Well, hello ladies and gents, Robert Sykes, keto, savage.com.
Today I've got special guest Doctor David Wiss on the line
and we dive deep, deep, deep into the world of disordered
eating tendencies, food addiction, what causes that,
what the catalyst is, what are some of the driving forces?
How to recover from that? We talk about body positivity,
we talk about different modalities for recovering from
different forms of disordered eating, both overeating under
eating, bingeing, purging. This is a topic that I hold near
and dear because this is something that I've struggled
with in the past. It's something I've worked with
multiple clients on. This is something that often
times gets swept under the rug because people are shameful in
talking about it, but nonetheless is an incredibly
important topic that needs to be addressed and people need to
find recovery from. SO.
I've thoroughly enjoyed this conversation.
I've learned a ton. I've got no doubt that you will
take something from it. Whether you are struggling with
a disordering tendency or you know someone that is, by all
means let them know about this, share it with them and let's
move the needle in the right direction as it pertains to
recovering from food addiction and disordered eating.
So without further delay, sit back, relax, enjoy the podcast
with Doctor David Wiss and we are live Doctor David
Wiss. How are you Sir?
Super. I'm so glad to be here chatting
with you today, Robert. I'm excited to be chatting with
you man. So we are going to be diving
into the topic of psychology as it pertains to one's
relationship with food, eating disorder tendencies, things of
that nature, which is something that I feel like a lot of people
deal with but is often times left unsaid.
So I'm really excited to just roll up her sleeves and see
where the conversation takes us. Where was the the inspiration to
get into this field to begin with for you, man?
Yeah, I think when I was in Graduate School getting my
master's degree, I did a master's thesis on nutrition and
substance abuse, and I was trying to learn about
connections between certain substances and how they can lead
to certain nutritional deficiencies.
And I really realized there there was an exciting area of.
Nutrition for mental health that was largely untapped.
The eating disorder field has been around for a few decades.
It has made some progress, but the progress has been pretty
slow and I got really interested in nutrition for substance use
disorder, which got me interested in nutrition for.
Addictions as a whole food addiction.
And then we learned about nutrition's role in depression,
anxiety, and it got really exciting to know that there was
a field that was needed and also largely untapped.
And I said, I'm not going to wait for the research.
I'm going to go ahead and be the guy that does the research.
I love it. I love it.
When you were doing your initial research, what kind of
substances were you studying that were leading to these
deficiencies? Yeah, I mean the the data is
quite sparse. It's not super robust in terms
of having trials and actual, you know, studies.
There's a lot of associational studies which point to
correlations. But you know, as a as a broad
stroke, you know, alcohol has the most pronounced effects on
the gastrointestinal tract. And of course, opioids are known
for impacting gut health as well.
And when I was doing my initial research, this was over 10 years
ago. It was before the microbiota
research had really exploded. So in recent years, you know,
we've been able to see very clearly that for example,
alcohol causes shifts in the internal ecosystem, changes in
the microbiota, it can lead to intestinal permeability which
can activate. Inflammatory cascades.
We know that the alcoholic liver disease isn't actually from the
effects of ethanol itself on the liver.
It's more from the effects of alcohol on the gut, leading to a
gut leakiness which you know can release.
Endotoxins and and bacteria, we call it bacterial translocation
into the bloodstream which ends up in the liver and that's the
source of a lot of liver damage. So we're looking at the gut
lining, we're looking at the microbiota, we're looking at the
liver. And yeah, alcohol and and
opioids have the most pronounced effect on the actual GI tract.
And then of course, you know we have other substances,
stimulants. Cocaine, methamphetamine,
etcetera. And there just isn't a lot of
data there. But we know, we know that
certain substances are associated with certain
nutritional deficiencies. But it's still unclear if the
deficiency comes from the substance over utilizing
nutrients or leading to deficiencies, or from the poor
dietary intake, because most people that are using alcohol
and drugs don't have a good. Nutritional regimen per SE.
So yeah, there's a lot of unknowns there and I got really
interested in it. But the data didn't move very
quickly. And I I I was like kind of
screaming nutrition for addiction from the rooftop for
for many years. And then I started to see where
the data, where the studies were happening, and that was in
nutrition for depression, nutrition for anxiety.
And the literature linking nutrition interventions for
improving depressive symptoms is actually quite robust.
And that's where I've. Really Sort of pivoted to
because depression is a growing problem and we need people to
think about how food and lifestyle medicine can be a part
of the solution. Yeah, I completely agree man.
On the alcohol front, it's interesting.
I've been, I have, I've never really had an issue with alcohol
consumption, but I started a challenge as part of a challenge
with some people and I haven't had a drop of alcohol in over a
year now and I'm not really motivated to have any more.
The more I dive into its implications on the gut
microbiome, just sleep quality. Like there's not really anything
working in favor of. Alcohol.
That's right. That's right.
But as far as food as a catalyst for good mental health and
well-being like that is something that I'm profoundly
interested in. Because the depression rates
seem to be ever skyrocketing, and it seems to be pretty well
correlated to people's lack of proper nutrition and
nourishment. So it makes total sense to me
that they would be interlinked in some form or fashion.
They're so, they're so interlinked.
And I think what questions still need to be answered is, you
know, is it the ultra processed foods themselves that are, you
know, leading to biological cascades and inflammatory
cascades that increase depressive symptoms or is it the
absence of the other nutrients? That are needed, right?
Is it is it the inflammatory fats that are in the processed
foods that are increasing inflammatory conditions and
leading to depression? Or is it the lack of the
polyphenols in the fiber and all the other essential nutrients
that people are not getting when they're eating mostly a western
diet? Or is it a combination of the
two? Like, I know some people that
have zero fiber in their diet and they seem to be thriving, so
I don't know if we could parse it out to just fiber
specifically for instance, but likely some combination of both
bad stuff coming in and not enough of the good stuff coming
in. That's right.
It's always a combination. It's always nuanced, right?
A 100% So when it comes to viewing addiction through the
lens of food, I've had several people on the podcast always
like picking their brain on this like that seems to be a
controversial topic. A lot of people think that
viewing food as an addictive substance is very unhealthy, and
a lot of people view it as rightfully A justifiable, you
know, lens and an objective, honest lens.
I'm assuming you are of the latter.
I'm actually quite nuanced there.
I do a lot of my clinical work with with people that have
eating disorders, and so I'm very aware of how certain types
of food addiction messaging can be harmful.
I'm very aware of of how certain communities have taken the food
addiction message. And turned it into something
that could be a little bit extreme or be very pass fail.
So for example, I think one of the major criticisms of food
addiction is people end up approaching it from a very
rigid. Pass, fail, approach and that
you're doing really, really good.
You're counting days and then one time you have a little bit
of sugar that's hidden in a salad dressing and now you know
you have to go back to day zero. There's a lot of 12 step history
with food addiction and I think that's where a lot of the
controversy comes from. I think people would agree that
food addiction exists, but I think the disagreement is in the
conversation of what do we do about it?
And I I, I, I've done a lot of work on this area to understand
the actual condition, the phenomenon, and to understand
the nuances of it. I'm still not convinced that I
know you know what the best course is.
I've I've written about it. I'd love to talk about treatment
from ultra processed food addiction, but yes, I do believe
that it's a real thing. The literature supports it, but
I'm also aware that some of the approaches out there.
Can actually make people's relationship with food worse
rather than better. Yeah, I can agree with that for
sure. Do you think the addiction stems
from more of a psychological or physiological phenomenon?
Great question. And you know there are people
that have genetic legacies of addiction, right?
So maybe one of their parents, both their parents grandparents,
have alcoholism and that tends to lend itself to a more
biological phenotype. And you know, it's been my
experience when people have the genetic legacy and they have the
early life adversity, the stress, the trauma, all the
other risk factors, and they've overexposed themselves to the
substance. They've taught their brain what
the substance does and how it reduces negative affect.
And they've had some efforts to try to stop, quit or even
moderate that have been unsuccessful.
You really do cement the addiction in place.
And so to answer your question, I think there are people that
might have the genetic legacy but less of the other risk
factors and they just have the biology, the biology of a person
with a use disorder. And then there's people that are
more circumstantial. Maybe they don't come from a
genetic legacy of addiction or alcoholism, but they have maybe
gone through a really tough time a a divorce.
And then the food issues started to spike and they developed an
addiction like relationship with food.
So it's pretty difficult to disentangle the biology and the
psychology, but I think that there are probably some
different phenotypes based on who has more of a genetic
predisposition versus who developed it based on stressful
life circumstances. Totally.
It is pretty hard to disentangle nutrition as an addiction 'cause
when you look at something like methamphetamines or alcohol,
which is something that the body is certainly not required to
have, you know you can simply cut that out and know that
you're moving in the right direction.
Whereas with food you have to consume food, obviously.
So the question as to what foods to consume and what quantities
to consume them is always top of mind for people that struggle
with these disorders. What is, in your opinion, the
right way to frame one's mind and thinking around viewing food
as an addiction if this is something that they struggle
with? Yeah, great.
I, I I think that first of all, there's been a few studies that
looked at whether this concept of food addiction is
stigmatizing to the general public.
And and there's been a handful of studies that have suggested
that when people understand that sometimes the experience of
living in a larger body is based on neurobiology, based on
addiction, like eating rather than willpower, it does decrease
stigma. So, so I think addiction as a
whole has come a long way in the last, you know, 80 plus years.
People are starting to understand that it's not always
just a matter of choice that people have neurobiology that
makes it very difficult for them to always make the most rational
decision. And I think that with alcohol
and other drugs, we've come to a place where we understand that
sometimes or most of the time, people need treatment.
They need to actually put their life on pause.
And address their underlying issues.
Be put in a safe environment where they can teach their
nervous system that they are safe and that they can heal,
right. And I, and I do believe that
with food addiction, just thinking about it in a similar
way can be very, very helpful, which is that this food is very
dopaminergic. It does have the power to
override common sense and willpower.
Therefore, people that want to stop usually can't.
And we'll continue to use despite negative consequences.
And with that knowledge, right, you start to realize that the
solution is going to actually be more of a recovery rather than
some new meal plan, right? Or some.
New fitness regimen. I think a lot of people are
still stuck in believing that all food and body issues can be
addressed with food and body solutions, right?
And I think that the concept of food addiction is really saying,
yes, we probably need to look at your food, we probably need to
move your body, but we probably also need to do some trauma
work. We probably need to teach you
how to breathe differently. Take a look at yourself.
Clean up some of the wreckage of your past.
Maybe focus on relational health, quality of life, develop
new purpose, meaning direction, new sources of dopamine, right.
So food addiction doesn't necessarily mean that you have
to put so much focus on the food.
In some cases, yes, you do. There are cases where the food
plan is the key ingredient to recovery, but there's a lot of
other cases where what people really need to do.
Is look at the entire picture of their life and all these other
dimensions of Wellness and see how they can create a supportive
plan of recovery so that they can live with the brain
chemistry that they have in the food environment that we live
in. Yeah, I don't ever want to be,
you know, a negative vibe or implication to people's path to
recovery. At the same time, there's all
this societal pressure that people are facing, like for an
alcoholic for instance, if they've become debilitated in
their ability to function because of their addiction to
alcohol, you know it. It's obvious and clear that
there's a problem that needs to be resolved.
They can take steps accordingly. Do you think this stigma and
societal pressure has like with with regards to the body
positivity movement for instance?
Do you feel like that is moving things in the right direction or
is that kind of giving people a scapegoat, so to speak, in order
to just lean into that addiction and not view it as a negative?
Yeah, I think there's there's both.
I do. I do believe that the body
positive movement is is necessary and essential because
a lot of times people do internalize weight stigma and
they isolate themselves and they start to make assumptions that
they don't fit into the world. And they really, really
internalize some of those negative messages.
And with that from that place, it's very hard to actually
achieve what I like to call sustainable recovery.
So I I I do believe that the, the journey towards what some
people call fat liberation, body positivity is the the ticket for
people. It is the revolution because
once people realize that, you know.
You know, waging war on their bodies is not going to lead to a
positive outcome once people realize that they need to start
engaging in life now instead of waiting for it to happen that we
do get positive outcomes. But I I think I I understand
what you're asking and I want to offer the flip side to that
coin. I also believe that the food
industries. And the pharmaceutical
industries have been smart enough to identify that message
as being beneficial to their bottom line and have amplified
voices in that community. And I do think that, you know,
some people have taken that too far and gone to extremes.
And I know social justice movements always sort of need to
be extreme and have have really, you know, use that message to
say. You know stop caring about what
you eat and just you know, be inclusive.
Eat intuitively and and I I've seen that message that I believe
to be positive get spun in a way that really promotes the the the
financial outcomes of the food companies and and really doesn't
you know, isn't grounded in science as much as it is
grounded in emotions. Yeah, I would agree with that
for sure. But I think there's definitely a
point at which the individual has to be objective and honest
with themselves. And if their their blood
markers, their health markers are all starting to decline as a
result of their obesity, like you can't really turn a blind
eye to that as well. And you have to just start
accepting responsibility of the fact that your actions are
likely not boding well for your overall health, and then to take
actions accordingly. Yeah, I definitely agree with
that. But I I I think the main message
that has come out of the weight stigma research is that.
If someone is in this very fight or flight state and they're
trying so hard to make something happen by forcing it through,
you know, unsustainable dieting or exercise, that it can
actually work against them rather than for them.
And I think that's an important piece to remember, that
everyone's different, and that stigma sometimes motivates
people to change. And for other people, it does
the opposite. And I think a good example is
smoking. Like, I'm in California and
smoking is like kind of like almost, you know, socially
unacceptable in in in the area that I live in Santa Monica,
right? Like you're like you'll get a
ticket if you smoke a cigarette. And so, like, there's a level of
shame that comes with smoking that has made a lot of people
stop. Right.
And of course people have switched to vapes and whatnot.
But but I, I, I, I think there's this positive that comes out of
some level of what some people might call healthy shame.
But I do think that when people feel shame about their bodies,
sometimes it motivates them to go make the changes right to get
serious and get to the gym. But other times it makes people
just want to isolate and they get worse.
So for those that isolate and get worse, what is the the path
to recovery look like for them? Like how?
How does that tangibly manifest itself?
Yeah, I think that what I try to offer people is to stop being
hyper focused on nutrition and exercise for appearance and even
for biomarkers and start moving into changing your food and your
movement patterns for the sake of mental health and and and I
feel like that's something that people can.
Can can get behind. It's not always appealing
because I know a lot of people have appearance related goals
and and I I am in full support of what people you know use to
motivate themselves. But when when we pitch, you
know, let's get moving, let's get you out into some sunlight
so that you can reduce some of your depressive symptoms, you
can start to feel better and then have energy to go to the
grocery store. It's a different message than
let's count your steps because we need to burn calories, if
that makes sense. Yeah, no, it totally makes
sense. I feel like people have to be in
the right frame of mind in order to see any momentum with any
life change that they make and it has to be done in a
sustainable fashion that they can continue to build momentum
and compound on over time. So I'm totally in favor of
making the the mental shift for the right reasons.
First. A lot of people have trouble
with that, man. Like they they.
They'll start a diet, they'll start an exercise program,
they'll start a meditation practice, and it seems to falter
within a matter of days. What do you think needs to
happen or to kind of elicit this staying power?
Yeah. I think a lot of people,
especially in in the populations that I work with in in mental
health, have very clear patterns of cognitive distortions where
it feels like you're doing something, you're on the wagon
or you're off the wagon, right? So you do something for four
days in a row, and then you miss it for one day and the mind gets
very negative and says, ah, I missed it.
Now I'm like, you know, I'm back to day zero and I'm gonna miss
it again until I'm ready to start again.
And and I think that cognitive rigidity does prevent a lot of
people from moving forward with positive momentum regarding
their lifestyle habits. I think it's it's wiser to think
about things in a big picture. I try to discourage people from
always thinking about things in a 24 hour a day mode.
Like think about nutrition over your lifespan.
What are the trends that are happening in your life?
And you know, I like to start sessions with people by looking
at the positives. I think especially with people
that have any history of trauma or addictions, the tendency is
to make negative predictions about where it's headed for them
to have a negative bias where they always point to the things
that are going wrong. If someone were to meditate for
four days in a row and then missed 2 days and then showed up
for session, they might say, wow, I'm bummed.
I I, I I ditched my meditation practice.
But then, you know, you might be able to point to like, wow, you
haven't really had a morning practice ever.
And you did it four days out of the last six.
So, you know, let's continue that trend.
I do believe in making small changes over time, and anything
that feels past fail is usually going to generate negative
emotions. And that's why in mental health
counseling, we try to use guiding principles rather than
rules. I know that the mind loves
rules. The mind needs things that are
concrete, and I'm all for it. OK?
Like, I believe there are people that need rules, but when you
can create guiding principles like let's do this to the best
of our ability, let's do this as often as we can, let's start
really small and you just start moving in general directions
over long periods of time. It's a formula for long term
sustainable behavior change. But here's the catch.
Someone comes to see me clinically and yeah, we never
know how long we have with them. And that's the that's the
difficult part. It's like if I know I'm going to
have someone for six months of weekly meetings, you know, we're
going to move at a very appropriate pace where it
doesn't feel like the person can fail.
But if there's financial limitations and it feels like,
you know, I'm only going to be with this person for three
sessions or for a month, yeah, the tendency is to want to move
quicker. Like, let's get this work done.
Let's go, let's go. Let's move fast.
And sometimes when we move too fast, trying to make dietary
changes and lifestyle changes, people do feel like it was too
much for them and they failed. And in my experience as a
clinician now for over 10 years, the last thing you want to do is
give someone an experience where they feel like they failed.
So you want to give people experiences where they feel like
they're gaining momentum and they're celebrating all their
little wins? Yeah, I definitely think the
long game approach is is paramount.
Like anything framed in the context of, you know, a hack or
a quick fix is just not not going to be the the life
changing behavior that needs to be implemented.
Some people are definitely moderators while other people
are are better suited for totally and completely
abstaining from certain foods. Is that something that you find
your practice? Like there's not one that's
necessarily right or wrong, It's just totally individualizing
that component? Yeah, I try to individualize
everything. I really do base my nutrition
and movement and other lifestyle recommendations based on what I
perceive to be someone's, you know, psychological profile.
And that sort of tendency for extremes is a big part of what
I'm assessing. I'm also looking at, you know,
someone's addiction, like neurobiology based on the stuff
we talked about earlier, genetic legacy, etcetera.
But I I have realized that there are some people that think a
more abstinence based approach is better for them that could do
better with some kind of moderation.
And there are people that believe that they should be
doing a more moderate and inclusive approach that might
actually do better on abstinence.
So yes, we we're, I'm all about listening to our patients and
figuring out what would be the most sustainable solution for
each individual. But there are times when I might
nudge someone to explore an alternative.
Just because someone's mind gravitation rotates towards
something and it feels safe doesn't always mean it's the
best thing for them. Gotcha, gotcha.
When it comes to eating disorders, body positivity
movements, things of that nature, the tension more often
than not goes to people over consuming and being obese.
On that end of the spectrum, I'm assuming you're also seeing a
client pool that is on the complete opposite end of the
spectrum and struggling with under eating, not eating enough.
Having binging, purging tendencies, things of that
nature. Yes, yes, that is a big part of
the work that I do and I love that work.
I find it very meaningful and it it's just super necessary to to
make that work deep, right. It's not just about, you know, a
meal plan or nutrition. People that have addictions,
eating disorders, tendency tend to have a soul that's searching
for some depth. And so some of that work can be
very important recovery and healing work in addition to just
looking at the food. But for people that have
restrictive eating disorders, the food is super important.
Like if someone is undernourished or they're
purging and they're not getting their nutritional needs met,
they're not getting enough calories, they're not getting
enough macros, they're not getting balance across the food
groups, they're not getting micros.
It's very difficult to actually recover without getting sound
nutrition. And so, yeah, there are times
with people on the under eating spectrum or with the lower BM is
where nutrition becomes even more important and part of the
work becomes focused on sometimes exposing themselves to
fear foods. So if there's foods that they've
avoided and they've put a lot of charge on, sometimes the
treatment includes eating those foods.
And sometimes I will eat those foods with my clients and
patients to show them that it can be done and that, you know,
some of these fears are just magnified, right.
Some of them are just magnified emotions that live in our brain
and that we can work through them together.
Do you find that this is obviously going to be very
individualized, but as a whole? Is it more so that these people
are struggling with certain types of foods that they're
avoiding and have the stigma towards or is just the quantity
of the foods great question when this word restriction gets
thrown around a lot, You know, and I think you've probably
noticed that there's a lot of anti diet, non diet energy on
the Internet and anytime someone is trying to promote health, it
seems like they can be accused of, you know, promoting
restriction. Right.
So I like to define the word restriction.
I think that's important in, in science we sometimes use the
phrase dietary restraint or restrained eating, right.
And so it's a great question you asked what is restrained eating?
And it's going to be different from person to person.
There are some people that are just restricting or restraining
calories and they have a long history of calorie counting and
maybe they've used My Fitness Pal and they, they have a magic
number, right? They believe that they should
eat under 1200 calories a day. And we see that number all the
time, probably because of some of the science there and and
some of the apps, etcetera. But there's other people that
will restrain particular macros, right?
We see people and and I know, I know especially based on the
work that you do, that there is a wide range of macro nutrient
based approaches that can work for nutrition.
I've seen people do well, you know, on protein and fat, and I
I know that that's a big part of what you discuss, but with
someone has an eating disorder and they've really developed
some imbalance in brain chemistry from imbalance eating.
The solution, usually, not always, usually does necessitate
having a balance between carbohydrates, protein, and fat.
I will say that there's been a couple studies in the last few
years that have challenged that. There was actually a few case
reports of people with anorexia nervosa getting better on
ketogenic diets, and when I saw that I was like super interested
in in that science and so I have a very open mind here.
But in general, traditional or conventional eating disorder
treatment has suggested that when people have very imbalanced
macros that it makes it very hard for them to recover.
So sometimes people will be plant based and very you know,
avoidant of protein. We see people that still have
this legacy of low fat, non fat dieting that comes from decades
ago. And then you know of course we
have a lot of people that avoid carbohydrates.
So we've got calorie restriction, macro restriction
and then we've got food group restriction.
Maybe people have a particular belief about a food group, for
example, dairy. Some people think dairy is just
not meant for human consumption and avoid it.
For some people, dairy is highly inflammatory.
But other people have dairy, you know, organic, high quality
dairy several times a day. And it's one of the most, you
know, beneficial things for their health, including mental
health, particularly some forms of fermented dairy.
But yeah, some people will restrict food groups.
And then the last piece, and this is where there's the most
controversy is when you think about restraining based on the
quality of the food. So organic versus non organic.
And then of course, you know, Whole Foods are minimally
processed foods compared to ultra processed foods.
And there's a lot of contention here and disagreement and debate
because there's a new term in the eating disorder community,
which is orthorexia nervosa, where, you know, if someone is
really concerned about the quality of the food rather than
the quantity, you know, it can be perceived by others as a
unhealthy obsession. And, you know, I think people
are over using that term. I think especially if there's
mental health needs or someone's on a fitness regimen, right, if
they have certain types of goals, being concerned about the
quality of the food is super important.
But we live in an era where people are being shamed for
talking about, you know, food processing and the quality of
food, at least in the dietitian community, because it it does
come across as promoting diet, culture, orthorexia nervosa.
So I'm working really hard to be that middle ground voice to be
able to tell people that, you know what, If you are concerned
about the quality of food and you're doing it for the purposes
of improving your mental health, then there should be some
understanding in a lane that feels safe for that person.
So yeah, there's a lot of ways that people restrain their
eating. Some people restrain it based on
time. You know, obviously, you know,
there are benefits to time restricted feeding.
But yeah, those of us that work with eating disorders, we see
the negatives of extreme approaches.
We see the negatives of dieting that most people don't get to
see. So any any dietitians that do
clinical work with eating disorders, you know we tend to
see some of the the negative outcomes more than the positive
outcomes. So I think some of us have a lot
of bias towards extreme approaches.
But I know that these approaches, you know fasting
keto, I know that they work for a lot of people and I know that
they have incredible mental health benefits for a lot of
people. And this is the conundrum we're
in. It's like eating disorders are
life threatening and they're super important and they are
part of mental health. But mental health is a much
broader field, right? And so people are caught in this
conundrum of, like, I'm gonna stick with the eating disorder
message or I'm gonna move into this broader mental health
message. And I think that the eating
disorder message is super important but it also can be
like a pigeonhole because those people, those of us that work
with eating disorders, you're very cautious about what you
say. You know you don't want to be
triggering, you don't want to come across as food negative.
But in the mental health literature the science is very,
very clear. You know if someone has
depression, anxiety, trauma, they do better eating less ultra
processed foods period. So, so let me just pose one
question, I don't have the answer.
What if someone has depression that's not getting better from
taking medications and they need an anti-inflammatory diet, and
they also have an eating disorder that's very
restrictive, right? What do we do with them, right?
How do you pick the right message to be inclusive and not
punitive around food, but also move them into eating more
intentionally and deliberately for their mental health?
And this is the work that I'm trying to do is like, what about
when people have multiple mental health diagnosis and they
respond differently to different nutrition messages?
How do we create a lane for them that feels safe?
Honors their psychological processes around food, honors
their body image, but also has a biologically based intervention
for their gut and for their brain.
It is very tricky, man. Like I you know, I used to
struggle with eating disorder myself.
After my first few competitions, and for me, the only thing that
really allowed me any you know, semblance of recovery was
adopting A ketogenic diet, removing carbohydrates as a
macronutrient group that I included, and then just doubling
down on that. And I feel like a lot of clients
that I've worked with have experienced the same.
A lot of them are more so abstainers than moderators, but
I feel like there's for me, there's been a lot of, like I've
noticed in myself and my client pool that.
When it comes to eating disorders and food addiction, so
much of it stems from some sense of shame around the foods
they're consuming. And if I can strip that shame
away by, you know, educating them on the biological benefits
of a properly implemented, well formulated ketogenic diet, that
is easier for them to embrace. And then they don't have to feel
guilty or shameful for eating foods that are not in line with
that. Then they can eat more of those
quality foods, making sure they're.
Nourished properly and then then they experience all the physical
benefits that come from that, which bodes well for them
staying motivated to stay the course and make it a lifestyle.
Now, I certainly don't want to shame anybody when it comes to
foods, and as far as improving overall food quality, I think
anybody should try to, you know, consume the highest quality
foods they can reasonably afford and do so for the right reasons.
I don't want to shame anybody in any direction.
But there's just so much nuance to the topic of how one should
think about food. And like, we're we're
interesting, man. Like, I don't know why we as a
species have so much confusion around this.
I don't know if it's because of societal pressures, because of
upbringing. But you look at any other
species in the wild, and these are all just questions that
aren't even in the repertoire. You look at humans and it's like
we don't have a clue what to eat or how much to eat.
Wow, I'm so glad you shared your personal story.
I think it's just so important, you know, that that we have
conversations like this and embrace open mindedness and it
really just points to the fact that everyone is different.
You know, there's a there's probably an eating disorder
clinic out there that would say that that what you did could
never, could never work. And here you are saying that's
the only thing that worked, right?
And so I just want to honor that and say we need to celebrate
diversity in the nutrition space and celebrate the fact that
there aren't singular approaches and that nutrition is a moving
target and what works for someone at one stage in their
life might change over time. I think that's an important
message that listeners need to get as well is that you might
find something that works really well now and that could change
over the course of the next few years as your life circumstances
change. And yeah, we need to really just
celebrate the unknowns and the uncertainty.
And I think to answer your question, why is nutrition
filled with so much contention and debate?
Well, one is because there's a lot of economic issues at hand,
right? A lot of food marketing, a lot
of food companies are controlling narratives around
food and really trying to maximize their profit.
And and one of the things I've noticed is that when you know
tyrants right, when the big forces, the elites right the the
powers that be want to maintain their power structure.
One of the best ways to do that is to get the population just
fighting amongst themselves. And I think there's a benefit
for food companies and pharmaceutical companies to have
us all here on the Internet fighting about what the best
diet is saying. This is diet culture, this is
non diet, You should do this, you should do that.
And then you know the tool in which that vehicle drives is
through emotions, right? So nutrition is supercharged
because it's it's it's a mesh with other social justice issues
we talked about, you know, right, weight, stigma.
And then of course we have culture and socio, economic
status. There's so many facets to
nutrition that goes above and beyond just the biology, right?
We think about neuroscience and economics and psychology and
marketing and there's so much there that leaves room for
people to disagree and debate. And I think that the machine
likes it when we disagree and debate.
And I think we need to have more conversations like this where
we're looking for areas of convergence and having more
questions than actually answers. And the last piece there that
I'll add is that everyone's an eater, right.
So everyone seems to have an opinion, which makes things more
difficult when you think about the sciences.
You know, if you were to think about more like obscure science
about physics or you know, orthopaedics, right, You have
these experts and these are the people that did their training
and and do this work. Whereas in nutrition we all eat,
we all have bodies. So there's room for a lot
broader range of expertise. And one of the most fascinating
things about nutrition is when you look at some of the bigger
influencers in the nutrition space, the people that have
written the the biggest books and have the biggest following,
they're usually not doctors or dietitians.
They're usually people that have just found their own little
passionate lane about health and have a really good message to
share and are able to share it with the world in a way that
lands on people and gets people's attention.
Yeah, I think that is something we can all get behind.
Like everyone's got their own story.
People are going to resonate with that story based off of
their own background. So the more we can have healthy
discourse and just open minded discussions is is going to be
the key. I feel like trying to force
anybody into this, you know, I'm too square peg into a round hole
scenario when it comes to nutrition.
It's just bad, bad juju all the way around.
So having these open conversations with people that
disagree, but doing so in a healthy manner is absolutely
paramount. So I completely agree with you
there. Yeah.
And I I would add to that that when when practitioners have
like a single thing that they do and it's like this, this is my
one philosophy right, that that's actually easier on the
practitioner. Right.
To just have a single a single thing right versus like if you
have multiple modalities right and have to think about each
individual and customize it, it's more work.
So that's another reason why a lot of people gravitate towards
like this is my thing. Anyone who comes to me just gets
this one thing. We definitely need more people
that are able to say, you know what, I have a lot of tools in
my tool kit. I'm multimodal and I'm willing
to learn more to meet people where they're at and meet their
needs. I think that's also super
important for our field moving forward.
Completely agree. What about the difference
between the sexes? So when it comes to eating
disorders, often times people's minds go to you know how that
impacts the female demographic that tends to be in the
limelight more. But this is quite often the case
in the male demographic as well. It just often times isn't
getting spoken of as frequently. Why is that and what are some
common denominators and differences there?
Yeah, I think it it points to the important conversation about
the difference between eating disorders being genetically.
Influenced right from risk factors.
In the germ lines, there is data to show that you know it.
It does pass through generations for sure versus eating disorders
as a socially constructed phenomenon.
I do think that a lot of people still assume that eating
disorders are just based on body image concerns.
And you know that they're socially constructed and that
they're a result of social media.
But interestingly, when you look at the data, when you look at
like the, you know, incidence and prevalence of eating
disorders over time and across the world, it it, it, it's
actually quite consistent. You know, there are places in
the world where they don't have social media the way we do here,
that also have, you know, restrictive eating disorders.
The, the incidence and prevalence of certain types of
eating disorders has remained constant despite all of these
pressures to be thin and some of the exposure to media that
people get. So I think that in terms of the
social construction of eating disorders, there's generally
been more pressure around women to, you know.
Be thin or be cut, whatever it is.
I think traditionally there was a lot of, you know, eating
disorders that centered around thinness.
And now in more recent years we have a a rise in, you know,
muscle dysmorphic disorder and not necessarily thinness but
leanness and muscularity. And so that's also really an
important trend that's changing. And so, yeah, the the.
The assumption has always been that women are interested in
thinness and that men are interested in muscularity, but
we know that that is absolutely not true, especially now we have
a lot of men in the relentless pursuit of thinness and a lot of
women that are now in the pursuit of muscularity.
But I I think the the best answer to your question is that
I think a lot more men have disordered eating than society
would like to believe. But they're just less inclined
to seek help because of the shame around it.
You know, I'm a male eating disorder professional.
And, you know, I did assume that my practice would be filled with
men because I would assume that men would might even feel safer.
But it turns out that, yeah, I still don't see as many men with
eating disorders seeking help. And I do think that there are
barriers, psychological barriers for for certain people to admit
certain behaviors and to move through it.
And I also think that. Men tend to seek help less in
general, at least in the realm of mental health.
Yeah, I agree. It's unfortunate.
I mean, I feel like there is like, I don't want to contribute
to this. I don't know.
I don't even know what it would be called this snowflake
phenomenon, which everybody, you know, what was me, Cry me a
river, 'cause I feel like people need to just own it in life and
and, you know, take, take responsibility and get after it.
But that said, to not come across too harsh, like you have
to be honest, objective. Like if there's something in
your life that you're struggling with, be honest with yourself
about that. Seek out help, fix and move
forward. You know, like be there doesn't
need to be this shame associated with, like, just simply be
honest with yourself and then take steps to correct course.
Like that's That is the path to everything in life.
I agree. But if you looked at your case,
for example if when you were struggling with some disordered
eating behaviors. You know, if if you would have
sought out like a professional, you would have not gotten the
treatment that you found for yourself, right.
And so there is a lot of distrust about mental health
treatment and distrust about eating disorder treatment.
I think a lot of people are very resistant to eating disorder
treatment because a lot of people assume and and they're
right in this assumption, is that the treatment will be just
about. Eating a lot of ultra processed
foods that are, you know super undesirable by the person and
and and that's just an area where I think there is a little
bit of change happening in the eating disorder field.
I think with the traditional case of anorexia nervosa and
bulimia nervosa, if the person was very fearful of certain
foods and they had imbalanced eating, teaching them how to be
able to eat like a piece of pizza or have, you know, some
candy with as a snack was actually a really important part
of treatment. But now we're seeing more and
more people that that model isn't probably the best fit for.
And, you know, this could be people with binge eating
disorder or people with bulimia nervosa or even anorexia.
And so, yeah, there's a lot of conversation happening in the
eating disorder world about what would be, you know, best
practices for nutrition and how that can change, you know, from
person to person. But keep in mind that when
people go to a treatment center like an eating disorder
residential, it's super hard to. To individualize treatment
there, it's like every there's 20 people there and everyone
sort of gets similar food. It's tough on dietitians to be
able to say, all right, this person's on a keto, this
person's on a low exposure meal plan, this person's on a lot of,
you know, fear foods, right? This person's on a lot of extra
calories, 'cause they have, you know, metabolic issues.
This person's drinking booze, like it's hard to tailor
treatment. So you end up getting a lot of
treatment that's scaled. Right.
A lot of food philosophies that are just scaled across the
entire population. But there are people that are
doing really good eating disorder work in the outpatient
level and individualizing care and asking more questions and
figuring out how do we use nutrition and lifestyle medicine
to help people move into a next chapter with grace and one that
will be sustainable over time. I don't know much about these
clinics. I've I've interacted with people
that have gone to them, that have been forced to go to them,
that have been prompted by the family to go through them.
And it definitely seems like many of them take a very you
know, one size all approach which I can see being incredibly
detrimental to the the patient that's going there.
Is there a lot of these clinics? Like, can people vet these out
and do some research and figure out which one makes the most
sense for them as this? Like like how does that go about
even finding these clinics? Yeah.
No, there there's a lot of eating disorder treatment
centers and there's definitely. Some places that have more of an
open mind about nutrition and individualizing care than
others, you know, there's been a few places in the last few years
that have said, you know what, we actually do honor food
addiction. We have a track for people with
food addiction. We think that, you know,
individualizing the nutrition program is going to be critical
for certain people's success. But generally speaking.
The eating disorder field has had a lot of gatekeeping and a
lot of cancel culture. So there's been this ethos in
the field of like, you know, you do it our way with all foods fit
intuitive eating or you're not welcome here And and and that
energy has been challenged in recent years because you know,
there's basically. You know, a collection of, you
know, a conglomerate of of treatment centers that are
saying this is, this is what what we believe eating disorders
are and this is how we believe they should be treated.
And anything that isn't this is dangerous, right?
So, for example, if an eating disorder treatment center helps
people lose weight, they will be cancelled.
Period. You know what I mean?
And like they they like, they will go the extra mile to make
sure that they don't get referrals.
And it's a really dangerous, like it's an unsafe community
because there are a lot of people that have binge eating
disorder that want to lose weight, you know, and they go
into eating disorder treatment and they're told that they're
that they won't, they won't be supported in that here.
And then they never want to go back to treatment again, you
know, So it's a really touchy space right now.
And, you know, I've been speaking out about it.
You know, I'm obviously speaking out about it now.
But when I speak out about these issues, you know, people come to
me and they say, wow, thank you, Doctor Wiz, for having the
courage to speak about some of these issues because it's been
on my mind and I'm so afraid to say anything, right.
Because it just has such a strong cancel culture vibe these
days. Yeah, that's incredibly
unfortunate. I I feel like that lack of
individualized care and nuance at these structured clinics is
likely the reason there's been this, you know, massive uptick
in outpatient care centers. People that are creating content
around this specifically, which is great to see because then it
caters more towards the individual with those that you
know resonate with whatever the messaging is, which is what
you're doing a lot of right now. Like you just came out with an
app as well, right? I sure did, and the whole point
of the Wise Mind Nutrition app was to.
Create some middle ground energy, right, to create a space
for people to be deliberate and intentional about their food,
but have it be very non diet and eating disorder informed and
therefore be very safe for certain people.
And just to give you a little more context there, there's a
lot of apps that focus on calories and macros and do the
math and I think those apps are great.
They're some of the most successful apps that have ever
existed on the app marketplace. I tried to create an app that
might be a little bit different in the sense that we focus more
on the qualitative aspects of eating rather than the
quantitative aspects. So it isn't so much about how
much did you eat, it's more about what food groups did you
eat, Checking in with hunger, checking in with fullness.
It discourages, you know, math centric approaches and really
gets people to focus on emotional responses to food.
The quality of the food they eat, the consistency with which
they eat, the distribution of their food groups and, you know,
allows people to set their own intentions that are not focused
on weight per SE. They're more focused on
relational health and quality of sleep.
And so it is a app that helps people use nutrition and
lifestyle medicine. To move into their next chapter,
but it doesn't have some of the nutrition and lifestyle energy
that could be triggering to some people.
So it it's it's it's not an eating disorder specific app,
but it has a lot of my eating disorder background in mind in
the creation of it so that we know that someone who wants to
walk this path will leave here. Better off than when they
started in, in terms of like having a better relationship
with food. So people are basically logging
what they're eating, but they're focused more so on how that
makes them feel as opposed to what the macronutrient and
caloric breakdown is. Yeah, I mean, the journaling is
quite optional, but you know. I've set it up to where
clinicians can can connect to their providers.
So for example, in my practice I've got most of my clients
logging using the Wise Mind Nutrition app and I can, you
know, check what they're doing and look at their nightly
reviews. And a nightly review is when you
kind of reflect back on your day.
You know, a lot of times people come to see someone like me once
a week, but if they do their own work on a day-to-day basis,
they're going to, they're going to grow.
So the food log is one part of the app.
And it's connect friendly, which means not only practitioners and
providers can follow their clients, but people can follow
their friends or other people in the community.
I have a couple people following me, so I'm sharing some
inspiration with, you know. Eating food for mood and brain
health, right? Getting the right kind of fats,
making sure there's adequate protein and colors.
I'm big on colors as well, but the other prong to the app is
the program. So there are a series of videos,
assignments, reflections, and additional reading links videos.
It's a very robust program for someone that wants to learn
about eating for gut health and eating for mental health.
So it really is designed to be an anti-inflammatory approach to
eating that focuses on changing the way we eat without being
overly taxing to our mind. So it's basically improving your
brain without taxing your mind. So yeah, it's it's designed for
people that have depression, anxiety, trauma, ADHD,
addictions that, you know, might not be at the highest level of
motivation. For change and and need to take
little steps toward making those changes.
You know one little baby carrot at a time to move into a
different chapter and it's a it's an empowerment program and
it's a it's a recovery journey. It's a healing journey.
It's not just nutrition and exercise.
There's breathing and meditation and cooking classes.
It's more about bringing joy back into food and helping
people make peace in the body that they live in while also
staying. Intentional about what they eat.
I love it, man. I feel like the reflection
component is key. I've recently started journaling
as a daily morning practice and the way I've got my journal
structures, I reflect on the day prior and at the end of the
week, I reflect on the week and then what I have coming up for
the the coming week. And we we as a species, as a
society, we've gotten so inundated with just over
sensationalized news. You know what's coming Like
nobody lives in the present moment anymore, and very few
people reflect on the past. And making a, you know,
legitimate effort to actually reflect on what you've done,
what the outcome of that was and how it will shape your future is
so, so profound. So anything that encourages
people to be reflective in a proactive way for what's coming
is, I think, absolutely key. Yeah.
And if you think about it, what are, what are we really doing?
We're mining the data, right? We live in an era where big tech
companies are are winning because they have not only
access to the best data, but they know how to mine the data,
they know how to build models, right?
So we have a little saying and you know, now I'm in the tech
world because I, I built an app. Whoever has the best data wins
right in the big picture. And like each of us, we all have
a lot of data. About our lives and our
emotional States and our our choices and our behaviors and
the consequences. If every single day you just
pause for a few minutes and take a look back through your
experience and see, wow, what can I learn from that?
How can I use this to make better predictions of the future
and and and and model my next self, right.
And you do that on a daily basis and you do that then on a weekly
basis and you do it on a monthly basis.
You're going to grow. You're going to become a better
person. And so I really want to, yeah,
emphasize what you said. It's so important for us to
pause, be in the moment, take a look back, and then after
looking back, you want to then look forward a 100% agree man.
Well Doctor Wiss, it's been an absolute pleasure learning from
you today. Where do people go to find out
more about you? Learn more about the app?
Dive deeper into your world. Absolutely.
The website is wise my nutrition.com and I've got about
80 or so blogs on there. They're just short blogs at the
intersection of nutrition and mental health.
The app is called Wise My Nutrition and it's it's in the
Apple App store. The Android version is like
almost done. So by the time the this is
released, I'm sure it'll be there and I'm on social media on
Tiktok Wise under score, Mine under score, Nutrition Wise My
nutrition Instagram. YouTube and then I have a
personal Instagram at Doctor David Wiss where I share a wider
range of things, sometimes posts about my family and other things
like that. But I love connecting with
people on social media. I'd love to hear from people
that are interested in this intersection of nutrition and
mental health. And then my clinical practice is
nutrition in recovery. So that's nutrition in
recovery.com. So yeah, I've got a lot of ways
to be contacted and I hope to hear from someone out there.
Thank you. Yeah.
I will definitely link out to all those, Make it easy for
people to find you. I certainly appreciate the work
you're doing. I think it is incredibly
important work that needs to be bought, brought to the forefront
of people's minds that are going through this or people that know
people that are going through this.
On a separate note, I would love to help in any way I can because
like I said, it's something that I've struggled with.
I work with many clients, I've struggled with this and I do
absolutely think that there is a demographic that would benefit
immensely from adopting A ketogenic lifestyle in as it
pertains to overcome disorder eating tendencies.
And I know that is a topic that is often times frowned upon by
people in that space, but I think there's a massive upside
potential there. So if there's anything I can do
to help, help in any way on that forefront, by all means man, let
me know. I appreciate that.
Yeah, there's data and you've got your anecdote.
There's more and more people speaking out about it.
And I and I think that there's a need to amplify that
conversation. And then I just want to also add
that the Wiseman nutrition app in the Food Log can absolutely
can be keto friendly, right? We're we're using food groups.
Rather than macros. And there's, you know, a way to
distribute your food group plan in a way that's ketogenic.
And so yeah, it's also possible that you could explore using the
app with some of your clients. Awesome.
Yeah. I think it was great that you
incorporated that into the app because that that surprised me.
So I'm glad. I'm glad to hear you've done
that for sure. That's forward thinking of you
without right. Well, Doctor Wiz, thanks again.
I really appreciate the time. Like I said, if there's anything
I can do for you, by all means, let me know.
And until we chat again, man, you have a wonderful, wonderful
day. Thanks, Robert.
Take care.