Research on Food Addiction and Binge Eating Disorder
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[00:00:00] This is the breaking up with binge eating podcast, where every listen moves you one step closer to complete food freedom hosted by me, Georgie fear and my team at confident eaters.

Georgie: today the topic that I thought would be interesting to discuss involves the idea of food addiction. And is that a legit concept when people say I'm a food addict? What does that mean for our work with them? And then also what else might be some differences? Between types of client within our client population, because we know so much is remarkably consistent, like by and large, the people that we work with are all very nice.

Many of them are too nice for their own good. They put other people's first, we know that they tend to have problems with. [00:01:00] emotion regulation and asking for their needs to be met. So we see a lot of patterns, but I think none of us would want to fall into the trap of being like, they're all fit the same mold.

Maryclaire: Yeah, no, they don't. I've told you before, I felt like there's Myers Briggs of this. Like there's different, I don't have many categories, but at least a couple that.

Georgie: Yeah.

Maryclaire: Right.

Georgie: Yeah. So that's what I thought we could talk a little bit more about today. I have some papers on food addiction and a little bit of like interesting personality differences, but mostly I just thought it would be fun for us to discuss how we handle all of these very different people that we end up working with.

Okay. So obviously not everyone's the same. They have a lot in common. What have you noticed would you say are some of the main differences? Some that I can think of right off the top of my head. Some people seem to do better with treats. And like small, frequent servings or doses.

And then some people are like, fewer would say like, I just want a piece of cheesecake from the cheesecake factory [00:02:00] once every two weeks and I'm fine. That's one thing I've noticed. Have you noticed anything else that seems to be kind of different between individuals, personality, eating?

Maryclaire: Almost like the degree of restrictiveness, like some people were very kind of harsh and other people who are more like, I want the maximum I can.

Like, that won't screw me up. Like permissive, I guess, versus restrictive. I don't know.

Georgie: That's a good one. I think I know what you mean. People who are like, how much can I get away with? And others that are like, I'm going to score myself as hard as possible.

Maryclaire: Exactly. Exactly. Yeah, I want all the fun, you know or yeah, or I blew it.

I had one extra M& M. Yeah.

Georgie: Yeah. I think I probably try to talk both of those ends of people into a middle ground.

Maryclaire: Yes, exactly. Exactly.

Georgie: You know, own, own when you've done something wrong and that you can improve, but you know, don't rake yourself over the coals. Because not everything is completely your fault.

Maryclaire: Yeah.

Georgie: I think also there's a tendency to blame [00:03:00] oneself and a tendency to blame others that can also be somewhat polarized.

Christina: Yes.

Maryclaire: Haven't had too many people blame others?

Georgie: Well, so when I hear that, it's like the excuses of like, well, my wife wanted Chinese, so we got Chinese, and my wife wanted this, and then the kids wanted that.

Maryclaire: Oh, that's cause that's real. That's a reall thing.

Georgie: Yeah.

Maryclaire: I feel that way sometimes so I can identify with that one.

Georgie: Yeah. Yeah. I hear people do that. And then there's, maybe it's not a blame others, but it's like an, I'm not to blame sort of passive language, which often comes up as, I ended up eating half of it.

Maryclaire: Yes. Okay. I ended, there you go. Yes. Ended up

Georgie: like, I just fell into the game.

Maryclaire: Like let's see how it goes. You know, yeah.

Georgie: Yeah.

Maryclaire: What can we do about that? The others thing, just briefly. You know, I have my own issue, my own house certainly, and clients, obviously, this comes up. [00:04:00] Sometimes I feel like spouses, like, do you hate your spouse? Like really creating very challenging situations for them. And I don't know from what they're telling me, like maybe the person who we're talking to doesn't communicate to their significant other about what might work for them. Sometimes they do and it doesn't, people often seemingly aren't all that helpful. Like they really have to stand their ground. Like I kind of view it, I guess, as an environmental thing where, you know, you're in an environment where you have, you're living with someone who, you know, brings a whole bag of chips and salsa to the coffee table.

And You've told them you'd prefer not to do that or whatever. And maybe you had to have to learn how to create that boundary. But you know, it's legitimate struggle or they bring in, you know, from Sam's club, treat foods and stock up the cabinets and somehow make you feel you know, "make you" right. No, one's making you feel bad implying that your lack of control is some issue with you as [00:05:00] opposed to maybe this isn't just a good idea to do this.

So I mean almost, that's like a whole ball of wax right there.

Georgie: The whole relationships thing that we observe.

Maryclaire: Yeah. Yeah. And just, yeah, there's different idea around what should be in the house. And then someone where they feel it's okay to assert their needs. And in this case, I think their needs might rank higher than the person who just wants to keep a lot of crap in the house.

Georgie: Yeah, yeah. I know what you mean. It's like, there can be this fundamental difference between how people view asking for things or having needs or even desires. Is that okay for me to have or not?

Maryclaire: And the other person maybe not getting it, right? But that doesn't mean you give up perhaps. But you know, people like I remember one father, his daughters love to bake and, you know, he comes in, there's like hot brownies on the kitchen island and stuff, and we just, we talked about we could ask them to put it away or them to freeze it, and he took, you know, I was proud of him. He took it and just like brought it in their room and put it on their dresser and shut the [00:06:00] door. But because he had asked them, you know, a few times to do this, and it's like, gosh, like is anybody working with this guy? He's really struggling. Like, I don't know.

Georgie: Yeah, definitely can create an uphill battle.

Maryclaire: Yeah,

Georgie: I found an interesting paper on men and women with binge eating disorder and how their personality traits actually show some difference. So we have a lot of research that points to people who have binge eating disorder having different personality profiles than people without binge eating disorder.

But it's very interesting to look at men with binge eating disorder and women with binge eating disorder. And if you ask me, Georgie, what do you see as the difference between this? I would have been like, I'm not sure. I'm not sure I would have come up with any difference just based on observation. I'll give you guys a crack at it.

Do you see any, any differences?

Maryclaire: I've just seen maybe some men coming at it from the sports angle, like where they got into like this idea of being more competitive in some sport and therefore getting really lean and kicking it off. Not to say that's different from [00:07:00] women, but maybe more like women may be having it develop over time based on a body image, parents you know, like developing through adolescence where this maybe just came from the, true restriction for a sports purpose. Not to say women couldn't have that happen too. It's just, I've seen that.

Georgie: Yeah, yeah. There's definitely different cultural forces at play.

Maryclaire: Yeah.

Georgie: Between like, get smaller, get bigger.

Maryclaire: Yeah. I guess women more likely, right. Have the force to be smaller.

Georgie: Yeah.

Christina: Think for the men I've worked with, it's usually like career driven, like they're so tied up in their career and I don't know that that's true for the whole male population, but the ones that I have worked with who have binge eating struggles, it's like, I never had to worry about my weight. It was just in the last few years and I'm super stressed and it's never had to be a priority for him to worry about it. And now he's got health concerns and things coming up, but there is a sense of he's doing a lot for other [00:08:00] people, but I think I hear more of what you were just explaining, like, not blaming others, but oh, well, so and so wanted to do this like, Oh, this came up and that came up.

Georgie: I think women, I guess they're a little more prone to just taking the responsibility on themselves.

Maryclaire: Which could go bad if it goes too far.

Georgie: Definitely, definitely.

Maryclaire: Right. They clearly are having their own difficulties. Self blaming and catastrophizing.

Georgie: Yeah. we talk about a lot of different personality traits are, have you guys heard of the Big five?

Christina: Yes.

Georgie: Yes.

Christina: The Jordan Peterson thing.

Georgie: I don't know who came up with the Big Five, but we've got extroversion, friendliness, conscientiousness, emotional stability, and openness.

Christina: Okay.

Georgie: Now there's been a lot of, you know, research into personality.

This is really the only theory of personality that seems to hold water or be consistent at all.

Maryclaire: Oh, okay.

Georgie: When multiple people study it.

Maryclaire: Okay.

Georgie: That these. five traits are all on spectra. And so people can be higher or lower [00:09:00] and, there's different things that associate with each of them. So this paper basically took a lot of people who have binge eating disorder. I believe they may have done like some control without it as well. Oh yeah, so they took people who were over 35 BMI but not all of them had BED, binge eating disorder, so only 10 percent and 18 percent met the criteria for diagnosed binge eating disorder.

So These were the, the different personality traits that they assessed. And then these numbers here, the males are on one half of the chart and the females are on one half of the chart. And these correlations, anything with a star is significant. So that means that most of this data is not actually significant.

So a lot of like, like the amount of extroversion, extroversion or introversion doesn't seem to have anything to do with, with somebody's weight or their BMI, but the interesting stuff starts to come in here as we would suspect emotion control is [00:10:00] linked. To bsq is a measure of binge eating so scores for like the frequency of binge eating.

So in women, emotion control is linked with binge eating and also with a diagnosis of binge eating disorder, but in men, it's not significant. In men, impulse control is linked more with higher BMI, as well as diagnosis of binge eating disorder. Now, what we can, at first glance, we might think like, okay, women, more about emotional control, men, more about impulse control.

Great. But what I think is also interesting is that you have to remember these are self reported. So what comes in here is like, I think it's also culturally more acceptable for women to say, I struggle with regulating my emotions.

Maryclaire: Absolutely.

Georgie: I can't hold back tears. Or like a man, given the same exact behavior and emotional predilection might be like, no, I can hold back tears.

Maryclaire: [00:11:00] Yeah. I talked to my, my son, he's And this is a couple of years ago, he was like really angry. His only emotion he allows himself is anger.

Georgie: Yeah.

Maryclaire: And I try telling him like, maybe you just feel sad that this happened or you feel disappointed. He's like, he kind of said like, I'm not a girl, like he really feels, and it's so funny.

Of course, you know, it wasn't the Mary Claire school of growing up and he learned this, but he got it from somewhere. Like I can't be having those feelings. I just get angry. Like.

Georgie: Yeah.

Maryclaire: You know, it's fascinating like how that, so not, not the other two I think would be more open to that, but

Christina: it's kind of like we've talked about too, or Georgie, you mentioned it in one of your books. I think . When we think about emotional eating, a lot of times won't necessarily identify that, or maybe it was like on an intake form, but they will say, Oh, stress eating. Yeah.

Maryclaire: Stress eating.

Christina: Yeah, I stress eat but if you call it emotional eating, it's like suddenly. Definitely wouldn't participate in something like that.

Georgie: Yeah,

Maryclaire: exactly.

Georgie: Right. So the idea that people will conceptualize [00:12:00] it differently. And so helping people. We might ask them, do you feel like your binge eating is more impacted by difficulty controlling emotions, or would it help you more to have more control of your emotions?

Or do you think it would be more helpful to have more impulse control? Because we can work on either of those. And I think if I were a client and somebody was saying to me that both of these can be impactful areas to work. And I'd be like, wow, this person really gets binge eating. They can even differentiate the differences between people with this condition.

So it just brought to mind to me, another conversation thread that we can go down with people. So Another paper that I looked up basically did what they call latent class analysis. Have you ever heard of that, either of you guys? Okay, now neither had I. So here's the dumbed down version of what latent class analysis is. Latent class analysis is like, let's take this group of people and let statistics figure out what are the subtypes or categories within there.[00:13:00]

Maryclaire: Cool.

Georgie: So you ask it, you give them questionnaires, whatever you feed all the data into a computer. And it says, you actually have five categories here that are statistically significant and different, or you have six or you have eight, however many it comes up with. So beyond that, I can't wrap my brain around the statistics of it all, but yeah, I have some really interesting

Maryclaire: seems like you'd have to do a lot of iterations to figure out like

Georgie: there's, yeah, there's all sorts of fancy loopholes and you have to set the different thresholds. For how much they can overlap or not. Yeah. So what this latent class analysis was looking at was. Like people who have food addiction, and by that I mean people who claim, they answer highly on questionnaires that ask about questions of food addiction. How different is that from binge eating disorder?

And how different is that from just people who are obese? Are these actually the same construct or the same idea, just with different labels on it? [00:14:00] People who eat too much? Or are there actual uniquenesses to each of these? And so I thought, my personal background is as you guys probably know, is I hear food addiction and I'm like, I don't like that term, I don't like that phrase, I don't think it's scientifically valid, and I don't think it's helpful for anyone to call themselves an addict.

So, I like to look up papers that might challenge my My way of being here. And so I'm going to read you just some things I've highlighted from this paper. so food addiction as a concept basically applies the diagnostic criteria for substance use disorders. to the intake of highly processed foods.

So the questionnaires that, or the main questionnaire that has been used is called the Yale Food Addiction Scale. And it asks people about things that are very similar to what you would think of for abuse of drugs or alcohol or, or behavioral addictions like gambling. And so I'll read you some of the things that it measures.

So this is the [00:15:00] idea of food addiction. The amount, the food often consumed in larger and larger amounts over a longer period than somebody planned. Like I ate more than I intended to. Attempts is another criterion. Persistent desire and unsuccessful efforts to cut down or control food intake. I think we've all heard of that from people.

I've tried a hundred times to stop doing this. Spending a lot of time on activities required to obtain food or recover from overeating. You can imagine that in like somebody who's pursuing a drug. They spend a lot of time trying to obtain their substance and use it and recover from it. So this is very much using those sort of languages to food.

Important social, occupational, or recreational activities are given up or reduced Due to overeating on foods. So is it impacting somebody's life activities? Consequences? Overeating is continued despite knowledge of having a persistent or recurrent physical or psychological problem caused or [00:16:00] exacerbated by overeating.

Like, is this person putting up with consequences? Their body, their relationships. Tolerance? Do they need markedly increased amounts to achieve a desired effect? Withdrawal? When people refrain from eating it, do they feel worse? And do they find that they're eating to relieve or avoid those withdrawal symptoms?

Interpersonal problems? Does it prevent them from also obligations? Do they have cravings? And the last one is significant impairment or distress. So the whole idea here of food addiction is basically comes from the addiction side. Like, can we take the concepts of addiction and say it happens with food just as much as with cocaine or methamphetamine?

So

when we look at binge eating disorder, which we're familiar with, We know that that's very much described by the binge itself, at least in the diagnostic criteria, it's consuming a larger amount of food than somebody would normally consume in a finite period of time, feeling marked distress afterwards, and the sense of loss of control.

Now, one of the things that's [00:17:00] different is in food addiction, episodes of eating can be continuous, such as grazing or chronic snacking, where in binge eating disorder they have to be episodic to fit that criterion, to fit the diagnostics. In theories of binge eating disorder, shape and weight concerns and dietary restraint Are seen as very causal and involved and in food addiction.

It's proposed that there's potentially addictive nature in highly processed food. So it seems very much to me and having done a fair amount of reading on this, that people who ascribe to food addiction or the theory of food addiction is that the food has addicted you through chemical means. And your brain is operating differently, therefore it's very difficult to stop.

Whereas the binge eating literature seems to focus on, people are trying to cut back their intake, their emotions are playing a much bigger role and dietary restraint is a significant causitive effect. Does this make sense so far? Kind of like these two different

Maryclaire: Yeah, [00:18:00] I'm, I'm curious how this scatters itself because There's lots of overlap, and it's, you know, not very clear.

Georgie: So around half of the people with binge eating disorder meet the cutoff, whatever it is, for food addiction. So just like thinking about that for a second, like if we imagine our roster and people in our group and we're like, okay, half of them believe, whether it's true or not, believe That this food has a chemical hooking effect, addictive effect.

Maryclaire: I mean, I think of hyper palatability, you know, like in terms of foods, the way they're made now that, you know, chips. People just want to keep eating them, that there's something to that. It's not cocaine, but you know, people keep going back for the slice of cake or the, they're not going to the sugar bowl.

Right. It's not addictive. Like I need to just eat sugar, but they say it's like the mouth feel, the maybe the fat, sugar, salt content together that make it [00:19:00] something that is difficult to manage. And, you know, you could say addictive. You know, just maybe extra pleasurable. I don't know.

Georgie: Yeah. Yeah. There's definitely the extent of brain studies and imaging has shown you can see something's happening in someone's brain when they eat a piece of cake.

Maryclaire: Yeah,

Georgie: but something also happens in your brain when you hug someone you love or you pet your dog. So it's not enough to say that

Maryclaire: Maybe not the same for everybody

Georgie: yeah, right.

Maryclaire: I drink a a glass of wine or something. I'm like, okay, I enjoy it. It's pleasant. Yeah. But I don't, I'm not excited. Like, I remember going to an AA meeting with a friend of mine and they were saying how they made the joke, like, Oh, my wife, she went to the restaurant.

She had one glass of wine saying, you know, Oh, I, my husband ate one potato chip. What? How's that even a thing? Right? Like I think people might be different in what they respond to. Like wine. I don't drink a glass of wine and then just want to, you know, Go on a bender

Georgie: yeah.

Maryclaire: But put a piece of chocolate cake on my kitchen [00:20:00] island.

God, you know, it feels addictive. I mean, it's not cocaine. It's not, you know, Oxycontin, which I don't even understand. It's still like, there's definitely something.

Georgie: Yeah. And that's my, that's why I think it's an interesting area. Cause I can't dismiss it because I agree that there's something that happens there, but there's also a lot of arguments. That don't support food addiction in the physical sense, for example, as you said, people don't go to the sugar bowl.

Maryclaire: Right. It's not withdrawal. Like, you know, I should feel better, right? If I have some less cake. But I guess it was a hungry brain, did you ever read that book?

Georgie: I don't know about, Oh, was that Judson Brewer?

Maryclaire: No.

Georgie: No, that's a crazy one. The hungry brain. Steven O. Guyanet. Yeah. He's, he's a good guy. I haven't read the book, though, no..

Maryclaire: He talks about that, like, what are the mechanisms in our brain that get hijacked, you know? Whether it's classical addiction or not but, you know, there definitely is something to the reward [00:21:00] factor for some people more so even than others.

Georgie: Yeah, I definitely think it can't be simplified down to just chemical. I mean, there's also habit. There's also meaning.

Christina: Yeah,

Maryclaire: well, how about that whole just the pattern of eat something dopamine spike? You liked it. Keep going. But I think what they're getting at, it's more than just sugar and it's more than just fat.

It's the combination of hyper palatability.

Georgie: Yeah, I think there's definitely a greater dopamine release with combinations of sugar and fat. It's also dose dependent. Like, you don't eat an apple and have the same, oh my god, I want more.

Maryclaire: Right, but an apple doesn't have that same, I don't think.

Georgie: Yeah.

Maryclaire: When my son was little, he was like two, and I would just drive around and just run errands. And to make the day pleasant, he liked it, we would stop off at Dunkin Donuts, I would drive past these places.

Georgie: It's like Pavlov's [00:22:00] dogs.

Maryclaire: Yes. You know, If you go into CVS, you're used to picking up a candy bar.

Georgie: Right.

Maryclaire: Like there's something going on there. And like, meanwhile, middle boy. You know, there's one last Malamar in the box. Do you want it? And he'd be like, Oh, you know, I'm not hungry. No, thanks. And it's like, what does that have to do with it?

There's one last one and It's really good. Don't you want it? No, Idon't really want to. So I, I think there's something, I don't know what we want to call it, but I think it's worth considering because I see it where people, clients feel that they should be able to have these hyper palatable foods in the house and just not want them.

And I don't find that works for me. I may forget about something there, but if I remember it's there. So is that addiction? It feels kind of like it. I can kind of relate to it, I guess.

Georgie: Yeah. Yeah. And we can hear from our clients that some, you know, they vary with regard to how much that sort of thing causes problems for them.

Maryclaire: Yeah. Yeah. I heard Julia Mann [00:23:00] once said, She said a piece of cake could be sitting on the table. And for me, it's the same as if a shoe was on the table. Like, wow. Yeah. Like you put a shoe on the table and I'll go I can't wait to eat it.

Georgie: Right.

Maryclaire: That's how she felt about like, you know, something like that. So yeah, it's different for different people for sure.

Georgie: Yeah.

Maryclaire: I don't care about chips. Like. Once I start eating them, yeah, I kind of want more, but

Georgie: you don't hear the crinkle of the bag and, like, run into the room because you want chips.

Maryclaire: No, no.

Georgie: Yeah. Okay, so when we give a whole bunch of people a lot of questionnaires, what shakes out between all these different things?

So I have a paper here, it's a 2024 paper, brand spankin new. And we've actually got five different groups of people here. One, non addicted. So these people don't have any of the symptoms of food addiction.

They read all that stuff and was like, no, the food on the counter it's like a shoe, right? So these are people who don't have those troubles. What this graph here shows is like, these are the 11 [00:24:00] areas of food addiction that I read you before, like the attempts, you know, these are the symptoms, like withdrawal, tolerance, craving, and those people, the non addicted are I believe this is 40 percent of our sample. These are people with obesity who are wanting to lose weight. So they reported to this, unit for treatment.

Maryclaire: That's interesting.

Georgie: So, 40 percent of the people

Maryclaire: 40 percent not food addicted, that's impressive.

Georgie: Not food addicted.

Maryclaire: What's happening here? I don't get it. Okay.

Georgie: Class number two. Attempters. Members of this class were characterized by full achievement of only the attempt. indicator. The only real other thing they have going on is persistent desire and unsuccessful efforts to cut down or control their food intake.

So that's the second group, people who only have that one. And that is 20%. So already we've covered 60 percent of the people.

Christina: Wow.

Georgie: Yeah. Yeah. So the remaining ones,

Class 3 is the smallest. [00:25:00] Interpersonal problems. Members of this class were characterized by the full achievement of problems and obligations. So these are people who's who have this subset here. They have this continued overeating despite social or interpersonal problems. And a failure to fulfill major role obligations at work, school, or at home.

So, yeah, I think that

Maryclaire: Meaning that eating causes the problems, or?

Georgie: Yes. Oh, I see. So, for example my spouse always argues with me when I eat dessert because they want me to control my diabetes, but I keep eating dessert. That would be a problem. Obligations, I'm late to work or I miss classes because I'm binging, or eating fast food, or I have a food hangover.

Maryclaire: All right, so there are people who eat in such a way that it's affecting their lives, but they don't seem to hit anything else on here for whatever reason.

Georgie: Right, right. Not necessarily as much.

Maryclaire: Yeah.

Georgie: So our interpersonal problems are, [00:26:00] high on this problems, low on withdrawal, high on that obligations, low on other stuff.

I mean, they have some measure of some tolerance, but those are the main two issues that they're reporting.

Maryclaire: Okay.

Georgie: Class four, highly functioning addicted. And I can imagine clients, I can recall specific clients that fit this one in my mind. People who are characterized by, they have the symptoms of withdrawal, tolerance, and psychological ones like craving and consequences.

But they aren't so functionally impaired. These are the people that still have high level jobs and careers. They're not late to work or missing things because of their eating, but they very much feel like food is in control of them. I don't know if you've ever had executives that say something like, I am successful in every area of my life except for this.

Maryclaire: Yeah, like Oprah Winfrey even, right? ,

Georgie: Right.

Maryclaire: Yeah.

Georgie: So this yellow line is [00:27:00] our high functioning addicted. They don't back out of their obligations.

They don't miss activities. Because they're eating, but they have really high levels of everything else. Like everything else is pretty difficult for them.

Maryclaire: Yeah. Yeah. Yeah. I function.

Georgie: Yeah. Fully addicted. Really all of the symptoms are highly endorsed and they're quite impaired. That's that red group up at the top. They are like, all of these things are me. I'm highly addicted. I have a lot of cravings. I have a high tolerance. I have problems. It's impacting my life. Most severely impacted people. Okay. So again, I'm not suggesting that we're going to put anybody in any of those categories, but it can remind us that people can be having such different experiences here.

Maryclaire: Right.

Georgie: So in the discussion of that paper, they point out something that's very interesting in that they gave people a questionnaire for depression. I think it was the Beck depression inventory and people who were in that [00:28:00] interpersonal problems group had high levels of depression compared to the other groups and compared to people without any food addiction things.

And it does make sense to me that, when we see people who's, you Marriage or significant other or relationship with their kids or their friends is really impacted by their eating I can see that being a gateway or like a really strong arrow toward becoming more depressed because now it's isolating you from supportive relationships.

Maryclaire: Yeah,

Georgie: your life. So for me, that sort of just highlighted like, yeah, I don't always ask people about if this is impacting their relationships with friends or whatever. But if that came up somehow in the discussion, like that, I don't have friends or I don't have anyone to hang out with this Thanksgiving, that it might be worth

talking about with people, or if we find out that somebody says, you know, I take medication for depression, or I've been wondering if I'm depressed, if depression enters the conversation that we can talk about how, maintaining relationships and not isolating ourselves can be such a powerful step.

Maryclaire: You know what do they [00:29:00] say interpersonal therapy. Now, this may be the opposite direction in terms of having relationship issues leading to the eating right. Interpersonal therapy was one of the therapies that was considered to be effective, right? With binge eating. I don't know exactly what it even implies because I tried to read about it.

It's very, it's very vague. I don't know. But a lot of people I notice you know, are very affected by what other people say and how they feel if there's conflict, if You know, it, upsets them at so much so that it really affects their eating and their self care. But this is saying people who have problems. Eating is causing the problems. I guess I see problems causing the eating, you know. Yeah. The interpersonal problems.

Georgie: Yeah, I think it's the chicken or egg.

Maryclaire: Yeah.

Georgie: It could go both ways. So, of the people in this sample that were like diagnosable with binge eating disorder, 90 percent of them fell into those categories four and five.

Maryclaire: Oh, which were those?

Georgie: High functioning addicted and fully addicted.

Maryclaire: Ooh,

Georgie: [00:30:00] yeah, that's a really big percentage. So we can expect that a lot of people that we work with would answer yes to the idea of I can send you guys a questionnaire, but yes, I need escalating doses. Yes. I have withdrawals if I eat less of whatever my problem foods are, you know, those sorts of things.

Maryclaire: Yeah, I, you know, myself personally, if I start eating sweets, like after Easter, there's like a bit of a, you know, I want to keep going. And I kind of have to give that let's take a break. That's the whole Gollum thing. Like once I'm going "my precious", it's time to like, Whoa, you know? And so is there, there are times when a little bit of something every day works great.

And there are times when it feels like it's creeping back up into the, my precious thing, and I have to back it off. So this is something that I'm always kind of on that meter or I'm always aware of where I am because I don't want to, get like that. And it still on occasion will happen where it's like, damn it.

[00:31:00] Yeah. All right. Pick myself up, you know, start again. And I think it's okay. I kind of view it as my canary in the coal mine, you know, But I, identify when people say, it feels like they're addicted. I kind of get it and do feel like there's, that wanting that can kind of be instigated and you have to get some space to let it simmer down again.

Georgie: Yeah.

Maryclaire: And it's just, it's not one answer either. It's kind of just, you know, navigating it. Yeah,

Georgie: I looked into the idea of withdrawals and apparently they also have a scale to measure withdrawals.

Maryclaire: Yeah.

Georgie: Again, even if it's not real, if you can get people to talk about it, it's real to them. Right. So yeah. People report mental, emotional, and physical things. So, many drugs have physical, like, if you withdraw from opiates, you have digestive issues. You have pain issues. A lot of physical stuff. But you also have stuff like withdrawal from nicotine making people very irritable. So it's not just physical, there's [00:32:00] also like mental.

And so if we are talking with somebody about that, I was like, Oh yeah, I should think about that. You know, I think one thing that I've seen, and I was talking about this with Roland, and he's like, so why are you doing all of this, looking into food addiction? Because if it's something that's on people's minds, like I want to, know how to talk about it.

And it changes people's self efficacy, I think. When somebody feels like an addict, they can feel a bit powerless. And Christina's nodding, so I guess you agree.

Christina: Yeah, I think that's my biggest challenge with hearing the term, because yeah, you're kind of already lost If you believe that about yourself and the same thing with like food neutrality or unconditional permission to eat. The reason we need these things in place is so that we don't believe the food has this like power over us. Even if we crave it, we're drawn to it, it's got these chemicals in it that make us want them, but ultimately can I do fine without it? Like with drugs, I'm curious about the withdrawal stuff. Cause with drugs, like you can see all that stuff. And yeah, it might be [00:33:00] you know, distressed or sad or, or uncomfortable that I'm not eating as much of it, but it's not like causing the same horrible things that like drug withdrawal or drug addiction. So it's like, I don't know.

It's hard for me to wrap my head around this, but I hear people saying. They feel that way. So I want to validate that experience, but I'm also like, it's just like a belief you have about yourself that's making it worse rather than like actual reality,

Georgie: totally. Like I miss my husband when I'm away from him, but if somebody suggested that was withdrawals, I'd be like, that's different.

That's like, yeah. So there are changes.

Maryclaire: I don't feel that this saying these certain foods are addictive or they have effects that are similar to addiction necessarily put someone in a box of that's who you are. I think it may be. like you said, kind of validates the experience and the understanding that, you know, I do require to watch out for myself with these things.

[00:34:00] And it makes sense for me not to keep them in my house. And it's not a matter of Hershey bars the same as the lettuce. It's not the same.

Georgie: Yeah.

Maryclaire: I worry about that. Like when people talk about you have an eating disorder. That's just, that's just who you are.

Georgie: that's not the same thing.

Maryclaire: I get more worried about that. Where it's like, you have this label and it's never going to be like, you're an alcoholic forever. You know, you're, you're this. But I think there is a difference with different foods. And if we tell people there is no difference, it's all the same sets them up to think that, They should be able to handle it. And I don't know, not working for me.

Georgie: I think it distances them from us as well, because they're like, Oh, she doesn't get it.

Maryclaire: I'll never that one woman that recent network with on Facebook and very nice lady. But, you know, she took a picture of like all this stuff on her counter. It was like Oreos and ice cream you know, it was like a food addict challenge.

Right. To see, I'm giving myself permission to it or so now, you know, it's okay. I don't want it. It [00:35:00] works for some people. And it's kind of like that intuitive eating thing where it's like, you know, if you really want it, just have it. And it's, you're restricting if you put any limits on anything.

So I struggle with that cause I think, I think there is real validity to the kicking off cravings, ongoing cravings, and a physicalness, whether, you know, like I said, it's not crack, it's not heroin. but it's not nothing.

Georgie: Yeah, I have found that I acknowledge to people that, you know, these things are reinforcing.

Maryclaire: Yeah.

Georgie: They have reinforcing qualities, but that they don't overpower your judgment.

Maryclaire: Of course not.

Georgie: So you know, trying to strike that sweet spot in the middle of acknowledging the pull of a chocolate bar is different than the pull of a carrot, but also We don't want our people to go over that edge because we've seen clients say things like, Oh, I had a Hershey's kiss. And then it was the rest of the day was a bender because the chocolate got into my system. And like, they really have a powerlessness to their language. I also feel [00:36:00] like people who ascribe to this addiction sort of position or theory, they seem like it definitely overlaps.

This is not from science. This is from my own anecdotal observation with an abstinence model, thinking that that's what they have to do.

Maryclaire: And that's what they've been told, probably, too, right?

Georgie: Yeah, unfortunately.

Maryclaire: Isn't that what overeaters anonymous is, like you're addicted to sugar, therefore you can't have sugar

Georgie: As well as bright line eating.

Maryclaire: Yeah.

Georgie: As well as bright line eating. So,

Maryclaire: right. And yeah, that I see as danger.

Christina: I don't even know what that is.

Georgie: So Bright Line Eating is by a woman who claims to be a neuroscientist, but I'm not sure that's actually what her field is. And she says Bright Line is like a firm line in the sand or whatever, like no sugar, no flour, no sweeteners, it's just super strict and that's how you have to be for the rest of your life.

Overeaters Anonymous is three meals a day, no snacking for the rest of your life, no flour, no sugar. Maybe no caffeine or something else, but it's like, these are very abstinence minded things like you can never eat a candy again. And I just see them [00:37:00] fail left, right and center. But anyhow when I think about this, like if this comes up in the sort of conversation with the client and they express any of these ideas, what I including the withdrawal thing, I think it's helpful to say, you know, processed foods are unique from other substances in that the best way or that we see that we have success, not with abstinence, but with moving toward moderation or regulated intake, because if you have, a modest amount of these foods, it doesn't cause those brain reactions. Like when people are getting those, remarkable brain scans, it's because they had like a whopping dose of sugar and fat and we can help you can feel a lot more in control basically that we don't have to go abstinence. And if somebody does ascribe to the idea of withdrawals, well, that's just a really good reason why we take things incrementally. Like we don't cold turkey anyone. we support people in getting to a better spot.

Maryclaire: Have you had people say they have withdrawal? I don't think I probably haven't asked them, but people have [00:38:00] told you they have withdrawal symptoms?

Georgie: I haven't asked, and I've only occasionally had people refer to something like that. And it's always because they were trying to be abstinent.

Maryclaire: I was having sugar withdrawal. Did you say that?

Georgie: Yeah, like I didn't like I cut out sugar completely while I did the Whole30. Yeah. like fantasizing over sugar and having headaches and

Christina: I've heard the headaches thing with Whole30. People who have been Whole30. Yeah.

Georgie: Yeah. Okay. So I also found something interesting that when people think of themselves as having food addiction, they may like that idea because it makes them feel less to blame for their behavior and it makes them feel less shamed.

The downside is That it limits their self efficacy and can make them feel powerless. So obviously, I think all the language that we use to help people not feel ashamed for what's happened to them. We can sort of have the best of both worlds there. And I found a really interesting paper where, it was a medical report [00:39:00] of what happens when talk about obesity as a disease.

And they found that it was really favorable because people felt less shamed for having a disease of obesity. However, it increased people's sense that there was nothing they could do about it because it was just a disease that they had and there was no changing. So it caused this like bi directional improvement in one area and Lack of improvement or decrement in another area. So take homes from this, just some interesting things to talk about, or maybe recognize if we have a client that mentions. Something about I'm a sugar addict or I have food addiction, or I need more and more and more of it. I always think if somebody brings that up, it might be helpful to ask them, have you had other issues with addiction in your life?

Maybe they did. And so they're thinking, oh, this is going to be a similar experience. I just have to detox and stay away from it forever. When this is actually a very different thing.

Maryclaire: Yeah. I guess I've seen it mostly with people who've had some introduction to overeaters anonymous or Breitling eating that have [00:40:00] espoused these ideas, right? as opposed to me just coming up with them on their own, that they're addicted. I might say it's, I like this kinds of stuff and I have a hard time controlling it, but I feel like it's,

Georgie: that's a really good reframe.

Maryclaire: yeah, people have that brush with that doctrine that kind of get caught up in it.

But I do believe there's something chemical and that's also worth understanding because. I believe it's valid, and it's not something you lose your agency, it's more you have to have your radar up. Don't set yourself up for this. And You know, whether it's amount, it could be frequency. You know, I pulled some papers myself, but honestly, I haven't finished, I haven't like got, I, I was kind of like, really I have a bug up my butt on this and, and kind of pulled a bunch of stuff and then didn't read them all through, but

Georgie: let us know if you find something fascinating.

Maryclaire: Yeah, because I, this, this does bother me and I don't know how to talk about it correctly, you know, I want to be, I want to be correct about it, but I do believe you know, it's funny when I read Steven Dianette's book, it was like. Oh, my God, he hit on everything. And then all the [00:41:00] solutions were exactly what we do.

Georgie: Yes,

Maryclaire: it still comes down to the same thing. It is no, you know, it's the same exact stuff, but it was just, it was a bit of just, you know, neurochemistry kind of explaining what's going on.

Georgie: Having treats with a meal definitely is helpful.

Maryclaire: Why? Why? Because we're not hungry as much? Or is it a glycemic response?

Or is it,

Georgie: It's tricky to say why, but the dopamine spike is higher on an empty stomach than on a full stomach.

Maryclaire: Okay. This is, this is exactly what I wanna understand because it's, it's definitely something,

Georgie: but I don't know if anybody has a real why, maybe because it's evolutionarily advantageous.

Maryclaire: Well, his, is it's evolution. And he looks at brain structures he explains, you know, these various things and how they might still be impacting us. But yeah, I just to me, it means like, all right, you got to be careful and mindful about how you go about eating these foods. And yeah, you don't want to put, you know, Fresh baked [00:42:00] brownies sitting on your island. And, and you might find if you have treats every day, or they kind of increase in the amount that, you know, try to wind it back.

Georgie: Yeah.

Maryclaire: There is like when I talk to people, you get this kind of craviness. Because you're used to it and when you, when you stop, just even for a brief amount of time, it, you know, it's

Georgie: readjust. Yeah. Cool. I realized this was so disjointed but it was a good discussion.

Christina: Yeah. It's very interesting.

Maryclaire: It reminds me that I kind of want to dig into this more too, because I do think there's some validity to it and I think it does lead to just validating kind of what we're doing, honestly, is everything so far that I've ever read. But there is something there. And I don't think it takes away anyone's agency. It actually just use strategies to support yourself because it's stuff that's challenging.

Georgie: Yeah. I like the reframe that you had earlier, which is like, this stuff has been hard to moderate for you, or it is hard for you to moderate right now. Like, that's such a great way to say it. Like, it doesn't have to be addictive, which to me is like too

Maryclaire: Right. Challenging to [00:43:00] moderate. Do you have foods in your home that are challenging to moderate?

Georgie: Challenging to moderate. I'm so grateful every day that I get to work with you guys. Thanks for being there. Bye.

Maryclaire: Bye!

Christina: Bye