Overcoming emotional eating and carbohydrate addiction
Dr. Robert Cywes is a bariatric surgeon who practices in Jacksonville and West Palm Beach, Florida. I first encountered him during my Nutrition Network Advisors certification training, as he was among the faculty.
Dr. Cywes sees obesity as a consequence of chronic excessive carbohydrate consumption as people use carbs to dissipate emotional tension by activating the endorphin system.
He has a Facebook page and has developed an excellent YouTube channel on which he teaches in greater detail, but in the video below from the Low Carb Down Under channel he provides a good introduction to his way of thinking.
I hope you'll take time to watch this, and then look through some of the key points I've highlighted below.
Instant endorphin-based gratification can come from substances or processes. He uses the example of the JUUL and the rise of vaping as an example, but alcohol and other drugs are also substance-based endorphin activators.
Carbohydrate overconsumption is just one more example of a substance addiction.
Whether they're substances or processes, these instant-gratification endorphin activators give the reward up front, and afterward there is a crash that leads to guilt, shame, depression and other negative consequences.
Dr. Cywes contrasts these instant gratification addictions with what he calls "effort-based" emotion management. These require effort up front for reward that comes later.
As people use these strategies, the focus should be on taking pride in the effort, not on the result. You don't have to do it perfectly. Having made the effort builds self-esteem, self-confidence and self respect.
So if when you're stressed you decide to take a two-mile walk but only are able to complete half of it, you focus on the effort expended and having made a good choice, not on the fact you didn't go as far as intended.
More key points:
- "Carbohydrate addiction is uniquely both a substance and a process addiction. A snack is always an emotional event."
- "The root cause of metabolic disease, diabetes and obesity has little to do with food: it's a dysfunctional emotion management system."
- Dr. Cywes makes an important distinction between weight loss and reversing obesity. Through surgery he can help patients lose weight, but if they don't develop more productive emotional management strategies, they'll gain the weight back.
- That's also why he says all "diets" tend to fail in the long term. They take away the carb-based coping mechanisms without providing alternative means of resolving the emotional tension. Then when stress gets too great, people tend to revert to the instant gratification behaviors that had previously brought them relief.
In the last 15 minutes Dr. Cywes outlines what he calls the Keto for Life Pyramid, with some really sound advice. You may want to review starting at the 36:00 mark in the video to hear this practical approach, which is very much in sync with our HELP: The Health, Energy & Longevity Plan.
We suggest exercise and also mindfulness about Mental, Emotional, Social & Spiritual (MESS) health as two elements of our plan. These fit well among the effort-based "Endorphin Time" priorities Dr. Cywes sees as so important for long-term success.
And interestingly, adopting some of our common strategies like intermittent fasting are in themselves effort-based endorphin activators that lead to an enhanced sense of self-respect and self-confidence.
You can download HELP for free. In addition, metabolic health coaching is available through HELPcare Coach, helping people to reclaim their health and even reverse disease through lifestyle changes. This is included at no extra charge with HELPcare Clinic membership!
What parts of Dr. Cywes' presentation resonated most with you and your experience?
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Hi Lee - great to be here at last!
I confess that this guy makes no sense to me at all compared to your own little book. 🙂 He says "We demonize carbs" as one of the wrong-headed thing we all do in trying to improve, and some of his other videos on YouTube talk about (e.g.) "Why keto diets fail." I certainly get that emotion-based eating etc is a distinct problem, but this guy says it's the WHOLE problem. Is that your experience? He seems to be asserting that anyone who's obese (and perhaps even anyone with metabolic syndrome) has emotional problems to work out.
In a sense, that's everyone - EVERYONE has something or the other going on. But honestly some of the oddest, most manipulative people I know are super lean and healthy looking. So I don't get it.
Personally I'm more inspired by the good food you promote! Let me know your thoughts.
Thanks for your comments, @epatientdave. I'm glad our little book is making sense to you! And I agree with you that there seems to be some dissonance between Dr. Cywes' call to not "demonize" carbs and his statement that chronic carbohydrate overconsumption is the cause of obesity.
I think what he means by this distinction is that when carbs become our means of managing emotional tension, that's when we tend to overconsume. Likewise with alcohol and alcoholism. Alcohol and carbs aren't the problem in themselves, but it's our relationship with them.
He also says you can't get fat by eating protein and fat, because your body's natural feedback loops cause you to stop when you've had enough. That seems to make sense to me, because I can always eat more chips and popcorn. There doesn't seem to be a limit.
Another big problem with highly processed foods is that they carry fat calories along with the carbs, and the "drug" of carbs sneaks those fat calories past the normal satiety mechanisms.
I think his main point about "diets" failing is that they focus on deprivation without giving a mechanism for managing the underlying emotional tensions. Then when the tensions get too strong we tend to return to the unhealthy ways of coping.
That can show up in other behaviors such as cutting or anorexia or obsessive physical exercise, which might explain your experience with lean but maladjusted people; they just may have emotion management systems that rely on processes or substances other than carbs.
I think his perspective from dealing with hundreds of obese patients considering bariatric surgery is helpful. He's TOTALLY supportive of keto and of carb limitation, but if it's just a "diet" and not a lifestyle, he says it will likely not last. His pyramid is "Keto for Life" which I think is a good way to describe what is likely to have long-term success.
I think where he lists "(substances)" under his FOURTH PRINCIPLE sends another good message, Many people can occasionally consume substances such as alcohol and not have problems. Likewise with carbs. But it's important to consider WHY we drink and consume carbs, and not have those substances be our primary emotion management tools.
Does that make sense?
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