The Badly Behaving Brain: How Ultra-Processed Food Addiction Thwarts Sustained Weight Loss

Abstract

Global obesity rates continue to rise, despite billions spent annually on weight loss. Sustained success is rare; recidivism is the most common feature of weight loss attempts. According to the DSM-5 criteria for substance use disorders, the pattern of ultra-processed food (UPF) overconsumption is best characterized as an addiction. There is significant overlap in how UPF and drugs of abuse impact many brain systems. Over time, neurological changes result in overpowering cravings, insatiable hunger, and a willpower gap. The Yale Food Addiction Scale 2.0 is a validated and widely used tool for the diagnosis of UPF addiction. Research on treatment is nascent, but two weight loss approaches that directly target addiction, GLP-1 agonists and Bright Line Eating, both decrease hunger and cravings and result in significantly greater sustained weight loss than other methods. Addressing addiction is an avenue to weight loss that warrants further study.