Ultra-Processed Food Addiction Paper “Low Carbohydrate and Psychoeducational Programs Show Promise for the Treatment of Ultra-Processed Food Addiction”

I am always excited to make a new contribution to peer-reviewed literature. As you might know, I have been committed to spreading awareness about food addiction as a public health issue that deserves attention in the policy arena. I have worked very hard to discuss food addiction in a way that is sensitive to those with restrictive eating disorders and view it from a trauma-informed lens. In other words, just because someone meets the criteria for food addiction does not mean they should start dieting and trying to cut out all foods. We need nuanced approaches.

In this paper, our team did a good job of identifying cases of ultra-processed food addiction and enrolling them into the group psychoeducational program. The intervention consisted of education about the neurobiology of addiction, and how to modify food intake (in this case reducing refined carbohydrates) along with recovery tools and social support. The study is ongoing but we reported some preliminary findings. Stay tuned for more findings next year!

I did not want the paper to focus on weight changes, but that data is important for journals and researchers. As more and people are learning, the weight that is lost is usually regained. While some of us do predict weight regain, we are curious to see if treatment for ultra-processed food addiction can engage people with recovery and improve their quality of life. This is such a tricky terrain to navigate, with weight stigma becoming an important social justice issue. It is my belief that food addiction science can help reduce weight stigma, if messaged properly.

Notice this paper was published by clinicians rather than academics 🙂

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Abstract: 

Food addiction, specifically ultra-processed food addiction, has been discussed in thousands of peer-reviewed publications. Although 20% of adults meet criteria for this condition, food addiction is not a recognized clinical diagnosis, leading to a dearth of tested treatment protocols and published outcome data. Growing numbers of clinicians are offering services to individuals on the basis that the food addiction construct has clinical utility. This audit reports on clinical teams across three locations offering a common approach to programs delivered online. Each team focused on a whole food low-carbohydrate approach along with delivering educational materials and psychosocial support relating to food addiction recovery. The programs involved weekly sessions for 10–14 weeks, followed by monthly support. The data comprised pre- and post- program outcomes relating to food addiction symptoms measured by the modified Yale Food Addiction Scale 2.0, ICD-10 symptoms of food related substance use disorder (CRAVED), mental wellbeing as measured by the short version of the Warwick Edinburgh Mental Wellbeing Scale, and body weight. Sample size across programs was 103 participants. Food addiction symptoms were significantly reduced across settings; mYFAS2 score −1.52 (95% CI: −2.22, −0.81), CRAVED score −1.53 (95% CI: −1.93, −1.13) and body weight was reduced −2.34 kg (95% CI: −4.02, −0.66). Mental wellbeing showed significant improvements across all settings; short version Warwick Edinburgh Mental Wellbeing Scale 2.37 (95% CI: 1.55, 3.19). Follow-up data will be published in due course. Further research is needed to evaluate and compare long-term interventions for this complex and increasingly burdensome biopsychosocial condition.

Dr. David Wiss became a Registered Dietitian Nutritionist (RDN) in 2013 and founded Nutrition in Recovery, a group practice of RDNs specializing in treating eating and substance use disorders. In 2017, David received the “Excellence in Practice” award at the National Food and Nutrition Conference and Expo. The California Academy of Nutrition and Dietetics awarded him the “Emerging Dietetic Leader Award” in 2020. He earned his Ph.D. from UCLA’s Fielding School of Public Health in the Community Health Sciences department (with a minor in Health Psychology) by investigating the links between adverse childhood experiences and various mental health outcomes among socially disadvantaged men. His treatment philosophy is based on a biopsychosocial model which incorporates an understanding of biological mechanisms, psychological underpinnings, and contextual factors that integrate the social determinants of health. Wise Mind Nutrition is an app-based interactive treatment program available for download now - https://wisemindnutrition.com/download.

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