GLP-1s and limits of medication

In this episode, Dr. Vera Tarman spoke with Adrienne Sprouse, MD, a Columbia-trained physician with extensive experience in emergency medicine, toxicology, and environmental medicine, as well as more than four decades of stable food recovery.

Adrienne reflected on how growing up in an alcoholic family system shaped her early coping strategies and how food became a primary source of comfort and regulation. Over time, she began to notice that certain foods didn't simply soothe emotional distress but instead triggered a predictable cycle of cravings, symptoms, and relapse. This realization led her to distinguish between compulsive overeating as a behavioral response and food addiction as a physiological reaction to specific foods.

A central focus of the conversation was Adrienne's Prouse Rotational Eating Plan, a structured four-day rotation approach rooted in the concept of cyclic food allergy, originally described by Dr. Herbert Rinkle. Adrienne explained the difference between fixed food allergy—where symptoms occur every time a food is eaten—and cyclic food allergy, where symptoms depend on frequency and amount. She described how repeated exposure to the same foods, common in modern eating patterns, can "stack" in the body and contribute to escalating symptoms such as bloating, edema, headaches, joint pain, and the familiar experience of temporarily "getting away with it" before relapse.

Adrienne also outlined the 24-day home food-testing process described in her book, which was designed to help individuals identify their "sober foods," clarify which foods destabilize them, and create a rotation that supports long-term stability without relying on willpower alone.

The conversation extended beyond biology into emotional and spiritual recovery. Adrienne shared why she believed that a food plan alone was insufficient for many people and how 12-step recovery supported her ability to cope with stress, trauma, and relational dynamics that previously fueled her eating. She described 12-step principles as a stabilizing force that helped her maintain honesty, accountability, and resilience alongside her eating structure.

Adrienne's book, 50 Years of Twelve Step Recovery, was discussed as a synthesis of lived experience, physiology, and recovery practice, offering both individuals and clinicians a broader framework for understanding relapse cycles, abstinence, and whole-person healing.

• How Adrienne differentiated compulsive overeating from food addiction physiology

• What she meant by "sober foods" and why identifying them reduced chaos and cravings

• Why cyclic food allergy patterns are often overlooked

• How the four-day rotation was intended to reduce food "stacking" and stabilize symptoms

• An overview of the 24-day food testing approach outlined in her book

• How certain foods might be reintroduced medically, while acknowledging psychological and spiritual considerations

• Why chemical exposures and non-organic foods were discussed as potential contributors to craving

• Adrienne's perspective on GLP-1 medications, including their limits in teaching coping skills

• How 12-step recovery complemented biological interventions and supports long-term maintenance

Adrienne Sprouse, MD, graduated from Columbia University College of Physicians and Surgeons and trained in emergency medicine at Bellevue Hospital, toxicology at the New York City Poison Center, and Nutrition/Allergy/Detoxification/Clinical Ecology with the American Academy of Environmental Medicine. She later served as faculty for the Academy, educating physicians internationally for 17 years. She was Medical Director of Manhattan Health Consultants for decades and was featured in major media outlets including ABC, NBC, Fox Good Day New York, and The New York Times.

She is the author of 50 Years of Twelve Step Recovery, drawing on both long-term personal recovery and decades of clinical practice.

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