The Food Addiction Crisis: Why Millions Can’t Stop Eating Sugar | Jen Unwin

Fill out our audience survey via https://drchatterjee.com/survey This episode is brought to you by: BON CHARGE: Save 20% off all Bon Charge products with code LIVEMORE https://boncharge.com/livemore Ever wondered why you can’t stop at just one biscuit? Or why your efforts to eat better go so well for a few days, but you’re soon back where you started – frustrated, ashamed and wondering what’s wrong with you? This episode has the answers you need, along with a roadmap for regaining control. I’m speaking with Dr Jen Unwin, a clinical psychologist who has struggled with and overcome food addiction. And if you’re thinking ‘I didn’t think that was a thing’ then stay tuned for the facts that will convince you otherwise. Over decades trying to understand her own relationship with food, Jen discovered that for a significant number of people, a compulsive habit around sugar and ultra-processed foods is real and damaging. In this enlightening conversation, she explains how sugar lights up the same reward centres in the brain as nicotine and alcohol. And how our hunter-gatherer ancestors may not have needed an ‘off switch’ for eating, but our modern food industry makes it almost impossible for vulnerable people to say no. The research is strong – and Jen is part of a charity campaigning to have food addiction formally recognised by the World Health Organization. That way millions of people would be able to get help from their doctors, in the same way as people with drug and alcohol misuse disorders – instead of being dismissed for a lack of discipline or willpower. Many of us get cravings or have a fondness for sweet or ‘blissy’ foods. So when does that tip into addiction? Jen shares a clever, six-point, self-assessment tool called CRAVED, which you can use right now to understand whether your relationship with food might be problematic. And we get super practical, with advice on whether cutting down or going cold turkey is right for you, how to handle social situations when everyone around you is indulging, and how to set up your home environment for success. Whether you score one or six on the CRAVED scale, I’m certain there’s something in this conversation for everyone. And if you’re someone who has been battling this quietly, perhaps feeling ashamed or hopeless, I honestly believe Jen’s message might mark a turning point for you – one that helps you see a way forward. #feelbetterlivemore Find out about Dr Unwin: Instagram https://www.instagram.com/jen_unwin/ X https://x.com/drjenunwin Dr Unwin’s book: Fork in the Road: A Hopeful Guide to Food Freedom UK https://amzn.to/48nADBj US https://amzn.to/4cM3ikP #feelbetterlivemore #feelbetterlivemorepodcast ------- Order MAKE CHANGE THAT LASTS. US & Canada version https://amzn.to/3RyO3SL, UK version https://amzn.to/3Kt5rUK ----- Follow Dr Chatterjee at: Website: https://drchatterjee.com/ Facebook: https://www.facebook.com/drchatterjee Twitter: https://twitter.com/drchatterjeeuk Instagram: https://www.instagram.com/drchatterjee/ Newsletter: https://drchatterjee.com/subscription DISCLAIMER: The content in the podcast and on this webpage is not intended to constitute or be a substitute for professional medical advice, diagnosis, or treatment. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.

Dr. Rangan Chatterjeehost

Apr 29, 20261h 53mWatch on YouTube ↗

EVERY SPOKEN WORD

105 min read · 21,399 words

0:00 – 2:18
Sugar cravings aren’t a willpower failure: the brain’s reward circuitry
1. RCDr. Rangan Chatterjee
  Many people blame themselves for lacking willpower around sugar. Is this a willpower problem or is it an addiction one?
2. JUDr. Jen Unwin
  [laughs] It's, it's so not a willpower problem. Just to say to people, because yes, people feel so self-blaming, don't they, and responsible for not being able to control what they eat. Yes, sugar has many effects in the brain, but one is to light up the reward centers, like other drugs. Where other drugs, like alcohol, um, nicotine, caffeine, they give us this sort of dopamine boost in, in the brain-
3. RCDr. Rangan Chatterjee
  Mm
4. JUDr. Jen Unwin
  ... which is the sort of reward motivation neurotransmitter. You're going to repeat the kind of things that give you that bit of a high, and, and sugar, sugar will do that. So some of us are more vulnerable than others. But because those are the primitive reward centers in the brain, um, it's not about logic really, it's about a kind of primitive drive. So a, a willpower, yes, maybe to some extent how you set up your environment and other things we can talk about in terms of how you can improve this problem. But once you've got into that addiction problem, you're never gonna solve it with willpower. No, it is much more about the effects of, of sugar and fine carbohydrates, ultra-processed foods on the brain itself, I would say.
5. RCDr. Rangan Chatterjee
  Yeah. It's kind of interesting, isn't it? This idea that sugar can be addictive. I, I guess people would say, yes, there are addictive, uh, properties of sugary foods, but going that step further to say sugar addiction is a real problem, or ultra-processed food addiction is a real problem-
6. JUDr. Jen Unwin
  Yeah
7. RCDr. Rangan Chatterjee
  ... is something that is still pretty controversial. You have been a clinical psychologist for many, many years. I think you identify as a food or sugar addict-
8. JUDr. Jen Unwin
  I do
9. RCDr. Rangan Chatterjee
  ... yourself.
10. JUDr. Jen Unwin
  I do.
11. RCDr. Rangan Chatterjee
  In your view, as someone who's at the cutting edge of this, Jen, why do you think this idea that food can be addictive for some people-
12. JUDr. Jen Unwin
  Mm
13. RCDr. Rangan Chatterjee
  ... is so controversial?
2:18 – 4:45
Why “food addiction” is controversial—and why UPFs change the argument
1. JUDr. Jen Unwin
  Yeah. You're, you're, you're completely right. It, it's, it is still controversial, and people do say, which kinda makes sense, how can food be addictive? Because we need to eat, so it make, it makes no sense that something we have to have can be addictive. So for example, people will say, you know, well, alcohol, you don't, you don't n- need, we don't need alcohol to survive, and alcohol's that substance which we know does have those effects in, in the brain. Whereas food, we, we need it to, to survive. My kind of response to that is, well, it's not all food. So we say food addiction, but we can perhaps go into the nuance of what-
2. RCDr. Rangan Chatterjee
  Sure
3. JUDr. Jen Unwin
  ... what we should call this disorder. Some people say sugar addiction, because there is a lot of evidence now from brain studies that of those effects I was saying about sugar sort of lighting up the reward centers. So sugar we know is, is a s- a substance that kind of lights up the brain. Refined carbohydrates, because they very soon become sugar, [laughs] you know, they, they can, they can have the same effect. And we don't have to eat those foods. So obviously, we have to eat to survive, and we need nutrient-dense food to feed the body and brain. We don't have to eat sugar, and we certainly don't have to eat ultra-processed foods that have been sort of manufactured in a factory and literally designed to hook us. The writing was on the wall for the cigarette companies. Those companies bought a lot of the big food companies and brought their marketing and their sort of science and to the formulation of those foods, and literally sort of have people in brain scanners while they're, while they're testing out their formulations to see what lights up the brain more. So they're kind of literally designing these foods to get us hooked. There's that fantastic book by Michael Moss called Hooked-
4. RCDr. Rangan Chatterjee
  Yeah
5. JUDr. Jen Unwin
  ... which sort of exposes this, this whole kind of industry. So, you know, we probably shouldn't call some of those things food. So that would be m- be my argument really, is that certain food-type substances have the same effects on the brain and, and can become addictive for, for some people. So we have to be... It, I think it really helps to think of the whole thing like alcohol. So we know that
4:45 – 9:18
A continuum like alcohol: from enjoyment to substance use disorder
1. JUDr. Jen Unwin
  most of us as adults get exposed to alcohol.
2. RCDr. Rangan Chatterjee
  Mm.
3. JUDr. Jen Unwin
  Uh, some people really like it [laughs] and they have, uh, maybe too much, maybe harmful uses. But then some people will develop a, a real problem with their relationship with alcohol, will become a substance use disorder. I see it as exactly the same with these kinds of foods, that some of us have this, for whatever reason, genetic, trauma can be a factor, you know, just overexposure when we're very young, um, w- we develop that substance use disorder. Which is very different from people saying sort of blithely, "I'm, you know, oh, I'm addicted to ice cream," because they, they love it and they have it maybe a couple of times a week. It's very different, a person with an actual food use disorder, th- th- the extent of the impact on their lives, for example. So although it's a continuum, [laughs] you've got people who you wouldn't classify as having food addiction as such, and, and people that y- you really would, and those are the sort of people that-
4. RCDr. Rangan Chatterjee
  Yeah
5. JUDr. Jen Unwin
  ... that I identify with, and I'm trying to look into the, the research and look into the sort of treatment programs that can, can help people. But I think using that comparator is a really good... 'Cause everybody understands, e- all the public understand that, don't they? They understand that some people-Have lost control of their relationship with alcohol and they need to abstain. And so it's a very similar picture in my view. But it is still, it is still controversial. And obviously there are people who are very anti the idea, particularly the processed food industry.
6. RCDr. Rangan Chatterjee
  Yeah. We'll, we'll talk later perhaps about the merits of getting this established formally as a diagnostic category, you know, food addiction or sugar addiction, okay?
7. JUDr. Jen Unwin
  Mm-hmm.
8. RCDr. Rangan Chatterjee
  My hope for this conversation is that it helps people understand if they may have a problem with foods. They, they may already know that anyway-
9. JUDr. Jen Unwin
  Mm-hmm
10. RCDr. Rangan Chatterjee
  ... but it may help them see it in a different light.
11. JUDr. Jen Unwin
  Yes.
12. RCDr. Rangan Chatterjee
  And then it's also really practical to help them actually start to do something about it, because I think-
13. JUDr. Jen Unwin
  Yeah
14. RCDr. Rangan Chatterjee
  ... one thing that I think we've both seen lots of is this idea that knowledge doesn't always convert to action. People can read books or listen to podcasts about the damages of excess sugar intake, right? They can see about its relationship with type 2 diabetes or obesity or your teeth or whatever it might be.
15. JUDr. Jen Unwin
  Mm.
16. RCDr. Rangan Chatterjee
  And they can even go on these two, three-week elimination protocols or diets and go through the withdrawal and go, "Yeah, you know what? I've, I've got so much energy. My skin's clearer. Um, I can concentrate for longer. My sleep's better." Yet some people, that's not enough.
17. JUDr. Jen Unwin
  Mm.
18. RCDr. Rangan Chatterjee
  They go back, and as you said right at the start-
19. JUDr. Jen Unwin
  Mm
20. RCDr. Rangan Chatterjee
  ... I think one of the problems is that people then feel guilt and shame because Susan down the road can have a sweet treat-
21. JUDr. Jen Unwin
  Mm
22. RCDr. Rangan Chatterjee
  ... at Christmas once a year-
23. JUDr. Jen Unwin
  Mm
24. RCDr. Rangan Chatterjee
  ... and doesn't think about it for the rest of the year, whereas other people-
25. JUDr. Jen Unwin
  Yeah
26. RCDr. Rangan Chatterjee
  ... they just have it once, and I think you have a quote, "One is too many. A thousand is never enough."
27. JUDr. Jen Unwin
  I love that quote-
28. RCDr. Rangan Chatterjee
  Is it?
29. JUDr. Jen Unwin
  ... because it just, anybody who's listening who has a food addiction problem will recognize that, that it's the first biscuit or the first spoon of ice cream that sets it, sets it off, and then you can't stop until you've had, you know, way too, way too much, and even that doesn't feel like enough.
30. RCDr. Rangan Chatterjee
  Yeah. The, what was the Pringles marketing campaign a few years ago?
9:18 – 15:06
Modern ‘toxic’ food environments vs hunter-gatherer biology
1. RCDr. Rangan Chatterjee
  If we go back to our hunter-gatherer ancestors, do you think that sugar addiction existed back then?
2. JUDr. Jen Unwin
  [laughs] I lo- that's such a great question, and I love the evolutionary lens. I think it, I think it's brilliant, and I think it really helps us to sort of, uh, understand. So I s- I think the reward center evolved in the, in the brain to keep us alive essentially, doesn't it?
3. RCDr. Rangan Chatterjee
  Mm-hmm.
4. JUDr. Jen Unwin
  And one of the things that we needed to do to stay alive was to eat as much as we could when it was available, um, because there would be times when it wasn't available, and particularly in the winter. So this is, I think it's kind of, you know, widely, uh, talked about now, isn't it? That, y- you know, in the autumn we needed to really eat all the fruit that we could find, and it wouldn't be, like, certainly in this country, it wasn't like we have now. There weren't banana trees and, uh, um, what else is a sugary... But mango trees and things like, things we can get now. There would be little sour berries, but, you know, as many as we could eat-
5. RCDr. Rangan Chatterjee
  Mm
6. JUDr. Jen Unwin
  ... would, would help us to put on weight. And the same with nuts, you know. They were there in the autumn, and so we would get those. Um, if, if we were really driven, [laughs] and I probably would've been one of these people, we might shimmy up a tree and get some honey out of a tree from the bees, but we'd have to be really driven to do that because we're gonna get stung probably and, you know, maybe fall out of the tree. So we had to be really motivated to, to go and get that food, and that was how we survived. It wasn't available all year round. So we didn't even have eggs all year round. We would've had those s- everything was seasonal. And, um, there's lots of evidence, isn't there, that, that wherever humans went, they, um, basically led to the extinction of all the sort of fatty herbivores [laughs] because that was what we liked, what we liked to eat, um, meat and, and, and fat. So, um, I, I think there wasn't, there wouldn't have been people who had a food addiction 'cause the food wasn't, the environment didn't support that behavior. You couldn't just go and, and get stuff.
7. RCDr. Rangan Chatterjee
  Yeah.
8. JUDr. Jen Unwin
  Whereas now it's all year round. It's everywhere. You don't even have to leave the sofa.
9. RCDr. Rangan Chatterjee
  That's the key problem, isn't it?
10. JUDr. Jen Unwin
  Yeah.
11. RCDr. Rangan Chatterjee
  I think, because on several occasions I've spoken to people who have spent time and lived with hunter-gatherers.
12. JUDr. Jen Unwin
  Yeah.
13. RCDr. Rangan Chatterjee
  If I think, last time I spoke to Daniel Lieberman, Professor Daniel Lieberman from Harvard, um, I think he told me that he has been out on a hunt with a Hadza tribe-
14. JUDr. Jen Unwin
  Mm
15. RCDr. Rangan Chatterjee
  ... who are hunter-gatherer tribe, you know-
16. JUDr. Jen Unwin
  Amazing
17. RCDr. Rangan Chatterjee
  ... still living, I think, in Tanzania in the way that they've always lived t- to, you know-
18. JUDr. Jen Unwin
  Mm-hmm
19. RCDr. Rangan Chatterjee
  ... mostly. And I think he's been out with tribesmen. When they find honey or they've had a long day out, they didn't manage to capture the-... whatever animal they were-
20. JUDr. Jen Unwin
  Yeah
21. RCDr. Rangan Chatterjee
  ... hunting, that they would literally gorge on honey.
22. JUDr. Jen Unwin
  Mm.
23. RCDr. Rangan Chatterjee
  When they, they found the honey, they got it, and they would literally almost, like, drink it.
24. JUDr. Jen Unwin
  Mm-hmm.
25. RCDr. Rangan Chatterjee
  And so there's a couple things for me that come up there, which is people say, "Oh, I've got a sweet tooth, you know, this is..." And I, but well, I kinda think we've all got a sweet tooth.
26. JUDr. Jen Unwin
  Mm.
27. RCDr. Rangan Chatterjee
  You know, we-
28. JUDr. Jen Unwin
  We evolved to have it
29. RCDr. Rangan Chatterjee
  ... we, exactly.
30. JUDr. Jen Unwin
  Yeah.
15:06 – 20:13
Hope and responsibility: small changes and the ‘Fork in the Road’ mindset
1. RCDr. Rangan Chatterjee
  ... and what does that say? Is there a risk, though, that this kind of message is disempowering? And what I mean by that is-
2. JUDr. Jen Unwin
  Mm
3. RCDr. Rangan Chatterjee
  ... if we're just victims to the food environment, I guess some people might make the case, Jen, that-
4. JUDr. Jen Unwin
  Mm
5. RCDr. Rangan Chatterjee
  ... well, there's nothing we can do until the food environment changes. I'm just playing devil's advocate there.
6. JUDr. Jen Unwin
  Yeah, no, I understand. Well, people, people can feel so hopeless because that's-
7. RCDr. Rangan Chatterjee
  Yeah
8. JUDr. Jen Unwin
  ... the environment we live in, and it-
9. RCDr. Rangan Chatterjee
  So give us some hope
10. JUDr. Jen Unwin
  ... it is difficult. Yeah, it's difficult. So, uh, so the, so the hope, of course, is, and it, it, it's exactly your, your message of, uh, this, this podcast, is that we can make small changes to our own environments. We can have control over the things that we do on a daily basis, um, that will really impact our metabolic health, but also cravings and the way that we respond to food. So it is supremely possible to become, uh, a food addict in, in recovery. It, it just takes some effort. So I think, uh, another thing that I like to say is it's not your fault that you have these struggles, but once you know the information that we're talking about today, then it become, it can become your responsibility to, to do something different.
11. RCDr. Rangan Chatterjee
  Well, that, well, it almost has to become your responsibility-
12. JUDr. Jen Unwin
  Yeah
13. RCDr. Rangan Chatterjee
  ... because there's no other option.
14. JUDr. Jen Unwin
  Yeah, that's why I called the book Fork in the Road, because there, there are choices. Like, we all have choices every day, you know, multiple times a day, about which path we're choosing, whether we're choosing health and wellbeing or whether we're choosing a path which is going to lead us into worse mental wellbeing, worse, worse physical health. And, and, you know, those, those choice points are, you know, it can be difficult to always make the right choice. And I'm not saying, you know, any of us are perfect at that. [laughs] You know, we all maybe take the, the wrong step from time to time. But I think if we've got that, it's almost like having a, a lighthouse, uh, that you're, you're aiming for, that, uh, even if you take a, a wrong step, you can still sort of re- you know, reroute and, and be following. You know, it's important that people are thinking about, well, what do they, you know, wh- when do they f- feel at their best? What, what, what's im- really important to them?
15. RCDr. Rangan Chatterjee
  Yeah.
16. JUDr. Jen Unwin
  So we were talking before we came on about family and that that's, that's so important, and I think if you can attach to those sorts of aims and, and goals, in the moment it can help you to make perhaps what seems the more difficult choice, but actually is the choice that's gonna lead you, uh, keep you well, lead you towards being able to live the life that you-
17. RCDr. Rangan Chatterjee
  Yeah
18. JUDr. Jen Unwin
  ... you know, you were kind of born to live and not be living... I've got a lovely clip which I often use in my lectures of one of the people that took part in our treatment study, and I, we asked him just to, uh, doing a video, and we said, "You know, what, what's it like to have food addiction?" He just said, "It's like, it's, it's, it's hell. You have no hope. You're, you're on a rollercoaster that you feel you just-"Don't see any way off. You know, you feel you can't control your own behavior. You feel totally hopeless about that. That's, that's no way, that's no way to live. And, um, I know because I've been there myself as well, that that's, it- it- that's a place where you're not connecting with family, you're not doing your best at work, you're not looking after yourself, so.
19. RCDr. Rangan Chatterjee
  Yeah. As part of my research for this conversation, I watched your conversation with Ken Berry on his YouTube channel, and it's a fascinating conversation. What was even more fascinating was reading the comments-
20. JUDr. Jen Unwin
  Mm-hmm
21. RCDr. Rangan Chatterjee
  ... under that interview, and I wrote a few down because-
22. JUDr. Jen Unwin
  Oh
23. RCDr. Rangan Chatterjee
  ... when people challenge this idea that it's an addiction, and I get, I understand, and, and sometimes I think these are academic things because ultimately, what does an individual want? If an individual is consuming too much food, whether that be sugar, ultra-processed foods, or whatever else, in a way that's harming their physical health and mental wellbeing-
24. JUDr. Jen Unwin
  Hmm
25. RCDr. Rangan Chatterjee
  ... they want help to s- reduce, stroke, stop that.
26. JUDr. Jen Unwin
  Mm-hmm.
27. RCDr. Rangan Chatterjee
  Whether we as professionals call it an addiction or not, ultimately for that individual, they just want help, right?
28. JUDr. Jen Unwin
  Yes.
29. RCDr. Rangan Chatterjee
  And some of the comments underneath that video were, were these, right? One, one person said, "I'm addicted to sugar. I gave up cigarettes so easy-"
30. JUDr. Jen Unwin
  Mm
20:13 – 26:51
Why formal recognition matters: stigma reduction, treatment pathways, and WHO efforts
1. RCDr. Rangan Chatterjee
  But we don't go to that. So why, well, I guess, first of all, why do you think it's important to have this recognized as a formal addiction, or, or do you think it's important?
2. JUDr. Jen Unwin
  Yes. I d- I do think it's important, and, uh, the charity that, that I work with, that's one of our key aims is to, um, get the World Health Organization to recognize this condition. So there's quite a lot of evidence. There's a, a, been a few research papers where if you, um, label this kind of behavior as addictive, you know, people mi- you might say, "Oh, that's stigmatizing," or, "People don't wanna be labeled as addict." But actually, the research shows that, um, that, that label makes m- people more sympathetic to themselves, and it also makes us more sympathetic to others-
3. RCDr. Rangan Chatterjee
  Right
4. JUDr. Jen Unwin
  ... because then we can understand a be- a behavior that on the face of it looks illogical. You know, what, why, you've got type 2 diabetes. Why are you still having ice cream every, every day or all these biscuits? You know, it, it seems like a crazy thing to do.
5. RCDr. Rangan Chatterjee
  Yeah.
6. JUDr. Jen Unwin
  But if we, if we label it as an addiction, I think people these days do understand. For example, you know, most of us know someone who's, who's had an alcohol problem, or we've seen it in the media where people have done that, and then they, through abstinence and other practices, they, you know, they're, they're in recovery from that. So I think we can feel more sympathetic, number one. Number two, um, I think we've got these massive epidemics that we've sort of touched on of obesity, type 2 diabetes, metabolic unwellness, um, m- m- mental health problems, and could it be that part of that story is to do, for some people, and why, you know, they continue to suffer is to do with the fact that they've got an, an addiction to sugar and these ultra-processed foods? And u- until we incorporate that in our treatment as healthcare professionals, they're never gonna be successful. And also, you know, same with the, we've not really touched on eating disorders, which sort of overlap with food addiction, but, um, many people with, with an eating disorder actually h- have a food addiction, and at, at the moment, you can't get treatment for that in the, in the UK.
7. RCDr. Rangan Chatterjee
  You can't get treatment for what? For you-
8. JUDr. Jen Unwin
  For food addiction.
9. RCDr. Rangan Chatterjee
  But you can, of course, for eating disorders.
10. JUDr. Jen Unwin
  You can, of course, for eating disorders, but if someone was misdiagnosed and they actually had an eating disorder, uh, a food addiction, beg your pardon, and they're in an eating disorder service, they're gonna get the wrong approach of, of treatment.
11. RCDr. Rangan Chatterjee
  So are they quite markedly different, the approaches you would take?
12. JUDr. Jen Unwin
  So generally, although obviously that's not my e- field of expertise, eating disorders, um, but generally, the idea of an eating disorder treatment program is a sort of all foods fit. You know, it's good. You shouldn't restrict certain food categories, and you should be able to sort of eat all foods. Now, if I went in, if I was, uh, you know, when I was really in the midst of my food, if I'd gone into a program like that, I never would've succeeded because I c- never could eat all f- foods and be all right. So I couldn't have had biscuits and, and been all right by definition because I'd lost my, uh, uh, control of that r-
13. RCDr. Rangan Chatterjee
  Yeah
14. JUDr. Jen Unwin
  ... that relationship with them.
15. RCDr. Rangan Chatterjee
  Because as you say, one is too many, a thousand-
16. JUDr. Jen Unwin
  [laughs] A thousand is never enough
17. RCDr. Rangan Chatterjee
  ... is never enough.
18. JUDr. Jen Unwin
  So I'd never have been in, in recovery then.
19. RCDr. Rangan Chatterjee
  Yeah, and we will get to your personal story, Jen.
20. JUDr. Jen Unwin
  Hmm.
21. RCDr. Rangan Chatterjee
  But, um, my understanding is that there are certain foods now that you simply cannot have, not even one.
22. JUDr. Jen Unwin
  Yeah.
23. RCDr. Rangan Chatterjee
  And you've learnt over the years to go, "No, no."
24. JUDr. Jen Unwin
  I just abstain.
25. RCDr. Rangan Chatterjee
  That's a, that's almost like a gateway food. If I start, I won't stop. And, and as you say, that might be different advice from what you're getting in an eating disorder clinic. So going back to that earlier question, I guess one of the reasons why it might be so useful to get this recognized-
26. JUDr. Jen Unwin
  Yeah
27. RCDr. Rangan Chatterjee
  ... is so there's a different-
28. JUDr. Jen Unwin
  The right people get the right treatment
29. RCDr. Rangan Chatterjee
  ... treatment pathway.
30. JUDr. Jen Unwin
  And, and treatment is, is available. So, uh, uh, at the moment, because it's not a recognized condition, of course, research isn't fundedUm, treatments aren't, treatment research and/or treatment clinics aren't funded. So if, if you, uh, we- you know, if you go to your GP and you say, "I can't give up cigarettes," they can send you to the quit smoking service. If you have lost control of your ratio with alcohol, they can send you to the alcohol team, um, or the, the drug team. Um, if you go to your GP and say, "I'm addicted to sugar," I, I don't know what they would do, unless they go and see David, obviously. [laughs] And then he's got a very good idea on what to do. But I think generally if people went, went to their doctors and, and, and said that, they, they wouldn't know where to refer them, and if they referred them to eating disorder service, that may or may not be right for them. So we've made a s- uh, now a second application to the WHO to get f- food addiction as a, a recognized, um, disorder, and I think, I think what's will also be good about it being recognized is that it really points the finger where the finger needs pointing. So we've actually applied for it to be called ultra-processed food use disorder. That's where the most research exists. Um, use, this use disorder term is the term that is used, um, in the International Classification of Diseases. So you get alcohol use disorder, for example, so.
26:51 – 30:55
What foods are most ‘addictive’: the sugar-fat-salt-refined grain combination
1. RCDr. Rangan Chatterjee
  ... and from your research, what are the common foods that people have a problematic relationship with?
2. JUDr. Jen Unwin
  Yeah. So things that have that combination of, uh, sugar, fat, refined grains, um-
3. RCDr. Rangan Chatterjee
  And salt often
4. JUDr. Jen Unwin
  ... and salt. Yeah. Although salt on its own probably isn't the problem, but it's when it's combined with, with these other things. Um, so that's so many of the modern foods that we eat. You know, I mean, bread has got m- most of those things in now, hasn't it? Sort of the industrially made bread. Pizzas, donuts. You've got ice cream, um, cakes, biscuits, all of these sort of-
5. RCDr. Rangan Chatterjee
  Tortilla chips
6. JUDr. Jen Unwin
  ... tortilla, yeah.
7. RCDr. Rangan Chatterjee
  Some people I know to-
8. JUDr. Jen Unwin
  Dorito type things. Yeah. Crunchy, as you said, s- so many ingredients, and kind of formulated to hit that, that sweet, sour, salty, crunchy. [laughs]
9. RCDr. Rangan Chatterjee
  Yeah. What I've noticed, Jen, is, and this is, I'm not, I'm... Obviously, you have to make progress somewhere. Like, if you can get the WHO, the World Health Organization, to recognize it, you know, around ultra-processed foods, it opens the door to progressing that over the years, right? Because-
10. JUDr. Jen Unwin
  Mm
11. RCDr. Rangan Chatterjee
  ... one thing I think... Look, if we deal with ultra-processed foods first, you know, you can get perhaps an, in inverted commas, clean tortilla chip packet, right, which only has three or four ingredients, but it, it's, it's not only the ingredients, it's the combination of them together and it becomes problematic.
12. JUDr. Jen Unwin
  Yeah. Our hunter-gatherer ancestors didn't have crunchy, salt, sweet-
13. RCDr. Rangan Chatterjee
  Together
14. JUDr. Jen Unwin
  ... together.
15. RCDr. Rangan Chatterjee
  Which is a delight for the taste buds.
16. JUDr. Jen Unwin
  Yeah. [laughs] Exactly.
17. RCDr. Rangan Chatterjee
  Right? It, it really is.
18. JUDr. Jen Unwin
  And that's why, yeah, that's your brain lighting up, isn't it? You can almost feel it kind of bing, bing, bing, [laughs] you know, when you, when you eat these things. Um, you, y- y- that, uh, that's the pleasure, the reward. That's the, the brain kind of very quickly, because they, they enter the bloodstream very quickly. That's another thing about drugs, isn't it? The faster they enter the bloodstream and, and hit the brain, the more addictive they are. So foods that, we all know that foods that are whole foods, that are full of fiber and sort of natural, they, they get digested slowly. So those, the sugar and the, uh, it's not, it doesn't hit the brain in the same way as these processed foods with processed grains, sugar, salt, fat, all, you know, quickly, quickly available.
19. RCDr. Rangan Chatterjee
  Hey, guys. Just taking a quick break to ask you a small favor. On this show, I'm always looking to improve things, make sure I'm booking the most interesting guests, having conversations about the right topics, and building relationships with the most aligned sponsors. But in order to do this, my team and I need to know a little bit more about you. So we have created a super short survey that I would dearly love you to fill out. It will only take you two minutes to do so, and I would really, really appreciate it. All you have to do is click the QR code on screen or go to drchatterjee.com/survey. That's drchatterjee.com/survey. People can also overeat whole foods, can't they?
20. JUDr. Jen Unwin
  For sure.
21. RCDr. Rangan Chatterjee
  Which I guess takes it beyond UPS, ultra-processed foods-
22. JUDr. Jen Unwin
  Yeah
23. RCDr. Rangan Chatterjee
  ... which of course I think is the main problem.
24. JUDr. Jen Unwin
  Yeah.
25. RCDr. Rangan Chatterjee
  But dairy, nuts.
26. JUDr. Jen Unwin
  [laughs] Yeah.
27. RCDr. Rangan Chatterjee
  Um, I actually heard, when you spoke to Ken Berry on that conversation, he was talking about a patient who was addicted to steakI think if you remember that-
28. JUDr. Jen Unwin
  Mm
29. RCDr. Rangan Chatterjee
  ... it, Ken was saying to you that they cut bits of steak, put them in a Ziploc bag, and put them in their bathroom.
30. JUDr. Jen Unwin
  Yeah.
30:55 – 35:24
Beyond substances: volume addiction, cues, comfort eating, and addiction substitution
1. JUDr. Jen Unwin
  They'll overeat anything, in a way. There's the thing, the, there's a, there's a thing called volume addiction, where people kind of get addicted just to having large amounts of food. And, you know, there's, and there's, there's many explanations been put forward. One is, which is, you know, when you stretch the stomach, you actually get oxytocin, serotonin kind of release. So you do get, you do get, you know, s- in, in some ways these sort of neurotransmitter highs. But I think the other thing to remember is that with any addiction, it's not just about the substance.
2. RCDr. Rangan Chatterjee
  Exactly.
3. JUDr. Jen Unwin
  It's about the behavior. So, um, it's about the, the cues. It's about w- who you're with, where, what, you know, w- the, the sort of social side of it. There's also the sort of, well, I suppose the sort of com- comfort side of a s- certain behavior. So that's where you can get this overlap with, with binge eating and, um, eating behaviors that are sort of triggered by emotional states because we, for comfort, you know, or if there's a trauma history and we're maybe eating to, you know, to feel oka- Gabor Mate talks about this-
4. RCDr. Rangan Chatterjee
  Yeah
5. JUDr. Jen Unwin
  ... a lot, doesn't he? Um, he's really the, the king of, of that, of that topic, you know, that we're eating to sort of fill a void, in a sense. So obviously, just like any addiction treatment, where people are coming into treatment, you have to take all of that into account. The other thing is that, say, so we were talking about nut butters [laughs] before, weren't we, as well, and how, um, that is a combination of, you know, carbohydrate, fat, salt, um, again, which you wouldn't really have had so much in, in nature. So things like nuts and dairy do have that rare combination of, of fat, carbohydrate, protein. Um, they're, they're the only sort of whole foods that, that have that, and they can be problematic, well, for any of us. But certainly those of us that have, you know, developed a food addiction problem can very easily overeat those things. And the other thing [laughs] about addiction that we kind of touched on but we didn't really go into is that once you've wired the brain for addiction, however that started, addicti- all addictions look the same in the brain. And so there was that, that lov- the lovely quotes you were giving from the people who'd listened to Ken's podcast about, you know, "Well, I, I gave up this, but then sugar was my problem."
6. RCDr. Rangan Chatterjee
  Yeah.
7. JUDr. Jen Unwin
  You know, the, it is sort of one, one, one problem with, with many outlets. And once you, it, if you treat somebody's main addiction problem, it's a very common thing that other things will try and take its place because you're still looking for that dopamine hit. So for example, if you go to an Alcoholics Anonymous meeting, you see a lot of strong cups of coffee. You often see people [laughs] smoking. You know, there's a lot of cake and biscuits because people are, people are trying to sort of get that hit. Or we all know if pe- if you give up smoking, people put on weight because they start eating Polar Mints. Um, or another really stark example is when people have bariatric surgery, because a lot of those people will be food addicts.
8. RCDr. Rangan Chatterjee
  Mm-hmm.
9. JUDr. Jen Unwin
  And then they can't, you know, they can't get that comfort from food. And a known side effect of bariatric surgery is the development of a new alcohol use problem.
10. RCDr. Rangan Chatterjee
  Wow.
11. JUDr. Jen Unwin
  Um, because people are, people can still dr- you know, get the alcohol.
12. RCDr. Rangan Chatterjee
  So, so you cut off one pipeline to that-
13. JUDr. Jen Unwin
  Exactly
14. RCDr. Rangan Chatterjee
  ... dopamine, but the, the brain has been wired in that individual to still want that. So they can't get it from food 'cause they feel full. They've had bariatric surgery. They're gonna seek it out-
15. JUDr. Jen Unwin
  They look for other sources of dopamine
16. RCDr. Rangan Chatterjee
  ... to get the same feeling, right?
17. JUDr. Jen Unwin
  Yeah.
18. RCDr. Rangan Chatterjee
  Because even going back to what you were saying before about emotions, of course, one of the biggest reasons that we overeat, I think whether you're a food addict or not-
19. JUDr. Jen Unwin
  Yes
20. RCDr. Rangan Chatterjee
  ... certainly from my clinical experience-
21. JUDr. Jen Unwin
  Comfort eating
22. RCDr. Rangan Chatterjee
  ... we eat our emotions.
23. JUDr. Jen Unwin
  Yeah.
24. RCDr. Rangan Chatterjee
  You know?
25. JUDr. Jen Unwin
  Stress.
26. RCDr. Rangan Chatterjee
  We don't need a hole in our stomach. It's often the hole in our hearts, right?
27. JUDr. Jen Unwin
  Mm.
28. RCDr. Rangan Chatterjee
  Loneliness, stress, a day on Zooms, when no natural light, we haven't been out, whatever it might be.
29. JUDr. Jen Unwin
  Yeah.
30. RCDr. Rangan Chatterjee
  Sugar gives you that nat- that quick hit.
35:24 – 42:27
Restriction vs nourishment: why ‘all foods in moderation’ fails for some
1. RCDr. Rangan Chatterjee
  One of the things I'm passionate about, and with every passing year I become more and more passionate about this idea, is that it's very rare that there's one piece of advice that works for everyone, okay? So for example, in the context of what we're talking about, Jen, it is common now with, you know, many nutrition professionals, not everyone, to be clear, but, but many people will say you shouldn't restrict anything.
2. JUDr. Jen Unwin
  Mm-hmm.
3. RCDr. Rangan Chatterjee
  And I understand the rationale behind that, right? I totally understand the rationale behind that, and those professionals will probably, um, share case studies, say, "Well, listen, I had a patient like this, and when I helped them not restrict, and say it's okay to have a little bit of everything, it works for them."
4. JUDr. Jen Unwin
  Yeah. Agreed.
5. RCDr. Rangan Chatterjee
  But then they make the next step, which is that's the advice for everyone.
6. JUDr. Jen Unwin
  Yeah.
7. RCDr. Rangan Chatterjee
  And it ain't.
8. JUDr. Jen Unwin
  It's not [laughs] .
9. RCDr. Rangan Chatterjee
  Right?
10. JUDr. Jen Unwin
  No.
11. RCDr. Rangan Chatterjee
  What you're saying is you know that that approach worked for one of your clients-
12. JUDr. Jen Unwin
  Mm-hmm
13. RCDr. Rangan Chatterjee
  ... or your patients, and maybe it worked for 100 of them. It doesn't mean it works for everyone, as you say, and we'll get into your story. That approach probably wouldn't have worked for you.
14. JUDr. Jen Unwin
  Mm.
15. RCDr. Rangan Chatterjee
  You know, that, that general advice that restriction means that you've got a problematic relationship with food, which is what many people say, I just think is nonsense, right?
16. JUDr. Jen Unwin
  Mm.
17. RCDr. Rangan Chatterjee
  In this modern food environment, in my view, if you're not restricting something to a degree-
18. JUDr. Jen Unwin
  Mm
19. RCDr. Rangan Chatterjee
  ... you're probably gonna be struggling with many aspects of your health.
20. JUDr. Jen Unwin
  Yeah.
21. RCDr. Rangan Chatterjee
  That's not the norm. That's not what people expect people to say. That's just what I've experienced myself, and that's-
22. JUDr. Jen Unwin
  Yeah
23. RCDr. Rangan Chatterjee
  ... what I've experienced with my patients over the years.
24. JUDr. Jen Unwin
  Yeah.
25. RCDr. Rangan Chatterjee
  You know, in fact, I would say from what I've seen, Jen, there's also this idea that, you know, health is about adding in stuff to your diet. You know, you s- you know, blueberries do this, so you wanna add in blueberries. Um, this food does that, you wanna add that in.
26. JUDr. Jen Unwin
  Yeah.
27. RCDr. Rangan Chatterjee
  Great. I'm not against that. And I would say, in my clinical career, most of my benefit with patients has come from when they cut out stuff. So rather than adding in healthy things-
28. JUDr. Jen Unwin
  Mm
29. RCDr. Rangan Chatterjee
  ... they cut out things that were problematic.
30. JUDr. Jen Unwin
  Yeah.
42:27 – 48:10
Wiring starts young: sugar as early state-change, family culture, and constant cueing
1. JUDr. Jen Unwin
  Those behaviors are so ingrained in our psyche, aren't they? [laughs] And I think the other thing which is super important is that... So we never, we don't give our kids caffeine or alcohol or drugs. We just don't. But-We give them sh- sugar, and often that's kind of glorified, isn't it? You know, you bang your knee, you're crying. You know, come and have... Come and sit down and, you know, have a lollipop or something. And so we give our children these foods that we now know because we've got the studies that show that they, you know, they're altering the structure and function of their brains. [laughs] Um, and I think society doesn't y- yet, it's changing, it's improving, but society doesn't yet view these foods with enough skepticism-
2. RCDr. Rangan Chatterjee
  Yeah
3. JUDr. Jen Unwin
  ... and enough, um, concern for our, our children's health. Because once, as we've already said, once the brain is wired for addiction, it's wired. And if those children have got... There, there is a bit of a genetic component. There's also the kind of, like you say, the family culture component. If there's a traumatic situation going on. Um, we show a, a brilliant video of Eric Clapton, um, who was famous for his drug and alcohol problems.
4. RCDr. Rangan Chatterjee
  Yeah.
5. JUDr. Jen Unwin
  And an interviewer says to him, "You know, so when did it start? Was it cocaine?" kind of thing. He says, "No, it was sugar." He said, "When I was a kid, that was how I altered my... It's the thing I had available to alter my consciousness, my sense of, you know, how I felt. And so I, that was what I used."
6. RCDr. Rangan Chatterjee
  Wow.
7. JUDr. Jen Unwin
  And, um, I've spoken to a lot of people who, who say similar things. That was what they had available. They were in very difficult situations, but they could get sugar, ice cream, you know, crisps, and, and that was their comfort.
8. RCDr. Rangan Chatterjee
  You almost learn it subconsciously. You know, the human desire for most behaviors comes from this, this need to change our state, right? We don't like the way we're feeling. You know, boredom, frustration-
9. JUDr. Jen Unwin
  [laughs]
10. RCDr. Rangan Chatterjee
  ... anger-
11. JUDr. Jen Unwin
  Anger
12. RCDr. Rangan Chatterjee
  ... whatever it might be, right?
13. JUDr. Jen Unwin
  Lonely, yeah.
14. RCDr. Rangan Chatterjee
  And so we want to engage in something to change that, and that something could be Instagram, TikTok.
15. JUDr. Jen Unwin
  We've not talked about scrolling, but that's-
16. RCDr. Rangan Chatterjee
  Right
17. JUDr. Jen Unwin
  ... another dopamine hit. Yeah.
18. RCDr. Rangan Chatterjee
  But it could be a cigarette.
19. JUDr. Jen Unwin
  Yep.
20. RCDr. Rangan Chatterjee
  It could also be food.
21. JUDr. Jen Unwin
  A drink.
22. RCDr. Rangan Chatterjee
  Right?
23. JUDr. Jen Unwin
  Alcohol.
24. RCDr. Rangan Chatterjee
  Because it's-
25. JUDr. Jen Unwin
  Yeah
26. RCDr. Rangan Chatterjee
  ... and, and in many ways they all try to do the same thing. So the question is, what have you been conditioned to?
27. JUDr. Jen Unwin
  To, to do. Yeah.
28. RCDr. Rangan Chatterjee
  What, what's your kind of innervated common-
29. JUDr. Jen Unwin
  And what's-
30. RCDr. Rangan Chatterjee
  ... drug of choice?
48:10 – 1:03:09
Self-assessment tool: the CRAVED screening for addictive-like eating
1. RCDr. Rangan Chatterjee
  Let's get super practical, Jen.
2. JUDr. Jen Unwin
  Yes.
3. RCDr. Rangan Chatterjee
  Um, how might somebody who's listening to this get an idea of whether they have a problematic relationship with food? Are, are there any symptoms, signs-
4. JUDr. Jen Unwin
  Yeah
5. RCDr. Rangan Chatterjee
  ... or questions they can ask themselves that would help them identify that?
6. JUDr. Jen Unwin
  Yes. So what we did is we took the six, um, symptoms that the WHO use to define substance use disorder. Um, we've made them into a little screening questionnaire called CRAVED. So, um-
7. RCDr. Rangan Chatterjee
  Okay
8. JUDr. Jen Unwin
  ... I love an acronym. So CRAVED is the six-symptoms that you'd look out for, for any substance use disorder. But as we go through them, I think you and everybody else will see how well these can actually apply to people's behavior with food. So if you, uh, uh, play along and, [laughs] uh, you know, count up, people who- people who are listening can say, well, how many of these would, you feel would apply to you? Um, and three or more is the, the cutoff in... So in the, in the, in the ICD criteria, three or more of these symptoms, um, would be the cutoff. I- not for diagnosis, obviously, because it's not a diagnosis, [laughs] but this would indicate that maybe you've got some addictive-like symptoms in relation to your food-
9. RCDr. Rangan Chatterjee
  Okay
10. JUDr. Jen Unwin
  ... behavior. So C is obviously for cravings and compulsions.
11. RCDr. Rangan Chatterjee
  So does someone listening have a craving or compulsion for a certain food?
12. JUDr. Jen Unwin
  For certain foods that feels so strong that, you know, you struggle to resist it or you, you can't resist it.
13. RCDr. Rangan Chatterjee
  Okay.
14. JUDr. Jen Unwin
  Yeah. So I think we can all recognize that. R stands for reaching for more, and this gets at the idea that we all understand, um, tolerance. We all understand it in relation to alcohol, don't we? So if you have, uh, one drink, you might feel a little bit of an effect. If you have one drink every night, after a while, you're not gonna feel so much of an effect from that, so you might then start having two glasses of wine a night to get... So you need more and more to get the same effect. So that's what R stands for, reaching for more. So you might, you know, it might have been a couple of biscuits, but now once you've opened the biscuits, it ends up being half a packet or a whole packet. So needing more and more to feel, mm, kind of the feeling that you were-
15. RCDr. Rangan Chatterjee
  Satiated in some way
16. JUDr. Jen Unwin
  ... say, yeah, you were hoping to sort of feel calm or whatever it is. A is for acni- activities neglected, and this gets at the idea that when people start getting addicted to substances, it sort of starts to fill up their whole lives. So they stop thinking so much about family. They stop thinking about hobbies. They stop thinking about doing well at work. Um-
17. RCDr. Rangan Chatterjee
  It becomes all-encompassing in their lives
18. JUDr. Jen Unwin
  It becomes all-encompassing, and other things sort of, you know, closing down. So is, is that happening?
19. RCDr. Rangan Chatterjee
  Can I just ask, Jen, there? Um, when I was reading out some of the comments before that people left on that YouTube video-
20. JUDr. Jen Unwin
  Mm
21. RCDr. Rangan Chatterjee
  ... um, that second comment I read out to you was, "I used to lie to my wife-
22. JUDr. Jen Unwin
  Mm
23. RCDr. Rangan Chatterjee
  ... and secretly buy-
24. JUDr. Jen Unwin
  Yes
25. RCDr. Rangan Chatterjee
  ... ice cream with cash so she couldn't track it." Does... That, that doesn't quite qualify for A, for activities neglected, does it?
26. JUDr. Jen Unwin
  It ki- kind of does because that's gonna affect your relationship with the wife.
27. RCDr. Rangan Chatterjee
  Yeah.
28. JUDr. Jen Unwin
  This kind of secrecy, um-
29. RCDr. Rangan Chatterjee
  Yeah, 'cause secrecy is n- you, you-
30. JUDr. Jen Unwin
  Sneaking around
1:03:09 – 1:10:17
Practical recovery plan: motivation, trigger lists, and ‘I know I’m in trouble when…’
1. JUDr. Jen Unwin
  Yeah. So number one is we talked right at the beginning about this lighthouse, about why, well, why would you want to change? 'Cause it's actually gonna be quite hard. So what's your guiding light? What's gonna really keep you going when the cravings come? What, what's your reason for wanting to change your relationship with foods? You know, and, and kind of, you know, just saying, "Oh, I want to lose weight," isn't, isn't a good enough reason. You know, what would be better if you lost weight? What would be different about your life? You know, what, what, what, why do you want to do this, and what's that sort of motivation? So it might be to do with, you know, your kids, being able to play with the kids or, you know, staying alive long enough to see the [laughs] the kids do certain things. You maybe want to be an example to the, to the kids. But finding some, some real motivation is, is, is probably step one.
2. RCDr. Rangan Chatterjee
  Okay.
3. JUDr. Jen Unwin
  Step two is being totally honest, brutally honest about the d- the drug foods, again in quotes. So which, which foods occupy your mind? M- m- might you have a secret stash, or often food addicts have secret stashes of their favorite things 'cause they don't want to run out. Um, you know, what, what are those things? [clears throat] You know, what are you kind of literally thinking it's gonna be really hard to live without? [laughs] It's nearly always the things that... David has lots of patients who say, "I literally can't live without... I couldn't live without bread."
4. RCDr. Rangan Chatterjee
  Yeah.
5. JUDr. Jen Unwin
  You know, lots of people, it's not sweet things always. It's sa- it can be savory things as well, and bread is such a common one actually. So if there are foods like that that you're saying, "I couldn't live without," hmm, [laughs] probably that's something to think about. Um, I would, you know, make a, make an, an honest list of all the, the foods, um, that you're having, where the relationship is that one of loss of control.
6. RCDr. Rangan Chatterjee
  Yeah.
7. JUDr. Jen Unwin
  Cravings, needing more and more, losing control of the amount, continuing to have them even though you kn- you know you're do- they're doing you harm.
8. RCDr. Rangan Chatterjee
  Yeah. I've heard you say that you often ask people to write down-
9. JUDr. Jen Unwin
  Yeah, write them down
10. RCDr. Rangan Chatterjee
  ... a list. You know, "I lose control over..." and then actually write down those foods.
11. JUDr. Jen Unwin
  Write them down. Yeah.
12. RCDr. Rangan Chatterjee
  There's something powerful about writing something down, isn't there?
13. JUDr. Jen Unwin
  Definitely.
14. RCDr. Rangan Chatterjee
  You can think about it and go, "Yeah, yeah." But I think, well, we know there's incredible benefits to journaling.
15. JUDr. Jen Unwin
  Yes.
16. RCDr. Rangan Chatterjee
  I think one of the benefits is that you see it in front of you.
17. JUDr. Jen Unwin
  Yeah.
18. RCDr. Rangan Chatterjee
  You've had to take it out of your brain.
19. JUDr. Jen Unwin
  Take it out, put it down.
20. RCDr. Rangan Chatterjee
  Put it down. You, you see it back. It, it kinda makes it real-
21. JUDr. Jen Unwin
  Yeah
22. RCDr. Rangan Chatterjee
  ... I think in a way that just thinking about things often doesn't.
23. JUDr. Jen Unwin
  Yes. No, ab- absolutely. The other thing we, we didn't, I didn't mention about when we, when our brain's in that state of high dopamine and, um, that sort of reward centre's flowing, another thing that happens is it actually cuts us off from our frontal lobes. And again, I, they think this is probably an evolutionary thing, that when you were driven to go and hunt, you had to, in a way, not think about it too much 'cause you, it's dangerous. So you-
24. RCDr. Rangan Chatterjee
  Yeah
25. JUDr. Jen Unwin
  ... [laughs] you may have decided, "Oh, we won't bother today." No, you needed to be really driven. So our frontal lobes are a bit cut off. So in the, in the moment of the cravings and the eating and the... our frontal lobes aren't really... So you can't think your way out of addiction. You have to sort of plan your way out. So, and one way is to be writing things down, to be really clear and to be making a plan, because then you've, you've sort of [laughs] you've put your frontal lobes on the, on the paper, if you like, and you've done that at a time when your, your brain's working properly.
26. RCDr. Rangan Chatterjee
  Yeah.
27. JUDr. Jen Unwin
  Once you, once you're, once you're in the food, it's really hard to stop that behavior when you're on the runway. So yeah, so write it down. Um-
28. RCDr. Rangan Chatterjee
  I think you said that one of the things you ask people to write down is, "I know I'm in trouble when..."
29. JUDr. Jen Unwin
  Oh, yes, that's such, such a good one. Yeah.
30. RCDr. Rangan Chatterjee
  I think that's such a great piece of advice.
1:10:17 – 1:27:06
Handling real-world pressure: social scripts, slips as learning, and cold turkey vs gradual
1. RCDr. Rangan Chatterjee
  And so let's say someone wants... Because I think peer pressure-
2. JUDr. Jen Unwin
  Yeah, it's massive
3. RCDr. Rangan Chatterjee
  ... is really hard, right?
4. JUDr. Jen Unwin
  It's really hard.
5. RCDr. Rangan Chatterjee
  And Jen, you've worked with so many, uh, patients and clients to help-
6. JUDr. Jen Unwin
  Yeah
7. RCDr. Rangan Chatterjee
  ... them through this, right? So if someone says, "Look, when I'm left to my own devices, I'm pretty good."
8. JUDr. Jen Unwin
  At home, you've got your own environment.
9. RCDr. Rangan Chatterjee
  But when I'm out with friends or at work when it's someone's birthday and they bring the quality street and all the, the, the, the, the home-baked cakes or whatever-
10. JUDr. Jen Unwin
  Yeah
11. RCDr. Rangan Chatterjee
  ... and people come around and say, "Oh, it's fine. It's just one," right? One's not gonna do you any harm. What advice do you have for that individual?
12. JUDr. Jen Unwin
  Yeah.
13. RCDr. Rangan Chatterjee
  How, how can they handle that scenario?
14. JUDr. Jen Unwin
  Yeah. It, it, it's really hard for people in the beginning because you're kind of, uh, trying to change how people see you to some extent, aren't you? And the... You know, we know- we don't like to have those-
15. RCDr. Rangan Chatterjee
  And how you see yourself
16. JUDr. Jen Unwin
  ... and how you see yourself, and how to have those sort of difficult conversations. And I think it is, again, as we were saying at the beginning, it's a very individual thing, so people need to work out what would they be comfortable saying. Um, so we sometimes, you know, give them a few examples or... What's wonderful in a group, of course, is you can say, you know, what the people would say, "Oh, God, I find it really hard when Jane at work, who, you know, is a fantastic baker, and she'll bring in the cupcakes." And you can say to the group, "You know what, what have, how have you handled that, and how have you handled that?" And we get some examples.
17. RCDr. Rangan Chatterjee
  When you say the group, so you're not talking about at work with your colleagues. You're talking about in the sort of-
18. JUDr. Jen Unwin
  In, in a treatment group or s-
19. RCDr. Rangan Chatterjee
  In a food addiction group
20. JUDr. Jen Unwin
  ... or a support group.
21. RCDr. Rangan Chatterjee
  Right.
22. JUDr. Jen Unwin
  You know, it can be really good to get other people's, uh, advice on that. So we would, we would often say, well, I would sort of say how it is that I'd handled it, and some- they'd get some other ideas, and then they could say, "Well, maybe I could do this." And we had one lady actually who had a group of friends. They always went out for coffee and a cake. It was kind of part of her important part of her week, and she was like, "How am I gonna handle it?" [laughs] And then she rehearsed it with her husband, like, you know, what she was gonna say. She was gonna say, "You know, I'm really trying to look after my health. You know, I'm gonna come for coffee. I love being with you guys, but, you know, I'm not, I'm not gonna have, have the cake, and I really hope you can all support me because, you know, this is so important to me." So y- but it has to come from that person, doesn't it? They have to feel that that's something they really could say. But it's great. It is great to-
23. RCDr. Rangan Chatterjee
  Well-
24. JUDr. Jen Unwin
  ... rehearse it, to sort of, you know, say it to a loved one that that's what you're gonna do so that you'll not- you don't find yourself in that situation and you haven't got a script almost. You haven't got a... It sounds like-
25. RCDr. Rangan Chatterjee
  Yeah
26. JUDr. Jen Unwin
  ... that's what he was saying, that he would, he would rehearse what he was gonna say and-
27. RCDr. Rangan Chatterjee
  Yeah. Well, and, and I would just add to that, you know, if you, in inverted commas, fail, at first, well, it's not failure, right? Each time you do that, it's a learning process.
28. JUDr. Jen Unwin
  Never. It's never a failure.
29. RCDr. Rangan Chatterjee
  Right?
30. JUDr. Jen Unwin
  Mm-hmm.
1:27:06 – 1:38:13
Home and family dynamics: partners, kids, and building supportive environments
1. RCDr. Rangan Chatterjee
  If someone's listening, Jen, and I know there'll be many who are thinking, "Listen, the problem is I try and do this, but my partner keeps certain foods in the house."
2. JUDr. Jen Unwin
  Yes.
3. RCDr. Rangan Chatterjee
  Right? "Which means that at some point I crack and end up eating those foods."
4. JUDr. Jen Unwin
  Mm-hmm.
5. RCDr. Rangan Chatterjee
  Um, I wanna know what your advice is for that person, and then let's expand it out a little, because a lot of people will say, and I'm interested as your take on what this actually means as a psychologist, they'll go, "Yeah, but, you know, I need to keep sweets and sugars and, and chocolates in the house-"
6. JUDr. Jen Unwin
  For the kids
7. RCDr. Rangan Chatterjee
  ... for the kids.
8. JUDr. Jen Unwin
  Or the grandkids. [laughs]
9. RCDr. Rangan Chatterjee
  Right, so two scenarios there. One is that the partner-
10. JUDr. Jen Unwin
  Yeah
11. RCDr. Rangan Chatterjee
  ... is not playing ball, or they don't... Maybe, you know, I don't mean unintentionally. Maybe they just, like, they don't recognize how serious it is.
12. JUDr. Jen Unwin
  Yeah.
13. RCDr. Rangan Chatterjee
  And then children, so take them in whichever order you want.
14. JUDr. Jen Unwin
  Yeah, so, so, so living in a household with other people who don't want to be abstinent, yes, of course that, that's a challenge. It's not insurmountable, but it does make it more different, difficult. Yeah, so I'm so lucky, because we both eat kind of more or less the same. A little bit different, but more or less the same. Um, and again, there are, there are many possible answers. One is, yeah, to really have that conversation. If it's a partner that loves you, hopefully they want you to be healthy and well.
15. RCDr. Rangan Chatterjee
  [laughs]
16. JUDr. Jen Unwin
  Um, so you have that conversation about, you know, "I'm beginning to think about my problem in, in this way, and I really want to try and, you know, be abstinence from, from these foods, which are my problematic foods." Um, sometimes partners are willing to have a go themselves. You know, they may be interested themselves in seeing how that goes. Otherwise, it's a negotiation about, you know, can I have this cupboard, uh, is my f- food, and you keep your food [laughs] over here. Or sometimes we've had people buy their husbands, like, lock boxes and give them the key, so they have their... If they wanna be eating chocolate and crisps, they have it in a locked box out of sight.
17. RCDr. Rangan Chatterjee
  Wow.
18. JUDr. Jen Unwin
  So that the, the person knows they can't get into that box, or that it's locked in a filing cabinet, something like that.
19. RCDr. Rangan Chatterjee
  I... When, when you hear that, you go, it's pretty hard to not make the case this is an addiction, right?
20. JUDr. Jen Unwin
  Yeah.
21. RCDr. Rangan Chatterjee
  When you, when you hear things like that, a locked box.
22. JUDr. Jen Unwin
  Yeah, yeah, that people have asked their husbands to ke- to keep it outside or, or only to eat it outside the home. Um, so it's, so it's an individual kind of negotiation about what's possible really in, in the home. Um, you know, as say, having a cupboard, so the cupboard you open only has the things in that you want to be eating, or a, a shelf on the fridge that's your food. It, it is more difficult if it, if you're seeing it-
23. RCDr. Rangan Chatterjee
  Yeah
24. JUDr. Jen Unwin
  ... all the time.
25. RCDr. Rangan Chatterjee
  But Jen, just to bring up alcohol for a minute.
26. JUDr. Jen Unwin
  Hmm.
27. RCDr. Rangan Chatterjee
  I, I guess-
28. JUDr. Jen Unwin
  Yeah, use the same analogy that-
29. RCDr. Rangan Chatterjee
  Use the analogy, and if you were, um, if you were recognized as an alcoholic-
30. JUDr. Jen Unwin
  Yeah
1:38:13 – 1:53:23
Community, resources, and the power of hope to sustain change
1. RCDr. Rangan Chatterjee
  If someone's listening, Jen, and they want to get involved with the community, maybe they don't have friends or family who are supportive, but they're really committed, is there a way they can get in touch with you or your groups, and, and if so, how? I know you have the book, Fork in the Road.
2. JUDr. Jen Unwin
  Fork in the Road.
3. RCDr. Rangan Chatterjee
  It's a great resource.
4. JUDr. Jen Unwin
  Yeah, I wrote, um, in lockdown, and it was sort of meant to be, yeah, for people that are probably listening to this conversation, it was, it was for people like me who'd had these sort of lifelong struggles. It explains all about food addiction and the symptoms and some of the science of it, and David's done the forward. Um, but then it a- it's also, like, you know, what to eat and how to deal with these social situations that we all get ourselves in and what other things you might want to think about in your life. But it's a very little book, and all the proceeds go to the, the charity, the Collaborative Health Community that I work with and that, that are... We're, you know, campaigning and doing research on food addiction. Um, and you know, ma- if you've got a partner or a member of the family that doesn't get it, read the book yourself, but then hand it over to them because it's-
5. RCDr. Rangan Chatterjee
  Yeah
6. JUDr. Jen Unwin
  ... it's a quick read, and it explains the problem to them in sort of simple terms. So, um, yeah, so that's, that's one thing to... Yeah, so the Collaborative Health Community, you can look on our website, and we've got information and resources for, for professionals, and we're just about to launch some, um, training for healthcare professionals so that they can understand how to recognize food addiction-
7. RCDr. Rangan Chatterjee
  Wow
8. JUDr. Jen Unwin
  ... in the clinic and, and what to do about it, and also got information for, for the public and some more resources that people can, can look at.
9. RCDr. Rangan Chatterjee
  You have practiced as a clinical psychologist for over 30 years, I believe, and I've heard you talk before about the role of hope in healthcare.
10. JUDr. Jen Unwin
  Mm-hmm.
11. RCDr. Rangan Chatterjee
  Why, in your opinion, is it so important to have hope?
12. JUDr. Jen Unwin
  So, h- yes. Hope was my, um, my passion really before I got into all of this space about, uh, food addiction, and I did my doctorate on the role of hope in, in healthcare. Um, hope is about having a sense of a possible better future. It's about believing that you can see the steps to that future and believing that you've got the motivation to take those steps or the, the... Yeah, you've got the... You, you're gonna be able to take those small steps. And when people have that sense of hope, it has such a massive impact on how they cope with everything in, in life really, um, and even about, you know, things like the level of pain they experience or the amount of medication that they take or even... It's even been linked with longevity, to have that, that sense of moving towards a preferred future. And I think often in, in healthcare settings, people are so, um... They've lost hope really.
13. RCDr. Rangan Chatterjee
  Yeah.
14. JUDr. Jen Unwin
  And they, they've, they've, they've, they've come. It's almost like a sort of, you know, particularly a lot of people that, that come to see us, uh, it- it's like you're the last house on the street really. They've, you know, they've, they've tried everything, and they've, they've sort of become very hopeless. So it's very important as healthcare practitioners that we're able to instill that sense that, you know, they, they can get to, they can get to a better place, and they've got the, the wherewithal to do that.
15. RCDr. Rangan Chatterjee
  Yeah.
16. JUDr. Jen Unwin
  You were talking about sort of, you know, you know, often people that we see are very competent in many walks of their lives. They've got successful careers or, you know, they've, they've got a lovely family. Um, but they, they just... There's this one area that they can't crack.
17. RCDr. Rangan Chatterjee
  Mm-hmm.
18. JUDr. Jen Unwin
  Like in this case, we're, we're talking about the food, and they've sort of lost, lost hope there. And it's about trying to give people the hope and the, and the confidence that they can actually take the steps. You know, they've got that within them to take the steps to this better future, and you know, not that it's all gonna be plain sailing, but you know that they will get there-
19. RCDr. Rangan Chatterjee
  Yeah
20. JUDr. Jen Unwin
  ... in the end with, you know, with some care and s- and support, and often all you're trying to do is uncover that for people. You know, like for Chris that you spoke to, it was only a matter of showing him that there was a way-
21. RCDr. Rangan Chatterjee
  Yeah
22. JUDr. Jen Unwin
  ... um, that he could recover his health, which he at that point probably could barely believe that he would end up on no medication and going-
23. RCDr. Rangan Chatterjee
  Yeah
24. JUDr. Jen Unwin
  ... to the gym every day. Um-
25. RCDr. Rangan Chatterjee
  Well, I think, Jen, what you clearly do with this work and what you've been doing for many years to try and raise awareness of food addiction, sugar addiction, UPF addiction, that this is a problem that many people are struggling with, that we need to recognize, and we need to give people solutions to or certainly practical steps they can take. That is giving people hope.
26. JUDr. Jen Unwin
  Mm-hmm.
27. RCDr. Rangan Chatterjee
  I'm sure there's many people who've taken hope just from hearing you today, even the fact that you've managed to... I don't know if you'd... you, you would, you would say you've conquered your food addiction, or you've learnt how to manage it-
28. JUDr. Jen Unwin
  I think you learn to live with it-
29. RCDr. Rangan Chatterjee
  You learn to live with it
30. JUDr. Jen Unwin
  ... a bit like migraine or something like that. You know, it's the same. It's always... or type 2 diabetes. It's, it-

Episode duration: 1:53:23

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Sugar cravings aren’t a willpower failure: the brain’s reward circuitry

Why “food addiction” is controversial—and why UPFs change the argument

A continuum like alcohol: from enjoyment to substance use disorder

Modern ‘toxic’ food environments vs hunter-gatherer biology

Hope and responsibility: small changes and the ‘Fork in the Road’ mindset

Why formal recognition matters: stigma reduction, treatment pathways, and WHO efforts

What foods are most ‘addictive’: the sugar-fat-salt-refined grain combination

Beyond substances: volume addiction, cues, comfort eating, and addiction substitution

Restriction vs nourishment: why ‘all foods in moderation’ fails for some

Wiring starts young: sugar as early state-change, family culture, and constant cueing

Self-assessment tool: the CRAVED screening for addictive-like eating

Practical recovery plan: motivation, trigger lists, and ‘I know I’m in trouble when…’

Handling real-world pressure: social scripts, slips as learning, and cold turkey vs gradual

Home and family dynamics: partners, kids, and building supportive environments

Community, resources, and the power of hope to sustain change

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