Do You Have Restless Legs?

You may know the feeling. You’re relaxing on the couch, watching some Netflix, and suddenly you get the overwhelming urge to move your legs. You may even feel some pain or a prickling sensation. Moving your legs around helps some, but once you stop, the urge starts up again. Or perhaps you experience it while you’re lying in bed, making it difficult to sleep. The phenomenon is known as restless legs syndrome (RLS), and it affects one in ten Americans. Restless legs syndrome, also called Willis-Ekbom disease, is a sleep disorder that causes an intense, often irresistible urge to move your legs, arms, or other parts of the body. Most people reach out to their healthcare providers for sleep difficulties.

Symptoms of RLS :

• Leg or arm discomfort: uncomfortable limb sensations - creeping, itching, pulling, crawling, tugging, throbbing, burning, or gnawing. The "creepy-crawlies."Most common at bedtime but can happen during the day at other times of limb inactivity (like a long car or plane ride, sitting for a long time).

• Urge to move legs or arms: an uncontrollable urge to move limbs, especially when sitting or lying down. Movements occur every 20 to 40 seconds for a few minutes or a few hours at a time.

• Sleep disruption: The leg sensations caused by RLS make it harder to fall asleep or return to sleep after awakening by the leg sensations. Many times people get out of bed and try to walk it off, unsuccessfully. Sleeping partners can also suffer, as most people with RLS also experience involuntary muscle movements called periodic leg movements of sleep (PLMS). These typically occur in the foot, ankle, or knee every 15 to 30 seconds, lasting for about two seconds and sometimes longer. People without RLS can also experience PLMS. 

• Bedtime behavior problems: overwhelming urge to get out of bed

• Daytime sleepiness: sleep deprivation usually leads to daytime tiredness.

• Behavior and work performance problems: nighttime sleep disruption may cause daytime irritability, moodiness, difficulty concentrating, hyperactivity, and compromised work performance.

Why does RLS happen?

• Inherited: Up to 92% of patients with RLS have a first-degree relative with the disorder. These patients tend to develop symptoms earlier in life (before age 45) than those with RLS without the genetic link.

• Medical problems are closely associated with the development of RLS, including:

• Iron deficiency.

• Underactive thyroid.

• Depression.

• Fibromyalgia.

• Parkinson's disease.

• Kidney disease.

• Diabetes.

• Rheumatoid arthritis.

• Nerve disorders.

• Sleep Apnea.

• Pregnancy. (especially in the last trimester; in most cases, symptoms usually disappear within 4 weeks after delivery)

• Dialysis.

• Medications: certain medications that may aggravate RLS symptoms, such as anti-nausea drugs (e.g., prochlorperazine or metoclopramide), antipsychotic drugs (e.g., haloperidol or phenothiazine derivatives), antidepressants that increase serotonin (e.g., fluoxetine or sertraline), and some cold and allergy medications that contain older antihistamines (e.g., diphenhydramine)

• Caffeine, nicotine, and alcohol can also make symptoms worse.

How to get rid of RLS?

During the day, drink adequate fluids. Drink a little extra when working or playing in hot weather or take medications that cause you to excrete excess water, such as diuretics. Build-in frequent walking and stretching the time between periods of sitting or resting. Wearing supportive shoes with firm arch support and laces or secure fastenings. 

Before going to bed, massage your leg muscles, gently stretch your legs or slowly pedal a stationary bike for a few minutes, or take a short walk, take a warm bath, or apply heating pads.

Avoid caffeine, nicotine, and alcohol, especially within several hours of bedtime.

Daily exercises may help to decrease RLS symptoms. 

Schedule activities that require prolonged sitting or reclining—like car and plane travel and medical appointments—in the morning rather than the afternoon.

Dietary iron may sometimes be enough to treat RLS. Iron is an essential mineral that we get from our diets, such as red meat, cooked soybeans, cooked lentils, ground turkey, and fortified bread and breakfast cereals. We need only a small amount of dietary iron each day: 8 milligrams per day for adult men and women after menopause. 

Oral iron supplements may be used when iron stores are deficient. The usual starting dose is one tablet of 325 milligrams of ferrous sulfate once per day. It's best absorbed when your stomach is acidic, so take it on an empty stomach or take it with vitamin C to acidify the stomach. Oral iron can cause stomach upset and constipation, so it may help take it every other day rather than daily. In some cases, an iron infusion may be needed. 

Magnesium deficiency may make RLS worse. If magnesium level is on the lower side, magnesium supplementation may be helpful.

Medication may also be used when there is no iron deficiency and symptoms are troubling. There are now five FDA-approved medications for people with severe and frequent symptoms of RLS. 

What is the prognosis?

RLS is generally a lifelong condition for which there is no cure.  However, current therapies can control the disorder, minimize symptoms, and increase periods of restful sleep.  Symptoms may gradually worsen with age, although the decline may be somewhat faster for individuals who also suffer from an associated medical condition.  RLS diagnosis does not indicate the onset of another neurological disease, such as Parkinson’s disease.  Besides, some individuals have remissions—periods in which symptoms decrease or disappear for days, weeks, months, or years—although symptoms often eventually reappear.  If RLS symptoms are mild, do not produce significant daytime discomfort, or do not affect an individual’s ability to fall asleep, the condition does not have to be treated.  

See your healthcare provider if your condition bothers you or if it keeps you from getting a good night's sleep.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280211/

https://www.mp.pl/paim/en/node/4148/pdf

Published 8/13/20

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About Us

Dr. Amar Singh, MD, and Dr. Poonam Singh, MD, are board-certified by the American Board of Internal Medicine and American Board of Obesity Medicine. They specialize in preventing, treating, and reversing chronic diseases using an evidence-based holistic approach. They are specifically interested in weight management, hormone re-balancing, and longevity. The American College of Physicians has recognized them as Fellows, FACP,  for their excellence and contributions made to both medicine and the broader community. They enjoy teaching, volunteering, and advocating for their patients. Their mission is to share simple, effective, and proven strategies that lead to meaningful, sustainable, and long-lasting well-being.

Key Benefits of the Anti-Inflammatory Diet

Inflammation is part of your body's healing mechanism — the reason why your ankle swelled and turned red when you injured it. But this inflammatory repair process can sometimes go awry, lasting too long and harming instead of helping. When inflammation is caused by an ongoing problem, it can contribute to health problems. Many major diseases that plague us—including cancer, heart disease, diabetes, arthritis, depression, autoimmune diseases, and Alzheimer's—have been linked to chronic inflammation. However, sometimes inflammation persists, day in and day out, even when a foreign invader does not threaten you. That's when inflammation can become your enemy.

Regularly adding anti-inflammatory foods to your diet may help switch off this process. An anti-inflammatory diet is based on whole foods and rooted in science. Choose the right anti-inflammatory foods, and you may be able to reduce your risk of illness. Consistently pick the wrong ones, and you could accelerate the inflammatory disease process. Our bodies respond differently to different ingredients, so a personalized approach is prudent.

Foods that cause inflammation

Try to avoid or limit these foods as much as possible:

• refined carbohydrates, such as white bread and pastries

• french fries and other fried foods

• soda and other sugar-sweetened beverages

• red meat (burgers, steaks) and processed meat (hot dogs, sausage)

• margarine, shortening, and lard

The health risks of inflammatory foods

Not surprisingly, the same foods associated with increased risk for chronic diseases (diabetes, heart disease, cancer) are also related to excess inflammation, which is the underlying mechanism for most chronic diseases. These are also unhealthy foods to eat in general, which also contribute to weight gain, which is itself a risk factor for inflammation. Several studies have demonstrated a link between these foods and inflammation, even after taking obesity into account. So these food have independent effects on inflammation over and above the increased caloric intake. 

Anti-inflammatory foods

An anti-inflammatory diet should include these foods:

• tomatoes

• olive oil

• green leafy vegetables, such as spinach, kale, and collards

• nuts like almonds and walnuts

• fatty fish like salmon, mackerel, tuna, and sardines

• fruits such as strawberries, blueberries, cherries, and oranges

Benefits of anti-inflammatory foods

Vegetables, eat 4 to 5 servings daily. One serving equals to 2 cups salad greens or ½ cup vegetables cooked, raw, or juiced. Lightly cooked dark leafy greens (spinach, collard greens, kale, Swiss chard), cruciferous vegetables (broccoli, cabbage, Brussels sprouts, kale, bok choy, and cauliflower), carrots, beets, onions, peas, squashes, sea vegetables, and washed raw salad greens are preferred. They are rich in flavonoids and carotenoids with both antioxidant and anti-inflammatory activity. Go for a wide range of colors, eat them both raw and cooked.

Fruits 3 to 4 servings per day. One serving is equal to 1 medium-sized piece of fruit, ½ cup chopped fruit, ½ cup of dried fruit. Raspberries, blueberries, strawberries, peaches, nectarines, oranges, pink grapefruit, red grapes, plums, pomegranates, blackberries, cherries, apples, and pears - all lower in glycemic load than most tropical fruits. They are rich in flavonoids and carotenoids with both antioxidant and anti-inflammatory activity. Go for a wide range of colors, choose fruit that is fresh in season or frozen. Fruits and vegetables such as blueberries, apples, and leafy greens are high in natural antioxidants and polyphenols—protective compounds found in plants. Fruit sorbet is a better option than other frozen desserts. Reduce inflammatory markers and lower the risk of cardiovascular disease and diabetes.

Coffee, which contains polyphenols and other anti-inflammatory compounds, may protect against inflammation, as well.

Tea, 2 to 4 cups per day - White, green, and oolong teas are rich in catechins and antioxidant compounds that reduce inflammation.

Turmeric, garlic, and ginger are powerful natural anti-inflammatory agents.

Soy foods contain isoflavones that have antioxidant activity and are protective against cancer.

Beans are rich in folic acid, magnesium, potassium, and soluble fiber. They are a low-glycemic-load food. Eat them well cooked.

As people age, inflammation within their immune system increases, damaging cells. A new study shows that people who consumed an anti-inflammatory diet that includes more fruits, vegetables, beans, and tea or coffee, had a lower risk of developing dementia later in life. An anti-inflammatory diet is a potent nutritional tool to help fight the inflammation that could contribute to brain aging. Diet is a lifestyle factor you can modify. It might play a role in combating inflammation, one of the biological pathways contributing to risk for dementia and cognitive impairment later in life.

Eating what’s in season is likely to be fresher, and obviously, there are other benefits, including those for the environment. Eating foods that are in season may also help your grocery bill. Mixing and matching different foods can help you tailor an anti-inflammatory approach that fits your personal tastes and choose the freshest in-season offerings. Whole grains, legumes, and heart-healthy oils can be year-round staples, but mix and match your fruits and vegetables for more variety. Here are some great options by season.

Winter: brussels sprouts, kale, collard greens, swiss chard, beets, sweet potatoes, turnips, kiwi fruit, lemons, oranges, and pineapple.

Spring: Asparagus, apricots, avocados, rhubarb, carrots, mushrooms, celery, and fresh herbs.

Summer: Berries, cherries, eggplant, zucchini, watermelon, green beans, honeydew melon, okra, peaches, and plums.

Fall: Apple, cabbage, cauliflower, garlic, winter squash, parsnips, peas, ginger, and all types of lettuce.

Whenever possible, when you choose an anti-inflammatory food, try to substitute it for a less healthy option. For example, trade a muffin for a fresh-berry fruit salad or a plate of French fries for a baked sweet potato. Making small trades in your diet can add significant health benefits over time. In addition to lowering inflammation, a more natural, less processed diet can have noticeable effects on your physical and emotional health.

References:

https://pubmed.ncbi.nlm.nih.gov/31574939/

https://pubmed.ncbi.nlm.nih.gov/30688088/

https://bit.ly/3n76e2S

Published 8/8/2020

Updated 11/11/2021; 12/4/2021

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About Us

Dr. Amar Singh, MD, and Dr. Poonam Singh, MD, are board-certified by the American Board of Internal Medicine and American Board of Obesity Medicine. They specialize in preventing, treating, and reversing chronic diseases using an evidence-based holistic approach. They are specifically interested in weight management, hormone re-balancing, and longevity. The American College of Physicians has recognized them as Fellows, FACP,  for their excellence and contributions made to both medicine and the broader community. They enjoy teaching, volunteering, and advocating for their patients. Their mission is to share simple, effective, and proven strategies that lead to meaningful, sustainable, and long-lasting well-being.

Tips To Prevent Pain While Working or Studying

We’re willing to bet a small fortune that many people reading this first line can’t say they’re not slouched at their work desks right now. Don’t believe us?

Take a second to evaluate your body.

Your current posture may feel cozy right now, but it may also be the cause of those slight kinks in your neck and back due to long hours spent behind a desk. Improper posture at work can lead to musculoskeletal disorders.

It’s no surprise that sitting all day, hunching over, pounding away on a laptop, can have undesirable consequences on your health. From an increased risk of cardiovascular disease and diabetes to back pain, sore hip, and stiff neck, properly setting up your desk and workspace should be a priority on your wellness list. Add in the new challenge of schooling and working from home during a pandemic, and you might be wondering how to set up your new work-study space to be productive and avoid pain. You can set up to achieve good posture and ergonomics. Ergonomics, the science concerned with understanding an individual’s interaction with the workplace and environment, aims to reduce stress, eliminate injuries resulting from repetitive tasks and incorrect posture, and maximize productivity. Ergonomics is about positioning yourself to avoid injury, pain, and fatigue and improve your overall performance. Let’s consider the following:

Head position

The head is like a 10-pound bowling ball when your spine is in a neutral position, and if you get into the wrong position, your spine takes on more of that weight. So the farther your head moves away from your neutral spine, the more the pressure goes up. Even moving your head 15 degrees forward (so slightly looking down), your head goes from 10 pounds to about 24 pounds! That’s a significant increase in your spine, which can potentially lead to neck and back pain. Add in looking down at a piece of paper – and the pressure on your neck and shoulders jumps to almost 40 pounds. If you do this for several hours and we’re talking significant pain and damage.

For this reason, always focus on your spine, and head is in a neutral position. Place your computer screen straight in front of you, where your eyes are looking primarily at the area of the screen that you use the most. You can use books or a box to prop the screen up to the appropriate level.

If you have two screens, put the primary display in the center and the secondary screen off your left or right. If you can, try to move your secondary screen around, have your secondary monitor to the right for a few weeks and then change it to your left in another couple weeks. Good ergonomics is about keeping your neck moveable and avoiding repetitive movements.

Arm position

If you use a laptop, you might run into having your screen up so high that you can’t reach the keys. Here a wireless keyboard will come in handy. If you can’t type comfortably, you’re going to be straining, which will quickly cause neck, trap, and wrist issues.

Whether you’re sitting or standing, your arms’ preferred position is going to be 90 degrees. So that means your shoulders need to be down at a resting position (not hunched up to your ears), and your elbows bent with your wrists staying neutral.

When it comes to your computer mouse, use an ergonomics mouse versus a traditional mouse. A standard computer mouse forces your wrist to twist, which can irritate carpal tunnel syndrome or give you general wrist pain. An ergonomics mouse allows the wrist to maintain a neutral position, almost like shaking someone’s hand. It’s also a good idea to move around your mouse pad from time to time to create a little variety in your positions. Again, focusing on reducing repetitive movement to avoid injury.

Back position

Most standard office chairs have built-in lumbar support and the ability to change your height, which is excellent for customizing your workstation. But if you’re working with a regular chair, maybe even at home, there are a few things you can try to support a correct back position. 

You first want to make sure your legs and thighs are parallel with the cushion of your seat. This allows the pressure of your weight to be evenly distributed and reduces the risk of thigh or leg pain. Make sure your legs aren’t dangling or that you’re not using the rungs of your chair to prop your feet up. If needed, get a box or stool to rest your feet.

Sometimes, when we’re engaged in our work, we tend to lean forward inadvertently. Ideally, the spine needs to be parallel and placed up against the back of the chair. If you’re continually leaning forward, you’re going to get tired, and that’s going to lead to tightness and back pain. Instead, try using a lumbar support pillow, which will allow you to sit with the natural curve in your back. Place the pillow in the small of your back and adjust it so that your head is over your neck and shoulders. This even works with a regular, small pillow.  

The curve of the spine is like a spring. As gravity bears down on it, the spring can change pressure and distribute it evenly. If you straighten your spine out or overly curve it because you’re in a weird position, you’re going to start to have some discomfort. 

Along with the lumbar support pillow, you can get a chair cushion, which is also going to help distribute your weight. Some cushions have a cut out for your tailbone, a common complaint, either from a previous injury or from childbirth.

Movement

Even if you sit in the best possible position, if you stay there for too long, it will cause some pain and discomfort. Whenever you get stuck doing the same thing, you’re going to get injured. Repetitive movement is a significant cause of injury. Our joints are made to self-lubricate when we move; that is why the movement is so good for us. When we move our muscles, we stretch out from being tense or overstretched from sitting or standing too long. The motion is lotion. We need to get up and move throughout the day. We ask our patients to get up and move for at least 5 minutes every hour. Do a simple neck stretch every hour. So, even if you walk 12 times a day, you will move for an hour a day just by doing that. Smartwatches can remind you when it’s time to move. Try to figure out times throughout your day where a little bit of movement or stretching won’t affect your productivity or learning.

Regular exercise such as walking, swimming, or bicycling will help the body stay aerobically conditioned, while specific strengthening exercises will help the back's muscles stay healthy. These benefits of exercise promote good posture, which will, in turn, further help to condition muscles and prevents injury. There are also specific exercises that will help maintain good posture. In particular, a balance of core muscle and back muscle strength helps support the upper body and maintain a good position.

Supportive footwear

Avoid regularly wearing high-heeled shoes, which can affect the body’s center of gravity and induce compensatory alignment of the entire body, thus negatively affecting back support and posture. When standing for long periods, propping a leg up on a footrest, wearing supportive shoe orthotics, or placing a rubber mat on the floor can improve comfort.

Remember good posture and ergonomics when in motion

Simply walking, lifting heavy materials, holding a telephone, and typing are all moving activities that require attention to ergonomics and posture. It is essential to maintain a good position while moving to avoid injury, walking tall with shoulders back. Back injuries are prevalent while twisting or lifting and often occur because of awkward movement and control of the upper body weight.

Blend tasks together. So while you’re reading a long email, you’re stretching. If you’re waiting for your lunch to heat up, throw in some movement while you wait. Take advantage of breaks to make sure you move. Or if you have a standing desk, switch from sitting to standing every hour and the back again. Creating variety throughout the day is going to help combat pain and discomfort. Movement is an essential element of excellent workspace ergonomics.

A comfortable, ergonomic workspace can help you feel and work at your best. We suggest keeping these tips in mind every time you start the workday!

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4160684/#ref24

https://pubmed.ncbi.nlm.nih.gov/30403772/

https://pubmed.ncbi.nlm.nih.gov/28826961/

Published 8/7/2020

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About Us

Dr. Amar Singh, MD, and Dr. Poonam Singh, MD, are board-certified by the American Board of Internal Medicine and American Board of Obesity Medicine. They specialize in preventing, treating, and reversing chronic diseases using an evidence-based holistic approach. They are specifically interested in weight management, hormone re-balancing, and longevity. The American College of Physicians has recognized them as Fellows, FACP,  for their excellence and contributions made to both medicine and the broader community. They enjoy teaching, volunteering, and advocating for their patients. Their mission is to share simple, effective, and proven strategies that lead to meaningful, sustainable, and long-lasting well-being.

DOSE of Happiness

‘Happiness depends on ourselves’  - Aristotle enshrined happiness as a central purpose of human life and a goal.  

‘If life is a journey, who’s driving your bus?’

‘If happiness is good medicine, how do you get your dose?’

DOSE, as it relates to happiness, stands for Dopamine, Oxytocin, Serotonin and Endorphins, the neurotransmitters and hormones that create that happy feeling.  They, of course, lead right into the bus question.  You can either sit in the passenger’s seat and just let life happen, or step up and ensure you get a daily DOSE of happiness to keep you in the driver’s seat.   

Dopamine is a motivator.  It’s released when you’re doing something you find pleasurable, and your brain loves it; it wants more.  As wonderful as it is to celebrate reaching one of our goals, we should also celebrate the journey, create sub-goals, the parts that create the whole.  Sub-goals act as signposts for our progress and celebrating each one sets us up for repeated hits of dopamine, which makes us feel good and motivates us to keep going.  It even works with the seemingly un-fun stuff.  If you think you’re running a little low on motivation, all you need to do is find just a tiny bit of fun in whatever you’re doing and celebrate that you’re doing it to boost your dopamine levels.  Use dopamine to your advantage, more celebration = more dopamine = more motivation = more to celebrate = (you get the picture). Dopamine provides the motivation that is the fuel that keeps both us and the bus of life moving. 

Oxytocin is often referred to as the hugging hormone.  It’s released when we feel connected to others, and it creates and strengthens the bonds of relationships.  A smile, a kind word, or only taking time to be with someone all cause the release of oxytocin, but the best way to raise your oxytocin levels is to share a hug. I’m not sure if hugging is appropriate in the current pandemic. Like dopamine, use oxytocin to your advantage – feel connected = oxytocin release =  more connection through smiles and even hugs = oxytocin release =  more connections through smiles and even hugs  =  on and on. Oxytocin is the hormone that makes sure we aren’t always traveling alone.

Serotonin flows when we feel significant or important when we feel grateful and through the absorption of a few (not too many) UV rays.  Yes, that’s (a part of) why getting out into the sunshine makes us feel good. We can create a feeling of significance just by thinking about things we’ve done well, and we can create feelings of gratitude only by being thankful.  Serotonin production is one of the key reasons why so many people continue to keep gratitude diaries and achievement diaries.  Writing down the things we are grateful for or recording our accomplishments not only makes us feel good, reading back over the entries causes a serotonin release that can boost our happiness. So serotonin helps remind us to practice gratitude and recognize our achievements on our journey.

Endorphins are released as a response to pain and stress and help to alleviate anxiety.  Endorphins diminish the perception of pain.  Most of us know that feeling of getting our ‘second wind.’ Some people call it the ‘runners high.’  That’s the endorphins kicking in.  Endorphins are produced by exercise. Why not quadruple up for a real DOSE of happiness: exercise (endorphins), in the sunshine (serotonin); connecting with people you pass (oxytocin); and congratulating yourself on your progress (dopamine).  Or you could laugh!  One of the easiest ways to induce an endorphin release is to laugh or think about laughing.  Yes, the mere expectation of laughter also causes the release of endorphins.   Endorphins make for a happy journey.

So there we have it.  Both questions were answered.  We can get our DOSE of happiness by practicing a few simple techniques, and they are simple: Celebration to create dopamine to fuel the bus of life; connections to create oxytocin to ensure we aren’t always traveling alone; gratitude and focus on our achievements to create serotonin and ensure journey filled with gratitude and accomplishment, and laughter to boost our endorphins to ensure our journey is a happy one.  Used in combination as a daily DOSE of happiness, they serve to keep us firmly in the driver’s seat in our bus of life.    

We also know that not every moment will be happy. Sometimes life will give us a flat tire, or a broken window, or a million other things that can go wrong with the bus of life. We might need to get the bus serviced (chat with a professional) or clean the bus (take a vacation), but if we take our DOSE of happiness regularly, we might stay in the driver’s seat and enjoy most, if not all of the journeys. 

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4449495/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6487779/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6596504/

Published 8/4/2020

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About Us

Dr. Amar Singh, MD, and Dr. Poonam Singh, MD, are board-certified by the American Board of Internal Medicine and American Board of Obesity Medicine. They specialize in preventing, treating, and reversing chronic diseases using an evidence-based holistic approach. They are specifically interested in weight management, hormone rebalancing, and longevity. The American College of Physicians has recognized them as Fellows, FACP,  for their excellence and contributions made to both medicine and the broader community. They enjoy teaching, volunteering, and advocating for their patients. Our mission is to share simple, effective, and proven strategies that lead to meaningful, sustainable, and long-lasting well-being.

How To Tame Emotional Eating

We have all experienced emotional eating at one point or another. The technical definition is eating in order to escape, numb change, or amplify our feelings. Research has indicated that about 75% of all of our eating is emotionally driven. We eat not because we're hungry, because we're bored, we're stressed, we're anxious. Think about that for a moment, 75% of our eating, that's a large number. So it's an incredibly important issue for us to think about and dive into.

Food is a big part of the culture and traditions. The link between what we eat and how we feel is strong. Many big emotional moments in our lives are paired with certain foods. Some individuals rely on food to cope while experiencing a life event; others utilize food after the event is over as a reward or recovery from the event. You stand at the freezer, steaming over a disagreement with someone and searching for ice cream to cool your emotions. You sit on the couch and mindlessly munch through a whole bag of chips after a stressful day. It is because there are parts of the brain that are rewarded from eating high-fat or high-sugar foods. Decades of psychological research suggest that any rewarding behavior is likely to be repeated. Here’s the problem: it works temporarily. The feel-good foods you reach for can make you feel worse. Sometimes the most potent food cravings hit when you're at your weakest point emotionally. When we encounter stress that we perceive as chronic and out of control, we are more likely to reach for food for comfort. When we eat highly rewarding food (aka food that is high in sugar and or fat and usually highly processed), it dampens the activity of our threat response system (TRS). TRS is an intricate network of brain structures that alert us to stress, and we start to feel better. This becomes problematic when the brain gets conditioned to believe that junk food is what we need to feel better during stressful situations. Hence, it actively seeks out these unhealthy foods again and again. Eating comfort food when things get tough—also known as emotional eating or stress eating—is not a solution to life's challenges.

You may be able to stop stress eating or emotional eating by figuring out why you need comfort food. Does it calm you down, cheer you up, compensate you for a tough day, or some combination? Recognizing these thought patterns can make it easier to resist giving in. It also helps to realize that emotional eating doesn't solve the problem that made you upset.

Sudden, urgent cravings

Physical hunger develops slowly over time. After you eat, you may be satisfied for a while and then your hunger is going to grow. You desire a variety of different foods, you feel the sensation of fullness and you can track feeling more satisfied or full as you’re eating. Emotional eating, in contrast, comes on suddenly and might have urgency. You say, ‘I need to eat something. I need some chocolate.’

Craving only specific foods

Not only do your cravings come on suddenly, but you might only want to eat certain foods. If you’re saying to yourself, ‘I don’t want to just eat something because I’m hungry. I want chocolate, and that’s all that’s going to satisfy me,’ it’s a red flag of emotional eating.

Overeating

Overeating is another hallmark of emotional eating. People want food to make them feel better or satisfied. No matter how much they eat, it never really brings them to that feeling until they feel sick or overly full and then they stop eating, But they’re hoping that as they’re eating, it’s going to change their sensation in some way.

Shame or guilt

Feeling emotional distress, like shame or guilt, over your eating habits is another sign.

Mood-Food-Weight cycle

For some, eating may be a way to suppress or soothe negative emotions-stress, anger, fear, boredom, sadness, and loneliness. Major life events or, more commonly, the hassles of daily life can trigger negative emotions that may lead to emotional eating. Although some people eat less in the face of strong emotions, if you're in emotional distress, you might turn to impulsive or binge eating, quickly consuming whatever's convenient without enjoyment. Your relationship with food changes, and you automatically reach for a treat whenever you're angry or stressed without thinking about what you're doing. Food also serves as a distraction. If you're worried about an upcoming event or stewing over a conflict, for instance, you may focus on eating comfort food instead of dealing with the painful situation.

There are many triggers for overconsumption in our culture today. Whatever emotions drive you to overeat, the result is often the same. The effect is temporary, the feelings return, and you likely then bear the additional burden of guilt about taking a step back in your health goals. This can also lead to an unhealthy cycle — your emotions trigger you to overeat, beat yourself up for getting off track, feel bad, and overeat again.

Difficulty distinguishing between physical and emotional hunger

Growing up, you probably leaned on external cues to let you know you were done eating. For example, if you’re eating a plate of food, one of the external cues is when your plate is finished, and you tell yourself, I’m done.’ With emotional eating, you often have trouble telling the difference between these internal cues — which signify physical hunger, or the signs your body sends to let you know it’s time for nourishment — and emotional hunger.

When does emotional eating become a problem?

Occasionally having too much unhealthy food isn’t harmful. Sometimes you just need some chocolate to feel better, and that’s okay. However, this indulgence can be an issue when it happens a lot — or turns into your main coping mechanism. It’s when you’re feeling stressed, and your first or only way of coping is turning to food. That’s often when emotional eating becomes more of a problem or an issue.

To control emotional eating, you have to figure out what your triggers are. The more ways you can think of distracting yourself, the easier it will become over time to stop stress eating. Instead, resisting will become your new habit.

Strategies to Help You Stop Emotional Eating:

Keep a food diary. You might see a pattern that reveals the connection between mood and food. Once you recognize it, develop a strategy to break it. For instance, if you often eat because you think you deserve it after a tough day, remember that you also deserve to maintain a healthy weight, feel healthy, and be proud of yourself. If you eat because of stress, learn to dial back that stress.

Tame your stress. Yoga, meditation, deep breathing, regular exercise help reduce stress levels, temporarily leaving a situation to regain composure and focus, or mental approaches such as looking at alternative ways to interpret the events or looking for options and resources to assist with managing the situation (responding versus reacting).

Practice mindfulness first. The best way to outsmart our reptilian brain, which urges us to eat even when we don't want to, is to practice mindfulness. When in the face of stress, the best thing we can do is slow down and take a couple of deep breaths. This resets our sympathetic nervous systems and allows us to focus on making better decisions, decisions that will serve us in the long run, and not just provide temporary satisfaction.

Reality check. Is your hunger physical or emotional? If you ate just a few hours ago and didn’t have a rumbling stomach, you're probably not hungry. Give the craving time to pass.

Seek support. You're more likely to give in to emotional eating if you lack a good support network. Lean on family and friends. Have a go at writing down:

• Five people, you can call when you feel down, upset, or need to vent.

• Five ways you like to relax (e.g., go for a walk, take a hot bath, play with your dog, listen to music, read).

• Five places you go to calm down (e.g., your bed, outdoors, to the water fountains, your game room).

• Five things you can say to yourself (e.g., “you’ve got this,” “this feeling will pass”). 

• Five activities you can do to distract yourself (e.g., start a puzzle, watch a film). 

Fight boredom.  We often engage in a lot of activities and receive plenty of external stimulation from screens and people. When there is a void in stimulation, food is usually utilized to fill this void. Instead of snacking when you're not hungry, distract yourself and substitute a healthier behavior. The best distractions from emotional eating are things that take only about five minutes—just long enough to help you switch gears. Some ideas for switching gears include:

Go for a five-minute walk

Sit outside

Listen to music

Read

Call a friend to chat

Play with your dog

Take away temptation. Don't keep hard-to-resist comfort foods in your home. Yours truly never keeps ice cream at home. And if you feel angry or blue, postpone your trip to the grocery store until you have your emotions in check.

Don't deprive yourself. When trying to lose weight, you might limit calories too much, eat the same foods repeatedly, and banish treats. This may just serve to increase your food cravings, especially in response to emotions. Eat satisfying amounts of healthier foods, enjoy an occasional treat, and get plenty of variety to curb cravings.

Don’t let yourself get too hungry. You’ve probably heard the term “hangry,” a portmanteau of “hungry” and “angry” used to describe someone who gets irritable when they’re past time to eat. Making sure you stave off this mood — for example, eating proteins can help you stay full for longer — is a good bet.

Consider taste hunger. Taste hunger is when food just sounds good! It doesn’t matter whether you are hungry or not. Like candies, cookies, ice-cream, hot chocolate, etc. This is not emotional eating.  If you’re feeling the desire to eat something sweet after your meal, maybe that’s just what you need to hit the satisfaction factor. If you’ve identified that you’re 100% not physically hungry, it’s not taste hunger, and no amount of food will fill you up, then it’s likely that you’re experiencing emotional hunger.

Snack healthy. Fresh fruit, vegetables with low-fat dip, nuts, and unbuttered popcorn. How does that sound? Overeating processed snacks can raise levels of the stress hormone cortisol. Unbuttered popcorn will provide you with the feel-good hormone serotonin. It’s a whole grain, and you’ll also get antioxidants and far fewer calories than chips. Roasted chickpeas are another great crunchy option with protein and fiber to fill you up. If stress, anger, or sadness trigger your sweet tooth, remember this: The sugar high comes with a low afterward. This low can lead to increased cravings later. Sweets and processed foods can even make specific mental concerns, including symptoms of depression, worse. As an alternative to your favorite candy, cake, or pies, keep a bowl of sweet fruit out in the open. Studies show you’re more likely to eat fruits and veggies when they are easy to access. One easy option is to keep frozen berries on hand that can quickly be thrown into a blender to make a healthy sorbet. Vitamin D-rich foods can improve your mood, so stock up on fortified milk and cereals, eggs, mushrooms, and fish like salmon.

Eat mandarin oranges. Not only are mandarin oranges portable, and easy to peel and eat, but they’re rich in vitamin C, which can help boost your immunity. Plus, citrus smells so good, it’s a stress reliever.

Choose foods that fight stress. How about trying hot tea in emotional situations? It turns out there’s more to it than soothing steam. Tea often contains helpful antioxidants. And green tea, matcha tea, and white tea contain an amino acid called L-theanine that may help reduce stress levels. If you tend to snack late at night, try dark cherries. Not only do they take care of sweet cravings, but they also increase the natural levels of melatonin to help you sleep. Likewise, salmon and other fish rich in omega-3 fatty acids may help with sleep. Dark chocolate (at least 72% cacao), whole grains, nuts, legumes, and fruits and vegetables all play a part in maintaining a healthy mind. The key is stocking up on foods that help with your stress or emotions and avoiding processed junk that might make you feel worse.

Create your list of other options. Our best tool to combat stress eating is to create a list of other activities that will make us feel better without the guilt that overeating often brings. Research tells us that other things will generate a response similar to what junk food brings without the guilt and frustration of overeating. These are things like connection, mindfulness, meditation, exercise. These things will also naturally dampen your threat response system and help you manage stress more effectively.

Learn from setbacks. If you have an episode of emotional eating, forgive yourself and start fresh the next day. Try to learn from the experience and plan how you can prevent it in the future. Focus on the positive changes you're making in your eating habits and give yourself credit for making changes that'll lead to better health.

What else can help?

If you're unsuccessful in trying to stop stress eating on your own, consider cognitive behavioral therapy. It helps with a cognitive restructuring that encourages you to discover and expose negative and unproductive ways of thinking—such as grabbing that chocolate bar—and teaches you to replace these thinking patterns with more desirable ones.

Next time you have a stressful situation, you might say to yourself, "I'm agitated, but if I eat to soothe myself, I'll feel upset about my weight. Instead, I'll go for a walk so I can calm down and feel better."

It may take a combination of approaches to stop stress eating. The goal is to introduce newer, more adaptive options. Beyond these tips, it bears repeating: If you need medical help to address emotional issues, ask for it.

References: https://bit.ly/3k5GkZZ

https://bit.ly/33haJyf

Published 8/2/2020

Updated 11/15/2021

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About Us

Dr. Amar Singh, MD, and Dr. Poonam Singh, MD, are board-certified by the American Board of Internal Medicine and American Board of Obesity Medicine. They specialize in preventing, treating, and reversing chronic diseases using an evidence-based holistic approach. They are specifically interested in weight management, hormone rebalancing, and longevity. The American College of Physicians has recognized them as Fellows, FACP,  for their excellence and contributions made to both medicine and the broader community. They enjoy teaching, volunteering, and advocating for their patients

How to maintain hormone balance

Hormones are chemicals made by various glands in our body. They are messengers that tell other parts of our body how and when to work. Hormones control almost all tasks in the human body. When hormones are out of balance, symptoms can occur, and health starts deteriorating.

Our body has internal sensors that determine how much of which hormone is needed at a particular time. These sensors signal glands to secrete hormones in pulses. Hormonal balance is a very intricate and precise mechanism. With time, we gradually lose the ability to produce certain hormones. Hormone replacement therapy, prescribed based on clinical judgment and the needs of the individual patient, can restore this balance. 

Synthetic hormones are chemicals manufactured in labs patented by pharmaceutical companies. They come in predefined doses, and their molecular structure is not identical to the natural hormones. Synthetic hormones can be taken as an injection or skin cream, or oral tablets. Their levels peak and trough in our body, which may not mimic the natural hormone patterns, leading to inconsistent responses. Since their structure is not identical to natural hormones, they are needed in higher doses and are more prone to adverse effects.

The bioidentical pellet hormone is unique. It is all-natural, derived from plant sterols, which have the same chemical and molecular structure as hormones naturally produced in our body. The pellets we use in our office are yam based. They are designed in the form of small pellets (similar to a tic tac), dosed precisely match each person’s hormone levels. They mimic the natural hormone function more than synthetic hormones. As the hormone levels change, their formulation can be altered to complement it. Pellets are inserted under the skin in the hip area, using a painless 10-minute office procedure. Their effect lasts for three to four months in women and five to six months in men.  As they are inside our body, bathing in body fluids, they release hormones mimicking our natural pattern. Pellets dissolve entirely in without leaving any residue. They offer better results at a lower dose than synthetic hormones. Since bioidentical hormones are an exact structural replica of endogenous hormones, side effects are uncommon. In a rare event, if it occurs, one usually has to adjust the dosage. 

Pellets are inserted 3 or 4 times each year in women and twice a year in men. This way, one does not have to think about it, and the hormone is available when the body needs it. It is a simple, one-and-done process, and there is no need to worry about remembering to take a pill every day. You may feel better regardless of your age. Bioidentical hormones can help you avoid the adverse side effects of synthetic hormones.

Why not just take the pellets orally?

Bio-identical Estrogen pellets are not suitable for oral ingestion as they are chemically inactivated during the intestinal absorption process. Any estrogen or testosterone-like drug taken by mouth are not bio-identical.

How long will it take to work?

Each person’s symptoms and metabolism are unique, so is their path to hormone optimization. Most report some symptom resolution in as little as 10-15 days, but full optimization may take several months. The bioidentical hormone therapy journey is customized to fit individual needs. It takes more than a few weeks for hormones to get out of balance, so one can appreciate that it may take a little time to get hormones back to an optimal level.  A few weeks after pellet insertion, hormone levels are checked to assess the improvement and adjust the dosing. 

Why?

Although the clinical effects of hormone optimization vary depending on the person, and the type of treatment, the symptoms that may potentially improve are:

• Fatigue

• Low endurance

• Mental clarity

• Libido

• Insomnia

• Irritability

• Depression

• Anxiety

• Memory

• Hot flashes

• Sexual function

• Inability to lose weight

• Bone health

• Muscle health

• Skin health

• Muscle and joint pain

• Glucose levels

• Cardiovascular health

• Headaches, Migraine

• Fibromyalgia, chronic body pain

• Feeling of wellbeing

The goals of bio-identical hormone replacement therapy are alleviation of the symptoms caused by decreased production of hormones and a reversal of diseases associated with aging. Bio-Identical hormone pellets are the foundation for restoring hormone balance in the brain and the body, creating a sense of well being. 

References:

https://www.ncbi.nlm.nih.gov/pubmed/21464264

http://archive.foundationalmedicinereview.com/publications/11/3/208.pdf

https://www.maturitas.org/article/S0378-5122(13)00012-1/pdf

https://mayocl.in/32VgzFl

https://bit.ly/3skv0NN

Every person has unique metabolic needs and body type; therefore, results may not reflect the typical experience or guarantee that anyone will achieve the same results.

Published 7/27/2020

Updated 1/10/2021

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About Us

Dr. Amar Singh, MD, and Dr. Poonam Singh, MD, are board-certified by the American Board of Internal Medicine and American Board of Obesity Medicine. They specialize in preventing, treating, and reversing chronic diseases using an evidence-based holistic approach. They are specifically interested in weight management, hormone rebalancing, and longevity. The American College of Physicians has recognized them as Fellows, FACP,  for their excellence and contributions made to both medicine and the broader community. They enjoy teaching, volunteering, and advocating for their patients