The Metabolic Approach to Treating Food Addiction | Dr. Tro Kalayjian | The Metabolic Link Ep. 77

12 snips

Oct 1, 2025

Dr. Tro Kalayjian, a board-certified internist and obesity medicine specialist, discusses revolutionary ideas about food addiction. He delves into whether food addiction should be classified as a true addiction and shares insights from his TOWARD intervention, revealing that nearly half of participants saw reduced addiction symptoms. The conversation covers the compelling links between dopamine signaling, ultra-processed foods, and the difficulties of treatment. Tro also highlights the importance of scalable, real-world solutions for overcoming food-related compulsions.

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ADVICE

Push For Diagnostic Recognition

Recognize ultra-processed food addiction in clinical practice and offer referral or support rather than dismissing symptoms.
Treating it would let doctors screen, diagnose, and connect patients with resources and programs.

INSIGHT

Timing Matters In Brain Studies

fMRI studies can miss food-related brain responses if timing ignores reactive hypoglycemia after high-carb loads.
Proper timing shows nucleus accumbens activity linked to glucose drops, supporting biological addiction mechanisms.

INSIGHT

Dopamine, Shame, And Compulsion

Obesity associates with lower dopaminergic signaling and D2 receptor changes, creating a bidirectional relationship with eating behavior.
Many patients don't choose their condition and experience shame, compulsion, and behaviors mirroring substance use disorders.

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Could treating food like a drug be the breakthrough we've needed in food addiction treatment?

In this episode of The Metabolic Link, Dr. Dominic D’Agostino sits down with Dr. Tro Kalayjian - physician, researcher, and former obesity patient - to explore whether food addiction should be classified as a true addiction, and how his TOWARD model is helping patients overcome binge eating and food-related compulsions.

Dr. Tro shares findings from his recent peer-reviewed paper, TOWARD: a Metabolic Health Intervention That Improves Food Addiction and Binge Eating Symptoms. The study evaluated outcomes from the TOWARD intervention, a telemedicine-based model that combines metabolic nutrition, real-time biofeedback, and coaching. Nearly half of participants reduced food addiction symptoms, and over 80% saw improvements in binge eating - often independent of weight loss.

This conversation explores the science of dopamine signaling, the failure of calorie-restriction models, the blurred line between food addiction and eating disorders, and how this approach could reshape treatment through scalable, real-world solutions.

Questions Answered in This Episode:

How should we define food addiction compared to binge eating disorder?
Should ultra-processed food addiction be officially recognized in the DSM?
Why is food addiction harder to treat than drug or alcohol addiction?
What were the key outcomes of the TOWARD study on food addiction and binge eating?
Can lifestyle interventions compete with bariatric surgery or GLP-1 drugs?
How can employers scale food addiction treatment for high-risk populations?

Check out Dr. Kalajian's TOWARD app here.

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