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Food addiction on a plant based diet: what the doctors say
Food addiction and cravings: what McDougall, Barnard, Goldhamer, Lisle and other doctors say, where they agree and differ, with sources.
Updated . For education only, not medical advice.
Our view
Almost all the doctors on this site agree that some foods make people eat far more than they need, and they trace that pull to concentrated sugar, fat and salt rather than to whole plants123. The split is over a word: Doug Lisle, Alan Goldhamer, Neal Barnard and Chef AJ speak of addiction, while John McDougall, who in 2006 likened refined sugar to cocaine, preferred by 2023 to call it a strong habit456789.
We give most weight to the low-fat clinicians who have watched patients change their diet for decades, and in practice they are closer than the quarrel suggests910. Lisle said McDougall would accept the idea of a compulsive pull toward something self-destructive, and that his objection to the label reflects his worry that drug makers want a foothold in this area10. Whatever the name, these doctors report that the craving for rich food fades within weeks to a few months once those foods are gone, and that is the point we take from them11212.
None of them offers a cure, and the evidence they cite is mostly clinical experience and small studies, so we report it as such131415.
Where they agree
Concentration is the common thread: Novick contrasts the sugar in fruit, corn or potatoes with table sugar, honey, syrup and dried fruit, comparing the gap to the one between a coca leaf and cocaine, and McDougall made the same comparison for refined flour and sugar in 200618. Lisle explains that food stripped of fiber and water delivers more calories per bite and a bigger lift to the brain’s dopamine system16. Goldhamer says people, like lab animals, overeat once salt, oil and sugar are added to their food3, and Campbell names fat, salt and sugar as addictive in the same way2.
They also agree that taste is learned and can change: Pritikin said in 1982 that a taste for dairy and similar foods is trained much like a taste for cigarettes17. Lisle warns that the switch back to whole foods feels wrong at first and that taste needs several weeks to recover1812. Esselstyn and Campbell describe the craving for fat fading after some months on a low-fat diet112.
Most of them also doubt willpower alone: Nelson says society made unhealthy food cheap, easy and normal and then blames people for weak will19, and Ornish built his program around love and pleasure rather than willpower20.
Where they differ
The doctors part ways on whether addiction is the right word, on what does the hooking, on how cravings fade, and on whether a little of a rich food is safe9212223.
Addiction or habit
In an October 2006 newsletter McDougall wrote that refined carbohydrate triggers the brain’s opioid and dopamine reward systems, and that some people find changing their diet harder than giving up heroin or tobacco24. By 2023 he rejected the word: after treating patients whose withdrawal from drugs, drink or cigarettes brought seizures and ambulance rides, he said no patient of his had ever had a seizure after dropping a food25. He added that the addiction label can serve as an excuse for not taking control of one’s eating9. Lisle answered in 2024 that addiction is a continuum, not a yes or no category, and called overeating rich food the most common addiction in the United States4. He also suggested the term refined food addiction, since nobody gets hooked on arugula26. Peter Rogers, in 2026, described the same split between Chef AJ and McDougall and sided with the view that people do get addicted to some foods27.
What does the hooking
Barnard points to the brain’s reward chemistry: in 2017 he said that some foods, like cocaine, tobacco and alcohol, make the brain release dopamine6. For cheese he adds casomorphins, opiate compounds freed when casein is digested that act on the receptors heroin uses21. Rogers blamed added glutamate, such as MSG, in processed food in a 2025 lecture28. Esselstyn and Campbell single out fat, Esselstyn calling nuts addictive and Campbell saying added oil leads people to keep increasing how much they use2930. Ornish looks behind the food, recalling in 2022 that patients told him overeating, smoking or drinking helped them bear loneliness and depression31. Jenkins said in 2026 that people on every continent struggle alike, only with different foods, so he traced such addictions to culture rather than to genes32.
How cravings fade
The doctors give different timelines132. Esselstyn cited work from the Monell Chemical Senses Center with groups on diets of roughly 34%, 20% and 11% to 12% of calories from fat; by his account the craving for fat went away, at around 12 weeks, only in the group eating least fat, and he gave no group sizes or date in that 2009 talk13. Campbell put the fading at one to three months after a diet change2. Goldhamer says fasting speeds things up, citing a study at his TrueNorth center in which responses to salt and sugar shifted after a fast so that whole foods tasted good again; he did not give its size in the talk22. Rogers agreed with The Pleasure Trap, the book by Lisle and Goldhamer, that some days of fasting can reset taste33. Hana Kahleova described a study of 56 overweight women with food addiction, randomly assigned for two months to a low-calorie diet or to eating within a ten-hour window; the time-restricted group lost more weight and fat15.
Abstinence or moderation
Chef AJ runs her weight loss program on abstinence: no animal foods at all, and none of what she abbreviates as SOFAS, meaning sugar, oil, flour, alcohol and salt723. Novick advises people prone to overeating to avoid foods dense in both sugar and fat, even whole-food ones such as date and nut truffles34. Lisle and Goldhamer stress that people differ: Lisle compared rich foods to alcohol, where in his estimate roughly 5% of drinkers are unable to stop at a moderate amount, and Goldhamer said in 2026 that each person has to know their own limits3536. Ornish takes the gentler line, with nothing forbidden in his program and a warning in 2014 that calling foods good or bad makes people feel bad and quit2037. Nelson’s answer lies in the home itself: as with cigarettes, foods that cause trouble should not be kept there, so willpower is not needed38.
What each expert says
JMJohn McDougall
In 2006 McDougall wrote that purifying carbohydrate, as with refined flour and sugar, strengthens both its pull and its harm, much as cocaine is purified from the coca leaf8. By 2023 he called the problem a strong habit, not an addiction, on the grounds that giving up food never causes the withdrawal he has treated in drug users259.
According to Esselstyn’s FAQ, read in 2026, within 8 to 12 weeks on his diet the brain’s receptor for fat becomes less responsive and patients no longer crave fat11. In a 2009 talk he linked that to a study in which only a very low-fat group lost its fat craving13, and in 2018 he called nuts highly addictive29.
In 2020 Campbell described fat, salt and sugar as addictive and said that children raised on high-fat food come to feel they need it, a desire he said wears off one to three months after the diet changes2. In 2022 he called added oil the richest calorie source and so addictive that people keep using more30.
Barnard said in 2017 that when he genotyped participants in one of his diabetes studies, about half carried a gene variant that leaves a person with fewer dopamine receptors (10% from both parents, 39% from one), a study with no comparison group14. From that he theorized that such people may seek comfort in chocolate, cheese, meat or simply in eating more, then go on to develop diabetes14. He sees cheese as both fattening and addictive, and described joint dairy industry and US government marketing designed to make people crave cheese3940.
Ornish treats overeating as a way of coping with pain, which is why he relies on neither information nor willpower alone3120. In a 2019 conference talk Ornish argued that the pull of food addictions weakens when a stronger reason takes their place, such as feeling well or wanting to see one’s family grow up41.
Goldhamer, co-author of The Pleasure Trap, said in 2025 that escaping it is as hard as escaping a drug, pointing out that even with the best treatment about 82% of alcoholics and roughly 90% of heroin users relapse within a year5. In his view taste can change, and a fast makes the change come faster22.
Rogers says highly palatable processed foods hook people until plain plant foods taste bland, and in 2026 he endorsed the fasting reset described in The Pleasure Trap33. In a 2025 lecture he blamed added glutamate for much of the pull28.
In a 2012 article built on the pleasure trap idea, Novick argued that concentration, not sugar or fat as such, is what makes a food hard to stop eating1. In his view a little sugar or fat diluted in a large meal of starch and vegetables is not the problem, while dense mixtures of both are best avoided by people prone to overeating34.
Nelson drew in 2026 on Lisle’s three drives, to seek pleasure, avoid pain and save energy, which once helped people survive scarcity but now meet food designed to be hard to stop eating42. He would change the surroundings rather than rely on willpower, as was done with smoking1938.
Chef AJ describes herself as a food addict and runs her program on abstinence from animal foods and from sugar, oil, flour, alcohol and salt723. In 2018 she suggested speaking of following the program or not, instead of being good or bad, because people punish themselves after a slip43.
Asked in 2026 why people find a new diet so hard, Jenkins answered that this happens in every part of the world with different foods, and he sees such addictions as rooted in culture more than genes32.
In 2025 Kahleova described a two-month trial in 56 overweight women with food addiction that compared a low-calorie diet with a ten-hour eating window15. The time-restricted group lost more weight, more fat and more waist, and their levels of BDNF, a brain growth factor, rose about threefold15.
In 1982 Pritikin suggested that health groups might resist diet change simply because food habits run deep and behave like an addiction, harder to break than any other habit44. He considered a liking for dairy and similar foods something learned, the way a smoker learns to like cigarettes17.
Lisle explained in a 2019 TEDx talk that the brain adapts to rich food, so people end up eating far richer meals without enjoying them any more, and are left with obesity, diabetes and heart disease45. He calls food addiction a continuum and prefers the name refined food addiction426. In 2026 he said people with a strong pull toward rich food may need a strict diet46.
The doctors above describe several routes when cravings feel out of control, from removing the most concentrated foods to keeping them out of the house, and they agree the pull usually eases with time34382. If eating feels out of your control, or you take medicines that diet changes could affect, talk it over with your own doctor before you change anything. This page is education, not medical advice.
Each small number links to its reference below: the video at the exact second, or the page where it was said.