Food Junkies Podcast

In this episode of the Food Junkies Podcast, Clarissa and Molly sit down with psychologist Dr. Carrie Wilkens to unpack what it really means to help people change without shame, stigma, or power struggles. Drawing from decades of work in substance use, eating disorders, trauma, and family systems, Carrie invites us to rethink "denial," "relapse," "codependency," and even the disease model itself, while still honoring the seriousness of addiction and the depth of people's pain. Together, we explore how self-compassion, curiosity, and values-based behavior change can transform not only individual recovery but also how families, helpers, and communities show up for the people they love. In this episode, we explore: Lived experience & professional work How Carrie's own long-term healing around food and her body continues to shape the compassion and curiosity she brings to her work. The idea that our relationship with food and our bodies changes across the lifespan—and why "lifelong relationship management" matters more than perfection. Do you have to be "in recovery" to help? The pressures clinicians face when they're asked, "Are you in recovery?" and how that question can be loaded with judgment and assumptions. Why personal experience with a specific substance or behavior is not a prerequisite to being deeply effective as a helper. How Carrie talks with clients and families about her own history in a way that's honest, boundaried, and clinically useful. Rethinking 'denial' and harmful language Why words like "denial," "addict," "codependent," "chronic relapser," and "it's a slippery slope" can shut people down rather than open them up. A more curious approach: asking "What do you mean by that?" and unpacking the real story underneath labels. How language can either invite people into self-understanding—or reinforce shame, fear, and disconnection. Softening the disease model without minimizing the problem Nuanced ways to honor addiction as a serious, complex disorder without collapsing everything into a rigid disease frame. How fear (of overdose, loss, chaos, or death) drives a lot of rigid thinking in systems and professionals. Why behavior change is slow, non-linear, and rarely a straight line—and how accepting that can actually make care more effective. Relapse as an "old solution that once worked" Carrie's reframe of relapse as returning to an old behavior that, at one time, made sense and worked on some level. How naming the function of a behavior (soothing, numbing, regulating, connecting) opens the door to new, less harmful solutions. The difference between "You didn't want it enough" and "Your brain reached for an old strategy that once helped you survive." The Invitation to Change Approach (ITC) The core elements of ITC: Motivational interviewing–informed curiosity and ambivalence exploration. Acceptance and Commitment Therapy (ACT) and values-based living. A deep commitment to self-compassion as a foundation for behavior change. Why ITC was originally developed for family members and then adapted for people with substance use concerns themselves. How the "wheel" of ITC lets people step in wherever they are—self-awareness, values, behavior strategies, or compassion—and build over time. Families, shame, and staying engaged without "tough love" Inviting family members to ask: "How does my loved one's behavior make sense?" instead of "What's wrong with them?" How this shift helps parents and partners move from fear and control into strategy, support, and skillful engagement. Concrete examples of how families can respond to return to use with curiosity, concern, and clearer communication instead of lectures or ultimatums. Codependency and other overused labels Why Carrie has never formally diagnosed anyone with "codependency." What often lives underneath that label: trauma histories, cultural norms, attachment dynamics, fear of loss, and learned survival strategies. How flattening all of that into "codependent" erases nuance and blocks meaningful change. Neurodivergence, trauma, and substance use/eating behaviors The high rates of PTSD and ADHD among people seeking help for substance use—and why that matters for treatment design. Carrie's reflection on her own undiagnosed ADHD and how it likely drove much of her earlier eating disorder behavior. How binges, purging, and substance use can function as powerful nervous system regulators, especially for neurodivergent and trauma-impacted brains. Why we need more ground-up, neurodivergent- and trauma-informed approaches that focus on emotion regulation, executive functioning, and skill-building. Self-compassion as a behavior change superpower Carrie's journey from skepticism ("this sounds too woo") to seeing self-compassion as essential, research-backed behavior-change work. How self-compassion reduces shame, helps people tolerate slow progress, and makes it safer to look honestly at their own behavior. Using both "tender" and "fierce" self-compassion to choose boundaries, seek support, and keep moving through discomfort. Reimagining 'expert' roles and community care Why Carrie is skeptical of rigid expert hierarchies in addiction treatment. Inviting families, community leaders, and lay helpers into the work through accessible tools like ITC groups and trainings. The power of giving non-clinicians simple, evidence-based language and frameworks so they can respond with compassion instead of panic or shame. About Dr. Carrie Wilkens Carrie Wilkens, PhD, is a psychologist with more than 25 years of experience in the practice and dissemination of evidence-based treatments for substance use and post-traumatic stress. She is the Co-President and CEO of CMC: Foundation for Change, a nonprofit dedicated to bringing evidence-based ideas and strategies to families, communities, and professionals supporting people struggling with substances. Carrie is a co-developer of the Invitation to Change (ITC) Approach, an accessible, skills-based framework that helps families stay engaged, reduce shame, and effectively support a loved one's behavior change. ITC is now used across the U.S. and internationally in groups, trainings, and community programs. She is co-author of the award-winning book Beyond Addiction: How Science and Kindness Help People Change, which adapts the Community Reinforcement and Family Training (CRAFT) model for families, and co-author of The Beyond Addiction Workbook for Family and Friends, a practical, evidence-based guide for loved ones who want concrete tools to support change without sacrificing their own wellbeing. Carrie is also Co-Founder and Clinical Director of the Center for Motivation and Change (CMC), a group of clinicians providing evidence-based care in New York City, Long Island, Washington, DC, San Diego, and at CMC: Berkshires, a private residential program for adults. She has served as Project Director on a large SAMHSA-funded grant addressing college binge drinking and is frequently sought out by media outlets including CBS This Morning, the Katie Couric Show, NPR, and HBO's Risky Drinking to speak on substance use and behavior change. Resources Mentioned CMC: Foundation for Change – Family-focused trainings, groups, and resources: cmcffc.org The Invitation to Change Approach – Overview of the ITC model and its core topics. Beyond Addiction: How Science and Kindness Help People Change (Book) The Beyond Addiction Workbook for Family and Friends (Workbook) 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.  

In this Clinician's Corner episode, Clarissa and Molly dive into what they lovingly (and accurately) call the "Hella-Days"—that stretch from early fall through New Year's where routines disappear, food is everywhere, emotions are high, and nervous systems are fried. Together, they unpack why this season is so activating for people with food addiction and nervous system sensitivity, and how to navigate it with values, boundaries, and a whole lot of self-compassion—whether you're surrounded by family or spending the holidays on your own. In This Episode Clarissa & Molly explore: Why the holidays can feel like the "Holiday Hunger Games" and "12 Days of Dysregulation" How the nervous system responds to the build-up from September to New Year's Using values as your North Star for holiday decisions Boundary tools and scripts for parties, family gatherings, and food pushers Why holiday food environments are an "engineered stressor" (hello, peppermint-everything marketing) Strategies for: Going to events without abandoning your recovery Deciding when not to go Coping with loneliness, isolation, and dark evenings Harm reduction during high-exposure events ("good, better, best" thinking) How to re-imagine your holiday story over time instead of chasing perfection Ideas for folks who love the holidays (Clarissmas) and folks who… don't (Molly 😂) They also share: Personal stories of childhood Christmas expectations, sibling dynamics, and parental pressure How early family patterns still shape how we show up at the holidays Reframing relapse and "taking the bait" with relatives like Aunt Linda (sorry, Linda) Key Takeaways You can use/adapt these directly in show notes as bullet points. Start with your North Star, not the menu. Before the doorbells, casseroles, and Aunt Linda's commentary, ask: What matters most to me about this season? How do I want to feel when the day is over? What will support my recovery and nervous system? Let those answers drive your choices more than other people's expectations, panic, or cookies. Boundaries are about self-respect, not punishment. Boundaries define what's okay and not okay for you. They're about taking responsibility for your experience—not policing others. As Brené Brown says, "Clear is kind." You don't have to over-explain or apologize. Use positive, non-defensive boundary scripts. "I don't eat sugar" often triggers defensiveness and comparison. Instead, frame your choice around how good you feel: "That looks amazing, but I've been eating in a way that's really helping my energy and sleep, and I'm so grateful I found what works for me. Thanks for understanding." Or keep it simple: "No, thank you." (A complete sentence.) "I'm focusing on foods that help me feel my best." Rehearsal reduces panic. Visualize the event ahead of time: Imagine someone offering food or a drink. Practice your boundary script. Role-play in group or with a clinician. Like athletes using mental rehearsal, you're teaching your nervous system that this "scary" behavior is survivable and doable. Don't arrive hungry to the Holiday Hunger Games. Skipping meals "to save up" for a party sets you up to be biologically and emotionally vulnerable. Eat a satiating meal (protein, healthy fats, veggies) before events. Then you can pause and ask, Am I actually hungry, or is this emotional/relational? Use "Good, Better, Best" instead of all-or-nothing. When your nervous system is hijacked and the perfect choice isn't accessible: Best: Aligned, recovery-supportive choice. Better: Less harmful option if "best" isn't realistic. Good enough: Reduces harm in a very stressful moment. This is harm reduction, not failure. Plan your support system: exit strategies, grounding, and non-food rewards. Exit plan: Decide in advance how long you'll stay and how you'll leave if overwhelmed (drive separately, ask partner to bring you back to the hotel, etc.). Grounding: Find a quiet corner, identify 5 things you can see, and locate something visually "neutral" or pleasant you can keep returning your gaze to. Non-food rewards: Think saunas, walks, reading, play with kids/nieces, skiing, time offline—let celebration include regulation, not just consumption. You don't actually owe the holidays anything. There is nothing magical about one date on the calendar that couldn't be created on another day. You can: See important people in smaller, less intense doses throughout the year. Say "no" to events that are more away-moves than towards-moves for your recovery. Ask: What does this event mean to me? How might it impact my recovery? Do I have the emotional energy for this? If you're alone or not celebrating traditionally, you still get to have a holiday that fits you. For folks spending holidays solo or outside of family systems: Create new traditions: a favorite meal (yes, lobster counts), comfort movies, lights-seeing drives, nature walks. Consider volunteering (community dinners, toy programs), which can shift perspective and foster connection. Plan virtual connection: Zoom rooms, watch parties, scheduled calls or voice notes, especially in the evenings when darkness and loneliness hit the hardest. Engineered holiday food environments are not a personal failure. Seasonal marketing is deliberately designed to trigger nostalgia, emotion, and craving (eggnog-everything, gingerbread-everything). It's an engineered stressor, not proof you lack willpower. Your brain is responding exactly as it was wired to; you're not broken. You are not "starting over"; you are learning. If you "take the bait" from Aunt Linda, eat off-plan, or get pulled into old patterns: You are not back at Day 1. You collected new data about triggers, resources, and needs. Recovery is peaks, valleys, and everything in between—that's human, not just "because you're an addict." Your holiday story can change over time. Clarissa names how her first, second, third food-sober holidays were hard—and now it's almost a non-issue. We can: Re-imagine the script (like Disney re-imagining its princesses). Hold younger versions of ourselves with tenderness. Trust that practice, time, and patience reshape the season. Resources Mentioned Sweet Sobriety Free Holiday Guide (PDF) ~22 pages of: Reflection questions to use your values as a North Star Boundary scripts and language examples Planning prompts for events, food, and nervous system care 👉 Link to download on website Contact / Listener Questions Have a holiday strategy that worked for you? A topic you'd like Clarissa & Molly to cover in a future Clinician's Corner? 📩 Email: [email protected]

In this episode, we sit down with integrative oncologist and metabolic health pioneer Dr. Nasha Winters (who insists we call her Nasha) to explore the powerful intersection of cancer, ultra-processed foods, metabolism, and sovereignty. Nasha shares her astonishing personal story: years of dismissed symptoms, normalized suffering, and relentless gaslighting that culminated in a diagnosis of end-stage ovarian cancer at age 19—and being sent home to die. Thirty-four years later, she's very much alive and leading a global movement to rethink cancer as a metabolic, terrain-driven disease rather than a purely genetic accident. We talk about how ultra-processed foods don't just starve our mitochondria—they starve our sovereignty, hijack our decision-making, and fracture our relationship with our own bodies. Along the way, Nasha invites us to move away from perfectionism and fragility and toward aligned, values-based choices and fierce self-responsibility. In this episode, we explore: Nasha's "pain to purpose" story Chronic health issues from infancy through adolescence: PCOS, endometriosis, autoimmune issues, RA, IBS, thyroid dysfunction, and more—constantly normalized and medicated. Being diagnosed with end-stage ovarian cancer at 19, with full bowel obstruction, organ failure, metastasis, and "3 months to live." How being sent home to die became the catalyst for asking "Why?" and beginning her life's work. A metabolic and psychological reset Why a prolonged period of fasting (due to bowel obstruction) functioned as an unplanned metabolic intervention. How an accidental very high-dose psilocybin experience in 1991 fundamentally changed her perspective, reduced her fear of death, and gave her a will to live. The insight that cancer is not just genetic—but deeply tied to environment, metabolism, trauma, and disconnection from nature. Cancer as an ecosystem, not a battlefield What Nasha means by seeing the body as an ecosystem instead of a war zone. How we are in constant relationship with our internal and external environments—our bodies, food systems, and the land all reflecting each other. Ultra-processed foods and cancer terrain Why ultra-processed foods are "as genetically mismatched as it gets" for humans. How UPFs impact all the hallmarks of cancer—driving inflammation, insulin resistance, oxidative stress, mitochondrial dysfunction, and brain hijacking. The role of emulsifiers, preservatives, seed oils, and other additives in damaging the gut, microbiome, and immune surveillance. Why "a little" ultra-processed food isn't neutral for people with a vulnerable system—and why in her oncology population, UPF often has to be all-or-nothing. Metabolic sovereignty vs. perfectionism Nasha's powerful idea that UPFs don't just starve our mitochondria—they starve our sovereignty. What it means to choose health as alignment, not achievement. How social pressure, cultural norms, and "moderation" language rob people of agency. Practical examples of reclaiming sovereignty: bringing your own wine, your own safe foods, and modeling a different way without preaching. Working with food addiction and emotional eating (without shame) How she meets people gently where they are, especially those whose only "comfort" has been food. "Upgrading" comfort foods and using cooking and eating as a creative, relational, and communal act rather than a shame-based one. Her boundary as a clinician: "I'm not willing to work harder than you." How that shifted outcomes and reduced codependency. Community, clinicians, and doing this together How she used farmers' markets and health-food store "field trips" as non-shaming education: reading labels together, swapping recipes, and making it fun. Seasonal group cleanses and experiments that removed UPFs without moralizing and re-connected people to real food. Justice, food deserts, and real solutions Stories from working in Indigenous and low-resource communities and helping reintroduce native seeds and traditional foodways. The Food-as-Medicine movement: projects like FreshRx, where CSA boxes for people with type 2 diabetes significantly lowered A1C and healthcare costs. Why she believes, increasingly, that the resources are there—and the work now is connection, awareness, and community organizing. A hopeful vision for the next 5 years Policy shifts around dietary guidelines and school food. Regenerative agriculture movements, farmer-led organizations, and bringing environmental, metabolic, mental health, and food systems together under one roof. Her dream project: a 1,200-acre regenerative farm, intentional community, and metabolic oncology hospital in Arizona. One small step you can take this week Start with non-judgmental awareness: a simple food and feeling diary. Her "triage" before reaching for UPFs: Big glass of water A bit of protein A bit of fat Then the UPF if you still truly want it—no self-punishment. How small wins ("I didn't eat the thing") build fierceness and confidence over time. Our signature question What Nasha would tell her younger self about ultra-processed foods: "I'm choosing health as alignment, not as achievement." Using food choices to align with who you really are and who you're becoming, rather than chasing perfection or performance. Connect with Dr. Nasha Winters Website, offerings, and clinician training: DrNasha.com Podcast: Metabolic Matters Social: Dr. Nasha / Nasha Winters across platforms Facebook Instagram Book: Metabolic Approach to Cancer: Integrating Deep Nutrition, The Ketogenic Diet, and Nontoxic Bio-Individualized Therapies   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.

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

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.