Weight Loss Drugs Can't Cure Food Addiction with Dr. Vera Tarman

Are GLP-1 weight loss drugs like Ozempic, Wegovy, and Mounjaro helping—or harming—people with food addiction and emotional eating?

In this powerful and deeply nuanced conversation, psychotherapist Esther Kane, MSW sits down with Dr. Vera Tarman, world-renowned food addiction expert and author of Food Junkies, to explore the real impact of GLP-1 medications on the body, brain, emotions, and long-term recovery.

We go far beyond weight loss and ask the hard questions:

• What happens to food addiction when appetite is chemically suppressed?
• Why do cravings often return stronger when the medication stops?
• Are GLP-1 drugs creating emotional blunting, depression, or anhedonia?
• Who truly benefits from these medications—and who is being left behind?
• Are there ethical, limited situations where GLP-1s can be helpful?

This episode is especially important for anyone who:

• Struggles with food addiction or emotional eating
• Has a history of trauma, anxiety, or depression
• Feels conflicted about taking weight loss medications
• Wants root-cause healing, not just symptom management

💛 This is a compassionate, trauma-informed conversation about choice, awareness, and true recovery—not shame or quick fixes.

⏱️ Timestamps & Chapters

00:00 – Introduction: Why this conversation matters now
01:00 – Who is Dr. Vera Tarman & her work in food addiction
02:10 – Why GLP-1 drugs are being prescribed “like candy”
03:30 – The antidepressant parallel: are we repeating history?
05:00 – Who profits from weight loss drugs? (Let’s get political)
08:10 – Side effects doctors aren’t talking about
09:25 – Polypharmacy & medication stacking concerns
11:40 – How the food industry benefits from GLP-1s
12:45 – Are addictive foods still the real problem?
14:20 – When GLP-1s might be life-saving
16:05 – Why food addiction doesn’t disappear on medication
18:30 – Emotional blunting, anhedonia & loss of joy
20:15 – Mental health risks for people already struggling
22:05 – What to focus on instead of weight loss drugs
23:50 – Food addiction recovery vs. quick fixes
25:40 – Muscle loss, bone density & long-term health risks
28:10 – Why discomfort is part of healing
31:45 – Trauma, the body, and the capacity to heal
34:35 – Emotional eating as communication, not failure
36:45 – What cravings are really asking for
38:55 – Root-cause healing vs. symptom suppression
41:25 – Resilience, recovery, and real freedom from food addiction
42:30 – Final thoughts & resources

📚 Resources Mentioned

📘 Food Junkies: Recovery from Food Addiction – Dr. Vera Tarman
🎧 Food Junkies Podcast
👥 Facebook Group: I’m Sweet Enough: Sugar-Free for Life

Links

To watch episodes on Esther's YouTube Channel:

https://www.youtube.com/@compassionateconversations441

www.estherkane.com

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Esther Kane, MSW, RCC

Transcript

Esther Kane, MSW (00:00)

I'm so excited about today's episode where I will be interviewing Dr. Vera Tarman for the second time. If you missed the first interview, which is an in-depth examination of all things food addiction, make sure to check it out here.

Dr. Vera Tarman is a medical addiction specialist working in the field since 2004. She is a world renowned food addiction expert who writes, speaks and treats people struggling with food addiction. She is the author of Food Junkies, Recovery from Food Addiction. She co-hosts the popular Food Junkies podcast. She also spearheaded the first inpatient and outpatient programs

in Canada for food addiction.

Dr. Tarman's main goal is to put food addiction on the table of services offered to people suffering from addictions. As a recovering food addict herself, Dr. Tarman knows that freedom from food addiction is food serenity. Welcome back, Vera.

Vera Tarman (00:56)

Thank you so much, for inviting me. I really appreciate being able to come back and speak.

Esther Kane, MSW (00:59)

Yeah.

You were the first person I thought of. So a little while ago, I did an episode ⁓ outlining my concerns about people with food addiction and emotional eating patterns, taking weight loss drugs. It also came from my experience as a therapist where many of my clients were taking these weight loss drugs and having horrific side effects. And it was not helping the food addiction issue at all. They were still eating

for emotional reasons and they were still highly addicted to certain foods. If those of you watching or listening haven't checked it out yet, you can watch it here. I thought Dr. Vera Terman has to come on the show and speak to this to follow up on this topic because you are the food addiction specialist, I bow to you. And I think my audience could benefit greatly from your wisdom on this.

I wanted to start with, we're seeing this huge uptake in drugs, Ozempic for example, there's a whole bunch of them out there, but they've just sort of taken off and people are taking them like candy, at least my clients are. And I'm just wondering-

What are your thoughts about why these drugs are so appealing and popular?

Vera Tarman (02:09)

Well, they're taking them like candy because they're being prescribed like candy. I sit on a couple, by the way, thank you, Esther, for inviting me to speak on. Hello, everybody. Yeah, I'm particularly interested in the field of food addiction and absolutely the concern about how the GLP-1s are being prescribed and what impact that might have on food addiction and the services is of great interest to me.

I happen to lurk on a couple of obesity clinician Facebook groups because I'm really interested in what they're talking about. So these are not food addiction professionals. These are obesity and bariatric surgery and bariatric clinicians, which it's really interesting. There's so much interest now in the medical field in this issue where there wasn't a number of years ago because a number of years ago,

We had very little treatment other than diet, which nobody ever followed through with because of the food addiction piece. But now there is treatment. It's these medications, especially the GLP-1s, which have really become a game changer in the field of bariatric clinical work and also the interest in this field. there's so much research and so much enthusiasm. It's the romantic first

phase. It's the being in love with this new phase that we're still in now. And yes, it's being prescribed like candy. This is the solution.

Esther Kane, MSW (03:33)

I just want to say this reminds me of when antidepressants first came out. And especially Prozac in the 1980s. Oh my God, everybody was taking Prozac and it was the 'bees knees' and everybody wanted a prescription. Yeah, so similar. We've seen that with other medications. So you're saying it's like the flavour of the month kind of thing?

Vera Tarman (03:37)

Yeah.

Well, yeah, it's the flavour of the decade. I mean, really, if we had to list a medication as being such a game changer, it's going to be the GLP-1s for the 2020s. There's no question about it. And who knows where it's going from there. Excuse me, maybe of the century. I don't know. It's definitely prescribed and seen with a lot of enthusiasm.

And I think that that worries some of us in the field because the issue of food addiction remains an issue. It's just it's getting kind of pushed to the side because we got the solution, which seems to solve all of the problems. you and I are going to talk about the fact that, the problem remains. We're still here dealing with a real issue that is still in the field, even for people taking GLP-1s. And I think that's what we're going to talk about.

that it isn't just about the medication, that isn't just a solution. Maybe it's a beginning, at best a bridge, but it is not a final solution. It isn't. We're already seeing that to be the case.

Esther Kane, MSW (04:52)

So, Dr. Terman, I'm curious, who do you think is profiting and benefiting from the usage of these weight loss drugs? Let's get political.

Vera Tarman (05:00)

Well, yeah,

mean, so many basically it's the business industry that's that's profiting. So number one, the pharmaceuticals, no question about it. I don't know specifics because they're all getting in on it in some way. But so let's just speak generically, the pharmaceuticals in the same way that they benefited from, you know, attention deficit medication and depressants, as you said, and antipsychotics. Those are all flavour of the month. Sorry.

Sorry about that. Those are off-favorite-of-the-year type of drugs. And they continue to be. Like the goal in the pharmaceutical industry is find a drug that the person has to stay on the rest of their life. And that is the case with GLP-1s, as it is with antidepressants. Yeah.

Esther Kane, MSW (05:29)

No.

⁓ anti-depressants.

and I just want to throw a caveat in there. I've learned so much. There's this wonderful book called Crossing Zero, and it's about getting off of antidepressants, psychotropic medications, and it's about hyperbolic tapering. This is the new thing that they've discovered is that you can get off these medications safely without terrible, most people can't get off the antidepressants and the psychotropics in general because of the horrific withdrawal.

Vera Tarman (05:56)

Huh.

Yes. Yes.

Esther Kane, MSW (06:11)

symptoms that

Vera Tarman (06:11)

Yes.

Esther Kane, MSW (06:12)

they get. But now we're learning you can get off those things safely. So you're saying the same with the weight loss drugs that you're, they're telling people they have to take them for life.

Vera Tarman (06:16)

and we'll see you.

Well, we're recognizing that any of the any and all of the positive effects are only in place while you're taking the medication. So if you are not suffering from food cravings, which is a common reason why people take them, those things come right back, roaring back as soon as you start using the drug. The weight loss comes right back and usually quite dramatically and quite quickly, like within months to a year. So that's going to be a sobering

decision to make to get off of these. And so the idea is you're to stay on these for life. And then there's people like me who say, you know, anytime you're on a medication, eventually tolerance will develop. And so that means we'll have to increase their medications. They are essentially dependent on them because there'll be a withdrawal. other words, rebound cravings and rebound weight gain. And then what's going to happen is

Esther Kane, MSW (07:04)

Mm-hmm.

Vera Tarman (07:14)

The same way that we've seen with the antidepressants and the antipsychotics, a sort of, I forget what the word is called, ⁓ a back to where people are on multiple drugs. So one didn't work. We've done this with Prozac. We had to up the dose from 20 to 40 to 60. Then we had to add, maybe we should throw some Zoloft as well. And then, you know, now we're going to add an anti-epileptic drug to enhance the effects in just a couple of

Esther Kane, MSW (07:25)

Yeah. Yeah. Yeah.

Yeah.

Vera Tarman (07:41)

So people are doing a cocktail of four or five. I think we're going to see that with the GLP-1 too. If it's not a of more than one drug, it'll be within one drug, a cocktail of various mechanisms. Like Monjaro, which is the most recent GLP-1, is now two hormonal manipulations. It's not just the GLP-1, it's another one on top of that. And so I expect that by next year or the year after, we'll have to add a third.

Esther Kane, MSW (07:46)

Great, great.

Yes.

Vera Tarman (08:08)

And so we're going to have multiple hormonal manipulations. You're on for life.

Esther Kane, MSW (08:13)

Yeah.

And my understanding,

too, with a lot of medications is that they put you on another medication to help you resolve the side effects of the first medication, right? Yeah.

Vera Tarman (08:24)

Yes, yes. actually see

that happening. Like people are taking GLP-1s, getting constipated, getting reflux. So we have to give them anti-reflex medication, constipation medication. You know, I don't know if we'll have time to talk about this. one of the things that is a side effect, I don't know if it's across the board, but it's enough to mention, and that is ⁓anhedonia.

Esther Kane, MSW (08:39)

Thank you.

Vera Tarman (08:51)

a mild depression that can follow. So people up their antidepressants or start an antidepressant to counteract the effect of the drug.

Esther Kane, MSW (08:54)

My.

my goodness. Wow.

And, that's just incredible. I didn't know that. Yeah. So thank you for outlining the side effects. Those sound quite serious and very distressing. And then people are taking all these other medications to deal with those. yeah, it's just piggybacking on one drug, putting another one on and we keep going. And I see that with ⁓psychiatric medication.

alarming to me how many medications people are on. Yeah, they end up on a huge load.

Vera Tarman (09:26)

They're on

They don't know what they're on and what doses they're on. Like it's that bad.

Esther Kane, MSW (09:33)

Yeah.

Vera Tarman (09:34)

You had asked me a really good question of who's benefiting from this. And so I started with the pharmaceuticals. But let me say that there's two other big parties that are benefiting. Can I carry on with that? Yeah. So the other party that's benefiting are the physicians, the bariatric physicians. They have a solution now where they didn't before.

Esther Kane, MSW (09:46)

Absolutely.

Vera Tarman (09:55)

So it's going to develop a whole structure, infrastructure of obesity medicine, which we're seeing now with all of the services that are attached to that, many of which will not be much focused on diet. There are going to be other things which are just more treatments, more visits, because it's a lifetime, you've got a lifetime patient now. So there is benefit for doctors.

And then the final one, maybe the most important approved benefits, the food industry, because the food industry is not held to task. If I'm engineer creating addictive foods, I can continue to do so. And it's up to the client, the patient, the customer to figure out how to deal with their food addiction while they take a GLP-1. And we see what is the food industry doing now.

Esther Kane, MSW (10:25)

Hmm.

Right.

Vera Tarman (10:45)

They're trying to get around that and make foods appealing to GLP-1 users. Yeah, they're making... A person can't eat... When they're taking a GLP-1, one of the things that happens is the person, just like with bariatric surgery, they don't want to eat as much. But with the bariatric surgery, they simply don't have the room. But similarly with the ⁓ GLP-1s, they don't have the hunger room. They only have so much hunger.

Esther Kane, MSW (10:50)

⁓ really? my goodness. What does that look like, Vera? is... ⁓

Yes.

Vera Tarman (11:13)

And are they going to waste that on Brussels sprouts and broccoli? No, they're going to take some kind of a treat that will be... Now, one of the things that I've seen is that people on GLP once say, I'm not interested in sweets anymore. I don't want to eat sweets anymore. I'm ⁓ more interested in savory or I'm more interested in healthy foods. So now the companies are trying to find a way to capture the different new tastes.

but still make it closest and highly palatable to the new taste. And I don't know what those products are. I just know that that's in the process of happening now. ⁓ now, yeah, anyway, so the food industry is not being held to task. So they get to do whatever they want. That I think is the biggest, if we want to get political, that's I think the biggest political target we should focus on.

Esther Kane, MSW (11:41)

my god.

⁓ my god.

Yeah, yes.

And I have some other videos where I interviewed experts on, the highly processed food addiction and especially the history behind it and the lobbying and the money. It's really awful when you learn about that. Very distressing. yeah, so maybe some of the things we're following are red herrings. know, like we should really be taking the food

Vera Tarman (12:18)

Yes.

Esther Kane, MSW (12:27)

manufacturers, these companies to task for making junk.

Vera Tarman (12:30)

Yes, it should. Yes,

and they're going to keep blaming us, the people, the clinicians, rather than themselves.

Esther Kane, MSW (12:38)

Yeah. Yeah. I'm just wondering, I remember in your

book, you talked about a patient of yours who I believe was over 600 pounds, and you went to his house personally and helped him. Do you think that there are extreme circumstances like that where these drugs might be lifesaving?

Vera Tarman (12:48)

Yeah.

Yes.

Yeah, okay, so that leads to the question of is it all bad? I don't think it is all bad. And I think that we can figure out a way, just like with bariatric surgery, to use these medications ethically and with wisdom. Even if I drug, and on some level I do, because it's pushing our message aside, because temporarily it's not an issue, it's going to come back.

to haunt us, but right now we're kind of getting lost in the shuffle ⁓ and the excitement of all this. So I tend to be negative about this, but there are some positives. And your point that if a person doesn't have the luxury of losing weight over the course of a year, which is what would happen if they did it diet wise. And I'm not just talking about going on a diet. I'm talking about

maybe I'll change the word diet to a more appropriate food plan, a non-food addictive plant, where there's still person still eating to satiation, they're not hungry, but they're eating better, they will lose weight, but it'll take a while. And if the person doesn't have that time, nor if they don't have that motivation, then sure, we can use surgery or the GLP-1s, which are essentially a chemical.

almost call it surgery. It's a chemical ⁓ manipulation instead of a physical manipulation of the hormones because actually the GLP1s are going to soon achieve the same success rate as surgery. So there'll be two options that one is physical one is chemical basically and they are for the extreme end like my patient probably appropriate because he couldn't even get down the stairs to see his doctor.

Esther Kane, MSW (14:23)

Hmm.

Vera Tarman (14:36)

And he died of a heart attack in the middle of treatment. And that's what happens to people. So yes, if we can either mentally motivate the person or physically get them healthy enough, then yes. But we have to acknowledge that this is just a temporary bridge and in and of itself will be either doomed to failure or doomed to

further medications, like we talked about earlier, gradual escalation of medications, like you'll be a patient for life. So either scenario, but we can prevent either of those two scenarios if we do it right. And that's where you and I come in because we have the right solution. It's just talking and sometimes.

Esther Kane, MSW (15:16)

Yeah, yeah. And we're going to get to that soon. Yes, yes. Yeah, so yeah, that

makes more sense to me and that there are, you know, life-saving, you know, situations. Yeah, yeah.

Vera Tarman (15:30)

And you know, yes. And

there are obesity doctors who prescribe the GLP-1s who also have what they would call an emotional eating management program attached to their clinic. And so they're better than the ones who are just prescribing willy-nilly. But unfortunately, even those doctors, they don't really understand the food addiction message. And so fear that they're not going to be as successful.

Esther, you and I know that we have to recognize that there are foods that are addictive and we have to address the addictiveness. It still needs to be out there as a riding principle for behavioral or dietary treatment.

Esther Kane, MSW (16:06)

Yeah, yeah.

Yeah, because we know that these food scientists basically are being paid big bucks to come up with formulations that make foods highly addictive and highly palatable, and they're highly processed. And like that Doritos add in the old days, you can't eat just one, right? And there's a book called The Doritos Effect. So let's dive in and get to the core of this.

Vera Tarman (16:22)

Yes. Yes.

Esther Kane, MSW (16:37)

So these drugs, how do they affect people with food addiction and what are your concerns?

Vera Tarman (16:42)

Okay, so how these drugs work is they, I mean, it's multifaceted and that impacts all of the different levels also impact food addiction. So the first thing is they were made to be diabetic medication. And that was because they corrected insulin resistance. They made a person more insulin sensitive. And when a person, ⁓

is insulin resistant and is becoming diabetic because that's the consequence of that. They also develop obesity and they develop poor eating patterns because when your sugars, if you're eating a lot of refined carbohydrates, sugars are up and down and that's going to make you want to crave sugar because you're on that sort of fuel roller coaster of chasing sugar. And if you are more insulin,

because of the medication, there's going to be less of that kind of eating, like those hypoglycemic crashes and surges upwards. So that's helped. It also impacts your ability to, like, your appetite, you're not going to eat as much. And that, how that happens is it flattens our appetite,

through manipulating ghrelin and leptin, these are our satiety and hunger hormones, it kind of flattens the effect of those so that you don't really have a sense of being hungry or even full. you're just, well, actually you feel full most of the time, but it flattens the effect of that. Now with food addiction, we want to have those hormones as cubes. We want to be able to say, hey, I'm hungry. This is appropriate hunger.

and I will eat until I'm full and that's appropriate fullness. But when that messaging has been mixed with, I become at a loss. So that's a problem. ⁓

Esther Kane, MSW (18:31)

Can I just interject here for a second? This is incredible.

As I'm listening to you, I'm thinking of the parallel narrative when people go on antidepressants. So maybe they don't feel like really low and really down and depressed or super anxious, but then they don't feel joy, pleasure, rest, relaxation. They can't enjoy the other feelings that are a natural gift of being alive and human.

Vera Tarman (18:42)

Yes, good.

Yes.

Esther Kane, MSW (18:58)

So they just dull everything across the board. It's kind of similar.

Vera Tarman (19:01)

Yes, actually,

I'm really glad you brought that point up because actually that's the very same thing that happens to GLP-1s. The other thing that happens is that it does seem to have some impact on our desire for sweet. Remember I said earlier, it changes the desire for sweet. And so it flattens my pleasure of even anticipating of something sweet. So I'm not going to bother because that chocolate bar just doesn't look that good anymore.

but neither does other things. And Dr. Biela just published a paper last year talking about the anhedonic effect of the GLP-1s. And this is not widespread knowledge and maybe it's not widespread yet enough clinically. ⁓

Esther Kane, MSW (19:29)

Mm-hmm.

Vera Tarman (19:44)

I suspect it's just not known as much. she talked about how

Yes, the person doesn't want the excitement of the food anymore, but it also takes away from the excitement, like you were saying, about just life. And I actually asked her, because I think she was making a link to that and suicidality, like was there a risk? We've seen that with other drugs. We've seen that with remandibam, which was a food addiction,

anti-craving drug in the 1990s that worked. It worked on the endocannabinoid system, but it was taken off the market because there was an increased risk of suicidality because people felt like, okay, I don't want to eat, but I don't want to do anything. So I may as well.

Esther Kane, MSW (20:20)

to me.

Yeah, ⁓ awful.

Vera Tarman (20:26)

And so I said, could that happen here? And she said, she wasn't sure if the effect was as pronounced, but more to the point, the drug companies are not going to let this get pulled off because it's too much of a blockbuster. They're going to find another way around this. so I think that we need to, as clinicians, watch out for this anhedonic effect because the more we see, I think the more we're going to see this, like the more we see people using the drugs, the more we're going to see this impact.

I mean, we have to ask the question, Esther, this goes to the other question that you were about to ask me, which is what are, let's talk about some of these side effects. Why is it that so many people who are on GLP-1s, might be 70%, 60, 70%, even though they know they have to be on them for life, stop them after a year or two? It's high number of people who get off and it's because of side effects.

Esther Kane, MSW (21:12)

Mm-hmm.

Yeah, I had one client who injected himself with one of these drugs and in the belly, I believe. And he had so many side effects, lasted for an entire week, the effect of the drug. So he felt horrible for over a week. It hardly functioned, but he had to wait it out. So that's pretty awful. The other thing I wanted to say to your point of the adedonia, you know, and the depression is that

Vera Tarman (21:21)

yes.

Esther Kane, MSW (21:43)

in my experience of almost 30 years of working with food addiction and emotional eating is that almost all of those clients that I have, they struggle with anxiety and depression or one or the other already. So then to add that, and they're usually on antidepressants before they take the weight loss drugs.

Vera Tarman (21:53)

already.

Yes.

which is an interesting

thing, like what that interplay will be, I don't know if we know yet. That's an interesting phenomenon, I think, to worry about actually.

Esther Kane, MSW (22:05)

Right.

What do think people with food addiction should be focusing on instead of taking weight loss drugs?

Vera Tarman (22:14)

Well, I mean, you had said a few minutes ago, is there something that we can, is this retrievable? Can we use the GLP-1s? So I don't want to throw that out. So I had said then, if you need a quick response or the person is otherwise not motivated, but if you have a motivated person, so it depends on who your client is. If they're already on medication, I wouldn't...

tell them to get off the medication, I would say, all right, the goal is... Okay. ⁓

Esther Kane, MSW (22:39)

Okay, how about we do this Vera? Let's say it's someone

that comes to you or me that hasn't gone on the medication but is considering it and tells us that. What would you say?

Vera Tarman (22:50)

Okay, well, I would first of all say, I want to assess a couple of things. First of all, what is their weight and what is their metabolic state and do they have the luxury of time? Do they have the willingness also? Because there's going to be a lot of willingness. It's a lot easier to do an injection and to do all the stuff I'm going to suggest without the injection. So if I have a highly motivated patient, then I would say, look,

If you follow the food addiction, food plan and package of tools that come attached with that, which includes emotional management and various addiction tools like support, abstinence, whatever, you will get the same results and you will get the same results as a GLP one or bariatric surgery. It'll take longer, but no side effects, no costs except the cost of the.

therapy or whatever, but basically no physical side effects. And yes, you will have to be on it for the rest of your life, but it's actually a healthy lifestyle that we're talking about. There's nothing unhealthy about making sure you have good sleep, good work, good social interaction, and eating a healthy meal like a whole food plant-based or meat-based keto. Both of those are extremely healthy if there's no processed food involved.

Esther Kane, MSW (23:50)

Great.

You

Vera Tarman (24:07)

If you're willing to do that, that would mean accessing services, you can do all of this without going on the medication. If the person is motivated and they continue every day, because it is a lifelong practice in the same ways the GOP1s are, they will get the same success. If the person is not so motivated or needs help,

or they've tripped and tried, they've tried multiple times and they keep failing and all this kind of stuff, then I might, and I actually have said to a couple of people, okay, maybe we should consider the GLP-1s. Your cravings are so strong that you can't even get through three days without picking up a gate. And we know once you pick up cravings are enhanced. So can we quieten them down so you can get some of your life in order? And...

That was the plan. Now, it actually didn't work out in the one case that I'm thinking of because the side effects were too great. Like, that's the problem. The side effects. But there are some people.

Esther Kane, MSW (25:00)

You win.

When you're

talking about very judicial and mindful use of the drug for a period of time.

Vera Tarman (25:07)

Yes, so

yes, yes, exactly. Judicial use within a limited period of time and also being aware that the weight loss, the fact that the person doesn't have cravings, doesn't mean they won't come back when they're off the drugs. So we still have to do craving management and all of that stuff, all of those kind of tools. And we still have to...

The weight that is being lost, and this is the other thing we haven't talked about, a major side effect of the GLP-1s is that the weight that you lose, at least 40 % of that is muscle loss. It's not just fat; muscle. That's not good, because sarcopenia, which is the medical term for significant muscle loss, is actually correlated with longevity of life. It's an important feature.

Esther Kane, MSW (25:39)

Which is dangerous. That's not good. Yeah.

We need our muscles. Especially as we get older.

Vera Tarman (25:56)

Yes, and not too far behind that is osteopenia, loss of bone mass. starvation, which people have akin GLP-1 weight loss to starvation weight loss. It's the same physical effects on the body. And the only way to, like I said, ethically, or the word you use is judiciously, use GLP-1s is by introducing the food addiction plan, but also making sure the foods that the patient eats are

highly protein-based and that they are using exercise so that they can kind of buffer the weight that they're losing in muscle by building muscle at the same time.

Esther Kane, MSW (26:23)

Mm-hmm.

And also the

weight bearing exercise I think is good for bones, isn't it?

Vera Tarman (26:36)

Yes, it's good for both. So it would be weight bearing exercise. So we're not talking about the jog down the street. We're talking about the slow burn or the heavy lifting, that kind of stuff. Yeah, exactly. The weight bearing exercises.

Esther Kane, MSW (26:48)

Yeah, ⁓

That is so interesting. I think so much of this we're just going to have to wait and see. people like you and I that are working on a more holistic, I would call it root-cause healing approach, are standing by the sidelines with horror on their faces. It's hard to watch. And I always say that

therapy, for example, and true transformation is hard work. And unfortunately, we live in a culture that looks at comfort as being the goal. We're always wanting to be comfortable and doing the hard work is not something a lot of people want to do. And I get very concerned, especially about younger generations, that everything is just handed to them and it's instant access and everything's easy-

in terms of technology, I worry. People need more grit. And I watched this funny video last night. It was talking about children that grew up in the 1970s. And I was one of those kids and I couldn't stop laughing. It was basically about how we were just free range chickens. You know, we were just basically let out in the morning. We had a key around our neck and then parents said, come home for dinner.

And we just kind of had to figure things out, like a lot of things and navigate and, but it gave us some really good skills. And the one point I love is that we, that boredom didn't really bother us as much as it does kids. Like we, could deal with boredom. We just had to figure out what else to focus on, right? Or if we couldn't solve a problem, we didn't have an adult intervening in everything, we had to figure it out ourselves and we made mistakes and we fell down.

Vera Tarman (28:12)

Yeah. Yeah.

Discontained.

Yeah. Yeah.

Esther Kane, MSW (28:25)

I think my generation, which is Generation X, I think we're pretty resilient, tough people, and we're pretty unique generation. I For those of you watching and listening, I really want you to think about, getting in there and doing the hard work. And yes, it's difficult, and it's hard, but it's ultimately worth it.

And Peter Levine, who is my hero, and he created somatic experiencing, which is to me the best therapy for trauma. He said that trauma, and I would say hard work, hard things, can be a portal to spiritual transformation. And I don't know what you believe. I know you're very spiritual. Vera, what do you think about that?

Vera Tarman (29:04)

Well, I think that's true. I think we'd probably use different words because I'm a generation behind or ahead of you. I'm not exactly the baby boomer, but sort of. And yeah, I agree with that. Esther, can I ask you a question? ⁓ We've been talking about judicious use of the GLP-1s and how they can be used if in the context of a larger program.

Esther Kane, MSW (29:18)

yet.

Vera Tarman (29:29)

And my fear is that today we're seeing people just using the drug and not the program. And with antidepressants, because you brought that up a couple of times as an analogy, that would be a bit like a doctor prescribing Prozac saying, OK, off you go. Whereas as a therapist, I'm sure you've worked with many people on antidepressants and you haven't told them to get off. You've worked with them, right?

Esther Kane, MSW (29:52)

Yes.

I'm very vocal though, especially now

because I've had my own experience and I'm finally getting off antidepressants after almost 30 years of being on them and being told I had to be on them for life. And now that I've discovered that you can get off of them safely without the horrible withdrawal symptoms, I'm really becoming more vocal about whether my clients need to be on these drugs. And of course it's up to them.

Vera Tarman (30:05)

Right.

Uh-huh.

Huh.

Esther Kane, MSW (30:19)

But I like to open that conversation that there's other possibilities that you don't necessarily, I don't think you should be looking at medication as a first response to something like depression and anxiety. I really believe that there are definitely situations. And again, it's life threatening when someone is, suicidal- there are situations where I think they can be helpful, but for the short term.

Vera Tarman (30:29)

That's a first. yeah.

Esther Kane, MSW (30:43)

And once people are back up on their feet again, I think it's a good idea to question whether they need to be on them. You definitely don't need them for life. What the confusion is with antidepressants and the psychotropic medication, what I'm learning now is that that doctors in particular, when they have a patient going off the medication,

they don't do it safely. They don't do the hyperbolic tapering. So they have these horrible withdrawal symptoms that look like depression or anxiety or whatever they were put on the drug for in the first place. And they say, yeah, you can't go off of it because look, you still need it. But that's not the case. Those are withdrawal effects. They're not "the disease" coming back. This whole disease model irks me, but anyway.

Vera Tarman (31:22)

Yes.

And

I think that we're seeing the very same thing with the GLP-1s and that we can take your approach ultimately that look, ⁓ you don't have to be on these for life. They may have helped you get out of that suicidal state, that dangerous state, but now you're in a different place and let's work with getting you off of them.

Esther Kane, MSW (31:45)

And the thing is,

human beings were designed for growth and transformation. And yeah, and the body, I don't know what you feel about this, Vera, but I really, the more I've healed my own trauma, which I've been doing for a few years now, and it's unbelievable, I've transformed. I've learned viscerally that you can completely transform and that the body always wants to heal itself. I'm just, I'm so,

Vera Tarman (31:50)

Yes, which is your point. Yes.

Yes.

Esther Kane, MSW (32:11)

in awe of the body through going what through the healing that I've gone through with Somatic Experiencing. I've released all this trauma. I literally feel like a different person physically. I feel like I had all these aches, pains, and troubles, and issues before that are gone. The anxiety is gone. The deep depression is gone. It's

Vera Tarman (32:33)

Huh.

Esther Kane, MSW (32:35)

miraculous and I was told by medical professionals for many, years that I would never be like this. I could never be normal, right? Well, poo poo on that. Yeah, it's not true.

Vera Tarman (32:45)

Yes.

And we can use that same analogy with the food world that, you know, we've been told you're going to be obese forever. You've got this chronic condition called obesity, which I actually think is actually food addiction. You know, yes, there are some people who are more tend to have more tendency to gain weight, but not necessarily 600 pounds. Anyway, we're told that we're told that you're going to have cravings and food disordered behavior the rest of your life. So you need to be on these medication. But we can actually

teach people and the body, like you said, wants to become normalized. And we can use hunger, which is akin to sadness or anger and mood as a cue. If I'm hungry, why am I hungry? Well, it's time to eat. Or, well, I've eaten something that was too refined in carbohydrates and now I'm crashing. Like we can use these cues, not as danger that we want to avoid because it's uncomfortable, like you said, but as instructional

Esther Kane, MSW (33:22)

Mm-hmm. Yeah.

Vera Tarman (33:41)

pieces.

Esther Kane, MSW (33:43)

I love

that, I love that. The way that I've reframed anxiety and depression is that the body is trying to tell us something. So I'll ask clients, if your body could speak to you, if this anxiety, this depression could speak to you, what would it be saying? What does it need? And people always know, there's always boom, they come up with an answer and it's things like,

⁓ to know that I'm not alone. That's a big one to know that I'm not alone in the world. And one of the roots of trauma, one of the worst parts of trauma for people is that they were alone with that, with that horrible thing that happened. There was no one there to bear witness. So as a therapist, I'm bearing witness to that early suffering or recent suffering, whatever it was and holding their hand through it and just knowing that they're not alone,

Vera Tarman (34:10)

Right. ⁓

Yes. ⁓

Esther Kane, MSW (34:36)

is so healing in and of itself. So what would you say an analogy is for the food addiction piece when people are healing? What do you notice with people when they're healing?

Vera Tarman (34:43)

you

It's not going to be as deep and profound as what you're talking about, but it would just be if a person has a craving for something like why are they having a craving? So it's not anxiety although. It's a kind of anxiety I need this thing to feel better so if your body could say what do you want right now? I can tell you Esther myself my own personal experience when I am really longingly looking at the fridge, and I haven't eaten sugar for years. It's like why am I behaving this way?

When I've asked myself, what is it that my body, what my hunger is trying to say, I will always say, I need to cry. I need to cry. And when I do cry, and usually the tears are not that far apart, because the moment I say it, it opens that up. And if I do cry, guess what? The cravings are gone. Like it was a way of saying, there's something behind this. And it wasn't.

Esther Kane, MSW (35:22)

⁓ Really?

Yeah.

Yeah, yeah.

Vera Tarman (35:39)

The cravings themselves but the cravings were important because I am so used to not paying attention to myself Not wanting to stop it not wanting to acknowledge that something bothered me. So it comes out this way and Yeah exactly

Esther Kane, MSW (35:54)

Well, I was just thinking, and I hope you don't mind me sort of psychoanalyzing you a little bit, but I'm just wondering if one of your survival strategies when you were growing up was to use food when you felt sad, because for whatever reason, that wasn't acceptable on the menu. Maybe being sad wasn't celebrated or attended to maybe when you were growing up. I'm not sure.

Vera Tarman (36:17)

Yeah, there was no way of soothing. So food was a soothing thing. And I have often felt that food acts as a kind of maternal, it has a maternalism about it, because it is our first way of interacting with mother and breastfeeding. ⁓ I think that there's something really inherent about that. Yes. Yes.

Esther Kane, MSW (36:30)

Yeah.

Yes.

Very primal. ⁓

Vera Tarman (36:42)

And the

LP1s don't even touch any of that stuff. And so you won't be able to, like I think that people who do food addiction work, it's like any other kind of addiction work or any psychotherapy work, you start at the layers, the initial layers of behavior and how's it affecting my job and all that stuff. And then eventually you get deeper and deeper into how's it affecting my life experience. And then when you get into the stuff like

Esther Kane, MSW (36:46)

Exactly.

Vera Tarman (37:09)

early childhood issues, you actually get into them because you have the cues, the emotional cues to do so. And if hunger has been away and you blunt that you're just missing, you're just bypassing a whole chunk of how to, you know, return to life in a way that's not happy, but meaningful.

Esther Kane, MSW (37:15)

Yeah.

Yeah, yeah, and I think there was a book a long time ago called What Are You Hungry For?, which is a great title about food addiction, emotional eating. So from my perspective as a therapist, what is your soul hungry for? What is it really wanting? What is it really needing? What needs to be attended to? But as you're talking about that, I call that the layers of the onion. We have to peel layer after layer.

And at first we start with the behavior and the stuff, because that's the safest point of entry. And then eventually many layers later we get to the root-cause, usually trauma or unmet needs in childhood. But it takes a while to get to those places. And I just want people who are watching or listening to this to be assured that you don't jump right into the childhood trauma stuff. That takes a long time.

Vera Tarman (37:54)

Yes.

Yes.

Esther Kane, MSW (38:15)

My job as a therapist is to help to build a safe container, right? And to help you to feel safe. That is 99 % of the work at the beginning and to trust me and as a guide, and that is about relationship building, about healthy relationships, I have to model that for people. And most of us did not grow up with the best role models in terms of parents and grandparents and

whomever, and that's not anyone's fault. It's just the way it happens. So we have a lot to heal. All of us have stuff that we need to heal. So I think What I'd like to really highlight from this conversation is that you and I are all about deep root-cause healing and fixing the problem. instead of just, we see a weed, one...

Vera Tarman (38:46)

Yeah.

Esther Kane, MSW (38:59)

way to do it is you just take a lawnmower and you mow over the weed, okay, it goes away for while, but then the weeds going to come back pretty quick. I think what we're talking about and what we're all about is we get in there and we dig up the weeds from the roots, get rid of them so they don't grow back. And that takes longer and it's harder work, but ultimately it's very fulfilling and I think life-changing. I just can't imagine doing it in a

Vera Tarman (39:13)

Yeah.

Esther Kane, MSW (39:24)

any other way. And I've been doing some very difficult work myself personally, the last couple of years, the hardest work I've ever done in terms of root-cause healing. And it's been brutal, but it has been life transforming. And what's happened for me, Vera, and the reason I was able to get off antidepressants finally too, well, one is being guided by people who know about hyperbolic tapering and getting off of them safely. But the other

piece is through healing the trauma that was there that created me to come up with these survival strategies. Anxiety and depression were ways that I coped with situations that were unsolvable and unlivable that most people, I mean, I wouldn't have survived.

And the big one though, talking about what we're talking about today was my eating disorder and food was my way of coping. And it nearly killed me with anorexia and bulimia in my teens and early twenties, but it didn't, but it also saved my life. So there's this very strange paradox there. I'm not sure if people watching or listening to this are in that extreme of a position, but

I think what we're saying is you may be addicted to food and there's a lot of resources out there and your book, Food Junkies, in my opinion, is one of the very best. And I know you also have programs and you work with people and I'll have your website listed in the show notes. But there's so many things you can do and so many other levers you can pull before you go to weight loss medication.

and antidepressants and all of those things as we're talking about that as well.

Vera Tarman (40:59)

Yes.

Yes, and The other thing you mentioned earlier on that I think is really important to bring out is resilience. you know, Through this process, you find your own resilience and medications, because the theme here is, know, how are these medications impacting food addiction treatment? If you only do the, you're just killing the weed, but you're totally missing the boat on resilience.

Esther Kane, MSW (41:28)

Yeah, and we

We are resilient. That is something I know after almost 30 years of being a therapist and after going through my own journey, and I'm still on the journey until I am not here. Boy, we are resilient. We are tough. We are very tough. I just want to end, Vera, with is there anything else you wanted to say, anything you're thinking about that we didn't get to?

Vera Tarman (41:31)

it. ⁓

Yeah.

⁓ No, just just For people listening that if they want to find out more like you mentioned I have my book Food Junkies: Recovery From Food Addiction. I have a Facebook group a free group I'm Sweet Enough: Sugar-Free for Life where people can access both free and paid resources and I also have the YouTube channel myself just just so that people know about like you said there's more resources

there are a lot more people getting involved in the field. We see ever more that you're not alone and that you're not alone if you want to say no to GLP-1s or if you want to say yes, you're not alone. The issue of food addiction will remain because we have the food industry that will remain. So we're going to be here and anybody listening, you're not alone. There is support. Yeah.

Esther Kane, MSW (42:35)

Wonderful. That's excellent.

I'll have all your resources listed. I just wanted to say that your podcast, the food junkies podcast is excellent. And you interview a lot of experts in the field and definitely worth subscribing to that following your show.

Vera Tarman (42:41)

Yes, that too.

Thank you.

Esther Kane, MSW (42:51)

Thank you.