How to spot a food-related addiction

Addiction and Recovery

By Bob Gaydos

The list of substances or behaviors to which adolescents can become unhealthily attached, even addicted, can seem endless to a parent inclined to be caring and protective: alcohol, smoking, drugs, gambling, video games, social media, internet, cell phones, sex, shopping, eating …

Wait, eating you say? Yes, eating. Or food. It depends. There’s a debate over whether the problems are the same thing. Some say that someone who craves the same food, say sweets or salty chips, and consumes it in unhealthy amounts might be considered a food addict, a term not universally accepted, but one that is useful in defining a behavior. The food in question reacts on the brain in the same way that alcohol or another drug would. It rewards the person, who feels good.

Some say that someone for whom eating -- anything and plenty of it -- is a fulltime job with significant negative consequences might be considered to have an eating addiction, rather than a food addiction. Eating may provide the same kind of escape and temporary excitement that gambling, for example, would in someone else. An irresistible reward.

And, of course, these harmful behaviors often co-exist. Addictions may have biological, psychological, or social causes, or, likely, a combination of them.The focus here is not on debating the food/eating addiction question, but rather on recognizing that food addictions and eating disorders -- a different category of self-destructive behavior, including anorexia, bulimia and binge eating -- can often be ignored in teens when there is so much talk in media -- social and otherwise -- about drinking and driving, opioid abuse, the pros and cons of marijuana and the rest of that list.

Teens eat, adults say. Sometimes they eat a lot. Maybe a lot of junk food. They’re growing. So what’s the big deal?

Maybe nothing; maybe something. A primary goal of this column is to provide useful information to help readers identify and get help for addictive behavior and some studies say up to 10 percent of Americans may have a food-related addiction or disorder. One in 10 female teens may have an eating disorder. A smaller percentage of teen boys, perhaps athletes such as wrestlers or runners, also have issues that revolve around body weight and image. What follows are some symptoms and questions to help you decide if you or someone you know, perhaps a teenager, has a health issue involving food.

The following are possible symptoms of a food addiction:

• Gorging
• Eating to the point of feeling ill
• Going out of your way to obtain certain foods
• Continuing to eat certain foods even if no longer hungry
• Eating in secret
• Avoiding social interactions, relationships to spend time eating certain foods.
• Difficulty functioning in a job or school due to decreased efficiency
• Spending a significant amount of money on buying certain foods to binge
• Obesity
• Fatigue
• Difficulty concentrating
• Sleep disorders, such as insomnia or oversleeping
• Headaches
• Irritability
• Digestive disorders
• Thoughts of suicide

Food Addicts in Recovery Anonymous, a 12-step group that seeks to help people with food addictions or disorders, offers its own quiz to help people determine if they have a problem with food. As always, answer as honestly as possible:

1. Have you ever wanted to stop eating and found you just couldn't?
2. Do you think about food or your weight constantly?
3. Do you find yourself attempting one diet or food plan after another, with no lasting success?
4. Do you binge and then "get rid of the binge" through vomiting, exercise, laxatives, or other forms of purging?
5. Do you eat differently in private than you do in front of other people?
6. Has a doctor or family member ever approached you with concern about your eating habits or weight?
7. Do you eat large quantities of food at one time (binge)?
8. Is your weight problem due to your "nibbling" all day long?
9. Do you eat to escape from your feelings?
10. Do you eat when you're not hungry?
11. Have you ever discarded food, only to retrieve and eat it later?
12. Do you eat in secret?
13. Do you fast or severely restrict your food intake?
14. Have you ever stolen other people's food?
15. Have you ever hidden food to make sure you have "enough"?
16. Do you feel driven to exercise excessively to control your weight?
17. Do you obsessively calculate the calories you've burned against the calories you've eaten?
18. Do you frequently feel guilty or ashamed about what you've eaten?
19. Are you waiting for your life to begin "when you lose the weight"?
20. Do you feel hopeless about your relationship with food?

A “yes” answer to any question could indicate a problem with food, the group says.

Obviously, these are complex issues with serious -- even life-threatening -- potential consequences that need to be addressed as early as possible by trained professionals. There are a variety of programs and organizations to turn to If you suspect a food-related problem. Consult your doctor to begin with and check any of the accompanying links for more information.

For help

-- www.foodaddictsanonymous.org

-- www.recoveryfromfoodaddiction.org

-- www.foodaddicts.org

-- www.oa.org

-- www.eatingdisordersanonymous.org

-- www.nationaleatingdisorders.org

-- www.nimh.nih.gov

-- www.mentalhealthamerica.net

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Test your knowledge on addiction

Addiction and recovery

By Bob Gaydos

The more things change, the more some other things seem to stay the same. This is particularly true in the field of addiction and substance abuse. With (a) an opioid epidemic sweeping the nation, (b) a growing nationwide movement to legalize the use of marijuana for medicinal and even recreational use, and (c) a growing consensus that the “war on drugs” has failed, a new administration in Washington seems determined to stick to the old, law-and-order approach to addiction.

This suggests that, while we may be in the midst of an unprecedented technological revolution, some of us may still be operating with outdated information. That’s why, from time to time, I devote a column to facts about alcohol and drug addiction. After all, if we’re going to treat it as a war, or as a crusade against a major health issue, we should know what we’re up against.

And, since Americans love quizzes, I’ve put one together to test your addiction IQ. It’s updated from one I offered a few years ago. Quizzes may be fun, but obviously this is a serious issue. The questions and answers are based on reports and other published materials of the National Center on Addiction and Substance Abuse.

What’s your addiction IQ?

1. a) 10 million; b) 20 million); c) 40 million; d) 60 million Americans 12 or older have substance abuse problems.
2. a) 15%; b) 25%; c) 50%; d) 75% of all high school students have used addictive substances, including cigarettes, alcohol, marijuana or cocaine.
3. More than a) 50%; b) 60%; c) 75%; d) 90% of people with a substance problem began smoking, drinking or using other drugs before age 18.
4. a) 26%; b) 36%; c) 46%; d) 56% of children under age 18 live in a household where someone age 18 or older is smoking, drinking excessively, misusing prescription drugs or using illegal drugs.
5. Seven in 10 people with the chronic diseases of high blood pressure, major depression and diabetes receive treatment. How many people who need treatment for substance problems receive any form of care? a) 1 in 10; b) 2 in 10; c) 3 in 10; d) 5 in 10.
6. The National Institute on Alcohol Abuse and Alcoholism defines risky drinking for women as: a) 3; b) 7; c) 10; d) 12 drinks in a week.
7. The NIAAA defines risky drinking for men as more than: a) 12; b) 14; c) 16; d) 20 drinks in a week.
8. Among people with a prescription drug use problem, nearly: a) 25%; b) 30%; c) 50%; d) 75% have another substance problem.

    9. Of every dollar state and federal governments spend on substance problems: a) 2 cents; b) 5 cents; c) 10 cents; d) 25 cents goes to prevention and treatment.

True or false

   10. Having a high tolerance (feeling less effect from the substance with continued use) is a sign that the person is not addictive.

   11. Because they use substances at lower levels than men, women typically progress from substance use to addiction more slowly than men and experience the health consequences of substance use, such as death, cancer, heart disease and memory problems, less intensely than men.

   12. Addiction, substance use and abuse are the largest preventable and most costly health problems facing the U.S. today, responsible for more than 20 percent of deaths in the U.S.

   13. Addiction, substance use and abuse cause or contribute to more than 70 other conditions requiring medical care, including cancer, respiratory disease, cardiovascular disease, HIV/AIDS, pregnancy complications, cirrhosis, ulcers and trauma, and account for one-third of all hospital in-patient costs.

   14. Total costs to federal, state and local governments of addiction, substance use and abuse are at least $468 billion per year – almost $1,500 for every person in America.

    15. Addiction can’t be a disease because it is caused by the individual’s choice to use drugs or alcohol.

Answers: 1(c); 2(d); 3(d); 4(c); 5(a); 6(b); 7(b); 8(d); 9(a).

10: False. High tolerance is a warning sign of a possible substance problem.

11: False. Women generally progress more quickly than men in addiction and suffer more intensely.

12, 13 and 14: True. Just putting out some perspective on the scope of the problem.

15: False, according to National Center on Addiction and Substance Abuse: “While the first use (or early stage use) may be by choice, once the brain has been changed by addiction, most experts believe that the person loses control of his or her behavior. Choice does not determine whether something is a disease. Heart disease, diabetes and some forms of cancer involve personal choices, such as diet, exercise, sun exposure, etc. A disease is what happens in the body as a result of those choices.”

Keep score yourself. The only way to fail is to ignore the issue altogether.

* * *

More info:

www.centeronaddiction.org.

www.niaaa.nih.gov.

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Government survey: Adolescents' drug use lessening

Addiction and recovery

By Bob Gaydos

Good news and drugs. It’s not a typical pairing in most people’s minds. Right now, for example, the United States is trying to come to grips with what many are calling an epidemic of deaths due to heroin overdoses tied to opioid addiction. The attorney general of the United States recently cited this serious reality in asking Congress for permission to prosecute states which have legalized the use of marijuana for medical purposes. This kind of political exploitation tends to confuse issues and make the bad news sound even worse. So I went looking for some good news.

It didn’t take long to find and it came, if you will, from the horse’s mouth, which is to say, the National Institute on Drug Abuse, which is part of the National Institutes of Health, which are part of the U.S. Department of Health and Human Services. The government.

Since 1975, the NIDA has been conducting the Monitoring the Future Survey, which tracks drug use and attitudes among eighth, tenth and 12th graders in the United States. Its most recent report was released in December of 2016. It contained quite a bit of good news.

According to the NIDA: “Use of many substances is at its lowest level since the survey’s inception (1975), including alcohol, cigarettes, heroin, cocaine, methamphetamine, inhalants, and sedatives (reported only by 12th graders). Other illicit drugs showed 5-year declines, including marijuana (among 8th and 10th graders), synthetic cannabinoids (K2/herbal incense, sometimes called "synthetic marijuana"), prescription opioids (reported in the survey as "narcotics other than heroin"), hallucinogens, amphetamines, and over-the-counter cough and cold medications.”

And on that national epidemic, here’s NIDA again: “Despite the continued rise in opioid misuse and overdose deaths among adults, past-year misuse of prescription opioids has continued to decline among high school seniors. Over the past 5 years, misuse has dropped 45 percent, from 8.7 to 4.8 percent. Heroin use remains very low, with past-year use reported by 0.3 percent in all grades.”

Bottom line, in a lot of ways an increasing number of adolescents are getting the message to do what Nancy Reagan suggested years ago regarding drugs -- just say no.

Of course, it took a little more to achieve these results than just telling teenagers to not do something because it could be harmful to their health. The all-time low levels of use of tobacco and alcohol surely are a reflection in part of federal laws that a) required states to raise their ages for purchase and public possession of alcohol to 21 or lose 10 percent of their federal highway funds (it worked) and b) banned cigarette and tobacco advertising on TV and radio, required warning labels on the packages and regulated product placement and ads in stores. It took a concerted, community effort, in other words.  

That effort continues with regard to tobacco, as Hawaii in 2015 led the way to raising the age for purchase of tobacco to 21. More than 100 cities and counties, including New York City, Suffolk and, recently, Orange County have also adopted the policy. Alabama, Alaska, New Jersey and Utah have set the legal age at 19.

These legislative efforts were accompanied by well-publicized campaigns that heightened awareness of the numerous health risks associated with smoking and drinking -- especially at a young age -- and the dangers of driving while under the influence of alcohol or other drugs. Stiffer DWI laws accompanied the raised drinking age in many states, again, a reflection of communities coming to terms with an unhealthy situation, discussing options and taking steps to remedy it. These positive actions and attitudes by adults are not lost on children and are passed on through generations, just as the negative ones are.

In response to the current opioid epidemic, law enforcement agencies have cracked down on over-prescription of pain-relief medicines and stricter regulations have been put in place to monitor their use. In addition, many communities have formed action groups to provide information about the abuse of prescription pain medicines and heroin, as well as other drugs. Such efforts increase awareness of the issue -- including the fact that help is available -- and tend to reduce the shame that prevents many who are suffering from addiction from seeking help.

As with the changes in drug and alcohol use among adolescents reported in the latest Monitoring the Future Survey, these attitudes and actions could certainly carry through generations. That would be more welcome positive news.  

From the 2016 survey

--  Marijuana: Among both 8th and 10th graders, daily marijuana use decreased over the past 5 years from 1.3 to 0.7 percent and from 3.6 to 2.5 percent, respectively. Among 12th graders, 6.0 percent continue to report daily use -- that’s about 1 in 16 high school seniors. Among all grades, the perception of risk associated with smoking marijuana regularly continues to decline, with only 31.1 percent of 12th graders reporting that regular marijuana use is harmful compared to 58.3 percent in 2000. However, disapproval among 12th graders remains somewhat high, with 68.5 percent saying they disapprove of smoking marijuana regularly.

-- Alcohol: The percentage of high school students who reported ever using alcohol dropped by as much as 60 percent compared to peak years. This year’s survey found that 22.8 percent of 8th graders reported ever trying alcohol, a 60 percent drop from a peak of 55.8 percent in 1994. Among 10th graders, lifetime use fell by 40 percent from 72.0 percent in 1997 to 43.4 percent this year. Among 12th graders, there was a significant 25 percent drop in lifetime alcohol use from 81.7 percent in 1997 to the current 61.2 percent.

.

FYI

Monitoring the Future is an ongoing study of the behaviors, attitudes, and values of American secondary school students, college students, and young adults. Each year, a total of approximately 50,000 8th, 10th and 12th grade students from more than 300 schools are surveyed (12th graders since 1975, and 8th and 10th graders since 1991). The survey is funded by the NIDA, a component of the National Institutes of Health (NIH), and conducted by the University of Michigan.

For more information about the Monitoring the Future survey:

-- http://www.monitoringthefuture.org/

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The 'worst thing' can actually happen -- talk to your kids about alcohol

Addiction and Recovery

By Bob Gaydos

Talk to your kids about alcohol before
they start drinking.

What's the worst thing that could possibly happen?

It's a question all parents should ask themselves when considering any event involving teenagers and alcohol. In fact, it's a question teenagers should ask themselves about any event involving them and drinking.

Unfortunately, even on the rare occasion when the question is asked, the “worst thing” seldom comes to mind. Until it happens. It happened New Year's Day in the Town of Crawford in upstate New York and a young man is dead and several people’s lives have been dramatically impacted.

A fight broke out at a party in a private home in which, police say, about 100 young people, most believed to be underage, were drinking. A 20-year-old male who tried to break up the fight was stabbed to death. Police are still looking for his killer. There were no adults present at the party, according to police.

According to New York state law, the parents whose teenaged children hosted the party could be liable for fines. Lawsuits are possible. It's called the social host law and its intent is to discourage underage drinking at parties in private homes by imposing penalties on persons responsible for overseeing the home when minors other than their children consume alcohol. Some New York counties have their own social host laws, which are tougher than the state’s. Orange County, where the killing occurred, is considering adopting one.

Such punitive laws -- essentially designed to protect us from ourselves -- are necessary in our society because the preventive approach is too often ignored. That approach consists of parents educating their young children -- preteens or young teens -- on the risks of drinking alcohol before they are physically, mentally and emotionally able to handle it and, yes, letting them know they do not approve of them drinking if they are not of legal age.

A common response to this suggestion is that kids don't listen to their parents and teens are going to rebel and drink anyway, because all

their friends do. If we don’t let them drink, the thinking goes, they’ll be ostracized. So let's teach them to drink responsibly when they’re young. That way they won’t have problems with alcohol when they are older.

Well, the National Institutes of Health, Mothers Against Drunk Driving, Partnership for Drug-Free Kids, the Treatment Research Institute, the World Health Organization, the U.S. Department of Justice and pretty much any organization that has studied the impact of alcohol consumption on young people, disagree with that view. The research all says that, despite a widespread assumption to the contrary:

• Parents still have the most influence on their children, especially when they are young;

• Having conversations, not lectures, with children about your feelings on alcohol before they begin drinking (eighth grade is not too soon) will have more influence than if they have already started;
• Even in later teen years, parents can still exert major influence on their children’s behavior.

The reasons for focusing on teenagers and alcohol have been discussed in this column before, but, briefly, teens who drink are more likely:

• to be victims of violent crime,
• to be involved in alcohol-related traffic crashes
• to have serious school-related problems
• to develop alcohol dependence than persons who wait until adulthood to start drinking

The earlier the child starts drinking, the greater the odds of some of those problems developing. This comes from the National Institute on Alcohol Abuse and Alcoholism, which also says, “The bottom line is that most young teens don’t yet drink. And parents’ disapproval of youthful alcohol use is the key reason children choose not to drink.”

The NIAAA has an excellent pamphlet for parents who are unsure about whether to or how to talk to their children about alcohol. It’s not unusual to be uncomfortable with the subject and each situation is different, but dealing honestly with uncomfortable issues and modeling responsible behavior are proven ways to help children make responsible decisions when they’re on their own. The pamphlet is called “Make a Difference. Talk to Your Children About Alcohol.” http://pubs.niaaa.nih.gov/publications/MakeADiff_HTML/makediff.htm

When the worst possible thing happens, it gets people’s attention. Unfortunately, that’s the way it is. At the very least, the New Year’s Day tragedy presents an opportunity to remind ourselves that there are positive ways to deal with difficult issues and help available in doing so. Now that we’ve got your attention, talk to your kids about alcohol.

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For more information

-- Partnership for Drug-Free Kids

(212) 922–1560

http://www.drugfree.org/join-together/

-- National Council on Alcoholism and Drug Dependence (NCADD)

(212) 269–7797; Fax: (212) 269–7510

http://www.ncadd.org

-- National Institute on Alcohol Abuse and Alcoholism

(301) 443–3860

http://www.niaaa.nih.gov

-- Substance Abuse and Mental Health Services Administration

National Drug Information Treatment and Referral Hotline

(800) 662–HELP (4357) (toll free)

http://www.findtreatment.samhsa.gov

-- MADD

24-hour Victim Help Line

(877) MADD--HELP

www.madd.org

-- Partnership for Drug-Free KIds

1-855-DRUGFREE

www.drugfree.org

A license to kill ... himself

(My latest Addiction and Recovery column.)

By Bob Gaydos
If James Bond were a real person, he'd be dead.

92 martinis a week, shaken
or stirred, would
 hamper even 007's style,
if he were a real person.

The famed, fictional British double agent, renowned for his ability to handle his fists and his booze, would have either drunk himself to death or been too drunk to find, never mind fire, his gun when some enemy agent intended him bodily harm.

That’s the conclusion of a study published last month in the British Medical Journal. Indeed, the scientists who studied 007’s drinking habits in all 14 of Ian Fleming’s Bond novels say the spy who could do no wrong would be dead at 56 if he were a real person and consumed what they calculated to be an average of 92 martinis per week. Shaken not stirred.

The scientists even offered an opinion on that stylistic choice as well, figuring it was driven by alcohol-induced tremors, which made his hands shake and, of course, would have made it impossible for him to aim his gun, never mind hit his target.

While the study may have been a semi-tongue-in-cheek look at a fictional character’s drinking habits, given the popularity of the Bond films and the profound impact of popular culture on our life styles, it makes a serious point. To wit: There is a limit to how much alcohol anyone can drink, in a day, over a week, or a lifetime, without putting himself or herself at serious risk. And that limit is nowhere near what what the suave Bond character consumes.

According to the Rethinking Drinking website of the National Institute on Alcohol Abuse and Alcoholism, for a healthy male adult, drinking more than four drinks per day or 14 in a week (remember, Bond averaged 92 a week) is considered “at risk” or “heavy drinking.” For women, the numbers are three per day and seven per week.

The site says that one in four people who exceed these limits already has alcoholism or alcohol abuse and the rest are at greater risk for developing them. And the more often someone repeats the pattern, that is, the more heavy-drinking days there are, the more at-risk that person is for alcoholism, alcohol abuse and the many health problems related to alcohol abuse.

The NIAAA, which is part of the National Institutes of Health, says 3 in 10 U.S. adults already drink more than the low-risk limits and 25 percent of them already have alcoholism or alcohol abuse. It also says many of these people may be unaware that their drinking habits are putting them at risk for alcohol-related problems.

This obliviousness is often fed by popular culture. Movies (not just Bond movies) are notorious for depicting alcohol consumption, sometimes in copious amounts, with the characters suffering little to no serious effects. A previous study published in the BMJ pointed to one of the risks inherent in this lackadaisical cultural approach to heavy drinking. It found that young teens who watch a lot of movies depicting drinking are twice as likely to start drinking as their peers and are more likely to progress to binge drinking. This was true for thousands of teens studied in Europe as well as the United States, according to the report.

James Sargent, PhD, of the Geisel School of Medicine at Dartmouth and a co-author of the report, says, “Exposure to movie depictions of alcohol predicts alcohol onset and progression to binge drinking during adolescence.” Sargent says his findings point to the need for more attention to alcohol use in film ratings and for restrictions on the placement of alcohol products in movies.  

That sounds reasonable, especially given that drinking habits are often established at an early age. But movies, TV and other popular forms of entertainment generally reflect what the the public demands. Smoking by characters in movies and on TV only declined when the real people who go to see the movies recognized the health risks and changed their smoking habits. In many ways, society remains uninformed about or seemingly uninterested in learning the many risks of alcohol abuse. This mass denial doesn’t mean it’s not a real problem.  

Drinking is a fact of life. The risk here is in confusing fiction with fact. James Bond is a terrific fictional character. Suave, smart, strong, sexy. But any real man who drank the way he does would likely be a stumbling, bumbling, mumbling, out-of-work loser with a lot of health issues and no lovely ladies on his arm.

Or he’d be dead.

* * *

NIAAA: http://rethinkingdrinking.niaaa.nih.gov/default.asp

James Sargent: http://geiselmed.dartmouth.edu/news/2012/02/23_sargent.shtml

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