Today I have a topic that’s central to our ongoing discussion on getting food addiction listed as an official diagnosis in the DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders) and ICD-11 (International Classification of Diseases). Those efforts are ongoing. There is a proposal currently under review by the American Psychiatric Association for inclusion of ultra-processed food use disorder as a substance-use disorder in the DSM-5, and other proposals are in the works.
Something that was a focus during the first International Food Addiction Consensus Conference (IFACC) in London last May was the need for research on withdrawal symptoms when you stop eating processed foods. So I wanted to update you on this research.
I belong to a group called the Food Addiction Professionals Network (FAPN). We have a journal article reading group there, and we recently reviewed and discussed an article called “Development of the Highly Processed Food Withdrawal Scale.”
The article was from 2018, and I hadn’t read it before. I didn’t know about this scale. It was created with 31 questions that measure physiological and psychological withdrawal symptoms.
Physiological withdrawal includes things like nausea, flu-like symptoms, shaking, joint pain, insomnia, and muscle aches. Psychological symptoms include feeling stressed, depressed, or anxious, having cravings or food thoughts, feelings of distress, or being overwhelmed or unable to cope.
Physiological symptoms come in two kinds: acute and long-term. Many people experience flu-like symptoms—headaches, muscle aches, and more—during the first four or five days of withdrawal. After that period, you go into another, longer phase where your leptin resistance starts to fade away and your dopamine receptors replenish and repopulate, which takes place over one to eight weeks. It could be longer.
Psychological withdrawal tends to peak early. In the first hours or days after giving up processed foods, your cue reactivity is high, which means that anything that reminds you of food is going to be distressing. The cues may hit you hard—for example, if a tv commercial comes on with images of food, it’s going to be attractive to you.
Cue reactivity goes up in the first days and weeks of abstinence—or longer for some people. If you’re not being fully bright, if you are intermittently reintroducing addictive foods, it could cause symptoms. But even if you abstain completely, in some very rare cases it could be a couple of years before it resolves. The clinicians in my article study group said they generally see a peak at around seven days, and then people turn a corner. I think it’s comforting to know that it doesn’t last forever.
For me, when I was in the worst throes of food addiction, I couldn’t get seven days Bright in a row. I could manage one or two days, but never seven. Seeking relief from withdrawal symptoms can drive us back to the food. Getting through the first week is really critical.
Currently we’re working to fill the gap in the scientific literature, putting out good studies using this validated scale. We need studies with a control group, daily measurements, and careful controls (like making sure people aren’t also withdrawing from caffeine and alcohol, for example). We need scientists doing careful research, and I want to be part of that group.
Right now, I’m writing up two papers to submit to the journal Frontiers in Psychiatry, for their special issue on ultra-processed food addiction. We are also retooling our own research program so that everyone in the Boot Camp can be included in the research voluntarily if they want to be.
If you’ve started Bright Line Eating, or have tried it before and experienced withdrawal symptoms that led you back to the food, just know that it passes. Keeping that in the forefront of your mind can be useful. Know that there’s a light at the end of the tunnel. You will feel Bright and free if you just hang in there.
