00:00 Introduction to Food Addiction
00:47 Jen Unwin's Personal Journey
03:32 Understanding Food Addiction
11:46 The Science Behind Food Addiction
17:07 Comfort Eating and Its Implications
25:45 Approaching Food Addiction Treatment
28:21 Understanding Food Addiction and Treatment Approaches
31:59 The Role of Sweetness and Cravings
36:37 Navigating Dietary Changes and Challenges
40:37 Support Systems in Overcoming Food Addiction
45:03 Managing Cravings and Emotional Eating
51:20 Top Tips for Reducing Cravings

Dr Peter Brukner (00:01.55)
Hello and welcome to our Defeat Diabetes webinar. Well, we have a very special guest today, from all the way from the United Kingdom and it's my pleasure to welcome Jen Unwin. Jen, welcome.

Jen Unwin (00:15.776)
Hi Peter, thank you for having me.

Dr Peter Brukner (00:19.822)
I should say that we're a few internet problems with Jen. Jen lives out in the sticks, so maybe the internet is not perfect, but the audio seems to be okay, and the video is little bit stilted, but I think we'll be okay. So let's get cracking, Jen. And we always start the same way. I always ask my guests to basically take us on their journey. Tell us your journey from go to woe. How did you finish up to be a...

superstar on food addiction. take right from the start.

Jen Unwin (00:51.306)
from the start, how long have you got? Okay, right. So as a child, I never remember a time when I wasn't kind of fascinated and motivated by sweet foods and, you know, of refined carbohydrates. I was always on the lookout for whenever I could have a pudding or buy some sweeties at the shop or whatever it was. So I always had that.

Dr Peter Brukner (00:54.658)
Hahaha!

Jen Unwin (01:20.864)
that tendency. And of course, yeah, that just kind of developed really and led into a sort of, well, I was an unusual child. went to a girls school and back in the day, weren't overweight kids. It wasn't a thing, but I was.

obviously because of that behavior, became an overweight kid, quite an overweight teenager. that set up, you know, then an adulthood of trying to diet to lose weight and to sort of, you know, feel good. And then not being able to maintain that. So yo-yo dieting, which I'm sure a lot of people listening will really empathize with. So it wasn't until about

14, 15 years ago that I stumbled, because I used to try everything. I used to try every scheme, every diet, some really weird ones, you know, again, like probably most of us. Anyway, stumbled across Low Carb, happened to read a book by Dr. John Briffer called Escape the Diet Trap. And that was all about basically low carb. It was explaining about insulin. was explaining about...

carbohydrate and how, you know, it sets you on this roller coaster and you know that if you eliminate those foods, your appetite goes down, your hunger cravings go down. So I thought, right, I'm diving right into that. imagine how bad I felt coming off a high carb high sugar festival, right into, you know, cutting all, cutting all those things out. Anyway, about day eight, I emerged.

from my misery and felt fantastic and couldn't believe how hungry I didn't feel, know, how well I felt and the weight just kind of dropped off. So, so that was amazing. And that sort of became the start then of what David and I did with working with people with type two diabetes, because we'd sort of, you know, understood that book, understood about blood sugar and insulin and people know because they've, I'm sure heard David speak about

Jen Unwin (03:32.458)
that project. So that was all that was all good, but it wasn't the whole story for me. It took me another few years and it's about nine years ago now. I listened to Bitten Jonsson, who's a Swedish nurse on the diet doctor website. She did a video on sugar addiction and I was watching this video and I thought, but that totally explains all my behaviour.

all my sort of, you know, history, you know, that I was in fact, am in fact a sugar addict. So it's not just okay to go low carb because us addicts will always find a way to kind of, you know, make a keto cookie or, you know, yeah, you know, we'll add sweetness to things or we'll kind of, you know, we'll find a way to sort of, you know, hang on to that.

sweet addiction. so I listened to that. And then I thought, right, that's, that's my mission now. And I went and trained with Benton Johnson. I retired from the NHS that I've been in for 30 years. And now I devote my time, as you say, to understanding food addiction, understanding the research, doing more research, campaigning to get it recognized as an official condition by the WHO.

and generally obsessing instead of, well I still obsess a bit about food but now I obsess more about food addiction and how to help people.

Dr Peter Brukner (05:09.452)
Right, we should tell our audience that you're a trained psychologist and that's what you were doing in the NHS, right? You were working as a psychologist there. Yeah.

Jen Unwin (05:17.772)
Yeah, yeah, I forgot to mention that. Yeah, I've been a clinical psychologist for 40 years and that makes it even more embarrassing because of course I'd trained with addiction. I understood about alcohol addiction and drug addiction, but because I was in denial, I didn't want to understand about sugar addiction until I had to.

Dr Peter Brukner (05:37.901)
Yeah.

Dr Peter Brukner (05:41.336)
Right. And we should also explain, I'm sure most of our audience know Jen's husband, David, who's been on a previous webinar of ours. David is a GP in Northwest England and had a sort of an aha moment, I guess, some years ago when he also discovered low, so what was the timing? Did you discover low carb before David did or how did that work?

Jen Unwin (06:05.26)
Yeah, yeah. So I did it. So it was me sort of reading this book, and then, you know, just leaping full, full throttle into it and kept telling him about, you know, you need to read this book. And did you know there's more sugar in cornflakes than there is in table sugar? And he was like, well, that's wrong. That's completely wrong. How can that be true? But then, know, slowly, slowly, he, he was sort of understanding it and obviously could understand

you know, he understood about starches, sugar. And suddenly, yeah, he had this moment where he's like, well, why, you know, why are pre-diabetics and people with diabetes being told to eat carbohydrate? It makes no sense. So then we, the partners in his practice didn't want us, we wanted to do a project around it. They didn't want us to do it. So we did it in the evening in our own time.

and our own expense. started with 13 people with pre-diabetes. We were a bit too nervous to start with the full-blown type 2 diabetes. And the results were amazing. And that was the first paper that we ever wrote on the project. there's been, I mean, I've lost count of the number of papers now we've written from that data. And he's still going with that. yeah.

Dr Peter Brukner (07:25.206)
Fantastic. All right. Okay. Enough of David. We'll forget about David. Let's move on to Jen. you what I mean, you, you mentioned food addiction. mean, I mean, if we're really talking about addiction in the same way that people are addicted to alcohol or heroin or something like that, I mean, what, what, what is, what's going on?

Jen Unwin (07:28.351)
Yeah, let's pick it.

Jen Unwin (07:40.428)
Yeah, absolutely. I believe we are. think I always say if it walks like a duck and quacks like a duck, then it's probably a duck. So if we look at the, if you take the six criteria for substance use disorders from the WHO and you think, do those apply to

certain people's behavior around food, not everybody, like not everyone has an alcohol problem that drinks alcohol. So not everybody gets a food addiction who eats sugar and processed foods and refined carbohydrates. But, you know, there's a significant proportion of us that do and it's interestingly about the same proportion of people who lose control of their relationship with alcohol. research shows that about 14 % of the general population.

in the, particularly in the Western world have food addiction. So shall I, shall I go through the criteria? the then people will see, right, okay. Yeah. Does, does that, or does that not apply to them? And also does that, or does that not apply to some people's behavior around food? So, use the handy acronym craved, which Heidi and I have come up with and is our screening,

Dr Peter Brukner (08:44.066)
Yeah, yeah, sure, let's do that.

Jen Unwin (09:04.684)
questionnaire that we've used using these six questions craves. So C, the cravings and compulsions. Obviously we recognize that with other addictions that people have cravings that are so strong they can't resist, you know, carrying out that behavior. So that was certainly me. I'd kind of make a decision on a Monday, right? No more biscuits. And then I'd come home from work and my disembodied hand would be reaching for the biscuit barrel.

So I couldn't resist that compulsion to eat those foods, even though logically I didn't want to. So C is for cravings. R is reaching for more. And again, we all understand this concept of tolerance with alcohol. So if you have a glass of wine every night, eventually that doesn't really do much. You kind of used to having a glass of wine every night. So if you want to get a bit tipsy, you're to have to have two glasses. And that's how people get in that cycle of that increasing.

consumption and it's exactly the same. So people might start out, yeah, maybe, you know, a couple of biscuits or their favorite ice cream or whatever is enough. But over time that amount to get that feeling that you're looking for, or even the relief from withdrawal symptoms gets more and more and more. So that's R. A is activities neglected? That's number three. You know, is life becoming more and

focused around getting those foods, eating those foods, maybe even in secret, you know, feeling bad because you've had the foods and then neglecting family, hobbies, work slightly because your thoughts are so preoccupied. And that definitely happened to me. I'd be sneaking around, sneak off to the cinema to have some Ben and Jerry's when I should have been, you know, I don't know, out doing a food shop for the...

kids or something, know, things that made no sense at all. So that's A. V is, sorry about that opinion. V is losing control of the volume. So we've already said sort of having more and more is a sign, but also, you know, never being able to control the amount, saying to yourself, I'll have one biscuit or I'll have, you know, a small bowl of ice cream and it never, it just never is.

Jen Unwin (11:26.412)
It never is. You can never moderate, you know, that sort of mythical unicorn of moderation. E is for exclusion. And the idea of this is that if you try and cut down and you have some success, or if for some reason you can't get hold of those high sugary, ultra processed foods, you start to get withdrawal symptoms and they can either be psychological or physiological.

So people describe headaches, grumpy, we all know about hangry, don't we? Grumpy, are hangry, shaky, low mood, gastrointestinal problems, that kind of thing. And then number six D is for damage. And it's for me the hallmark, which is continuing to use the foods in this case.

despite knowing they're doing you harm. say you've got type 2 diabetes, say you're very overweight, say you've got mental health struggles, and yet you can't stop, even though you know those things are doing you harm. So those are the six criteria and you only need three to be considered to have a problem with substance use problem according to the ICD. Now I would have been six.

I hope people were sort of counting along at home and maybe thinking if they have three or more. And whenever we do this with our type two diabetes group, practically the whole room would scream positive. They nearly all recognize that that is an issue for them.

Dr Peter Brukner (13:06.766)
Right. So why do some people then become addicted to food or carbs in particular? I presume we're talking mainly about sugar and carbs as far as food addiction goes. mean, why some people, why you are not, you know, someone else? mean, what is it do you think? Is it genetic or what's the issues?

Jen Unwin (13:27.722)
Yeah, yeah, for example, David isn't, I mean, he, he, yeah, he kind of gave himself two diabetes because probably because he lived with me and I did a lot of baking. he, but, but he can, he can, he never does eat carbs now, but he could, he could moderate or he could say Monday morning, right? You know, I've been a bit greedy, I'm going to stop now. And I never could. So there was that difference between us.

And I do know other people, his mom actually has chocolate in the cupboard since 1986 that she's never touched. So she's able to do it as well. I think you're right. There is evidence that there's a genetic component. My mother for sure was a sugar addict looking back now at her behavior. So there is a genetic component. We often hear women talk about well,

You know, in the family, nobody else had this problem, but my dad had an alcohol problem. So it's not just that a relative might've had a food addiction, but in the brain, in brain terms, addiction is addiction. So often that's a thing that runs in families and expresses itself in different ways. So, so men have more of a tendency to struggle with alcohol. We tend to see more women who struggle with food addiction, but that's not, you know, that's...

That's not, it's not exclusive. It's not black and white. And there's also other behaviors and things that we can, we can fall into once we get a little bit wired for addiction, like scrolling, shopping, gambling, obviously caffeine, nicotine, all of these things, both substances and behaviors. It's all to do with the reward center in the brain. So yes, some genetics.

Yes, some environment. if you, if you were exposed, if you've been exposed to a lot of sugar and ultra processed foods, that's, you know, that's going to make it easier for you to slip beyond, you know, liking to sort of needing, needing those, those foods because of, because of what's gone in the brain. they, obviously there's an environmental issue because nobody had food addiction.

Jen Unwin (15:50.602)
When we were running around the plains, they were just seeking food. And it made sense that they were very motivated to get food for survival. So we think what's happened is that that natural motivation to get food has just been hijacked in the modern environment where sweet, highly stimulating, highly rewarding foods are so easily available. You basically.

pick up the phone and press a button and somebody arrives at the door with a pizza. There's no effort involved, but we've still got that brain. We've still got that sort of ancient man and woman brain that responds to those foods. Yeah, so it's the same with alcohol, isn't it? Not everybody who gets exposed to alcohol loses control of their relationship with alcohol.

you know, it's about the same 10 to 14 percent, the same with foods.

Dr Peter Brukner (16:58.654)
You mentioned that as a teenager you had these of cravings. Is that typical? It tends to start at an early age and continues into adulthood? Or could you become a late addict?

Jen Unwin (17:11.532)
Late stage. Yeah. Yes. A lot of people we talked to say, oh, I was six or I was five. My earliest memory of that sort of sensation or that thinking was quite young, five, six, you know, or like me, probably I can't really remember a time when I, you know, I've got very, maybe four, a memory of going to Sunday school and we made cheese scones and...

We were allowed to take them home. took them home and I had a whole plate of cheese scones and I cried because I thought they were all for me. And it was pointed out, but you know, I should share. was not impressed with this idea. So that, yeah, so that's, that's pretty typical. I've, you know, yes, we do come across people who later stage. So another thing that can happen is there is this link with trauma and addiction or adverse experiences. So obviously.

Dr Peter Brukner (17:49.902)
you

Jen Unwin (18:06.826)
where people have had adverse childhood experiences, sugar is really the only psychoactive substance that they have access to generally, although sometimes obviously in extreme circumstances, but generally kids don't have access to alcohol, caffeine, nicotine. don't, we need those, why the brain? We know those are addictive, so we don't give them, but we do give children or children have access to, because if they have money or these things tend to be in the house. So,

There's a lovely clip of Eric Clapton being interviewed about his drug addiction problems. the interviewer says, so it started with cocaine. I think the guy says it started with cocaine, right? And he said, no, no, it started with sugar as a child. I would just try and put as much sugar down my mouth as I could to change the way that I felt is what he says. So kids can do that at young age. But I have known people...

have traumatic events later in life. And then it, you know, then it can trigger that relationship with food to sort of develop into something that it wasn't before to develop into this need to sort of have something that alters the mind in some way. Yeah. So trauma is definitely a factor as well that plays in.

Dr Peter Brukner (19:35.982)
You hear the term comfort eating a lot. Where does that fit into it? Is it all part of the syndrome?

Jen Unwin (19:42.676)
Yeah, so what happens in the brain when we eat highly processed, highly stimulating food, so sugar, refined carbohydrates, things that have sugar, salt and fat in that sort of holy trinity that the food industry create for us.

So I've already said that eating, any eating is rewarding. So you get the reward and motivation neurotransmitter released in the brain, dopamine, which most of us have heard about. Dopamine is a great thing. We all need it to get up in the morning and to motivate us to do things and to get that reward when we've done something. What you get with these foods is a sort of unnatural, unnaturally high level of dopamine. And that's exactly what happens with

other substances of abuse, drugs, nicotine, caffeine, we get this kind of hit, this fast hit of dopamine. Now what happens in the brain, everything in nature is trying to be in balance. So what happens in the brain is some dopamine receptors are, they call it down regulated, but think of them as being kind of switched off. So although there's dopamine in the brain, the brain's trying to protect itself by

shutting down some receptors for dopamine. I mean, I always say, I hope people can see that shutting down your dopamine receptors is actually a really bad idea because then you're not sensitive to the dopamine that's in your brain. the horrid trap that people get in then is, know, when they're feeling kind of flat or low, then...

because it's in a very primitive part of the brain, you're then driven to do the thing that has previously given you that dopamine boost. So then we're driven to repeat that behavior and we kind of learn all the cues that go along with it and we get that boost of dopamine again. We need slightly more to get the same effects. We've got lost some receptors.

Jen Unwin (21:51.5)
And we knock out a few more receptors. So what happens over time, and we know from the research that people who have very high sugar diets, they get depressed. They, you know, they get clinical levels of depression and it's a sort of linear relationship, more sugar, more depressed. So sugar and refined carbohydrates. So you get the dopamine. The other thing is that you get, so serotonin, which is the other neurotransmitter that people will have heard of.

is the sort of happy, relaxed neurotransmitter. and the same thing happens. So we get a big serotonin boost, but we're also knocking out some serotonin receptors. So we're getting more anxious over time. So people feel this is when they kind of, if those foods aren't available, they get this sort of, you know, agitation or kind of antsy feeling because, you know, serotonin is going lower over time. we're, we're.

knocking out our dopamine and our serotonin. And then we look to sort of, how do we get those? And we repeat the behavior. So comfort eating, I sort of see as part of that cycle that yes, yes, you do feel better after you eat those things temporarily. You do get that sense of comfort. The other thing that gives people a sense of comfort is a big

full tummy. Again, that's probably an evolutionary thing. And that seems to release oxytocin, which is the sort of closeness bonding hormone that we know that moms and babies have a lot of. And again, that's a sort of relaxing neurotransmitter oxytocin. So a a big full tummy. I saw some of the questions that came in about that. It's like, why, you know, even if I'm eating the right foods, why am I still overeating? And I think

one of the explanations that surrounds is that we've sort of got also sort of addicted to the full tummy sort of relaxation response.

Dr Peter Brukner (24:03.918)
And we tend to, with food these days, mean, servings seem to be much bigger than they used to be. And there's always this thing of, you well, you've got to finish what's on your plate sort of thing. you know, people don't like to leave food. mean, you know, my mother always used to say, you know, you've got to eat everything, you know, the poor people, you know, in Africa, you know, would love to have your leftovers, you know, all that sort of stuff. And so, you know, you get into a habit of eating everything that's on your plate. And as the servings get bigger and bigger, then...

then your intake gets bigger and bigger.

Jen Unwin (24:35.252)
Yeah, yeah, and there's lots of evidence looking at looking at that, you know, but, you know, the sort of things that that

influences to overeat. Yeah, we were kind of children of the war babies, wouldn't we? And, you know, my parents had all been through rationing as kids. you know, so for them, you know, they gave us, I think it was a pleasure for them to feed us and give us give us lots of food. It was a way of sort of showing love. But then, yeah, we got those messages about, you know, when in the war,

You know, we didn't have the, you need to eat everything. Yeah. And we get in the habit of eating everything on, the plate for sure. Yeah. So there's a lot of behavioral things that feed in as well. It's not just about the substance of the sugar and the ultra processed foods. There are a lot of these habits that we've all got into for cultural reasons, like eating everything on the plate, like every...

celebration is some kind of crazy festival of sugar, Christmas, Easter, Mother's Day, Valentine's. They all seem to now just rotate around chocolate as far as I can see. And we've all just sort of drifted into that and accepted, you know, it's normal to have cupcakes in the office at work, when somebody's baked them for you, you know, that's a normal thing, office cake. You go and buy petrol and the...

You walk past 10 meters of chocolate, you know, display before you can even pay the bill. And we know, so what happens with dopamine is that we get sort of wired to the cues that are around when we get that hit. And this is how the process of food industry get you really. So I'll give you a lovely example.

Jen Unwin (26:29.78)
I had Georgia Ede in the car. She's a psychiatrist from America, if people haven't heard of her. Georgia Ede was in the car and we were driving through a big city. And I don't know if you guys have Cadbury's chocolate over there, but Cadbury's chocolate in the UK is the best. And it's purple, isn't it? The whole thing's purple. And they'd done this, there was a massive hoarding advert that was just purple and just said, I think it just said Cadbury's or something or...

some word, it may not even have been cabris. That was the advert. We both laughed because we literally both started salivating when we saw this advert. it's, again, this advert's on the TV, weird cues. Someone that we worked with closely had counted one day all the cues to eat sugar and processed foods that she came across in her day. And it was

It was hundreds. It's everywhere. So we get queued, the dopamine starts flowing. lose our minds literally. What happens when that's triggered is not only do we get the dopamine, but the frontal lobes, interestingly, sort of shut off. They're sort of shut down. And again, evolutionarily, that makes sense. So back in the day, we had to get food. We had to be inordinately brave. We had to run.

we had to climb cliffs, we had to throw arrows and rocks and there was a real and present danger involved in getting food. So it was good that we didn't think about the danger, we just were motivated and went and did it and we're more likely to survive, our ancestors survived. So that's still happening in our brains in that.

You know, like I said, I didn't want to eat those, those biscuits when I got back from work. But the minute I thought about them, even thought about them or saw the tin where I would keep the biscuits for the kids, the dopamine is flowing. The frontal lobes are shut down. mean, my primitive brain, my hand is reaching. So it's all very sort of automatic. So the main thing that I hope people take from that is that.

Jen Unwin (28:50.858)
You know, we've kind of been had by the food industry. It's not our fault that some of us have got addicted to food. It's a human brain in a ridiculous environment. and once we accept that it gives us, you know, new ways to think about it, really a new ways to, you know, to get out of that trap using our frontal lobes.

Dr Peter Brukner (29:16.726)
Yeah. So is that really the first step in rehabilitation is to sort of stop blaming yourself for it.

Jen Unwin (29:22.954)
Yeah, and we find that it's a really powerful moment. Like I've done quite a few residential courses for this problem and people are often really emotional when they hear that. It's not your fault message because they feel it has been their fault. They're very ashamed of their behavior. They don't know, you know, what's wrong with me that I go in the bin to get, you know, stuff that I know someone's thrown in there. Behaviors that kind of make no sense to any of us.

They feel very ashamed, very embarrassed. So yeah, absolutely. It's not your fault, but it is your responsibility. Now you know the, now you know the facts.

Dr Peter Brukner (30:02.168)
Okay, so we've sort of established what food addiction is and the triggers for it and so on. Let's say I come and see you looking for help. I've got type 2 diabetes or pre-diabetic, I'm overweight, I can't stop eating, I just love food. I don't know that I'm addicted, but I just say I love food. I'm always hungry and I love food. Help me. What's your approach to that sort of

Jen Unwin (30:28.364)
you

Dr Peter Brukner (30:31.458)
you know, to a patient like me.

Jen Unwin (30:34.548)
Yeah. So I'm going to channel David here because he, he has this in every clinic. Obviously he has people who, yeah, exactly as you say, they don't know that the food addicts, the diabetes may be very poorly controlled. They may have obesity or whatever, and they're coming to him for help and he doesn't want to give them drugs necessarily. and, a typical example would be somebody who's been refused surgery because they're

either too overweight or their blood sugars are too out of control to have the surgery. So they're in a bit of a pickle. So he'll kind of go through, you know, to kind of gently inquiring about, you know, are there any foods that, you know, you feel you can't control?

Does it, you know, does it feel like that that might be sort of a bit like an addiction? And often at that point, people will say yes, and they'll cry and they'll say, nobody's ever asked me that. can't stop eating bread. Bread is a really typical one. People will say, you know, it's ridiculous, but I just can't stop eating bread. And I'm having kind of, you know, a loaf a day or whatever it is. you know, sort of, you know, starting to recognise that. And then...

That opens the door then to some of that education and explanation about what's going on. And he does actually use the craved scale because I think what happens there is that people sort of fill in a questionnaire and they're six yeses. The fact that there is a questionnaire kind of validates their experience and they say, yes, that's exactly me and I've scored five or six. And then he can say, you

you know, that's looking at, have you got to a place where you're addicted to certain foods? And then there's a logical step, isn't there, is that we all understand that if somebody's lost control of their relationship with alcohol, what's the treatment? The answer is abstinence, however you're going to get there. And we know that with cigarettes, and we just know that that's the truth. So then there's a question about, well, which are the foods that...

Jen Unwin (32:45.948)
you have that relationship with because it's not all foods obviously and then it's about working with someone to some people like to go cold turkey I was one of them it's just the way that I roll that has to be carefully managed obviously if someone's on insulin or other type two diabetes medications or blood pressure medication that's David's job not mine thank god

Or maybe then only on metformin or something like that. And then, then it's fine. people can, some people, yeah, they can go cold turkey and he'll, he'll review with them how that goes. Other people like to maybe cut out foods in a stepwise way. And I would always say, you know, it's a harm reduction approach. Take, take the worst thing first, cut that, cut that out first, you know, and then go stepwise.

Diet Coke is another menace actually. mean, I know it's not sugary, but I know lots of people who just can't give up those caffeinated sweetened beverages, even though they're, you know, it's sweetener.

again, cold turkey or trying to sort of maybe dilute it or, you know, limit to a certain number of day and sort of tailor it down. Now I would say word of warning is that people who were really at the sort of, like me, were sort of at the point of no return. You can't always do it stepwise. Some people...

will try step-wise and it won't work because they're still in the, still having the addictive substance. So some people do need the whole cold turkey thing. Sometimes people does, David does prescribe some people who really struggle a low dose of a GOP1, a tablet form to help with the cravings and so on. So he does do that sometimes.

Dr Peter Brukner (34:56.302)
So would you say you can be addicted to sweetness rather than the actual food itself? It's the sweet sensation and that's why the problems with the diet coke and things like that.

Jen Unwin (35:07.038)
Yeah, I think particularly for those of us that again, more sort of end stage that that sweet taste is triggering those same things in the brain, the dopamine, you know, and then craving more and more to sort of get, get that and of course, the caffeine in them is is addictive in its own right. Yeah, so we are definitely seeing that the people can have a

a struggle with with sweeteners. I had to give them up myself and that was for me more or less just as hard as giving up the sugar itself interestingly and I've heard other people say that yeah sweeteners try and avoid the sweetness if you have this tendency of course some people can just have a little bit of sweetener and they're okay you know it's not everybody.

Dr Peter Brukner (36:03.97)
You mentioned bread. think we all agree bread is one of the biggest problems. What's your approach to someone who I can do anything, but don't ask me to give up bread or I couldn't give up bread. How do you approach that patient?

Jen Unwin (36:19.4)
Yeah, I think the thing is it's kind of weighing up the pain, it? So it's, if you do what you've always done, you'll get what you've always got. So people might not be willing to give up bread and that's obviously their choice and it's up to them, but nothing's going to change if they're struggling with type 2 diabetes, you know, maybe...

low mood, maybe, maybe gut issues, whatever it is for that person. So they might come along to David, for example, and he'd sort of gently suggest that, you know, maybe, maybe they're very, and they, they say that then, you know, he'll, obviously it's up to them, but it is about weighing, weighing up the, the pros and the pros and cons of that. And interestingly, it's often the thing we really crave that is actually the thing.

that's in a way doing us more harm. So like the sugar or, you know, thing that can happen, we've not really sort of mentioned because it's still a real food, but people can get this relationship. Also with dairy, we've had people on our residential, you know, they're low carb really, they're, you know, even keto, but one woman in particular could not give up double cream. And...

you know, that was her, she was trying to lose weight, was harming that probably it was, you know, leading to some inflammation. She wanted to give it up, but she still had this, this struggle. So dairy can cause some problems for, for people as well. Sometimes the thing that sort of, you know, harming you that you weirdly, weirdly crave. Strange.

Dr Peter Brukner (38:08.942)
Yeah, bizarre, it? So with something like, I don't want to focus totally on bread, but with something like bread, is your approach to get them to, I mean, there some low carb breads around nowadays, there's sort of sourdough bread, which is probably a little bit better. mean, is that your sort tendency or it just depends on the individual person as to how they go about it?

Jen Unwin (38:35.372)
individual whether you you can actually persuade them to try you know even two weeks of going without because I think if you can get people through the withdrawals and they start noticing the benefits then you're winning really so I think people get scared by forever and I completely understand that and that's me as well like if you're proper

food addict, the idea of never having chocolate or ice cream or bread again is kind of terrifying because it's been such a focus of your life and your emotional state and so on. So just trying, just for today really, like a bit like in alcohol and drug addiction, one day at a time and seeing if you can get...

you know, past eight to 10 days, that's when people are through the physiological withdrawal and they will start to notice the benefits. And a lot of people have never managed to get to that point. And I think if you give them the information that, you know, you need to go...

that long people will try and they'll feel so terrible on day three. They'll just say, well, I just can't do it. You know, that's that. But I think you can get them through with support, with, you know, education that, you know, it is going to be that with, you know, have a bit more salt is a really good piece of advice. You know, don't be restricting if you'd have plenty of protein, plenty of fat, you know, all of those sorts of bits. So can we get somebody through?

or yeah, I mean, there are substitutes on them. We've got patients that make almond flour bread or, know, CD crackers or, you know, they've, find another, they find something to, to substitute. And that's definitely a step in the right direction. some people, including me would still overeat almond flour bread. I mean, I would just go mad for that. Put some butter on it. I'll eat the whole thing.

Dr Peter Brukner (40:42.755)
there

Jen Unwin (40:42.924)
Thank you very much. So some of us, but that, you know, that can come down the line again. It's individual, you know, what does a person's abstinent food plan look like is very individual. My plan, we know what's right for me is different for someone else with a food addiction. Some people can cope with some, you know, new potatoes or some refined grains. Again, probably if they're not type two diabetic.

other people, loads of people doing really well, just like straight carnivore, if that's, you know, if they can not be too bored with that, you know, if they can tolerate that. So everyone finds their own solutions really.

Dr Peter Brukner (41:26.956)
She obviously warned people that the first week, eight days, 10 days, whatever is going to be tough. What sort of symptoms do you tell them to expect?

Jen Unwin (41:36.268)
Well, for me, so it's headaches, know, really low energy kind of feeling glum because you've got this sort of what goes up must come down thing. So dopamine is going to feel a bit low, serotonin and so on, maybe sleep problems. People are different. So some people just sail through, don't they? But most of those that...

sort of having an addictive relationship, there'll be some withdrawal symptoms. So yeah, kind of preparing for that is a good idea. Make it a time when you're not giving a conference speech or got some big thing on at work. Make sure you tell everybody that that's what you're doing. Ask for the support of your families. They're not eating cabbages.

Dr Peter Brukner (42:27.646)
Yeah, was going to mention the support. What are the factors that really determine success? Obviously, family support, friend support is a big one.

Jen Unwin (42:38.452)
Yeah, massive. Again, just keep coming back to like any kind of addiction. Like if you can get a support group or if you can get all your family and friends to understand that, you know, whether they've got this problem or not, you know, you, you have, and you're asking for their support. You're asking for them not to eat those foods in front of you, you know, for a few weeks, you're probably not going to go out for a meal because that's going to be too doing. You're going to clear out your

fridge, freezer and cupboards. And if you live with other people that want to continue eating those foods, you know, maybe you're going to have your own cupboard or your own shelf in the fridge. That's your stuff. You know, you're going to learn to sort of not looking at what they have. I mean, we've had people who've, you know, they've, they've, they've bought a lot of kind of safe, but metal safe boxes with keys and they've told their husband who wants to keep eating his cabarets bar.

that he has to keep them in there and they don't know where the key is. Literally sort of that, because when the cravings strike and if the husband's out of the house, they would have, you know, gone to raid the stash. Yeah, so whatever works for you to sort of keep it, keep it particularly clean until you've got, you know, those, you know, those first few weeks under your belt and then you might be able to sort of tolerate people eating some things around you without.

feeling that you can't control what you're going to do.

Dr Peter Brukner (44:11.714)
What are some of the other factors that really can enhance your chances of success?

Jen Unwin (44:17.78)
Yeah. Having, yeah, having an accountability body. that like a bit like a sponsor in a way, you know, often do really well in, in groups because like maybe even online groups are really good. There's a few, you know, that are provided now for, for food addiction. And I think what happens there is that.

You know, we feel so kind of isolated and weird in our own families if we're the only ones that have this struggle. But in a group, everybody's saying the same. They've all been in the bin to get stuff out. They've all driven to the cinema to get the juries. So you, you've, know, it's normalized and you hear other people's struggles. You don't feel so sort of, you know, weird and you get, you can ask for help. You know, you can get that support. So yeah, definitely.

doing it in a group if you can do that is excellent, I think. That's what we've definitely found is that people do really well with that rather than one to one.

Dr Peter Brukner (45:24.472)
Yeah. Okay, great. Well, look, we've got a whole bunch of questions that have come in. So let me let me start firing some of them at you, Jen. Robin would like to know why she has sugar cravings in the late afternoon and evening.

Jen Unwin (45:41.792)
Yeah. It's because we kind of used up all our, by the end of the day, we've sort of used up our willpower muscle. kind of, you know, that's more robust in the morning. Like my experience, you know, by the end of the day, you're kind of tired, aren't you? We've talked about this sort of, you know, maybe we're feeling we want a bit of comfort.

I think often, particularly women as well, I've really seen this in our work and when we've done residential with people. Women really struggle with understanding how much protein and fat they need to eat. We've been brought up with this, don't eat the red meat thing. It's not ladylike to chow down into an enormous plate of steak and eggs. Fat, we should all be low fat.

So we really encourage, I don't know if this is a factor for you, Robin, but we really encourage people to have those meals based around protein and fat and have those, you know, I mean, not all of us eat breakfast, I don't, but you know, at lunch, make sure you're getting plenty of protein because otherwise you are literally hungry later on. Your body is kind of wanting that nutrition. It's wanting that protein. It's trying to hit sort of, you know, we've got this idea now that

you know, the brain will keep seeking food till it's, it's got what it needs. So make sure you're basing your, we haven't really sort of talked about this, have we? But make sure you're getting plenty of protein, 1.5 grams per kilogram body weight, which when we go through it with our female people on the residential, they can't believe how much is, how much, and Heidi and I are sort of heaping our plates. Yeah.

plenty of protein, either two or three times a day, plenty of fat as well. Yeah, so we tend to be tired or later on. So are there some sort of non-food things that we can learn to do? The other part of recovery is really, we haven't talked about is, you've got to get the food right, but also, you know, we have to find ways, we've been looking to the food for comfort.

Jen Unwin (48:05.516)
for, you know, dopamine, serotonin, oxytocin. How can we get those things? How can we balance those neurotransmitters without turning to the food? Because we're going to drop that. So we need to think of something else. The one that hits the most bang for your buck is some sort of exercise. And people often go, God, exercise. You know, it doesn't have to be anything dramatic. It can just literally be a walk maybe in the evening after work.

You know, you're going to get some dopamine from having done it. You're going to get serotonin from being out in the sunshine. If you hold hands with your partner and they'll come with you, you get some oxytocin, you know, exercise can be a good one. Or, you know, something like yoga, something like learning some, you know, doing a little recorded meditation, have a hot bath with a candle, you know, something that's in the evening.

when you're trying to wind down, you know, you're finding something else other than food to do that with. And we really encourage people not to eat in front of the television. That's such a classic. And of course, they're advertising your food on the television. So you sit down and got into this habit of, well, I always have a snack or I have something in front of the TV. You know, if you're going to eat, it, sit down at the table, do it mindfully. So you're enjoying the food. And if you need

I'm a big knitter and crocheter. If I need something to with my hands in the evening, which I often do, I'm doing something else other than that. So I hope that helps, Robin.

Dr Peter Brukner (49:43.266)
What role does sleep play in all this, Jen?

Jen Unwin (49:46.636)
Yeah, such an important question again. Yeah, we've there's loads of research showing that if people have a poor night's sleep, they're much more likely to overeat the next day. It's partly a sort of willpower thing, I think it's partly a sort of maybe a cortisol thing. You know, we just feel hungrier if we haven't slept so well, we're more likely to lose control. So yeah, getting in a good

sleep habit, getting a good night's sleep is really going to help you balance the neurotransmitters, but also be able to stick to whatever your food plan is for sure.

Dr Peter Brukner (50:28.864)
Okay. I've got a couple of questions from, from Susie and Bob. And, and, know, obviously we get the fact that, you know, have cravings for sugar and processed foods, but, they're both talking about the fact they can't stop eating even, healthy foods. How do you approach something like that?

Jen Unwin (50:47.102)
Yeah, so it goes back to what we say that probably the overeating is giving some reward, probably some oxytocin, some serotonin, you know, that's the reward. I would say it's really important not to be thinking about this as dieting, try and get out of the...

diet mentality because when we're in a diet mentality we tend to restrict earlier in the day as we've already said to Robin and then you're more likely to really eat fast and need that sort of bigger meal at night so one way is to sort of split that throughout the day so you're not getting super ravenously hungry I don't know if that applies to you too but

The other thing, as I say, is that we just want to eat to feel super full. there's a number, I mean, it depends on your sort of personal circumstance with that. One way is to sort of decide beforehand what is, are you having the right amount of protein? Put that on your plate, put the fat on the plate, give yourself a nice big load of low carb vegetables, because that's going to fill you up. And then...

it away. One thing that happens to me is I always cook enormous amounts because I'm a bit of a feeder and then if it's out on the side you are much more tempted to keep going back and have seconds and so on. maybe put it away, put it in the freezer and then sit down to eat. When you sit down to eat, the other thing is I have a tendency to be a real shoveler. So

I've got some on the fork, I've put it in the mouth, but I'm loading up the fork, you know, so trying to slow down a little bit. Don't eat with distractions as well. Put the phone away. Just sit there and concentrate on the food. Enjoy it, really enjoy the food, chew it slowly so that those, signals that you should be getting from the protein and the fat, the sort of satiety signals will start to come.

Jen Unwin (53:04.403)
Yeah, don't be, don't be low fat because we need that, you know, we need those fats for, for the, for the brain and the body and to feel satisfied. And the same with the protein. We've already said having off protein over the day. and then, you know, that's getting registered and it should start reducing the appetite later, later in the day. So those are a few tips and it just depends if any of that kind of, kind of applies to.

to the people that have put the question in.

Dr Peter Brukner (53:36.91)
Yeah, I think taking your time over meals is brilliant. I mean, that's what the Southern Europeans do very well. know, they make a meal as a social event as well. You you eat slowly, can have conversation. Whereas, you we tend to sort of, oh, you you rush for time and so you shovel your food down and off you go and so on. I think that makes a big difference.

Jen Unwin (53:55.594)
Are you in front of the computer? You know, like I say, some people are eating in of the television or they're working and eating at the same time. Yeah, anything like that. Try and get out of those habits so that the meal becomes more of an event. Yeah, I'm really trying to practice. Take a bite, put my knife and fork down until I've chewed and swallowed that bite and then pick the knife and fork up again.

Dr Peter Brukner (54:23.31)
Alright, DW has asked how to break out of a negative self-talk cycle.

Jen Unwin (54:30.822)
yeah, for sure. Yes. Yeah. Yes. It's really hard, isn't it? Around, around food in particular. Yeah. I really sympathise. yeah, I mean, sometimes I think it can be, if you're in it in your head a lot, either speaking out loud to someone else or writing it down, writing down the, the, the cycle of, of negative thoughts.

Dr Peter Brukner (54:33.038)
There's a question for a psychologist, yeah.

Jen Unwin (55:00.49)
Because, you know, when you see them in black and white, you're then often able to kind of go, well, you know, actually that makes no sense. Or I can, I have some counter arguments. So I often talk to people about having like the prosecution lawyer, which is your negative self-talk. And they're saying, well, you know, this is a load of rubbish, isn't it? There you go. Failing again. You know, you, you'll never amount to anything, guilty.

And we'd forget to listen to the sort of defence lawyer, you know, trying to sort of think, well, what would they say? what would, you know, think of, is there somebody, like a best friend or your mum or, you know, somebody who would be on your side, even if it's not you. What would they say? Or what would a defence lawyer say to that argument? And I think if you kind of write it down, put it in back and white, you process it in a slightly different way.

And you can see that some of the things that you're saying to yourself, you know, actually make no sense. And the other thing to ask yourself is, would you, if you were talking to a child or a friend, would you ever say something like that? You know, would you ever say something like that to somebody that you're trying to help? No, you wouldn't. You'd never be outright critical like that to somebody.

So, you know, what would you say instead? So trying to get out, get out of your head and kind of think of it as a third person problem. What would you say instead? Maybe write those things down, have them stuck on the fridge or, you know, on a little card. And if you get really stuck in that, you know, yeah, get it out and then also do something different. I think we've, we've become very sort of intellectual in modern life. We're trying to think problems through it. I think sometimes we have to.

particularly with food addiction because it is this primitive brain. You can't really think your way out of it. You have to act your way out of it. So, you know, can you take yourself out for a walk or phone a friend or, you know, sometimes people do like 10 jumping jacks or, you know, just something to sort of, yeah, I don't know. Get some cold water and splash it on. Give yourself a bit of a surprise.

Dr Peter Brukner (57:18.114)
and break the cycle sort of, yeah.

Dr Peter Brukner (57:24.952)
Cough

Jen Unwin (57:25.824)
Just to sort of, yeah, to break out of that loop. Sometimes we have to do something active to break out of that. It's very difficult, sympathies.

Dr Peter Brukner (57:35.63)
Hmm, yeah.

Dr Peter Brukner (57:40.684)
Right. Okay, last question. It's a good one to finish on. Jackie's asked for Jen's top three tips people can do now to stop cravings.

Jen Unwin (57:52.076)
Okay, right. Well, stay away from ultra processed foods. Top tip. They are designed, they even put people in brain scanners and fed them whatever it is, Doritos, let's say. I know, maybe liable, maybe they never did, but you know, there's evidence of food, people in scanners fed them the food and they see which formulations light up your brain, your reward center the most.

So you've been had, know, we're kind of, we're, we're rats in a maze. Let's, you know, stick it to them and just eat real food as much as you can. If it's in a packet, don't have it. So it needs to have been running around, swimming or growing in a field. Then you can have it. so I think that would be absolutely number one way to get out of cravings.

Number two, eat enough protein and fat because otherwise your brain and your body are actually craving nutrition. have to have enough nutrition. Tip number two. Tip number three is find other ways to feel good. So whether that's a hobby, socializing, some form of exercise, you know, get routines in your life. Like a recovery routine looks like, say for example, I go to a bootcamp every morning. I lift some weights. I eat my delicious.

protein foods, but then, you know, I might go walk later on. I might go to yoga, do some knitting. I might, you know, yeah. So you're, you're trying to design your day that so you don't need to fall back on the foods.

Dr Peter Brukner (59:31.096)
Fantastic. Well, great advice. Great advice, Jen. It's been terrific. Now you've got a conference coming up, is that right?

Jen Unwin (59:37.228)
Oh yes, everybody. So we've got a conference 4th and 5th of September in London. Obviously most of you won't be able to come that are listening. But we've got a live stream and we've done a special code for Peter PBO, Peter Bruckner's offer. And you can get 40 % off the live stream. So go to www.the-chc.org.

Dr Peter Brukner (01:00:01.454)
I

Jen Unwin (01:00:07.212)
forward slash FAS forward slash conference. Perhaps we can put the link. I'll put it up on the notes. Yeah, you're going to get 40 % off the live stream. So I really hope you can come. David will be speaking. Trocal agent's never been to London. He's very excited. We've got Georgia Ede. We've got a guy from UNICEF who's going to talk about, you know, what we're trying to do for children's diets. So there's some amazing speakers. Nicole Oveena, if you...

Dr Peter Brukner (01:00:11.212)
Okay, we'll put that up on the notes anyway. Yeah.

Dr Peter Brukner (01:00:24.014)
Yeah.

Jen Unwin (01:00:36.138)
If you want to know more about food addiction, but also the comorbidities, so obesity, cancer, cardiology, all of that's on day two. Please come along.

Dr Peter Brukner (01:00:47.938)
Well, I think everyone who's listened to you, Jen, has learned a lot about food addiction today. It's been fantastic and we really appreciate your time. I know you're a very busy woman, but we're very grateful for you to spend this time with us. And yeah, thank you. We look forward to catching up.

Jen Unwin (01:01:03.244)
Yeah, see you soon.

Dr Peter Brukner (01:01:08.334)
See you.