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A study in Frontiers in Psychiatry describes the results from a pilot program testing the feasibility and acceptability of an online, peer-supported intervention for adults self-identifying with ultra-processed food addiction (UPFA).
Ultra-processed food addiction is not recognized as a condition, so no formal diagnoses can be made. People must self-identify based on symptoms and clinical assessments. The authors of this paper estimate that the global prevalence of UPFA may be as high as 14% to 20%, and estimates are even higher for those with binge eating disorder (63%), bulimia (84%), or type 2 diabetes (30%).
The program called for 6 weeks of coach-led education sessions covering food planning, the neuroscience of addiction, hormonal influences, and behavior change strategies. Additionally, the program included peer-to-peer support and personalized dietary changes focused on abstinence or harm reduction. It “draws on evidence from substance use disorder treatment where abstinence is often the gold standard, while also incorporating harm reduction principles for those not ready for abstinence.” This approach is favored because, according to the researchers, “Individuals who experience ultra-processed foods as addictive may require different support from standard moderation-based approaches.” (In plain English, telling someone to just “eat less” or simply “eat in moderation” when it comes to trigger foods rarely works!)
The goal of the pilot study was to assess retention and adherence, and determine the magnitude of change in addictive behavior, eating disorder scores, mental well-being scores, and anthropometric measures (weight and BMI), as well as to evaluate participant acceptability of the program in order to inform recruitment for a larger trial in the future. Qualitative data collected included UPFA symptom measurements (such as the Yale Food Addiction Scale and CRAVED) and assessments of mental wellbeing.
Statistically significant improvements were observed in UPFA symptoms and mental wellbeing after the intervention and were sustained at 6-month follow-up. Statistically significant decreases were seen in weight and BMI but they were deemed clinically negligible. Participants reported greater self-awareness, reduced impulsive eating and eating behaviors, and increased confidence in managing UPFA symptoms.
A core tenet of the program is helping people view UPFA as a disease in order to remove self-blame, encourage self-compassion, and understand the root causes of addiction. This approach may be more fruitful in yielding long-term improvements for individuals who may blame themselves for a lack of “willpower” or “discipline” when they have difficulty moderating intake of certain foods.
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