix.

Now, let’s look at Dr. Pretlow’s Huffington Post article about his W8Loss2Go program, which warns of the following harmful side effects: none. Dr. Pretlow writes:

The sensory addiction component is treated similarly to drug addiction by withdrawal/abstinence, first from each problem food, one-by-one, until cravings or difficulty resisting the food resolve. Next comes withdrawal from snacking (non-specific foods), accomplished by advancing snack stoppage time periods — morning, afternoon, evening, night time — with the aim of zero snacking for the entire day. Lastly, withdrawal from excessive portions at home meals is achieved by weighing and recording typical amounts of frequent foods served and incrementally reducing amounts.

Using the W8Loss2Go smartphone application results in no yucky taste in the mouth, no disfiguring rash, no weird dreams, and best of all, no risk of spewing up stomach contents that look like coffee grounds due to the presence of coagulated blood. With W8Loss2Go, absolutely no gastrointestinal distress is involved except for normal feelings of hunger, which diminish over time.

Your responses and feedback are welcome!

Source: “Treating sugar addiction like drug abuse,” ScienceDaily.com, 04/17/16
Source: “Chantix,” RxList.com, undated
Photo credit: DavidFlam via Visual Hunt/CC BY

Emotions and Habit

student-studying
Emotional eating is often characterized as a weakness more common in women, but a study from Cornell University shows that when sports are involved, men are equally prone to abandon rationality. This was determined by tracking the responses of college students to the victories and defeats of their hockey teams.

Asst. Prof. Robin Dando says that a person’s emotional state affects taste perception, and bummed-out people crave sweets more intensely than those in a positive frame of mind. ScienceDaily.com elucidates:

The study shows that emotions experienced in everyday life can alter the hedonic experience of less-palatable food, implying a link to emotional eating, according to the researchers. Dando explained, “In times of negative affect, foods of a less pleasurable nature become even more unappealing to taste, as more hedonically pleasing foods remain pleasurable. This is why when the team wins, we’re okay with our regular routine foods, but when they lose, we’ll be reaching for the ice cream.”

Looking at college students and exams, a University of California research team headed by Prof. Wendy Wood observed a different trend. When a person feels stressed or even simply tired, self-regulation can become a challenge. At exam time, consumers of morning doughnuts and pastries stuck with their preferences and, predictably, ate more sweets than usual.

Before we shake our heads over the folly of youth, two things: One, the students who typically ate healthy breakfasts continued to do so, and those who usually worked out at the gym continued to do so. In fact, their good habits became slightly more pronounced. Two: Remember what happened when French researchers examined the habits of grownup Americans in relation to the wins and losses of their favorite football teams? The day after a game, the losers’ fans consume crazy amounts of food, especially the kind replete with saturated fat.

In their efforts to discover interventions that can curb emotional eating, researchers from Kennesaw University have published several papers concerning the efficacy of “cognitive-behavioral methods of exercise support.” They have developed a treatment protocol that demonstrates “significantly greater improvements in exercise outputs and self-regulation.”

Getting back to the USC research, the point is that stress encourages people to stick with habit, either bad or good. Habits are what make up a human’s default mode. We know that habit is key, and that with kids, the best intervention is early intervention. Also we know that the W8Loss2Go smartphone application is a tool for the formation of habits. Kids will always love gadgets, and this one is a life-changer.

Your responses and feedback are welcome!

Source: “Is defeat sweeter than victory? Researchers reveal the science behind emotional eating,” ScienceDaily.com, 07/09/15
Source: “Healthy habits die hard: In times of stress, people lean on established routines — even healthy ones,” EurekAlert.org, 05/27/13
Source: “Indirect effects of exercise on emotional eating through psychological predictors of weight loss in women,” NIH.gov, December 2015
Photo credit: John Althouse Cohen via Visual Hunt/CC BY-ND

No Reprieve — Cancer

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In the literature, there are references to childhood obesity as the apparent cause of various malignancies including those of the endometrium, uterus, prostate, gall bladder, breast, colon, esophagus, pancreas, kidney, and even lung. People became accustomed to the idea that tumors lurk in the distance, waiting to strike some day, like maybe in middle age.

Bad things might happen later in life, but the consequences, it seemed, would be postponed and, from the youthful point of view, “some day” means never. However, it becomes increasingly clear that obese young people can get cancer before they are old enough to legally drink, vote, or marry.

In children, both kidney and thyroid cancer are rare — though not as rare as they used to be, and they seem to have increased in tandem with childhood obesity. The tipoff came from researchers who noticed that these same cancers have become more common in adults since the obesity epidemic took hold.

Using a kind of working-backwards reasoning, they looked at what has been happening with children, and found cause for alarm. These numbers may not sound like much of a clue, but when the lives of children are at stake, every fraction of a percentage point counts:

For thyroid cancer, the diagnosis total was almost 5,000 cases, and the rate climbed from nearly six cases per million children to eight per million children in 2009.

For kidney cancer, the total was 426 and the rate climbed from 0.5 cases per million to 0.7 cases per million.

Research into esophageal cancer found that overweight kids are more prone to develop it than normal-weight kids.

Pediatric endocrinologist Steven Mittelman has spent many years investigating the link between childhood obesity and leukemia, and asking why obesity increases cancer risk and makes the disease harder to cure. For instance, kids who were obese at the time of their diagnosis, and who were treated with the standard protocols, were discovered to have about a 50% higher chance of relapse than their normal-weight peers. In other words, obesity both increases the chance that a child may contract leukemia, and decreases the chance of surviving it.

Dr. Mittelman learned that fat cells protect leukemia cells from chemotherapy, and that fat has other ways of accelerating the progression of leukemia, which is the most common type of cancer in children. Among other things, fat tissue…

Attracts leukemia cells to migrate closer to fat cells.

Absorbs and metabolizes some chemotherapy drugs, making them unable to reach the leukemia cells.

Releases fuels such as amino acids and fatty acids that help leukemia cells survive.

Secretes substances that signal the leukemia cells, making them more able to resist chemotherapy.

Just to make these propositions absolutely clear, we will also quote the description of his research (in collaboration with Drs. Nora Heisterkamp and Anna Butturini) as it appears in his professional biography:

His laboratory is currently investigating how obesity and cancer interact, using both mouse models and tissue cultures. He has found evidence that fat tissue may absorb some chemotherapies, so that these drugs are not available to kill the cancer cells. He also found that fat cells play an active role in the cancer microenvironment, participating in a two-way communication with cancer cells, and producing metabolic fuels and survival factors which protect cancer cells from chemotherapies.

Dr. Mittelman serves as director of the Diabetes & Obesity Program at Children’s Hospital Los Angeles and as director of the Keck/Caltech Combined MD/PhD Program. He is already familiar to readers of Childhood Obesity News, because he is principal investigator in the current study of Dr. Pretlow’s W8Loss2Go smartphone application.

Your responses and feedback are welcome!

Source: “Study suggests cancer-obesity link in children,” ProvidenceJournal.com, 09/15/14
Source: “Overweight children may be at higher risk of oesophageal cancer,” SpireHealthcare.com, 02/09/15
Source: “Steven D Mittelman,” USC.edu, undated
Source: “Steven Mittelman, MD, PhD,” CHLA.org, undated
Photo credit: frankie.baldo via Visual Hunt/CC BY-SA

Comorbidity Roll Call — Cancer

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The director of the National Cancer Institute has estimated that as many as 20% of the cancer cases in America would not exist if the population were not so obese.

Only a few months ago, the United Kingdom was shocked by a report published by Cancer Research UK and the UK Health Forum, which extrapolated from current trends to predict that by the year 2035, almost three-quarters of the nation’s people will be obese. Among many other undesirable consequences, this would probably mean 700,000 new cancer cases and the collapse of the National Health Service.

Israeli researchers at Tel Aviv University, who had access to 18 years worth of records for more than one million males, discovered a clear link between childhood BMI (body mass index) and the later development of urothelial and colorectal cancers in adulthood.

Danish researchers, who studied the records of well over 300,000 adults  of both sexes, discovered:

Adults who were obese as children are at increased risk for liver cancer… The study authors calculated that at age 7, the risk of developing hepatocellular carcinoma increased by 12 percent for every one-point increase in BMI. By age 13, that risk increased to 25 percent.

The Lancet has reported that obesity-related cancer is more likely to affect women than men, “largely due to endometrial (womb/uterus) and post-menopausal breast cancers.” Cancer Research UK says:

Obesity increases a woman’s risk of developing at least seven types of cancer – including bowel, post-menopausal breast, gallbladder, womb, kidney, pancreatic and oesophageal cancer.

For men, the colon and kidneys are more likely to be the site of a malignancy. Or the gullet, also known as the esophagus. This structure, which connects the throat with the stomach, is subject to being bathed in stomach contents when the patient — usually obese — suffers from acid reflux (commonly and erroneously known as “heartburn”).

As University of Southhampton surgeon and researcher Tim Underwood phrased it:

From a surgical point of view, we’re seeing a link between obesity and reflux and there is definitely a link between obesity and esophageal adenocarcinoma. So you could join the three dots together.

Of course, only men are susceptible to prostate cancer, and if they are obese or even just overweight when diagnosed, they are more likely to die, according to a Kaiser Permanente study. In fact, when it comes to the more aggressive forms of prostate cancer, the link between mortality from the disease is even more strongly linked with obesity.

Swedish researchers who studied the health records of 240,000 men say that “overweight teens may double their risk of developing bowel cancer by the time they reach middle age.” The raw fact of the connection is more evident than its precise mechanism:

Adult obesity and inflammation have been associated with an increased risk of bowel cancer, which is the third most common form of cancer among men, worldwide. However, less is known about how obesity and systemic inflammation might be influential during late adolescence.

Even the brain is not safe from threat, because overweight and obesity are closely related to the occurrence of meningioma, a type of brain tumor. This is according to a German meta-analysis which utilized information from “12 studies on body mass index and six on physical activity.”

The study author was Gundula Behrens, Ph.D., of the University of Regensburg. Science Daily reported:

Behrens said several biological processes could potentially link excess weight and increased risk of meningioma. For example, excess weight is associated with excess production of estrogen, and estrogens promote the development of meningioma. Also, excess weight is linked to high levels of insulin, which could promote meningioma growth.

Your responses and feedback are welcome!

Source: “Obesity linked to increased risk of leukemia,” EmaxHealth.com, 10/30/12
Source: “Obesity could lead to 700,000 more cancer cases in next 20 years,” TheGuardian.com, 01/07/16
Source: “Childhood obesity linked to bladder, urinary cancer,” Thaindian News, 07/24/12
Source: “Childhood Obesity May Raise Odds of Adult Liver Cancer,” HealthDay.com, 04/20/12
Source: “The Lancet Oncology: Overweight and obesity linked to nearly 500,000 new cancers in 2012,” EurekAlert.org, 11/25/14
Source: “Obese women 40 percent more likely to get cancer,” EurekAlert.org, 03/16/15
Source: “Obesity fuels rise in throat cancer in men,” DailyMail.co.uk, 06/17/13
Source: “Bowel Cancer: Overweight Teens Double Their Risk in Middle Age,” NatureWorldNews.com, 05/26/15
Source: “Being overweight may increase risk of type of brain tumor,” ScienceDaily.com, 09/16/15
Photo credit: davis.steve32 via Visualhunt/CC BY

Less Familiar Problems of Obese Kids

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As writer Grant McArthur reminds us:

Obese children are 27 times more likely to have type 2 diabetes than a child with healthy weight, twice as likely to have hypertension and obstructive sleep apnea, and also have a significantly higher chance of suffering asthma and gastric reflux.

Many people are also aware of the likelihood of heart problems, and some are aware of the host of other complications that can appear in the life of an obese child. Some of the difficulties don’t qualify as an actual disease, like diabetes, but are horrendous nonetheless — like having to sleep sitting up.

The need to make a major production out of picking up an item that fell on the floor is pretty unpleasant. How does it feel to a 15-year-old when someone decides to wait and take the next elevator, because he is a passenger? What if her family lives in a mobile home with a tiny cramped shower stall that she can’t even fit into?

On the road

A report on motor vehicle fatalities states that seatbelts are not worn by “a certain number of individuals from some subgroups,” which is a tactful way of saying fat people. The odds of seatbelt use for normal-weight individuals were found to be 67% higher than the odds of seatbelt use in the morbidly obese.

Crash test dummies are being developed that better represent the morbidly obese human, but no amount of clever engineering can help if people don’t buckle their seat belts. What are the dangers?

Prof. Richard Kent of the University of Virginia says:

The risk of your head hitting against something may go down if you’re obese. Whereas the risk of getting a thoracic injury, abdominal injury, or a lower limb injury especially, will go up.

Diagnostics

If an obese young person has to go to a doctor because of a mysterious pain or some other sign, layers of fat make physical examination difficult, and when it comes to the fancy machines, more trouble is in store:

Modern imaging equipment has designated weight limits established in order to ensure patient safety while avoiding damage to the equipment itself, and at most hospitals, there is a lack of equipment that can accommodate the size of obese patients. Obesity is also detrimental to image quality. Increased tissue thickness makes it difficult to obtain diagnostic images; therefore, the quality of care given to these patients suffers.

Obese patients are likely to experience embarrassment as technicians struggle to accommodate them on the imaging equipment. During the transfer from one surface to another, the patient is at risk for a fall, and the medical personnel also are vulnerable to injury. For the radiologist, it is difficult to obtain images of acceptable diagnostic quality, and obese patients wind up absorbing more radiation because of the need for multiple exposures.

Computed tomography, known familiarly as the CT scan, poses its own limitations. With any luck, the scanner might hold a 450-pound person. MRI or magnetic resonance imaging is even more restrictive, with the typical limit being 350 pounds, and even then, a large body poses multiple problems for a number of reasons. And ultrasonography? Forget it. “Ultrasound is the imaging modality that is most affected by patient obesity.”

And if they need surgery…

The doctors who specialize in keeping patients “out” during surgery face unprecedented challenges. They have to get used to 130-pound 6-year-olds and 200-pound 10-year-olds, and to calculate the correct and appropriate dosage of anesthetic for such kids is not easy.

The need to proceed with caution, and the possibility of error, can turn what should be a simple outpatient procedure into a hospital stay. Pediatric anesthetist Balvindar Kaur of Melbourne, Australia says:

Children have a relatively higher metabolic rate than adults — higher heart rate and other outputs — and while we generally dose by weight you can’t give a 90kg child what you might administer to a 90kg adult.

Your responses and feedback are welcome!

Source: “Obesity and Medical Imaging,” ISU.edu, 11/13/12
Source: “Anaesthetists struggling with dose sizes in childhood obesity cases,” HeraldSun.com, 05/04/15
Source: “Obesity and seatbelt use: a fatal relationship,” ajemjournal.com, July 2014
Source: “Study Finds Obesity Impacts Seatbelt Safety,” Newsplex.com, 01/27/15
Image by Tschaff

Catching Up on Sugar

sugar-bowl

The World Health Organization recommends that a person eat no more than 13 teaspoons of sugar per day, max. That’s just what are called “free” sugars — in other words, extra sugar that is added to food or consumed separately in the form of fizzy drinks. That’s over and above whatever sugar is naturally found in milk and fruit. The 13 teaspoons per day means “at most,” but you wouldn’t know it from the behavior of people — especially Australians. Their average is 14 teaspoons per day.

But the meaning of average is that some people do more and some do less. Australian teenage boys do far, far more than their share. They consume as much as 38 teaspoons per day. This is part of the reason why diet-related disease is the biggest killer of Australians. Very appropriately, a research team from an Australian institution, Queensland University of Technology, just published a couple of groundbreaking items.

A paper published by Frontiers in Behavioral Neuroscience shows that “long chronic sugar intake can cause eating disorders and impact on behavior” in lab animals, and presumably also in humans. Many medical professionals already suspected as much, so to have this kind of confirmation is just icing on the cake. The study that excites the imagination was published in PLOS ONE and explained by Professor Selena Bartlett:

Excess sugar consumption has been proven to contribute directly to weight gain. It has also been shown to repeatedly elevate dopamine levels which control the brain’s reward and pleasure centers in a way that is similar to many drugs of abuse including tobacco, cocaine and morphine.

After long-term consumption, this leads to the opposite, a reduction in dopamine levels. This leads to higher consumption of sugar to get the same level of reward.

Like other drugs of abuse, withdrawal from chronic sucrose exposure can result in an imbalance in dopamine levels and be as difficult as going “cold turkey” from them.

It may seem a bit strange to reference “neurological and psychiatric consequences affecting mood and motivation” when speaking of lab animals, but tests have been developed to demonstrate both mood and motivation in them, and after all, dopamine is dopamine.

The setup for the big news is a refresher course, or rather a refresher sentence, on pharmaceutical drugs that act “as a neuronal nicotinic receptor modulator” and help humans stop smoking cigarettes. Some of their generic names are mecamylamine, cytisine, and varenicline (marketed as Champix).

And the big news is… Going by the animal trials, this type of drug seems able to unhook them from sugar as successfully as it unhooks them from nicotine. Dr. Pretlow’s reaction is, “Champix appears to be treating the sensory addiction component of eating addiction.” But is it enough?

Eating addiction is the more accurate term for what is widely known as “food addiction.” Dr. Pretlow teaches that eating addiction is a combination of two different things, a component of sensory addiction and a behavioral addiction component. The proportions of those two components vary from one individual to the next. He says:

Simple abstinence/withdrawal for 10 days treats the sensory component very readily, as in the W8Loss2Go app with problem foods like sweets/sugar. The behavioral addiction component of eating addiction (chewing, swallowing large amounts) is more difficult to treat and must be treated with behavioral addiction methods like urge surfing, deep breaths, squeezing hands, and viewing white noise.

For a more complete description, please visit the W8Loss2Go page.

Your responses and feedback are welcome!

Source: “Australian teenage boys are consuming up to 38 teaspoons of sugar in a single day,” DailyMail.co.uk, 04/27/16
Source: “Treating sugar addiction like drug abuse,” ScienceDaily.com, 04/17/16
Image by: Mendhak

Co-morbidities — Now for Kids!

sid-vicious-cycle
As we have seen, a co-morbidity is another serious disease that a patient has along with obesity. Maybe it and obesity are risk factors for each other, or causes of each other, or are like a couple of troublemakers who just happen to hang out in the same bad neighborhood and decide to join forces.

Where children are concerned, the realization of how many conditions can co-exist with obesity arrived in two stages. First came the awareness that obese children would probably face heavy consequences, further on down the line. Medical professionals and the public became accustomed to the idea that overweight children are gearing up for a future marred by heart disease, type 2 diabetes, or arthritis.

Then came awareness that right now, not in the future, millions of young humans are suffering from conditions that children never had before. We all got used to the idea that co-morbidities can blossom in the cardiovascular system, the central nervous system, the metabolic system, the reproductive system, the gastrointestinal and respiratory tracts.

Co-morbidity can take orthopedic or psychological form, or show up as a malignancy. Obese kids are likely to have bone, joint and muscle irregularities, or asthma, or ear infections, or allergies, or crazily sequenced development, behavioral problems, ADHD, depression, and a bunch of other stuff.

A 2013 study from UCLA’s Center for Healthier Children, Families & Communities pointed to stress as the chief villain, which was reported by the American Pediatric Association thusly:

It’s a chicken-or-egg scenario, the APA says, because stress may contribute to the risk of obesity and related issues, while obesity and health issues may contribute to stress.

In other words, what we call a vicious cycle is at work. Another vicious cycle is set up by the interactions of obesity and pain, which cause and perpetuate each other. The journal Obesity published a study based on “a Gallup poll of 1,062,271 randomly selected adults interviewed between 2008 and 2010.”

Compared to normal-weight people, the overweight report 20% higher rates of pain, and the obese report 68% higher rates of pain. Now, when it comes to Class III obesity, defined as a BMI of 40 or more, people who truly are morbidly obese, that group reported 254% more pain.

Obviously, someone who is in pain just sitting still is not a good candidate for an exercise program. Dr. Arya Sharma, who is scientific director of the Canadian Obesity Network, calls pain a major barrier and “a major driver of weight gain in a lot of patients.” Reporter Sharon Kirkey wrote:

According to the researchers, one plausible explanation is that excess fat is biologically active. It secretes leptin and other hormones that can cause inflammation throughout the body “that ultimately create states that result in pain.”

Oddly, the same word appears in a piece titled “Obesity Conclusively Linked to Gum Disease.” Previously, researchers were aware of links between diabetes and gum disease, and between diabetes and obesity, but despite this indirect connection, a direct relationship between obesity and gum disease had not been proven.

This changed when a Case Western Reserve University study determined that the two are linked by the “underlying inflammatory processes found in both conditions.” The report quotes lead author Dr. Charlene Krejci:

Obese individuals’ bodies relentlessly produce cytokines, proteins with inflammatory properties. These cytokines may directly injure the gum tissue or reduce blood flow to the gum tissue, thus promoting the development of gum disease.

And yes, children and adolescents can absolutely get periodontal disease.

Your responses and feedback are welcome!

Source: “The Kids Aren’t All Right: Childhood Obesity may be at the root of more problems,” NASM.org, 09/14/14
Source: “People who are obese face higher rates of pain: study,” Canada.com, 07/09/12
Source: “Obesity Conclusively Linked to Gum Disease,” Frisco-Dentist-Blog.com, 02/21/13
Photo credit: Mark Turnauckas via Visualhunt/CC BY

More on Morbid Obesity in Kids

fixing-a-car

The photographer titled this “Talk about junk in the trunk!”

Food addiction has been discussed here many times. Like other popular expressions, it is an incomplete shorthand term for something that takes more than a few syllables to say.

The addiction to overeating is more of a behavioral addiction than a substance addiction. Even that simplification has to be qualified, by admitting that quite a few foods and pseudo-foods do cause the same reactions as hard drugs.

Among many similar studies, the extensive European project NeuroFAST found that people diagnosed as morbidly obese “show changes in their dopamine systems which are similar to the changes in a person who is addicted to drugs or alcohol.”

In the course of creating Weigh2Rock and developing W8Loss2Go, Dr. Pretlow became familiar with the health journeys of thousands of children and teens. He observes:

Dependence on the pleasure of food may be on a continuum: overweight children may be only partially dependent (addicted); obese children may be fully dependent (addicted); and morbidly obese children may be in addictive tolerance mode.

This is explained further in Dr. Pretlow’s book Overweight: What Kids Say:
Overweight: What Kids Say:

Chapter 9 describes “tolerance,” which is a characteristic of addictive behaviors, where an individual must use more and more of a substance or behavior, or worse substances, to obtain the same pleasurable effect. If the childhood obesity epidemic is due in part to an addiction to highly pleasurable foods, then tolerance might be a factor that is worsening the epidemic and contributing to development of severe or “morbid” obesity in some kids.

If overweight kids need progressively larger amounts of pleasurable food or higher pleasure-level foods to feel satisfied or comforted, this would certainly worsen the childhood obesity epidemic and contribute to morbid obesity.

Morbid obesity is skyrocketing because cheap, high pleasure, high calorie food is becoming even more widely available, in the face of ever increasing tolerance. Furthermore, the stress of morbid obesity continually stokes the vicious cycle of spiraling comfort eating.

Last time, we spoke of how some individuals who suffer from morbid obesity may, either knowingly or unconsciously, derive some type of reward from their condition. No doubt in many cases it is the same reward that all addicts partake of. To be hooked on anything is to inhabit a life where all complications are removed and all answers are simple, because all decisions boil down to one question: Will this action get me more of my addictor?

If an eating addiction leads to morbid obesity, the trouble is doubled. Consider this: Many substance-addicted people are able to maintain a normal appearance. Their addiction disease is not readily discernible, but the person addicted to overeating can’t fool anybody.

Psychotherapist Mary Jo Rapini has learned the importance of helping a morbidly obese person identify what benefits they might be reaping from morbid obesity. What does the extra weight allow the person to protect or avoid? When the “condishun” fills a need, therapy can help to reduce that need or find another way to satisfy it.

When a person no longer benefits from old behaviors, Rapini says, those behaviors can be left behind. She adds:

It is also important to look at obese children’s homes especially if there is a substantial weight gain. Many times, something is going on at home that is causing this child to medicate their anxiety with food.

Dr. Pretlow is concerned by the number of children who are homeschooled so they can avoid the embarrassments and threats posed by public school. It is possible that their isolation and lack of socialization opportunities combine to encourage even more “comfort eating,” which in turn leads to more obesity. Dr. Pretlow writes:

We once had a weekly parents chat on our website hosted by a nurse. Mostly it was attended by parents, who were desperate for help, in regard to their morbidly obese homeschooled kids. Typically, they were single parents with no recourse.

Your responses and feedback are welcome!

Source: “Food addiction: know the facts,” Food.UK.MSN.com, 01/05/2013 10:15
Source: “Addiction to Highly Pleasurable Food as a Cause of the Childhood Obesity Epidemic: A Qualitative Internet Study,” Tandfonline.com, 06/21/11
Source: “What is Being Morbidly Obese Protecting You From?,” Chron.com, 09/27/11
Photo credit: kennethkonica via VisualHunt/CC BY-ND

Childhood Obesity News | OVERWEIGHT: What Kids Say | Dr. Robert A. Pretlow
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