Hope, clinical psychology, and solution focus

• Clinical and health psychology work in physical-health settings showed that distress is not proportional to pathology; the meaning of a change for a person’s future is central.
• A businessman attacked with a machete remained hopeful about rebuilding his life and business even if he needed a wheelchair, while a war reenactor who lost an arm stayed optimistic because his friendships and reenactments could continue.
• A shy joiner who lost only the tip of a finger became profoundly distressed because the injury threatened his imagined future, making hope and future interpretation central.
• In the nun study, positive, hopeful emotional content in autobiographies written by young nuns was linked with better health and longer life decades later. [1]
• In a very large older-adult sample, greater hopefulness predicted less medication and health-care use, less disease, and greater longevity. [2]
• In prospective lower-limb amputation work, age, sex, and amputation factors were poor predictors of adjustment, while hope was the best predictor of mood, quality of life, and rehabilitation. [3]
• Solution-focused practice asks about best hopes, the preferred future, strengths, and what is already working; it gives clinicians a practical way to build hope without scolding people or simply giving advice.
• Research across mental health, education, and social work links solution-focused practice with greater resilience to work stress and burnout.
• Combining solution-focused psychology with low-carbohydrate nutrition transformed David’s general practice, and an academic background led to systematic data collection and publication of the outcomes.

My own food history and the addiction model

• Jen was obsessed with sweets and refined carbohydrates from childhood, was overweight as a teenager, and grew up where dieting and baking were both common.
• John Briffa’s Escape the Diet Trap provided a low-carbohydrate explanation centered on insulin and sugar; after about eight difficult days without those foods, mental clarity returned and hunger became minimal.
• That freedom was not sustained consistently when keto cookies, cakes, and other recreated foods entered the diet, because foods that maintained the same relationship could still be overeaten.
• Bitten Jonsson’s Diet Doctor material on sugar addiction made the addiction model fit the experience: the problem involved both nutrition and the relationship with sugar and refined carbohydrates, leading to real whole foods as nature intended.
• Dave Feldman’s history with French fries shows food noise bargaining with rules: after years without fries, exceptions expanded from travel to restaurants until fries were back whenever the rule permitted them.
• Addiction is intelligent people doing stupid stuff; abstinence from personal trigger foods can remove constant internal negotiation in the same way that complete abstinence can simplify recovery from alcohol, cigarettes, or drugs.
• Food differs because eating is necessary, so each person has to identify foods that trigger loss of control; for many people these are ultra-processed foods, refined grains, and sugar, while vulnerability exists on a continuum.

Children, reward, and addictive learning

• Food can become a child’s first self-soothing drug because children usually cannot access nicotine, alcohol, or illicit drugs, while sugar is everywhere and is routinely used as a reward.
• Research on adverse childhood experiences links childhood adversity with a greater likelihood of later addictive problems, including problematic relationships with food.
• Chris van Tulleken ate a diet that was about 80% ultra-processed food for a month and had brain MRI scans before and after; new connections formed between reward areas and habit or automatic-behavior areas, and those connections were still there six months later. [4]
• A developing, highly neuroplastic brain can wire these reward-and-habit pathways strongly, making repeated exposure to highly rewarding foods especially important in children.
• Once an addictive pattern is wired, stopping one substance or behavior can expose another: people giving up sugar can suddenly increase scrolling, shopping, or another compulsive behavior.
• After bariatric surgery, a proportion of people develop a new alcohol-use disorder, another example of an addictive process moving to a different outlet.

Recognition and the case for ultra-processed food addiction

• Ashley Gearhardt developed the Yale Food Addiction Scale, which applies addiction criteria to eating behavior and is widely used in research. [5]
• The first application to the World Health Organization was rejected because there was no consensus, too little intervention evidence, existing obesity and eating-disorder categories, and concern about confusion.
• A Delphi process involving 40 experts and two workshops answered the consensus objection; 37 reached consensus, with the terminology ultra-processed food addiction and, in ICD language, ultra-processed food use disorder. [6]
• Food addiction is not the same thing as obesity: a meaningful proportion of people who meet food-addiction criteria are normal weight or underweight, while many people with obesity do not meet the criteria.
• Food addiction overlaps with binge-eating disorder and bulimia but not completely, so forcing everyone into obesity or existing eating-disorder categories misses people whose core problem is addiction.

Intervention data and recovery programs

• An unfunded citizen-science intervention with Sweet Sobriety and Leva Sockerfri used roughly ten weeks of online education, real whole low-carbohydrate food, addiction education, planning for social situations, and relapse prevention.
• Yale Food Addiction Scale scores, CRAVED symptoms, and Warwick-Edinburgh mental wellbeing were measured; the initial pre-post paper and the 12-month follow-up found large improvements, with 62% of completers in remission at the end and benefits maintained over follow-up. [7][8]
• Tro Kalayjian’s metabolic-clinic data show that a metabolic health intervention can reduce food-addiction and binge-eating symptoms. [9]
• Ellen Bennett’s Liberate program has produced similarly strong improvements using an online, peer-supported psychoeducational program. [10]
• Susan Peirce Thompson’s Bright Line Eating program has six-year follow-up data for an abstinence-based food-addiction recovery approach. [11]
• These are early intervention data, and the field needs direct comparisons between approaches; a direct comparison between this program and a properly delivered ketogenic approach would test which model works better.
• Guido Frank’s ketogenic-therapy work in adults with anorexia nervosa provides a proof-of-concept example that nutritional ketosis can be studied even in a population where people have been very cautious about it. [12]
• Formal recognition can unlock research funding, clinician training, and services for people who currently fall between obesity, eating-disorder, and addiction systems.

Clinical systems, industry, and the recovery environment

• Doctors, eating-disorder services, and addiction services are often not trained to recognize food addiction, and an “all foods fit” approach can be disastrous for someone whose problem is loss of control around specific foods.
• The situation is roughly where smoking was 60 or 70 years ago: the harm was visible, but it was socially normalized, minimized, and difficult to escape because the product was everywhere.
• The food industry also resembles tobacco in obscuring addiction; Michael Moss’s Hooked documents companies using brain scans and reward responses while formulating foods, and major tobacco companies later owned large food businesses. [13]
• The low-fat era intensified this by removing fat from products and adding sugar for palatability while teaching people to fear foods such as butter and fatty meat and favor “heart-healthy” grain-based products.
• A residential recovery environment can remove cues, provide real whole very-low-carbohydrate food, exercise, community, and enough time for the early withdrawal period to pass before people return to their usual environment.
• Recovery still has to work at home, where cues and social pressure return; ongoing fellowship and support matter because old addictive pathways can reactivate quickly.

Classification, terminology, and diagnosis

• Food addiction, sugar addiction, refined-carbohydrate addiction, and ultra-processed food addiction are overlapping names for the problem; for formal classification, ultra-processed food addiction currently has the strongest evidence base.
• Refining a food changes the speed and concentration with which rewarding substances reach the body and brain, much as extracting concentrated substances from plants changes their addictive potential.
• The practical diagnostic axis is behavioral: cravings and compulsions, tolerance, neglect of other activities, loss of control over amount, withdrawal, and continuing despite harm.
• The CRAVED tool mirrors these addiction features and gives a compact way to identify the pattern.

How common it is and who is vulnerable

• A study of retired elite athletes using the Yale Food Addiction Scale found a striking level of food-addiction problems after retirement, around two-thirds, especially around carbohydrate-rich foods that had been part of high-volume training. [14]
• Across the general population, food addiction is around 14%, so it does not affect everyone but is far from rare. [15]
• Food addiction is associated with about a 6.7-times higher likelihood of type 2 diabetes. [16]
• Food addiction is also associated with mental-health problems, with a figure of about 2.6 times higher.
• The number of affected adults in the United Kingdom is therefore in the millions, and prevalence may be a little higher in children.
• The host’s “bingery hypothesis” is that episodes of extreme bingeing may cause acute, unnoticed vascular injury that accumulates over time; it is explicitly a hypothesis, not an established finding.

Recovery in daily life

• Lionel Sanders moved from drug addiction into extreme exercise and became an Ironman champion, then later entered “sugar rehab” after heavy carbohydrate loading left him waking at night to eat granola bars; the outlet changed, but the addictive pattern remained.
• Creative repetitive activities such as knitting, crochet, and sewing can be calming and absorbing, and evidence links repetitive, meditative activity with better mental wellbeing.
• Jen’s old pattern included thinking about carbohydrates from morning to night, secret eating, and foods such as butter and sugar, condensed milk, and peanut butter; peanut butter is still kept out of the home because it can restart the food noise.
• Giving up a trigger food can involve real grief: one retreat participant held a funeral for a particular chocolate bar because it had functioned as comfort, reward, and companionship.
• Social pressure is often surprisingly strong, with other people urging someone in recovery to have “just a little” of the very food they are trying to abstain from.

Caffeine, GLP-1 drugs, and behavior change

• Dave Feldman’s lipid self-experiments included people with unexpectedly high triglycerides and an N-of-1 investigation in which filtered versus unfiltered and caffeinated versus decaffeinated coffee were tested; triglycerides fell only when coffee stopped.
• Jen’s caffeine withdrawal became obvious when a coronary calcium scan required skipping coffee: the headache disappeared almost immediately after caffeine, and after tapering off there were about two weeks of chest pressure and panic-like sensations.
• GLP-1 drugs can be useful for severe cases, but they should be paired with addiction knowledge, nutrient-dense food, and habit change so that people are not simply eating smaller amounts of the same nutrient-poor diet.
• David has used very-low-dose oral semaglutide as a bridge for some difficult cases while working on behavior and food quality, using the same broad logic as a medication bridge in another addiction.
• Bariatric surgery also shows why behavior still matters: after about two years, a proportion of people begin regaining weight if the underlying food relationship and environment have not changed.

Nutrient density and prevention

• In residential work, women who had chronically eaten too little protein often became much less hungry when enough protein and nutrient-dense food were supplied.
• Ty Beal’s nutrient-density paper shows how dramatically foods differ in the amount needed to obtain key micronutrients: roughly 7 grams of liver three times a day versus about 4 kilograms of refined grains at each meal. [17]
• Food addiction can be easier to prevent than to manage for life, making children and adolescents the current priority: parents, schools, and young people need to understand how repeated exposure to highly rewarding food can shape behavior before the pattern becomes entrenched.

References

1. [00:22] Positive emotions in early life and longevity: findings from the nun study — https://doi.org/10.1037/0022-3514.80.5.804
2. [00:23] The role of Hope in subsequent health and well-being for older adults: An outcome-wide longitudinal approach — https://doi.org/10.1016/j.gloepi.2020.100018
3. [00:24] A prospective study of positive adjustment to lower limb amputation — https://doi.org/10.1177/0269215509339001
4. [00:59] UCL academic follows ultra-processed food diet for BBC documentary — https://www.ucl.ac.uk/news/2021/may/ucl-academic-follows-ultra-processed-food-diet-bbc-documentary
5. [01:04] Preliminary validation of the Yale Food Addiction Scale — https://doi.org/10.1016/j.appet.2008.12.003
6. [01:08] Toward consensus: using the Delphi method to form an international expert consensus statement on ultra-processed food addiction — https://doi.org/10.3389/fpsyt.2025.1542905
7. [01:14] Low carbohydrate and psychoeducational programs show promise for the treatment of ultra-processed food addiction — https://doi.org/10.3389/fpsyt.2022.1005523
8. [01:14] Low carbohydrate and psychoeducational programs show promise for the treatment of ultra-processed food addiction: 12-month follow-up — https://doi.org/10.3389/fpsyt.2025.1556988
9. [01:15] TOWARD: a metabolic health intervention that improves food addiction and binge eating symptoms — https://doi.org/10.3389/fpsyt.2025.1612551
10. [01:16] A feasibility and acceptability study of Liberate: an online, peer-supported, psychoeducational intervention for ultra processed food addiction — https://doi.org/10.3389/fpsyt.2025.1620372
11. [01:16] Six-year follow-up of an abstinence-based, food addiction recovery approach to weight management — https://doi.org/10.3389/fpsyt.2025.1584201
12. [01:17] Symptom impact and safety of ketogenic therapy in adults with anorexia nervosa: a feasibility trial — https://doi.org/10.1038/s43856-026-01644-0
13. [01:30] Hooked: Food, Free Will, and How the Food Giants Exploit Our Addictions — https://www.penguinrandomhouse.com/books/246273/hooked-by-michael-moss/9780812987133/
14. [01:52] Investigation of Retired Elite Athletes’ Food Addiction — https://doi.org/10.23751/pn.v23i4.11156
15. [01:53] Prevalence of food addiction determined by the Yale Food Addiction Scale and associated factors: A systematic review with meta-analysis — https://doi.org/10.1002/erv.2878
16. [01:53] Food addiction is strongly associated with type 2 diabetes — https://doi.org/10.1016/j.clnu.2023.03.014
17. [02:37] Priority Micronutrient Density in Foods — https://doi.org/10.3389/fnut.2022.806566