If you’ve been following along on our series on addiction to certain foods you may have started with what is food addiction (FA) before exploring how and why it can develop for some people. This article moves into how you can unhook from the vicious cycle and create food freedom.

• Food freedom - in my definition - means the learning process of creating a flexible relationship with food that is not controlled by impulsive or compulsive thoughts, feelings and bodily sensations after being exposed to certain foods (or cues to consume them). 

• It means being able to choose what, when, and how much you consume in a way that supports your health and well-being. 

• It focuses on the inclusion of nourishing, low-processed foods, but can tolerate the current reality of a world that includes highly processed foods and advertising and social encouragement to buy and consume these. 

An important disclaimer before reading on - if you have an active eating disorder including anorexia or bulimia please ensure you have the additional support you need. These have different treatment needs that are outside the scope of this article. The article may be helpful if you also experience FA which can co-occur (and has been found to make resolution of an eating disorder difficult) but it won’t be sufficient as we don’t focus on restriction or purging behaviours. 

If you struggle with FA we want you to know that it’s possible to change it. However, we find that a lot of people get stuck by using ineffective ideas and approaches. Some of these may work in the short-term but are not sustainable, which can create a cycle of self-blame (e.g., “it’s my lack of self-control” or a “character flaw”), shame, and hopelessness. 

A little-known but significant mistake you may be making is to not use both food and psychology in your approach to change. To effectively change FA you’ll need a combination of:

1) “about the food” - changes to the food you purchase, store and consume - AND

2) “not about the food” - changes In how you think, feel and respond to food.

An approach combining both these principles is likely to provide the best results. But it can be hard to find inclusive support that does both well. 

The path to change in 5 steps

These steps outline a roadmap that can look quite different from person to person - the details are best adapted to you, your personality, your environment, and what you find actually works for you. 

1. Knowledge of food addiction, 

2. readiness to change, 

3. a workable goal and plan for this, 

4. preparation for withdrawal, cues, urges, and cravings

5. future-proofing yourself.

You’ve already ticked off step 1 (which we set out in part 1 and part 2) and if you’re reading this article it is likely that you are in a contemplation or preparation stage of change. In contemplation, you’ll be weighing up the pros and cons of change versus staying the same when it comes to FA. In preparation, you’ll be collecting ideas and starting to plan for change (e.g., removing trigger foods from your house). Many people flip-flop in these early stages of change before tipping into an action stage of change. If you want to learn more about the stages of change you can see these in the free eBook here on making sustainable health behaviour change. 

Important question: Why is making a change important to you and how come now? What’s your why? 

When you are clear on your why and can tick off being in an action stage of change then you can move forward with step 3 - choose your goal and form a workable plan.

When setting your goal and plan to free yourself from food addiction, there are really just two options to start with. 1) a period of abstinence (reset) or 2) harm reduction. After a reset then you also need 3) a plan for the reintroduction of certain foods. We’ll circle back around to each of these options, but before you embark on them, let’s set you up for success by skipping ahead to step 4.

How to deal with withdrawal

A withdrawal syndrome may sound dramatic when we are talking about food but when you reset or reduce certain foods, you may experience feeling flat, tired, unmotivated, agitated and that your brain is foggy - processed foods, sugar, gluten and dairy can all result in this as your brain is hunting for reward. You may have cravings and obsess about eating certain foods and be on the search to fill yourself up. Your microbes will be using their strategies to get you to eat the foods they need and they can do this by making you feel awful and amplifying cravings. 

It’s vital to know that this will pass in time if you don’t give in to the urges and cravings.

To get through withdrawal, you’ll need strategies to ride it out without giving in to cues and urges which will pass in time.

The first strategy is making sure you are not hungry (“hangry” or “hanxious”), thirsty, or experiencing low blood sugar. Have you nourished yourself with adequate protein, healthy fats, micronutrients and sufficient water - or is your brain hungry and searching for fast nutrients? If so, what are the healthful foods that you can nourish yourself with that include a decent helping of protein (20gm or more), which helps with feeling full and providing the brain with micronutrients and amino acids needed to feel calm and satiated?

Preparing to feel under the weather, needing to rest, and having a plan for moments when you are struggling with cravings means that you can ride out this stage, which could last a few days to a couple of weeks. 

Let’s now cover some important addiction recovery language: cues, urges, and cravings.

Strategies for cues, urges, and cravings

Cues

A FA cue is a learned response where your brain has linked certain stimuli with a strong urge to eat a certain food. Cues can be either external (e.g., sights, smells, sounds, people, places or things) or internal and involve your own physical or emotional reactions. 

Our world is now set up to regularly cue us to eat UPFs. You only have to watch evening TV to see the desert adverts that cue your brain to desire and source these highly palatable junk foods for a short-lived high. Unfortunately, it’s not likely that this will change anytime soon, and while you can simply turn off the TV, a sustainable approach will be to learn how to respond to cues and the urges to act on these. 

This is because cues can also come from inside of you! Such as feeling physical and emotional feelings of sadness or stress and linking that with eating chocolate or pizza to numb, distract or feel calm or happy. 

One helpful strategy for cues is the Urge Surfing technique from mindfulness-based relapse prevention created by addiction psychologist Alan Marlatt. Marlatt turned the idea that substance addiction was incurable on its head through his innovations in relapse prevention.  

Urges

An example of a FA urge is when you are struggling with the powerful desire or impulse to act on eating a certain food which increases your discomfort (thoughts, feelings, sensations) - and this discomfort in turn creates further urges to eat to feel better, creating a vicious loop that rewards the urge and keeps the cue alive for next time. 

However, a typical urge lasts no more than 20 minutes so if you can ride this out, you will notice lessening discomfort. Another urge may follow, like ocean waves (sometimes large and fast, other times slow and gentle), but your job is to surf them one by one. 

In Urge Surfing you can learn to become more aware of what feelings and sensations occur in your body during an urge, and can watch them rise and fall with more acceptance and curiosity - and without needing to act on them. With repeated practice the links between urges and discomfort start to be unhooked so that you are 1) less likely to be cued and 2) if cued, less likely to act on any urges. You can learn more about this vital concept and follow some guided exercices here. This takes time, practice and troubleshooting (see the future-proofing section coming up).

Cravings

FA cravings may result when an initial cue sets off an urge that persists and recruits compelling and persistent thoughts and physiological activity relating to wanting to eat certain foods. Urge surfing each urge can help prevent and mitigate cravings. 

Your experience of cues urges or cravings will be strongest in the initial reset or withdrawal stage, and may persist if using reduction or when reintroducing certain foods (usually UPFs). Over time, cues often fade and may disappear along with the urges and cravings.

However, a cue can surprise people even many months or years later - such as running into an old friend you used to drink with, or visiting a certain place, or going through a high-stress experience like a relationship breakup. This is why people can relapse into substance addiction after many years of sobriety.

Other tools for dismantling cravings:

• HALT - are you hungry, angry (or other emotions), lonely or tired? Make sure you meet your real needs if so. 

• 5 D’s - delay, distract, drink water, deep breathing, and discuss with someone who understands. Brainstorm a list of ideas of what you can do instead during an urge or craving.

• Remind yourself of your “why”. What really matters to you? How come you are willing to go through this and what are your values - health, perseverance, family, role modelling for others? 

Right, now let’s unpack your options of a reset or reduction so you can choose your adventure!

Reset

1) A reset: (minimum 1 month but can be longer term) is used in addiction treatments and enables you to clear out the interference of addictive foods effects on the brain's reward pathways. Now with addictive eating we are obviously not talking about a month of not eating at all! This is what differs from alcohol or drug abstinence plans. You still need to eat. But the options of what, when and how much you will eat are what you focus on changing. The abstinence is from the foods that can hijack your brain - your trigger foods. Following a structured guide (one famous example is the Whole 30 programme) that includes eggs, seafood, meat, fruits and vegetables, nuts and seeds, herbs and spices and healthy fats like olive oil means that you have taken out processed foods, refined sugar, gluten, and dairy. As we discussed in part 1, for some people it’s best to remove gluten and A1 dairy (as well as create an exclusion list of any other foods that you feel you personally have a problematic relationship with - e.g., some have found this is true for foods like potatoes). To be most successful, it’s often also best to have an alcohol (and, for some, caffeine) holiday while you do this period of abstinence.

Important question: If you take these addictive foods out - what will you plan to add in? What foods, what activities, and what strategies to cope can you turn to while you adjust?

To be most successful in a reset, you’ll need to set up your environment for success at home and your workplace. You’ll need to consider things like: 

• Have you chosen a good time in your life to do this? E.g., not moving house or stressful deadlines due over this time?

• Clear out the foods you will no longer be eating from your kitchen and ensure you have an abundance of the foods you intend to nourish yourself with. 

• Reflect on the people you eat with, the environment you eat in, and any changes needed there (e.g., eating on the couch, in front of a laptop, or bed).

• Do you know how to prepare and cook meals? Upskill with recipes and support so you reduce any barriers.

• Tell relevant people that you are making this change and recruit their support if you think that will be helpful. 

• How will you meet your needs - nourishment, sleep, movement, connection?

• What will you do instead of eating for reward? Hobbies, social activities, other fun habits to replace?

• Identify your cues for FA urges and learn skills to cope - e.g. urge surfing, self-soothing, mindfulness, emotional regulation, and distress tolerance (e.g., this DBT skills book for emotional eating).

• Anticipating and problem-solving loneliness if this is a trigger for you.

• Addressing underlying mental health contributions - anxiety/depression, ADHD, trauma and get support for these if they bubble up after you take out addictive eating and once you are through any withdrawal (some of these things may resolve if UPFs is the cause).

• Anything else you think might get in the way of being successful?

After at least a month, you can make the conscious choice to explore the reintroduction of certain foods (or not) to see whether you can consume some of these without reactivating FA or whether abstinence is more workable for you (more on this in the reintroduce section.)

Reduce

2. Harm Reduction: reducing the negative consequences of FA on your health and wellbeing. Some people prefer a reduction of FA instead as they don’t feel ready for the commitment of a full reset - or they may experience mild FA that may respond well to a reduction. For those with moderate or severe FA who choose a reduction over a reset, it often means that they are still in the pre-contemplative or contemplative stage of change, and if you are in this place this is absolutely ok!  Experimenting with harm reduction (and from our observations, often this will mean being unsuccessful for reasons that are “about the food”) may bring you closer to committing to change in time. 

Harm reduction involves:

• making a clear plan on how much, how often, when, where, and what foods you will consume. 

• It also includes the “high-risk situations” - places, people and circumstances that you may decide not to eat certain foods (e.g., if home alone at night and feeling down or lonely). 

• Monitoring and reviewing what works and what doesn’t and adjusting your plan as needed.

It’s personalised to your own needs and goals and could look like deciding:

• you will eat takeaways on Fridays and Saturdays but you will make healthful home-cooked meals the rest of the week. 

• not eating gluten and dairy most days but consuming this if you go out with friends or to events. 

• still eating refined sugar but only when it’s home-cooked baking (not UPFs). 

If harm reduction works for you and your physical and mental health then great! Be honest with yourself about this and notice if things slip back to old patterns over time and re-evaluate.

For many people experiencing addiction, harm reduction is unsuccessful without a period of abstinence first and sometimes even with one. It may work better if you are at the milder end of the FA continuum and depending on the complexity of any underlying factors in your relationship with food (e.g., stress, anxiety, loneliness, or mood symptoms) and your own biological response to the types of foods you consume and your health situation. It is a case of individual trial and error. 

Write out your plan so you can get clear on it - the more concrete you make it the more likely it is to be successful. You may like to continue harm reduction or you may choose to move on to the reset and following stage of reintroduction.

Reintroduce

“All foods fit. But not all foods fit for all people. And just because the food industry manufactures and sells it, does not mean we have to include it”  (DEFANG Guide p.54)

3) Reintroduction of certain foods. After your reset, how would you like your use of trigger foods (UPFs, gluten, dairy, etc) to be going forward? This is a stage of trial and error to navigate what works for you. The end goal is a workable and sustainable relationship with food in the modern food context. 

Reflect on the following:

• Do you still want to include UPFs at all - or do you feel differently now that the addictive reinforcement pathways have been broken and cravings have ceased? 

• When it comes to gluten and dairy, how do you feel when these are added back in?

• Think about what foods/drinks, how much, how often, when, and where and with whom, that you will ideally be consuming. 

• Reflect on the foods you will no longer include or only very infrequently - your trigger foods. These can vary for different people.

• Have any physical or mental health symptoms returned when you reintroduced certain foods?

• Do any foods result in a return of cues, urges and cravings?

• Are there any situations where you will not consume high-risk foods (e.g., if home alone and feeling tired, lonely, emotional, after drinking alcohol etc)? 

• Write your guidelines down to keep in mind and be clear about when shopping for food or choosing food when out.

• Plan for “emergencies” by having easy protein options you can turn to such as protein powder, hard-boiled eggs in the fridge, edamame beans in the freezer, or leftover meats.

As you navigate your reset. reduction, or reintroduction, there’s the opportunity to “see what’s left” of any underlying mental health experiences that need additional input.

If, after withdrawal is over, you find yourself experiencing lasting or worsening increases in anxiety, low mood and motivation, intrusive thoughts and recollections of traumatic events, or feeling that your brain isn’t working so well you may want to get some psychological assistance with a clinician with speciality in addiction. This can also be good if you have really struggled to adhere to any changes throughout reset, reduction or reintroduction.  

Future proof yourself from relapse

Slip-ups and setbacks are an expected part of change. I have never seen anyone making changes of these kinds experience zero slip-ups. A slip-up is a single incident of FA while full relapse is a complete return to FA and no longer being in the action stage of change.

Slip-ups are a great source of additional information about yourself and your evolving relationship with food and help get you back on track before a relapse. They also provide real-world data about what can realistically work and can relate to your stage of change, any barriers there may be, or if now is just not the right time.

It’s wise to monitor how your reintroduction of foods is working and a great tool to do this is the behavioural chain analysis.

The chain analysis tool

This is great for any setbacks or slip-ups.

• Review your recent experience of giving into a FA urge from start to finish. 

• You start with vulnerability factors (e.g., being tired, not eating well that day, staying up too late last night).

• You identify the triggering event and any external or internal cues (e.g., a fight with a friend, being home alone on a Friday, feeling emotionally overwhelmed),

• Note down any “seemingly irrelevant decisions” such as “I’ll just drive home past the drive-thru on my way home from work.” These seem benign but are part of the voice of addiction lulling you towards a slip.

• Record exactly what happened in response (e..g, your thoughts - “I’ll just do it this one time then get back on track tomorrow”, what you ate, how much, where, when, how you felt afterwards etc). 

• List all the relevant links in your chain of events that are potential targets for future success - such as making sure you have a protein snack before you leave the office, if tired having good self-care to go to bed for an early night. Or working out which emotional regulation or other skills would help when you are upset from conflict or feeling bored and lonely.  

• You collate all this information so you can watch for trends over time about what your high-risk scenarios are and what is effective for you.

If needed due to FA taking hold again, return to the reset for another month and review your plan to reintroduce and any changes that may be needed (e.g., maybe pizza is a trigger food best not eaten at all). Your brain may also need longer to break the reward patterns and set up new preferred eating habits. 

If you continue to attempt to return to “moderate” use of UPFs or the foods you find problematic for you, and it always results in slips and then relapse, you may like to re-evaluate whether harm reduction or reintroduction works for you or whether maintaining a version of the reset diet is simply going to take away the mental struggle. Exposure to UPFs for some people will always prime the brain to obsess about having more again through the endogenous reward system of the brain, especially at times of high risk (e.g., stress, hormonal shifts, certain emotional triggers).

The main aim of being future-proofed is to clarify your high-risk situations and have a plan if you know you will be facing one of these. (E.g., being home alone on a weekend, after being out for a couple of alcoholic beverages, when jet-lagged, when your period is due, after a stressful event). 

Important question: “Can you accept the situation as it is with compassion and then make the next right choice after a slip?”

Like walking away from a pathway that has been well worn down, unhooking from FA means one step at a time on the new path towards food freedom. 

If you find yourself heading down the old FA pathway, that’s understandable - it’s familiar and easy to return to but will be less familiar with less use. FORGIVE yourself, take the learning from a fresh chain analysis, and get back on the upwards spiral of health change.