00:03
Hey everyone, it's Mikki here, you're listening to Mikkipedia, and this week on the podcast, I speak to Dr. Jen Unwin. So Jen is a clinical psychologist and a self-stated food addict, and unsurprisingly, that is the topic of conversation that we have today. So we discuss what food addiction is, why there is so much controversy over the term addiction, how to know if you are addicted to food and what that even means.

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and what steps to take to help overcome. Jen has over 35 years of experience in her field and she's really taking the helm with her colleagues in this space to get a consensus on food addiction and potentially also reduce any stigma that might be attached to it. So Dr. Jen Anwin is a consultant clinical health psychologist and has been working in the NHS for over 30 years.

01:00
helping people with chronic illness to live well with their conditions. She has researched into the importance of hope and health and wellbeing. She got a great book called Fork in the Road about food addiction in her own journey and helping you overcome. And we discussed this in the podcast. And she's recently collaborated with her husband, Dr. David Unwin, to support patients in primary care to manage their diabetes with making lasting changes to their sugar consumption, to improve their condition and reduce medication.

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And so Jen and I also discuss, of course, the low carbohydrate approach and its applicability here. Jen has been actively involved with the British Psychological Society, of which she is a fellow, and also the UK Association for Solution Focused Practice, of which she is a past chair. As I already mentioned, and Jen and I talk about, she's also the author of Fork in the Road, a book about food addiction, how to overcome.

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So I have links to Walk in the Road and to Dr. Jen's Twitter account, and also links to Eventbrite for the International Food Addiction Consensus Conference 2024, which is taking place this Friday. Now, I mean, if you were lucky enough to be in the area and could go along, there are some fantastic speakers, including Rob Lustig and previous guest, Dr. Anna Lemke.

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However, they also have online tickets, so if this is an area of interest to you, I highly recommend checking it out. Before we crack on into the interview though, I would just like to remind you that the best way to support this podcast is to hit the subscribe button on your favorite podcast listening platform. That increases the visibility of this podcast in amongst literally thousands of podcasts that are out there. So more people get the opportunity to learn from experts that I have on the show, like Dr. Jen Unwin.

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Alright team, enjoy this conversation.

03:00
Jen, thank you so much for taking time to speak to me this morning. I really appreciate it and I was very sorry to have missed you and your husband when you were in Auckland earlier this year. I guess your interest area and just what you spend your life work on are just real passions of mine as well and I really like to try and understand more, particularly the food addiction side because I feel like there's a little bit of, not controversy, but...

03:27
it's for whatever reason, it's not as well accepted. So I'm pleased to spend time with you this morning. Can we begin by you going through the, I guess the catalyst that led you to specialize in the psychology of diet and food addiction? Yeah. Because I know that you've got a bit of a journey. Yeah, totally. Okay, so cutting a long story so it doesn't go on for too long.

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So I'm a clinical psychologist by background. So I've always worked in the National Health Service. I've actually retired from the National Health Service in the UK now, just to focus on this work. So I've always obviously been interested in behavior and how you help people to change and motivation and all of those mental wellbeing, all of those kinds of issues. And I particularly was interested in the idea of

04:23
of hope. So that's been something that I did my doctorate on and the importance of hope in healthcare, but also obviously generally in terms of how people adjust to challenges or cope with life. So I'm very interested in hope. Outside my professional life, looking back, I'd always been...

04:49
a sugar addict. From very young, I can't really remember a time when I didn't really want sugar, wouldn't be looking for sweet treats and thinking about them and wanting them. I just can't remember a time when that didn't happen. Running alongside that successful career was a person who had real challenges with weight management because I would go through phases where I'd eat whatever I want and inevitably put on weight.

05:18
quite altered way and then get to the point where I was so fed up with myself and felt so ill and depressed that I would embark on some strict whatever the latest thing was. I think I've done everything and all the schemes and groups and diets and so on. That went on for many years really until I did stumble across the idea of low carbohydrate.

05:46
high, moderate protein, higher fat eating. That was a real game changer for me. I did so, so much better avoiding carbohydrates. That was a real step change. That's what led into my work with David actually, where we were focusing on people with type 2 diabetes and other conditions that his practice, we worked together on that. For me personally, it didn't.

06:13
It didn't seem like the full story because I could still really overeat on certain foods or I did that thing that a lot of people, where you go down the rabbit hole of keto baking and it's still low-carb but it's got all these sweeteners in it and stuff like that and nut flowers and I could really overeat all of that stuff. Time goes on, time goes on and I get to about...

06:37
maybe eight years ago. I'm listening to Bit Njonsson, who's, I don't know if you've come across her, but she's from Sweden. She's a registered nurse and she's specialized in food addiction for the last 30 years. She's one of the people in the world who started talking about this and is very clinically skilled. There were some videos of her on Diet Doctor, the website that we often recommend to people when we're saying, go low carb, there's loads of recipes here. They'll explain what they're doing.

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what you need to do and why. I was watching some videos of her on the Diet Doctor website talking about her work and talking about this concept of sugar addiction, she basically called it, sugar addiction. I just recognized myself totally in what she was saying. That was the real epiphany moment. I went to train with Bitten. She does an online training course for

07:36
From there, the rest is history. I've just focused on, obviously still collaborating with David, but really focusing on this issue, trying to learn as much as I can, looking at all the research, doing some research, which I've got exciting news about. Then the campaigning work. Much of this I do with a colleague called Heidi Yeva, who I met when I was training with Bitten. She's a nutritionist based in the UK at the moment.

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we're currently working on getting together a consensus between all the clinicians, researchers, and other people working in this space on what's the nature of this thing, what should we call it, what's the research that's out there, what more research do we need, etc. etc. So we're focusing a lot on that sort of campaigning work, although we do still do, Heidi and I do retreats for people.

08:35
with food addiction so that they can get a grip on it and after care and so on. That's it in a nutshell really. It starts from a personal experience and then also witnessing in David's practice how incredibly well people do with low carbohydrate if they're type 2 diabetic, even type 1 diabetic, have obesity.

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other problems, sometimes mental health problems. They do incredibly well and yet still people struggle. You'll have seen this yourself. A proportion of people struggle to stick to it, even though they feel so much better. They'll go ahead and sabotage their progress. That's interesting and it's interesting to be able to explain to them why they've done that.

09:32
People are mystified by their own behavior as I was, as a psychologist, I was mystified by my own behavior that was sort of self-harming and other people are too. But once you see it through the lens of addiction, it all makes sense. So we do quite a bit of this work with the patients with diabetes as well. Amazing. And I think some of those things that you mentioned, Jen, I imagine there'll be a lot of listeners who will recognize some of those.

10:00
behaviors that you mentioned with food or just ways of thinking because I often think that you don't know what's normal and what's not normal out there when it comes to how you are around food and how you should behave and of course there are a lot of messages particularly in my field of how we cannot call food good or bad. You cannot say that food is addictive that there must be this moderation is balance and and all of these words are thrown around which actually

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that actually thinking about the individual and what's balanced for them, you know, and what means moderate to them, which is why your work is so important. Yeah, no, that it's a great point. And you're right, that in particularly in the eating disorders world, there's this idea that recovery looks like people being able to eat a bit of everything in moderation and not worrying about it, not obsessing about food. But the problem with that.

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for a food addict is they'll never be able to eat certain things in moderation. So whatever their, in quotes, drug foods are, and they're usually things that are high in refined carbohydrates, sugars, often combined with fats and salts that have this sort of real potential to light up the reward centers. And some of us have this overblown reaction to those foods. And we'll...

11:25
just never be able to eat, let's say, biscuits, cookies, cake. I'd never be able to eat that in moderation because it would just light up my reward center. Then that craving and that compulsion to eat more is kind of at the kind of, I can explain why it happens in the brain, but it's kind of out with my conscious control. I'm so driven that I don't

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pre-verbal level that I will carry on reaching for those foods, even though I've decided not to or wishing not to do that logically, I'm still driven to do it. And that's why we try and explain to people, it's not their fault that they behave in this way. But once you've understood it, as I say, through this addiction lens, then you know what you can do to keep yourself safe and to not pray to that.

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But it's kind of evolutionary. You know, it makes sense from an evolutionary point of view, from a survival point of view, driven to eat things that are going to help us put on weight and survive the winter. We're literally driven to do that at a very fundamental level. But once you have all the right information.

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know, it's really possible. It's really possible to recover. That's the hope. That's the hopeful message that, you know, I really want everyone to hear is that it is an incredible struggle and people feel very ashamed and tend not to talk about it. But, you know, there really are, you know, the research we're doing is showing that, you know, recovery is entirely possible.

13:14
if you sort of see the behavior through that lens and then do the things that that would imply, the cravings and the other symptoms of food addiction will lessen. A bit like type 2 diabetic, you'll always be a food addict in the background, but if you're abstaining from those foods, essentially, then the symptoms go away at least. Yeah, for sure. I think what was...

13:44
What some people might find a little bit surprising, Jen, is how you also spoke of the keto baking and the sweeteners and the almond flowers and things which people don't necessarily sort of correlate with big food or the processed foods that we should, that we quote unquote know are likely to, I don't know, be more problematic. So in your experience, are these as problematic or can be for some people

14:13
how they mimic the sensory pathways. Yeah, I think that's a good way to put it. So most people with proper food addiction would struggle to moderate things that mimic their drug foods in terms of sweetness and palatability and so on. So that's really the problem with sweeteners because they...

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the whole taste experience and the fact that that confuses the brain but also the biochemistry. It's not that, so essentially they don't have the triggering carbs and glucose and other things in them, but it is that that makes them, they do mimic as you say.

15:05
Again, nothing universal is it? So there is an individual. Individuals, some can cope with some nuts or a bit of nut flowers, maybe so long as it's not too sweet. So really we encourage people to be very honest about what their own experience is after they eat certain things and then decide, right, is that something I need to add?

15:29
the list of things I need to avoid because obviously you don't want people cutting out things unnecessarily because then it does start to look a bit more like an eating disorder, but just to cut out the things that really trigger the addiction symptoms and not cut things out necessarily. It's a process of slight experimentation and elimination for those

15:59
There's a few like that. So some people can still maybe have a little drink of alcohol occasionally. I've known people be able to do that. Other people have to cut out alcohol altogether because that also triggers the reward center and sets off food cravings. So I'm one of the people I gave up drinking alcohol. Caffeine is another example. Some people can carry on drinking caffeinated coffee and they're fine. Other people find that.

16:28
that actually that's part of the problem as well. So they put that out. Dairy is another middle thing. So there's some things obviously that you should totally cut out like refined sugars, grains, refined grains. But there's some things in the middle like dairy and nuts that some people struggle to moderate or have cravings, increased cravings for. But other people can have a few nuts or have some dairy. Yeah.

16:58
But yeah, sweeteners, we usually say to, sometimes people find them helpful in the beginning because they're trying to get off all the sweet, sugary foods that they really need to move towards abstinence at their own pace, whatever that is. And sweeteners can be a tool in that. But we...

17:21
and say to people, bear in mind that probably you're going to have to give those up as well at some point. You know, probably you will find that they become problematic in their own way at some point. But yeah, it's an individual for sure. I remember when I did the Sarah Wilson I Quit Sugar program. Well, I didn't do it properly actually. I just went, oh, I really need to give up all of these sweeteners and sugars. And I remember after about 10 days,

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blueberries tasted incredibly sweet to me, which prior to that, they'd just sort of, they'd been quite bland and a lot of food were like that. And is that a normal experience of someone who goes through the elimination, Jen, in your experience? Yeah, totally. You start to taste the sweetness in things that really had no idea were sweet at all, like almonds or milk. So milk's one where, I mean, we actually know that there's a...

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every hundred mils, which isn't very much really, there's a teaspoon of sugar and you get, you start to really taste the sweetness in milk, for example, which would never have occurred to you. And the other thing that always really surprises people is that suddenly their toothpaste starts to taste incredibly sweet because it has got some, it's in it. So, you know, at the end of the day, you're brushing your teeth, you know, this is really sweet. And I've actually found, I've actually found a toothpaste that doesn't have any.

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any sweeteners in it. I actually use that now. All kinds of things happen to your taste buds that you're really surprised about the sweetness, like you say in fruit and so on. Of course, back in the day, that was the driver for people in the autumn was to eat the fruit so that they survived the winter. They put on some fat and they survived the winter.

19:12
fruit, you know, tastes sweet and pleasant to us. And we want to eat more of it for that survival mechanism. Yeah, sure. And how you described, you know, the process or at least just parts of the process of reducing or figuring out what foods trigger is really similar to how you approach any nutrition problem. Not that it's a nutrition problem per se, it's almost like the nutrition is the symptom of the problem.

19:40
You know, an elimination diet is like gold standard in a lot of the areas that we work in, in our field. Jen, are there common misconceptions that people have about food addiction that you come across in your practice about either what it means or how to approach it? Like, do you have anything like that? We get a lot of sort of wealth, and I think because we've sort of up to now been calling it

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food addiction. People say, you know, well, how can you be addicted to food? You know, you need to eat. It's not like cigarettes. You don't need to smoke or alcohol. You know, there's other things to drink other than alcohol. So people say, well, you know, be addicted to food. So I think in some ways, what we're calling it is a problem. And that's, again, what we're working on with this consensus exercise that we're doing with all the experts in the field is, you know, what

20:37
There's never going to be a perfect thing to call it because some people sort of disagree around the edges of whatever you choose. But really, food addiction is too broad. We need to be a bit more specific. Which kinds of foods do people struggle with? Also, it's not just sugar. That's the other thing. We do need to think about the sort of A, the carbohydrate angle. So a lot of people will say,

21:07
I don't eat any sugar. I'm not a sugar addict or a chocolate addict because I don't eat those things. But you might find that they're really struggling with bread, for example, is such a common one in practice. People losing control of the amount of bread that they're eating during the day because obviously it digests down very quickly into glucose. So that's...

21:35
One misconception is that it can't be an addiction. That makes no sense. We do hear that a lot. The evidence is there. All kinds of different evidence. Evidence on the neurological side, what happens in the brain when we eat these foods, looks just like any other addiction. The brains of people.

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with severe food addiction look like the brains of people with an alcohol problem or a drug problem. They just look exactly the same. The same changes are going on. The behaviors and the thoughts and feelings are exactly the same as they would be for another addiction. There is lots of evidence to counter that. I think also it's because, I think I mentioned before that people feel a bit ashamed of their behavior. It's not something that they...

22:29
talk about very openly that they've lost control of their eating. Other people say, well, I don't know anyone with a food addiction, but that's because those people aren't talking about the fact that they throw something away because they don't want to eat it and then later on they're going in the bin to try and find it because they've got such strong cravings. It's not the kind of thing you talk to your family about necessarily or your friends. It's very secretive.

22:58
That's what I often say, that's why we often get pushback on social media. Well, I've never known anyone just eat pure sugar out of the bag, but that's because you don't know anyone who's talking about it. Yes, people are, I've done that. So that would be one kind of pushback, I think, just sort of denial of it. And I think that's also partly because, but you know, a quite a

23:26
Nobody is very neutral about food, are they? We all have these very emotional responses when people are talking about food and the kinds of things we should eat. We all like the kinds of things we are eating, so we don't want to change it. Quite a few people obviously probably have a bit of a…because it's on a spectrum, they have a slight addiction to some of those foods, if they're ultra-processed foods.

23:53
So they don't want to be challenged about that themselves. And that's what you find when you're helping people to try and change their own behavior around these foods. They often get a lot of pushback from friends and family who, you know, who don't want to give up those foods themselves. And it's not that you're asking them to even, it's just that the fact that you're doing it or trying to do it, they find sort of

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challenging. So they'll, you know, not maybe in a conscious way, but they try to sort of undermine your efforts. I mean, you've probably experienced that yourself a lot in practice, but that can happen. So yeah, it's an interesting thing, isn't it? It's almost like people feel like you're putting a mirror up on their behaviors when you're changing something about yourself, because they then start to think about what they do and they start to question it. Whereas

24:51
It's interesting what people take personally with nutrition that actually isn't personal to that person at all. It's actually the person themselves. It's someone else's journey. I find what you said about dairy super interesting actually, Jen, because people talk about being addicted to dairy. And when I, as a clinician, talk to particularly women of actually during perimenophils, it

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the consequences of having it throughout that phase. And it's like you're asking them to chop off their arm. Like there's just this thing about dairy that people find incredibly difficult to give up. Do you have that in your practice as well? Yes, totally. And some people we've had on our retreats, they've been doing low carb for a long time, but they've got a problem with cream or yogurt or, as you say, they're really struggling.

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in the same way with dairy. And of course, a lot of the clients that we see are women of that age, they're the most common client that we see. Because I think that's when the health problems start to kick in. It's when they start to think, well, I've tried everything else, you know, I've tried every diet, and I'm still got these problems. Yeah, so dairy is a really interesting one. And of course, I think that the thing there is that...

26:17
When you get, you don't often get in nature these combinations of carbohydrate and fat and protein. That's quite a rare thing. Either usually it's a vegetable and then it's sort of carbohydratey or it's a piece of meat and fish and then it's proteiny and fatty. It's not that you get those combinations. Whereas in dairy and nuts, you've got those combinations that are very moorish.

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you come across Ken Berry, he's a doctor in the States who talks about the proper human diet. Ken's pretty good on the topic of dairy and he says, of course, we're the only species on the planet that eat dairy as adults, all other animals. It's for babies, nursing and getting them to on weight and to eat so that they put on weight. That's what milk is for and that's where

27:13
obviously all our dairy, then Ben can say, well, we're the only species that eat it as adults. It is a growth food, it is designed to be easily consumable so that babies grow and put on weight. It makes sense. Then I don't know all of the information on this, but dairy and cheese in particular, you can get converted into morphine like substances in the gut.

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And then of course, that can be a little bit addictive because if people are very stressed or they may be in some pain or whatever, you know, there's that tiny bit of relief when you're, if you're having that, certain people have it more than others. If you're having that response, consuming dairy, it's going to be reinforcing. So you're going to repeat that behavior. So there's this interesting sort of...

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things that go on in the body when we eat dairy that are a little bit different, but they do have that ability, again, to light up the reward center. Also, there's something about certain textures that people with food addiction get to like. One is crunchy things, but the other is the smoothness of cream and dairy. It's comforting, isn't it?

28:40
mouse feel. That can be another factor as well. There's lots of different factors that play in. Another interesting one is the stretch receptors in the stomach. When we eat a large meal, you can get that release of oxytocin, which is again a relaxy, comforting hormone, really neurotransmitters.

29:07
That's another explanation of why some people will like to overeat on anything really, just to get that really full feeling. That totally resonates with me, Jen, because when I was reading your backstory and you do such a lovely job on your blog post when you're like, hey, this is me, this is what I went through, and you talk about your childhood and the foods and stuff that you loved. The condensed milk was the one from my, oh yeah, that was delicious.

29:37
When I was like, I have been an overeater for like throughout my childhood, I overate all of the time and it wasn't unhealthy food. It was just to have that feeling of fullness, those stretch receptors. And it actually in my adult life took me, I still am a volume eater. I still eat large quantities of food, but I have been able to train myself to not overeat.

30:05
actually. So now it's very rare. But I do know that if I don't have a particular volume of food, I feel a little bit anxious isn't the right word, but I'm distracted. I'm like, I need it to feel calm. I need to have this amount. Like a small meal is, I don't enjoy a small meal. Because I know it's just distracting to me. Yeah, same. It just lights up.

30:29
It lights something up that then becomes a sort of craving that you can lose control of. I agree. Lots of people with food addiction do struggle with this issue of once they start eating, you always feel a bit sad when you have to stop eating. So how do you kind of deal with it? People have different approaches. So I've known there's quite a few, obviously a lot of the professionals in this space are themselves.

30:57
food addicts and that's why they've learned how to help other people. They will literally weigh and measure their meals to stop them overeating. I've personally resisted doing that. It doesn't really sit well with my personality to carry scales and things with me. I totally respect people who are able to do that and keep up with it.

31:28
I'm not saying people should do this. This is totally people's own. You find your own way, don't you, as you have. I don't tend to eat breakfast because I'm not very hungry in the morning. I think, well, why start if I don't need to start that? Because once I start eating during the day, it's a little bit more difficult. I have a really good brunchy lunch with plenty of protein and fat in it, so it's very satiating.

31:57
I love that, you know, some time around the day and then I'll have, I'm not quite as hungry later on, that can help. And then I'll have a sort of smaller meal in the evening and I have it reasonably early. I don't try not to eat later on because, partly because I sleep better, but also it's quite good to have a sort of cutoff wherever I've eaten that. That's it now. It's easier for my brain to understand we're not having anything else than it is, you know, do I.

32:26
Oh, am I still a little bit hungry or shall I have another little snack before I go to bed? So just literally have those sort of two mealtimes to deal with. And food addicts often find that things like cutting out snacks. So we always advise on our course that try and cut out snacks because otherwise your brain is kind of wondering if it's time for a snack. Yes. Whereas you need fewer decisions.

32:54
You need to take away the decision load. Now get all your nutrition into however many meals you're going to have today. I'm not saying people shouldn't have to read the can if that's what suits them and their lifestyle and hunger and so on. But have some ring fencing around your eating times and choices. There's certain things, obviously, that we have to be abstinent from.

33:22
And again, that's an individual thing, but it's very commonly refined sugars and carbohydrates and combinations of those with, so, you know, unprocessed foods and ultra-processed foods, yeah, try and avoid. So focusing on real full foods as nature intended, prepare those in whichever way you choose and limit the meals.

33:52
Yeah, and I like the way that you talk about that because I really do feel there is a bit of freedom when you've got those food rules for some people because it just takes... It takes history. Yeah, and people who sort of criticise or question that, I feel like they don't have either the lack of personal experience or people around them who they see actually really benefit from it. And I think this is the...

34:18
This is a problem with the nutrition spaces as I see it right now is that people see any type of restriction as deprivation for that individual without actually seeing how much it's actually offering them in terms of peace of mind and the ability to control their behavior, all of those things. You must see that all the time in your work. All the time, all the time. So we did a residential recently and we just had the followup.

34:48
couple of weeks in and people were saying, well, it's amazing because when you're a food addict, people don't realize that actually your brain is full of food thoughts from the minute you wake up to the minute you wake up to imagine, when can I eat? What can I eat? Can I have that? No, I shouldn't have that. Oh, I had too much of that. I mean, it's this kind of constant chatter and it means that you can't focus on really what's important in life. So if you can be free.

35:18
from that. You're more connected to your work, you're more connected to your family, you're more connected to the things that you can do. We've talked a lot about food, but we also talk a lot on our courses about if we're going to give up these food, the absence from these foods that have been serving us in some way psychologically, whether it's stress management, comfort.

35:45
structure, whatever we've been using these foods for, then we need to find a way to get this oxytocin, this dopamine, the serotonin in other ways in our lives. And having some rules around the food frees up the space for us to say, right, well, I need to go walk in the sunshine or I need to, you know, to go around, you know, thinking about other sources of those

36:13
neurotransmitters is a massive part of recovery. You don't want to be white-knuckling your way through life. It gives people other ways of managing their emotions. We do talk a lot about beyond the food initiatives that it's important to build in those new habits that are nothing to do with food because food has become too dominating in our lives.

36:43
For sure, Jen, are there any particular lifestyle behaviours that you see are really helpful for people as they move through their journey? Or is it individual? In your experience, what do you see? Yeah, I mean, obviously it's individual to some extent, but I'd say the biggest hitter is probably some form of exercise or activity. I mean, it doesn't have to be crazy, crazy vigorous. We're not punishing ourselves by, you know,

37:12
I've eaten this many calories so I need to run them off. That's more eating disorder type thinking, but it's building in some physical activity during the day, preferably outside if we can manage it. Oftentimes, it can help to maybe do that with someone else or if you've got a dog or whatever.

37:39
hits all the markers in terms of you're going to get those endorphins, you're going to get dopamine, you're going to get serotonin, particularly if you go outside and you're getting the sunlight in the morning, that's really important. I always like to encourage people to think of we are animals at the end of the day and we've evolved a certain way. The more we can do to be like...

38:09
proper humans that evolved. Probably the better our quality of life and mental health is going to be. So yeah, being outside, being moving, being physically active, being sociable, you know, doing things. I think this is why volunteering and helping people is so good for mental health. You know, it's...

38:36
We used to rely on each other to survive literally. So, you know, if we can do things that are altruistic, that can make a big difference as well. Also things like, you know, gardening, singing. I'm a big crafter actually, so I do exercise every morning. So I'll be going this morning. I go to a boot camp. But also if I can get a walk in every day outside, I do.

39:06
Also, I love to knit and crochet in the evenings. I'm crocheting because it's sort of incompatible with eating. If you sit down, I've got you knitting on your knees, it's a bit of a get up and go to the fridge and you don't want to get greasy hands and so on. So finding something, yeah, just finding something that you love and activity that you love and enjoy and building that in to your life. And

39:36
things can't we as time goes by really. Yeah, and I guess that's the thing as well is, you mentioned with people who have type 2 diabetes, that will always be there in the background for them, yet we can control their metabolic parameters through the diet. The same I guess with food addiction.

39:57
that it's likely to always be in the background. And I think even having that understanding and awareness that it might, or acceptance of that, I think that must make it a little bit easier for some people. Because I often see that in my practice, not in food addiction, but in other areas when people actually accept, well, this is something I actually have to work on. And it does feel hard sometimes, and that's normal. I think that's almost a relief for them. Yeah, I totally agree. I think it really, really helps to accept that.

40:27
people learn that as well along the way because they kind of, they might do abstinence for a while and then they'll think, oh, I think I've nailed it now. I think I've got it. I think I'll have a little bit because it's my birthday or whatever's going on and they'll have a little bit and it can go really horribly wrong. But then that's a learning experience. It's not something to beat yourself up about. It's right. Okay. I've learned something.

40:54
And often it does take those couple of slips and trips to really, for people to really accept that that's the problem and really do need to abstain from certain things. So that can be really, really useful. And there's a sort of, we also give them a sort of the explanation of, so what happens

41:24
certain foods, particularly ultra processed foods, high sugar and fat foods, we get these unnatural levels of dopamine in the brain. What happens is that some brain receptors for dopamine and serotonin get downgraded so they're less sensitive, if you like, to the dopamine that's around. Of course, that explains why you need more and more of the substance to get the same effect.

41:52
sort of in a downward vicious cycle really. So it's the same with any addiction. Say if you take alcohol, people will recognize that if they have one drink a night, after a while that doesn't really affect them much. So they might kind of up it to two glasses a night and then the body gets used to that, the brain gets used to that. So it's the same with the foods that you need more and more to get some sort of effect. There's this downgrading of the receptors. So when we go abstinence,

42:22
What happens is that the brain goes, aha, okay, right, feel a bit rough for a while. And we've got this sort of low availability of dopamine. So the receptors are sort of upgraded again, you get more receptors for dopamine. So that their normal life seems normal. You have these normal levels of sort of motivation and good mood and so on.

42:47
Then, of course, if we then slip up and say we had a big slice of cake, those receptors are all there ready. When we have that big slice of cake in the slip, the brain really lights up. We get this kind of wow. You're straight back in, straight back into the addiction. Then trying to pursue that high again. It's this sort of...

43:10
we call sort of euphoric recall. We're trying to get back to that euphoria of the first time we had that food or that slice of cake and you're chasing it down a rabbit hole and life becomes more and more restricted. So I explain a little bit more about that in the book, but there's things going on in the brain that explain all of our experiences around food addiction.

43:36
You know, a lot of the stuff that we've been chatting about, I can imagine there'll be people listening going, well, that sounds a bit like me. I sounded a bit like, you know, like, so they may, as I said earlier, but again, with all of this other information, sort of resonate a little bit with this. How do you know if you are food addicted, actually? Okay. So, so there's kind of six sort of key, key symptoms and criteria.

44:05
for any addiction, but if we're thinking about food, and this explains more. I've written a little book, really very simply done for the general public, it's called Fork in the Road. You can get it on Amazon. All of this in a lot more detail and any proceeds go towards the charity and the work that we're doing in the space. The six are cravings and compulsions

44:35
impossible to control. So C for cravings. R is reaching for more. I've just said that thing about needing more and more to get the same effect. That's rough. A is activities neglected. That picks up this idea of we start to get so obsessed with the food that other things in life get left behind. So that's the A.

44:58
V is volume and this is what we were talking about, losing control of the volume of food that you eat. So thinking to yourself, right, I'll just have one slice of cake because it's my birthday and then just losing control of the amount, never being able to sort of just have one slice or one piece. So V. E is for exclusion and this picks up the idea of if you try and give up

45:27
Do you get withdrawal symptoms? So do you either mentally or physically? So you do get like, so some physical symptoms will be things like headaches, shakiness, gastrointestinal distress, problems sleeping, that kind of thing. But also, do you feel maybe anxious or depressed, you know, at the physical or mental health? Issues.

45:55
try and quit. So withdraw symptoms basically. Then number six is D for damage and this is continuing to use the food even though it's doing you harm mentally or physically. This is the key. One of the features of addiction really is you know it's doing you no good either physically perhaps because you've got type 2 diabetes or you're worried about your weight or...

46:24
or mentally, you've got mental health challenges, feeling depressed or anxious, which we know that's linked with high sugar, high processed food diets, but are you still struggling to change that behavior? So those are the six. And if you've got three or more, that's not a diagnosis, but it's an indication of a problem. And then the thing to do would be to...

46:53
obviously read the book. There are loads and loads of services and people, but there are. There's Overeaters Anonymous, which is completely free and there's lots of online meetings that people can attend. I can send you some links. I've got some amazing colleagues in North America who are called Sweets of Variety.

47:21
They offer amazing supports and amazing coaching to people. Heidi and I do these retreats. At the moment, we're doing it in an amazing place in the UK, in the Southwest, and it's a place called Coombe Grove, and they specialize in symbolic health, so we're very happy to sort of be there working with them. So if people, sometimes it can be really good to get out of your

47:51
your environment and come up with a tip and then they'll feed you and look after you for a few days and then tell you all the, you know, give you all the information that you need to know and then there's sort of after, you know, this support afterwards as well. So that's another thing that we can do. So and also we've got some, we're running, so we're running this conference on May the 17th in London. So anyone who's in the UK can come in person.

48:20
Or we have got online, there's a live stream option so anyone around the world can sign up and watch the conference. Also if you were in New Zealand, for example, you wouldn't have to watch it at the time it's on, which would obviously be in the middle of the night. It's recorded. Yeah, so that's in London, as I say. We've got really all the best world experts coming.

48:43
to speak on the topic and talk about the latest. And we're launching this consensus statement that we've all been working on all year, which is the next step for going back to the World Health Organization to say, this is the consensus now around this condition, there's all this research as well. We're asking that it gets recognized as a legitimate disorder that people.

49:11
you know, there'll be more research then and also, you know, there'll be more research into treatments. Yeah, nice one. Jenny, you mentioned at the start of our call that you've got, there is some new research that you are really excited about that is coming out. Can you give us any sort of indication on what that is? Yeah, of course. So what we did, because there's very little outcome,

49:39
research in the literature on food addiction. There is research on food addiction. There's a lot of papers using a particular scale called the Yale Food Addiction Scale, which is based on the DSM criteria for food addiction that they use in America. So we thought, right, what we could do is just literally audit the work that we were doing, which is based on these ideas of explaining to people how the brain works and why food can...

50:07
can cause addiction and then also encouraging them into this real food, low carbohydrate eating and then give them some support. Also, we knew of a couple of other clinics that were working in the same way. It's Sweet Sobriety in North America and then a group called Lever Succa Fry, which is living sugar-free in Sweden. They both had online programs like ours where they were encouraging people.

50:33
to do this sort of abstinent food plan, but also explaining about food addiction and moving towards abstinence. So we thought, right, well, we'll all do it. We'll all order our practice. So that started a few years ago, and we all ran 10 week online groups, and we got people to complete questions. The Yale Food Addiction Scale, the Crave Scale, which is the six questions that I asked you, that's the one, the scale that we developed.

51:02
and very easy to use in clinic. That's why it's a good one. Quality of life, well, it's well-being measure, the Warwick Edinburgh mental well-being scale, and obviously things like weight and HbA1c and so on if they had them. But we weren't so interested in that. We're more interested in the food addiction symptoms. So we did the 10-week pass and then we've been doing the follow-up. And the initial data looked really good. We've published that. So the paper's already published, which is the before and after.

51:30
program and that was all everything significantly improved. But now we've got the one year data which we're going to be showing at the conference. But we're super excited because people continue to improve once they've had that information. And yeah, it's all looking really good. So we're basically going to be saying, well, this approach which works in three different sort of cultural settings.

51:58
what is a successful treatment for people with food addiction. So that's super, super exciting to be able to show that. I mean, it's what we thought was happening, obviously. And obviously, there need to be other trials comparing different kinds of treatments. But it's just the first time really it's been shown that there is a successful treatment for food addiction. You know, and we know that you can treat.

52:26
So it's not too much of a surprise, but it is the first time it's been demonstrated. And we'll be obviously writing that up and publishing that as soon as we can after the conference. Yeah, that sounds amazing, Jen. And I think that there's, you know, you're right, you know, for, for, you know, people love when published research has the comparison of different treatments. And so we can sort of compare them head to head. But ultimately, like,

52:53
I just think at that individual level, you're working with people and you're seeing those real results. And I know in my clinic, just the success that people have, and I'm not even thinking of food addiction, but just even just how they feel day to day when they make diet changes that sort of align with the approach that you're talking about, the lower carbohydrate, higher protein, more fat, just how they feel on a day to day basis. Like you have thousands and hundreds of thousands of anecdotes.

53:21
But you're right, it isn't until it's published. It's putting it together, which is so powerful. Yeah, and it does want to be published. And really, it mimics the same thing that David and I did with the work for the type 2 diabetes. Yes, it's literally many, many case series kind of added together. The fact you can do it in the real world, I think often the problem with...

53:48
these sort of randomized control trials is that you're trying to control so many things and you're selecting patients, you know, they've only got this problem, they haven't got this problem, they have to be not on this medication, not on that. You're trying so many things that even if you get an amazing result, you're then not sure that clinicians can do that in practice because

54:08
you have to take the person that walks through the door. You can't say, oh, I'm, you know, you can't do this protocol because you're over 65 or you're on antidepressants or whatever, was it the original trial? So there's this sort of external validity, if you like, that these kind of what we're publishing, what David publishes, shows, which is that it works for heaven's sake.

54:38
you're sort of bridging that gap between the research and the clinician. And I think that's what makes your work just even more exciting. I think so. I'd be super interested to see that paper when it comes out. And of course, look into the online food addiction symposium that you're running, because that does look super interesting. And I and there are some people on there who I've also interviewed for my podcast, who are just real specialists. So that's yeah.

55:07
Really looking forward to that, Jen. Yeah, yeah. Amazing. It's going to be an amazing day. Very excited. So obviously I will put links to that and to your book, Fork in the Road, and your website in the show notes. With some of those other links as well, like the Sweets of Briety and the Swedish group, like it was so great for you to sort of offer up those other resources. Jen, can you just mention for our listeners where they can find you and your work? Yeah.

55:36
So I hang around on X, which I still can't call X. I have to still call Dr Jen Unwin. So that's easy to remember. Dr Jen Unwin. And also, so our website is so we now call it, Heidi and I now call ourselves Food Addiction Solutions.

56:04
part of Heidi's charity, which is called the Collaborative Health Community. So I can, I can send you the links to the website. And the other project she's got is collaboration for kids, which is the sort of, really the idea of that is why don't we try and do some preventative work? And that means that young, young people who've got higher levels of food addiction, even than we have, need to be encouraged to eat these real whole foods as nature intended. And

56:33
a massive project that she's doing with, you know, in schools and different settings to try and encourage parents and children to eat real whole foods. Yeah, oh, that sounds so amazing. And 100% so necessary so people don't have to go through like 10, 20 or 30 years of struggling with something the way that so many, you know, so many people do.

56:59
Jen, thank you so much for your time. I really appreciate it. And yeah, I look forward to seeing more of your work in the future. Yeah, thank you so much, Mickey. Have a good day.

57:19
writing. Hopefully you enjoyed.

57:21
that as much as I enjoyed doing it and super easy to chat to, super passionate in her field. And I really think that you would have gotten a lot from it. And do not forget Jen's book, Fork in the Road, and also those virtual online tickets, if you're not lucky enough to be able to go in person for this Friday's event. That is, if you're picking this up on Wednesday or Thursday, that it is published. Next week on the show, I talk to Victoria Vieira Potter

57:51
adipose tissue. Super geeky yet informative conversation. Until then though you might be wanting to join Monday's Matter and if you do there is still time to sign up. Go to my website mckywilledon.com and you will see a little pop-up box and there is also a tab for Monday's Matter there. It is my eight-week fat loss program designed around protein only days, full of delicious and tasty menus. We eat full meals, there's a strength-based

58:21
program that has been developed by Darren Ellis who is a regular guest on Micropedia and a great mate and an amazing functional exercise specialist and you have the support and connection of hundreds of other like-minded individuals in the Facebook group and all the while I'm there to help guide you through it. Now is the perfect time to think about fat loss. Rather than hibernate on your health goals this winter why not join us and get a head start to...

58:50
the next half of the year. Alright team, drop me a line. I'm over on Instagram, threads and Twitter @mikkiwilliden, Facebook @mikkiwillidenNutrition. Head to my website, mikkiwilliden.com and sign up to Mondays Matter there. Alright, have the best week. See you later.