https://www.foodaddicts.org/documents/twelve-steps-of-FA

The Twelve Steps suggested for recovery in the Fellowship of Food Addicts in Recovery Anonymous are as follows:

1 We admitted we were powerless over food—that our lives had become unmanageable.

2 Came to believe that a Power greater than ourselves could restore us to sanity.

3 Made a decision to turn our will and our lives over to the care of God as we understood Him.

4 Made a searching and fearless moral inventory of ourselves.

5 Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

6 Were entirely ready to have God remove all these defects of character.

7 Humbly asked Him to remove our shortcomings.

8 Made a list of all persons we had harmed, and became willing to make amends to them all.

9 Made direct amends to such people wherever possible, except when to do so would injure them or others.

10 Continued to take personal inventory, and when we were wrong, promptly admitted it.

11 Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.

12 Having had a spiritual awakening as the result of these steps, we tried to carry this message to food addicts, and to practice these principles in all our affairs.

https://www.goodtherapy.org/learn-about-therapy/types/transactional-analysis 

Transactional analysis, developed by psychiatrist Eric Berne, is a form of modern psychology that examines a person's relationships and interactions. Berne took inspiration from Sigmund Freud's theories of personality, combining them with his own observations of human interaction in order to develop transactional analysis. In therapy, transactional analysis can be used to address one's interactions and communications with the purpose of establishing and reinforcing the idea that each individual is valuable and has the capacity for positive change and personal growth. 

DEVELOPMENT OF TRANSACTIONAL ANALYSIS

Dr. Eric Berne developed transactional analysis in the last 1950s, using “transaction” to describe the fundamental unit of social intercourse, with “transactional analysis” being the study of social interactions between individuals. His influences included contemporaries such as René Spitz, Erik Erikson, Paul Federn, Edoardo Weiss, as well as Freud and Wilder Penfield, a Canadian neurosurgeon.

Inspired by Freud’s theory of personality—primarily his belief that the human psyche is multifaceted and that different components interact to produce a variety of emotions, attitudes and complex behaviors—and Penfield’s groundbreaking experiments involving the stimulation of specific brain regions with electrical currents, Berne developed an approach that he described as both neo- and extra-Freudian.

Discerning the need to build upon the philosophical concepts Freud introduced with observable data, Berne developed his own observable ego states of Parent, Adult, and Child, following Freud’s proposal of the existence of the Id (emotional and irrational component), Ego (rational component), and Superego (moral component) as different and unobservable factions of personality.

Berne also took special note of the complexities of human communication. He highlighted the fact that facial expressions, gestures, body language, and tone may be regarded as more important by the receiver than any spoken words. In his book Games People Play, he noted that people may sometimes communicate messages underpinned with ulterior motives.

Examining the Ego States of Transactional Analysis

Like Freud, Berne posited that each individual possesses three ego states. His ego states—the Parent, the Adult, and the Child—do not directly correspond to Freud’s Id, Ego, and Superego, however. Instead, these states represent an individual’s internal model of parents, adults, and children. An individual may assume any of these roles in transactions with another person or in internal conversation. These roles are not directly associated with their typical English definitions but can be described as follows:

Parent consists of recordings of external events observed and experienced by a child from birth through approximately the first five years of life. These recordings are not filtered or analyzed by the child; they are simply accepted without question. Many of these external events are likely to involve the individual’s parents or other adults in parent-link roles, which led Berne to call this ego state “the Parent.” Examples of external events recorded in this state:

Do not play with matches.

Remember to say “please” and “thank you.”

Do not speak to strangers.

Child represents all brain recordings of internal events (feelings or emotions) that are directly linked to the external events observed by the child during the first five years of life. Examples of events recorded in this state may include:

I feel happy when Mom hugs me.

Dad’s late night movie was very scary.

I feel sad when Mom is sad.

Adult, the final ego state, is the period in which a child develops the capacity to perceive and understand situations that are different from what is observed (Parent) or felt (Child). The Adult serves as a data processing center that utilizes information from all three ego states in order to arrive at a decision. One important role of the Adult is to validate data which is stored in the Parent:

I see that Suzie’s house was burnt down. Mom was right—I should not play with matches.

COMMUNICATION USING TRANSACTIONAL ANALYTIC THEORY

Any indication (speech, gestures or other nonverbal cues) that acknowledges the presence of another person is called a transactional stimulus. All transactions are initiated via the use of a transactional stimulus. When two individuals encounter each other and the receiver reacts in a manner related to the transactional stimulus, that individual has performed a transactional response. The key to successful person-to-person communication generally lies in identifying which ego state (in the speaker) initiated the transactional stimulus and which ego state (in the receiver) provided the transactional response.

Due to the typically rational and reasonable nature of the Adult, Berne believes that the easiest and simplest transactions occur between Adult ego states, but transactions may occur between any of the three ego states. In a complementary transaction, the transaction response from the receiver is directed to the sending ego state in the speaker. For example, if the Adult in the speaker sends a transactional stimulus to the Child in the receiver, then the transaction will be complementary if the Child in the receiver then sends the transactional response to the Adult in the speaker. According to Berne, communication will continue if the transactions remain complementary.

A crossed transaction occurs when an ego state that did not receive the transactional stimulus sends the transactional response. Crossed transactions may lead to breakdowns in communication, which may sometimes be followed by conflict. For example, the Adult state in an individual may send a transactional stimulus to the Adult in another individual, asking “Have you seen my coat?” But the Child in the second individual may instead send the transactional response to the Parent in the first individual by replying, “You always blame me for everything!”

Not only is communication considered to be an important aspect of everyday life, it is also thought to be an integral part of being human. Even newborns exhibit the need to be recognized and acknowledged. Research conducted by Spitz showed that infants who received less cuddling, handling, and touching were more likely to experience physical and emotional challenges. Berne described this innate need for social recognition as recognition-hunger, defining the fundamental unit of social action or recognition as a stroke.

From Berne’s perspective, the adversely affected children in Spitz’s studies exhibited physical and emotional deficits due to a lack of strokes. Berne applied this theory to adults, theorizing that men and women also experience recognition-hunger and a need for strokes. However, while infants may desire strokes that are primarily physical, an adult may be contented with other forms of recognition, such as nods, winks, or smiles.

While strokes may be positive or negative, Berne theorized that it is better to receive a negative stroke than no stroke at all. When one person asks another out on a date, for example, and receives a flat refusal, that person may find the refusal to be less damaging than a complete lack of acknowledgment.

TRANSACTIONAL ANALYSIS IN THERAPY

The goal of transactional analysis is help the individual in therapy gain and maintain autonomy by strengthening the Adult state. Typically, the individual and the therapist will establish a contract that outlines the desired outcome they wish to achieve in therapy. This may contribute to the person in therapy taking personal responsibility for events that take place during treatment. The individual will generally then become more able to rely on their Adult ego states to identify and examine various thoughts, behaviors, and emotions which might hinder the ability to thrive.

The atmosphere that supports transactional analysis is one of comfort, security, and respect. When a positive relationship is forged between the therapist and the person seeking treatment, this often provides a model for subsequent relationships developed outside of the therapy arena. Analysts who practice this form of therapy generally use a broad range of tools gathered from many disciplines including psychodynamic, cognitive behavioral, and relational therapies.

WHO CAN BENEFIT FROM TRANSACTIONAL ANALYSIS?

Transactional analysis is frequently applied in the areas of medicine, communications, education, and business management as well as therapy. The mainstream appeal of this technique has attracted parents, professionals, social workers, and others who strive to achieve maximum personal development. Transactional analysis is considered to be one effective method of enhancing relationships with oneself and with others.

Studies show that transactional analysis, often used by counselors and clinicians to address issues currently faced by the person in treatment, can be an effective tool in the treatment of emotional and relationship difficulties that may develop as a result of chronic health challenges. 

Transactional analysis is used widely in the educational arena, and this method can serve as a vessel through which educational principles and philosophy can be incorporated into the daily lives of students. This type of therapy can be administered to children and adults of all ages, regardless of social circumstances.

HOW TO BECOME A CERTIFIED TRANSACTIONAL ANALYST

In order to qualify as a certified transactional analyst (CTA), individuals must first complete a Transactional Analysis 101 course and then:

Contract a sponsor who is qualified in the same TA field in order to adequately prepare for certification. The International Board of Certification acts as the third party to the contract.

Log hours in training (600 hours of tutor contact), supervision (150 hours supervised while professionally applying TA in the field), and application (750 hours of client contact time in the professional field). An additional 500 hours may be spent in any area, bringing the total number of required hours to 2000.

Complete and pass a written exam (up to 24,000 words).

Take and pass an oral exam.

References:

1 Bennett, R. (1999). A transactional analysis approach to the categorization of corporate marketing behavior. Journal of Marketing Management, 15, 265-289.

2 Key Concepts in Transactional Analysis. (n.d.). Retrieved from https://itaaworld.org/key-concepts-transactional-analysis

3 McLeod, J. (2013). Process and outcome in pluralistic transactional analysis counselling for long-term health conditions: A case series. Counseling and Psychotherapy Research, 13(1), 32-43.

4 Qualifying in TA. (n.d.). Retrieved from https://itaaworld.org/qualifying-ta

5 Transactional Analysis. (n.d.). Retrieved from http://www.ericberne.com/transactional-analysis

This Emotions 

Definition of Emotions from https://www.britannica.com/science/emotion

emotion, a complex experience of consciousness, bodily sensation, and behaviour that reflects the personal significance of a thing, an event, or a state of affairs.The variety and complexity of emotions

“Emotions,” wrote Aristotle (384–322 BCE), “are all those feelings that so change men as to affect their judgements, and that are also attended by pain or pleasure. Such are anger, pity, fear and the like, with their opposites.” Emotion is indeed a heterogeneous category that encompasses a wide variety of important psychological phenomena. Some emotions are very specific, insofar as they concern a particular person, object, or situation. Others, such as distress, joy, or depression, are very general. Some emotions are very brief and barely conscious, such as a sudden flush of embarrassment or a burst of anger. Others, such as long-lasting love or simmering resentment, are protracted, lasting hours, months, or even years (in which case they can become a durable feature of an individual’s personality). An emotion may have pronounced physical accompaniments, such as a facial expression, or it may be invisible to observers. An emotion may involve conscious experience and reflection, as when one “wallows” in it, or it may pass virtually unnoticed and unacknowledged by the subject. An emotion may be profound, in the sense that it is essential to one’s physical survival or mental health, or it may be trivial or dysfunctional. An emotion may be socially appropriate or inappropriate. It may even be socially obligatory—e.g., feeling remorse after committing a crime or feeling grief at a funeral.

This is about 27 different emotions 

https://greatergood.berkeley.edu/article/item/how_many_different_human_emotions_are_there#:~:text=A%20new%20study%20identifies%2027,together%20in%20our%20everyday%20experience.&text=Psychology%20once%20assumed%20that%20most,surprise%2C%20fear%2C%20and%20disgust. 

https://s3-us-west-1.amazonaws.com/emogifs/map.html#modal

Resting State Hypoconnectivity of Reward Networks in Binge Eating Disorder

The clinical presentation of binge eating disorder (BED) and data emerging from task-based functional neuroimaging research suggests that this disorder may be associated with alterations in reward processing. However, there is a dearth of research investigating the functional organization of brain networks that mediate reward in BED. To address this gap, 27 adults with BED and 21 weight-matched healthy controls (WMC) completed a multimodel assessment consisting of a resting functional magnetic resonance imaging scan, behavioral tasks measuring reward-based decision-making (i.e., delay discounting and reversal learning), and self-report assessing clinical symptoms. A seed-based approach was employed to examine the resting state functional connectivity (rsFC) of the striatum (nucleus accumbens [NAcc] and ventral and dorsal caudate), a collection of regions implicated in reward processing. Compared with WMC, the BED group exhibited lower rsFC of striatal seeds, with frontal regions mediating executive functioning (e.g., superior frontal gyrus [SFG]) and posterior, parietal, and temporal regions implicated in emotional processing. Lower NAcc–SFG rsFC was associated with more difficulties with reversal learning and binge eating frequency in the BED group. Results suggest that hypoconnectivity of striatal networks that integrate self-regulation and reward processing may promote the clinical phenomenology of BED. Interventions for BED may benefit from targeting these circuit-based disturbances.

Binge eating disorder (BED) is a psychiatric illness characterized by recurrent episodes of binge eating (i.e., consumption of an unusually large amount of food in a discrete time period accompanied by a sense of loss of control over eating) in the absence of the repeated compensatory behaviors that are associated with bulimia nervosa (APA 2013). Lifetime prevalence rates of BED are estimated between 1% and 4.7% (Smink et al. 2013), making it the most prevalent of the primary eating disorders. BED is associated with a wide range of negative psychological consequences, including mood, anxiety, and substance use disorders, as well as with an increased risk of suicide attempt (Udo et al. 2019; Udo and Grilo 2019). Furthermore, approximately 75% of individuals with the disorder are classified as either overweight (body mass index [BMI] of 25–29.9 kg/m2) or obese (BMI > 30 kg/m2) and, therefore, are subject to the physical sequelae associated with excess body weight, such as cardiovascular and metabolic disorders (Kessler et al. 2013; Udo and Grilo 2019). Although a number of treatments have been developed to target BED, only half or fewer of affected individuals attain binge eating abstinence following standard treatments (Brownley et al. 2016), and the mechanisms of action for these treatments are poorly specified (Kober and Boswell, 2018).

Relative to other eating disorders, very little research has been conducted to elucidate the neurobiology of BED (Steward et al. 2018). Therefore, the underlying mechanisms of this disorder remain poorly understood. Given the heightened drive toward palatable food that is characteristic of BED, it has been suggested that abnormalities in reward responding and corresponding patterns of striatal functioning may be implicated in this disorder, paralleling findings from the literature on addictive disorders (Volkow et al. 2013; Volkow and Baler 2015). In particular, consistent with other eating disorder and addiction models (Smith and Robbins 2013; Walsh 2013; Pearson et al. 2015), recently proposed neurobiological models of BED suggest that frontostriatal dysfunctions promote the transition from typical eating behavior to an impulsive-compulsive pattern of recurrent binge eating (Kessler et al. 2016). These theories posit that individuals with BED, when exposed to palatable foods, initially experience hyperresponsivity in the ventrally located regions of the striatum (e.g., nucleus accumbens [NAcc] and ventral portions of the caudate), which demonstrate greater associations with the emotional and motivational components of reward responding (Di Martino et al. 2008; Huang et al. 2017). Over time, there is hypothesized to be a shift toward greater reactivity of the dorsal regions of the striatum (e.g., dorsal caudate), which are linked to habitual motor and cognitive functions informed by prior reward learning. Additionally, individuals with BED have demonstrated impairments in executive functions (e.g., response inhibition) that are facilitated by the activity of prefrontal regions (Balodis et al. 2013), limiting the ability to constrain the drive toward rewards. Thus, the phenomenology of BED is suggested to result from inadequate reward circuit coordination between striatal and prefrontal inputs, yielding an imbalance between hedonic pursuit and inhibition.

Although this area of research is nascent, studies utilizing functional neuroimaging have demonstrated heightened striatal activity and diminished prefrontal activity for individuals with BED compared with overweight controls during exposure to high-caloric images (Weygandt et al. 2012; Lee et al. 2017). Preliminary evidence also suggests that reduced frontostriatal activity during processing of nonfood rewards, perhaps reflecting decreased sensitivity to disorder-irrelevant stimuli, is associated with the persistence of binge eating following treatment for BED (Balodis et al. 2014). Further, a broader body of neuroimaging research based on the food addiction model has highlighted the salience of frontostriatal dysfunction in relation to binge eating behavior (Smith and Robbins 2013). Most of the limited number of studies focused on the functional patterns of frontostriatal circuitry in BED have utilized task-evoked designs with food cues as stimuli, which provide valuable information about reward responsivity in disorder-salient contexts. However, such studies do not address whether there are more generalized disruptions in the functional architecture of frontostriatal circuitry or in associated mechanisms such as reward-related impulsivity or compulsivity (Berner et al. 2017).

Thus, there is a need to extend the existing literature beyond stimulus-evoked neural activity in BED to further investigate the underlying functional characteristics of brain networks that may subserve the behavioral dysregulation characterizing this disorder. Resting state functional connectivity (rsFC), which examines the correlational patterns of naturally occurring fluctuations in the blood oxygen level-dependent (BOLD) signal between brain regions, provides an opportunity to investigate the abnormalities in the synchrony of brain circuits independent of cue presentation that may reflect transdiagnostic neurobiological mechanisms shared with other psychiatric disorders. Indeed, prior research has provided evidence for reduced rsFC between the striatum and prefrontal regions in relation to a variety of addictive behaviors (Kühn and Gallinat 2014; Motzkin et al. 2014; Zhou et al. 2018). However, to date, only one study has examined the rsFC of frontostriatal networks in a sample that specifically included participants with BED (Baek et al. 2017). Using a data-driven approach informed by graph theory, these researchers found that individuals with obesity (with or without BED) exhibited lower frontostriatal rsFC relative to a comparison group (BMIs between 18.1 and 25.9 kg/m2). Lower frontostriatal rsFC was related to higher BMI across groups. However, because this study did not specifically examine how patterns of frontostriatal rsFC differed between participants with and without BED, it can provide only limited insight into the neural patterns specifically associated with recurrent binge eating. Additionally, this investigation employed a whole brain approach, precluding a theoretically guided probe of reward circuit functioning, and it did not examine associations between rsFC and the performance on reward-based behavioral paradigms, which could link connectivity patterns to clinically relevant neurocognitive processes. Therefore, more data are needed to determine how frontostriatal rsFC patterns relate to behavioral and clinical indicators of reward dysfunction and symptom expression in BED. Additionally, it would be valuable to determine if the patterns of neural synchrony differ across the ventral areas of the striatum traditionally linked to reward and/or dorsal areas linked with habitual motor functions, given the theorized dissociable role of different striatal regions in the development and maintenance of BED (Kessler et al. 2016).

To address these gaps in the literature, we conducted the first seed-based investigation of rsFC focused on striatal regions of interest (ROIs) (i.e., the NAcc, ventral caudate, and dorsal caudate) to examine the organization of reward-related brain regions across the ventral through dorsal functional gradient from goal-oriented to habitual responding in adults with BED. Given the substantial overlap between BED and overweight/obesity, as well as the evidence regarding abnormal striatal activity in obesity (Volkow et al. 2013; Volkow and Baler 2015; Baek et al. 2017), the current study included a weight-matched control (WMC) group in order to provide findings specific to BED rather than excess weight more broadly. Based on the defining behavioral feature of BED (i.e., recurrent loss of control over consumption of a large amount of typically palatable food) and patterns of frontostriatal rsFC in additive disorders (Kühn and Gallinat 2014; Motzkin et al. 2014; Zhou et al. 2018), we hypothesized that individuals with BED would exhibit lower rsFC of all striatal ROIs with frontal regions involved in self-regulatory control.

In order to provide preliminary data regarding the clinical relevance of group differences in rsFC, we examined the correlations of rsFC with BED symptom severity (i.e., frequency of binge eating days). We also examined the relation between rsFC patterns and performance on neurocognitive paradigms that measure the tendency toward impulsive (i.e., delay discounting; Monterosso and Ainslie 1999) or compulsive (i.e., reversal learning; Izquierdo and Jentsch 2012) drive for reward. These measures were included due to the theoretical suggestion that BED is maintained by an impulsive and/or compulsive pattern of engagement toward food rewards, which may reflect more global reward response patterns (Kessler et al. 2016). These measures have been associated with externalizing behaviors in a variety of psychiatric disorders (van Timmeren et al. 2018; Lempert et al. 2019) and may capture a transdiagnostic bias toward the pathological pursuit of a range of rewards, including the reward of food consumption. Given the role of frontostriatal functioning in effective modulation of reward pursuit, it was hypothesized that reduced ventral and dorsal frontostriatal rsFC would be associated with a greater severity of binge eating and poorer performance on tasks assessing the tendency toward impulsivity and compulsivity in reward-seeking behaviors.

This case-controlled, cross-sectional study was approved by the Institutional Review Board at the University of Minnesota. Data used in the present study were obtained between December 2008 and July 2010 as a part of a broader study examining the differences in the dissociable influence of gamma-aminobutyric acid levels on the impulsivity between participants with BED or substance dependence and healthy controls. For this analysis, only BED and WMC participants were examined; results relevant to substance dependence have been previously reported (Camchong et al. 2011). Participants included 27 adults who met the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV; APA 2000) criteria for BED and 21 controls who were weight-, age-, gender-, and education-matched at the group level. Demographic and clinical characteristics of the sample are listed in Table 1. All inclusion and exclusion criteria are described in Section A and the matching procedures are described in Section B of the Supplementary Material. For female participants of childbearing potential, scanning and neurocognitive testing visits occurred in the luteal phase of the menstrual cycle. Written informed consent was obtained from all individuals prior to study enrollment, and the participants received financial compensation.

Diagnostic Screening and Clinical Measures

All participants completed a full Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-IV; First et al. 1995) administered by an extensively trained member of the research staff to establish the eligibility criteria. Additionally, all participants with BED completed the Eating Disorder Examination-16 (EDE-16; Fairburn et al. 2008) and an investigator-led semi-structured interview assessing eating disorder symptoms to confirm BED diagnosis and obtain the number of days within the past month on which episodes of binge eating occurred, which served as our binge eating frequency variable in this study. The EDE-16 was not administered to WMC participants in order to reduce the measurement burden; however, the absence of binge eating in the WMC group was confirmed with the widely used questionnaire version of the EDE: the Eating Disorder Examination-Questionnaire 6.0 (EDE-Q; Fairburn and Beglin 2008). The EDE and EDE-Q have been shown to demonstrate generally high correspondence (Berg et al. 2012), and estimates of binge eating episode frequency have been shown to be slightly higher on the EDE-Q (Fairburn and Beglin 1994). Therefore, use of the EDE-Q to confirm the absence of recurrent binge eating is considered an adequate metric for determining a sample distinct from the BED. Participants also completed the Beck Depression Inventory (BDI; Beck et al. 1996) and the Beck Anxiety Inventory (BAI; Beck and Steer 1993) questionnaires; scores on these measures were used as covariates in analyses to determine if the group differences were impacted by depression or anxiety symptoms.

Behavioral Tasks

In a separate session prior to the functional magnetic resonance imaging (fMRI) scan, participants completed two behavioral tasks assessing the impulsive and compulsive reward pursuit in order to capture the transdiagnostic neurocognitive mechanisms related to dysfunctional reward seeking. Data were available for a subset of participants on these delay discounting (n = 33) and reversal learning (n = 34) tasks. See details about the group behavioral differences on these tasks in Section C of the Supplementary Material.

Delay Discounting Task To assess the impulsive tendency toward immediate reward-related gratification, a delay discounting paradigm was used, which requires the participants to make a series of choices about whether to accept smaller immediate monetary rewards or larger monetary rewards administered on a delayed time scale. Participants were presented with two identical boxes on a computer screen and were instructed to make hypothetical choices between them by clicking a mouse: one with an immediate smaller monetary reward and another with a delayed larger monetary reward (e.g., “Would you rather have $5 now or $10 in 30 days?”). Although in some versions of delay discounting, financial payouts are given according to the participants’ choices, research suggests that choices on hypothetical and real scenarios are comparable (Johnson and Bickel 2002). The delay k parameter derived from this task represents the tendency toward immediate gratification. A higher delay k represents less willingness to delay gratification, which likely indexes more reward impulsivity. The delay k parameter is derived from the optimal discounting rate based upon minimizing the error around the five indifference points of the hyperbolic delay function.

Reversal Learning Task The reversal learning task was used to assess the participants’ reward-based compulsivity versus flexibility in the ability to adapt their responses to shifting contingencies. In this task, which consists of three 5-min blocks with a maximum of 150 trials in each block, participants make choices between different stimuli to receive a reward. Participants were simultaneously presented with two visually dissimilar gray patterns. Participants had to respond to one of these objects by using either a left or a right button-press depending on whether their chosen object was on the left or right side of the screen. The screen gave feedback after each response to indicate if the reaction was correct or incorrect. After 10 correct responses, the strategy reversed and participants had to adapt their reactions and respond to the formerly wrong stimulus. To distract participants, false feedback was provided 20% of the time indicating a wrong choice despite a correct response. Although participants were informed that they would occasionally receive false feedback, they did not know how often this would occur. We examined trials to the first reversal, the number of trials required for the participant to first change behavior in response to a change in reward contingencies, which reflected the tendency to compulsively pursue previously rewarded cues.

Imaging Data Acquisition

Six-minute resting state fMRI data were collected using the vendor-supplied 12-channel receive-only head coil on a Siemens Tim Trio 3 T scanner. Participants were instructed to be as still as possible, keep their eyes closed, and stay awake. Participants were queried at the end of the scan to determine whether they had stayed awake. Sequence parameters included: gradient-echo echo-planar imaging (EPI) 180 volumes, time repetition (TR) = 2 s, time echo (TE) = 30 ms, flip angle = 90 °, 34 continuous anterior commissure–posterior cingulated cortex aligned axial slices with an interleaved acquisition, voxel size = 3.4 × 3.4 × 4.0 mm, and matrix = 64 × 64 × 34. For registration purpose, a high-resolution T1-weighted anatomical image was acquired using a magnetization prepared rapid gradient-echo sequence (TR = 2530 ms, TE = 3.65 ms, time to inversion [TI] = 1100 ms, flip angle = 7 °, and 1 mm isotropic voxel). A field map acquisition was collected and used to correct the fMRI data for geometric distortion caused by the magnetic field inhomogeneities. Time of day of fMRI acquisition was not standardized. Groups were matched on the average time of day at which imaging occurred; however, the BED group was scanned on average more recently to standard meal times (see Section D of the Supplementary Material).

fMRI Imaging Analysis

Data Preprocessing The following fMRI data preprocessing steps were applied for each participant using FEAT (FMRIB’s Software Library [FSL]): deletion of the first three volumes (to account for magnetization stabilization), motion correction, B0 field map unwarping, slice-timing correction, nonbrain removal, spatial smoothing (with a 6-mm full-width half-maximum kernel), grand mean scaling, high-pass temporal filtering (100 Hz), and registration of all images to Montreal Neurological Institute (MNI) 2 × 2 × 2 mm standard space. The preprocessed fMRI data were used to calculate the individual level functional connectivity maps for each ROI. In order to remove all major sources of artifactual correlation in the rsFC data while preserving the integrity of the continuous time series, an Independent Component Analyses (ICA)-based denoising procedure was performed. The individual preprocessed 4D fMRI data sets were decomposed into independent spatiotemporal components using FSL MELODIC. Individual components were manually classified by an experienced rater (JC) as either noise or signal using spatial and temporal characteristics detailed in the MELODIC manual and previous methodological reports (Kelly et al. 2010). Components accounting for movement, respiration, heart rate, and head motion, and components localized to the ventricles and white matter signal were regressed out of the preprocessed data for each subject data during ICA denoising. BED and WMC groups did not differ in the percentage of components, explained variance, or total variance removed during ICA, t(46) = −0.14 to −0.37, ps = 0.478–0.890, indicating that noise was comparable between groups. Further, BED and WMC groups did not differ in the mean absolute value along the six motion parameters that characterize translations and rotations along x, y, and z dimensions, t(46) = −0.02 to −1.77, ps = 0.083–0.981, and no participant surpassed our threshold of >1.88 mm motion for removal (Camchong et al. 2017). Additional information characterizing the motion parameters can be found in Section E of the Supplementary Material.

ROI Generation Figure 1 presents a visual representation of the NAcc, ventral caudate, and dorsal caudate seed maps with MNI coordinates. For all regions, we generated a spherical seed with 3.5 mm radius in the right and left hemispheres, which were then combined in the analysis. Center of mass MNI coordinates were as follows: x = ±12, y = 10, z = −9 (NAcc); x = ±10, y = 15, z = 0 (ventral caudate); and x = ±13, y = 15, z = 9 (dorsal caudate), established according to precedent from prior research that has parcellated the striatum (Di Martino et al. 2008; Camchong et al. 2013). Time series were extracted from each of these seeds for each participant.

Figure 1

NAcc, ventral caudate, and dorsal caudate seed map: Image depicts nonoverlapping NAcc (blue) (right: x = 12, y = 10, z = −8; left: x = −10, y = 10, z = −8; only right is pictured); ventral caudate (orange) (bilateral, x = ±10, y = 15, z = 0); and dorsal caudate (red) (bilateral, x = ±13, y = 15, z = 9) seeds used to examine the strength of rsFC overlaid on MNI brain.

Resting-State Individual-Level Analysis For each participant and each ROI (bilateral NAcc, ventral caudate, and dorsal caudate), we performed a multiple regression analysis on the denoised data. The correlation between the mean time course of each ROI and the time course of every voxel in the brain was calculated and Fisher z-transformed to standardized z values. Bilateral seeds were combined for each ROI (NAcc, ventral caudate, and dorsal caudate) to produce correlation maps reflecting connectivity associated with both left and right seeds. The resultant z maps showed the degree of positive or negative correlations between the corresponding NAcc and caudate seeds averaged time-series for each seed for each participant.

Group-Level Analysis

Group differences for each ROI were separately analyzed using 3dtest++ with AFNI, using the -clustsim option to calculate smoothness, given the non-Gaussian data distribution. Based on Cox et al. (2017) and addressing concerns of “inflated false-positive rates” raised by Eklund et al. (2016), Monte Carlo simulations (1000 iterations) accounted for the full-width half-maximum Gaussian filter (6 mm full-width at half-maximum [FWHM]; 3dFWHMx) and with a conservative connectivity radius of 5.6 mm, specifying that active voxels whose center of mass are less than 5.6 mm apart were considered as belonging to the same cluster. To avoid false positives, we selected the most stringent output (neural networks [NN] = 1 and bisided results) for significant clustering and thresholding. On the basis of these simulations, the familywise α of 0.01 was preserved with an a priori voxelwise probability of 0.005 and 3D clusters resulting in minimum volume criteria of 242 voxels for the NAcc, 83 voxels for the ventral caudate, and 83 voxels for the dorsal caudate. Using these minimum cluster size thresholds, clusters that survived correction for multiple comparisons were identified and used as masks from which individual mean z-scores were extracted for graphs visualization and for exploration of functional connectivity correlates. To examine whether results were impacted by symptoms of anxiety or depression, analyses of covariance were conducted to determine the group differences in rsFC after controlling for BDI and BAI scores, maintaining the familywise error rate, p < 0.01.

Associations of rsFC with Behavioral Tasks and Clinical Measures

To examine the relationship between rsFC strength from clusters that showed significant differences between the groups and measures of impulsive and compulsive reward pursuit, we extracted the average z-scores from clusters in Table 2. Separate Pearsons correlations (r) were conducted in the BED and WMC groups to examine the relations between rsFC z-scores within each of these clusters and: (1) behavioral measures representing the delay k parameter (delay discounting task) and (2) the average number of trials it took for an individual to perform first reversal (reversal learning task). Additionally, to examine the relationship between rsFC strength in ROIs and binge eating frequency, we conducted separate Pearson correlations (r) between the rsFC z-scores within each of the identified clusters and number of the past month binge eating days from the EDE-16 for the BED group only. Visual inspection and normality testing revealed that the delay k parameter was significantly skewed (Skewness statistic > 1.5; Shapiro–Wilk: p < 0.001); therefore, these data were log-transformed prior to correlational analyses. For all behavioral and self-report measures, significant outliers > 2.5 standard deviations (SD) above the mean were excluded from the correlation analyses, resulting in an exclusion of two BED participants from the correlations involving delay k and one BED participant from the correlations involving the reversal learning score. To avoid alpha inflation resulting from multiple separate statistical tests, all correlation analyses were two-tailed and corrected for familywise error using the Benjamini-Hochberg (1995) procedure.

Food Addictions Are Real Addictions—And More and More People Are Getting Hooked

https://time.com/5718798/food-addiction/ 

Time/life Article 

Nobody has to score Hershey’s kisses on the street. Nobody has to smuggle Pringles across the country hidden in the wheel well of a car. And if you’re paying $100 for a gram of Coke, you’re definitely being overcharged.

But that doesn’t mean that the life-sustaining substances we come into the world loving and couldn’t survive without—the sugars and salts and fats and proteins, the fruits and vegetables and breads and meats—can’t get us into every bit as much danger as the deadly, often illegal substances that cause so much suffering. You can eat compulsively, just as you can smoke or drink or do drugs compulsively. And in all those cases, compulsions can become full-blown addictions, as repeated exposure plays the pleasure centers in the brain, creating a feedback loop of craving, indulging, consuming, regretting—and doing it all over the next day and the next.

Some numbers suggest that food may be as addictive as drugs, and in some cases more so. About 30% of people who try heroin become addicts; the same goes for about 16% of cocaine users. One study published in Frontiers in Psychology found that, when the definition of addiction is explained to obese or overweight subjects, up to 29% of them describe themselves as addicted to food. That takes its toll: more than 40% of Americans who are obese and the overall 71.6% who are overweight—which suggests at the very least an unhealthy dependency on food is common in the U.S.

This article is excerpted from TIME: The Science of Addiction—What We Know. What We’re Learning.

In some ways, of course, food is more insidious than drugs, because there’s no such thing as abstinence, no such thing as never starting in the first place, no such thing as being able to say, “Food? Never touch the stuff.” You eat because you’ll die if you don’t, so you spend your life in a sort of nutritional two-step—a little but not too much; go overboard today, cut back tomorrow; eat the good stuff but never the junk. Sometimes you succeed at all of that, and other times you fail terribly; we all do. The more we learn about how the brain and palate and metabolism process food, the more we’re realizing that a lot of this is not our fault.

“In all my years as a physician, I have never ever met a person who chose to be an addict, nor have I ever met someone who chose to be obese,” said Nora Volkow, the director of the National Institute on Drug Abuse, in her celebrated 2015 TedMed talk. “So, imagine what it must be like to be unable to stop doing something when you want to.” That inability is at the heart of addiction—and when it comes to food, we’re all at risk.

Pleasure gets processed in many parts of the brain, but if you’re looking for the spot where good feelings can turn into bad outcomes, you’ll find it in the striatum. Buried deep in the midbrain, the striatum is rich in what are known as D2 receptors, whose job it is to bind with the feel-good neurotransmitter dopamine. Dopamine drives the reward system—the sensation of satisfaction you get from an obstacle overcome or a job well done. Dopamine also helps you experience more-primal pleasures: food, sex, intoxication.

As long as the dopamine system remains in balance in the striatum, so too will our ability to control those pleasures—a single slice of cake; wine with dinner but no more after that. When the system starts to flicker, however, with too few D2 receptors and too little dopamine being released to engage with them, our behavior is affected dramatically. Most notably, we give way to impulsivity, grabbing what we want when we want it, with little regard to the downstream consequences.

In a 2014 study published in Neuropharmacology, a pair of psychiatric researchers studied PET scans of the brains of both healthy subjects and heroin addicts and found that a fall-off in striatal function indeed could be detected in the subjects hooked on the drug. The researchers cited additional studies showing similar brain deficits in people addicted to other substances and behaviors. Significantly, in the case of those addictions, the pleasure is processed in a variety of brain regions, but the inability to resist temptation is consistently linked to the striatum.

When it comes to food addictions, dopamine is not the only chemical in play. Also implicated is the hormone leptin, which is released by fat cells and is responsible for feelings of satiety. When you’re hungry and dive into a meal, your leptin levels are low. When you’ve eaten your fill, it’s leptin that tells you to push away from the table. Ideally, that’s something to which you don’t give much thought; you just know you feel satisfied and stop eating. For people who eat compulsively, either leptin is not released in sufficient quantities or it is, but the brain doesn’t react to it adequately. “In animal models, we know that leptin modifies the rewarding effects of alcohol and possibly cocaine,” said Volkow in her TedMed talk. “In obesity, there is leptin tolerance.” In this case tolerance is not a good thing—it means the brain shrugs off the hormone.

The particular foods that make up our menu can play a role in addictive eating too. Nutritionists often lament America’s ostensible sugar addiction as a leading cause of the obesity epidemic, but it’s more complex than that. We may find candy and doughnuts and other sweet foods irresistible, eating them even when we know we shouldn’t. “But that wouldn’t happen if you walked into an office and there was a bowl of white sugar on a table,” says Rachele Pojednic, an assistant professor of nutrition at Simmons University. Instead, the sweets we eat compulsively are products of a trifecta of irresistibles: sugar, fat and salt. Individually they’re entirely unappetizing; together they make magic, turbocharging the so-called hedonic eating system—or the business of eating just for pleasure.

This doesn’t only happen in humans. In a 2013 study led by neuroscientist Joseph Schroeder at Connecticut College, researchers found that Oreos—an indulgent staple of the human diet if ever there was one—lit up the neurons in the pleasure center of rats’ brains even more powerfully than cocaine. And, like humans, the rats knew where to find the sweetest, fattiest, tastiest part of the cookie. “They would break it open and eat the middle first,” said Jamie Honohun, a student who assisted in the research, in a release that accompanied the study. In another statement released at that time, Schroeder and his team wrote, “These findings suggest that high fat/high sugar foods and drugs of abuse trigger brain addictive processes to the same degree.”

What happens to the same degree can lead to the same (or at least similar) consequences—in this case dependency, and too often misery. There’s profound joy to be found in food, and unlike the destructive pleasure often found in drugs, it’s a joy that can be experienced in moderation. Very much like the destructive pleasure of drugs, however, it’s something that can easily spin out of control. Compulsive eaters—sometimes dismissed as lacking willpower or discipline—can have every bit the battle on their hands that drug addicts do. And they deserve every bit of the support as they work to recover.

—Jamie Ducharme, Mandy Oaklander and Maia Szalavitz contributed to this story

Dopamine

Dopamine is a neurotransmitter made in your brain. It plays a role as a “reward center” and in many body functions, including memory, movement, motivation, mood, attention and more. High or low dopamine levels are associated with diseases including Parkinson’s disease, restless legs syndrome and attention deficit hyperactivity disorder (ADHD).

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What is dopamine?

Dopamine is a type of monoamine neurotransmitter. It’s made in your brain and acts as a chemical messenger, communicating messages between nerve cells in your brain and your brain and the rest of your body.

Dopamine also acts as a hormone. Dopamine, epinephrine and norepinephrine are the main catecholamines (a label based on having part of the same molecular structure). These hormones are made by your adrenal gland, a small hat-shaped gland located on top of each of your kidneys. Dopamine is also a neurohormone released by the hypothalamus in your brain.

What’s the role of dopamine in my body?

Dopamine plays a role in many body functions.

As a neurotransmitter, dopamine is involved in:

• Movement.

• Memory.

• Pleasurable reward and motivation.

• Behavior and cognition.

• Attention.

• Sleep and arousal.

• Mood.

• Learning.

• Lactation.

As a hormone, dopamine is released into your bloodstream. It plays a small role in the “fight-or-flight” syndrome. The fight-or-flight response refers to your body’s response to a perceived or real stressful situation, such as needing to escape danger.

Dopamine also:

• Causes blood vessels to relax (at low doses, it acts as a vasodilator) or constrict (at high doses, it acts as a vasoconstrictor).

• Increases sodium (salt) and urine removal from your body.

• Reduces insulin production in your pancreas.

• Slows gastrointestinal (GI) (gut) content movement and protects your GI lining.

• Reduces lymphocyte activity in your immune system.

How does dopamine make someone feel happy?

Dopamine is known as the “feel-good” hormone. It gives you a sense of pleasure. It also gives you the motivation to do something when you’re feeling pleasure.

Dopamine is part of your reward system. This system is designed, from an evolutionary standpoint, to reward you when you’re doing the things you need to do to survive — eat, drink, compete to survive and reproduce. As humans, our brains are hard-wired to seek out behaviors that release dopamine in our reward system. When you’re doing something pleasurable, your brain releases a large amount of dopamine. You feel good and you seek more of that feeling.

This is why junk food and sugar are so addictive. They trigger the release of a large amount of dopamine into your brain, which gives you the feeling that you’re on top of the world and you want to repeat that experience.

How might I feel if I have the right amount of dopamine?

If you have the right balance of dopamine, you feel:

• Happy.

• Motivated.

• Alert.

• Focused.

How might I feel if I have a low dopamine level?

If you have a low dopamine level, you might feel:

• Tired.

• Unmotivated.

• Unhappy.

You may also have:

• Memory loss.

• Mood swings.

• Sleep problems.

• Concentration problems.

• A low sex drive.

How might I feel if I have a high dopamine level?

If you have a high dopamine level, you might feel:

• Euphoric.

• Energized.

• A high sex drive.

The negative side of having high levels of dopamine include:

• Having trouble sleeping.

• Having poor impulse control.

• Being more aggressive.

What health conditions are associated with high or low dopamine levels?

Many diseases are associated with high or low levels of dopamine. There’s still much to be learned. For example, does a high or low level of dopamine cause disease or does disease cause a change in the dopamine level? Can the answer be both? Adding to the confusion is that the function of a single neurotransmitter like dopamine can’t be viewed in isolation of other neurotransmitters or other chemicals in your brain or body. Many interact with each other. There’s a lot going on.

All that being said, there are still diseases in which the dopamine levels are high or low.

Diseases associated with low levels of dopamine:

• Attention deficit hyperactivity disorder (ADHD).

• Parkinson’s disease.

• Restless legs syndrome.

Diseases associated with high levels of dopamine:

• Mania.

• Obesity.

• Addiction.

Diseases associated with both high and low levels of dopamine:

• Schizophrenia. Some symptoms of schizophrenia can possibly be caused by having too much dopamine in certain areas of your brain — delusions and hallucinations. Other symptoms are possibly caused by not having enough dopamine in another part of your brain — lack of motivation.

What are dopamine agonists?

Dopamine agonists are drugs that mimic the natural neurotransmitter dopamine. Dopamine agonists bind to and activate the dopamine receptors on nerve cells in your brain, causing nerve cells to react in the same way as they would to natural dopamine.

Dopamine agonists are used to treat Parkinson’s disease, depression, restless legs syndrome, attention deficit hyperactivity disorder, low sex drive and hyperprolactinemia.

Examples of these dopamine agonist medications include:

• For Parkinson’s disease: pramipexole (Mirapex®), ropinirole (Requip®), rotigotine (Neupro®), apomorphine HCl (KYNMOBI®).

• For depression: pramipexole (Mirapex).

• For low sex drive: pramipexole (Mirapex).

• For hyperprolactininemia (excess hormone that makes breast milk): bromocriptine (Parlodel®), cabergoline (Dostinex®).

What are dopamine antagonists?

Dopamine antagonists are drugs that bind to and block dopamine receptors (on the receiving nerve cell) in your brain. This means they block or stop dopamine from being received by the next nerve cell. Many antipsychotic drugs are dopamine antagonists.

Dopamine antagonists are used to treat schizophrenia, bipolar disorder, nausea and vomiting,

Examples of dopamine antagonist medications include:

• For agitation in schizophrenia: aripiprazole (Abilify®), risperidone (Risperdal®), ziprasidone (Geodon®).

• For bipolar disorder: risperidone, olanzapine (Zyprexa®), ziprasidone.

• For nausea and vomiting: metoclopramide (Reglan®), droperidol (Inapsine®).

What are dopamine reuptake inhibitors?

Dopamine reuptake inhibitors are drugs that prevent dopamine from re-entering and being reabsorbed by the nerve cell that released it. This makes more dopamine available to more neurons in your brain.

Dopamine reuptake inhibitors are used to treat depression and narcolepsy, and to overcome addictions such as smoking, overeating and binge eating.

Examples of dopamine reuptake inhibitor medications include:

• For depression: bupropion (Wellbutrin®).

• For narcolepsy: modafinil (Provigil).

• For cocaine addiction: bupropion, nomifensine, benztropine (Cogentin), mazindol.

• For stopping smoking: bupropion.

What is levodopa?

Levodopa is used to treat Parkinson’s disease. Loss of dopamine is responsible for the movement symptoms seen in people with Parkinson’s disease. To help levodopa reach your brain (as opposed to other parts of your body), levodopa is combined with carbidopa. Once it reaches your brain, it’s converted into dopamine.

What’s dopamine’s role in addiction to recreational drugs?

Recreational drugs interfere with the way nerve cells in your brain send and receive messages. Drugs like marijuana and heroin mimic natural neurotransmitters. Other drugs, like amphetamine and cocaine, cause the release of large amounts of natural neurotransmitters or prevent the recycling of these neurotransmitters.

Recreational drugs overstimulate your brain’s “reward center.” Over time, with repeated drug exposure, a certain area of your brain becomes less sensitive and you don’t get the same feeling of pleasure from anything else but the drug. Also, you’ll often need to take larger and larger amounts of drugs to produce the same effect. At the same time, another area of your brain becomes more sensitive to the feelings of withdrawal, such as anxiety and irritability, as the drug effects wear off and you’ll seek drug use for another reason — to get relief from this discomfort. So, addiction is a vicious cycle that develops from multiple mechanisms.

Scientists now think that dopamine’s role isn’t to directly cause euphoria, but serves as a reinforcement for remembering and repeating pleasurable experiences. So, when drugs cause surges in dopamine, it’s teaching your brain to remember the experience. Your brain links your drug use and all of your routines and other cues surrounding the drug event. It’s a reason why you might crave drugs when returning to the location where you once used drugs long after you’ve quit.

How can I improve my dopamine levels in a natural way?

You may wish to try remedies that naturally increase dopamine. Further research is needed on the effects of food on neurotransmitters such as dopamine.

• Eat a diet that’s high in magnesium and tyrosine-rich foods. These are the building blocks for dopamine production. Tyrosine is an amino acid. It’s absorbed in your body and then goes to your brain, where it’s converted into dopamine. Foods known to increase dopamine include chicken, almonds, apples, avocados, bananas beets, chocolate, green leafy vegetables, green tea, lima beans, oatmeal, oranges, peas, sesame and pumpkin seeds, tomatoes, turmeric, watermelon and wheat germ.

• Engage in activities that make you happy or feel relaxed. This is thought to increase dopamine levels. Some examples include exercise, meditation, yoga, massage, playing with a pet, walking in nature or reading a book.

A note from Cleveland Clinic

Dopamine is a type of neurotransmitter and hormone. It plays a role in many important body functions, including movement, memory and pleasurable reward and motivation. High or low levels of dopamine are associated with several mental health and neurological diseases. Much research remains to be done to determine how dopamine works in relation to health conditions and how it interacts with other neurotransmitters, hormones and other chemicals. If you think you have symptoms of high or low levels of dopamine, see your healthcare provider. They’ll review your symptoms, conduct any needed tests and help determine a proper plan of care if a medical condition is found.

https://my.clevelandclinic.org/health/articles/22581-dopamine 

What we know about the health risks of ultra-processed foods

Emb

This morning, while tidying up my office, I found an open box of packaged coconut and chocolate cookies that I'd bought sometime last year. The "use by" date had come and gone more than eight months ago. Curious, I took a small bite. They still tasted pretty darn good.

A closer look at the ingredient list revealed some things I've certainly never baked with, including carrageenan and sorbitan tristearate, additives used to do things like thicken, emulsify and preserve the flavor and enhance the texture of food.

Welcome to the world of ultra-processed foods – edible products made from manufactured ingredients that have been extracted from foods, processed, then reassembled to create shelf-stable, tasty and convenient meals.

"These are foods that are industrial creations," says Allison Sylvetsky, an associate professor in the department of exercise and nutrition at the George Washington Milken Institute School of Public Health.

And we're eating a lot of them. Ultra-processed foods currently make up nearly 60% of what the typical adult eats, and nearly 70% of what kids eat.

The category includes everything from cookies and sodas to jarred sauces, cereals, packaged breads and frozen meals, even ice creams. You might not realize you're eating one, but look close and you'll see many ingredients you wouldn't find in your kitchen – think bulking agents, hydrolyzed protein isolates, color stabilizers, humectants.

They dominate the food supply. And a large and growing body of evidence has consistently linked overconsumption of ultra-processed foods to poor health outcomes.

"Four of the top six killers are related to an inadequate diet, which in the U.S. is probably largely due to convenient, safe, inexpensive food that we eat too much of," says Christopher Gardner, the director of nutrition studies at Stanford University, who has spent decades studying the links between diet and chronic disease. "Too much of it leads to obesity and type two diabetes and heart disease and cancer."

Gardner says the emergence of ultra-processed foods led to products that were inexpensive and safe to eat for longer periods of time. "But it just went too far."

High consumption of ultra-processed foods has been linked to health concerns ranging from increased risk of obesity, hypertension, breast and colorectal cancer to dying prematurely from all causes.

While there's clearly a link to health, researchers are still not completely sure what it is about this category of food that appears to make us sick. But one researcher, Kevin Hall, has a hunch.

Why worry about ultra-processed foods?

One reason ultra-processed foods likely contribute to health issues seems obvious: They tend to be low in fiber and high in calories, salt, added sugar and fat, which are all linked with poor health outcomes when eaten in excess.

But back in 2009, researchers in Brazil proposed that it wasn't just the nutrients that made these foods unhealthy, but rather, the extent of processing these foods undergo.

Kevin Hall, a senior investigator at the National Institutes of Health, where he studies obesity and diabetes, says when he first heard this theory, he was skeptical.

THE SALT

It's Not Just Salt, Sugar, Fat: Study Finds Ultra-Processed Foods Drive Weight Gain

"It struck me as a really odd way to think about nutrition science, because, after all, nutrients seem to be important for nutrition," says Hall.

Hall designed a study to find out whether there was anything to that theory. Now, most studies that have linked ultra-processed foods to harmful health effects are observational, which can only show correlations – they can't prove cause and effect. What Hall did was different: In 2019, he put together the first randomized controlled trial to compare the ultra-processed diet to one based on less processed foods.

Hall used the NOVA classification system — developed by the Brazilian researchers — which categorizes foods based on how much processing they undergo. It distinguishes between unprocessed or minimally processed foods, like an ear of corn or frozen peas; processed foods – like tuna canned in oil or smoked meats, which generally have two or three ingredients; and ultra-processed foods, which are created with formulations of ingredients made using industrial techniques.

Hall recruited 20 healthy adult volunteers to stay at an NIH facility for a four-week period. Participants were randomly assigned to either an ultra-processed or minimally processed diet for two weeks at a time, then switched to the other diet for another two weeks. People on the ultra-processed diet were fed meals like canned beef ravioli, chicken salad made with canned chicken, tater tots and hot dogs. The unprocessed diet mainly featured fruits, vegetables and unprocessed meats – think baked cod served with a baked potato and steamed broccoli.

Both groups were served twice as many calories as they would need to maintain their body weight, and they were told to eat as much or as little as they wanted. Both diets were nutritionally matched, so each meal contained essentially the same total amount of fat, sugar, salt, fiber, carbohydrates and protein.

The results took Hall by surprise.

"I had sort of expected that ... there wouldn't be any difference," says Hall. "But in fact, what we saw was that when they were on the ultra-processed diet, they were eating about 500 calories per day more than when they were on the unprocessed diet and they were gaining weight and gaining body fat" – they put on about 2 pounds on average.

On the unprocessed diet, people ended up eating less and lost weight.

Looking for 'a way forward' for ultra-processed foods

The findings strongly suggested that it wasn't just salt, sugar and fat, but something about the highly processed nature of these foods itself that was propelling people to overeat and gain weight. Gardner, who was not involved in that study, agrees that there's a signal in the data that needs to be explored. "There's something there," he says.

But what, exactly, is that something?

Hall is currently running another randomized control experiment designed to help suss that out. This time, he is offering participants variations on ultra-processed diets to hone in on why we overconsume them.

He says one reason might be that these foods tend to pack more calories per bite, in part because they often have water removed from them to make them shelf stable. Or it may be that they tend to feature irresistible combinations of fat, salt, and sugar more frequently – and in higher levels – than normally occur in unprocessed foods.

"If we can figure out what it is about ultra-processed foods that drives people to overeat and gain excess weight, then we can at least then target which ones to avoid," says Hall – and perhaps eventually, figure out how to re-engineer these foods into healthier products that still have the benefit of being cheap and convenient.

"I think that's really a path forward" for packaged foods, says Hall.

Not all ultra-processed foods are created equal

Even among the range of processed foods currently on the market, "not all ultra-processed foods are bad," says Dr. Fang Fang Zhang, a nutritional epidemiologist at the Friedman School of Nutrition Science and Policy at Tufts University who has studied the rise of ultra-processed consumption and correlated health risks.

For example, she points to packaged whole grain breads. Under the NOVA classification system, most mass-produced breads are considered ultra-processed. But if they have little or no added sugars and high levels of fiber, they could be a healthy option, Zhang says. Her research has found that yogurt consumption was linked to a lower risk of colorectal cancer in women, even though the yogurts in the study qualified as ultra-processed because they contained added sugar.

Those kinds of examples are one reason why some critics want to see the NOVA classification system tweaked to allow for more nuanced distinctions, so that not all ultra-processed foods are vilified.

Even so, Zhang says there is enough research linking ultra-processed foods to health issues that it makes sense to try to cut back on our consumption in general – especially when these foods are high in salt, sugar and fat.

And that goes for kids, too, she says. While the evidence is limited linking ultra-processed food consumption in children to health concerns, Zhang notes the evidence is pretty strong in adults – and "dietary habits in children often carry over into adulthood." So cutting back now could help set kids up for better health down the road.

Putting limits on ultra-processed foods

Christopher Gardner of Stanford agrees, though he'd prefer to focus the message on what people should be eating instead. "If you're going to tell them what to avoid, Americans are often clever enough to choose something else that's just as bad or worse," Gardner says.

He worries, for example, that if a family on a tight budget hears that jarred spaghetti sauce is ultra-processed, instead of opting for a fairly healthful homemade meal of pasta served with jarred sauce with vegetables and lean meat tossed in, they might opt for fast food.

His advice? Focus on eating a diet that's primarily plant-based – though that doesn't have to mean no meat whatsoever. And if you're considering eating a packaged food, read the ingredient list. "If you really have no idea what some of those ingredients are, it probably went too far," Gardner says.

Gardner sits on the independent advisory committee that reviews scientific evidence and makes recommendations that will inform the development of the next iteration of the U.S. dietary guidelines to be issued in 2025. He says ultra-processed foods are one of the issues they're considering. Some countries, including Brazil, Peru and Uruguay, have dietary guidelines that specifically recommend freshly prepared meals and avoiding ultra-processed foods.

Ultimately, Zhang says the burden of making healthier food choices shouldn't fall solely on consumers – especially when it comes to setting kids up for better health long term.

"It does need the whole society to pay attention to this, to work together, including the food industry, including the government, to be able to reduce the amount of ultra-processed food our kids are consuming in their day," she says.

https://www.npr.org/sections/health-shots/2023/05/25/1178163270/ultra-processed-foods-health-risk-weight-gain#:~:text=Rizzo%20for%20NPR-,Foods%20classified%20as%20ultra%2Dprocessed%20are%20those%20that%20have%20many,it%20gets%20made%20into%20applesauce  

The definition of Comfort foods - Definition and history[edit]

The term comfort food has been traced back at least to 1966, when the Palm Beach Post used it in a story: "Adults, when under severe emotional stress, turn to what could be called 'comfort food'—food associated with the security of childhood, like mother's poached egg or famous chicken soup."[4] According to a research by April White at JSTOR, it might have been Liza Minnelli who used the term for the first time in its modern meaning in an interview, admitting to craving a hamburger.[5]

When the term first appeared, newspapers used it in quotation marks. In the 1970s, the most popular comfort food in the United States were various potato dishes and chicken soup, but even at the time, the definition varied from person to person. During the next decades, the nature of comfort food changed in the USA, shifting from savory dishes to sweet ones, while comfort food themed cookbooks started to spread and restaurants started to offer items labelled as such, when originally the term was used for food items consumed 'home alone'. Worldwide diet trends, emerging in the 1990s, like the low fat or the low-carb diet were unable to end the cravings for comfort food. According to White, the COVID-19 pandemic that hit the world in 2020 further strengthened people's need for comfort food that evokes nostalgia and the feeling of belonging.[5]

Psychological studies[edit]

Consuming energy-dense, high calorie, high fat, salt or sugar foods, such as ice cream or french fries, may trigger the reward system in the human brain, which gives a distinctive pleasure or temporary sense of emotional elevation and relaxation.[6][7] These feelings can also be induced by psychoactive ingredients found in other foods, such as coffee and chocolate.[8] When psychological conditions are present, people often use comfort food to treat themselves. Those with negative emotions tend to eat unhealthy food in an effort to experience the instant gratification that comes with it, even if only short-lived.[9]

One study divided college-students' comfort-food identifications into four categories (nostalgic foods, indulgence foods, convenience foods, and physical comfort foods) with a special emphasis on the deliberate selection of particular foods to modify mood or affect, and indications that the medical-therapeutic use of particular foods may ultimately be a matter of mood-alteration.[10]

The identification of particular items as comfort food may be idiosyncratic, though patterns are detectable. In one study of American preferences, "males preferred warm, hearty, meal-related comfort foods (such as steak, casseroles, and soup) while females instead preferred comfort foods that were more snack related (such as chocolate and ice cream). In addition, younger people preferred more snack-related comfort foods compared to those over 55 years of age." The study also revealed strong connections between consumption of comfort foods and feelings of guilt.[11]

Comfort food consumption is seen as a response to emotional stress and, consequently, as a key contributor to the epidemic of obesity in the United States.[12] The provocation of specific hormonal responses leading selectively to increases in abdominal fat is seen as a form of self-medication.[13]

Further studies suggest that consumption of comfort food is triggered in men by positive emotions, and by negative ones in women.[14] The stress effect is particularly pronounced among college-aged women, with only 33% reporting healthy eating choices during times of emotional stress.[15] For women specifically, these psychological patterns may be maladaptive.[16]

A therapeutic use of these findings includes offering comfort foods or "happy hour" beverages to anorectic geriatric patients whose health and quality of life otherwise decreases with reduced oral intake.[17]

https://www.nhlbi.nih.gov/health/sleep-apnea#:~:text=Anything%20that%20could%20narrow%20your,the%20signals%20needed%20to%20breathe

Obstructive sleep apnea happens when your upper airway becomes blocked many times while you sleep, reducing or completely stopping airflow. This is the most common type of sleep apnea. Anything that could narrow your airway such as obesity, large tonsils, or changes in your hormone levels can increase your risk for obstructive sleep apnea.

Central sleep apnea happens when your brain does not send the signals needed to breathe. Health conditions that affect how your brain controls your airway and chest muscles can cause central sleep apnea.

https://psychcentral.com/health/need-to-form-a-new-habit#:~:text=How%20long%20does%20it%20take%20to%20create%20a%20habit%3F,the%20chances%20of%20habit%20formation 

Habit formation can take an average of 59 to 70 days. According to a 2021 study

Trusted Source

, it can take about 59 days until a new habit becomes automatic. Further stating that implementing routine-based and time-based cues help to increase the chances of habit formation.

For example, if you want to implement the habit of flossing on a more consistent basis, you may plan to floss every morning after brushing your teeth.

But the length of time it takes for a habit to be formed can vary from person to person, so you may not always see success in 2 months.

Older research from 2012

Trusted Source

 focused on creating lifestyle changes to improve health outcomes. Research suggests that implementing small changes daily that are time and location-based can encourage habitual behavior change in about 10 weeks.

Habit formation largely depends on the habit itself and the individual, explains Heather Wilson, a licensed clinical social worker from Blackwood, New Jersey.

You may form habits quicker, for example, if you’re highly incentivized or monitored. Habits that aren’t enjoyable — even if they’re beneficial — may take longer to establish.

The introduction of rules, regulations, or restrictions may also

Trusted Source

 force you to develop habits more quickly.

https://www.mindpath.com/resource/how-long-it-takes-to-break-a-habit-and-7-steps-to-actually-do-it/ 

We all have bad habits. Tom Cruise bites his fingernails. Marilyn Monroe was famously late to events. Barack Obama rarely gets the recommended eight hours of sleep per night. Even people who may appear to be above such things have bad habits, too. It’s just part of being human.

But that doesn’t mean that we won’t want to change some of those unwanted habits. Continual self-improvement is another trait of being human. So, why do we do these habits in the first place, even when we know they’re “bad”?

Why we develop bad habits

Unsurprisingly, it all comes down to the brain. Kiana Shelton, LCSW, with Mindpath Health, says that automatic responses happen when we do a particular thing consistently, whether it’s good or bad.

“The brain picks up on these habits and makes them automatic,” Shelton explains. “In a way, the brain is trying to be helpful, but unfortunately, there isn’t a differentiation between good or bad— just how many times you’ve used the pattern. This can make it difficult to break or change unwanted habits.”

Jacinta M. Jiménez, PsyD, BCC, prefers not to think of habits as “good” or “bad.” Rather, she believes that habits, even less-than-desirable ones you want to break or change, serve some sort of purpose.

We learn habits through rewards-based learning, where there’s a trigger (stressor), a behavior (eat ice cream), and a reward (ice cream is delicious, and the brain receives a pleasure signal via dopamine).

How long does it take to break a habit?

Since the brain doesn’t distinguish between good and bad habits, and it’s difficult for the brain to unlearn them, it can take an average of 30 to 60 days to actually break a habit, according to Shelton.

That’s why consistency is key when trying to reach a desired goal. But when it comes to changing a habit once and for all, it can be a challenge just to start.

Trigger by definition - 

https://care.unc.edu/understanding-mental-health-triggers/#:~:text=A%20trigger%20is%20a%20stimulus,%2C%20and%2For%20eating%20disorders 

A trigger is a stimulus that elicits a reaction. In the context of mental illness, "trigger" is often used to mean something that brings on or worsens symptoms. This often happens to people with a history of trauma or who are recovering from mental illness, self-harm, addiction, and/or eating disorders. When someone has a history of any of these issues, being unexpectedly exposed to imagery or content that deals with that history can cause harm or relapse.

Many different stimuli can be possible triggers, and they are often strongly influenced by past experiences.

Understanding, identifying, and working to prevent triggers can be empowering and effective, especially in comparison to supporting someone after they have been triggered.

Body Shaming 

https://www.helpguide.org/articles/abuse/body-shaming.htm 

What is body shaming?

Body shaming involves humiliating someone by making inappropriate or negative comments about their body size or shape. As well as “fat shaming,” you may also hear negative comments if you’re underweight or in reference to a specific body part.

This type of criticism can be made to others or yourself. You may feel unhappy with your weight or how your body looks and judge yourself harshly. You may even engage in negative self-talk, such as “I feel so fat today” or “I need to stop stuffing my face with food.”

The act of body shaming can be carried out in person or remotely via the internet and social media and can be done by your parents, siblings, friends, or people you’re not even close to.

Even in a joking manner, remarks about what you eat or how much food you consume constitutes body shaming. Giving someone advice about dieting or praising weight loss is also considered body shaming, whether intentional or not. Often, your friends and family members don’t want to hurt your feelings, but their comments can still be of a critical nature. They may not realize the negative effect that questions like “Have you lost weight?” or “Do you really need to eat all of that?” can have.

While nobody is immune to societal pressures to look a certain way, comments about your body are unnecessary in any context. Whether the body shaming is being done by yourself or others, there are ways to overcome the problem, build body positivity, and learn to look at yourself in a more compassionate and realistic way.

Anxiety - https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/11-tips-for-coping-with-an-anxiety-disorder 

11 tips for coping with an anxiety disorder

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TOPICS IN THIS POST

Behavioral Health
 Anxiety
 Balance Your Mental And Emotional Health

Having occasional feelings of anxiety is a normal part of life, but people with anxiety disorders experience frequent and excessive anxiety, fear, terror and panic in everyday situations. These feelings are unhealthy if they affect your quality of life and prevent you from functioning normally.

Common symptoms of anxiety disorders include:

• Feeling nervous

• Feeling helpless

• A sense of impending panic, danger or doom

• Increased heart rate

• Hyperventilation

• Sweating

• Trembling

• Obsessively thinking about the panic trigger

These feelings of anxiety and panic can interfere with daily activities and be difficult to control. They are out of proportion to the actual danger and can cause you to avoid places or situations.

You should see your health care provider if your anxiety is affecting your life and relationships. Your provider can help rule out any underlying physical health issue before seeing a mental health professional.

While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes and coping strategies also can make a difference.

Here are 11 tips for coping with an anxiety disorder:

1 Keep physically active.
Develop a routine so that you're physically active most days of the week. Exercise is a powerful stress reducer. It can improve your mood and help you stay healthy. Start out slowly, and gradually increase the amount and intensity of your activities.

2 Avoid alcohol and recreational drugs.
These substances can cause or worsen anxiety. If you can't quit on your own, see your health care provider or find a support group to help you.

3 Quit smoking, and cut back or quit drinking caffeinated beverages.
Nicotine and caffeine can worsen anxiety.

4 Use stress management and relaxation techniques.
Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety.

5 Make sleep a priority.
Do what you can to make sure you're getting enough sleep to feel rested. If you aren't sleeping well, talk with your health care provider.

6 Eat healthy foods.
A healthy diet that incorporates vegetables, fruits, whole grains and fish may be linked to reduced anxiety, but more research is needed.

7 Learn about your disorder.
Talk to your health care provider to find out what might be causing your specific condition and what treatments might be best for you. Involve your family and friends, and ask for their support.

8 Stick to your treatment plan.
Take medications as directed. Keep therapy appointments and complete any assignments your therapist gives. Consistency can make a big difference, especially when it comes to taking your medication.

9 Identify triggers.
Learn what situations or actions cause you stress or increase your anxiety. Practice the strategies you developed with your mental health provider so you're ready to deal with anxious feelings in these situations.

10 Keep a journal.
Keeping track of your personal life can help you and your mental health provider identify what's causing you stress and what seems to help you feel better.

11 Socialize.
Don't let worries isolate you from loved ones or activities.

Your worries may not go away on their own, and they may worsen over time if you don't seek help. See your health care provider or a mental health provider before your anxiety worsens. It's easier to treat if you get help early.

Coping 

https://thriveworks.com/help-with/coping-skills/unhealthy-coping-mechanisms/ 

What are unhealthy coping mechanisms, and how do they affect me?

Whether it be stress, grief, anger, or any other tough emotion, we all have to find a way to cope with what life throws at us and the emotions that come along with it. Coping mechanisms are an integral part of functioning and dealing with life’s problems, but sometimes they can do more harm than good.

Unhealthy coping mechanisms happen when the behavior used to protect yourself is more damaging in the long run, even when it might relieve stress or injury in the short term.

What Are the 2 Types of Coping Mechanisms?

There are two main classes of coping mechanisms: adaptive and maladaptive. Adaptive coping mechanisms are also known as healthy coping mechanisms, since the behavior works to resolve problems using methods that reduce stress and harm.

Maladaptive, or unhealthy, coping mechanisms are behaviors that do not always seek to resolve the problem but are usually attempts to reduce its symptoms in the short-term. These can end up causing harm and increasing stress in the long term.

Maladaptive coping strategies can be tricky to avoid, since they can tend to feel like they’re helping. However, the relief experienced is only helpful in the short term. Patterns like these give temporary comfort while leading to harm and creating more problems in the long term, which is what makes them unhealthy.

Coping mechanisms can also be classified as meaning-focused, problem-focused, emotion-focused, or social coping.

Meaning-focused: Behavior that works to find out what the problem or feeling of distress means, then adjusts their perspective or feelings to help deal with the situation. 

Problem-focused: Behavior that is focused primarily on confronting the issue that’s distressing you.

Emotion-focused: Behavior that works to minimize the negative emotions caused by an issue, such as acceptance, a joking attitude, positive affirmations, or cognitive restructuring.

Social coping: Behavior that employs use of a support system and community to relieve stress and emotional strain.

Each of these four types can relate to both adaptive and maladaptive coping mechanisms depending on how they’re used.

What Are Bad Coping Mechanisms?

Coping mechanisms aren’t inherently bad, but when they become too much of a crutch and start to affect your mental and physical health, they can be harmful. These patterns might not look bad at first, and may even seem to help, but they can be unhealthy in the long run. 

Here are some coping mechanisms that can be unhealthy or maladaptive:

1. Isolation.

When you feel overwhelmed or constantly annoyed by others, isolating yourself from everyone might seem like a logical way to remove stress from your life. However, connection is a very important part of a healthy life, and decreased social interaction and physical activity can be harmful to one’s mental and physical health if it persists for too long.

2. Relying on others too much.

On the other hand, it’s also possible to over-rely on people in your life. Having support is good, but if too much of one’s self-worth and validation needs are placed on family or friend groups, one’s self-esteem can be put in a precarious position. When your happiness is wholly dependent on others being around you, it’s much harder to deal with hardship without them.

3. Jumping to conclusions/catastrophizing.

Trying to figure out potential outcomes to choices or problems can be a helpful way of solving them. However, if you start making quick judgements and constantly thinking of the worst outcomes so that you avoid any kind of hurt, you might be catastrophizing. This kind of cognitive distortion can affect one’s ability to consider positives as well as negatives, preventing one from making fully-informed decisions when it’s employed too often.

4. Doomscrolling.

Social media has become a very common stress outlet, but oftentimes it can heap on stress instead of relieving it. Doomscrolling is a habit of continuing to look through social media despite feeling weighed down by the bad news and emotions it brings up.

5. Avoiding problems.

Types of avoidance like procrastination, living in the past, oversleeping, toxic positivity, or overworking are often used to cope with stress by not thinking about it, but burying emotions and problems will only cause them to build under the surface. Emotions and hardship can feel overwhelming to face, but if they’re avoided, these emotions and problems will continue to cause you stress.

6. Impulse spending.

Retail therapy can provide a quick hit of dopamine, but if it becomes a constant stress-relief tactic, you could find yourself facing a different kind of stress. In the extreme, impulse spending can lead to severe financial and relationship problems that negatively affect your life.

7. Substance use.

Depending on substances to relieve your worry, stress, or tension can be a very slippery slope. Blowing off steam can be helpful, but when a substance becomes the only way that you can deal with your circumstances or emotions, using it can lead to serious physical and mental health problems.

8. Excessive worry.

It’s good to be prepared for bad outcomes as well as good ones, but when worry and fear start to hold you back from living your life, they can become toxic. When worry moves past being helpful and starts to look like catastrophizing and jumping to conclusions, it might be adding stress and discomfort to life rather than taking it away. 

There are many more ways in which habits can become debilitating and unhealthy coping mechanisms, since nearly anything can be used to avoid one’s problems. However, recognizing these patterns is a great first step toward unraveling them. It will take time, but it’s possible to replace these coping mechanisms with ones that will serve you better in the long run and help you adapt to life as it changes.

Unhealthy Coping Mechanisms for Stress

Many of the patterns listed above are used to deal with stress. Though tactics like avoidance, overworking, or isolation can provide relief in the moment, the stress usually remains. Decreasing stress in the long run requires using more healthy approaches to coping.

Unhealthy Coping Mechanisms for Depression

Unhealthy coping, when stemming from depression, often takes on many of the patterns above, but it can also start to blend with symptoms that frequently occur due to depression. 

For example, depression can cause a tendency toward more inactive coping strategies like oversleeping, over or under eating, or isolation, none of which will end up breaking the depressive cycle. If you find that your unhealthy coping habits might point to depression, talk to a mental health professional. They can help you break out of your cycle of unhealthy coping and give you potential tools to help combat depression.

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What Are Negative Coping Behaviors?

Since we’ve already explored what unhealthy coping mechanisms look like as habits, let’s explore what it might act like as they struggle to cope in healthy ways.

If you are using more unhealthy coping mechanisms than healthy ones, you may tend to be on-edge or irritable. It might be hard for you to find energy to spend time with friends or family, especially if you feel that you have to hide how you’re really doing.

You also might make more rash decisions, or conversely, have a hard time making any decisions without feeling overwhelmed. Your feelings might have a habit of exploding out of you every once in a while, either in anger, rage, or sadness, making you feel your emotions in extremes.

It might be hard to redirect away from your coping mechanism, causing you to spend more and more time doing that activity or habit as you feel worse. It can become an obsession, or even an addiction, something you start to do automatically when you start to feel stressed. 

Unhealthy coping mechanisms are something that many people struggle with on a daily basis, whether they know it or not. However, this behavior can be overcome. It’s never too late to address the patterns that are hurting you and try to change them.

How Do I Break Unhealthy Coping Habits?

Unhealthy coping habits are hard to break, but replacing them with good habits over time will help you lead a much healthier life. There are also ways to release the stress before it causes you to resort to maladaptive coping mechanisms. Here are some examples of ways to address your problems in a healthy way:

Physical exercise, like going for a walk. Being active and exercising regularly is an excellent way to relieve stress and anxiety.

Talking it out with someone. Talking to someone you trust, like a friend or family member, about your problems can help keep you accountable as well as create a solid support system around you. Reaching out and staying connected to others can help you decompress.

Mindfulness or meditation. Self-reflection can help you move through difficult emotions like anger or sadness instead of trying to shut them out, which allows them to pass through you rather than build up over time.

Hobbies or fun activities. Getting involved in something that makes you happy or gives you peace can be a great outlet for your feelings.

Facing the issue. Spend time trying to assess the source of your problem. Once you’ve realized what it is, work to find ways to overcome it, both in the long run and short-term. Work with your mind and your emotions, not against them.

Discovering your triggers. When you’re regularly faced with difficult feelings, finding out what triggers them is one of the best ways to help regulate them and even avoid situations that set them off.

Giving yourself appropriate down time. Setting aside time to relax or be alone can help you refocus and restore emotional balance. Being low on energy can make it easier for your triggers to affect you and put you on a shorter fuse. By recharging like this, you might boost your energy enough to make you reach for healthy coping mechanisms rather than ones that take less time and energy.

Talking to a mental health professional. While self-reflection can be helpful, sometimes what you’re facing might be too much to figure out on your own. Finding a good therapist or psychiatrist and working through treatment with them can be extremely beneficial for learning to process your emotions.

Coping mechanisms are processes you’ve developed to help yourself get through the difficult parts of your life. They can be helpful as often as they can be hurtful, so it’s important to know your patterns and make sure that you redirect from any that will end up being harmful long-term.

Creating a solid foundation of healthy coping skills will make you much more prepared to weather whatever problems come your way and live a well-rounded life.

Journaling

https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentID=4552&ContentTypeID=1#:~:text=Keeping%20a%20journal%20helps%20you,de%2Dstress%20and%20wind%20down  

Keeping a journal helps you create order when your world feels like it’s in chaos. You get to know yourself by revealing your most private fears, thoughts, and feelings. Look at your writing time as personal relaxation time. It's a time when you can de-stress and wind down. Write in a place that's relaxing and soothing, maybe with a cup of tea. Look forward to your journaling time. And know that you're doing something good for your mind and body.

Sabotage 

https://www.betterup.com/blog/how-to-stop-self-sabotaging#:~:text=What%20does%20it%20mean%20to,well%20as%20our%20mental%20health 

Self-sabotage is when people do (or don’t do) things that block their success or prevent them from accomplishing their goals. It can happen consciously or unconsciously. Self-sabotaging behaviors can affect our personal and professional success, as well as our mental health.

Meditation 

https://www.mayoclinic.org/tests-procedures/meditation/in-depth/meditation/art-20045858#:~:text=%22Meditation%2C%20which%20is%20the%20practice,disease%20and%20high%20blood%20pressure 

Meditation: A simple, fast way to reduce stress

Meditation can wipe away the day's stress, bringing with it inner peace. See how you can easily learn to practice meditation whenever you need it most.

By Mayo Clinic Staff

If stress has you anxious, tense and worried, consider trying meditation. Spending even a few minutes in meditation can help restore your calm and inner peace.Anyone can practice meditation. It's simple and inexpensive. And it doesn't require any special equipment.And you can practice meditation wherever you are — whether you're out for a walk, riding the bus, waiting at the doctor's office or even in the middle of a difficult business meeting.

Understanding meditation

Meditation has been practiced for thousands of years. Meditation originally was meant to help deepen understanding of the sacred and mystical forces of life. These days, meditation is commonly used for relaxation and stress reduction.Meditation is considered a type of mind-body complementary medicine. Meditation can produce a deep state of relaxation and a tranquil mind.During meditation, you focus your attention and eliminate the stream of jumbled thoughts that may be crowding your mind and causing stress. This process may result in enhanced physical and emotional well-being.

Benefits of meditation

Meditation can give you a sense of calm, peace and balance that can benefit both your emotional well-being and your overall health. You can also use it to relax and cope with stress by refocusing your attention on something calming. Meditation can help you learn to stay centered and keep inner peace. And these benefits don't end when your meditation session ends. Meditation can help carry you more calmly through your day. And meditation may help you manage symptoms of certain medical conditions.

Meditation and emotional and physical well-being

When you meditate, you may clear away the information overload that builds up every day and contributes to your stress.

The emotional and physical benefits of meditation can include:

• Gaining a new perspective on stressful situations

• Building skills to manage your stress

• Increasing self-awareness

• Focusing on the present

• Reducing negative emotions

• Increasing imagination and creativity

• Increasing patience and tolerance

• Lowering resting heart rate

• Lowering resting blood pressure

• Improving sleep quality

Meditation and illness

Meditation might also be useful if you have a medical condition, especially one that may be worsened by stress.While a growing body of scientific research supports the health benefits of meditation, some researchers believe it's not yet possible to draw conclusions about the possible benefits of meditation.With that in mind, some research suggests that meditation may help people manage symptoms of conditions such as:

• Anxiety

• Asthma

• Cancer

• Chronic pain

• Depression

• Heart disease

• High blood pressure

• Irritable bowel syndrome

• Sleep problems

• Tension headaches

Be sure to talk to your health care provider about the pros and cons of using meditation if you have any of these conditions or other health problems. In some rare cases, meditation might worsen symptoms associated with certain mental health conditions.Meditation isn't a replacement for traditional medical treatment. But it may be a useful addition to your other treatment.

Types of meditation

Meditation is an umbrella term for the many ways to achieve a relaxed state of being. There are many types of meditation and relaxation techniques that have meditation components. All share the same goal of achieving inner peace.

Ways to meditate can include:

• Guided meditation. Sometimes called guided imagery or visualization, with this method of meditation you form mental images of places or situations you find relaxing.
You try to use as many senses as possible, such as smells, sights, sounds and textures. You may be led through this process by a guide or teacher.

• Mantra meditation. In this type of meditation, you silently repeat a calming word, thought or phrase to prevent distracting thoughts.

• Mindfulness meditation. This type of meditation is based on being mindful, or having an increased awareness and acceptance of living in the present moment.
In mindfulness meditation, you broaden your conscious awareness. You focus on what you experience during meditation, such as the flow of your breath. You can observe your thoughts and emotions. But let them pass without judgment.

• Qi gong. This practice generally combines meditation, relaxation, physical movement and breathing exercises to restore and maintain balance. Qi gong (CHEE-gung) is part of traditional Chinese medicine.

• Tai chi. This is a form of gentle Chinese martial arts training. In tai chi (TIE-CHEE), you perform a self-paced series of postures or movements in a slow, graceful manner while practicing deep breathing.

• Transcendental meditation. Transcendental meditation is a simple, natural technique. In this form of meditation, you silently repeat a personally assigned mantra, such as a word, sound or phrase, in a specific way.
This form of meditation may allow your body to settle into a state of profound rest and relaxation and your mind to achieve a state of inner peace, without needing to use concentration or effort.

• Yoga. You perform a series of postures and controlled breathing exercises to promote a more flexible body and a calm mind. As you move through poses that require balance and concentration, you're encouraged to focus less on your busy day and more on the moment.

Elements of meditation

Different types of meditation may include different features to help you meditate. These may vary depending on whose guidance you follow or who's teaching a class. Some of the most common features in meditation include:

• Focused attention. Focusing your attention is generally one of the most important elements of meditation.


Focusing your attention is what helps free your mind from the many distractions that cause stress and worry. You can focus your attention on such things as a specific object, an image, a mantra, or even your breathing.

• Relaxed breathing. This technique involves deep, even-paced breathing using the diaphragm muscle to expand your lungs. The purpose is to slow your breathing, take in more oxygen, and reduce the use of shoulder, neck and upper chest muscles while breathing so that you breathe more efficiently.

• A quiet setting. If you're a beginner, practicing meditation may be easier if you're in a quiet spot with few distractions, including no television, radios or cellphones.
As you get more skilled at meditation, you may be able to do it anywhere, especially in high-stress situations where you benefit the most from meditation, such as a traffic jam, a stressful work meeting or a long line at the grocery store.

• A comfortable position. You can practice meditation whether you're sitting, lying down, walking, or in other positions or activities. Just try to be comfortable so that you can get the most out of your meditation. Aim to keep good posture during meditation.

• Open attitude. Let thoughts pass through your mind without judgment.

Everyday ways to practice meditation

Don't let the thought of meditating the "right" way add to your stress. If you choose to, you can attend special meditation centers or group classes led by trained instructors. But you can also practice meditation easily on your own. Or you may find apps to use, too.

And you can make meditation as formal or informal as you like, however it suits your lifestyle and situation. Some people build meditation into their daily routine. For example, they may start and end each day with an hour of meditation. But all you really need is a few minutes of quality time for meditation.

Here are some ways you can practice meditation on your own, whenever you choose:

• Breathe deeply. This technique is good for beginners because breathing is a natural function.

• Focus all your attention on your breathing. Concentrate on feeling and listening as you inhale and exhale through your nostrils. Breathe deeply and slowly. When your attention wanders, gently return your focus to your breathing.

• Scan your body. When using this technique, focus attention on different parts of your body. Become aware of your body's various sensations, whether that's pain, tension, warmth or relaxation.
Combine body scanning with breathing exercises and imagine breathing heat or relaxation into and out of different parts of your body.

• Repeat a mantra. You can create your own mantra, whether it's religious or secular. Examples of religious mantras include the Jesus Prayer in the Christian tradition, the holy name of God in Judaism, or the om mantra of Hinduism, Buddhism and other Eastern religions.

• Walk and meditate. Combining a walk with meditation is an efficient and healthy way to relax. You can use this technique anywhere you're walking, such as in a tranquil forest, on a city sidewalk or at the mall.
When you use this method, slow down your walking pace so that you can focus on each movement of your legs or feet. Don't focus on a particular destination. Concentrate on your legs and feet, repeating action words in your mind such as "lifting," "moving" and "placing" as you lift each foot, move your leg forward and place your foot on the ground. Focus on the sights, sounds and smells around you.

• Engage in prayer. Prayer is the best known and most widely practiced example of meditation. Spoken and written prayers are found in most faith traditions.
You can pray using your own words or read prayers written by others. Check the self-help section of your local bookstore for examples. Talk with your rabbi, priest, pastor or other spiritual leader about possible resources.

• Read and reflect. Many people report that they benefit from reading poems or sacred texts, and taking a few moments to quietly reflect on their meaning.
You can also listen to sacred music, spoken words, or any music you find relaxing or inspiring. You may want to write your reflections in a journal or discuss them with a friend or spiritual leader.

• Focus your love and kindness. In this type of meditation, you think of others with feelings of love, compassion and kindness. This can help increase how connected you feel to others.

Building your meditation skills

Don't judge your meditation skills, which may only increase your stress. Meditation takes practice.

Keep in mind, for instance, that it's common for your mind to wander during meditation, no matter how long you've been practicing meditation. If you're meditating to calm your mind and your attention wanders, slowly return to the object, sensation or movement you're focusing on.

Experiment, and you'll likely find out what types of meditation work best for you and what you enjoy doing. Adapt meditation to your needs at the moment. Remember, there's no right way or wrong way to meditate. What matters is that meditation helps you reduce your stress and feel better overall.

True Hunger 

https://www.sharecare.com/health/eating-habits-nutrition/what-true-hunger#:~:text=True%20hunger%20is%20a%20signal,know%20how%20much%20to%20eat 

Our bodies have the beautifully orchestrated ability to tell us exactly how much to eat to maintain an ideal weight for our long-term health. These signals are what I call true hunger. This name also differentiates it from toxic hunger (physical addiction to an unhealthful, low-micronutrient diet), which is what everyone else refers to simply as hunger. Most Americans have not felt true hunger since they were toddlers.

Feeding yourself to satisfy true hunger cannot cause weight gain. If you only ate when truly hungry, it would be almost impossible to become overweight. True hunger is a signal to eat to maintain your muscle mass. Eating to satisfy true hunger does not put fat on our body. Excessive fat stores are developed only from eating outside of our body's true hunger demands. When you get back in touch with true hunger, you will instinctually know how much to eat. When you exercise more, you will get more and more frequent hunger; when you exercise less, you will get much less hunger. Your body will become a precise calorie-measuring computer and steer you in the right direction just from eating the amount that feels right and makes food taste best.

True hunger is not uncomfortable. It does not involve your stomach fluttering or cramping. When you feel it, you know it is a normal reaction that signals a need for food. It signals that the body is physiologically ready to digest, and the digestive glands have regained their capacity to secrete enzymes appropriately. It makes food taste much better when you eat, and it makes eating much more pleasurable. People are consistently amazed at how good the simplest foods can taste when they are truly hungry.

True hunger requires no special food to satisfy it. It is satisfied by eating almost anything. You can't crave some particular food and call it hunger. A craving by definition is an addictive drive, not something felt by a person who is not an addict. Remember, almost all Americans are addicted to their toxic habits. A disease-causing diet is addicting. A health-supporting diet is not.