Dietary Methadone

Sweet'n Low. Truvia. Low-fat cupcakes. We want this stuff. We want it bad. Even if it's just a poor imitation. Those of us who spent years mainlining sugar and fat are looking for a magical way to keep those goodies without the killer calories. So we drink diet soda, nutrasweetened iced tea, non-fat cookies. Seems like a good idea in practice – get our fix, don’t get the calories. But for so many of us who struggle with weight, it isn’t that simple.

Sweet'n Low. Truvia. Low-fat cupcakes. We want this stuff. We want it bad. Even if it's just a poor imitation. Those of us who spent years mainlining sugar and fat are looking for a magical way to keep those goodies without the killer calories. So we drink diet soda, nutrasweetened iced tea, non-fat cookies. Seems like a good idea in practice – get our fix, don’t get the calories. But for so many of us who struggle with weight, it isn’t that simple. 

These artificial sweeteners are like methadone. Methadone is actually a pain-killer that is often used to help ease people ease through opioid withdrawal, a sort of “heroin-lite.” So these “fake” sweeteners are like sugar methadone – a way to ease us off of sugar. The problem is that methadone is still an abusable substance and while not as addictive or dangerous as heroin, it can lead to its own abuse/dependence pattern. 


At the end of the day, it is not just about substituting one sweet thing with another, but figuring out what the sweets are doing for us. The fact is, we aren’t addressing the cravings if we just find a calorically trimmed down version of them. We aren’t addressing the psychological ends being filled by the sugary means. Sadly, because they sometimes have “fewer” calories we often consume more than we intended and may consume these chemical-laden foods than other, healthier foods. A good weight management program should consist of more than just trimmed down versions of your favorites; it should have real foods – such as fruits and vegetables. When calories count, consuming empty ones doesn’t make good sense.

By reaching for this form of “dietary methadone” we often don’t get to the root cause of why we are eating the way we are eating, and then when the stress is on, it is easy to go down the slippery slope of continuing to use sweet foods (real sugar or not) as a way of filling the void, managing the anger, quieting the anxiety. Lydia Bartoshuk’s research argues that our brains and bodies actually get a bit confused by these artificial sweeteners. Though they ostensibly contain no calories, the taste of sweet can set off a classically conditioned response that gets our bodies responding as though “sugar is coming.“

I am not the sugar police – I love sugar and I’m a diet soda fiend – but I know that I reach for those artificially sweetened foods for the same reasons I reached for real donuts back in the day. Methadone is meant to be a transition, not a permanent fix. Treat artificial sweeteners the same way. And when you do want something sweet – indulge in the real thing in a reasonable quantity. 

Just like life - better a few minutes in paradise than a full day of mediocrity. 

Your Parent Has Dementia: What to Talk to Their Doctor About

Make sure all their doctors are aware of all the medications she is taking.

Q: My mom is 94 and has dementia. She is taking a whole medicine cabinet-full of medications and I think they actually make her fuzzier. How should I talk to her various doctors about what she is taking and if she can get off some of the meds? — Gary R., Denver, Colorado

A: Many dementia patients are taking what docs call a "polypharmacy" — three or more medications that affect their central nervous system. And we really don't know how that mixture truly affects each individual person.

A new study in JAMA Network that looked at more than 1 million Medicare patients found almost 14% of them were taking a potentially harmful mix of antidepressants, antipsychotics, antiepileptics, benzodiazepines such as Valium and Ativan, nonbenzodiazepine benzodiazepine receptor agonist hypnotics such as Ambien or Sonata, and opioids. And almost a third of those folks were taking five or more such medications. The most common medication combination included an antidepressant, an antiepileptic, and an antipsychotic. Gabapentin was the most common medication — often for off-label uses, such as to ease chronic pain or treat psychiatric disorders, according to the researchers from the University of Michigan.

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