Mental Health
August 3, 2023
One of the most profound things I learned from studying statistics in my doctoral program was that “all models are wrong, and some of them are useful.” In science, we use modeling to make a particular part or feature of the world more accessible to understand, define, quantify, visualize, or simulate by referencing it to existing and usually commonly accepted knowledge.
With data, we build models to detect associations, and those help us make predictions, but we also do this in our minds and our bodies, and it promotes our survival by helping us detect threats. We used our lived experiences to predict safety through the detection of familiarity.
For example, “Intuitive eating” is a model. It is often wrong, but it is useful in understanding how diet culture contributes to loss-of-control eating. “Ultra-processed food addiction” is a model that is also wrong but holds promise for individual-level recovery and public health nutrition reform. I recently gave a presentation about the conflict between these models.
Do you have a particular food philosophy that you subscribe to? If so, this article is for you!
Key Terms Relevant to the “Nutrition for Mental Health” Discourse
To think scientifically about different food philosophies in the mental health space, consider the following:
Dialectics: the art of investigating and discussing truths of varying opinions. It's any systematic reason, exposition, or argument that juxtaposes opposed or contradictory ideas and seeks to resolve their conflict. It's a method of examining and discussing opposing ideas to find the truth, often acknowledging that multiple truths are simultaneously present.
Convergence: the act of converging toward union or uniformity. It's a point where two or more data points or pieces of information encounter one another. This is the commonality between theories where the overlap can serve to support or validate the other theory. Most ideas about nutrition converge at some points.
Divergence: when two things become different or the departure point for conceptual frameworks. For example, intuitive eating suggests that the more you avoid specific foods, the more you crave them. Ultra-processed food addiction suggests that the more you eat specific foods that are highly reinforcing, the more you crave those foods. Both models are correct, and simultaneously both models are wrong. No one model will capture all observable phenomena. Therefore, we need multiple models and an open mind to see where they converge and diverge.
Bias: an inclination of temperament or outlook which could be a systematic error introduced into sampling or testing by selecting or encouraging one outcome or answer over another. It could also be an unfair opinion that influences someone's judgment. We know that bias in any process at any inference stage tends to produce results or conclusions that differ systematically from the truth. We all have biases, and nutrition science tends to be biased by each individual’s personal relationship with food. Are you regularly checking for your biases and blind spots?
Confirmation Bias: an unconscious act of referencing only those perspectives that fuel a pre-existing view, filtering out feedback that doesn't help in supporting our assumptions. This is particularly heightened in the era of social media algorithms that reinforce existing perspectives through repetition in a feed.
Anchoring Bias: the tendency to rely too heavily on the first preferred piece of information when making decisions. This can be dangerous in science because it is meant to be iterative and encourage new positions based on new data. Being overly anchored to one philosophy can work against open-mindedness.
Bandwagon Effect: what I like to call “groupthink.” This is where group members may agree upon a decision that deviates from the correct decision just to attain harmony and avoid conflict. This phenomenon is best observed in politics, but we are starting to see it in the nutrition space as well 🤯
Cognitive Dissonance: a state of having inconsistent thoughts, beliefs, or attitudes especially related to behavioral decisions and attitude change. It could be a feeling of mental discomfort that alters one of those attitudes, beliefs, or behaviors to reduce that discomfort and eventually restore balance. When someone has some inconsistency between attitudes or behaviors, that is the dissonance, and they must do something to eliminate it. Individuals in a state of cognitive dissonance often take unconscious steps to resolve it.
Extrapolation: the action of estimating or concluding something by assuming that whatever trends are happening will continue or that a current method will remain applicable.
Examples of extrapolation include:
“This is what works for me, so it should work for you”
“This is what most of my clients experience, so it must be what you're experiencing,”
“Eating disorders are all about the pursuit of thinness”
“Eating disorders are all about restriction”
“Eating disorders are all about control.”
Now to the question in debate…
Does the Concept of Ultra-Processed Food Addiction Promote Diet Culture?
We know that chronic dieting is a problem. But where does all the dieting come from in the first place? If diet culture is the core problem, where does it originate? Does it all come from weight stigma? Or might the food industry have something to do with the obsession with dieting?
Can public health interventions to reduce exposure to highly processed foods eventually reduce food addiction and subsequently reduce chronic dieting? From this perspective, the impact of contemporary Westernized foods may contribute to poor eating disorder treatment outcomes. And no one wants to discuss this except for a small minority in the field.
One reason people tend to steer clear from public health conversations around the food supply is that many people assume it cannot be changed. Practitioners must be able to provide solutions that are attainable in the present moment, so teaching people to stop dieting feels way more productive than lobbying against corporate greed.
Prevailing narratives and notions that are not helpful: Socially disadvantaged individuals are resigned to consuming ultra-processed food because they have no other options. Yes, some people face structural marginalization, and what I'm saying here is that we can help overcome structural marginalization. This idea that institutions have their hands tied and can't implement change is just not a helpful notion. This includes schools, hospitals, and mental health treatment!
We can change the system. We have to believe that we can be heard. And if we can’t be heard, we can vote with our wallets and forks.
We are not resigned to doing what the food industry wants, which is buying all of its products and trying the latest fad diet. Individuals with dysfunctional reward circuity can opt out of this cycle by changing their food for the benefit of mental health, and this is not the same as diet culture. We need nuanced and dialectical ways of thinking about these issues to move the field forward. You don’t have to “pick a side” in this debate. You can use your Wise Mind.
I hope the scientific explanation at the beginning of this article helped you to better understand the complexity of this topic. It’s a loaded conversation that you can join on TikTok or Instagram. Would love to hear from you!
