23 October 2020
Written by Dr Kate Beaven-Marks
The hypnotherapist working with weight management clients will often encounter habits and beliefs around the consumption of certain foods. Some clients may report craving their usual sweet treats if they eliminate them entirely from their new healthy eating plan. Indeed, without addressing this, a client may simply give up on their new eating habits, as the perceived side effects are so distracting. Some clients may think that it is all in their head and to just ‘suck it up’ and get on with their new eating habits. However, both mind and body (psychological and physiological) factors are involved in the client’s desire for something sweet. This blog will explore some of these underlying factors, as well as considering how to address these in a hypnotherapy setting and for client self-care (homework).
Both your short and long-term memories contribute towards your reward-seeking behaviour and this is partly the responsibility of your hippocampus. This C-shaped area of your brain, located in your medial temporal lobe helps you remember foods and distinguish different tastes, such as the differences between the taste of milk chocolate and the taste of dark chocolate. Interestingly, the neurons in the hippocampus can change with a high sugar diet, resulting in shorter and thinner dendrites. When making memories, neurons in the hippocampus communicate through synapses which are located on dendrites. So, a high sugar diet may not be helping your client remember to eat healthily.
As well as memories to consider, there is the influence of the basal ganglia which is involved your reward-seeking behaviour and your caudate nucleus which has a role in forming new habits. An interesting point, it doesn’t distinguish between good habits, like making healthy food choices when eating out, and bad habits, like eating half a pack of biscuits each time you have a cup of tea without you even realising that you are doing either. Indeed, these responses take on the form of conditioned responses, rather than conscious choices. However, because these habits tend to be outside of conscious awareness, they can be more challenging to change.
Other brain influences include the effect of the insula. This responds to sensory experiences with emotion and has a role in regulation of the body’s homeostasis. We know that emotion is commonly employed in food advertising and marketing, such as the imagery of that first taste of ice-cold beer on a hot day. It doesn’t even take the taste of that cold beer to raise your dopamine levels, just the thought will cause a spike of pleasure. All of these factors and many more brain processes come together to create our responses to food and influence our food choices.
Depending on which healthy eating plan your client adopts, their food choices may trigger cravings for sweet treats, particularly if on a very low intake diet with low protein and fat. A lack of these (which naturally slow down the release of sugar into your bloodstream) can result in more rapid rise and fall of blood sugar, resulting in a craving for sugary foods associated with rapid energy release. Also common on drastic diets can be a reduction of carbohydrates. Where someone is used to a high simple carbohydrate food intake, they may be used to a rapid increase in blood sugar level. However, reductions of fibre, fat and protein can leave someone feeling hungry again much quicker. Interestingly, the body can also be fooled by artificial sweeteners and people can still experience the same longing for sweet foods.
If you have a craving for a certain food, some people might think that they have a vitamin or mineral deficiency and the craving is their body telling them what it needs. However, whilst a sodium deficiency could lead to a desire for something salty to eat, it is thought that a desire for sugary food can arise from a need for certain minerals. For example, calcium, chromium, iron, magnesium and zinc imbalances can generate sugar cravings. These and other minerals are responsible for a vast number of body functions including hydration levels. If these minerals are not maintaining a good hydration status, then you may be craving sugary food when actually you are really thirsty. If the client has a highly restricted diet, it can be helpful for them to consult with a nutritionist who can help them assess their mineral levels and find appropriate sources of relevant minerals.
When working with weight management clients, the classic homework of keeping a food diary can be really helpful in providing insight into amounts and types of food. However, with a multitude of excellent tracking apps available, these can be great in assessing quite how much sugar a client is having and when. This can give even greater insight if a client also keeps an emotions log (logging positive and negative).
Your sleep habits can influence your desire for sweet foods. The part of your brain responsible for complex decisions and judgments (the upper brain part of the cerebrum) can experience a decrease in activity with even just one night of inadequate sleep. For some, this can result in craving sweet stuff, for others, they turn to junk food. A study found when we are sleep deprived, our brain becomes more able to notice food odours but as the brain is less able to make decisions, it can result in choosing food with richer energy signal and higher energy density. This study also refers to past research which found sleep deprivation disrupts natural endocannabinoids, important for feeding behaviours. As the endocannabinoid system is involved in feeding and reward (amongst other roles), activation of the endocannabinoid receptors stimulates eating for pleasure (hedonic eating).
A sleep-deprived brain’s impact on complex decision-making can affect both habit-based and goal-based decisions. A habit-based decision would be having exactly the same breakfast (e.g. boiled egg and toast) every day. Someone who used to have an unhealthy breakfast every day (such as adding bacon and sausages to their breakfast), may revert to an old habit when tired. Strategies to address this could be a simple as the client leaving themselves a post-it note reminder on the egg carton or bread box.
Goal-based decision-making is more complex to address. Say, for example, the bread was mouldy or there were no eggs left, then another response would be needed. This new response could involve a number of decisions. As a result, more behavioural conditioning in hypnosis could be helpful, as could a range of strategies to ensure that a good decision route is possible.
Ultimately, if your weight management client has poor sleep, it can help to address this to reduce the risk of sleep deprived food decision-making. Not only can sleep (or lack of) affect food choices, your client’s food choices can affect their sleep. Awareness of and action for good sleep hygiene may be a curious element to add in to your weight management process, yet it can have significant benefits for your client, including helping them be more rested so they exercise and also have greater resilience so they can be less affected by lifestyle stressors.
Is your client a stress eater? If so, it will be rare to find one to who binges on lettuce or cucumber. Some stressed clients will report losing their appetite, whereas others will talk about been hungry, particularly for certain foods, as stress can have an impact on cortisol levels and, as a result, quickly use up their levels of glucose and insulin. When a sugar high crashes, it can lead to symptoms that people may associate with anxiety and stress, such as difficulty in making decision and fatigue. People can then self-medicate with sugary foods in the hope that they will feel better. Indeed sucrose (in sugary foods) does have hedonistic properties. Sugar can suppress the hypothalamic pituitary adrenal (HPA) axis in the brain which controls your response to stress, leading to some individuals turning to sweet ‘comfort foods’ to reduce the impact of stress. Research shows that people’s eating habits can change when stressed, with a reported 60-70% of people choosing sweet treats (e.g. cake, biscuits, chocolate, donuts) at time of high stress, which can have even greater impact for emotional eaters. Thus, when working with a client who is addressing sugary food issues, helping that client identify stressors and develop stronger coping strategies can have significant impact not only on their stress levels but also many aspects of their health, including their ability to make healthy food choices.
The world can look a different way when we are in a good mood to a bad or low mood. When we feel good, it can be easier to make healthy food choices, even delay perceived gratification. However, when we feel low, it can be easy to use food in the belief it will lift our mood. Indeed, serotonin, a neurotransmitter that regulates appetite, memory, mood and social behaviour, is increased by sugar consumption. As a result, someone will feel temporarily happier. However, the brain can start to want this happy chemical over and over again, especially if someone has a low mood (or is in a bad mood). Rather than a client eating sugar as a temporary (and relatively inefficient) mood booster, it can be helpful for a client to develop other strategies for increasing their serotonin levels. For some this may be dietary changes, such as eating cheese, eggs or walnuts, or drinking green tea. A referral to a nutritionist can be helpful here. Whilst other clients may find that adjusting (or having) an exercise routine gives them a sufficient boost. It may even be that you liaise with a personal trainer or gym and refer clients as part of their weight management journey. Interestingly, those endocannabinoids we mentioned earlier (sleep section), are mobilised by physical activity and contribute to the mood-elevating effects of exercise.
Rather than simply telling weight management clients to change their diet, no matter what, it can be helpful to understand the many psychological and physiological influences that will have an impact on their ability to make healthy food choices. Psycho-education is a good start, boosting the client’s awareness of what the different types of food are and how the mind and body are influenced by their food choices. However, there is also much that can be achieved from a hypnotherapeutic perspective, including behavioural work addressing positive habits, and building coping strategies, together with cognitive work helping the client develop resilience and positive beliefs. Not forgetting the valuable insight and change that can also come about as a result of more analytical/Ericksonian interventions. Finally, the influence of the therapy can be enhanced by effective homework strategies.
If you would like to develop your hypnotherapy knowledge and skills to better work with weight management clients (and many more), have a look at our Hypnotherapy Diploma course, starting in February 2021.
We hope that this blog about the science of sugar cravings has been helpful. If you have any questions about this topic or anything else for that matter, do please get in touch, because we’re always happy to help!
– written by Dr Kate Beaven-Marks