Highly processed food addiction: A concept analysis

Aim: This concept analysis aims to clarify the highly processed food addiction (HPFA) concept and discuss its implications for treating obesity.

Background: Emerging empirical evidence suggests addictive-like eating may contribute to obesity in some individuals, increasing interest in HPFA's role in obesity. Clarifying the HPFA concept will aid in developing individualized interventions for patients with obesity and HPFA.

Design: This concept analysis followed Walker and Avant's approach. The case studies are of participants in a study that included individuals with and without HPFA (Yale Food Addiction Scale 2.0-diagnosed).

Data source: We searched PubMed, CINAHL, PsychInfo, and Ebscohost databases. Keywords were "food addiction" and "food addiction concept."

Review methods: Criteria included recent reviews and empirical studies that measured HPFA and focused on HPFA characteristics and/or treatment implications.

Results: The model case displayed all 11-substance use disorder (SUD) symptoms and clinical significance, supporting a severe HPFA diagnosis. The contrary case was negative for all YFAS 2.0 symptoms and clinical significance and did not eat compulsively or experience cravings. The borderline case met the minimum symptom criteria for severe HPFA but not clinical significance. Clinical interviews may help determine whether such individuals truly exhibit addictive-like eating behaviors.

Conclusions: Growing empirical evidence and our case studies support the HPFA concept and the utility of the YFAS/YFAS 2.0 for identifying a distinct subset of individuals with overweight/obesity who may benefit from interventions developed to treat established SUDs. Future research should examine HPFA separately and in relation to obesity and eating disorders and include longitudinal studies and gender-balanced samples.