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Avoid or Alter?

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I am frequently asked about whether certain foods should be completely avoided or if it is essential to learn to eat all foods responsibly. Individuals who believe they are “addicted” to certain foods (like sweets) or certain ingredients of food (like sugar) commonly ask this question, and it’s a great question. The most common method of dealing with addiction to substances such as nicotine, alcohol and cocaine is complete avoidance of the substance, referred to as abstinence. Abstinence from these types of substances, while difficult to achieve, is far easier than the alternative of trying to moderate one’s intake of the substance. In the case of nicotine, heroin, cocaine and “hard drugs,” nobody challenges this approach because there is no benefit in continuing to use them. These substances are just plain bad for you so abstinence is completely rational. Alcohol has often been shown to be healthy when consumed in moderation, but for people who have battled with alcohol abuse and dependence it’s just not worth it and once again, abstinence is the preferred approach. In the case of specific foods or certain food ingredients, the story can become much more complicated.

There is an ongoing battle as to whether or not certain foods or food ingredients are “addicting.” Is sugar an addictive substance in the same way as nicotine, cocaine and alcohol? Can someone actually be “addicted” to sweets or carbohydrates? The jury is still out, but a definitive answer may not be necessary. What’s important is for you to consider how you plan to change your behavior given that the environment seems to be making little effort to eliminate the availability of these foods.

Almost everyone has one or more foods that they are prone to eat compulsively, whether they consider themselves to be “addicted” to them or not. Often these foods include sweets that are high in sugar (like cake, cookies, or ice cream); however, many people struggle to control their intake of a variety of foods like deli meat, pizza, peanut butter, nuts or even beef jerky. For many people, sugar isn’t the big problem.

What is interesting to consider is that most people have trouble controlling their intake of foods that they believe they shouldn’t be eating. Over and over I hear stories of people who binge on exactly the foods that they were told they couldn’t have as a child. These are often called “forbidden foods.” Whether it is peanut butter, ice cream, potato chips, cookies, pizza, or cheese doodles, it may be their “forbidden-ness” that makes us eat them compulsively and not their content of sugar or other ingredients that’s the problem. The literature on binge eating lends some support to this hypothesis as a very high percentage of binge eaters describe a history of restrictive dieting and/or deprivation. Indeed, a overwhelming number of patients I have seen over the years who describe themselves as binge eaters describe histories of either chronic over-restrictive dieting or having grown up in homes where their parents or others denied their access to certain foods. Some patients jokingly referred to one or both their parents as the “food police.” Once they were free from such restrictions (either by moving out to live on their own or by going “off” the diet) their consumption of these foods seemingly became uncontrollable. It seems that avoidance or total abstinence from such foods might actually be causing the binge eating. There is an all-or-nothing quality to this behavior. One possible explanation for this pattern is that the individual has never actually had the opportunity to eat these foods in moderation but rather to be forced to avoid them or eat them like there was no tomorrow. They were never allowed to eat them, so when they were finally available, they overindulged. So again I ask: “Is this type of compulsive eating or bingeing due to an “addiction” or to over-restriction, and what should you do about it in either case?” Should you continue to avoid certain foods or food ingredients or try to learn alter your behavior?

The answer really depends on your personal philosophy and how much distress the whole matter is causing you. Do you want to learn to eat certain foods more responsibly or would you rather continue to try to avoid them? Does it cause you great distress to think of a life without your favorite foods? Does it cause you great distress to make constant efforts to avoid certain people, places and events because your “trigger foods” will be available? If you decide that you would like to learn to eat certain foods more responsibly, you need to accept that this will take some work. To be successful, you need to become a bit of a scientist and experiment with different approaches.

Perhaps you are experiencing anxiety about the proposition of trying to learn to eat your “trigger foods” responsibly because you have never had the ability to do. This is completely understandable. Also, consider that if the foods you find to be triggers are inherently unhealthy (like “junk food),” maybe abstinence isn’t such a bad idea. After all, like heroin and cocaine, it’s hard to make the argument that chocolate covered cheesecake is good for you. You could try to learn to eat chocolate covered cheesecake responsibly, but life will continue even if you permanently take it off the menu. However, many people believe that they shouldn’t have to live the rest of their lives without chocolate, peanut butter, cashews and other foods or perhaps they just don’t want to. They are aware that most people do not need to resort to such levels of restriction. If you think in this way, then you need to learn how to eat these foods responsibly. You have to practice a new way of eating to get better at it and strengthen your ability to do so just like you would any other skill.

One approach to strengthen new eating skills is to eat certain foods in a limited number of circumstances and in a different manner. For example, if you believe that cashews are a “trigger food” and you have no history of eating cashews responsibly, it would be silly to continue to buy the one-pound jar of cashews from the bulk food store. You know how that story is going to end. Similarly, it may not be wise to bring a gallon-sized container of ice cream into your home if ice cream is a “trigger food.” However, it may be possible for you to learn to eat a responsible amount of cashews or a single serving of ice cream if you buy a small container of either when you’re at a convenience store. This is a good way to learn with a much smaller chance of bingeing. You don’t have to completely avoid cashews or ice cream for the rest of your life. Just don’t buy them in large quantities and bring them home for the time being. Many people adopt this approach. They’re not averse to eating these foods and don’t avoid them completely; they just don’t bring large quantities of them into their home. Many a patient has told me a similar story about pizza. When they want pizza, they go to the pizza parlor and buy a slice or two. They just don’t have a whole pizza delivered to their home. These are examples of altering behavior rather than avoiding certain foods altogether. This is how you learn to eat responsibly…you practice.

Another approach gaining a great deal of attention is called “mindful eating.” There is a growing literature on the merits and effectiveness of mindful eating in the treatment of binge eating as well as for those who simply want to learn better eating habits even if they don’t have concerns about their weight or eating behavior. Mindful eating is an approach where one learns to be more present-focused while eating, and can be especially helpful when eating “trigger foods.” A primary objective of mindful eating is to learn to develop an ability to control one’s eating behavior. Mindful eating involves slowing down and focusing on the thoughts, feelings and sensations you are experiencing while eating to be in better control of your behavior. Mindful eating is the antithesis of avoidance. Much has been written about mindful eating, so do some research if you’re interested in learning a powerful method to alter your eating behavior so that you may be able to develop the ability to enjoy eating certain foods without experiencing distress and anxiety or leaving them off the menu completely.



Good tips, Doc. Enjoyed my visit with you a few months ago. Had surgery April 26th with Dr Fielding nod doubt great.

Please post more often!

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I have found that if I take the bulk foods out of the original packaging (such as the nuts you refer to in the article) and repackage them into real single servings (snack bags work great) then I am less apt to over eat when I desire these foods. In the past I would start on the bag, box or jar and "forget" to stop eating. Even with the new sleeved stomach, I have found times when I am bored and fall back on old habits. Then I am miserable when that "thanksgiving dinner" feeling takes over. With the foods in single serving packaging handy, I do not over eat. I have never "gone back" for a second portion of what I chose for a snack.< /p>

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Well I can tell you from experience, sugar is my enemy. If I eat one cookie the result will be 20 Cookies. It's my trigger that I must stay away from. I know this and I cant have it period because I have no control over sweets. I do believe that people can definitely be addicted to certain foods.

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I believe that the concept of learning to eat so called "trigger foods" more responsibly is a positive goal for those who feel that they genuinely want to revise their relationship with food, and understand that their maladaptive eating habits and beliefs about the role of eating and food in their lives were core issues to the development and maintenance of obesity.

There are many people who are unable or unwilling to make the effort to create the necessary change to overcome their entrenched behaviors and/or beliefs. They will offer little or no resistance to the cravings resulting from carbs.

In my own experience, while I do not believe that I am genuinely addictided to carbs, I have noticed the irrefutable pattern of the connection of eating unhealthy carbs leading to craving more unhealthy carbs. I find it much easier for me to simply avoid the unhealthy carbs than coping with resultant cravings. Other "trigger foods" for me, such as Peanut Butter, are not a problem for me to manage.

Edited by ♥ Sojourner ♥

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"For example, if you believe that cashews are a “trigger food” and you have no history of eating cashews responsibly, it would be silly to continue to buy the one-pound jar of cashews from the bulk food store"

For me, you hit the nail on the head with this example. I'm fine with walnuts, pecans, peanuts, but cashews or macadamia nuts are trigger foods. Thinking about it, so is ice cream and a few others.

And I agree wholeheartedly with your approach. I've been doing this for a few years now but never really put a label or thought to it. Maybe once a month I'll grab one of the little single serve Hagen Das from the ice cream isle and gobble it down. But having it in my freezer turns into a daily routine. So I don't.

Great article and an affirmation that I'm doing something right.

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This is a good read. I definitely lean towards the alter approach. After all, this isn't just another diet. As you mentioned, most of the time foods placed on "not allowed" list will soon be calling our names. Usually ending with a guilt ridden binge. Like TMF stated, only enough for one serving, or at least IMO a taste to soothe that craving.

Lastly, the mindful eating has been the biggest difference in my weight loss process. My WLS helps me be mindful of everything I put into my mouth, how big the bites are and how long I chew. Then waiting for that sensation that what I've eaten has passed through my band. Mindful always of all things good or not so good that I put into my body. It's all altered from the place I was.

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As a Counselling Psychology PhD candidate, and someone who is recovering from Binge Eating Disorder and Bulimia (exercise type), it really saddens me that so many people who suffer "food addiction" aren't aware there is a lot of very good psychological support available out there; or they are ashamed to come forward and talk about their food issues. I really honestly can't tell you how much seeing a therapist has changed my perception of food and portions over the last year. I no longer have to choose between avoiding or altering my favorite foods, but can enjoy them in moderation without the psychological backlash that would either lead to over-restriction, binge behavior, or exercising until I was out of my mind.

Thank you so much for writing this article. I really believe it will help a lot of people.

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Great Article!! I struggle with this myself since I have such an "all or nothing" personality. I am finding that I can occasionally enjoy a trigger food if I can get them in limited quantites. I never buy them to bring into my home now. However, if I am at my parents, I may have a tablespoon of peanutbutter. If I am out dining with my family or friends, I will eat Protein, order a dessert and offer to share it with someone at the table. Many times I can only handle 2 bites of it! It's a wonderful new feeling of control over my food that I have never had before. Moderation seems to be the key for me. :)

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