Live Q&A Part 2: Food Addiction vs Emotional Eating (Plus Sweet Cravings & Identity Shifts)

Understanding what empowers you vs what makes you feel broken

“It feels like I must eat and I don’t know how to not do it. Is there such thing as food addiction or is it all emotional eating that’s driving me?”

This question came from a physician during my live Q&A Part 2, and I could feel the desperation behind it. Because I’ve been there too – convinced that certain foods had some power over me that I couldn’t break.

This is Part 2 of my live Q&A series where we dive into the deeper questions that keep physicians up at night. The stuff that makes you wonder if you’re fundamentally broken. (Spoiler: you’re not.)

The Questions That Hit Deep

In this episode, I tackled three questions that get to the heart of our complicated relationship with food:

Question 1: Is it food addiction or emotional eating? When it feels like “I must eat and I don’t know how to not do it”

Question 2: What do you do about sweet cravings hitting every 4-5 days when eating low carb high fat?

Question 3: How do you handle identity shifts when your health finally improves after years of limitations?

These aren’t surface-level questions. This is the deep work.

The Food Addiction Question: What Actually Matters

As physicians, we love clear diagnoses. When we can’t control our eating around certain foods, labeling it “addiction” can feel like relief – finally, an explanation for something that’s been torturing us.

And there IS legitimate research supporting food addiction, particularly around highly processed foods and sugar. Many of our eating patterns do meet DSM-5 criteria for addiction.

But here’s what I’ve learned after years of struggling and now coaching hundreds of physicians:

The label you choose matters less than whether it empowers you to change or makes you feel fundamentally broken.

When the Addiction Framework Helps

For some physicians, understanding their eating as addiction provides:

• A framework for recovery (often abstinence-based)
• Relief from self-blame and shame
• Recognition that intense cravings are real and physiological
• Community with others who get the struggle

If thinking about your relationship with certain foods as addiction feels empowering and gives you tools that work, then use that framework.

When the Addiction Label Hurts

For others (including me), the addiction label can feel:

• Disempowering (“I’ll always be this way”)
• Hopeless (“I’m fundamentally broken”)
• Limiting (“I can never trust myself around food”)
• Shame-inducing (“I’m a doctor who can’t control herself”)

What I Discovered About My Own Food Struggles

I wondered for years if I was addicted to Wendy’s french fries. I had intense cravings that felt completely out of my control. I would drive there even when I didn’t want to. It absolutely met addiction criteria.

But when I started addressing the chronic stress in my life – the impossible schedule, the perfectionism, the complete lack of self-care – something interesting happened.

Those fries lost their pull. Not because I used willpower or avoided them, but because my brain didn’t need them anymore.

With hindsight, I can see it wasn’t true addiction for me. It was my brain’s response to chronic overwhelm.

The key insight: what matters most is finding the approach that puts you back in control, whether you call it addiction, emotional eating, or something else entirely.

Sweet Cravings on Low Carb: A Real Example

During the Q&A, another physician asked about sweet tooth cravings hitting every 4-5 days while eating low carb high fat.

This is completely normal during the adaptation phase. Here’s why it happens and what actually helps:

Why it happens:

• Your body is transitioning from burning sugar to burning fat
• Habit patterns are still strong (your brain remembers that sugar = quick energy)
• You might not be eating enough fat to feel truly satisfied

What actually helps:

• Have good low-carb sweet options ready (berries, low-carb ice cream, fat bombs)
• Increase fat intake during the first few weeks while your body adapts
• Be patient with the learning curve – this is a skill, not a character test

Don’t try to white-knuckle through cravings. That’s just setting yourself up to feel like crap.

Identity Shifts When Health Improves

One of the most profound questions came from a physician whose health had dramatically improved after surgery. She could suddenly sleep 6-8 hours instead of 3-4, her mobility was restored after 10 years of challenges, and she could exercise again.

But her identity around what her body could do felt completely foreign.

This is incredibly common and rarely discussed. When our physical capabilities change dramatically, whether from recovery, weight loss, or improved health, it can create an identity crisis.

Strategies for navigating health-related identity shifts:

• Start with “I am the type of person who cares for my body”
• Focus on consistency over intensity
• Ask yourself “How am I the type of person who shows up for myself?”
• Remember that recovery isn’t linear – some days will be better than others

The Empowerment Approach

Whether you call it addiction, emotional eating, or brain weirdness, the most important question is: What puts you back in control?

For most physicians I work with, this means:

• Understanding the real triggers (usually stress, not food)
• Learning to process emotions without food
• Creating eating patterns that actually satisfy you
• Building genuine self-care practices that address root causes

Moving Beyond Labels

Here’s what matters more than any label:

You have the capacity to change your relationship with food.

Whether through addressing underlying stress, learning new coping skills, changing your environment, or getting support – you have options. You have agency. You are not powerless.

Your Next Step

If you’re struggling with feeling controlled by certain foods:

1. Get curious instead of judgmental – What’s happening in your life when cravings are strongest?
2. Look for patterns – Is it certain times of day, emotional states, or situations?
3. Address the root causes – Usually stress, restriction, or unmet needs
4. Choose empowering beliefs – You can figure this out, you’re not broken, you have options

Remember: The goal isn’t to never want certain foods. The goal is to feel empowered in your choices around them.

If you missed Part 1 of this Q&A series, go back and listen. We covered emotional eating during chronic stress, those brutal 2 AM call room binges, and why starting feels so impossible.