Food Addiction Debate: Symptoms, Causes, and Treatment

By Hugo Francisco de SouzaReviewed by Benedette Cuffari, M.Sc.

Introduction
Defining a food addiction
Proposed mechanisms and causes
Growing evidence, ongoing debate
Treatment approaches
References
Further reading

Food addiction describes addiction-like responses to ultra-processed foods, but it is not yet a formal DSM-5 or ICD-11 diagnosis. Evidence links it to cravings, loss of control, reward pathways, trauma, and eating-disorder overlap.

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Introduction

As the prevalence of obesity continues to rise throughout the world, emerging research indicates that a subset of individuals may experience addiction-like responses to ultra-processed foods (UPFs), with symptoms similar to those observed in substance use disorders (SUDs). However, food addiction is not currently a formal diagnosis in the DSM-5 or ICD-11, and its validity remains debated.^3,5 In this context, food is considered a substance, with food addiction symptoms most commonly associated with foods high in fats and/or refined carbohydrates like sugar.

Defining a food addiction

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), addictions can be further classified as behavioral or substance use disorders. Gambling is currently the only behavioral addiction recognized in the DSM-5, despite the involvement of eating behaviors in food addiction.

The Yale Food Addiction Scale (YFAS) is a self-report instrument that is used to monitor eating behaviors based on DSM-5 criteria for SUDs, including intense cravings, loss of control, continued use despite harm, and unsuccessful attempts to mitigate intake.¹ Recent meta-analytic data cited in a 2025 commentary suggest that 14% of adults and 12% of children globally exhibit this addictive-like eating phenotype, a prevalence rate comparable to that of alcohol use disorders.⁴ Prevalence estimates vary widely by population and measurement tool; for example, a representative household survey in Rio de Janeiro estimated food addiction at 2.78%, while other general-population estimates have been higher.⁵

Clinical presentations of food addiction often involve continued consumption despite severe negative consequences, such as the persistent intake of UPFs following bariatric surgery or among individuals with diagnosed metabolic conditions.² Withdrawal-like symptoms, including irritability, anxiety, and anhedonia, have also been observed in individuals attempting to abstain from refined carbohydrates.²

Proposed mechanisms and causes

Food addiction is characterized by proposed dysregulation of mesolimbic dopaminergic signaling, specifically within the reward pathway projecting from the ventral tegmental area to the nucleus accumbens.¹ Most studies on food addiction implicate UPFs in this process due to their industrial formulation that combines high fat and refined sugar content to engage reward pathways and reinforce cravings.⁶ UPFs may also affect eating behavior through palatability, reward sensitivity, cue responsiveness, marketing exposure, and easy availability, rather than through a single addictive ingredient.^2,3,6

Both genetic and environmental factors modulate individual susceptibility to food addiction. For example, higher brain mu-opioid receptor availability has been observed in anorexia nervosa, providing broader evidence that opioid reward systems may be altered in eating disorders, although this finding is not direct evidence of food addiction.⁷

Childhood traumatic experiences (CTEs) are considered a potential developmental risk factor for addiction-like eating patterns, with mediation models indicating that attachment insecurity and emotional dysregulation explain up to 53.5% of the variance in appetite drive.⁸ The ubiquitous availability and aggressive marketing of inexpensive UPFs further exacerbate these biological vulnerabilities.⁶

Growing evidence, ongoing debate

Neurobiological and behavioral evidence increasingly supports the existence of addiction-like eating patterns. In a systematic review of 52 studies, every DSM-5 SUD criterion was empirically supported in the context of food, with brain reward dysfunction and impaired control demonstrating the strongest evidence base.¹

Observational studies corroborate these findings and consistently show associations between food addiction symptoms and poorer mental and physical health, including depression, anxiety, binge eating disorder, bulimia nervosa, diabetes, gastrointestinal symptoms, and lower quality of life.⁵ This overlap with binge eating disorder and bulimia nervosa is clinically important because it raises questions about whether food addiction is a distinct condition, a transdiagnostic construct, or a different label for established eating-disorder symptoms.^3,5

Despite these findings, there currently remains no definitive consensus on diagnostic validity, as some researchers maintain that food craving, emotional eating, binge eating, body-image distress, and perceived loss of control may overlap with existing eating-disorder constructs rather than proving a distinct addiction diagnosis.³ Alternatively, proponents argue that recognizing food addiction is essential to justify public health policies such as UPF taxation.² Recent expert consensus efforts have increasingly focused on “ultra-processed food addiction” or “ultra-processed food use disorder,” but these terms remain proposed rather than officially adopted diagnoses.^4,9

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Treatment approaches

Current treatment approaches for food addiction primarily rely on behavioral therapies, particularly cognitive behavioral therapy (CBT), to reduce disordered eating.¹⁰ However, there is no established standard treatment for food addiction itself, and evidence from broader eating-disorder treatment research suggests that CBT is often better than no treatment, but not consistently superior to other active interventions.¹⁰ Dietary modifications that emphasize a harm reduction model encourage the reduction or exclusion of specific UPFs while maintaining the intake of healthy, whole foods.² Some clinicians and researchers also discuss abstinence-based approaches for specific trigger UPFs, although the safest and most effective intervention model has not yet been established.⁹

Because food addiction symptoms often overlap with binge eating disorder, bulimia nervosa, trauma histories, anxiety, depression, and other health conditions, assessment should consider co-occurring eating disorders and mental health concerns rather than focusing only on weight or willpower.^3,5,8

Emerging data from GLP-1 receptor agonists suggest potential to reduce cravings. However, these drugs are currently indicated for weight management, rather than as a primary treatment for food addiction.³

References

1. Gordon, E., Ariel-Donges, A., Bauman, V., & Merlo, L. (2018). What Is the Evidence for “Food Addiction?” A Systematic Review. Nutrients 10(4), 477. DOI – 10.3390/nu10040477. https://www.mdpi.com/2072-6643/10/4/477
2. Gearhardt, A. N. & Hebebrand, J. (2021). The concept of “food addiction” helps inform the understanding of overeating and obesity: YES. The American Journal of Clinical Nutrition 113(2); 263-267. DOI: 10.1093/ajcn/nqaa343. https://www.sciencedirect.com/science/article/pii/S0002916522005846?via%3Dihub
3. Oliveira, J., Bestetti, G. C., Stelmo, I. D. C., et al. (2025). Questioning the validity of food addiction: a critical review. Frontiers in Behavioral Neuroscience 19. DOI: 10.3389/fnbeh.2025.1562185. https://www.frontiersin.org/journals/behavioral-neuroscience/articles/10.3389/fnbeh.2025.1562185/full
4. LaFata, E. M., Moran, A. J., Volkow, N. D., & Gearhardt, A. N. (2025). Now is the time to recognize and respond to addiction to ultra-processed foods. Nature Medicine 31(11); 3586-3587. DOI: 10.1038/s41591-025-03858-6. https://www.nature.com/articles/s41591-025-03858-6
5. da Cruz, V. L., Appolinario, J. C., Sichieri, R., Hay, P., & de Souza Lopes, C. (2025). Food addiction and its associations with mental and physical health comorbidities and with quality of life in the general population. Journal of Eating Disorders 13(1). DOI: 10.1186/s40337-025-01400-0. https://link.springer.com/article/10.1186/s40337-025-01400-0
6. Mottis, G., Kandasamey, P., & Peleg-Raibstein, D. (2025). The consequences of ultra-processed foods on brain development during prenatal, adolescent and adult stages. Frontiers in Public Health 13. DOI: 10.3389/fpubh.2025.1590083. https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1590083/full
7. Pak, K., Tuisku, J., Karlsson, H. K., et al. (2025). Anorexia nervosa is associated with higher brain mu-opioid receptor availability. Molecular Psychiatry 30(7); 2840-2847. DOI: 10.1038/s41380-025-02888-3. https://www.nature.com/articles/s41380-025-02888-3
8. Rossi, A. A., & Mannarini, S. (2025). Childhood traumatic experiences and addiction-like eating behaviors: the mediating roles of attachment, mentalization, and emotional eating. Journal of Eating Disorders 13(1). DOI: 10.1186/s40337-025-01473-x. https://link.springer.com/article/10.1186/s40337-025-01473-x
9. Unwin, J., Wiss, D. A., & Soto-Mota, A. (2025). Editorial: Ultra-processed food addiction: moving toward consensus on mechanisms, definitions, assessment, and intervention. Frontiers in Psychiatry 16. DOI: 10.3389/fpsyt.2025.1751346. https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1751346/full
10. Wade, T. D. (2025). The Meta‐Analytic Evidence Is In - Time to Get on and Improve Our Treatments. International Journal of Eating Disorders 58(11); 2058-2061. DOI: 10.1002/eat.24520. https://onlinelibrary.wiley.com/doi/10.1002/eat.24520

Further Reading

• All Addiction Content
• Tremors Following Alcohol Dependency
• Video Game Addiction Symptoms, Diagnosis and Treatment
• Sun Addiction: Evolutionary Survival Advantage?
• What is Heroin Addiction?

Last Updated: May 31, 2026