In this insightful and compassionate episode, Clarissa and Molly take a deep dive into post-acute withdrawal syndrome (PAWS)—an often overlooked but critical phase in ultra-processed food addiction recovery. While well-known in substance use disorder recovery, PAWS is rarely discussed in the context of food addiction, yet it shows up in significant ways.

Clarissa and Molly break down what PAWS is, why it happens, and how it can show up months or even years into recovery. They share real client experiences, neurobiological explanations, and clinical insights—plus, they normalize what can feel like a confusing and distressing time. They also offer practical strategies for clients and clinicians alike, always with compassion, humor, and a forward-thinking, growth-focused perspective.

💡 Key Takeaways:

✅ What is PAWS? Post-acute withdrawal syndrome describes the emotional, psychological, and physical withdrawal symptoms that can persist or reappear months or years after quitting a substance (including ultra-processed foods). It’s a normal part of recovery, not a failure or a sign that you’re “doing it wrong.”

✅ When it shows up: Typically around the 3-, 6-, and 12-month marks, but can happen later—Molly shared an example of it showing up at 22 months! Can be a surprise to those who believed the cravings and struggles were only short-term.

✅ What it feels like: Physical symptoms: low energy, sleep issues, fatigue, and “meh” motivation. Emotional symptoms: irritability, anxiety, low mood, feeling “flat” or joyless (anhedonia). Cognitive symptoms: brain fog, intrusive food thoughts, and the return of “food dreams.” A heightened sensitivity to emotional triggers and stress, feeling like everything is a “zing” or too much.

✅ It’s actually a sign of healing. The brain is rewiring—dopamine pathways are adapting and recalibrating. It’s part of long-term recovery, a sign that deeper healing is taking place.

✅ Common client fears: “I thought I had this figured out—why am I struggling again?”
“My coping skills don’t work anymore—what’s wrong with me?” Clarissa and Molly reframe this as an invitation to deepen your recovery work and adapt new strategies.

✅ What helps? Revisit the basics: simple structure with food, movement, sleep, and stress reduction. Connection and support: peer groups, Sweet Sobriety, or other safe spaces. Meaningful, non-food dopamine boosts: nature, creativity, connection, movement. Supplements: like omega-3s or l-glutamine (check with your provider!). Clinician support: not pushing but holding space with compassion and curiosity.

✅ For clinicians: Learn about PAWS from the substance use disorder literature—it’s crucial for validating and normalizing the client experience. Support clients without imposing your own fears about relapse—meet them with presence and empathy. Be mindful of co-occurring issues (trauma, chronic illness, medications) that can amplify PAWS. Don’t pathologize or shame—this is part of the healing arc!

This conversation is a powerful reminder that healing is not linear. PAWS can feel like a step backward, but it’s actually a sign of forward movement. As Clarissa and Molly beautifully put it: “You’re not broken—you’re healing.” When PAWS shows up, it’s a call to pause, reset, and give yourself the same compassion and patience you’d offer anyone else in deep healing.

Want to connect? Reach out to the team at:
📧 foodjunkiespodcast@gmail.com

Get Mollys PAWs Presentation here: https://www.sweetsobriety.ca

The content of our show is educational only. It does not supplement or supersede your healthcare provider's professional relationship and direction. Always seek the advice of your physician or other qualified mental health providers with any questions you may have regarding a medical condition, substance use disorder, or mental health concern.

In this illuminating episode we speak with Dr. Filippa Juul. An epidemiologist and leading researcher on the impact of ultra-processed foods (UPFs) on human health. Together, we unpack what ultra-processed really means, why it's not just about calories or macros, and how these foods are stealthily contributing to the global rise in obesity, chronic illness, and food addiction.

Dr. Juul is Assistant professor at the School of Public Health at SUNY Downstate Health Sciences University. She earned her PhD in Epidemiology from NYU GPH in 2020, following a MSc in Public Health Nutrition from the Karolinska Institute in Stockholm, Sweden, and a BA in Nutrition and Dietetics from Universidad Autónoma de Madrid in Spain.

Dr. Juul's research focuses on improving cardiometabolic health outcomes at the population level, with a particular interest in the role of ultra-processed foods (UPFs) in diet quality, obesity, and cardiovascular disease. She utilizes large U.S. population studies to examine these associations and is also exploring the biological mechanisms underlying the impact of UPFs on cardiometabolic health.

Dr. Juul explains the NOVA classification system, dives into recent groundbreaking studies, and offers insights into why UPFs are so difficult to resist—and what we can do about it, both individually and at the policy level.

Key Takeaways

🧠 It's About the Processing
Ultra-processed foods (UPFs) are engineered for convenience and hyper-palatability—not nourishment. Processing changes how the body absorbs and responds to food, often leading to overeating and poor metabolic health.

📚 NOVA System in a Nutshell
Group 1: Whole/minimally processed (e.g., fruit, eggs, plain yogurt)
Group 2: Cooking ingredients (e.g., oil, sugar, salt)
Group 3: Processed foods (e.g., canned veggies, artisanal cheese)
Group 4: Ultra-processed (e.g., nuggets, soda, protein bars)

🍟 Why We Overeat UPFs
Soft, fast-eating textures bypass satiety signals
High energy density = more calories, less fullness
Hyper-palatable combos (fat + sugar/salt) trigger cravings
Rapid absorption causes blood sugar spikes and crashes

🧬 Health Risks & Mechanisms
Linked to inflammation, gut imbalance, and poor glycemic control
Some additives may be harmful or addictive
Genetic factors may influence vulnerability to UPF addiction

🚸 Policy & Public Health
UPFs make up 60–70% of the modern diet
Strong links to obesity, heart disease, diabetes, and poor mental health
Regulation on marketing, school meals, and additives is critical
Teaching cooking skills and nutrition literacy is essential

❤️ Rethinking Nourishment
Nourishment means satisfying, whole-food meals—not restriction
True recovery is about reclaiming joy, not giving up pleasure

💬 Quotes:
“We regulate food by volume, not calories—and UPFs pack a punch.”
“Nourishment is key to living a healthy, happy life.”
“UPFs don’t just harm—they replace what heals: real food and connection.”

📣 To Policymakers:
The obesity crisis is urgent. Make whole, nourishing foods affordable and accessible. Regulate what’s sold and marketed—especially to children.

Follow Dr. Juuls Research: https://www.researchgate.net/scientific-contributions/Filippa-Juul-2070176684/publications/3

The content of our show is educational only. It does not supplement or supersede your healthcare provider's professional relationship and direction. Always seek the advice of your physician or other qualified mental health providers with any questions you may have regarding a medical condition, substance use disorder, or mental health concern.

Dr. Cynthia Bulik is a clinical psychologist and one of the world's leading experts on eating disorders. She is the Founding Director of the University of North Carolina Center of Excellence for Eating Disorders and also the founder director of the Centre for Eating Disorders Innovation at Karolinska Institutet in Stockholm, Sweden. Dr. Bulik is Distinguished Professor of Eating Disorders in the Department of Psychiatry at UNC, Professor of Nutrition in the Gillings School of Global Public Health, and Professor of Medical Epidemiology and Biostatistics at Karolinska Institute.

Dr Bulik has received numerous awards for her pioneering work, including Lifetime Achievement Awards from the National Eating Disorders Association, the Academy for Eating Disorders, and the International Society of Psychiatric Genetics. She has written over 750 scientific papers, and several books aimed at educating the public about eating disorders.

Currently, Dr. Bulik's focus is in the reconceptualization of eating disorders as being a metabo-psychiatric diseases. Food Junkies is keen to explore this interest in how metabolic disease plays a role in disordered eating: can this construct be the common ground to start to understand the muddy waters between eating disorders and food addiction?

In This Episode, You’ll Learn:
💡 The Myth of Choice: Why anorexia, bulimia, and binge eating are not willful acts, but biologically driven conditions with strong genetic roots.
🧬 The Metabo-Psychiatric Model: Dr. Bulik's innovative framework showing how genetic and metabolic pathways interact to shape eating disorder vulnerability.
⚖️ The Energy Balance Switch: Why people with anorexia feel better in a state of starvation—and how this paradox rewrites what we thought we knew.
📈 New Genetic Discoveries: How genome-wide association studies (GWAS) are uncovering shared and distinct risk factors for anorexia, bulimia, binge eating disorder—and possibly food addiction.
🔄 The Overlap with Addiction: Where eating disorders and food addiction intersect—and why treatment needs to consider both psychological and nutritional healing.
🧠 Recovery Isn’t Just Psychological: Why intuitive eating and one-size-fits-all treatment plans may not work for everyone—and what truly individualized care could look like.
🧭 Hope Through Science: How understanding the biology behind disordered eating can reduce shame, validate lived experience, and open new doors for healing.

🔗 Topics Touched:
Why abstinence-based recovery may be life-saving for some—and harmful for others
The risk of relapse tied to negative energy balance and undernourishment
What we can learn from addiction recovery in developing dual-diagnosis programs
The danger of renourishing with ultra-processed foods
ARFID, orthorexia, and the need for diagnostic nuance
The promise of personalized treatment using genetic risk profiles

💬 A Quote to Remember:
“Recovery from an eating disorder is an uphill battle against your biology. It’s not a lack of willpower—it’s a metabolic and psychiatric legacy that deserves compassion and understanding.”

Be a part of Cynthia's Research: https://edgi2.org/

Follow Cynthia: https://www.cynthiabulik.com

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The content of our show is educational only. It does not supplement or supersede your healthcare provider's professional relationship and direction. Always seek the advice of your physician or other qualified mental health providers with any questions you may have regarding a medical condition, substance use disorder, or mental health concern.