Are ultra-processed foods addictive? Let’s look at the evidence | Nutrition By Carrie

For all the talk of food addiction like it’s a certain thing, idea of food addiction is actually controversial, for several reasons. Perhaps even more controversial is the current belief that ultra-processed foods, specifically, are not only addictive but intentionally designed to be so.

Let’s just say this particular aspect of the food addiction conversation is having quite a moment. Proponents of the food addiction framework have started using the phrase “Ultra Processed Food Addiction” (UPFA). They are arguing that UPFA is it a substance addiction (as with drugs, alcohol or nicotine,) and not a behavioral addiction (as with gambling, shopping, pornography, etc.).

Let’s look at why the general idea of food addiction, which has gained traction in public consciousness over the past few decades — paralleling talk of the modern food environment and its highly palatable foods — isn’t certain. Along the way, I’ll also look at the notion that ultra-processed foods are out to hook us.

Addicted to what, exactly?

Can we really become addicted to food in the same way we might become addicted to tobacco, alcohol or cocaine? It’s a controversial question that presents a few conundrums:

• One, unlike alcohol or drugs, we depend on food to live.
• Two, what people experience as food addiction doesn’t match up to the science — currently there is no evidence that food, or even sugar, are chemically addictive substances. Food is far more complex than a single substance like cocaine or alcohol. We eat a mixture of foods and scientists have yet to identify a single ingredient, even in ultra-processed foods, that’s physically addictive properties in humans.

Much of the research on food addiction comes out of Yale University, including brain scans showing that in people who report food addiction, eating addictive foods trigger brain responses that look very similar to responses to alcohol or hard drugs. But there’s a problem with that. Alcohol and drugs hijack the neurological pathways that were designed to release dopamine (the “pleasure hormone”) in response to natural rewards like foods, not the other way around.

For example, just because sugar and cocaine share the same neuropathways doesn’t mean sugar is addictive. Let’s look at it this way: activities such as looking at a loved one’s face, cuddling a pet, and listening to music also activate those pleasure pathways — yet no one worries about them being addictive.

I know that some people feel more comfortable viewing food as simply fuel, but food is meant to be rewarding, because, just like sex, there was an evolutionary advantage to finding food rewarding. Think of the hunter-gatherer days when our ancestors had to really work hard to procure food — if food wasn’t rewarding, why would they bother?

Finding food rewarding is part of what keeps the human race alive.

Yale Food Addiction Scale

The Yale Food Addiction Scale has set criteria for diagnosing food addiction that include:

• Persistent eating despite negative consequences to physical or emotional health
• Persistent desire for food
• Unsuccessful attempts to cut down
• Impairment of functioning to daily routines, relationships or health because of overeating

It also includes poorly defined criteria for tolerance and withdrawal symptoms — which is especially controversial. The primary problem is that the Yale Food Addiction Scale is diagnosing addiction based on someone’s felt or subjective experience rather than something that can be observed happening on a neurobiological level with brain scans.

I want to pause that this doesn’t discount people’s feelings of food addiction. If you’ve ever thought, “If I don’t bring chocolate/ice cream/potato chips into my house, I’m OK, because the moment I start eating them, I can’t stop,” your feelings are very real, but what lies beneath your experience might not be what you think.

I remember that when I first encountered the Yale Food Addiction Scale some 15+ years ago, before I went back to grad school to study nutrition, it seemed like a revelation. But then I learned more about the science of addiction — and learned that most of the participants in Yale’s food addiction research studies were college-age women. What do a lot of college-age women have in common? If you said, “They’re dieting or otherwise restricting food,” you get a gold star.

And what happens when you are in a food-restricted/deprived state? If you said, “You crave food more and may feel out of control around it when you do eat, especially if it’s tasty food like the milkshakes often used in food addiction studies that then do brain scans to observe the brain’s pleasure centers,” you get a whole sheet of gold stars.

The problem with abstinence

Abstaining from “addictive” foods is a common treatment tool, but this may contribute to the problem. Many people translate “food addiction” as “I can never have these foods because I’m an addict, and I can’t be trusted with them.”

This seems like a good place to point out that human food addiction studies generally don’t assess attitudes about “good” and “bad” foods or screen for history of chronic dieting or disordered eating. In fact, the only studies that show true addictive-like or compulsive behavior are with rodents that have been intermittently deprived of sugar.

This means that when we abstain from a food, we are depriving ourselves of it, potentially setting ourselves up to eat in a way that feels compulsive when we do have that food. Why? Because we get a bigger burst of dopamine than when we would if we regularly ate that food. Just like with the rats that are intermittently deprived of sugar.

Imagine abstaining from chocolate for two years, then letting yourself have a brownie. There is going to be that surge of dopamine, and it’s going to feel really good. This may increase the likelihood that you have another brownie, then another, and another, because it tastes amazing — maybe even better than you remember prior to vowing to never have chocolate again.

When you add in the “Last Supper mentality” of “I don’t know when I will let myself have chocolate again so I better enjoy it now,” this can make you feel even more out of control around the brownies — and vowing to never eat them again. But what you forget and lose sight of in the moment is that this all began with abstaining from the food out in the first place. The restricting preceded the overeating.

What about ultra-processed foods?

Another problem with food addiction research is that it centers on responses — real or theoretical — to “hyperpalatable” foods high in sugar, fat and sometimes caffeine. Think milkshakes, chocolate, soda, pizza or French fries. Coincidentally — or not — these are not just ultra-processed foods, but also the types of foods most likely to be labeled as “bad,” and, let’s face it, forbidden fruit tastes the sweetest. The more someone tries to avoid these foods, the more likely the experience will feel out of control when they eventually “lose their willpower.”

Now let’s talk about those milkshakes again. Results of a study published in March found that brain dopamine responses to ultra-processed milkshakes are highly variable in humans. They’re also not significantly related to body fat levels, which kind of blows a hole in the ideas that:

• Ultra-processed foods are addictive
• That addiction to ultra-processed foods is responsible for weight gain

This study was led by former National Institutes of Health (NIH) researcher Kevin Hall. Hall resigned from the NIH in April because he was barred from talking to The New York Times about his findings. Why was he barred from doing this? Because evidence that ultra-processed foods are not additive doesn’t fit with the opinions and beliefs of the current political appointee heading up Health and Human Services, the agency that encompasses the NIH as well as the Food and Drug Administration (FDA), the Center’s for Disease Control and Prevention (CDC) and numerous other health-related agencies.

No, the party line, which is unfortunately shared by a number of otherwise “health experts,” is that ultra-processed foods are addictive and they were deliberately designed to be so in order to drive sales.

Now, obviously food manufacturers want to sell as much of their products as possible, and so want to make them as tasty and appealing as possible, but there’s super-tasty (which is actually somewhat subjective) and then there’s addictive.

But what if you feel like you’re addicted to food?

Even the researchers behind the NIH study I mentioned said their results don’t discount the experience of individuals who feel out of control around ultra-processed foods high in fat and sugar. However, they said their results do but call into question the narrative that the dopamine response in the brain’s pleasure center after eating these foods is similar in magnitude to that of illicit drugs and makes people want to eat more in a way that’s similar to drug-seeking behavior.

There are many reasons someone might overeat in a way that feels out of control, including having a diagnosable eating disorder, such as binge eating disorder or bulimia nervosa, which both need and deserve expert treatment.

For some people, simply discovering that restriction and abstinence can lead to binging and feelings of being out of control about food isn’t enough. Trying to break the cycle by suddenly granting permission to eat the “forbidden” food may make things worse.

Why? Because abstaining primes your brain to become preoccupied with those foods. Without unlearning the unhelpful thoughts and judgments about ultra-processed food and developing skills for approaching those foods more neutrally, reintroducing those foods can lead to binging or other out-of-control eating. This unfortunately provides what appears to be proof that, see, you can’t be trusted around those foods.

But with support to reintroduce these foods as part of a balanced, calorically adequate diet — so you’re not experiencing extra hunger and deprivation — these foods can become less seductive, and feelings of compulsion and lack of control tend to fade. You become habituated to having those foods.

Again, making sure you are eating enough is essential, because the biological drive to eat enough calories is a survival instinct, and that survival creates a very strong drive to eat.

Hi, I’m Carrie Dennett, MPH, RDN, a weight-inclusive registered dietitian, nutrition therapist and body image counselor. I help adults of all ages, shapes, sizes and genders who want to break free from disordered eating or chronic dieting, learn how to manage IBS symptoms with food, or improve their nutrition and lifestyle habits to help manage a current health concern or simply support their overall health and well-being. This post is for informational purposes only and does not constitute individualized nutrition or medical advice.

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