Food Addiction, Eating Disorders, and the “Freedom Plan”: Nikki Glantz on the Milestones Approach

Two Decades at Milestones: Experience That Shapes the Model

Nikki has worked at Milestones for 22 years — first as the center’s nutritionist and now also as its COO.
She describes arriving early in her career, initially trained in conventional dietetics:
calorie counting, food groups, low-fat guidelines, and standardized nutrition plans.
What she encountered at Milestones was something entirely different.

Instead of focusing purely on nutrients, she found herself confronting addiction patterns,
behavioral rituals, emotional triggers, and distorted relationships with food.
Over time, she realized that traditional nutrition education alone wasn’t sufficient.
She had to understand addiction psychology, compulsion cycles, and how food behaviors
can mirror substance dependence.

That shift reshaped her entire professional philosophy.

Food Addiction and Eating Disorders: Not Either/Or

One of Nikki’s most important clarifications is that food addiction and eating disorders
are not cleanly separated categories.
There is significant overlap.

However, she does offer a helpful framework:

• Food addiction tends to be more substance-driven. Individuals may experience
  a powerful physiological and psychological response to specific ingredients —
  particularly sugar and flour — similar to alcohol or drugs.
• Eating disorders may be more strongly driven by emotional triggers,
  restriction patterns, control dynamics, and psychological distress —
  though food can still function addictively within that pattern.

In practice, most people show traits of both.
Nikki focuses less on labeling and more on identifying what repeatedly causes loss of control.

The “No Sugar, No Flour” Foundation

A central element of the Milestones approach is removing sugar and flour.
Nikki describes these as the “substances” most commonly linked to addictive responses.

Importantly, this does not mean eliminating all carbohydrates.
At Milestones, individuals can still eat:

• Potatoes
• Sweet potatoes
• Oatmeal
• Whole grains
• Rice
• Quinoa

The aim is not carb-phobia.
The aim is removing the substances that most consistently drive compulsive behavior.

In private practice, Nikki may take a more gradual approach,
often starting with sugar elimination first and adjusting based on individual response.

Why “The Story” Matters More Than the Rulebook

Nikki repeatedly emphasizes that recovery must begin with understanding
the individual’s history:

• How did food become unmanageable?
• What patterns are present?
• Is restriction part of the cycle?
• Are there emotional triggers driving behavior?
• What previous attempts have been made?

Rather than applying a one-size-fits-all template,
she tailors structure around the person’s lived experience.

The Hidden Drivers: Sleep, Timing, and Daily Routine

One of the most practical sections of the interview addresses something often overlooked:
relapse frequently begins long before a binge.

Nikki uses the term “chaining back” to describe identifying the earliest link in the chain.
Common early triggers include:

• Staying up too late
• Skipping breakfast
• Restricting during the day
• Rushing meals
• Failing to prep food
• Unstructured evenings

Addressing these upstream behaviors often prevents downstream chaos.

Volume Eating: When “Healthy” Becomes Compulsive

Removing sugar and flour does not automatically remove compulsivity.
Some individuals shift toward volume eating —
consuming large quantities of otherwise “approved” foods.

Nikki has seen clients binge on vegetables, radishes, mushrooms,
or other non-trigger foods.
The substance may change, but the behavior remains addictive.

To address this, she incorporates:

• Clear portion ranges
• Weighing and measuring guidance
• Structured meal plans
• Intentional accountability

The goal is normalizing eating behavior — not simply swapping symptoms.

Structure as a Bridge to Intuition

Nikki respects intuitive eating as a long-term goal.
However, she argues that early recovery often requires structure.

When addiction or eating disorder behaviors have distorted hunger and fullness cues,
“just listen to your body” can be unrealistic.

In her model:

• Structure stabilizes the system.
• Consistency reduces mental obsession.
• Trust rebuilds gradually.
• Intuition can re-emerge once stability returns.

The Two Recovery Pillars: Timing and Intention

Nikki identifies two primary predictors of success:

1. Timing

Are meals happening on schedule?
Is food prepped?
Is the individual compressing meals or improvising under stress?

2. Intention

Was a deviation accidental — or was it driven by hidden motives?
Nikki encourages clients to check their intention honestly.
Self-awareness reduces relapse risk dramatically.

Inside Milestones: A Real-Life Recovery Environment

Milestones differs from many traditional inpatient programs.
It operates in apartment-style living arrangements rather than a locked facility.

Clients:

• Shop for groceries twice weekly
• Plan meals (“meal mapping”)
• Prep their own food
• Weigh and measure portions
• Eat socially with peers
• Attend multiple daily therapeutic groups

There is no tray service.
The skills practiced are the skills required at home.

Relearning Social Eating

Eating in community settings helps normalize behavior.
Clients practice:

• Sitting for meals
• Engaging in conversation
• Avoiding ritualized behaviors
• Tolerating normal portions
• Reducing plate comparisons

Behavioral quirks are addressed compassionately,
both privately and in group settings.

Weighing and the Role of Trust

Milestones conducts blind weights, typically weekly.
Numbers are not the focus.
Behavior change and stability are.

Nikki emphasizes that trust builds over time.
Early days are filled with fear.
By week one or two, many clients begin noticing:

• Improved satiety
• Reduced obsession
• Less chaotic eating
• Greater emotional stability

Admission Criteria

• Age 18+
• BMI of 16 or higher
• Clinical assessment for medical and psychological stability

The program is designed for individuals whose relationship with food
has become unmanageable and disruptive to daily life.

The Core Outcome: Freedom

Nikki frequently uses the term “freedom plan.”
Freedom from obsession.
Freedom from mental gymnastics.
Freedom from secrecy.
Freedom from food dominating every waking thought.

Recovery, in her view, is not about perfection.
It is about reclaiming bandwidth —
so individuals can return to relationships, work, hobbies,
and living fully.