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In Episode 2x05 Big Girls Don't Cry of The Sopranos, Dr. Melfi has the following dialogue with her therapist and former teacher, Dr. Kupferberg:

Kupferberg: You mentioned you've put on a little weight lately. Do you think the overeating has anything to do with your patient?

[Melfi shrugs reluctantly]

Kupferberg: What is it you're not telling me, Jennifer?

Melfi: I don't know. I don't know what you mean.

Kupferberg: [Unconvinced] Okay.

Melfi: I don't. What are you driving at?

Kupferberg: Just, watch your intake of sugar. And sugar substitutes.

Both characters seem to be quite uncomfortable throughout the dialogue.

What is Kupferberg hinting at with the sugar substitutes?

If possible, try to answer without spoiling too much from later episodes.

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Melfi has a history of alcohol abuse.

Kupferberg is aware of this and is afraid that Melfi might use alcohol to escape her guilt about abandoning Toni. He uses the term sugar substitutes as a euphemism for alcohol.

Alcohol is not a sugar in the chemical sense, but rather a product of fermenting sugar. It can however, toxic effects left aside, serve as a nutrient for humans, similar to sugar and other carbohydrates. In particular, excessive alcohol consumption often results in weight gain.

Kupferberg knows that if he accused Melfi straight away she would shut him out again (as she did in a previous session on the same episode). He instead tries a more subtle approach, hoping that Melfi will understand his warning.

Later in that same episode, when Melfi calls Tony to tell him that she is willing to treat him again, she is repeatedly drinking from a glass of red wine. This further indicates that she uses alcohol as a means of dealing with a stressful situation.

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I don't think he's hinting at anything but rather advising Melfi about her health. Sugar substitutes (AKA sweeteners) might be as detrimental to your health as sugar and might lead to weight gain.* From the Wikipedia page about sugar substitutes:

A 2012 study at Universidade Federal do Rio Grande do Sul showed that addition of either saccharin or aspartame to the diet of test rats resulted in increased weight gain compared to addition of sucrose, when total caloric intake was similar among groups.

*[Please don't regard an answer on a movie & TV fansite as actual medical advice...]

  • As to why it's awkward, well, Melfi's sessions with Kupferberg usually are, esp. when they discuss Tony. Melfi is annoyed with Kupferberg on one hand insisting that she should lose Tony as a patient (probably because she suspects he's right) and on the other always seeming eager for some gossip about him. I found it to be one of the funnier aspects of that show. – Walt Jul 17 '15 at 18:41
  • From the way that Kupferberg emphasizes this part of the dialogue, I would find it odd if he just gave generic health advice. It's plausible from just the written dialogue, but not in how the scene is played (sorry I can't offer a video). I posted a theory of how I understood that scene as an answer, but since I did not yet proceed further in the series, I don't know what it's worth ;) – ComicSansMS Jul 18 '15 at 15:40
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    Hmm, after rewatching the scene, he does look like he's hinting at something. However, though it's an interesting theory, it's a bit farfetched that someone would say 'sugar substitute' as a euphemism for booze IMO. – Walt Jul 18 '15 at 16:28

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