One in seven adults could be addicted to ultra-processed food

It is estimated that roughly one in seven (14%) adults could be addicted to ultra-processed food, according to experts writing in the British Medical Journal.

In a new paper, Gearhardt et al looked at whether certain types of food may possess addictive qualities, and what implications this could be having on public health.

The authors of the paper warn that ultra-processed foods (which are high in refined carbohydrates and added fats) are highly rewarding and appealing and may be addictive, and that understanding these foods as addictive could lead to novel approaches in clinical care.

Food addiction prevalence

The authors of the paper first looked at the prevalence of food addiction, and refer to a recent analysis of two systematic reviews, which included 281 studies from 36 different countries.

The studies used the Yale Food Addiction Scale (YFAS) to estimate the prevalence of food addiction in the general population, which assesses all 11 criteria for substance use disorder in the DSM-5, including diminished control over intake, cravings, withdrawal, and continued use despite negative consequence. A substance use disorder is defined as the presence of two or more symptoms in the past year and clinically significant impairment or distress.

This analysis estimates the prevalence of food addiction to be 14% in adults and 12% in children, a similar prevalence to alcohol (14%) and tobacco (18%).

The YFAS asks people to report on intake of foods with high levels of refined carbohydrates or added fats, as these types of foods are most strongly implicated in the behavioural indicators of addiction.

The researchers say that since refined carbohydrates or fats evoke similar levels of dopamine in the brain to addictive substances, ultra-processed foods are a “strong candidate for an addictive substance”.

What is ultra-processed food?

While addiction to certain foods is not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), this new research suggests that behaviours around ultra-processed food may meet the criteria for diagnosis of substance use disorder in some people.

Ultra-processed foods (or UPFs) are defined as industrially produced foods which contain ingredients you would not use when cooking at home. UPFs are the main source of refined carbohydrate and added fats in the modern food supply.

While naturally occurring foods often contain high levels of carbohydrates or fats, they rarely contain both. For example, fruit and vegetables often contains a high amount of carbohydrates but very minimal amounts of fat, while dairy products and some types of fish and meat typically contain higher amounts of fat and minimal carbs.

The research therefore suggests that it is the combination of refined carbohydrates and fats, rather than either macronutrient alone, that is likely to give UPFs their additive effect.

Other factors which may affect how addictive UPFs are is the speed at which they deliver carbohydrates and fats to the gut and whether they contain any additives such as artificial sweeteners.

However, the researchers say that more research is needed to determine what makes UPFs addictive, for example, how certain ingredients interact to increase addictive potential and at what dose.

Calls for new policies which tackle food addiction

If the science supports reclassifying UPFs as addictive substances, then it is likely new policies will be put in place to tackle UPF addiction, similar to policies which aim to discourage tobacco use.

The authors of the research suggest this could involve introducing ultra-processed food and beverage taxes, mandatory or voluntary front-of-pack or shelf labelling systems and mandatory or voluntary reformulation of the food supply.

They add that a “multipronged” approach will be needed to “address the factors that allow the spread of potentially addictive UPFs to occur unchecked.”