The Kick Sugar Coach Podcast
The Kick Sugar Coach Podcast
Dr. Susan Peirce Thompson: Why Some Foods Are Harder to Quit Than Cocaine
Dr. Susan Pierce Thompson delivers a powerful exploration into the complex reality of ultra-processed food addiction and the revolutionary approaches that enable sustainable recovery and weight loss. With her unique background as both a recovered drug addict and a brain scientist, Thompson brings extraordinary credibility to this conversation about why some foods trigger addictive patterns more powerfully than even cocaine or methamphetamine.
The podcast reveals exciting developments in how the scientific community is finally recognizing the legitimacy of ultra-processed food addiction. Thompson describes the recent consensus reached by 40 international experts working to have this condition recognized by the World Health Organization—a critical step toward better treatment protocols and policy changes. This recognition isn't just academic—it could transform how schools, healthcare systems, and governments approach our relationship with food.
Thompson's Bright Line Eating program demonstrates what's possible when we apply addiction medicine principles to our relationship with food. Their groundbreaking six-year follow-up research shows participants maintaining an average 14% weight loss—outperforming even the most celebrated weight loss medications without their side effects or costs. The "bright lines" approach creates clear boundaries around sugar, flour, meals, and quantities, helping participants develop automatic habits that remove the exhausting decision fatigue around eating.
Perhaps most compelling is Thompson's raw comparison between drug addiction and food addiction recovery. After 30 years of sobriety from substances, she shares why food addiction presented an even greater challenge: "There's nowhere safe to go in society when you're in recovery from food... your whole life is a cue to break your abstinence." Unlike recovering drug addicts who can avoid trigger environments, food addicts face constant exposure, making their recovery journey uniquely difficult but ultimately more rewarding.
Whether you're struggling with your relationship with food or simply curious about the science behind sustainable weight loss, this conversation offers profound insights that might forever change how you view ultra-processed foods and the possibility of true freedom from food obsession.
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Welcome everybody to an interview today with Dr Susan Pierce Thompson and I will hit you up some highlights from her bio. She has her PhD. She's an adjunct associate professor of brain and cognitive sciences at the University of Rochester. She's a multiple New York Times best-selling author of two books well, three technically now, but two that just went off the charts Bright Line Eating Cookbook and her original book Bright Line Eating, both of which if you don't own you need to. She's an expert and she's renowned as an expert in ultra-processed food addiction and how that corresponds with sustained weight loss. She's an expert in the psychology of eating, the president of the Institute for Sustainable Weight Loss and the founder of Brightline Eating, a global movement that helps people break free from ultra-processed food addiction and maintain a healthy weight loss long-term, which is what we're told is impossible. But I understand you've got some new research out six-year follow-up study to show us that it is not impossible, that in fact it's very doable. So welcome Susan. Thanks so much.
SUSAN:It's great to be here with you. Florence, it's great to be here. Thanks for having me.
FLORENCE:You're welcome, so every year you've been on my summit. I really appreciate it, and every year there's something new. There's something new research coming out, a new sort of collaboration of people working in this space. So I know you've got some insights, some new information to share this year.
SUSAN:So where would you like to start? Oh, great question. Let's start with the international collaborations that are happening on food addiction. It's really exciting stuff. I am relatively new, I guess, to the international food addiction scene. There were people years before I got involved in an organization called the Food Addiction Professionals Network, most of them in Europe. There is a woman named Esther Helga who's got the Infact School, which is a school based in Iceland, but it trains experts internationally Iceland, but it trains experts internationally. The graduates from her program are certified both in Europe and in the United States as food addiction professionals, as experts, and yeah. So she trains people to be clinicians helping people to recover from ultra-processed food addiction and she follows the basic standards and best practices from addiction medicine and applies it to ultra-processed food addiction.
SUSAN:And what's happening now is that there was an application back in 2021 to the World Health Organization to get ultra-processed food addiction included in the ICD, that's, the International Classification of Diseases. This is the internationally accepted list, like the registry, the encyclopedia of all the diseases, both physical diseases, parkinson's, cancer, all the physical diseases, and also mental diseases, depression, et cetera. Right, and of course, lots of addictions are listed in there, as you know, substance-related disorders, to cocaine and heroin and alcohol and things like that, and the application was to get food listed as one of the substance-related disorders, and the application was rejected and the rejection came out in November of 2021. It was a very thoughtful rejection. It was long and detailed and they said several things. Among them, we don't think we need to include this in the ICD because we have all these other food related classifications. They said, you know, we don't see how this is really that different from binge eating disorder or from all the obesity related disorders that we already have in here, and we think we're handling all of that pretty well. We've got, you know, people with these types of issues with food are already covered basically in the ICD, and so this sent the community sort of scratching their head and saying, okay, what do we think about this? They also said there isn't enough research to show that this is warranted or needed.
SUSAN:So over the last three years since then, people have been organizing and realizing that there wasn't enough international consensus on things like is this a legitimate disorder? If so, what should it be called? Is it food addiction? Is it processed food addiction? Is it ultra processed food addiction? Is it an eating addiction. Is it actually a behavioral addiction? Is it a substance use disorder or a behavioral or process addiction disorder? Is it really that different from binge eating disorder? And, if so, how should it be classified, and so forth.
SUSAN:And so they gathered together 40 experts from around the world psychologists, psychiatrists, neuroscientists, physicians, researchers of all ilks and I was one of the 40 people, and over the course of about a year we went through a process of coming to consensus on answers to those questions and we hashed it all out pretty thoroughly and what we ended up coming up with was a consensus statement, a consensus document, which you can read online. It's in the public domain now. Not everyone agreed 38 out of 40 of the experts signed on and, I think, probably the most contentious piece I'm not sure I can't speak for the two people who didn't sign on, but the name that we decided on was ultra-processed food addiction, and one of the reasons we didn't go with food addiction, which most of the scientific research is published using the term food addiction, and there's the Yale food addiction scale. Of course. That says food addiction, not ultra-processed food addiction. But the challenge is that. Well, a few things. One is there's good data now that all foods are not equally addictive. If it was an eating addiction, you would see people addictively eating all things equally, and it's not what you see at all.
SUSAN:There's very specific foods that get eaten addictively and then other foods that almost never get eaten addictively. There is an eating addiction component to it and some people could potentially, under certain circumstances, eat you know, iceberg lettuce addictively, or you know button mushrooms addictively or something. But by and large, the foods that get eaten addictively fall under a certain phenotype and that's, you know, ultra processed foods, right, sugar foods. The foods that get eaten addictively fall under a certain phenotype and that's, you know, ultra-processed foods, right, sugar foods, flour foods, greasy foods, fried foods those are the foods that get eaten addictively. And also, if you look at the substance use disorder category in the DSM, the Diagnostic and Statistical Manual of Mental Disorders, and in the ICD, you're looking at heroin, cocaine, alcohol. You're looking at basically very identifiable molecules like specific substances. Right, food is very broad, like, oh my gosh, you can hardly imagine a broader category, right.
SUSAN:And to say people get addicted to food then puts you in a position where it's not clear what to abstain from, the policy ramifications that would flow downstream from declaring food to be addictive aren't clear. Like what can governments then do about that right, like outlaw food? So when you narrow it down to ultra processed food, all of a sudden you give people at least some starter clarity on what to do about it and you give governments some policy recommendation teeth to say, okay, now we know what cannot be in preschools, what cannot be in school lunchrooms, what should not be served, you know. Uh, on our dime, on you, on government subsidy programs in prisons and schools, et cetera, and you start to have a path forward to getting us out of this mess. Because while it's not true that someone who has the addiction already is likely to recover if they only abstain from ultra-processed food and that's all they pay attention to, and that's a big concern, it is true that if we were, for example, to eliminate ultra-processed food from society tomorrow, we would go to great lengths to stemming the tide of the development of the addiction in next generations. So, anyway, so we met in London in May of this year, 2024.
SUSAN:We met in London and had a conference and it was wonderful, and I was one of the keynote speakers at that conference. I actually gave the talk at the end that summarized the workshop meetings that the experts had had the day before for two main follow-on projects. One is on more research, like what's needed to fill gaps in the research, and the other was on a committee to create a new application to the World Health Organization to get ultra-processed food addiction included in the ICD-11. So, yeah, so I've been talking for a long time, but I'm very excited and passionate about this work. I'm curious for your thoughts. I know you meant to be in London and there was a conflict so you couldn't be there. I was so sad that you weren't there.
FLORENCE:Oh, thank you. I was so bummed. I really agonized about the decision to not go. How can people get involved and support this work, Susan, Because I imagine there's lots of people going. Gosh go, 40 people go.
SUSAN:That's a great question. It needs funds. Very, very specifically, it needs funds. It's very hard to raise money to study a disorder that doesn't yet exist right, and we know that it exists, but there are some clinical trials that need to be run. There are some clinical trials that need to be run, and the work is being done by volunteers right now, and the movement very, very clearly needs funds, and you can go onto the website to donate. So, florence, maybe you could put the website for this in the, you know, in the link somewhere, the show notes or whatever you've got, and let people donate. I think that would be the number one way, yeah.
FLORENCE:That's brilliant because, yeah, we know that there's millions and billions and trillions being made from the companies that are really a part of the problem. And, yeah, if we stand a chance of, if we stand a chance at all of sort of having our voice heard and our warning and our suggestions to reach where it needs to reach, you're right, we probably need to start with getting some funds in place, and a little goes a long way. If everyone chips in, I'll definitely get the link in the show notes. Thanks for that. And tell us a bit about some of the research you've been doing clinical research through Bright Line Eating Is that correct? That helps track people over time to show what interventions seem to work in terms of turning the ultra-processed food addiction into remission and also with sustained weight loss.
SUSAN:Yeah, so we have just submitted for publication a six-year follow-up study on Bright Line Eating outcomes, and the results are pretty stunning. I mean, one thing that kind of blew me away is that we followed up on people who enrolled in our at the time, it was an eight-week program. It's now a 12-week program the Bright Line Eating Bootcamp. We, just a year or two ago, released Bootcamp 2.0, which is longer and better in lots of ways, but the original boot camp was very potent too, and so these were people who enrolled in an eight-week program in the fall of 2017. And we followed up with them six years later, in the fall of 2023. And so the only criteria for being included in these follow-up efforts was that they enrolled in one eight-week online weight loss program six years ago.
SUSAN:So, first of all, 50% of them replied with a response to the survey, which is pretty stunning, right? I mean, you know the people listening out here. I don't know how many surveys you get sent from something you did six years ago. I don't know how many times you're going to click on that link and reply. This was in an email, right, like so. So there was that. And then the the cohort again would be people who signed up and immediately dropped out, people who signed up and finished, people who signed up and did it for, you know, a couple months and then never did it again. Including people who did it for a year and then dropped out, people who did it for two years and then dropped out all the way up, to people who did it all six years and are still gung-ho right.
SUSAN:And what our data found was that while society at large has been continuing to gain weight over these six years, the people in our cohort, on average, were still maintaining every on average all of them, like on average across everybody, whether they still did Bright Line Eating or not a 7% weight loss. That's not seven pounds y'all, that's 7%. So just to put that in context semaglutide, wagovi it's Ozempic right, the weight loss drug Wagovi just released four-year weight loss results. People who are still on Wagovi they're still taking the drug four years later are maintaining a 10% weight loss, still on the drug right. These are people who, many of them, aren't even on the intervention anymore. Now the people who are still on the intervention are maintaining a 14% weight loss in Bright Line Eating six years later, again compared to 10% for Ozempic or Wagovi. So the intervention of Bright Line Eating is very powerful and people who continue to do it are maintaining weight loss at a result that's better than weight loss drugs Probably not as good as weight loss surgery, but probably pretty close.
SUSAN:Weight loss surgery has a lot of weight regained. Six years later you'd be in the domain of weight regain is happening. So trending up toward the territory of weight loss surgery with a purely behavioral approach, Right, so let's talk about the details of bright line eating.
FLORENCE:What is this behavioral approach and why does it work so well?
SUSAN:Well, what we teach people is to abstain from sugar and flour, like a bright line. That's what we mean by a bright line is a clear boundary that you just don't cross. So just like if you're going to quit smoking cigarettes, you're not going to dabble with smoking sometimes You're going to really have a bright line for cigarettes, a clear boundary that you just don't cross. So our bright lines are for sugar, flour, meals and quantities. So that means we're not snacking in between meals. We're doing three meals a day typically, although the Bright Line isn't for the number of meals. It's just that you're not eating in between meals. So you could do Bright Line eating and eat two meals a day or four or five meals a day, but we recommend generally people start out with three meals a day as a starter and adjust from there if they need to, and the quantities are typically weighed with a digital food scale, and that's not to restrict quantities. People eat typically more food on Brightline Eating than they expect to, and for some people then they want to be eating. People write in and say the right balance and composition of food. So a digital food scale is very helpful for that and mostly the digital food scale helps to create freedom, so that you're not thinking about whether you should go get more because you know you had the right amount already. So there's the food plan part, and I could talk a lot more about the food plan part. It turns out that the secret to the food plan is something called automaticity, which is that it's optimized scientifically to make it as easy as possible to become automatic, to become rote, like brushing your teeth, right? It's this magical thing that, whether you're, for most people 95% of people whether you're sick, you're tired, you're traveling, you brush your teeth before you go to bed, right? But for most people, eating is not like that. It's not automatic. You're making decisions about what to eat and whether you're frustrated, fatigued or you've just been sitting in traffic it's a Friday night has a big impact on whether you decide to order a pizza for dinner or whether you actually get out the lettuce and start making the salad and start grilling the chicken or whatever you intend to be having for your healthier option. So getting people on a style of eating that's more automatic is a big part of it.
SUSAN:We have a huge social component of our program. People feel more loved, connected and seen and heard and felt than they've ever felt in their lives because we have such a loving, supportive community and we've got a lot of support structures that you know buddies and mastermind groups and study buddy groups and all sorts of social technology, online support communities and live coaching and all sorts of social technology, online support communities and live coaching and all sorts of things that help people connect up. And then there's a lot of behavioral retraining like habits and meditation and a morning habit stack and an evening habit stack. So it's a whole life transformation. People end up being healthier than they ever imagined, being happier than they ever imagined, and the people who do it really flourish. We have published data showing that their energy goes up. Their depression goes down. Clinically depression goes down. Days of poor mental health go down. Life flourishing goes up. Feelings of being loved and supported in the world go up.
SUSAN:Weight loss is equivalent across all ages. This was a study we published with 4,509 people showing that on Bright Line, eating 60-year-old women lose weight as fast as 20-year-old women, literally, and that's because I mean you might think that's impossible. We know that post-menopausal women have a hard time losing weight metabolically speaking, but it turns out the reason for that is that their lack of estrogen isn't there to facilitate their insulin, and insulin is a fat storage and fat release hormone. But when you change your eating the way we do in Bright Line Eating, you're not messing with your blood sugar. It doesn't matter that you don't have estrogen on board anymore to help out your insulin, because you're not jacking with your insulin anymore by eating your keto bar or your ultra-processed 100-calorie snack baggy, thingamajiggy You're not eating any of that stuff anymore, so you don't need that estrogen to be helping your insulin. Your insulin is fine because you're eating the right foods, finally.
SUSAN:So anyway, yeah, it's an amazing program and we just passed our 10 year anniversary. We've been around for 10 years. Over 2 million people have joined our email list and gotten free information on the psychology and neuroscience of of healthy eating and life transformation and weight loss. And I've gotten really into the semaglutide drug craze lately and just studying it and learning about it and I'm still super curious about that. But yeah, that's basically what Bright Line Eating is. I don't know if you have any questions or if I did a good job explaining that, but yeah, Amazing, amazing job.
FLORENCE:And I just wanted to add that you know, a hundred years ago, if you said to people, yeah, this is what I do for a living, this is my calling, this is what I do. I teach people how to eat three meals a day, no snacks, whole foods, only to get up and have some quiet time in the morning, to get to bed on time and connect to each other, they would laugh their heads off right. You think, like what People pay you to tell them to eat three meals a day and no snacks and whole foods? Like who doesn't? Okay, maybe more than a hundred years ago, only just right, like it's so basic, it's nothing radical, nothing, nothing not doable, it's, it's just common sense to you know, just that's how people lived.
SUSAN:Thank you for saying that. I know some people hear like no sugar, you're like? Well, first of all, it's not healthy to cut out whole food groups, to which I say, well, hold on. So since when did sugar become a food group? Sugar is not a food group. We eat all whole, real foods in Bright Line, eating every single one.
SUSAN:But then also some people say it sounds really extreme and I just think, oh my gosh, but aren't you injecting yourself with insulin in every day, and didn't you just have a quadruple bypass and didn't they crack open your chest cavity and then do stuff to your veins and your artery? That's extreme. What we are now facing as normal is super extreme. What people are going through I mean diabetes is shortening people's life by 10 years on average, and then some people get a limb amputated. And then, of those who get a limb amputated, 55% of them will have the second limb amputated within a year or two, which just goes to show this is truly addiction. You know, we have like become really normalized to this incredibly rampant addiction that's among us.
FLORENCE:Yes, and we've all sort of taken on the idea as well from mainstream marketing very clever that you know everything in moderation and that you know it can create an eating disorder if you restrict ultra processed foods. And some of the emerging really early science from my understanding is that it actually shows that the ultra processed foods more predisposes more to eating disorders. Right, that is not necessarily the cause of it. It's it's it's.
SUSAN:It's complicated for sure, but yeah, yeah, let's pause right there at that point. That is what the data are showing is that if you look at people with disordered eating, with eating challenges right, and you track their life history, usually the most common trajectory is that the food addiction symptoms were there first. What they developed first was food addiction. So what do I mean by food addiction? I mean difficulty controlling how much they eat, obsession with food, an inability to cut back, to quit, to lay off certain foods, even though you want to. You're trying to right, trying to stop eating chocolate, trying to not eat the whole box of chocolate, et cetera. Not binging yet right. This is not eating disorder behavior, this is addiction behavior. And then what happens is the eating disorder develops as a compensatory mechanism to try to handle the addiction. So they start to try to put in food rules to help them. They develop bulimia right To get rid of the after they eat. They know they're gaining weight. They develop bulimia as a compensatory mechanism to handle the food addiction.
SUSAN:So what's really interesting actually is, when you get treatment for food addiction in the mix, you actually help prevent a lot of eating disorders and you actually start to treat a lot of eating disorders properly, because a lot of people with eating disorders also have food addiction about 50% of them do and if they've been getting standard of care, eating disorder treatment in an all foods fit for all people, moderate eating, intuitive eating framework, and they're sitting there and literally an eating disorder treatment in an all foods fit for all people, moderate eating, intuitive eating framework, and they're sitting there and literally an eating disorder inpatient being told that they have to eat this donut. You know to be a good patient. They're sitting there eating that, thinking I know this is going to lead to a binge, this is not food that I can handle, but they try to voice that and the and the therapists say you know, that's just your eating disorder talking. You've got to eat that donut. It's just one donut, it's a moderate amount, it's part of your recovery. You just rice and broccoli. They start to recover and some of them have been to several rounds of eating disorder treatment.
SUSAN:So it is nuanced and there's many different trajectories and, yes, for some people, having the types of boundaries that we have in Bright Line Eating is triggering in some ways. So people are different and one person's medicine is another person's poison. But it is not the case in my experience. Nor do I think the research shows that, on average, eating disorders are kicked up by an abstinence approach to food addiction. As a matter of fact, I think it's the opposite. On average, eating disorder prevalence goes down when you start to treat food addiction symptoms.
FLORENCE:Absolutely yeah. We see a trending down to bulimia and obsessive, compulsive behaviors, binge eating, bulimia all of it seems to seem to. It seems to improve. However, I will say that there is. There's this message that if you can't do it, it's either because of restriction. It's the root cause. If you didn't restrict, that would resolve itself. Or you've got these other issues that you need to work through, like trauma or childhood adverse experiences, and if you work through that, so if you work with the psychological underpinnings of your, of your disordered eating, or if you stop restricting, that, that would solve it. And there's this third pillar, this third piece that you know that we're bringing to the table. That's just starting to surface and through your work and all the others, you know to say what about the role that addiction plays? Because it's real. It's real for people for whom it's real.
SUSAN:Yeah, it is real. And still some people are going to struggle right, because if you look at addiction in other contexts too, not everybody who goes to rehab comes out a winner. The first time, right Addiction is a beast and the average smoker quits a couple dozen times before they actually quit. And people quitting alcohol and other wicked substances relapse all the time. And food is the hardest.
SUSAN:I mean, we didn't get into my background, but I come from a drug addiction background. I was a cocaine addict, I was a crack cocaine addict, I was a crystal meth addict, I dropped out of high school, I was a prostitute. I have bona fide creds when I talk about addiction. I lived in a hell of addiction for many, many years and then I got clean when I was 20 and my addiction just jumped right to food. And I can tell you right now food has been harder, harder to kick, harder to treat than crack cocaine, harder to treat than crystal meth, because it hijacked my brain more intensely. But because there's nowhere safe to go in society when you're in recovery from food, there's everywhere you go, someone's trying to get you to eat something else.
SUSAN:Every commercial, every billboard, every your whole life is a cue to break your abstinence. Whereas you know, if, like I was, I was, you know, at the end of my drug addiction I was living my life in this little neighborhood in San Francisco, sort of between South Van Ness street and mission uh mission street, and I was mainly in this crack house and I would put on this blonde wig and I'd go work and I'd make a bunch of money and then I'd come in the crack house and I'd stay there for a few days and smoke it up and then I'd go out and make some more money, come in the crack house and smoke it up. When I got clean, I left that neighborhood and I moved in with my mom and I went to work at a movie theater selling popcorn and although now I had cues to eat addictively, I no longer had to grapple with cues to smoke crack addictively. There were none, there were no billboards, no one in my family was suggesting that I do it, no one at work was suggesting that I do it.
SUSAN:I lived a life almost utterly free from cues to use right, I changed people, places and things. If ultra processed food is your drug of choice, you cannot, cannot, no matter how diligent you are being in your recovery, change people, places and things. There's no way, unless you're going to be a monk and, and you know, absent yourself from society entirely, right Like so. That's why it's harder, it's just harder.
FLORENCE:Totally, and I imagine it's harder as well. I haven't, I don't have a background of drug and alcohol abuse, but I imagine that it's harder because that voice in your head that says, oh, just have a cigarette, it's no big deal, it's good for you, it's fine, everyone else is doing it as a lie and your brain goes that's a lie, I don't need alcohol, I don't need the cigarettes, I don't need crack cocaine. There's no part of my brain that actually believes that voice, the addictive voice, when it says it's fine. But when the voice says, well, everyone else is eating it, it's okay, it's not so bad, like you kind of can fall for it, you're right, it's just a bite, it's just a cookie, my grandma made it, it's like right, like it that lie.
SUSAN:Totally yeah. The voice, the seductive, rationalizer, voice the seductive or the loving grandmother, you deserve it. You deserve a treat. You've had such a hard day.
FLORENCE:There's so many archetypes of the saboteur in our mind, right yeah, so many different angles that that voice plays, the addictive voice plays that works on us. We buy it. If we buy it, we'll relapse or slip, we will. It just makes sense, but it, yeah. The other thing I wanted to mention is that, back to that whole idea that restriction causes, you know this disordered eating that we're calling food addiction, and that they are separate. In Sweden, bitten told me that they actually have approved surgeries that are covered under their medical system that allows you to book yourself in or a doctor will say, yes, this person cannot stop eating. They qualify for the surgery. Do you know what the surgery is? Do you know?
SUSAN:what I'm going to know. No, no, what are you talking about?
FLORENCE:Fascinating they will. You know how you get a pouch for your colon or your kidneys, like your bladder? A colostomy bag? Yeah, you can have it for your stomach, so you can binge and you can empty the contents of your stomach into your pouch and then you can keep eating. No, way. I'm not kidding you. True story, because there's this whole idea that some of us can't stop.
SUSAN:So how does the person get nutrients? Yes, I need a little more information on this.
FLORENCE:Well. Well, if you're binging junk food and you feel bad about it, you empty your pouch and then maybe you know you don't empty the pouch if, if it's healthy, whole foods Like. I think there's some sort of like capacity to be discerning on what stuff you're emptying out instead of bulimia coming up this way You're doing right, instead of bulimia coming up this way.
SUSAN:you're just right. So what's really interesting? I just want to pause here for a second Florence, because the really tragic part is that I know I'm a gutter drunk food addict and I know that there are people listening to this right now for whom that sounds like a really good idea.
SUSAN:They're like, oh, I need that, you know. Then, really, I could just eat, and eat, and eat and it's just going to go into this little bag that I could cover up in my coat, you know, and just flush it down the toilet. It's signed me up, that's exactly what.
FLORENCE:I want, yeah, and that sounds like heaven. That sounds like heaven on earth. It sounds like the magic pill sort of equivalent that I've been looking for. And yet, if that is an evidence that this isn't addiction, so when you understand that if you're struggling to stop it might be addiction, in which case then there's protocols in place that can help you recover, just like any other addiction. Right, there's best practices. I don't know if you'd be open to going there. Do you want to share anything more you want to add other than the fact that Bright Line Eating has got all these best practices in play? But anything else you want to say about that, to sort of let people know that if you're caught in the grip of this, you know there's a way out.
SUSAN:There is, yeah, I mean, I think, check out our masterclass If you go to brightlineeatingcom. I don't want to make this an advertisement for Bright Line Eating, but we you know, I'm a brain and cognitive sciences professor and for eight years I taught a college course on the psychology of eating and the neuroscience of food addiction and I teach people for free all about this. So if you're interested and you're curious, go watch a free masterclass and just learn about it. It's just free. If you go to brightlineeatingcom B-R-I-G-H-T-L-I-N-E brightlineeatingcom G-H-T-L-I-N-E brightlineeatingcom Right there you'll see the free masterclass.
FLORENCE:It's two hours, it's fun, it's interesting, it's a college-level education and if you have this condition, it'll teach you about your brain in ways you might be interested to learn, and the upside of this brain, on the other side of this addiction, when it stopped being hijacked by these ultra-processed foods. What's possible? What's possible for our brains, these brilliant, sensitive, creative, easily obsessed? Totally.
SUSAN:Tell us a bit about some of the research you're doing with the GLP-1 drugs. Is there anything you wanted to say about that? Yeah, so let me. I have a slide that's in an article that I published earlier this year that I just want to show you, because we publish our data and not many people do, and the GLP-1 folks, they publish their data too. So this is comparing semaglutide Semaglutide you've heard of semaglutide, right, it's Ozempic, it's Wagovi, right, and this is our program Bright Line Eating.
SUSAN:And then here's Noom, weight Watchers, slim Fast, atkins, nutrisystems Zone. These are common programs and really, florence, you could put any program that's had data published on it vegan, whole foods, low fat, high fat, all of them right. Keto they're all down here. Basically, research shows that when people start losing weight in the first two months they lose three to 5% of their weight. Now, with Bright Line Eating, they lose way more than that, just about double that. So that's the first thing to notice is people are losing twice as much weight immediately in the first two months on Bright Line Eating as they do on Ozempic. That's because I think they have to gradually introduce the Ozempic, because it makes people feel so sick if they start on a full dose right away. So they have to start on like a one or one 10th of the dose and gradually build you up. So by two months in you may not even be at a full dose yet. So that's why the weight loss is slow at first.
SUSAN:But with Bright Line Eating you lose weight really fast at first and then after that most programs really differ. For some programs the weight loss really ends at about four to six months and people start to regain weight, like with Atkins. Some programs like SlimFast have pretty stellar weight loss results up to a year, but almost none of them have good results at two years. This is why they don't publish two-year results. You see Weight Watchers here published two-year results that look pretty good compared to their other results, but you can see it's just 3% here. If you just think about what that means, 3% is really not much. It's like someone was 300 pounds and over two years they lost nine pounds. Right, it's nothing. So these are all abysmal results and this is the research literature that just shows diets don't work. Diets don't work and as much as Noom claims they work, none of them work. They just don't work.
SUSAN:And at two years people have regained the weight With Bright Line, eating and Ozempic. The results are pretty stellar. It's a significant amount of weight and it lasts. Now, like I said at the beginning, our six-year results are 14%. So there's not weight regain for people who are still doing it still members still actively doing it 14% at six years, whereas semaglutide has trended down to 8% at four years, meaning the brain is adapting to the GLP-1 drug right. It's not having as strong of an anti-appetite effect at four years. So anyway, you can find these data and all of the citations and stuff published in the paper that I published recently called the Badly Behaving Brain how Ultra-Processed Food Addiction Thwarts Sustained sustained weight loss. I can give you the link for that, florence, so you can put that in the show notes too.
FLORENCE:Perfect, so great. And the thing that I find the most ironic maybe annoying about the research on these GLP-1s and I'm not saying they don't have a place, and I'm not saying that some people haven't used them short term to buy them some space from the unrelenting cravings of ultra processed foods and to sort of get their heads wrapped around what our whole foods get in the kitchen, start cooking again, learn some recipes, right to support themselves, to create a lifestyle change and then to drop the drug and carry on. So I'm not saying it doesn't have a place, but it's going to go and get credit, that those drugs are going to get credit for doing what we're talking about on the summit. Just drop the ultra-processed foods, right Like you drop your appetite, you don't have as much interest in eating and you're eating less of the processed foods and you get the benefits of weight loss.
FLORENCE:I recently saw a study that says that the GLP-1s improve kidney function. Is it really the drug or is it the fact that they're eating less ultra-processed foods which is it? Is the drug going to get credit for doing what reducing, if not eliminating, ultra-processed foods are doing, and are they going to tease that out? Doubt it, I think the drugs will just go take all the credit. And it's actually-.
SUSAN:Yeah, it's tricky. So there's a few things here. It does look like, at least in the cardiac data, that the benefit to the heart is above and beyond the weight loss itself, which is interesting. So the drugs may have some benefit for certain organs and systems. Now, careful, because not all. They're causing tremendously damaging retinal issues, eye issues, in a non-trivial subset of people. Something like six to nine percent of people who take them are developing a retinal issue that can lead to blindness, and it's a very serious deal. And I wonder if you know, just like fen-phen, these drugs might be off the market soon, because it's actually kind of a big deal, this retinal thing. You can look that up, but it does look like the benefits to certain organs and systems are above and beyond the weight loss.
SUSAN:These drugs help people eat less food overall, but most people, most people are not eating better food, they're just eating less food, right? As a matter of fact, the appetite suppressant is so intense for some people that they almost default to simpler foods. They're eating white bread, they're eating chocolate because it's all they can stomach eating, and you know the feeling of like being really nauseous, like how a salad is the last thing you can eat when you being really nauseous, like how a salad is the last thing you can eat when you're really nauseous. For a lot of people, that's what they're experiencing, and they can't eat healthy foods. On this, now, I know, you know I'm very pro-choice when it comes to these drugs. I know a lot of people who are benefiting from them tremendously. The thing that I find most interesting about them is how seldom people stay on them. Even when they have the money to be on them, even when their insurance is covering them, they get off of them. Like 70% of people don't even stay on them for a year. And you look at that.
SUSAN:I was talking to my endocrinologist about this because I was asking him hey, are you prescribing these drugs? He's like oh, yeah, hand over fist. And I said how's it going for your patients? And he said well, a lot of them stop using it. And I said, yeah, isn't that interesting? And he said the reason they stop is because they find they don't want to live in a world where they get no pleasure from food or drink, like a world where they sit down to a latte and they're just like, oh, I can't, I don't even want to drink this, like yuck.
SUSAN:It makes the aversion to food so intense. And then they find themselves thinking I don't want to live in this world Like there's no pleasure from food. Now I eat three meals a day no sugar, no flour but I love my food. I get tremendous pleasure from my food. I sit down to a meal and it's like exact in the same way that I get pleasure from my hot shower. It's not like I'm thinking about my hot shower all day, but I love my hot showers and I would be devastated if you took them away from me. But I have them. I don't think about them before afterwards and I move on with my life. That's how I feel about my meals. They're amazing and I wouldn't want to live in a world without them.
FLORENCE:And people get off these drugs because they can't stand a world where food holds no pleasure for them. That's so interesting, yeah. And even I mean I'm sure that the data will be done, that they'll show that the reduction of appetite and the reduction of the consumption of ultra-processed foods even if the foods that are left are still ultra-processed, it's a significant reduction is playing a big part of what's making these drugs look so great. It's just that simple, like just if we could help support people to reduce, if not eliminate, their consumption. And if you're on the addiction spectrum, try abstinence, get the support you need. We can always go back.
SUSAN:One more thing about these drugs, Florence, is that as a brain scientist, right, I just need to speak up here because we don't know yet at all what these drugs are doing to the brain long-term, especially for people who have a more addictive relationship with food. So let's imagine that you're a binger, that you really have struggled with sugar, right Of overeating. You are one of these people who eats a box of chocolate and can't stop. You are one of these people who goes through drive-thrus and orders two meals and eats it up in your car, feeling guilty and ashamed, right? If you have that kind of relationship with food, you can go on these drugs and the research shows that you will get relief, most likely pretty profound, miraculous feeling relief. And that's not all. An appetite suppressant effect.
SUSAN:Glp-1 is impacting the reward centers of your brain effect. And not only are GLP-1 receptors in the reward centers of the brain, but they're all through the brain. It's like serotonin, right, which is people take selective serotonin reuptake inhibitors and then they're like oh my gosh, I don't want to have sex anymore. Oh, my sleep is off now. Oh my, I've gained some weight, right? Why? Because serotonin is all through the brain and you can't just like, increase the effect of serotonin in the brain and not affect all these other systems. The effect of serotonin in the brain and not affect all these other systems. So we don't know that much about what GLP-1 is doing all throughout the brain. And what we don't know is if someone who had a really addictive relationship with food goes on one of these drugs, stays on it for a couple of years, two, three years, goes off it, as most people do, or maybe stays on it three years, goes off it, as most people do, or maybe stays on it. What happens then? You go off the drug. Does your binging go back to as bad as it was before? Is it better now? Is it worse? What have you done to your brain now? We don't know.
SUSAN:You know GLP-1 is a naturally occurring hormone in the body that goes up very briefly when you eat and then right back down so that you start to feel like you could eat again pretty soon after, an hour or two hours later. The body is used to low levels of GLP-1, generally speaking, and high levels for very brief times right after you've eaten. That's what it's expecting To bathe the body and the brain in high levels of a fake form of GLP-1, it's not bioidentical, it's a fake form. It's an agonist. It's not actually GLP-1, it's a fake molecule you're taking into your body at extremely high levels all the time. We have no idea what that does to the brain long-term, and nor does Novo Nordisk, by the way, Like they don't know either. And they're happy, you know. God bless them. They're happy to make their billions, you know, but we need to be watching very closely for this and Novo Nordisk is not going to publish this data. We need to be looking, especially for the people who had a bingey relationship with food going in, what happens going out.
FLORENCE:Incredible. Thank you for that. Yes, and I think that it's people working on the front lines. It's going to be clinical data, not necessarily the in the labs gold standard, all the stuff that these pharmaceutical companies will probably be doing. But yeah, just the anecdotal story and just keep sharing it around, keep having conversations and keep supporting each other. We can do this. For the most part, we can unhook from these foods and little support goes a long way and some good science, and we're in this together. You're not alone. It's hard and we miss it, and then you don't. You're free. It's the life beyond these ultra processed foods. That's way, way, way, way better. You just need support.
SUSAN:Totally, totally, yeah, I mean I can share. Now I'm years free from food and 30 years free from drugs and alcohol. I just had my 30 year sobriety anniversary clean and sober anniversary shortly ago sober anniversary shortly ago and what I can say now is, for the last couple of years, almost all of the time and I say almost for a reason I can remember a week or two here or there where it's not true Almost all of the time I've been completely addiction-free for the last couple of years. No one I've been texting with obsessively that I have some kind of sexual intrigue with. Nobody that I'm fantasizing about.
SUSAN:No caffeine or decaf that I'm drinking every morning with any kind of need or addiction. No whirly twirl with cigarettes again. No food that is calling to me addictively morning, noon or night. No food that I'm thinking about whether I'm going to cook for a company or thinking about whether I've eaten or not eaten the right amount. No shopping behavior where I'm one-clicking and feeling a rush of guilt or the package arrives from Amazon and I'm thinking why did I buy this? No addictive behavior whatsoever.
SUSAN:For the last two I just say most of my 30 years in recovery I've had some form of addictive behavior whatsoever. For the last year and I just say most of my 30 years in recovery I've had some form of addictive behavior like happening. You know, I often think that one of the reasons I've stayed clean and sober so long is because I've had other things to use. You know, god bless me, I'm certifiable, but recovery is real. You know, addiction is progressive but recovery is progressive and there's a level of peace and integrity and self-esteem and gratitude and spaciousness that's possible on the other side of putting down those foods. It really is worth it.
FLORENCE:Wow, what a powerful note to end on, but I'll give you an opportunity. Is there anything else you want to add before we wrap up today? Note to end on, but I'll give you an opportunity.
SUSAN:Is there anything else you want to add before we wrap up today? No, just thank you for your work, florence. I'm really grateful that you do this summit and, yeah, thank you for your work.
FLORENCE:Thanks everybody for tuning in today.
