Insights from Nikki Glantz, Nutritionist and Co-Founder of Milestones in Recovery (In Search Of More podcast)
Food is everywhere—celebration, comfort, family, culture, holidays, and social life. And that’s part of the problem: it can become one of the most socially “acceptable” vices, even when it’s quietly taking someone’s life over.
In a recent episode of the In Search Of More Podcast, host Eli Nash sits down with Nikki Glantz, co-founder of Milestones in Recovery (an inpatient eating disorder treatment center), to unpack the overlap between food addiction, eating disorders, emotional pain, and the way culture can intensify the pressure around food. Nikki’s central point is both simple and hard to swallow:
“It’s not about the food. It is, but it’s not.”
In other words, sometimes the “substance” matters (what the food does in the brain and body), but the deeper engine is emotional—what food is being used to fix, soothe, avoid, or control.
Milestones in Recovery: Eating Disorders, Disordered Eating, and When Life Becomes Unmanageable
Nikki explains that Milestones in Recovery is an eating disorder treatment center that blends both an addiction model and a medical model. They treat the full range of eating disorders and related behaviors, including:
- Anorexia
- Bulimia
- Diabulimia (insulin manipulation among insulin-dependent clients to change the body)
- Compulsive overeating/bingeing
- Restrictive and compensatory behaviors
But they’re not there for everyday “I wish I ate a little better” struggles. Nikki describes the line where they typically meet people: when life has become unmanageable. That may look like:
- Not being able to function at work because bingeing is consuming time and energy
- Losing significant money because spending on food has become compulsive
- Food behaviors are taking over nights, weekends, relationships, and mental space
Food issues can show up on both ends—overeating and undereating—and Nikki notes something important: even when symptoms look different, they can share the same underlying emotional driver.
Food Addiction vs. Eating Disorders: “It’s the Substance” and “It’s the Feelings”
Nikki draws a useful distinction:
- Food addiction often points to the substance itself—the ingredients and their effects in the body and brain.
- Eating disorders often point to the emotional system—the relationships, trauma, coping strategies, and internal pain that drive the behaviors.
But in real life, these often overlap. People can have both: foods that trigger an addiction-like response, and emotional dynamics that keep the cycle running.
Nikki’s “not about the food / it is about the food” line is essentially a warning against oversimplification. If you only focus on the food, you may miss the emotions. If you only focus on emotions, you may ignore that certain foods reliably light people up like a slot machine.
The Four “Problem Areas”: Sugar, Flour, Fat, and Salt
When asked what people tend to struggle with, Nikki gets blunt:
It’s rarely, “I overate broccoli.”
The struggle is typically with combinations and processing—especially:
- Sugar
- Flour
- Fat
- Salt
More specifically, she highlights the combos that hit hardest:
- Sugar + flour (cakes, pastries, desserts, many packaged snacks)
- Fat + salt (many snack foods and hyper-palatable processed items)
Nikki ties this to processing: the issue isn’t “food” in the broad sense—it’s often highly processed, engineered foods that drive compulsion.
When Eli reflects that it sounds like certain ingredients function “like a drug,” Nikki agrees and explains that this is part of why they treat it with an addiction-informed lens.
Food as Both a Chemical Addiction and a Process Addiction
Eli raises a helpful framework: some addictions are “process addictions” (gambling, sex), others are “chemical addictions” (drugs, alcohol). Nikki agrees that food often overlaps both categories.
Food can work like a substance, but also like a behavior loop—ritualized, compulsive, and emotionally reinforced.
That overlap also explains a pattern they see frequently: people stop one addiction, and food surges as the replacement.
Nikki describes referrals from drug treatment centers where clients put down the alcohol or drugs, and then food pops up. It can work in either direction—remove food and another compulsion can surface too.
She describes it like a “whack-a-mole” dynamic: you put one thing down, and something else pops up—because the real target is the underlying emotional system.
Culture, Pressure, and the “Acceptable Vice”
In the episode, they discuss how food can function in certain cultural contexts (including Orthodox Jewish communities) as one of the few socially acceptable pleasures—especially when other vices are strongly discouraged.
Nikki expands the point: it’s not just Jewish culture. Every culture centers food. Holidays, celebrations, socializing, connection—food is the hub.
That’s beautiful… and also pressure.
And here’s the trap: because food is so normalized, people often don’t realize they’re building a compulsive relationship until it’s out of hand.
It Starts Early: The First Memories Are Often Around Food
Nikki notes that for many people, the roots begin young—often before they’d ever label it “a problem.” The early memories can be things like:
- Hiding cookies
- Checking groceries for sweets
- Overeating during holidays or special occasions
- Developing secrecy, urgency, or obsession around certain foods
Over time, what starts as “normal” becomes a deeply reinforced coping system—and sometimes it evolves into other addictions (alcohol, drugs, gambling, sex), depending on the person.
“How Do I Know If It’s Really a Problem?”
Eli pushes for practical guidance: okay, you treat severe cases—how does an average listener know if their food struggle has become a real problem?
Nikki’s first answer is straightforward: get assessed. Milestones offers assessments to help people determine whether they’re dealing with disordered eating, an eating disorder, addiction-like patterns, or something else.
Then she offers a core diagnostic question:
- Does your relationship with food stop you from living your life?
That can show up as:
- Pulling away from friends
- Not engaging socially
- Trouble holding a job or staying connected
- Isolation, secrecy, and a shrinking life
Nikki also points out a common psychological defense: at first, many people say “no.” The brain that built the disorder often answers defensively. But over time, patterns become clearer: “Huh… I notice I’m not going. I’m not engaging.”
She calls eating disorders a disease of isolation—like addiction in general.
Addiction Markers: Tolerance and Withdrawal
Nikki mentions addiction-style markers that can show up with food:
- Tolerance: needing more food to feel satisfied
- Withdrawal-like symptoms when trying to stop (headaches, irritability, etc.), especially around sugar/flour
She gives a vivid example: someone who says, “This is my brownie,” but in reality the mentality is, “No, that’s for you… and the tray is for me.”
That’s compulsion—where it’s not “a little treat,” it’s a lock-in.
Learning to Sit in Discomfort: The “Pause” Instead of the Fix
Eli shares a concept he’s been exploring: becoming comfortable with hunger—not starvation, but the normal discomfort of “I could eat.” He references a talk (and frames it more broadly as being able to tolerate discomfort in general).
Nikki agrees this is hard for most humans, and especially hard for people with eating disorders—because the instinct is to fix discomfort immediately.
In their work, a key concept is the pause:
- Noticing the urge
- Stopping the automatic response
- Asking: “If it wasn’t food, what else is coming up?”
Sometimes the trigger isn’t food at all. It’s an upsetting email, a passing comment, a spike of anxiety, a flash of anger. The craving is a signal—often pointing to what’s actually bothering the person.
Why a Food Plan Comes First
Nikki explains that as the nutritionist, her job begins with establishing a structured food plan. The food plan isn’t the cure—it’s a stabilizer.
It reduces the constant internal negotiation:
- “Was that enough?”
- “Should I eat more?”
- “Am I hungry or emotional?”
When the body is reliably fed, the emotional content can “bubble up,” and the work becomes clearer. The plan helps separate physical hunger from emotional eating.
Do You Go “Zero” on Trigger Foods?
Eli asks an important question: if sugar/flour/fat/salt combos are addictive, do you go “zero” like addiction programs often do?
Nikki clarifies their approach:
- Sugar and flour are the main targets.
- Fat and salt aren’t universally eliminated (some people don’t struggle with them the same way).
They use a practical guideline: read the label.
If sugar or flour appears in the first four ingredients, it’s typically not part of the plan. Nikki explains why: ingredients are listed from most to least, so the first four are what the product contains the most.
If sugar is ingredient number five, it may be workable—depending on the person and how they respond.
She also emphasizes personalization: for some, sugar is the main issue; for others, flour is the bigger trigger; for some, even certain fruits can become too stimulating and lead to compulsive patterns.
It’s Not a Hospital Bubble: “Real Life” Treatment
One of the most distinctive elements Nikki describes is that Milestones is intentionally “real life.”
Clients live in apartment-style settings and practice the actual behaviors they’ll need at home:
- Making their own food from day one
- Grocery shopping (often twice a week)
- Meal mapping / meal planning for the week
- Bringing meals for lunches
- Group dinners
The philosophy is clear: the last day in treatment should mimic the first day at home as closely as possible. This reduces the “I did it in treatment, but I can’t do it at home” gap.
Is This “For Life” or Just for Treatment?
Nikki explains that during treatment, they start clean because they know it works—especially for sugar/flour-driven addiction patterns.
Over time, some people can reincorporate certain foods, carefully and with support. Others need hard boundaries long-term.
She compares it to alcohol recovery: you don’t tell someone who identifies as an alcoholic, “Let’s bring back beer” and see how it goes. For some people, certain foods have to be treated the same way.
At the same time, the program is tailored: their goal is to meet people where they are, and help them evolve recovery as life evolves.
The “Invisible” Cases: You Often Can’t Tell From the Outside
Eli notes that some eating disorder cases are visible (very underweight, very overweight), but asks about the ones you can’t see.
Nikki confirms: many people don’t look “obviously” disordered. They might be nurses, teachers, principals—people functioning outwardly.
Assessments often include frequency-based questions, such as:
- How often do you overeat or binge?
- What does it look like (portion, duration, timing)?
- Are you restricting? For how long?
- Are you compensating through exercise? How extreme?
Nikki gives examples ranging from bingeing after dinner to all-night eating patterns that can reach extreme calorie levels.
Exercise Compulsion, Orthorexia, and “Healthy” That Turns Obsessive
Nikki describes how disorders can start from a “healthy place” and become obsessive:
- Orthorexia: an obsession with eating “clean” or “healthy” that escalates into rigidity and compulsion
- Exercise addiction/compulsion: where movement becomes mandatory, punishing, or extreme—despite injury, exhaustion, or life disruption
She describes the fine line between being diligent and being trapped—like needing to exercise two to three hours daily, skipping life events, or pushing through injuries.
Body Dysmorphic Disorder: Often Behind the Eating Disorder
Nikki explains body dysmorphic disorder (BDD) as something that can sit behind eating disorders:
- Seeing your body differently than others see it
- Fixation on perceived flaws (size, skin, hair, specific body parts)
- Repeated checking behaviors (mirror checking, measuring, squeezing/checking)
- Spending hours evaluating and “testing” appearance
BDD isn’t always the eating disorder itself, but it can fuel the discomfort that drives eating behaviors and obsession.
What Healing and Recovery Looks Like
Nikki outlines a typical structure:
- Residential treatment
- Individual therapy
- Group therapy (including processing emotions, relapse prevention, exercise/body image topics, and more)
- Medical support (doctors, psychiatrists)
- Nutrition sessions and food planning
A typical stay can be about 30 days (sometimes longer), followed by transition support and telehealth check-ins after returning home.
She emphasizes how important it is to be in a room with people who identify with the struggle—because so much of eating disorders and addiction is secrecy and isolation.
The Emotional “Theme Underneath” Addiction
Eli shares a theory: beneath many addictions there’s a similar pain—often loneliness, self-consciousness, or self-hatred.
He notes that alcohol can reduce social self-consciousness, drugs can chase spiritual “union,” and sex addiction can be fueled by intense loneliness. For food, he senses self-hatred or disgust toward oneself.
Nikki largely agrees and adds nuance: these factors can blend together. She sees strong judgment and self-hatred frequently, alongside discomfort in the body and emotional pain that food temporarily fixes.
She also connects restrictive patterns sometimes to upbringing and internalized “not good enough” beliefs—again tying the food behavior to deeper emotional systems.
Closing Message: If You’re Wondering, That Matters
Near the end of the conversation, Nikki offers a simple, practical encouragement: if you’re curious or wondering whether this is a problem, that curiosity matters.
You don’t have to be an “extreme case” to benefit from asking questions, getting assessed, and finding support. Sometimes it’s not treatment—but it may still be therapy, nutrition guidance, or structured help.
And if it is treatment, they work with people from many places, not just locally.
Men and Food Addiction: The Stigma Factor
Nikki explains Milestones is a 20-bed facility that treats adults (18+)—men and women.
They discuss how men often hesitate to seek help for food issues. Alcohol addiction is widely recognized; food addiction still confuses people. For a lot of men, it can feel “more acceptable” to say they struggle with alcohol or drugs than to admit they struggle with food.
Nikki’s message is direct:
If you need help, you need help. No shame in that.
Ozempic and Weight-Loss Medications: A Tool, Not a Cure
After the main interview, the host brings up the Ozempic craze and asks for Nikki’s thoughts.
Nikki says Milestones is actively educating itself medically and watching how protocols evolve. She draws a boundary: they are not a weight-loss center, and they don’t believe a pill “fixes” the emotional or addiction component by itself.
She compares it to gastric bypass becoming mainstream: many people avoided treatment, tried the procedure, and later still needed help because the underlying emotional/substance issue remained.
That said, Nikki is not ideologically anti-medication. She frames it the way many people frame medications like antidepressants:
- It can take the edge off.
- It can be a tool in the toolbox.
- It does not replace therapy or recovery work.
They want to stay current with medical protocols while staying true to their core belief: recovery requires addressing both the behavior and the emotional system underneath it.
Final Takeaway
Food addiction and eating disorders aren’t just about “bad choices” or “lack of willpower.” Nikki’s perspective is that recovery means treating the whole system:
- The substances (trigger foods and processing)
- The behavior loop (compulsion, ritual, escalation)
- The emotional drivers (pain, discomfort, self-judgment, loneliness, trauma)
- The lifestyle structure (a plan that works in real life, not just in treatment)
And if you’re wondering whether your relationship with food has become a problem, Nikki’s advice is simple: ask the question, get assessed, and don’t wait until your life shrinks down to nothing but managing food and the fallout from it.
Listen to the full Podcast: Nikki Glantz On The In Search Of More Podcast
