Processed food addition has been a topic of controversy for more than a decade, but those working with patients who have symptoms of food addiction have recognised it as a complicating feature of obesity. Consequently, there has been a motivation to include processed food addiction in the spectrum of disordered eating (1, 2).

It is estimated that 14% of the general population may meet the criteria for ultra-processed food addiction (UPFA), though it is still not a recognised diagnosis, making evidence-based assessments and treatment guidelines a challenge to develop (3, 4). UPFA increases the risk of metabolic disorders like obesity and type 2 diabetes, which, in light of the global burden of these conditions, indicates that UPFA should be considered as a potential contributing factor.

Screening for UPFA could play a role in ensuring individuals have the appropriate level of support for making lifestyle changes commonly recommended for obesity or type 2 diabetes. In clinical populations with disordered eating diagnoses, estimates place the prevalence of UPFA closer to 40%, with studies indicating that individuals with bulimia nervosa have a high pooled prevalence of UPFA (84%), followed by binge eating disorder (63%) and anorexia nervosa (53%) (4). 

Metabolism and neurobiology

Various streams of evidence suggest that dysfunctional metabolic and neurobiological signaling pathways contribute to hedonic food drives, and these pathways are influenced in a bidirectional manner, differentially by carbohydrate and fat consumption (5).

Recent studies have pointed to a relationship between dopamine signalling and adiposity, suggesting neurobehavioural characteristics in common with those experiencing addiction and compulsive behaviours (6). Data from Darcey et al. suggest dietary fat intake can modulate dopamine tone, and fat restriction (tested using a low-fat diet) has been shown to increase dopamine tone, which may increase food drive and hunger (5, 6). Conversely, a higher-fat approach (tested using a reduced-carbohydrate, higher-fat diet) has been shown to decrease dopamine tone, reducing the desire for food (5).

Low-carbohydrate and ketogenic interventions

Reducing carbohydrates in the diet, especially into the ketogenic range (typically carbohydrates < 50 g/day), promotes metabolic and neurological changes that collectively reduce hunger and cravings, increase lipolysis (fat burning), alter dopamine tone, and improve mental wellbeing (3, 5, 7). As well as reducing food drive (or ‘food noise’), improvements in metabolic health are an added benefit (7, 8).

In 2020, a case series by Carmen et al. used a ketogenic diet to treat 3 patients with obesity who had binge eating and food addiction symptoms (7). Patients reported significant improvements in binge eating episodes and food addiction symptoms (cravings and a lack of control) as measured by a range of validated food addiction and binge eating scales (e.g., YFAS, YBOC-BE, BES).

In 2022, a multicentre study (103 participants) reported positive outcomes for UPFA recovery using a real food, low-carbohydrate educational programme (10-14 weeks) across 3 locations (8). Improvements were documented using a modified Yale Food Addiction Scale 2.0, CRAVED (ICD-10 symptoms of food-related substance use disorder), and the Warwick Edinburgh Mental Wellbeing Scale. Body weight was also recorded. In a follow-on study, Unwin et al. (2025) have reported 6- and 12-month data showing significant, sustained improvement in UPFA symptoms and mental well-being (3).

The CRAVED assessment is described in the Unwin et al. (2022) paper and is briefly described as:

C – Compulsion to eat

R – Reaching for more: tolerance

A – Activities neglected

V – Volume uncontrolled

E – Exclusion causes withdrawal

D – Despite damage, can’t stop

Toward a consensus on ultra-processed food addiction

The interconnected disorders of overeating behaviour and diseases related to diet deserve more attention in our current environment, where the growing global consumption of ultra-processed foods is occurring alongside increasing rates of chronic diseases. While many recognise UPFs as problematic from a nutritional standpoint, looking deeper at the neurobiology reveals their biochemical impacts on the brain have the potential to drive overeating and addictive symptoms in vulnerable individuals (9). A new consensus paper with 40 participants from clinical and research backgrounds has sought to provide a clear definition of terminology and symptoms to bring clarification and pave the way for official recognition of a distinct condition of UPF addiction (9). This is the first step in formal recognition which will encourage possible preventative measures and treatment protocols that can bring freedom to those struggling with the mental and physical effects of this condition. 

Further resources

Nutrition Network has partnered with leading experts who have identified strategies to help those facing the challenges of ultra-processed food addiction. Several training modules can be combined to equip clinicians and coaches in diagnosing and supporting those who struggle with cravings and addiction symptoms related to ultra-processed foods. Training options can be explored on the website (https://nutrition-network.org/online-training/).

1. Davis, C. et al. (2011) ‘Evidence that “food addiction” is a valid phenotype of obesity’, Appetite, 57(3), pp. 711–717. Available at: https://doi.org/10.1016/j.appet.2011.08.017.

2. Wiss, D.A. and Brewerton, T.D. (2017) ‘Incorporating food addiction into disordered eating: the disordered eating food addiction nutrition guide (DEFANG)’, Eating and Weight Disorders, 22(1), pp. 49–59. Available at: https://doi.org/10.1007/s40519-016-0344-y.

3. Unwin, J., Delon, C., et al. (2025) ‘Low carbohydrate and psychoeducational programs show promise for the treatment of ultra-processed food addiction: 12-month follow-up’, Frontiers in Psychiatry, 16, p. 1556988. Available at: https://doi.org/10.3389/fpsyt.2025.1556988.

4. ‘Correction to “Prevalence of food addiction determined by the Yale Food Addiction Scale and associated factors: A systematic review with meta-analysis”’ (2024) European Eating Disorders Review, 32(3), pp. 610–611. Available at: https://doi.org/10.1002/erv.3078.

5. Darcey, V.L. et al. (2023) ‘Dietary fat restriction affects brain reward regions in a randomized crossover trial’, JCI Insight, 8(12). Available at: https://doi.org/10.1172/jci.insight.169759.

6. Darcey, V.L. et al. (2025) ‘Striatal dopamine tone is positively associated with adiposity in humans as determined by PET using dual dopamine type-2 receptor antagonist tracers’, Molecular Psychiatry, pp. 1–10. Available at: https://doi.org/10.1038/s41380-025-02960-y.

7. Carmen, M. et al. (2020) ‘Treating binge eating and food addiction symptoms with low-carbohydrate Ketogenic diets: a case series’, Journal of Eating Disorders, 8(1), p. 2. Available at: https://doi.org/10.1186/s40337-020-0278-7.

8. Unwin, J. et al. (2022) ‘Low carbohydrate and psychoeducational programs show promise for the treatment of ultra-processed food addiction’, Frontiers in Psychiatry, 13. Available at: https://www.frontiersin.org/articles/10.3389/fpsyt.2022.1005523 (Accessed: 2 October 2022).

9. Unwin, J., Giaever, H., et al. (2025) ‘Toward consensus: using the Delphi method to form an international expert consensus statement on ultra-processed food addiction’, Frontiers in Psychiatry, 16, p. 1542905. Available at: https://doi.org/10.3389/fpsyt.2025.1542905.