Nobody sits, you know, and just eats tobacco leaves, right?

So like, you know, cigarettes are addictive not because they come from plants.

It's because the addictive ingredient, nicotine has been concentrated, extracted, concentrated, and then all of these additives have been like, like sugars and flavorings have been added to make them even more palatable.

And then they've been made abundantly available everywhere.

Welcome to the Metabolic Mind Podcast.

I'm your host, Dr. Bret.

Metabolic mind is a non profit initiative of Bouzouki Group where we're providing information about the intersection of metabolic health and mental health and metabolic therapies, such as nutritional ketosis as therapies for mental illness.

Thank you for joining us.

Although our podcast is for informational purposes only and we aren't giving medical advice, we hope you will learn from our content and it will help facilitate discussions with your healthcare providers to see if you could benefit from exploring the connection between metabolic and mental health.

If you've ever felt out of control around food, like you just can't stop no matter how hard you try, you're not alone.

Today on Metabolic Mind, we're talking about food addiction, what it is, what it isn't, and how real healing is possible.

Whether you've battled cravings, shame, or even the cycle of starting over again, this episode's for you.

Joining Dr. Georgia Ede and myself is Dr. Jen Unwin, a psychologist with over 30 years of experience in the NHS who's become one of the pioneering and leading voices on the clinical syndrome of ultra processed food addiction.

She's written a book, she's hosted conferences, and she's helping people understand what food addiction is, what's happening in our bodies, and most importantly, the hope for recovery beyond food addiction.

So I hope you enjoy this interview with Dr. Georgia Ead and with Dr. Jen Unwin.

Many of the interventions we discuss can have potentially dangerous effects if done without proper supervision.

Consult your healthcare provider before changing your lifestyle or medications.

In addition, it's important to note that.

People may respond differently to ketosis and there isn't one recognized universal response.

Well, Jen, thank you so much for joining me in Georgia today.

It's great to have you on Metabolic Mind.

Oh, it's a pleasure.

Thanks so much for having me.

Of course.

Yeah, I'm really excited to hear all about, you know, sort of your experience and, and your great knowledge about food addiction and how it impacts, you know, people's health and more importantly, the what we can do about it as well.

And I know, Georgia, you've had a lot of experience working with this as well.

So I think we're going to have a very fruitful discussion here.

But first, Jen, tell us why you got interested in food addiction.

How it got on your radar screen and how it became such a passion for you.

Several strands really, as always with these things.

So I now understand, of course, that I am and have been a food sugar addict all my life.

Really as long as I can remember.

As a small girl, I was very, very interested in sweets and when I could get some sweets.

And that just carried on into an experience of kind of weight gain and then all kinds of weight loss attempts.

You know, I'm sure lots of people listening are sort of identifying with that themselves.

And as part of that journey, you know, Maybe it's about 15 years ago now, I did discover a sort of low carbohydrate ketogenic diet kind of, you know, it was just the, the next thing to try.

And that, that made a massive difference to me for reasons that we're probably going to talk about.

And then I heard Bitten Janssen, who we can also maybe talk about some more if there's time, on a diet doctor video online talking about sugar addiction.

And I suddenly thought that's what it is.

That's what explains my behavior.

I suddenly understood it in, in a much deeper way when I thought of the concept of an, of addiction.

And it also explained a lot of the patients behaviors.

And what was kind of doubly embarrassing is of course I'm a psychologist by training and I've worked with addiction.

I, you know, I, I understand addiction as a concept.

I just fall all kinds of reasons.

That denial and the fact that it isn't a recognized condition.

I've never sort of applied that concept to my own experience or to the experience of patients.

But since I've started doing that, it's made a world of difference.

And that's why I'm now so passionate about spreading that concept and that knowledge and that, you know, what are the effective treatments for that.

Yeah, that's such an interesting point that here you are as a psychologist and you've worked in addiction, but at first you didn't make the connection between addiction and food addiction because it hasn't been talked about, because it's not a recognized diagnosis.

So Georgia, actually let me bring you in here.

So how do we differentiate then food addiction from just sort of, you know, disordered eating, emotional eating?

And why isn't it, you know, a diagnosis?

So why don't you start and then we'll go over to Jen to Hear her perspective as well.

Right.

So there is no such thing currently as an official diagnosis of food addiction or sugar addiction or refined carbohydrate addiction or ultra processed food addiction.

There according current, to the current DSM 5 and to the current International Classification of Diseases and the World Health Organization, these beasts do not exist.

And yet we see them every day right in front of our very eyes.

And we, even many of them, we struggle with personally ourselves in our own lives.

Dr. Jen Unwin and I are very good friends.

We have had many conversations about this.

We both identify as having these issues going all the way back to our childhood.

We both see them in our clinical work every day.

And as Jen likes to say, you know, if it walks like a duck and quacks like a chicken, it's a duck.

And so people with these people, people self identify, people know, people know when they have these conditions, they will come in and say, I'm a carboholic, I'm a sugar addict, I'm a food addict.

They will tell me before I even start, you know, doing an official evaluation of whatever it is they've come in to see me with.

Many people already know that they struggle with these things.

But one of the reasons why Jen's work is so important is that most people blame themselves.

Most people think that these issues are within their control, that it's just a lack of willpower, that this is somehow a failing on their part.

They just need to work harder at it.

They just need to be stronger.

And you know, and, and, and this is, this is not.

They're never given a biological explanation of what's going on.

And therefore they're never given the tools that they need in order to be successful in, in dealing with the problem.

So if we can't point to, if we can't identify the problem specifically we want to get to what is the addictive substance or substances that people are, are becoming addicted to.

Then how do you know what abstinence, what abstinence looks like?

How do you know what it is you're supposed to cut down on?

How, what.

So you're not going to have a fighting chance unless you have some real biological information to share with people.

Yeah, and that's a really important point that, that we'll definitely get into, like what is the addictive substance?

But, but before we get into that, so, so a lot of people will say, yeah, you know, when I'm really emotional, I'll overeat or, you know, I just, I'll have moments where I sort of Binge and eat, eat more than I want.

And in those moments I feel like I can't control myself.

But that isn't quite food addiction.

So Jen, how, how do you differentiate food addiction from those types of behaviors?

Yeah, absolutely.

And of, of course, all human behavior is on a continuum.

So there are people who, who struggle from time to time or, you know, have, have certain kind of difficulties.

But what we're really talking about in terms of a sort of clinical entity of ultra processed food addiction is a set of symptoms that just completely aligns with what we understand to be substance use disorder in, as George was saying, the ICD and the dsm.

So for example, if we take the six criteria that the World Health Organization use in the ICD to diagnose substance use disorder, and we think about, you know, do those things apply to, to food related behaviors, the sort of things that Georgia and I have experienced.

So number one symptom is compulsions to eat certain foods that are so strong, you know, cravings and compulsions are so strong you can't resist them, which is what people often describe.

The second one is tolerance, which is, you know, needing more and more of the substance to get the same effect.

And people describe that with food, you know, just having to eat more and more sugary or refined carbohydrate or ultra processed foods to, to sort of, you know, get, get that effect that they're looking for.

The third symptom is a sort of neglect of other things in life over time and again.

You know, we all completely understand that, say with alcohol and drugs that people start to neglect, maybe work or family or hobbies.

But I mean, you do see that in people's behavior with food as well, that the getting of the food, the eating of the food and the sort of recovering from it starts to occupy people's minds and behaviors for a lot of the day.

The fourth one is a loss of control of the amount of the substance.

And I mean, really, this is one that so many people will recognize with ultra processed food that, you know, you kind of say to yourself, well, you know, the family's having pizza, I'm just gonna have one slice, cause I'm trying to be healthy.

And then, you know, one slice leads to 10 and leads to a bucket of ice cream.

And then the fifth symptom is withdrawal.

So if you try and cut it out, you get either sort of physiological or psychological symptoms, you know, like gastrointestinal symptoms, maybe headaches, maybe shakiness, but also, you know, maybe anxious feelings, maybe poor sleep, you know these typical sort of things that people describe.

And then the sixth symptom is continued use despite knowledge of harm.

So, I mean, that's so, so typical in our patients with type 2 diabetes and that they know full well that it's not a great idea to eat refined carbohydrates and sugary foods, and yet they feel powerless to stop that.

They know it's doing them harm, but they carry on.

So there's those six symptoms.

And to sort of meet the criteria of, you know, a probable diagnosis of a substance use disorder, you'd need three out of six.

Yeah.

So as you're listing these off, I'm sure people listening are so many are going check, check, check, check, check.

Especially the one that you.

Where you mentioned inability to control it.

And I imagine that's what's so frustrating for people and sort of this feeling of almost helplessness around it.

So is that something you see often helpless?

Oh, yeah, absolutely.

It's kind of a hallmark of the thing where people are ashamed.

They hide it, you know, they, they.

They hide it from the.

Their families.

They'll hide the.

Have secret stash of the food, you know, so embarrassed.

They're kind of trying to hide it in the, in the bin so nobody sees the wrappers, you know, feel like, you say, hopeless and helpless about anything ever being different.

Because usually, like me, they, they tried, you know, kind of every, every scheme that comes along, you know, that, that every new, every new regime that pops up.

And so we'll definitely get into some of the strategies to help with this.

But first I want to go back, Georgia, to what you said.

Until we have an understanding of sort of what the addictive substance is or how to, you know, better define it to what, then it's going to face challenges of becoming a diagnosis.

So I started this conversation by saying food addiction.

Jen, you said ultra processed food addiction.

Georgia, you've thrown in sugar addiction, refined carb addiction.

So what is it?

How do we decide what this is?

This is the great debate of our times.

Are you trying to understand?

I mean, I think this is part of what interferes with the ability to get this.

These problems recognized as official mental health disorders is that there is no consensus around what the addictive substance or substances are.

And so there have been debates at multiple conferences and workshops around this.

And there's an argument to be made that many different elements of the ultra processing process, the process of processing food additives and flavors and textures and ultra refining and concentrating and so forth, and even the packaging and coloring can make foods ultra palatable and virtually impossible for many people to resist.

So it makes it difficult to pinpoint one particular, one particular ingredient.

I personally think that the easiest, the easiest ingredient to hang our hats on are the, are the refined carbohydrates, because they are the ingredients that produce that dopamine signature, that, that sharp spike in glucose that gives you that sharp, unnaturally high glucose spike, unnaturally steep and, and then the unnaturally steep spike in dopamine that you can get from any other kind of addictive substance when it's concentrated.

The problem that a lot of critics point out about pointing to sugar, for example, or flour as an addictive substance is, well, it comes from food and we need food and of course the brain is going to look for these things.

But just like any other addictive substance, if you eat it in nature, if you're eating a banana or if you're eating a potato and you never get exposed to ultra concentrated, ultra refined sources of refined carbohydrate that have, that have had their fiber stripped away, their water removed, et cetera, then, then you may never become addicted to those things.

But once you, once you are exposed to the ultra, the, the concentrated high amounts of these ingredients and an unnaturally unnatural amount, it's really the dose and the delivery and the quick absorption rate that make them addictive.

And there's a wonderful presentation by Dr. Ashley Gerhardt, who's one of the scientists in this field, who says, you know, nobody sits, you know, and just eats tobacco leaves, right?

So, like, you know, cigarettes are addictive not because they, they come from plants and, you know, it's because the addictive ingredient, nicotine, has been concentrated, extracted, concentrated.

And then all of these additives have been like, like sugars and flavorings have been added to make them even more palatable and, and then they've been made abundantly available everywhere and then you smoke them and that gives you that ultra rapid delivery of nicotine into your bloodstream.

So I think, you know, sugar really blurs that line between food and drug just enough that it makes it very difficult to get everybody on the same page about whether or not it's addictive.

What do you think, Jen?

Do you agree or do you have any areas to push back on that or change?

Yeah, yeah, no, I mostly agree with all of that.

We did.

So we made a submission to the WHO to have essentially food addiction recognised as an addictive disorder in 2022.

And we got a response back.

Obviously we weren't successful.

We weren't particularly surprised about that.

But it was interesting to see what the response was from the WHO so we could sort of address those issues.

And one of the things that they said was there's no consensus, which is absolutely right and remains contentious.

But we did a consensus exercise that we've just published in Frontiers in psychiatry involving 40 experts from 10 different countries who were clinicians, researchers, academics who are working in this field.

Georgia was one of them, I think.

Yes, I think so.

She's nodding yes.

And the consensus that 37 could agree.

And in fact, I know for a fact that one of the others has kind of since changed their mind, but we've published it, so it was too late.

So 38, essentially of those experts could agree around the term ultra process.

Food.

Use disorder, if you like, so old processed food addiction, because, as Georgia says, that kind of points the finger where the finger needs pointing, which is these very refined foods that are high in, you know, refined carbohydrates and sugars and, you know, these sort of colorful foods in colorful packages that just hijack the reward center, basically.

Now, I mean, obviously we have quite a bit of evidence for sugar.

Sugar as a.

As a.

As a culprit for lighting up the brain in the same way as other addictive substances, giving us that big sort of hit of dopamine, which is sort of unnatural to the way that we have evolved.

So I totally agree with what Georgia said, is that we're trying now to encourage people to use that term and to publish papers using the term ultra processed food addiction, because if we don't all get behind one term, I think it allows the naysayers to say, well, they can't even agree, blah, blah, blah, all the sort of smoke and mirrors that happened exactly with cigarettes in the past.

So that.

So that, you know, people didn't.

Weren't able to sort of recognize the harmful nature of that refined substance.

And so that, you know, there was appropriate sort of public health action.

And it makes a lot of sense to have to agree on the definition and agree on the substance, because people need to know, what do I avoid?

Right.

Do I need to avoid homemade lemonade, right.

Which is not ultra processed but has sugar in it, or even a homemade cookie which is not ultra processed but has sugar in it.

So do you think it.

For now, we're kind of getting into the treatment a little bit.

Does it.

Does it have to be like, avoid all sugar, Avoid anything with sugar in it?

Or can it be.

Avoid the ultra processed formulated products that have sugar in it?

Again, you know, obviously there's a spread of experience.

And every person will find their sort of unique abstinence, if you like.

But it's nearly always sugars, refined grains, and ultra processed food.

I don't think I've found someone who was a true sort of food addict who was able to get into a solid recovery without avoiding all sugars, refined grains, and ultra processed foods.

That seems to be the sort of the bottom line really.

And I, I mean, I personally would probably chuck sweeteners in there as well, because I see them as sort of ultra processed because they usually sort of, you know, chemical or, you know, even if it's something like stevia.

Well, again, we're back to this issue of, you know, people, people were chewing on stevia leaves.

Yes.

But they weren't, you know, having this refined white powder which has this intense sweetness and that if, as Georgia was saying, if, if, if you, if you weren't a food addict, if you haven't got to that point, then probably you can cope with a bit of stevia and, and, you know, not, not lose control of your behavior.

But for people who've already rewired the brain for food addiction, then oftentimes when they're exposed to sweeteners, then those sort of behaviors of the cravings and the sort of compulsions to eat will kind of rear the head again.

So that would be my sort of basic program.

Yeah.

Georgia, what do you think about artificial sweeteners?

Because they don't raise glucose like you mentioned before about the refined carbs and the, and the sugars, but they can still trigger the brain.

Do you find that they act similarly?

It depends on the person.

And so in clinical experience, there are people who are very triggered by sweeteners, whether they're natural or artificial, because that sort of starts lighting up your reward system.

And other people who find them very useful, certain types of sweeteners anyway, very useful in following their recovery plan.

And, and this is where some personalization comes in and getting to know oneself and, you know, where, where one needs to draw the line for themselves.

So some people find them a really useful tool.

For others, they are a slippery slope.

And then different sweeteners can behave differently for different people too.

So, and this question, just circling back to this really interesting point you made a couple of minutes ago, Brett, about, well, homemade lemonade that, you know, kids are selling on the sidewalk, well, that's not ultra processed.

So how do you know where to draw the line?

And if you call, if you call this an ultra processed food addiction, then isn't homemade Lemonade.

Fine.

And this is, this is exactly the kind of problem that we run into all the time.

And I would just kind of point out that crystalline sugar does not exist in nature.

You can't walk through the forest or a field and find a little pile of sugar.

That's just not how it works.

You have to extract it.

And it takes an awful lot of labor to extract it from, from, from cane, from sugar.

Cane sugar.

So it, it is a processed ingredient that is not found in, in a significant amount in, in nature.

And so this is where it can be useful for people to understand what a whole food actually is.

Because we talk all the time about whole foods principles and whole foods principles are very powerful.

But most people, like, let's say you walk into a Whole foods grocery store.

I don't think you have these in the uk, Jen, but you probably have something similar sort of natural food stores.

Much of what's in a whole foods grocery store is not whole foods.

Not whole foods, but they all.

Because it's natural, it's organic, it doesn't have anything added to it.

But you know, there's tons of products in a whole foods grocery store that contain sugar, flour and vegetable oil and all kinds of, you know, added ingredients.

Whether they're.

Even if they're natural, they're still additives.

And so they're not whole foods.

And this is where children, this.

I hope we talk about children because, Jen, you were talking about the brain getting rewired.

The brain, the addicted brain is rewired.

We would never expose, intentionally or, or in good conscience, never expose a child to nicotine or alcohol or caffeine because the developing brain is very vulnerable to addiction.

But yet we encourage children to eat sweet and sugary foods and starchy foods all day long.

And this is.

Once the brain becomes addicted to a substance, it becomes very, very difficult to change that pattern of behavior.

Yeah.

Jen, are you seeing this more and more often in teens?

Yeah, in kids.

Yeah.

I mean, couldn't, could not agree more.

I think the evidence is that in terms of the prevalence of food addiction, yeah, it's as high now in kids as it is in adults.

And the kids that are coming through now, of course, have had that environment all their lives.

Whereas, you know, people my age, we still were brought up on a mainly whole food, home cooked diet.

But you know that that's not the case with kids.

With kids now.

And yeah, it's a, it's a little bit terrifying.

What's, what's coming down the line, I think for, for Children.

Yeah, it's.

It's incredibly impactful.

And you know, yeah, sugar is the only substance that kids have access to, which is psychoactive as, as Giorgio was saying, you know, we wouldn't ever dream of giving them, you know, even caffeine particularly.

We wouldn't give small kids usually, certainly not nicotine or alcohol.

But yeah, we all kind of go the other way with the sugar because the kids love it so much because it's so rewarding.

It's kind of seen as cute.

Unfortunately for those of us who sort of understand this issue, it's just kind of, it's just painful to watch those people laughing at those videos of.

You only have to Google kids babies first ice cream.

And you see these babies kind of cramming ice cream in their mouths and everyone's laughing.

But yeah, it's not going to be funny really in the long run.

Well, I think a big part of the problem though is a lot of people may be making the decisions or a lot of people who are doctors and they say, well, Beth, I can eat potato chips and stop, or I can eat cookies and stop, and I'm not addicted to it.

And you know, just, just like we can say some people can drink alcohol and not be addicted to it.

Right.

But, but there is that concept that's not really a thing because it's not universal.

And, and how do you, how do you kind of argue against that?

Well, I just say, you know, like alcohol.

Yeah.

So I think it's about 10%, isn't it, of the adult, adult population who have eight substance use disorder with alcohol, you know, have that, that sort of level of a problem.

And, but we don't deny that that exists.

So I would say it's exactly the same.

So it's, you know, it's 14% of the general population who have this problem with, let's say, ultra processed food or, you know, sugar, refined carbohydrates.

I think it really behoves every clinician to understand this condition, to sort of look out for it, to be able to have a sensitive conversation with someone about it and then know, you know, either what sort of basic advice to give or where to refer people on.

And this is why we're campaigning to have it recognized by the who.

And Ashley Gerhardt in the States is campaigning to get it in the dsm because I think until we do that, there will be this, you know.

Well, you know, it kind of.

It doesn't exist.

Well, you know, it really does exist.

It's everywhere and people are struggling More and more.

And they, you know, we're just prescribing more and more drugs for a condition that, you know, can be.

We know because, you know, of the search that we've published can be significantly helped by a.

The right sort of nutritional advice, as George was talking about, but also seeing the problems through this addiction lens so that we add that addiction piece into the treatment, and we educate people about what's going on in their brain, and it's not their fault, even though it's their sort of responsibility to, once they know that, to sort of get the support and make the right choices.

Yeah, I think it's so interesting.

The flip side of that is that many clinicians themselves are also dealing with this problem.

And it's hard to recognize it.

It's hard to acknowledge that this is a problem.

If you.

You really want to continue eating these things yourself, and if you acknowledge to yourself or your patient that these foods are actually.

They're not good for anybody.

They're really not foods to begin with.

Nobody should really be eating them, including the clinicians themselves.

That's a tall order.

This is the way most people are living now.

Most people are eating these foods multiple times per day, enjoying them, and they don't want to give them up.

And so I think there is the vulnerability differences, genetic differences, and then there's also some denial going on and some attachment going on to some of these products that everybody loves.

Yeah, that's really, really good point, the denial part of it.

But so now if someone's listening to this and they really connect with this, like, wow, you are describing my experience, but I just can't quit.

Every time I try to quit.

Right.

Treatment is stop eating them.

Well, it's not that simple.

I can't just stop eating it.

So how do you start someone on their healing journey?

What are sort of the keys to help people get over this?

Well, that's the subject of Jen's research.

She's done some of the best studies in the world.

Yeah, I think support is massively important.

Important.

You know, I think if people can get into a group program, you know, we know that from other addiction problems.

You know, that having that sort of, you know, here's these other people who suffer just like me, and it's okay for me to say, you know, I got something out of the bin and ate it, because they've done that too.

You know, they.

There's no need to feel ashamed.

And you have that lovely support and that accountability.

So I think that's part of it.

I think the other part is this education about the brain that we've sort of touched on the effect that these foods have on the reward system in the brain and how that sort of gets super lit up in those of us who have that vulnerability.

As Georgia says, that can be genetic thing.

I mean, there's also.

We haven't really talked about sort of trauma aspect, but we know that, you know, people who maybe had early or even later trauma actually are more vulnerable to these sort of substance use problems.

So, you know, a lot of education about, about the brain and about why an abstinent food plan and working out that individual, you know, individualizing that and working out the person's individual abstinent food plan is so important and why abstinence is the key.

And then it's about trying to support them to keep going in that.

And that's why groups are so good, because people are so brilliant at supporting each other and sort of keeping each other going.

And then the other thing is this idea of there's no such thing as failure because I think people have failed so many times in their own eyes, they've sort of failed to stick to the plan.

So we talk about the process of getting into recovery as that.

It's a process, you know, yeah, you will slip up, you know, you will make mistakes.

But you know, it's how you respond to those slip ups and how you, you know, can kind of learn from, well, what was it about that situation?

What can I do differently next time?

You know, maybe it was a holiday or particular sort of family situation.

Well, you know, how would I do that differently next time so that I don't fall into that trap again and having that sort of learning mentality rather than sort of pass fail.

Because I mean, addicts are very black and white in the, in their, in their thinking often and like to have these sort of categories of, you know, right or wrong, pass or fail.

But I, you know, I think if we can sort of think of it as a learning process, that recovery is a process that we're in for the rest, rest of our lives and we're kind of learning what works for us as individuals.

And you know, George's recovery is different from mine, is different from Heidi that I work with.

Yeah, so we did with some colleagues in North America and in Sweden, we, we each tried a sort of, it was a real food, low carbohydrate plan with all the education about the brain with group support and with sort of relapse, you know, planning and all of this that I've just talked about.

And in completers, we got 62% of the group of the patients into remission from a food addiction.

And the result at one year.

So it wasn't just straight after the program.

Everybody's doing fine at 12 months.

Many, many of the patients that sort of come out of the severe food addiction category into like, no, you know, they look like they had no food addiction.

Um, and yeah, so we're, you know, it's.

You.

You can, you can treat addiction and you can treat food addiction.

Yeah.

So the combination of diet and support over 60% remission at one year is remarkable.

I mean, really remarkable.

So, so, I mean, Georgia, in your experience, what is the most effective diet for addressing food addiction and why?

What is happening with the change in the diet?

Yeah, so as Jen was saying, everybody's plan is going to be personalized to their own vulnerabilities.

And, you know, there are certain substances.

I think I do agree that refined carbohydrates are a major factor for just about everybody with addictive eating patterns.

And so removing that substance and the most effective, efficient way to do that is with a low carbohydrate diet.

Um, and even better, in my experience, is a ketogenic diet where you're actually not just limiting carbohydrate, but making changes to your dietary plan that actually get you into ketosis and get you burning more fat and less carbohydrate for energy.

Then your cells are getting.

They're le.

They're looking for less carbohydrate, and they're.

They can draw more on your fat stores, whether that's from your.

From your body or from your plate.

And then you're.

You're really kind of fundamentally changing your metabolic operating system over to more fat and less sugar.

And, and that's going to be good.

Your cravings are going to go down.

Your hormonal signaling is going to work better when you're eating foods that are keeping your blood sugar and insulin levels too high and kind of putting you on this roller coaster of, you know, insulin and glucose.

And it's not just insulin and glucose that are going up and down.

It's.

There's many chemicals in the brain that are going up and down.

There are stress hormones going up and down, blood pressure hormones coming and down, appetite and satiety hormones going up and down.

Everything is being destabilized from within simply by having the wrong information about what a healthy breakfast is supposed to look like.

So if you have a bowl of cereal for breakfast, Or a bagel or a muffin or juice or a smoothie, it's off.

Really.

You can throw yourself, your, your, your internal chemistry off for the rest of the day.

It's gonna be a real struggle.

And so for most people, getting the refined carbohydrates out is, number one, getting low carb might be step two, ketogenic might be step three.

There's a different degrees of metabolic intervention, but then there is another layer if that doesn't work well enough.

There are some whole foods that some people find difficult to control, and that's a different level of personalization.

So for some people, it's nuts.

For some people, it's dairy, you know, that sort of thing.

And so, but, but, but beginning with that metabolic foundation, quieting everything down by getting yourself off that glucose and insulin roller coaster is, Is really useful because if you can do that, you're going to need so much less willpower than you ever thought you.

I mean, most people say, well, I can't give up those things because I can't imagine getting through a day without them.

And, and that's true of people who are attached to alcohol.

They can't imagine going for a day without drinking.

And it's not easy the first few days.

But once you get, once you, Once you've made that shift after a week or two, it becomes so much easier because the substance isn't driving your craving for more of that substance.

So kind of cleaning, cleaning that, cleaning that, cleaning your plate of these things, getting to the other side, and then personalizing if you need more help beyond that.

So it really is understanding which types of foods and ingredients you personally have difficulty controlling your intake of.

Yeah, I really like how you talked about, though, a dietary intervention that actually changes your metabolism and changes your fuel source and how that impacts it.

So I think that that is key.

I think it's a really good point about people understanding that, that addiction model and that once you're through the withdrawals, things get a lot easier.

I think you need to give people that expectation.

Otherwise they do three days and they feel so bad and, you know, so low and grumpy, and their family is saying, oh, God, just such a grouch.

And, you know, and they're not sleeping.

And you're such a grouch.

Here, just have some carbs.

You feel better.

Just have some.

Yeah, have this, have this chocolate bar.

You know, I mean, there are families that, yeah, they do, they do literally give people, you know, carbohydrate and chocolate to eat.

But, yeah, if People can understand some withdrawal syndrome and they need to, they need to really push through, you know, probably till day eight, day nine, but before that physiological withdrawal is over and then they start to get the benefits.

And I think once you've got someone to that point, even once, and they start to, you know, the lights come on.

It's like Ian Campbell talks about when he went keto and he was on the bus and it was like someone had plugged his brain back in.

You do literally get that moment where, you know, you suddenly start to feel the sort of chance, cheerful and energetic, and the cravings are leaving you.

And I think if we can just get people to that point, you know, even once, they then have that motivation to try and stay, stay there.

You know, if they do have a wobble, they know how great they felt when they were abstinent in inverted commas.

So, you know, they've got that, that motivation to get, to get back to it.

Most people have been eating this way, eating these substances every day of their lives since they were small children.

So they just can't imagine their lives without these substances.

And it is hard, very, very hard if you are addicted to these things, to even go a day without them.

And so most people have never tried to go more than a few days without them and really have the information and the tools and the rules that they need to follow to get to this much happier, healthier place.

And they don't realize how much easier it can be if they, once they get to the other side, if they've never experienced that, it's hard for them even to believe that it's possible.

And it doesn't really, it doesn't need to be that hard.

It just.

You've got to get through.

As Jen was saying, you need the support and the information and the time to, to make that shift.

And once you're on the other side, then you can see, well, you know, this.

Wow.

I, I've just walked past a pastry shop and not thought about pastry.

That's, that's interesting.

Who am I?

You know, and people always don't recognize themselves when they are in this different metabol.

It's a different state of mind.

And it, it's like wearing a suit of armor.

You know, it, it's not perfect.

You know, the, the storage can still get you.

If you, you know, in certain places, you're not going to be completely.

This is where the support and the ongoing education and the relapse prevention all comes into play.

You're going to need, just like any Addiction, ongoing support.

It's a lifelong vulnerability.

You're not going to just poof, it's going to disappear, but you're going to have a real fighting chance.

Yeah.

We should say, of course, for anybody listening is thinking of doing this and going cold turkey, please.

If you're on medication, make sure you talk to your health care providers before you do that.

You shouldn't quit.

Or, you know, refined carbohydrates and sugars.

If you're on medication for diabetes, blood pressure meds, probably some mental health meds, I don't know, Georgia can advise on that.

You know, you're probably going to need to have those cut down quite, quite rapidly.

You know, people see incredible improvements in blood pressure and blood sugars.

And if you're still on the medication, you know, those things can go a little bit too low.

So it's a great thing to do, but make sure you're doing it with support.

That's such an important point.

And I'm glad you brought up medications because there's medications you have to be cautious with if you're on.

But also this concept that, well, can't a medication just help with this food addiction?

And now there's this new kid on the block with the GLP1s and you know, some people are probably saying, why would I have to change my diet and do all these, you know, crazy restrictive diets as people sometimes think of a keto diet when all I have to do is take a GLP1.

So.

So Georgia, what are your thoughts about the rise of GLP1 agonist medications like Ozempic, Wegovy, Manjaro, et cetera, as treatments for food addiction and carb, processed carb addiction?

Yeah, you know, they're, they can be very useful tools and I think it's wonderful for people to have options, but not a, not everybody has the luxury of being, of being able to access GLP1s.

Not everybody can afford them.

They're not available everywhere.

And, and the other thing is that, is this, is this really the solution, the long term solution to the problem of we're, we're eating all the wrong foods and making ourselves very ill, mentally and physically ill. We're just gonna medicate our way out of that problem.

So we're gonna give kids ice cream cones and sugary cereals and popsicles and, and potato chips and Doritos with one hand and give them a GLP1 injection with the other hand.

That's gonna be our solution.

I don't think that's a good long term solution.

It's not a root cause solution.

The problem is the food.

And so for some people, the GLP1s are going to be really valuable, already have been shown to be very valuable tools to help people get started on their journey if trying to change their lifestyle is too daunting a task.

And so I'm all for, I'm all for personalizing the protocol, especially in the beginning, to give people all the support they need to get healthier.

But it's been already being shown in a lovely study by Virta, and there'll be more information coming out about this approach.

More clinicians are using GLP1s in this way, using GLP1s as a bridge, using GLP1s as A bridge to giving people the confidence and the benefits, the progress that they need to see to start to feel confident and move forward and to changing their lifestyle, getting their appetite under control, giving them a head start, you know, taking some of the pressure off of their insulin signaling system.

Because GLP1s, what they're primarily doing is they're, they're bringing your glucose and insulin levels and your appetite hormones into better balance and just like a ketogenic diet can do, but of course, much easier.

And so the study in Virta Health showed that if, if you switched people over from a GLP1 to a low carbohydrate diet, that they could maintain the weight loss and the appetite control that they had gained from the GLP1 and.

But they were able to then stop the GLP1.

So it didn't need to be a lifetime of medication.

Yeah.

It's so interesting to see sort of these parallel paths that we're seeing research for GLP1s for weight loss.

We're seeing research for food cravings, and then we're seeing research for also addiction, Alcohol, another substance addition.

And with ketogenic diets, ketogenic therapy, we're seeing research for weight loss, for food cravings, and for other addictions as well.

I mean, it really is not that they're exactly the same.

Obviously they're very different, but there are very sort of parallel paths.

So, I mean, Jen, in your practice, are you seeing people come to you and say, well, can't I just take this medication and take care of everything?

Is there like a right, rising trend of that?

Yeah, I mean, we've certainly, certainly in the, the patients that we've treated, say in the, in the treatment program.

It's interesting because the GLP1s, when we were gathering that data, they weren't really available or in the ascendant in the uk.

But I have heard from a few people that you know, since they've become available, they have, they have been trying them.

I mean I think in a way in strangely the fact that the GLP1s are you know, working in, they seem to be working in the reward centers and there is this idea that they're sort of work working in the addictive parts of the brain and they work so well for people's relationship with food.

I think it in a way proves the point that you know, that people's, some people's relationships with food is addictive.

You know, it's, it's a way of sort of saying well aha, you know, yeah, food addiction is real because you know these medications that are helping, that's, that's how they work.

That's how they're acting.

They're acting in the reward center to some extent.

So I think it, they actually, you know, adding more weight to the argument that some of these modern foods are addictive.

And I think one of the downsides of, of medic trying to medicate our way out of this problem is that you can take a GLP1 and assuming you can access it and tolerate it, you can take a GLP1 and your appetite for all kinds of foods goes down, not just for ultra processed foods.

And so then you know, people can, whatever they are eating, they may not think it matters, right?

So they can just eat.

You know, they can still have the same poor eating habits and make the same poor choices because they can trust themselves to a certain extent not to overeat those foods.

So now they're, it's kind of a license to eat whatever you want in smaller amounts.

And it's not necessarily going to help you build healthier habits that are going to support your mental and physical health.

You are going to lose weight, but what about your muscle mass?

What about your brain health?

What about your, you know, generally speaking the health of all of your cells.

Are you getting enough nutrients?

Are you, are you eating things that are damaging your cells?

So it's, I had a patient actually who severe food addiction relapsing over and over again even on a low carbohydrate diet had lost over 100 pounds using a low carb diet, still had some more to go.

Lots of medical issues, type 2 diabetes, cardiovascular disease, all kinds of all kinds of medical issues.

And again made tremendous progress but, but couldn't get, couldn't.

Had hit a plateau, was really struggling with overeating of other Foods, not carbohydrates, but protein especially.

And so finally just really tired of battling this.

And so we had tried every kind of intervention that I could think of together.

And we were working together for many years.

I said, well, you know, maybe you want to consider talking with your primary care about a GLP1.

And so he did that.

But the fascinating thing about what happened for him was that he started the GLP one, made him, you know, he had some gastrointestinal issues and you know, after each injection, but he got through those and his appetite did go way down.

The fascinating thing was it did backfire because now he thought, oh wow, you know, I, maybe I can get away with eating these foods that for so many years I've had to avoid to be well.

And, and, and he started slipping back into his old habits.

Blood sugar started to go up, you know, and, and the, these addictive patterns start to kick in again.

And he thought to himself, now wait a minute, I worked really hard with my lifestyle to get off, to get off injected insulin.

And I was really, really proud of myself for doing that.

And now what am I doing?

I'm back on an injected medication and I'm eating it in a healthy, unhealthy way again.

So, so, so human beings are complicated and some, sometimes these things can have unintended consequences.

Yeah.

So important.

I hope people go back and listen to that whole thing again because it's not just how much you eat, it's, it's what you eat and how you fuel your brain, how you fuel your body, how you feel your cells still absolutely matter.

So, so important.

Well, this has been a really good discussion, very deep discussion about food addiction, ultra processed carb addiction and where we stand and how to treat it and what it is and so important for people to understand.

But before we wrap up, I mean, one of the questions I think a lot of people have is where can I go to learn more?

Right.

I want to know what exists out there.

So I know there are a number of resources.

Jen, you have a wealth of information out there.

So where do you recommend people go to learn more about food, food addiction or about you and your work?

Okay, well, number one, we're very excited about.

We've got a conference coming up in London on the 4th to the 5th of September.

It's on Ultra processed food addiction and it's comorbidities.

So lots of expert speakers on ultra processed food addiction, but also on these conditions that go along with it, like ultra process food addiction and type 2 diabetes, how to deal with that cardiovascular disease.

George is going to be talking on the mental health side.

We've got speakers on cancer and so on.

So we're really excited about that.

And you can livestream that conference.

For those of you over in the States that don't want to make the trip to London, of course we'd love to see you.

But if you can't make it then you can live stream that conference.

And the website for the charity that I work with that are hosting that conference is www.the-chc.org.

that's-chc.org and if you go to the conference page there you can, you can click through to buy tickets from Eventbrite.

I mean that's really going to be the main thing if people want to.

I've written a little book called Fork in the Road which is on Amazon and all the profits go to the charity, the CHC that I was just talking about there.

Yeah.

The subtitle of Jen's book A Fork in the Road, which is a lovely book, wonderful little book, is a hopeful guide to food freedom.

And I really love that subtitle because it just summarizes there's so many tips and tricks in that book and so many personal stories of people who've found a path to recovery.

And it's really inspiring and it's, and it's beautifully illustrated.

It's really sweet and so sweet in the best possible way.

And then and the food addiction conference that the Internet, this is the.

So what people may not know is that Dr. Jenna was quite the pioneer in this space.

And so she last year was the first, the very first international food addiction conference that she held in London.

It was wonderful.

It was really like one of the best conferences I've ever attended.

And this year the presentation that I'm going to give is going to be called when food makes you hungry.

And I'm going to have a special guest co presenter, Dr. Albert Dana from Toulouse, France.

And he's the psychiatrist in France who conducted that wonderful French study that I helped him publish with people with severe, chronic, so called treatment resistant mental illnesses recovering in many cases with a simple ketogenic, mildly ketogenic diet.

And he's never spoken at a conference before.

So he's going to be speaking with me.

He's going to share some wonderful cases from his practice of using ketogenic diets to treat not just food addiction in children and adults, but, but all of the other psychiatric comorbidities that come along with that.

Well, thank you both so much I mean, the work you're doing is so important in helping people realize if they struggle with food addiction, they're not alone, they're not broken.

This is a real thing and there is a hopeful path to recovery.

So thank you both so much.

I really look forward to that conference.

Thank you.

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