Food Junkies Podcast

• Episode 256: Dr. Erica LaFata - Diagnosing Ultra-Processed Food Addiction with FASI

  On this episode of the Food Junkies Podcast, we welcome back Dr. Erica LaFata to dive into her groundbreaking work developing the Food Addiction Severity Interview (FASI) — a clinician-administered diagnostic tool modeled after the SCID alcohol use disorder module and adapted for ultra-processed foods. Building on self-report tools like the Yale Food Addiction Scale (YFAS) and mYFAS, Erica explains why the field urgently needs a structured clinical interview to validate ultra-processed food addiction as a distinct psychiatric presentation and move toward formal recognition in the DSM. Together, we explore the nuance at the intersection of eating disorders and ultra-processed food addiction: where they overlap, where they diverge, and how mislabeling can harm people on both sides. Erica unpacks key addiction mechanisms like withdrawal and tolerance, the risks of false positives and false negatives in screening, and what clinicians should be listening for when trying to tell restrictive eating, binge eating, and addictive patterns apart – especially in youth, men, and other under-researched groups. The conversation also gets practical and hopeful: we talk about the competencies therapists, dietitians, coaches, and other practitioners need before working with ultra-processed food addiction; the tension between abstinence and harm reduction; the "volume addiction" question; and how orthorexia and the "health halo" of protein bars and high-protein UPFs can quietly hijack recovery. Erica closes by sharing how FASI data could inform future public policy and regulation of ultra-processed foods without fueling weight stigma – and gives an exciting update on the DSM submission process for ultra-processed food addiction as a condition for further study. In this episode, we discuss: Why self-report tools (YFAS, mYFAS) were a crucial first step—and why a clinician-administered interview like FASI is the necessary next one How FASI was modeled after the SCID alcohol use disorder module and adapted for ultra-processed foods The core addiction mechanisms (loss of control, withdrawal, tolerance, consequences) and how they show up with ultra-processed foods Key differences between traditional eating disorder frameworks ("all foods fit," no good/bad foods) and an addiction lens focused on specific ultra-processed foods What many food addiction coaches and practitioners may be missing without formal substance use or eating disorder training False positives vs false negatives in food addiction screens—and why missed cases (false negatives) are especially concerning How FASI uses follow-up questions to differentiate restriction, binge eating, and true addictive patterns What we know (and still don't know) about ultra-processed food addiction across sex, age, BMI, and developmental stages Early exposure in childhood and adolescence as a potential public health crisis for lifelong addictive responses to ultra-processed foods The high overlap between binge-type eating disorders (BED, bulimia nervosa) and food addiction—and what to prioritize in treatment "Volume addiction": whether what we call "addicted to volume" may actually be binge eating disorder in disguise Orthorexia, "clean eating," and the health halo of protein bars, high-protein snacks, and dressed-up "safe" foods The tension between abstinence-based and harm reduction approaches for ultra-processed foods, and why different strategies may work for different people How clinician bias (diet culture, anti-addiction frameworks, or rigid abstinence views) can affect assessment—and how FASI creates room for nuance How FASI and future data could support DSM recognition, inform policy, SNAP and marketing regulations, and reduce shame by naming ultra-processed food addiction as real and treatable A hopeful update on the DSM application for ultra-processed food addiction as a condition for further study

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• Episode 255: Challenging the Naysayers with Dr. Nicole Avena

  In this powerful episode, Dr. Vera Tarman and Clarissa Kennedy welcome back Dr. Nicole Avena, one of the first researchers to scientifically validate the concept of food addiction. Together, they unpack the latest critiques of food addiction and explore why this diagnosis is still being challenged – and why the science strongly supports it. 🔍 Key Questions We Tackled Is food addiction "too broad" to be useful? Can we really rely on self-report tools like the Yale Food Addiction Scale? What about brain imaging – doesn't Kevin Hall's PET study "disprove" food addiction? Are we just pathologizing normal overeating under stress or dieting? If withdrawal from ultra-processed foods isn't like alcohol or opioids, does it "count"? What Dr. Avena Wants You to Know 1️⃣ Overlap with eating disorders ≠ "not real" Food addiction can overlap with eating disorders and obesity, but that doesn't mean it's the same thing. Lots of conditions share symptoms; that's exactly why we need more research, not less. 2️⃣ Self-report doesn't make it "fake" Critics argue that the Yale Food Addiction Scale (YFAS) isn't valid because it relies on self-report. Dr. Avena reminds us: If we reject self-report, we'd also have to throw out: Depression inventories Alcohol and substance use screens Most mental health assessments we use every day Self-report + clinical judgment + (where possible) biological measures = standard science, not junk science. 3️⃣ One PET scan ≠ "case closed" Kevin Hall's PET study is often waved around as "proof" that food isn't addictive. Dr. Avena explains major limitations: PET is a blunt tool for measuring dopamine compared to methods like microdialysis. The milkshake used was lower in sugar than many people consume in real life. Participants weren't clearly separated into food-addicted vs non–food-addicted groups. Dopamine is highly time-sensitive: anticipation and early consumption may be where the real action is, not 30 minutes later. And importantly: We don't throw out alcohol or nicotine addiction just because a single brain study fails to show a clear dopamine spike. Science is built on many studies over many years, not one headline. 4️⃣ We're not pathologizing everyone who overeats Yes, lots of people overeat on holidays or under stress. That's normal. Food addiction is when: Overeating is persistent and pervasive It causes distress, impairment, and health consequences Multiple DSM substance use criteria are met (tolerance, withdrawal, loss of control, continued use despite harm, etc.) That's a very different picture than "I ate too much at Thanksgiving." 5️⃣ Withdrawal from ultra-processed foods is real (and looks a lot like other addictions) Research now shows that withdrawal from ultra-processed foods can include: Irritability Fatigue Low mood Crankiness / lethargy These symptoms tend to peak in 2–5 days, similar to what we see with substances like nicotine. You don't need seizures for it to count as withdrawal. 6️⃣ Not having a "perfect definition" is not a reason to stop studying it We are still refining: What exactly counts as "food addiction" Which foods / combinations are most addictive How best to diagnose and treat it That's how science works: definition → research → refinement → better definition → repeat. If we'd waited for perfect definitions, we wouldn't have moved forward on half the diseases we now recognize. 💊 GLP-1 Medications & Food Addiction: Clues from Treatment The conversation also touched on GLP-1 medications (like semaglutide and others): For some people, GLP-1s dramatically reduce "food noise" and cravings. For others, they only partially dampen urges – they still need tools, structure, and support. This suggests these drugs are interacting with reward and satiety circuits that are highly relevant to addiction. Dr. Avena and Clarissa both emphasize: Medication alone is not enough – people still need skills, structure, and support to navigate cravings, emotions, and the food environment. 🧬 Big Picture: Why This Debate Matters Naysayers often publish opinion pieces without new data, recycling old critiques that the research has already addressed. Media then amplifies a single study or opinion as "proof" that food addiction isn't real. Meanwhile, millions of people are struggling in silence, wondering: "If this isn't addiction, what's wrong with me?" Dr. Avena's message is clear: There is now a large body of evidence – animal, human, behavioral, and neurobiological – supporting food addiction as a valid construct worth recognizing, researching, and treating. ❤️ For Those Who Feel Seen by "Food Addiction" If you've ever felt like: You can't stop with certain foods You eat more than you want, more often than you want You experience cravings, withdrawal, or obsessive food thoughts And you've been told "it's just lack of willpower" or "there's no such thing as food addiction" This episode is for you. You are not making this up. The science is catching up to what lived experience has been saying for decades.

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• Food Junkies Recovery Stories Episode 30: Ashley Elizabeth

  C J shares a moving conversation with Ashley Elizabeth, a woman whose honesty and courage shine through her recovery journey. Ashley is remarkably open about her experience with food addiction and the lifelong impact of being put on a diet at a very young age. Like so many, she spent years trapped in the cycle of obsession, shame, and the constant search for control, returning to foods she didn't even like just to get her fix. When Ashley first entered a 12-step program, she approached her food plan like another diet, and for a while, it worked. But true transformation came when she embraced the entire program and surrendered her will to her Higher Power. Today, Ashley shares her story with heart and hope, inspiring others to believe that freedom from food addiction is absolutely possible.

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• Episode 254: Dr. Paul O'Malley

  Dr. Paul O'Malley is a Los Angeles-based dentist who's redefining what it means to care for your teeth—and your whole body. With more than 30 years of experience, Dr. O'Malley specializes in biomimetic and holistic dentistry, which basically means he works with your body, not against it. His focus is on preserving your natural tooth structure, using biocompatible materials, and avoiding the "drill and fill" mindset that leaves so many people anxious about the dentist's chair. He earned his DDS from Creighton University and completed a residency at Baylor University, but what really sets him apart is his philosophy: dentistry should heal and protect, not just patch things up. Over the years, he's trained with some of the top names in cosmetic and restorative dentistry and has become a fellow of both the International Academy of Dentofacial Esthetics and the Academy of Biomimetic Dentistry. At his practice in Encino, California, Dr. O'Malley helps patients restore confidence, comfort, and long-term oral health—often with procedures that are far less invasive than traditional methods. He's also the founder of Great Oral Health, a line of probiotic-based products designed to support a healthy mouth microbiome and overall wellness. We all know sugar messes with our health — but did you know it's one of the biggest culprits behind tooth decay, gum disease, and even inflammation throughout your body? 😬 💥 It's not just how much sugar you eat — it's how often! Every sip or bite keeps your teeth bathing in acid and your enamel under attack. 🦠 Your mouth has a microbiome too — good bacteria that protect you! Constant sugar, grazing, or even "healthy" acidic drinks (like lemon water or sugar-free soda) can throw that balance off. 💧 The fix is simple and kind: ✨ Eat in meals, not all day. ✨ Rinse with water after coffee, tea, or lemon water. ✨ Wait 20 minutes before brushing to protect enamel. ✨ Floss daily (it breaks up the "bug party" that causes decay). ✨ Use a soft brush and gentle angle — your gums aren't a kitchen floor! ✨ Try hydroxyapatite toothpaste (it helps re-harden enamel naturally). ❤️ Your mouth is part of your body — not separate from it. Bleeding gums, bad breath, or constant sensitivity are not normal signs of "aging." They're little SOS signals asking for care. 💬 And for parents: kids copy what we do, not what we say. Brushing and rinsing together is a tiny daily act of prevention and connection. Let's make "self-care" include our smiles. Because a healthy mouth = a healthier body.

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• Episode 253: Clinician's Corner - From Rules to Guardrails: Rewriting the Manual for Recovery

  Molly and Clarissa get real about the spoken and unspoken "rules" we inherit—from family, culture, religion, peers, and recovery spaces—and how those rules can quietly run our lives. They explore when structure is protective (especially early recovery) and when rigidity shrinks our world. The invitation: notice the rule, name whose voice it is, examine its intention, and rewrite it as a flexible, values-aligned boundary (a loving guardrail) that serves your recovery today. What we cover Invisible operating systems: How covert rules ("Don't cry in public," "Finish your plate," "Don't upset Dad," "Work before rest") get encoded as truth and shape choices, identity, and self-worth. Where rules come from: Family modeling, culture/diet/purity narratives, religion & tradition, media comparison loops, and past painful moments that birthed survival strategies. When rules help vs. harm: The cast-to-brace metaphor—early structure can be lifesaving; never taking the brace off becomes its own injury. Food-recovery example: "The kitchen is closed after dinner." Helpful as temporary scaffolding; harmful if it overrides true hunger, fuels all-or-nothing thinking, or becomes punishment. Language that frees: Swap "I can't" for "I choose not to (right now)." Replace rules with loving guardrails anchored in values, not fear. Meeting the Rebel: How the inner rebel shows up when we feel controlled, and how flexibility + permission reduces backlash and binge risk. Compassion over condemnation: Seeing the origin story of a rule reveals it was protective, not defective—which softens shame and opens space to change. Support matters: Borrowing a "prosthetic prefrontal cortex" from trusted people (group, therapist, friend) to reality-check and practice flexibility safely. Try this: a simple Rule Audit Spot it: What's one rule you notice yourself following today? Name the voice: Whose rule is it (family, program, culture, scared younger you)? Intention check: What safety or benefit was it trying to create? Does that need still exist? Cost check: How does it limit you now (shame, rigidity, disconnection from body needs)? Rewrite it: Old: "I can't eat after dinner." New: "I stop after dinner unless I'm truly hungry—then I have a planned, recovery-friendly snack without shame." Make it safer: Pre-plan options, text a support person, add a brief grounding before eating, pre-portion, and debrief after. Nuggets & reframes "Rules kept me safe then; values-based guardrails grow me now." "Different doesn't equal dangerous. It's okay if new feels wobbly." "Recovery should make life bigger, not smaller." "Permission reduces rebellion." "Thank you, old rule, for what you protected. I'm choosing something kinder now." Reflection questions for listeners Which rule in your life feels most rigid right now? What would a kinder, values-aligned version look like? If you replaced one "I can't" with "I choose not to—for now," what changes in your body and nervous system? Who are your go-to people to borrow perspective from when your threat system is loud?   The content of our show is educational only. It does not supplement or supersede your healthcare provider's professional relationship and direction. Always seek the advice of your physician or other qualified mental health providers with any questions you may have regarding a medical condition, substance use disorder, or mental health concern.

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