[00:00:00] You are listening to episode number 292 of Better Blood Sugars with Ghislaine, Maryland.
[00:00:07] Welcome to Better Blood Sugars with Delaine MD where you can learn strategies to lower your blood sugars and improve your overall health. I'm your host, Dr. Delaine Vaughn. Ladies, if you know you're capable of doing badass things at work and for your family, but you're confused and frustrated with why you can't seem to stop eating the chocolate cake, this podcast is for you. Let's talk.
[00:00:30] I want to welcome you to the podcast. I am so glad that you're taking some time for you and for your health today. And I feel privileged that you're choosing to spend that time with me. And I hope you learned something today that's helpful and beneficial.
[00:00:43] Today, I want to discuss urges, cravings and desires. This is a struggle that anybody with type 2 diabetes has to address at one point or another in order to fix their type 2 diabetes. The recognition that we feel these desires for foods and these cravings for foods and these urges to eat foods, and they grow in intensity until we feel like the only answer is to manage these feelings by complying with the desires, the cravings, the urges. This complying, this compliance with these desires and cravings and urges keep keep us stuck and diabetic. And then of course, those feelings are further compounded or the feeling of being stuck is further compounded by the fear that's associated with being out of control or knowing that we're eating foods that are, quote, unquote, bad for us and worrying about the long term consequences that come from this out of controlness and eating the bad foods, worrying about our medications and medication side effects, worrying about worrying about the next doctor's appointment, worrying about the fate that, you know, our fate is going to be the same as the fate of family members that we've seen who are sick with their type 2 diabetes or who suffered from type 2 diabetes. All of this, this combined intensity of urges and cravings and desires, aggravated by worry and fear and anxiety, compounded by the habitual nature that comes with eating these foods, is at the heart of why it's so hard to change these behaviors. And this, again, it keeps us sick. So today I want to break down what urges are, what cravings are, what desires are, how our emotions of worry and anxiety and fear make it worse, and then how the habit forms, and then I want to talk about strategies for breaking this behavior.
[00:02:44] Before we get started, I want to give you the.
[00:02:47] The warning that I always Give with diabetics for if you're medicated. So if you have been medicated for your type 2 diabetes, you have been medicated because of the way you've eaten in the past. If you change the way you eat, if you learn to manage these fear or these, this habit loop, this, these desires, these cravings, if you learn how to manage that in a different way, you're also going to need different medication regimens. If you don't change the medication regimens as you change the way you eat, you can end up very sick. The kind of sick that looks like ER visits, hospitalizations and even death.
[00:03:27] So in order to avoid that, you're not doing, you're not making these healthy changes in order to have more health problems. So in order to keep that from happening, you really need to get on the phone with your primary care or whatever provider has prescribed these medications to you and ask them. I, you know, let them know I'm making some dietary changes. How can I share my blood sugar readings with you? And they're going to tell you, I want you to email it to me, I want you to fax it to me. I want you to call my nurse every day, whatever they're going to tell you and then you're going to ask them, okay? And how should I expect to hear back from you? What medications you want me to change?
[00:04:01] And then they're going to tell you, I'm going to put it in your portal. I'm going to have my nurse call you, whatever it is, get very clear on how that line of communication is going to happen in order for you to stay safe. Okay? I want to encourage you to do that. If you're not sure what you need to be eating to make these changes, like to see these better blood sugars. That's okay. I have help for you. I have a 14 days to better blood sugars guide on my website. You can go to delanemd.com forward/better B E T T E R to find that 14 day guide. That 14 day guide is clear cut menus like breakfast, lunch, dinner menus. And there are, you know, guidance on how to make changes to that menu, how to make additions if you need to. There is very clear cut help in that guide to show you what to eat. So if you've ever wondered, like I'm not sure if it's my food. I really think, Delaine, that it is my jeans. If that's what you think, that's cool, that's fine. It's not your jeans. Most of the time, it's not your jeans, it is simply the food that you're eating. Follow this guide for 14 days and you're going to get a clear answer like, I followed this and there were no changes. That happens. We're going to talk, right? I have an option for that too. But most people find when they follow this guide it changes their blood sugars. They see their blood sugars drop and they see it drop in that 14 day period and then they know, oh my gosh, living healthy and off medications is absolutely possible for me. If you're medicated, make sure you make that phone call before you start this guide. But use this guide. Use this guide to show yourself. Like, yeah, absolutely. If I change my foods, I can see huge differences in my blood sugars. That's what this guide is for. Now if you've used the guide and you haven't seen changes, please set up a better blood sugars assessment call. You can do
[email protected] delanemdcall or you can always email me
[email protected] but to get to my calendar calendar, you go through the calendar Lee link and that C A L E n d l y.com delanemd forward/call C A L L During these Better Blood Sugars assessment calls, again, if you haven't seen changes, I want to talk to you. I want to figure out why that is. If you have seen changes but can't figure out how you're going to apply that long term, set up this call. That's what this time is for. It's a 45 minute Zoom call. You and I hop on that zoom link and we talk about what has, what is the struggle that you've had in those 14 days. Why do you think it's hard to apply that long term? What have you done? What changes have you seen? What have you done in the past when you saw changes, how can we incorporate that into going forward? A plan for you? That's what this what Better Blood Sugars Assessment call is for. Set that up. It's free. There's no charge. There is help for you. If you are sick of being medicated and diabetic, there is help for you. The 14 days of better Blood Sugar Guide and then the Better Blood Sugars Assessment Call. Two pieces of help that are both entirely free. Set that up. Take the help that's there for you.
[00:07:18] So let's talk about desires and urges and cravings.
[00:07:23] We use these terms interchangeably, but they're really there's subtle Differences. I feel like they're on a spectrum and they grow into each other unless we learn to stop that intensification. So desires tend to be a broader, long term feeling of want. We have certain desires. I desire chocolate over potato chips almost always. Like though, we have these broader kind of categories. I desire sweet over salty. Right. I desire, you know, these are my things that I like in the future. That's a desire. But then we have cravings, and those cravings tend to be more intense and more specific than that broader desire. Right. So that's where my chocolate over sweets, right. I'm never interested in a hot tamale. I'm always interested in chocolate, though. Always, always, always. Like, that's a very specific chocolate. That's my thing. And they tend to be a little more intense than that broadness of the desire.
[00:08:27] They tend to be pretty focused on a given substance or thing.
[00:08:32] But urges are even more intense. They tend to be pressing, they tend to be motivating. They tend to be very focused and very pressured into a action. They tend to be impulsive in nature, creating an action. Urgent urges are kind of the intense, almost automatic experience.
[00:08:56] So dopamine affects some of these. Right. Dopamine is a neurochemical agent that's released in our brain in response to certain activities, and it creates motivation to push you down this kind of desire, cravings, urges, pathway. Okay? The more dopamine that's released from a behavior, the more intensely motivated you will be to repeat that behavior to get to that urge. The more urge you will really appreciate with it. Urges are associated with action and behaviors, and dopamine is meant to drive behaviors.
[00:09:43] So the more dopamine that's released from a behavior, the more motivated you're going to be to repeat that behavior. Everybody thinks about dopamine as this neurochemical transmitter of feel goodedness. And it is. There is a feel goodedness that comes with dopamine, but beyond that, far more than that. Dopamine drives motivation to repeat a behavior.
[00:10:07] And the more dopamine you release, the more intense the urge, the drive to repeat that behavior will be.
[00:10:16] When we layer fear, worry and anxiety about our health and the consequences of our diabetes on top of these behaviors, these associated intense feelings really compound. Right? So we have the association of fear, worry and anxiety with the desire, cravings and urges, and those layered together really compound and then distort the intensity of the experience.
[00:10:53] So the dopamine intensifies it, but those feelings of fear, worry, anxiety layered on it distort your experience.
[00:11:04] So when we have. So the feelings of stress, or. I'm sorry, of fear, worry, and anxiety, they're stress feelings. And when we have a stressful experience, our body releases neurochemistry, hormonal chemistry, not just in our brain, but in the rest of our body also in the form of cortisol and epinephrine and norepinephrine, or those are adrenaline and noradrenaline. Our body releases these other chemicals, and then the way that those chemicals impact our brain is to actually distort or change the way the memory is laid down.
[00:11:42] So our memory of the experience, right? So I have a desire for sweets, and then I see a salted caramel brownie. My daughter has one of these in the fridge right now, salted caramel brownie. And I see it, and then I have a craving, and then I sit there and I fixate it, fixate on that salted caramel brownie. And then I have an urge.
[00:12:03] When we have those feelings and then associated feelings of worry and fear and anxiety, we're releasing the adrenaline and the cortisol, or the epinephrine and the cortisol, that then distorts the memory of the last time that we had these feelings of the last time we ate a brownie. Okay? This is why, if you think about traumatic events like a shooting or an assault of some sort, we know that witnesses to those events tend to have unreliable memories. Like, there's evidence out there that those memories are frequently unreliable. And the reason that they're unreliable is because of the effect of these stress hormones as people are laying, as those witnesses are laying down those memories.
[00:12:58] So our memory of a salted caramel brownie and the desire, urges and cravings or desires, cravings and urges that show up when I see those, our memory of what happens when we eat those is unreliable because we have these stress hormones that are released in that time also.
[00:13:19] This is why these feelings are so hard to navigate. And then they become a habit because of the dopamine effect of the salted caramel brownie. For me, right? Like a salted caramel brownie is sugar with sugar with a little bit of more sugar, and then some chocolate flavored and then some high fructose corn syrup. All sugar, sugar, sugar, carbs, right? Like, that's what the salted caramel brownie would be.
[00:13:45] When that happens, when we eat just the quantity of that, you know, one bite of all of that sugar has far more. Like that brownie, One bite of it has far more carb and dopamine effect than one bite of an apple or grapes. It's just the quantity of the dopamine producing macronutrients in that food is just so much more intense, which means your dopamine effect is going to be more intense. Your dopamine production is going to be more intense.
[00:14:22] That dopamine is what drives the habit of repeating that behavior. When you have a feeling of desire or cravings or urges to eat something, and you meet that feeling with dopamine and the memory is distorted by the stress associated with it, what you do is you set yourself up to be heavily motivated to repeat the eating. Every time you feel desire or cravings and urges in the presence of stress, every time you get that combination of those feelings, the intense dopamine response that happened when you ate it becomes the driving force of that habit. And this is what causes that kind of progression of, I know I like chocolate, but then I saw chocolate, and now I'd really like the chocolate, and then, oh, my God, I gotta eat it. That feeling that feels like you just cannot stop. It happens because of the layering of these feelings that you're having and the dopamine that occurs from eating those foods.
[00:15:43] So I always remind folks that I work with, when I work with my clients, I always remind them continuing to eat the food prolongs that habit. It prolongs that effect Every time you have those feelings, the desire, the cravings and the urges, and then you have the story. I know I shouldn't. Right? That right there is adding on that stress component. Every time you have that combination and you meet it with the food, you are reinforcing that. The next time that you have that combination of feelings, you will eat the food again.
[00:16:24] The only way to break it is to break it. Like you have to, like heels in the ground break it. And you don't have to do that forever. I don't expect you to rely on, you know, brute force and coercion of your desires for the rest of your life. But if you want it to get easier and want to stop relying on that, you have to stop reinforcing that neurochemically with dopamine.
[00:16:46] So I have been asking my clients all week as I was prepping for this podcast, what are the things that have been most helpful for you as you are learning to manage cravings?
[00:16:57] All of them talked about the different thoughts that they had about the food that allowed them to have a pause and to start thinking something different about the food. But I do think it's important to have a Plan.
[00:17:11] If we don't have a firm plan developed, our brain will tell us that we were planning on doing something else. I was planning on starting tomorrow. That's a plan that my brain would tell me if I hadn't written down that I'm starting today.
[00:17:25] I planned on eating the salted caramel brownie because I knew it was in the fridge and clearly I wanted it. And I thought about, like, yes, I'll have the chicken and the salad, and that's great and grand. But I also would say, I mean, like, it makes sense. I knew about that brownie. I definitely wanted it. It was probably on the plan. When we don't write plans down and we let them live in our head, they become. They morph, they change, they evolve. They're nebulous, they're like clouds. They move into different shapes and they take different forms.
[00:17:54] So make a plan and write it down. That is the first thing I always encourage my clients to take into consideration their desires, their cravings, and their urges when they have to execute the plan. Because they're far more successful if they can mitigate that desire, those cravings, those urges, if they can manage them ahead of time. I know I'm going to want the brownie, so I'm going to make sure that I have some fruit available to me or something that I'm going to see as a treat. I'm going to plan for that. Maybe it's not a food treat. Maybe it's. I'm going to go, I'm going to eat my lunch, and then I'm going to go for a walk. I'm going to eat my lunch and I'm going to call somebody. I'm going to eat my lunch. I'm going to read my favorite book, whatever it is you're going to. That thing that you know you're going to have these cravings, these urges to do something special, quote, unquote, and you're going to do something different that's also special because of the associated intense feelings. And then that dopamine response that comes when we eat these foods.
[00:18:56] This can be really difficult to execute the plan. So you need to be aware of that. Like, it's going to be hard the first few times, and that's okay.
[00:19:08] Recognizing as long as you continue to repeat the dopaminergic, like, behavior, that the behavior that creates all the dopamine and that behavior that creates all the dopamine is the eating of the highly processed foods. That's what creates the dopamine. If we continue to have that behavior. We are going to continue to struggle to break that habit. Okay? So that is where the plan comes into play. We plan it out and then we expect that it's going to be difficult in the moment. Your brain, because again, of the effect of dopamine, your brain is going to negotiate with very compelling arguments to remove this habit, this block that we've put up. Okay? They are going to want. Your brain, these negotiations, these compelling arguments want you to complete the urge, the action of the urge, which is to eat the food. Okay? You're gonna have to expect that. And it's not gonna go away immediately. That's just gonna be there. It's kind of like when we have a child that's pitching a fit and we're like, I ain't gonna tell you yes after pitching this fit. I'm just gonna encourage the fit to be pitched. Nope, it's still a no. And now I'm really hell bent on the no.
[00:20:23] The other part of this is to learn to process the emotions. Emotions like the tide, the ocean tide, ebbs and flows. It's going to come in and it's going to go out and then it's going to come back in, and then it's going to go out and then it's going to come back in and then it's going to go out. And over time, it does that less until it comes back again and then it goes away. You will have spells where it is easier and that your brain isn't consumed with this. And that's okay. But part of learning to process an emotion is learning to sit with it. I like to sit with it and describe the emotion. Where in my body is it? What kind of characterist can I give it? A color, a temperature, a texture? Is it a rapidly vibrating emotion or is it a slow vibrating emotion? Would I call it dull? Would I call it sharp? Describe it. Figure out what that feeling is and get used to sitting with it. How long can I sit with this description of a feeling and not act on it? That is your superpower that you're trying to hone. So the thought model is, again, this is one of the biggest things that my clients repeatedly mentioned was different thoughts that they had about their food. So you have five components of the thought model. You have a circumstance, you have a thought, you have a feeling, an action, and a result. Your results almost always support your thoughts or are somehow related to your thoughts. But a circumstance is like a circumstance. Right now, is there is a salted caramel brownie in My refrigerator, my thought is my thought, which leads to feelings, which leads to actions, which leads to results. If my thought was, I'm never going to be able to not eat that because it's my favorite and it's all I want and my feeling was cravings or desire or urge, my action.
[00:22:18] If I continue to tell myself that I can't not eat it, that I can't just let it sit there, your action will eventually support that, giving you the result that you didn't let it sit there and that you went and ate it. My thought about that food is it's full of flour, inflammatory flour, inflammatory sugar, inflammatory, high fructose corn syrup, among a hundred other things that are not good for my body.
[00:22:44] That is my thought about that food. That took time.
[00:22:49] It had to learn to replace the, oh, my God, I love that thing. I'm never going to be able to forget about it until I eat it. That used to be my thought, but hands down now, when I see flour and sugar, that's what I think, because I can feel it achy in my bones when I eat it, because I've gone enough times without eating it.
[00:23:06] When I have that thought, my feeling about that brownie is very neutral. It's just the same as the dog food in my garage. Like, I'm just like, yeah, that's there. It's just not food for me.
[00:23:17] My action is to go about my day, and my result is that food is not eaten because it makes me feel badly. That is the reality. My clients will use thoughts like that food is diabetic food. That's food that diabetics eat, that keep them diabetic.
[00:23:36] That food is food that made me sick. That food is food that creates too much insulin. That food is food that drives more desire and cravings later on. And I don't want to do that. All of these are different thoughts that my clients have. Recognize that your cravings, your desires and your urges do not come from the food. They come from your thoughts. If I made those brownies with xlax, like the chocolate xlax, you would not think they're that great. If my mother put walnuts on brownies, which my mother loves to do on brownies. I don't like walnuts on brownies, so that's suddenly not appealing for me. One of the jokes in my group was that we, you know, what if those brownies are so what if that food, whatever the food is, what if it was soaked in cat urine and you just didn't know? Suddenly that becomes unappealing.
[00:24:29] So your desire for the food comes from the things that you think about the food. These are cognitive changes, right? Some women will think, I want to take care of myself and my future me. I want to be healthy in the future.
[00:24:44] Some women clearly know that the pleasure that was once derived from that food is now offset. Like there's less pleasure because I know how uncomfortably physically and mentally I am when I eat that These are thought changes. These require you considering both sides of the story. The food tastes good and the food makes me sick.
[00:25:05] Lots of times women are like, well, when I make this plan and I plan to eat these things and not that food, then I have all this spare time because I'm not eating that junk food, but I'm thinking about it all the time. Time. What do I do in that space?
[00:25:18] That slowing down in that space allows you to question the story you're telling yourself about the food. It allows you to decide what else is true about that food. So you can stop believing only the story that it's good. Because if it was just good, there wouldn't be a question, right? All that stress that develops from the back and forth and the negotiation, I shouldn't eat it, but here I am. But what about the doctor? What about the meds? What about this when if it was just good, if it was just a hug from somebody you love, that's just good. There's no reason to talk yourself out of that.
[00:25:53] But the food is not just good. The story that you're hearing about the food is only good. And that's why you talk yourself into eating it. And that's what you need to do in that space where you have some time. Give yourself the opportunity to see both sides of the story and to change it. My friend, what to expect with this is you're going to always want the food.
[00:26:14] And the reason that you always want the food is because it's really an unnatural neurochemical experience that human beings have when they eat these foods. There is no way that we naturally will not want these foods because these foods are not natural to our bodies.
[00:26:30] So you're always going to want the foods. And if that's the case, how do you want to create health? And that comes from reprogramming the things that you're choosing to believe about the food. Your cravings, your urges and desires come from your thoughts. You have agency and control over those thoughts. Learning to exhibit that control is imperative to learning to live without type 2 diabetes.
[00:26:55] That's all I have for you today. I hope it was helpful as always. If you have any questions, don't hesitate to to email
[email protected] Lastly, I have an ask if you're finding this podcast helpful, please rate and review the podcast on your podcast player. Nine out of ten Americans are insulin resistant and on their way to type 2 diabetes. I need to get the word out there that you don't have to be sick and diabetic for the rest of your life. The more of you that rate and review this podcast, the more it helps me do that. So if you could do that, I'd greatly appreciate it. Last thing, keep listening, keep avoiding those foods that are making you sick, and keep making the choices for your health, your longevity, and your vitality. We'll talk soon. Bye.
