Other Signs of Hunger

When we think of hunger signs we commonly imagine the classic sign of a growling stomach. Yet, there are a variety of hunger sings, some more subtle than others.

1. Headache or Mental “Fog”

   1. When you haven’t eaten in 3+ hours your body will experience a gradual dip in blood sugar levels. This can lead to a headache or lack of mental clarity. You might find it difficult to focus on a task or notice yourself continually zoning out.

2. Tiredness

   1. If the body is running low on energy, then we will likely feel tired. This can be one sign that it’s time to eat again.

3. Food Thoughts

   1. Are you constantly thinking about food or drawn to pictures of food? We are biologically wired to seek food when our body is hungry. This might show up as obsession with cooking, food pictures, grocery stores, or planning food.

4. Anxiety or Fidgeting

   1. While anxiety can have many origins and influencers, one of those can be related to hunger. When the brain is malnourished or hungry, it can produce an anxious state. Scientists suspect the anxiety might be a biological drive to make us more alert for food sources.

5. Irritation or Hangry

   1. Hangry is the mix of hunger and anger. When you notice your irritated (especially if its for no reason) check in with yourself. When was the last time you ate? Was it enough? Perhaps try eating something.

6. Feeling shaky or weak

   1. When the body is running low on energy, you might feel physically shaky or weak. Physical exertion, such as lifting weights, running, etc. may become more difficult than usual. This is a sign that your body doesn’t have enough energy.

7. Nausea or Stomach Pains

   1. This one may seem counterintuitive, however, nausea can sometimes be a symptom of hunger. This can occur due to the acidity of stomach acid, in addition to taking certain medications (ex. NASIDS) or supplements (ex. multivitamin) without food.

While this isn’t an exhaustive list of hunger signs, it hopefully provides you some guidance on navigating your less obvious hunger cues. Questions or want more? Contact us to meet with our nutritionist!

Diets Don't Work

FACT: Research shows that diets are proven to fail long term (~5-10 years post start of the diet). The research that shows weight loss diets “working” is all conducted within the 5 years time or less.

Why do diets not work?

Well, first of all, your body is WAYYY smarter than any diet program. Your body recognizes “oh crap, I’m not getting enough energy; there is a limited amount of food…guess I should slow things down.”

You’re body doesn’t know the different between purposeful restriction and unintentional /environmental restrictions. And let’s be real, it all has the same outcome of reducing the body’s ability to repair, move, think, grow, and heal.

Now you’re probably thinking “okay, great, what do I do now?”

Eat like you did as a young child. Eat in a way that respects your physical and emotional needs. Become attuned with your body, listen to it, and nourish it.

If you feel really detached from with body’s needs, that okay. You’re not alone.

Working with an ED-informed or intuitive eating specialist can be really helpful in rebuilding a healthy relationship with food.

Note: this post is not meant to replace individualized healthcare recommends. Information has been simplified for the purpose of making a brief post.

New Upcoming Event: Family-Based ED Caregiver Skills Group

Family-Based ED Caregiver Skills Group starting on September 13th!

Will be held VIRTUALLY Monday 6-7pm for 10 weeks.

Lead by Eva-Molly Dunbar, MA

Co-lead by Rebecca Hardin, PsyD

This group is for caregivers of individuals with eating disorders, that are receiving FBT treatment at PBS.

In this group you will be able to:

• share experiences on caring for your loved one with an eating disorder

• receive peer support and professional guidance

• and build coping skills to prevent burnout

Interested? -> contact us!

571-257-3378

info@pbshealthcare.com

Clothing Sizes and Body Image

THESE JEANS ARE ALL THE SAME “SIZE” ACCORDING TO THE TAGS.

Now visually we can tell that of course these jeans are not physically the same size as each other.

So even though you may be a size [something] in one brand, doesn’t mean there’s anything wrong with your body when the size doesn’t fit right elsewhere. Using arbitrary sizes to judge your body will likely lead you feeling upset and frustrated. Our bodys change from day to day, hour to hour. This is natural, normal, and healthy! We are dynamic and organic beings, rather than static machines.

With that being said, we recognize it can be hard to accept your body, or to accept that your body will change. We recognize that from a young age, many of us have been taught to feel a certain way about our bodies - such as it “needs” fixing. Therefore, it can be difficult to accept that your body doesn’t need to fixing. Instead, it likely needs compassion. So…

REMEMBER.... the clothes are meant to fit YOU. And not the other way around!

Contact us via our website or phone number if interested in services regarding body image.

When is your child's picky eating TOO picky?

“My kid is such a picky eater! I’m afraid they arent getting enough.”

Ever heard or said this phrase? Or perhaps you’ve said it before. It’s common for kids to go through a picky eating phase when they’re young. But….

How do you know when it becomes TOO PICKY?

• they become emotionally distressed when told to have a food they dislike (e.g. crying, screaming, running away from table, etc)

• they’re gagging on foods they don’t like

• they will only eat VERY specific foods

• their variety is severally limited

• they aren’t growing sufficiently

This isn’t a diagnostic list but it gives an idea of the difference between simple food preferences and a type of disorder eating, called Avoidant Restrictive Food Intake Disorder (ARFID).

ARFID is typically first noticed in young children and can persist into adulthood if not addressed.

It frequently includes severe texture, taste, smell, and temperature preferences, resulting in a very limited diet and anxiety around food.

How to approach treatment?

• Work with a trained ED-informed dietitian or therapist that provide in-person sessions

• they will likely have your child do controlled food exposures with feared / disliked foods

• these food exposures will likely need to be replicated and repeated at home

• understand that these feared / disliked food may be very distressing for your child… AND that don’t mean they can’t grow distress tolerance to them

Interested in treatment? Message us through our website portal!

Basic Nourishment

By: Julia Yuskavage, MS, RDN

With so many sources of nutrition information readily available in this day and age, it’s no wonder why people might feel confused about what, when, how, and why to eat. Oftentimes, nutrition counseling begins with providing some basic information about the major nutrients that our bodies use. The word “nutrition” is derived from “nourish”, which is from the Latin nutrire, meaning to sustain with food or nutriment; supply with what is necessary for life, health, and growth. There are three macronutrients, which include carbohydrate, protein, and fat. Many people have heard that it is “healthy” to avoid certain macronutrients entirely. However, this is not the case, as each of them serves vital roles in the human body. In fact, eliminating food groups from one's eating pattern can be a risk factor for developing an eating disorder. 

Keep in mind that consuming adequate food and nutrients helps the body (including cells, tissues, and organs) operate optimally and provides the body with the energy it needs to perform daily functions. Sometimes, people may find that they either eat too little or too much food in part due to intense emotions and overwhelming feelings (it can be helpful to talk about such emotions and feelings with a trained mental health clinician). When the human body is deprived of precious fuel and nutrition, both the mind and body can suffer and deteriorate, leading to complications that require medical intervention. The following is a brief description of each macronutrient, some of the functions that each serves, as well as some of the foods that each is found in. 

Carbohydrate

Carbohydrates are a major energy source for humans, and can be compared to the function of gasoline fueling a car. Without adequate fuel, you may find that you are “running on empty”. The brain prefers to use this macronutrient for energy, and it is also used during any physical activity/exercise. By consuming adequate carbohydrate, protein is spared, which preserves lean body mass. The three types of carbohydrates are simple (such as sugars found in fruit or cookies), complex (also known as starch), and fiber (which comes from plants and is indigestible). Foods such as corn, beans, potatoes, yogurt, milk, bread, fruit, and candy all provide some level of carbohydrates which are then broken down into glucose for use by the body.

Protein

Protein can also be used as an energy source, although it will not be used for energy needs if adequate carbohydrates are consumed and/or stored in the body, and if fat is also available for energy metabolism. This leaves protein available for functions such as building, maintaining and repairing muscle, skin, hair, bone, organs, and nails. Proteins are used in the creation of hormones and enzymes, and are needed to form antibodies in order to fight off infections and maintain a strong immune system. Some of the major food sources of protein include chicken, beef, pork, fish, cheese, milk, eggs, tofu, certain grains, and legumes such as soybeans, lentils, and peanuts, which are then broken down into amino acids by the body for use. While animal sources of protein provide all of the necessary amino acids our bodies need, plant-based protein sources lack certain amino acids. For this reason, it is important for vegetarians to be mindful about their food choices, in order to ensure that all essential amino acids are consumed through various foods.

Fat

Fat is the most energy-dense macronutrient and can be used as a fuel source. It is used by the body to support brain health, form cell structures, create hormones, regulate inflammation, and absorb fat-soluble vitamins (Vitamins A, D, E and K). Dietary fats create energy reserves for our bodies and protect vital organs. Along with providing insulation to keep one’s body warm enough, dietary fats also keep hair and skin vibrant and healthy. Among other foods, fat is found in oils, nuts, seeds, avocado, beef, salmon, cheese, potato chips, and ice cream. Dietary fats are broken down into free fatty acids and monoglycerides, which the body then uses for various functions. Like essential amino acids, the body also requires certain essential fatty acids, which can be found in plant foods as well as some fish.

References:

1. http://www.dictionary.com/browse/nutrition

2. https://www.eatrightpro.org/

3. http://www.diabetes.org/

4. https://mynutrition.wsu.edu/nutrition-basics/

5. http://lpi.oregonstate.edu/mic/other-nutrients/

6. https://www.hsph.harvard.edu/nutritionsource/

Sarah Fischer, PhD in the News!

Dr. Fischer has been interviewed by several media sources related to her most recent research at George Mason University and Potomac Behavioral Solutions! Thank you to all the participants who volunteered. 

Sarah Fischer, PhD

FOR IMMEDIATE RELEASE
Monday, July 10, 2017
Contact: Jim Sliwa

(202) 336-5707

jsliwa@apa.org

UNDER STRESS, BRAINS OF BULIMICS RESPOND DIFFERENTLY TO FOOD

Scans suggest food is a form of escape from self-critical thoughts

WASHINGTON -- Magnetic resonance imaging scans suggest that the brains of women with bulimia nervosa react differently to images of food after stressful events than the brains of women without bulimia, according to research published by the American Psychological Association.

In women with bulimia, the researchers found decreased blood flow in a part of the brain associated with self-reflection, compared with increased blood flow in women without bulimia. This suggests that bulimics may be using food to avoid negative thoughts about themselves, the researchers said. 

“To our knowledge, the current study is the first investigation of the neural reactions to food cues following a stressful event in women with bulimia nervosa,” said lead author Brittany Collins, PhD, of the National Medical Center. The research was published in the Journal of Abnormal Psychology.

Stress is considered to be a trigger for binge-eating in patients with bulimia nervosa, but there is little research on how people with bulimia nervosa process and respond to food cues.
 
The researchers conducted two experiments. In the first, 10 women with bulimia and 10 without came to a lab where they all ate the same meal. After waiting for about an hour and becoming familiar with an MRI scanner, they then entered the scanner and were shown a series of neutral pictures, such as leaves or furniture, followed by a series of high fat/high sugar food pictures, such as ice cream, brownies, pizza or pasta with cheese sauce. 

Participants were then asked to complete an impossible math problem, a task designed to induce stress and threaten their ego. They then re-entered the scanner and looked at different photos of high fat/high sugar foods. After every activity in the scanner, the women rated their levels of stress and food cravings. 

“We found that everyone experienced increased stress after the stress task, and that everyone reported that stress went down after seeing the food cues again. Also, every time that participants saw the food cues, they reported that their craving for food went up,” said co-author Sarah Fischer, PhD, of George Mason University.

What was surprising was even though patterns of self-reported results were similar for both groups, the two groups showed very different brain responses on their MRI scans, Fischer said. For women with bulimia, blood flow to a region called the precuneus decreased. For women without the eating disorder, blood flow to this region increased. The precuneus is involved in thinking about the self.

“We would expect to see increased blood flow in this region when someone is engaged in self-reflection, rumination or self-criticism,” said Fischer.

In the second experiment, the researchers asked 17 women with bulimia nervosa to complete the same task as the women in the first study, in order to examine whether the findings could be replicated in a different sample of women.
 
“Our results were the same in the second study,” said Fischer. “Women reported increases in stress following the stress task and increases in food craving after seeing food cues. More important, blood flow to the same region, the precuneus, decreased when viewing food cues following stress.”

Collins believes that this decreased blood flow in bulimics suggests that the introduction of food shuts down self-critical thinking in bulimics and gives them something to focus on instead of the painful prospect of dealing with their own shortcomings.

Psychologists have previously theorized that binge-eating provides bulimic women an alternate focus to negative thoughts about themselves that may be brought on by stress. This research provides support for this theory, according to Collins.

“Our findings are consistent with the characterization of binge-eating as an escape from self-awareness and support the emotion regulation theories that suggest that women with bulimia shift away from self-awareness because of negative thoughts regarding performance or social comparisons and shift focus to a more concrete stimulus, such as food,” said Collins.

The results of these experiments could also suggest a neurobiological basis for the use of food as a distractor during periods of stress in women with the disorder, she said. The researchers called for further studies to confirm their results, which they termed preliminary.

The article is part of a special section of the July 2017 issue of the journal devoted to outstanding contributions by young investigators in the field of eating disorders.

“This issue is dedicated to highlighting the accomplishments of an impressive group of young researchers,” wrote the section co-editors Pamela Keel, PhD, Florida State University, and Gregory Smith, PhD, University of Kentucky, in their introduction. “The papers offer a glimpse into the many and multifaceted forms of progress young researchers are making in the effort to understand and address an extraordinarily important form of psychopathology, dysfunction related to the basic need of food consumption.”

Article:  “The Impact of Acute Stress on the Neural Processing of Food Cues in Bulimia Nervosa: Replication in Two Samples,” by Brittany Collins, PhD, National Medical Center; Jennifer McDowell, PhD, and L. Stephen Miller, PhD, University of Georgia; and Lauren Breithaupt, MA, James Thompson, PhD, and Sarah Fischer, PhD, George Mason University. Journal of Abnormal Psychology, published July 10, 2017.

Full text of the article is available from the APA Public Affairs Office and at

www.apa.org/pubs/journals/releases/abn-abn0000242.pdf

Contact: Sarah Fischer can be contacted by email at snowaczy@gmu.edu or by phone at (703) 993-5635. 

 

The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States. APA's membership includes nearly 115,700 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance the creation, communication and application of psychological knowledge to benefit society and improve people's lives.

www.apa.org

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Body Image Acceptance!

Annyck Besso, RD and Joanna Marino, PhD recently volunteered at a local kindergarten to provide education on body image acceptance and loving our bodies!

Resistance in Eating Disorder Treatment

Resistance to treatment is a common symptoms in eating disorders. It's never too early to get screened for symptoms. Read more here.

#NEDAwalk Washington, DC April 2!

Join us for the #NEDAwalk in DC where Dr. Joanna Marino will give a keynote speech about eating disorders.