Renascent Pilot Vera Tarman, MD, FCFP, ABAM Food Addiction Program 2016 - 2018 Copyright Vera Ingrid Tarman 2018

Food Addiction: A Clinical Syndrome? ASAM ABCDEs of Addiction Inability to consistently Abstain Impairment in Behavioural control Craving or increased 'hunger' for drugs or rewarding experiences Diminished recognition of significant problems with behaviour @ relationships A dysfunctional Emotional response Copyright Vera Ingrid Tarman 2018

Dr. Caroline Davis: Historical / Cultural Overview of Syndromes

Continuum of ED / FA Syndrome Dr. Caroline Davis

food sex gambling

Severity of Addiction Dr. Caroline Davis

Food - Reward Notice which foods enhance the reward neurochemistry: Serotonin: warm milk, pasta, potatoes, bananas, turkey Dopamine: sugar, white starches Endorphins: chocolate, sugar, dairy, spices

Food Addiction Syndrome Disease Stage Recommended Action Pre-disease Prevention Early Stage Detox and abstinence Middle Stage Counseling or 12-step group Late Stage More structure and support Final Stage Primary inpatient or residential treatment Death

Contrasting Treatments: BED or FA? Emotional Eater Food Addict Focus on Feelings Abstinence First Moderate Eating of All Foods Complete Elimination of Toxic Foods Mindfulness Training Cognitive or Expressive Therapy (psycho-dynamic) Developing Emotional Skills (to be able to stay abstinent) Empowerment Acceptance of Powerlessness Goal: Return to Normal Eating Goal: Life-long Management of Food Addiction One Day at a Time Contrasting Treatments: BED or FA?

Client Demographics of Renascent Pilot 60% subsidized or retirement income Predominantly partnered and college educated 1 in 4 were diabetic 1 in 3 were ED 1 in 5 had bariatric surgery 60 subjects with over 80% response rate Copyright Vera Ingrid Tarman 2018

Addicted? Using DSM 5 criteria: 93% had ‘severe’ food addiction Using YFAS criteria: 92% meet criteria pre-treatment Copyright Vera Ingrid Tarman 2018

Correlations in FA Treatment Seekers YFAS DSM-5 BES LOCES EES YFAS (Food Addiction) --- .75 .72 .80 .62 DSM-5 (Modified SUD) .90 .71 BES (Binge Eating) .88 LOCES (Loss of Control Eating) EES (Emotional Eating) Sample: 53 patients from Renascent Food Addiction Program

Post Treatment YFAS: 37%, DSM - : 4 / 11 criteria (mild) - yet 92% felt FA label still applicable Binge Eating Scale: average in ‘non binging’ range Loss of Control Over Eating Scale: average rarely experience loss of control Emotional Eating Scale: average had small to moderate urge to over eat

WEIGH AND MEASURE BY KATHY PRICE https://www.youtube.com/watch?v=nsqrkdTGMkE