2nd Annual Food Addiction Conference and Be Mentally Well Symposium

2nd Annual Food Addiction Conference Downloadable / Viewable Reference Documents Sponsored by the UMass Department of Psychiatry and the Food Addiction Institute A Tool Kit for Food Addiction Assessment and Treatment; The Basics from A to Z For Physicians, Dietitians, Therapists and other Allied Health Professionals Phil Werdell, MA • Normal Eater, Emotional Eater, Food Addict • Challenging Food Addiction Denial • Pre-Assessment Clues to Food as a Substance Use Disorder Marty Lerner • Neurotransmitters and the Brain Vera Tarman, MD • Medications for Food Addiction – No Silver Bullet Beth Rocchio, MD • Treatment, Intervention and 12-Step Support Programs … Continue reading

International Training In Mapping Sugar/Food Addiction

September 23-25, 2015 Reykjavik, Iceland Come to Iceland for a magical exploration of SUGAR (Sugar Use General Assessment Recording) The training is aimed for professionals that work with the problem of eating and overweight in any capacity! The SUGAR training is for you if you want to be able to assess and map sugar and/or foodaddiction with your clients. You will also be trained to set up appropriate treatment plans and get a clear insight on your clients situation concerning other possible addictions. Once we assess the problem, recovery can begin! Sept: 22nd: Time: 08pm: Open introductory lecture on SUGAR. … Continue reading

Second Annual Food Addiction Conference

We are pleased to invite you to attend the “Be Mentally Well” Symposium jointly sponsored by the UMass Department of Psychiatry and the Food Addiction Institute: “Trouble with Food? Sorting it Out with a Focus on Recovery”. This 1-day symposium is for anyone struggling with food issues, their family members and the professionals that work with them directly. You are also invited to attend the 2nd Annual Food Addiction Conference: “Diagnosing and Treating Food Addiction: A Toolkit for Physicians, Dietitians, Therapists and Other Health Care Professionals.” See below for more information on both events. We hope you will be able … Continue reading

The Missing Piece in Response to the Obesity Epidemic: Diagnosing and Treating Food Addiction

1st Annual Food Addiction Conference Downloadable / Viewable Reference Documents Sponsored by the UMass Department of Psychiatry and the Food Addiction Institute Food Addiction Treatment – Background Chart – Normal Eater, Emotional Eater, Food Addict Food Addiction Progression and Recommended Actions Compulsive and or Binge Eating Brochure (UMASS) Resource Sheet – Emotional Eating, Compulsive / Binge Eating and Food Addiction Keynote – Food Addiction Treatment: A Missing Piece in the Response to the Obesity Epidemic Food Addiction and Bariatric Surgery Resources – 12 Step Organizations Food Addiction Institute Talking Points ASAM: Definition of Addiction ASAM Releases NEW Definition of Food … Continue reading

Format for Professional Training Continues to Evolve

The new model for the FAI/ACORN Professional Training, conducted July 19-25, 2013, in Tampa and Sarasota, Florida, was a success. All participants who are food-addicted were rigorously abstinent at the end of the first weekend, which was followed by the new two-day academic component at the Florida School of Addiction Studies. Phil Werdell taught the two-day course and used material from his Springfield College course on food addiction. Dr. Vera Tarman lectured on medications for eating disorders and food addiction. (Basically, there is not much that is very helpful yet, but the research underlying these medications helps us understand how … Continue reading

Werdell, Foushi Speak on ‘Weight and Food Addiction’ at Yale

Phil Werdell gave a presentation and led a discussion group on “Weight and Food Addiction” at his 50th Yale University reunion. Mary Foushi told her story, the progression of a late-stage food addiction and 22 years of recovery without surgery, including a 195-pound weight loss. Werdell’s Overview: The important differences among physical obesity, psychological eating disorders, and chemical dependency on food. The possible number of adult food addicts in the United States: 70 million — 50 percent of the obese, 30 percent of the overweight, 20 percent of all others. The characteristics of food addiction: a primary disease, physical craving, … Continue reading

Brownell and Lustig Challenge APA on Food Addiction

At the recent annual assembly of the American Psychiatric Association, Dr. Kelly Brownell of Duke University and Dr. Robert Lustig of the University of California at San Francisco spoke on how food addiction is affecting the United States. Brownell remarked that a growing scientific literature indicated that processed foods negatively affect the brain. “This is a game-changing concept… because it’s true that food can hijack the brain, you can imagine how parents are going to feel about this when their children are exposed to these ‘substances’. It could come down to helping us protest children’s food environments, much like we … Continue reading

DSM-V Acknowledges Food Addiction

DSM-5 CoverThis past May, The American Psychiatric Association unveiled its updated Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). The inclusion of Binge Eating Disorder as a diagnostic category bodes well for the eventual recognition of food addiction as a substance use disorder in future editions of the manual.

The following is an excerpt:

“Binge Eating Disorder:

A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

a. recurrent episodes of binge eating, in which binge eating is defined as eating in a discrete period of time, (e.g. within a 2-hour period) an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances, and

b. a sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating.).

B. Three of the following:

a. Eating much more than normal.

b. Eating until feeling uncomfortably full.

c. Eating large amounts of food when not physically hungry.

d. Eating alone because of feeling embarrassed by how much one is eating.

e. Feeling disgusted with oneself, depressed or very guilty afterwards.

C. Marked distress regarding binge eating.

D. The bingeing occurs as least once a week for 3 months.

E. The binge eating is not associated with the recurrent use of inappropriate compensatory behavior as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa…..

Specify current severity:

The minimum level of severity is based on the frequency of episodes of binge eating (see below). The level of severity may be increased to reflect other symptoms and the degree of functional disability.

  • Mild: 1-3 binge-eating episodes per week.
  • Moderate: 4-7 binge-eating episodes per week.
  • Severe: 8-13 binge-eating episodes per week.
  • Extreme: 14 or more binge-eating episodes per week.”1

Health professionals familiar with food addiction, as well as self-assessed food addicts, will immediately notice that many, possibly a large majority, of cases of food addiction fulfill all the characteristics of Binge Eating Disorder and that most late- and final-stage food addicts display severity equivalent to “severe” or “extreme” Binge Eating Disorder. In the introduction to the Feeding and Eating Disorder section of the DSM-5, this is acknowledged:

“Some individuals with disorders described in this chapter report eating-related symptoms resembling those typically endorsed by individuals with substance-use disorders, such as strong craving and patterns of compulsive use. The resemblance may reflect the involvement of the same neural systems, including those implicated in regulatory self-control and reward in both groups of disorders. However, the relative contributions of shared and distinct factors in the development and perpetuation of eating and substance use disorder remain insufficiently understood.” (DSM-5, p 329)

This recognition of food as a substance-use disorder in the diagnostic manual is of extreme importance. It gives clinicians encouragement to look for a psycho-socially caused eating disorder, a biochemically caused food addiction, or both. It also means that in the treating of Binge Eating Disorder, both the traditional treatment for eating disorder (i.e. therapy, mindfulness training, and medication) and traditional addictive-,model treatments (i.e., abstinence, education about chemical dependency and preparation for 12-Step-type aftercare) should be covered by health insurance reimbursement as appropriate to the clinician’s diagnosis. This principle obviously applies equally where binge-eating co-occurs with anorexia and/or bulimia. Here too, the binge eating may have psychodynamic roots, be caused by biochemical addiction or both.

These conclusions align completely with the observations of Dr. Charles O’Brien, chairman of the Substance Use Work Group of the DSM-5. As we reported earlier, in his letter to the Food Addiction Institute, Dr. O’Brien wrote:

“We share your interest in understanding how eating behaviors can take on characteristics that strongly resemble the behavior of individuals who abuse substances such as cocaine. It is likely that this resemblance reflects the fact that neurobiological systems involved in processing of reward are disturbed in both disorders. The problem is that, at present, the precise nature of these disturbances and how the neurobiology of eating disorders resembles and differs from the neurobiology of substance-use disorders is unknown. We, and the members of our Work group, wholeheartedly endorse research to understand this important overlap.” (foodaddictioninstitute.org. July 2012)

We replied that The Food Addiction Institute favors introducing food as a Substance Use Disorder on an experimental basis – as Binge Eating disorder was published in the DSM-IV-TR – to encourage clinical and scientific experimentation. Meanwhile, we encourage clinicians to look not only for psycho-social, trauma-based eating disorders but also for biochemical cravings that may be caused by consumption of a specific food or foods. Each needs to be treated differently, and the most complex cases often satisfy criteria for both psycho-social eating disorders and food addiction.

  1. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, pp. 350-352. Arlington, VA, American Psychiatric Association, 2013. []

Food Addiction Treatment for the Impaired Professional

Phil Werdell Presents “Food Addiction Treatment for the Impaired Professional” at the University of Florida The University of Florida (UF) Gainesville invited Phil Werdell to speak Wednesday, March 20 during their Continuing Medical Education Grand Rounds lecture series at the Florida Recovery Center. Phil’s lecture, “Food Addiction Treatment for the Impaired Professional” was webcast live and we have the opportunity to share the lecture with you.We are sure you will enjoy the presentation and feel free to forward this to those you think may benefit from viewing. … Continue reading

ACORN Professional Training Primary Intensive

New ACORN Professional Training Primary Intensive, July 19 – 25 The intensive will include: 2-day “Introduction to Food Addiction” course worth 10 CEU’s 6 day Intensive instead of 5 days at the same cost Additional faculty member from Iceland’s highly successful outpatient food addiction program and graduate of the ACORN Professional Training program Dr. Vera Tarman, Medical Director of the largest drug and alcohol treatment center in Canada, will speak on medical and scientific aspects of food addiction This is a wonderful opportunity to further your training! Download PDF Flyer Download Details About the Intensive Download Registration Form … Continue reading

Adding Food Addiction as a clinical diagnosis in the DSM-5

Gail Marcus, Chair of the Food Addiction Institute, and Phil Werdell, Director of the Food Addiction Professional Training Program, headed up a delegation to the national conference of the American Psychiatric Association May 5th – 9th in Philadelphia. Their focus was to educate psychiatrists about the need to include food as a substance use disorder in the next update of the association’s Diagnostic and Statistical Manual (DSM-5) due out in 2013. They also shared information about the urgent need for food-addiction treatment. Phil Werdell was well received when he spoke to this issue at one of the open forums. Since … Continue reading

Tina S.

I am writing to support the inclusion of “food” as a substance use disorder in the DSM-5 as well moving Binge Eating Disorder to a formal diagnosis.  I suffer from both of these diseases and am alive today because I have been able to find treatment for it, in many cases, people who have helped me out of the goodness of their heart.  In 1991 I was a client at Glenbeigh Hospital of Tampa.  There I received formal treatment for binge eating disorder.  I also received treatment for food addiction, although it wasn’t formally recognized as an addiction.  I have … Continue reading

Rich R.

I have struggled with uncontrollable eating my whole life (I am now 66). For the pas t 15 years I have been able to maintain a healthy body weight through a combination of 12-step groups and treatment programs.   I find that the observations of Phillip Werdell reproduced below correspond quite exactly with my own experience and the stories of hundreds of people with similar problem whom I have gotten to know through my participation in treatment groups.

Christine L. Palmer

I recommend and strongly support the addition of Binge Eating Disorder as a formal category of diagnosis and food addiction as a Substance Use Disorder to the DSM-5. I am not a scientist and I am not a physician, psychologist or therapist. I am, however, a food addict who has suffered from and recovered from binge eating. (Like alcoholism, my food addiction has been arrested, but not cured.) I know firsthand how my body responds to certain substances, primarily sugar and highly refined flours. Once ingested, these “drugs” trigger behaviors (consumption of massive quantities of similar foods), thoughts (primarily of … Continue reading

Mary Foushi

I am a late stage food addict with over 20 years of stable weight loss, abstinence and recovery; I have been maintaining a 200-pound weight loss for 19 years — with NO bariatric surgery. As an active binge eater, I had lost 100 pounds five different times and each time I gained it back. In 1990 I was personally taught the addictive model of treatment for food as a substance use disorder. It has worked for me when everything else failed. For the last 16 years I have been working professionally with other late stage food addicts. I am a … Continue reading

Dr. Mark Cheren

As a professional in the field of continuing medical education and former director of the Case Western Reserve University School of Medicine’s CME Program, I strongly urge that food be added to the list of substances  to which people can become physically as well as psychologically addicted. 1. Given that there is now conclusive evidence supporting the hypothesis that food is a not only a substance that can be abused but to which people can become physically as well as psychologically addicted, failure to identify food addiction and the criteria for identifying it as such in the DSM5 will interferes … Continue reading

Karen B.

I believe that Food Addiction should be added to the DSM-5 as a substance related disorder. As a late stage food addict I have spent my whole life (65 years) trying to control my eating. My first diet was at 7 years old and I have lost 100 pounds multiple times only to convince myself that I could have just 1 bite of my binge food and then gained all my weight back and more. I have learned that much like the drug addict or the alcoholic if I pick up my trigger foods (for me, sugar and white flour) … Continue reading

Anonymous

I have had literally dozens of psychiatrists, dietitians, and therapists tell me that food addiction does not exist. I know this not be true; I have been maintaining a 195 lb. weight loss for over twenty years by treating myself as addicted to food. I know hundreds of other long time recovering food addicts. Not only are we getting inaccurate advice from our health practitioners, there is almost no way to get insurance reimbursed health care for our food addiction when self help efforts are not sufficient. I support adding Binge Eating Disorder to the DSM 5. And it is … Continue reading

Anonymous

As a disabled veteran, I have been diagnosed with bipolar disorder. My psychiatrist was not able to stabilize my medication, however, until I began treating myself carefully as a food addict. I am abstinent from sugar, flour and caffeine; I weigh and measure my meals and I work with other food addicts for support. This has not only impacted my primary diagnosis positively, it has stopped my bingeing, supported appropriate weight loss and ended my food cravings. Please include food as a Substance Use Disorder in the DSM-5. This will allow many more food addicts to get the medical treatment … Continue reading

Is it possible to recover from food addiction?

Yes. Treatment is simple but not necessarily easy, and like other addictions and chronic diseases, there is no permanent cure. It is possible however, to put food addiction in physical remission and then slowly to repair the psychological, social, economic and spiritual damage it has caused. The principles of recovery are simply to: 1) completely eliminate specific binge foods and compulsive eating behaviors; 2) develop feeling skills to deal with difficult emotions without using food; 3) ask for help, especially in identifying and making decisions about chronic irrational thinking about eating, body image and food; and 4) effectively break biochemical … Continue reading

What does science say about food addiction?

Since 1995 there have been a number of lines of scientific research, each developed separately, that have established evidence of chemical dependency on food: human genetic research, controlled animal studies, comparative brain imaging of dopamine receptors, controlled human studies using opioid blockers, biochemical studies of the digestive processes, outcome surveys of those in voluntary food addiction recovery fellowships, and outcome studies of professional food addiction treatment programs. There are a number of other lines of scientific investigation which could illuminate the complexity of food addiction: discovery of several other gene markers associated with obesity and digestive disorders, studies showing the … Continue reading

Are all overweight people food addicted?

No. Obesity, eating disorders and chemical dependency on food are three very different medical problems. Some have only one of these medical problems, though it is not unusual for people to have all three. Obesity is entirely a physical disease. It is caused by excessive calorie intake and/or not using enough calories – and, occasionally, by a metabolic or other medical dysfunction. Using Body Mass Index (BMI) and established medical standards, the Center for Disease Control has found that a third of the U.S. population is obese and another third is overweight. (CDC, 2010) Historically, between 10% and 30% of … Continue reading

How do you determine if someone is food addicted?

If someone eats when they really do not want to or if they persistently eat more food than their body needs, or eat in a way that they know is not good for them, they may be a food addict. It is certainly worth investigating the matter further. There are a number of tests and questionnaires for assessing food addiction. Many of the food-related 12-Step programs – OA, FAA, FA, RFA, CEA-HOW and GSA – have a list of self-assessment questionnaires on their websites. There are a number of excellent self-help books on food addiction – by Hollis, Sheppard, Katherine, … Continue reading

What is Food Addiction?

Food addiction is a disease which causes loss of control over the ability to stop eating certain foods. Scientifically, food addiction is a cluster of chemical dependencies on specific foods or food in general; after the ingestion of high palatable foods such as sugar, excess fat and/or salt, the brains of some people develop a physical craving for these foods. Over time, the progressive eating of these foods distorts their thinking and leads to unwanted negative consequences. Despite this, they still cannot stop overeating. In Early Stage food addiction there is moderate, often infrequent, loss of control. This could express … Continue reading

Bariatric Surgery Fails, Food Addiction Treatment Succeeds

When Deborah finally accepted that diets did not work for her and that therapy did not curb her overeating, she elected to have bariatric surgery. Deborah lost weight at first, but then she found herself eating out of control and gaining weight faster than ever. She could not stop until she discovered that she was chemically dependent on specific foods and starting treating herself as a food addict. I have always known I was a competent person. I am a graduate of an Ivy League university, earned two graduate degrees with honors, and serves capably as one of the nation’s … Continue reading

A Vegetarian Solution to Food Addiction

Miki was overweight and had a history of dieting, losing some weight and then soon gaining it back.  One day she accompanied her husband to see Dr. Neil Barnard. Her husband had cancer, and Dr. Bernard’s center had a reputation for using both traditional medicine and a holistic nutritional approach.  They went to a series of classes at the center and started taking the steps also suggested in Dr. Bernard’s book, Breaking the Food Seduction: The Hidden Reasons for Craving and 7 Steps to End Them Naturally.  Miki decided to do the program with her husband. They followed the suggested … Continue reading

Morbidly Obese: Breaking the Addiction to Food

Nearly 4 years ago, Amber W. was struggling with her weight. At the same time she was struggling to fit into a society that puts blame and shame on the obese. But an involvement with a 12 step program put her on a path to truth of self, recovery and eventually life changing weight loss. “Prior to being introduced to 12 steps, my life was about food and the acquisition of it,” said Amber. Only 48 months ago Amber weighed nearly 320 lbs with a dress size of 26. Tired of fad diets and breaking self promises, she turned to … Continue reading

Am I a Food Addict?

Assessing Whether or Not You are Food Dependent In the popular language, the term “food addict” can mean anything from eating a lot of packaged snacks – as in “junk food junkie,”- to having a really a serious disease like alcoholism or addiction to other drugs. However, unlike for those with alcohol and other addictive drugs, there are very few places that can help you get through a one-week chemical detoxification and even fewer places to receive treatment in the way you can for other chemical dependencies. Health insurance usually does not cover the programs that do exist unless you … Continue reading

Steps to a Slip Inventory

A “food slip” begins with a spiritual disconnection (from being in “fit spiritual condition”); followed by emotional disconnection (trying to be the “director” and control events); and then the obsession (false craving) with food, which leads to addictive eating. Recognizing that a slip begins long before the food is eaten, this tool will help you identify what happened at each stage, so that you can learn to back out of relapse. … Continue reading

A Food Plan As a Spiritual Tool

In the long term, diets do not work for compulsive eaters and food addicts, but we still need a way to give structure and support to our physical recovery. Since we have become powerless over food, a food plan must be used in a spiritual context. Thus, a food plan is a spiritual tool; it is an instrument for implementing “surrendered” food abstinence. … Continue reading

The Process of Abstinence is Surrender

The initial surrender necessary for recovery from food addiction is to accept completely that you are a food addict. This means that you have a progressive disease that is physical, mental-emotional and spiritual in nature. Because it is a disease of the mind, there are times when you cannot trust your own thinking, so you need to rely on a Power beyond yourself. What does this look like specifically? A. Physically, it means – A surrender of one’s specific binge foods, i.e.foods to which you are addicted. If one is addicted to volume, surrender to weighing and measuring or to … Continue reading

Levels of Denial

Food addicts experience denial at different levels: inability to distinguish between hunger and the false starving impulse of physical craving, confusion between sane thinking and the false rationalizations associated with compulsions regarding eating, and distortion of will and sense of self in relationship to food and life as a whole. Before we look at each of these inter-related levels of denial in depth, it’s useful to see that there are three quite different definitions or types of denial: common denial, psychological denial, and addictive denial. … Continue reading

The Phenomenon of Craving (False Starving)

A food addict is distinctly different than a normal eater or an emotional eater. A food addict has a chemical dependency like an alcoholic or drug addict. Specific foods or food in general can trigger a process of physical craving. The food addict often thinks this is hunger, but it isn’t. It is more like the experience of starvation; the food addict thinks that s/he has to have more food, even if she is physically full and nutritionally satisfied. Sometimes s/he thinks life will not be worth living without a specific food or that s/he’ll die if s/he doesn’t get … Continue reading

Abstinence First, Absolutely

Beginning the Process of Abstinence There are two schools of thought about the strategy for surrendering to a food plan. One says that it is best to proceed incrementally. The other says that it is best eliminate all dangerous food and triggers at once. There is an abundance of experience that both of these strategies work well for some people, and many “true believer” arguments that their way is the only way among those for whom their food plan or their strategy has worked. … Continue reading

Bulimia & Food Addiction

Food addiction begins with physical craving, evolves into mental obsession, and, ultimately, becomes a whole life of spiritual illness. It is also a physical disease of chemical dependency upon one or more foods or on volumes of food in general. Bulimia is a psychological illness, a mental-emotional problem usually rooted in unresolved trauma from before the earliest incident of purging. … Continue reading

Anorexia & Food Addiction

The common image of food addicts is that they are overweight. A majority of those for whom the disease of food addiction has progressed certainly are obese – and/or morbidly (i.e., life threateningly) obese. Yet there are many food addicts who are a normal weight. Some of these healthy looking food addicts are bulimic. Others just have a metabolic system that keeps them appearing “normal,” even when they are bingeing abnormally. There is also a small but important group of food addicts who are dangerously thin. Most of these are food addicted and anorexic. Even some overly thin folks who … Continue reading

Binge Eating Disorder & Food Addiction

It is frequently difficult to distinguish between “compulsive overeating” and “food addiction,” especially since many recovering people as well as the professionals who support them use the terms interchangeably. At ACORN, we have come to use the terms “compulsive eating” and “addiction to food” to define two distinctly different problems. We use the term “compulsive overeating” to identify what is now called “binge eating disorder” by psychologists. This psychological disorder derives from unresolved trauma and family dysfunction as well as a lack of cognitive feeling and behavioral skills to deal with difficult emotions. … Continue reading

Step 2 – The Lies I Tell Myself

Step Two: “Came to believe that a Power greater than myself could restore me to sanity.” My food addict’s mind is endlessly creative. It will tell me that changing my diet, arguing with my sponsor about food amounts, thinking I need to lose more weight, and impulsively trying a new food are all perfectly reasonable. My thinking is my problem. … Continue reading

Step 1 – Writing

“We admitted we were powerless over food, that our lives had become unmanageable.” First Step writing is about admitting powerlessness over food. If there was something else that a person could do in a particular situation to have control over their eating, then they would not be powerless. That is obvious. … Continue reading

The Difference Between a Diet and a Food Plan

Why Use the Term “Food Plan”? Since most of us have been unable to eat or diet like normal eaters, we choose not to use the word “diet”. To us, diets mean something we can follow by reason and will power alone. We have come to accept that we cannot manage our food by self-control alone. Willpower failed us utterly, so we surrender to our powerlessness over food. The purpose of the food plan is to make this surrender more specific. … Continue reading

Sugar & Flour: Addictive Substances for Food Addicts

As food addicts, most of us find we have to pay a great deal of attention to what is in the content of the food we eat. Unlike alcoholics and drug addicts, we cannot just “stop eating.” However, we do have to surrender our binge foods and addictive eating habits as part of our recovery. After making a list of our binge foods, we can identify the substances that we are addicted to in order to surrender them to our Higher Power so that we don’t have to eat them anymore. “Surrender,” in this context, means doing something we don’t … Continue reading

Normal Eater, Emotional Eater, Food Addict

NORMAL EATER, EMOTIONAL EATER, FOOD ADDICT © NORMAL EATER (problems of obesity) EMOTIONAL EATER (eating disorders) FOOD ADDICT (chemical dependency) The Problem is Physical: Excess Weight The Problem is Physical and Emotional: Binge eating, restricting, and/or purging over feelings Unresolved trauma And possible weight issues (either over-or- underweight) The Problem is Physical and Emotional and Spiritual: Abnormal response to specific foods Physical craving (false starving) Mental obsession (false thinking) Self-will run riot (false self) And often trauma and weight issues The Solution is Physical: Medically approved diet Moderate exercise Support for eating, exercise and lifestyle change The Solution is Emotional: … Continue reading