Using the Non-Diet Approach with the Addiction Patient (December 2012)

As we approach the holidays many individuals find that their addictions come to the surface. Whether they are dealing with relationship issues, work issues or whatever issue has led them to use and abuse many of you know I see people with body image issues/eating disorders whom also have drug and alcohol addictions.

I recently gave a talk on how I work with this population. I wanted to share a snap shot with how I address using the non-diet approach and the addiction patient. I always let the client know that the number one goal is for them to remain clean and sober. Everything else is secondary.

I have an acronym which is what I share with all of my addiction clients:

• AA
• BB
• CC
• DD
• AA

Adjust attitude is what “AA” stands for. The client has to have their head be in the correct place before we even meet or anything we speak about won’t be very helpful. This brings up various myths they have centered on diets, carbohydrates, protein and fats. If the individual is not open then our session will not go very far. This tends to be a time that I clarify misconceptions they have which may allow them to be open to introducing some other foods into their diet.

I let the client know that I am working at the place that feels right for them. This is not about me.

BB

Begin biological eating. This is very scary for many people as they notice that they may feel hunger regularly since they are not using and abusing. We speak about how metabolism works and I will typically start them with Mechanical eating to help them reconnect to the internal wisdom that they were born with. Sometimes that individual experiences more “mouth hunger” due to the fact that when they are in meetings, or sitting in therapy/with their sponsor they can be triggered which may increase the desire to eat. We discuss how they know if it’s “real” hunger or not.

CC

Consider cravings can also be scary especially if the individual believes they are always craving a specific food such as chocolate! We discuss that after going through detox it is common to have more sweet tooth cravings and since this may happen it is important to have meals “real meals” not shakes or bars but three meals with two to three snacks per day all containing protein, carbohydrate and fat. If an individual doesn’t have enough fat they may notice that they are hungrier sooner or if there is a suboptimal amount of protein then they may notice that their sweet tooth craving is stronger. Also if the person is not eating carbohydrates chances are they will have a stronger sweet tooth craving too. I like to recommend high fiber whole grain complex carbohydrates as they will satiate the individual sooner and sustain them longer resulting in less searching for “play food”.

DD

Anyone who knows me or who has worked with me knows that I am not supportive of diets. Don’t Diet is what “DD” means. This comes down to being ready to being open to develop a whole new relationship with food. This will not be a quick fix and as I would tell any client substance/alcohol abuse of not they have to be in the right frame of mind and truly be at their bottom to want to change. I would imagine that they hear this from their sponsor or psychologist and it is the same with food. Wouldn’t it be nice to eat what you want without remorse or shame with feeling comfortable and confident in your body? Or to be able to make food choices freely without obsessing about calories, carbohydrates and/or fat? Learning how to get back to that place of being an intuitive eater is what “DD” is about.

These are just a few of the principles I take my clients through who have addictions/ eating disorders and disordered eating when they are ready to break away from the diet cycle.