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.