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Addiction Transfer; Does the "Oprah Phenomenon" really exist?

Addiction Transfer; Does the "Oprah Phenomenon" really exist?. Gregory S. Jones, Ph.D. Health Psychologist Premier Psychological Services, PLLC & Surgical Weight Loss Center Marquette General Health Systems. Objectives. Brief discussion of the “Oprah phenomenon.”

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Addiction Transfer; Does the "Oprah Phenomenon" really exist?

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  1. Addiction Transfer; Does the "Oprah Phenomenon" really exist? Gregory S. Jones, Ph.D. Health Psychologist Premier Psychological Services, PLLC & Surgical Weight Loss Center Marquette General Health Systems

  2. Objectives • Brief discussion of the “Oprah phenomenon.” • Cursory review of possible relationship between problem eating behavior and alcohol misuse. • Provide brief description of biological and behavioral correlates that proposes food addiction. • Summary and questions.

  3. No DisclosuresCalloway – “I want to be rich”

  4. “Oprah Phenomenon”

  5. “Oprah Phenomenon” • What started the “Oprah phenomenon”? • Show in October 2006 entitled “The truth behind bariatric surgery.” • http://www.oprah.com/media/20080601_tows_tows_20061024_1

  6. Problem Eating Behavior And Alcohol Misuse

  7. Questions About Problem Eating Behavior And Alcohol Misuse • Sogg (2007) • Kalarchian, et al (2007) • Marcus, et al (2009) • Petry, et al (2008)

  8. Questions About Problem Eating Behavior And Alcohol Misuse • Sogg (2007) • Consensus on “addiction and food addiction?” • Transfer addiction/Symptom substitution not strongly supported empirically • Treatment implications - abstinence • Kalarchian, et al (2007) • Psychiatric disorders among bariatric surgery candidates • 32.6% lifetime SA versus 1.6% current SA

  9. Questions About Problem Eating Behavior And Alcohol Misuse • Marcus, et al (2009) • Psychiatric evaluation and follow-up study • Reiterated reported lifetime SA versus SA at time of evaluation, no significant findings on follow-up • Petry, et al (2008) • National Epidemiologic Survey on ETOH • Overweight and obesity • Results similar

  10. Biological Correlates of Food Addiction

  11. Biological Correlates of Food Addiction • Gearhardt & Corbin (2009) • Mathes, et al (2009)

  12. Biological Correlates of Food Addiction • Neurobiology of binge eating behavior mirrors that seen in substance abuse behavior. • Opioid pathway • Dopamine pathway • Reward and hedonic properties of food

  13. Biological Correlates of Food Addiction • Gearhardt & Corbin (2009) • Neuroimaging and animal model research basis for conclusions of neural pathways • Excess food consumption associated with same biological changes caused by drugs

  14. Biological Correlates of Food Addiction • Mathes, et al (2009) • Similar biological correlates • Raised questions about classification of “binge” • How defined – “syndrome” not DSM-IV disorder • Objective measures • No consensus on most reliable or valid • Behavior or disorder?

  15. Behavioral Correlates of Food Addiction

  16. Behavioral Correlates of Food Addiction • Gearhardt and Corbin (2009) • Fischer, et al (2004) • Mathes, et al (2009)

  17. Behavioral Correlates of Food Addiction • Gearhardt and Corbin (2009) • Animals given intermittent access to sugar developed sxs of tolerance and withdrawals • Fischer, et al (2004) • Trait Urgency • Expectancy Theory • Mathes, et al (2009) • Conditioning

  18. Behavioral Correlates of Food Addiction • Trait Urgency • Form of impulsivity • Four forms • Lack of planning • Lack of perseverance • Sensation seeking • Urgency

  19. Behavioral Correlates of Food Addiction • Urgency • Drink/eat to cope with distress • Neuroticism influences drinking/eating behavior • Impulsivity plays role in drinking/eating behavior • Expectancy Theory • Learned anticipations of the outcomes of future behavioral choices

  20. Behavioral Correlates of Food Addiction • Conditioning • Learned association between rewarding properties and environment/conditions contributed to development of physiological and sensory cues for food in absence of hunger • Cue-elicited conditioned responses key contributors in relapse to binge eating and substance abuse

  21. Conclusions

  22. Conclusions • The "Oprah Phenomenon” exists, however the question seems to more about the exception than the rule. • Need better clarification of what we are talking about: • “food addiction” • “binge eating” • How do we measure?

  23. Conclusions • Important to continue to understand biological and behavioral components to further research and treatment.

  24. Thank you!

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