Food Junkies Podcast

Food Addiction and Eating Disorders: Rethinking the Divide

In a recent interview on the Food Junkies podcast, I discussed the complex and often contentious relationship between food addiction and eating disorders. As someone who has dedicated my career to bridging these two seemingly opposed fields, I’ve observed firsthand how polarization has hindered our collective progress in helping those struggling with disordered eating patterns.

The Historical Tension Between Fields

The tension between the eating disorder and food addiction communities dates back to around 2011-2012 when food addiction research began gaining momentum. Many eating disorder professionals initially rejected the concept, arguing that all food addiction symptoms stem from dietary restraint or restriction. Their perspective was shaped by their clinical experience: when patients with eating disorders resumed regular eating patterns, many of their “addiction-like” symptoms disappeared.

This led to a deeply entrenched position that food addiction simply doesn’t exist as a distinct phenomenon. As I explained on the podcast:

“They had a very strong selection bias based on who they were seeing… They dug their heels in really deep and said this is not a real thing, it doesn’t exist. And they had some very clear talking points: It’s only in rodents. This isn’t in humans. It hasn’t been proven.”

The political climate around 2016 intensified this division, creating an environment where discussing concepts like food addiction or obesity could trigger hostile reactions at professional conferences. Practitioners felt pressured to declare allegiance to one side or the other, with little room for nuanced perspectives.

Rigidity vs. Fluidity: The Core Philosophical Difference

At the heart of this divide is a fundamental philosophical difference that I’ve observed between the two approaches:

The eating disorder model generally views rigidity as the problem. It promotes cognitive flexibility, making peace with all foods, and addressing psychological factors underlying disordered eating.

The food addiction model often sees rigidity as part of the solution. It acknowledges certain foods as potentially triggering and may recommend abstinence from specific ingredients or food types.

These opposing viewpoints create conflict in treatment settings. As I noted:

“If someone is really working to eat in a way that’s going to help heal their brain from the ravishes of addiction, but their therapist is challenging all of their cognitive rigidity and saying you need to ease up and just lighten up, right? There’s a conflict there.”

Moving Beyond Diagnosis to Personalized Care

Rather than focusing on rigid diagnostic categories, I advocate for seeing both conditions on a continuum. Most people exhibit symptoms of both food addiction and eating disorders, with some leaning more strongly in one direction than the other.

The key to effective treatment lies in careful assessment and personalized care. I recommend:

1. Creating a detailed timeline of someone’s lived experience
2. Using standard screening tools while developing clinical intuition
3. Focusing on safety and stabilization first
4. Empowering individuals to discover their own sustainable path

As I emphasized in the podcast:

“Make a timeline of someone’s lived experience… When did it start? But if you think about adding trauma early, like addictions, right, life stressors, all the things, and you start to see the diet and how it all plays together, you can get a really clear picture.”

Challenging Traditional Models with New Research

My recent research has begun challenging the long-held assumption that food addiction is merely a consequence of dieting. Through structural equation modeling of data from over 300 patients, I’ve found evidence suggesting that for many people, the pathway runs in the opposite direction:

“We are now able to show empirically that a lot of dieting is a result of food addiction, that it starts with the loss of control, eating and the food addiction. And it ends up becoming the purging, all the other things, the obsession with appearance, etc.”

This finding has significant implications for how we conceptualize and treat these conditions. It suggests that addressing addiction-like eating patterns may be an essential first step for many individuals before they can develop a healthier relationship with food.

Integrating Individual and Public Health Perspectives

Another crucial continuum to consider is between individual health and public health approaches. When discussing issues like ultra-processed foods, it’s important to distinguish between guidance for individuals and population-level concerns:

“There’s a difference between what a person should hear and what the country should hear… We need to think about ways to talk about nutrition, health, body image, the food supply in a way that’s sensitive to people and to populations as a whole.”

This perspective acknowledges social justice issues, including food insecurity and access, while still recognizing the harmful effects of our current food environment. As I argued during the interview, if low-income populations have limited food options, we have an even greater responsibility to ensure those options aren’t harmful:

“If it is true that we have disadvantaged populations that can’t afford healthy food, then we have even more responsibility to make sure that food is not toxic, poisonous and addictive.”

The Path Forward: Wise Mind Nutrition

To help bridge these divides and provide practical support, I’ve developed the Wise Mind Nutrition app. This platform embodies the middle-ground approach I advocate for, offering:

• Educational content that challenges black-and-white thinking
• Tools for food logging and reflection
• Personalized feedback based on individual patterns
• A supportive community environment

The app is designed to empower individuals to discover their own sustainable path rather than prescribing rigid plans. As I explained:

“It’s this adventure of curiosity that makes people positioned for success afterwards… The journey of learning and doing the assignments and reflecting and sharing and eating food with people… that’s gonna empower someone.”

Conclusion: Embracing Nuance and Doing Our Own Work

The path to reconciling these seemingly opposed approaches requires embracing nuance and complexity. Both food addiction and eating disorder models contain valuable insights, and most individuals will benefit from an integrated approach.

Perhaps most importantly, this work requires us as professionals to examine our own biases and do our personal healing work:

“In order to stay flexible in our thinking, we have to do our own healing work. If someone has a lot of unresolved trauma, being able to hold dialectical truths is gonna be more difficult. So we have to do our own work to be open minded and open hearted.”

By staying curious, remaining flexible in our thinking, and prioritizing compassionate care over ideological purity, we can better serve the diverse needs of those struggling with disordered eating patterns in all their forms.