December 12, 2011

Is it time to rehab your diet?

Enhance your recovery with sensible nutrition 

By Michael Berg
Anyone who has been through it knows rehab can be challenging mentally, physically and emotionally. And because the focus is on overcoming a powerful addiction to drugs or alcohol, probably the last thing folks in treatment can fathom is fine-tuning their eating habits.
Although sensible nutrition might not top your list of concerns, what you eat (and what you don’t) can make a palpable difference in your recovery process. “When you’re an active drug user or consuming copious amounts of alcohol, those substances break down the organs of your body,” says registered dietician Sherry Fixelle, a nutritional consultant with Promises Treatment Centers in Malibu and West Los Angeles, Calif. “The other aspect is, when you’re actively abusing, you tend not to eat particularly well. You’re likely malnourished from a poor diet and poor healthcare, and your body is going to be ravaged.”
There are also mental issues that result from chemical damage and a lack of critical nutrients. “Your brain is an organ, and it’s going to be compromised,” Fixelle says. “You may have depression, anxiety and moodiness, in part because of improper neurotransmitter formation.”
Recovery and Poor Nutrition
Although programs vary, some sort of nutritional component is a common part of the rehab experience. Michell B., 37, Bisbee, Ariz., who is three years clean after a cocaine, marijuana, PCP and alcohol addiction, graduated from a rehab center with a nutritional policy stricter than most, limiting unhealthy options and banning white refined sugar from the premises. “I was in for eight months, so I was into the swing of things nutritionally when I left rehab,” she says. “But sometimes when I first got out, I wanted what I wanted when I wanted it—and I got it. When you’re in a place and they tell you that you can’t have something, you kind of want it more.”
Jimmy D. of Phoenix, who is 11 years sober after his four-month stint in rehab, experienced a less restrictive environment. “The rehab center I was in did try to stress the importance of eating well,” he says. “Having said that, they also had cupboards full of Twinkies and Ding Dongs. More often than not, when first coming down from their drug of choice, addicts will crave sugar. The center fed us well but did not restrict or discourage anyone from eating the goodies.”
Although Jimmy admits his bad eating habits were set long before treatment, research has uncovered some links between the two. A study out of Cornell University, published in 2008 in the journal Appetite, shows nutrition can be a struggle throughout the course of rehabilitation. In-depth interviews with 25 men at different stages of recovery revealed struggles with excess weight gain, disordered eating and choosing healthy food options, though the severity differed depending on whether the subjects were in the early, mid- or later recovery stage.
“Men in early recovery described dysfunctional eating practices such as mood and binge eating, the use of food as a substitute for drug use and the use of food to satisfy cravings,” the researchers wrote. “Men in mid- to later recovery expressed weight concerns and distress about efforts to lose weight.” 
With the chips thus stacked against you, is it advisable to try and tackle poor eating habits on top of the ongoing challenge of maintaining sobriety? The Cornell research points to an answer in the affirmative, a conclusion with which Fixelle agrees.
Now’s the Time
“[Recovery] is a good time [to start eating sensibly] because you really want to give your body the raw materials to rebuild and replenish itself,” Fixelle says. She recommends a baby steps approach to healthy eating. “I know it’s so difficult for people who have spent years not taking care of themselves to suddenly have one more thing that they have to do. In a treatment center such as Promises, our goal in inpatient treatment is to start the education process as far as the importance of eating breakfast every day, including a balance of protein, carbohydrates and fats in all of your meals and not going too long between meals. We don’t push a rigid new diet with so-called ‘good’ and ‘bad’ foods but just the idea of getting acclimated to healthy eating and taking care of yourself.”
The concept of not pushing a strict diet might surprise some—after all, many recovering addicts need to reverse years of nutritional deficiencies—but Fixelle’s philosophy revolves around a more attainable approach at a vulnerable moment in the recuperative process. “[Those in recovery] are going through a tremendous metamorphosis,” she says. “There’s an emotional component to all of this, and having to follow some kind of rigid dietary regimen is asking a little bit much.”
Instead, a subtler approach is recommended. If, for instance, you can’t imagine getting up in the morning and cooking eggs or cracking open a yogurt, but you’d love pancakes with a side of sausage, well, go for it. “Yes, that meal may be high in fat and may not be the perfect choice, but if it means you’re not skipping breakfast altogether, that’s healthier than eating nothing. If the best I can get a client to do is go to Starbucks and start the day with a muffin and latte, that’s better than a steady stream of black coffee and cigarettes.”
Fixelle also emphasizes a focus on eating good foods throughout the day, versus skipping meals. “Your pancreas can be compromised from the drug and alcohol abuse so that your blood sugar levels can drastically fluctuate if you go long periods of time without eating.”
The Next Step
For those itching to embrace a more rigorous diet and workout program, the good news is you can. “It depends on the individual, but many are ready for the next step in improving their health,” Fixelle says. “You do see a lot of eating disorder behaviors in people who are coming off of substance abuse such as compulsive overeating, bulimia or anorexia.
But if he or she doesn’t have an eating disorder and is serious about it, then yes, it’s okay to start a [more progressive] program of diet and exercise.”
As Michell points out, embracing healthy food choices is just another part of her overall recovery. “Some of the residents I was in rehab with were like, ‘Screw this, I’m just trying to stop drinking and doing drugs. I want to eat what I want to eat.’ I can understand that reaction, but all of it does go hand in hand. I’ve caused damage to my body. The next step is to put nutrients into it to help it grow stronger and refurbish itself.
“If you’re really into your recovery, a lot of your perspective changes,” she adds. “I don’t eat right because it’s the right thing to do. I like to eat right because I want to see my kids grow old. I’m willing to go to any lengths to stay clean and eat healthy.” 
Six Sensible Tips
Follow these six nutritional guidelines post-rehab, courtesy of Sherry Fixelle, R.D., consultant to Promises Treatment Centers in Malibu and West Los Angeles, Calif., and you’ll be well on your way to a healthier lifestyle.
  • Don’t go long periods of time without eating. Eat breakfast when you get up, and then be sure to eat a meal or snack every 2 to 4 hours thereafter until bedtime.
  • Your meals and snacks should be a balanced mix of protein, carbohydrates and fat. Although it’s not recommended you keep strict track of the percentages, as a rule of thumb, a meal should consist of 50 percent carbohydrates (such as fruit, green vegetables, baked potatoes, yams, pasta and whole grain bread); 25 percent protein (such as chicken, turkey, beef, fish and dairy); and no more than 25 percent fat.
  • Engage in physical activity at least four days per week (if not more), 45 to 60 minutes a session. Choose something that you enjoy, whether it’s weight training, aerobic activity or a sport. 
  • Watch your caffeine intake, as it negatively impacts your appetite.
  • Stay hydrated by drinking non-caffeinated fluids throughout the day.
  • Take a good multivitamin and an omega-3 fatty acid supplement daily.
Michael Berg is certified by the National Strength and Conditioning Association as a personal trainer. He has contributed to Men’s Fitness, Muscle & Fitness and Better Nutrition and is a regular contributor to


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