Chocolate and the brain

I was surfing the Web the other night, just playing around, looking at food addiction treatment-type things--I was curious what was out there. There is actually quite a famous center that treats food addiction close where I live--they have been included in TV documentaries I've seen--so I went to their website and discovered (a) there were no prices listed anywhere, which is never a good sign; and (b) they threw the word "God" around an awful lot as it related to treatment. Salted don't play that; even if I was into that, and I'm not, I think God has bigger fish to fry than my fat ass.

I went to the Food Addicts Anonymous website and it looks as though they use the old Overeaters Anonymous model, which was attended by a close family member back in the day, so I have some familiarity with it. I also read about it in Betsy Lerner's memoir "Food and Loathing". It's a 12-step program. No sugar, no flour, no nothing. I will continue to look for post-op support groups. Though it has worked for many and I respect that, I don't see myself being able to embrace the 12-step model. I will continue to research post-op support groups.

So, I started looking up chocolate addiction, and when Googling the words "chocolate rehab", lo and behold, a British woman is writing a book called "Chocolate Rehab". It sounds like genius to me; I can't believe no one else has written it before. I hope it comes out soon. I found other websites of many different stripes, some claiming that chocolate was more addictive to the brain than cocaine and marijuana and may have similar effects (!).

I found an academic paper from the Journal of Affective Disorders that was fascinating--it was debating whether or not chocolate had antidepressant effects. The writers argued that chocolate craving and chocolate emotional eating were two entirely different things, although they could both exist in the same person. Some studies have shown that seasonal affective disorder and atypical depression sufferers who tend to self-medicate are able to achieve some elevation in their serotonin levels by ingesting chocolate, but the writers of this paper argued that chocolate would not be as effective as other foods or chemicals in achieving this result, yet chocolate is the specific substance craved. The paper's writers ultimately come to a similar conclusion regarding the possibility of chocolate cravings as the result of a magnesium deficiency, providing evidence that other foods would be more effective in making up the difference there, but would not satisfy a chocolate craving, possibly because of the uniquely appealing texture, aroma and taste of chocolate.

The paper went on to define emotional eating and conclude that it failed to produce any real or lasting benefit to a psychological or mood state, and that continued or elevated emotional eating could actually contribute negatively to mood. (I think anyone who's ever been a binge eater would be able to vouch for that.)

Though food craving shares some of the same features of drug addiction, the writers of the paper point out, they found no consensus that food craving qualifies as an actual addiction. They cite the possible reason for this as different reasons for craving drugs vs. craving chocolate--craving drugs is related to a physiological requirement by the body to put it into a certain altered state that alleviates a negative state of "low", where craving chocolate is related to the sheer "hedonic experience" or pleasurable sensation of smelling, tasting, and consuming it.

I found this paragraph interesting: "Chocolate was not greatly preferred over other sweets for self-medication, even among chocoholics. Self-medication occurred most commonly in response to depression, tension and irritability, less often in response to anxiety, and least often to anger." (Indeed! How can one be angry while savoring a Ghirardelli creation? Nom nom nom...) "Anecdotal evidence indicates that chocoholics who are also emotional eaters only crave chocolate, but when stressed, they will crave any other carbohydrate." The paper ultimately concludes that chocolate is an indulgence that invokes pleasure and it may provide some comfort in emotional eaters, but that it is more likely to prolong depressive mood and so cannot be called an antidepressant.

So, basically, according to this paper, I am not an addict, I'm simply a hedonist. Do they have a Hedonists Anonymous?

Nutritionist appointment

Just got back from nutritionist appointment #3. I lost (get ready for it) ONE (1) WHOLE FREAKIN' ENTIRE POUND. Two months = five WHOLE FREAKIN' ENTIRE pounds. To spare the expense of paying for a skywriter, whoomp! there it is. A concrete illustration of the reality of insulin resistance, sleep deprivation's effect on the cortisol hormones (I did not sleep one minute last night, fyi), and why I need medical intervention. 60 !@#$%^&* days, and I would say I deprived myself of anything that tasted really good for at least 55 of them.

I do like the nutritionist. She's easy to talk to, reasonable, and realistic. I forgot to turn my phone off and got a text during the appointment--the text ringtone is "Bust a Move", so she started dancing to it in her chair and we had a giggle. She didn't give me too much guff about that ridiculous craving assignment--she said a lot of people didn't even try to do it, at least I had tried. (I didn't try all that hard, it took all my energy to hold back the bile, but she didn't have to know that. I take my positive strokes where I can get 'em.)

She praised my food diary, which I have kept faithfully (grumblegrumblegrumble) and added caloric content when I had it. She recommended a couple of websites, calorieking.com and fitday.com, that have calorie counts on them. The new assignment is to incorporate more protein into the diet and begin to calculate that.

Protein becomes extremely important because immediately after surgery you are only taking in 400-600 calories per day. Post-bypass, the recommended protein intake is 60-80 grams of protein per day, which is a LOT. You're supposed to eat all the protein you need in a day before you eat anything else. I think the low-sugar Instant Breakfast and I are going to become even better friends than we already are. Apparently Atkins makes some protein drinks, and there is one called Muscle Milk that they sell at Costco and Super Supplements. SlimFast and Ensure have too much sugar (I thought I was the only person in the world who gained weight on SlimFast; now I know why I did). Milk, yogurt, cottage cheese, meat, tuna, tofu, peanut butter, nuts, beans, peas, lentils, cheese. She gave me a protein foods list with happy Clip Art illustrations of happy, happy food. Happy.

We talked about the water-drinking requirements for post-op. I'm drinking enough water, it's just how I drink it that is going to be different. You have to drink 16 ounces of water half an hour before eating, not drink anything while you eat, eat the protein first, drink 16 ounces of water after you eat.

We discussed the dreaded dumping syndrome, or specifically, sugar and dumping syndrome. I'll have to post more about dumping syndrome when I have the fortitude to research it further and make an articulate blog entry with some good information in it. Basically from what I gather, if you eat too much sugar, fat, and grease post-gastric bypass, you'll get violently sick. People don't know what foods are going to trigger dumping until they've had the surgery, though some have proven to be universal, and sugar is one of them. Simple sugars are apparently a huge culprit, so even the sugar-free chocolate isn't so hot because the sweeteners used in making it--the sugar alcohol derivatives, such as sorbitol--are catalysts for dumping syndrome. Splenda and aspartame sweeteners do not pose a problem.

She told me I won't be able to use chocolate to cope anymore. She wasn't mean about it, it was just a statement of fact. I told her I seriously thought I was going to need some kind of rehab. She gave me a food addiction website to look at and some sample questions to ask counselors if I got to the point where I could afford to see one. Since money is an issue, maybe a support group would at least provide some balm. It's not the amount of food or even the type of food I eat; it's the relationship I have with it. It sounds so trivial and silly, but it's a very real concern.

Tomorrow, the exercise physiologist. I'm so thrilled (NOT). It looks like I have to see him every time I see her, so, once a month. I'm not doing any more than I have to, and I told them that today.

Re: the disputed psych eval payment--I had to eat the $220 written report fee, but the billing person spent a good half hour on the phone with my insurance while I was there, who are now "reprocessing" the claim for the remaining $300.

Oh yeah, and it's snowing. WTF?