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Objective <p>Ultra-processed food addiction (UPFA) is increasingly recognized but remains controversial among eating disorder (ED) clinicians, partly due to concerns that introducing food addiction concepts might intensify dietary restraint, a core feature of EDs. This study examined whether integrating UPFA assessment, psychoeducation and treatment into residential treatment (RT) impacts ED symptomatology, particularly dietary restraint.</p> Methods <p>Adults (N = 132) admitted to RT completed the Eating Disorder Examination Questionnaire (EDE-Q) and the modified Yale Food Addiction Scale 2.0 (mYFAS2.0) at admission and discharge. Changes in EDE-Q global scores and EDE-Q restraint subscale scores were analyzed using repeated-measures analysis of variance (RANOVA) with ED diagnosis as a between-subjects factor and age, gender identity, sexual orientation, and admission BMI as covariates. Pearson correlations between mYFAS2.0 and EDE-Q scores were calculated at both time points to assess construct overlap.</p> Results <p>Both EDE-Q global and EDE-Q restraint scores decreased significantly in the ED patients (<i>p</i> ≤ 0.001) and remained low in the non-ED patients. mYFAS2.0 scores were not significantly correlated with EDE-Q restraint scores at either admission or discharge, while they were weakly correlated with EDE-Q global scores at both time points.</p> Conclusions <p>UPFA-informed assessment, psychoeducation and/or treatment did not increase EDE-Q restraint scores. Instead, they declined significantly in ED patients, with no worsening observed. Modest post-treatment correlations between UPFA and EDE-Q global scores but not EDE-Q restraint scores suggest partial but incomplete overlap between EDs and UPFA symptomatology, with caloric restraint confined to EDs alone. These results support their nosological distinction and the feasibility of concurrent treatment without worsening ED-related dietary restraint. </p>

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First do no harm: the impact of assessing for ultra-processed food addiction on dietary restraint in patients with and without eating disorders during residential treatment

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月29日

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  • Kim Dennis,
  • Cindy Nguyen,
  • Nikki Bishop,
  • Dean Bilenker,
  • Timothy D. Brewerton

摘要

Objective

Ultra-processed food addiction (UPFA) is increasingly recognized but remains controversial among eating disorder (ED) clinicians, partly due to concerns that introducing food addiction concepts might intensify dietary restraint, a core feature of EDs. This study examined whether integrating UPFA assessment, psychoeducation and treatment into residential treatment (RT) impacts ED symptomatology, particularly dietary restraint.

Methods

Adults (N = 132) admitted to RT completed the Eating Disorder Examination Questionnaire (EDE-Q) and the modified Yale Food Addiction Scale 2.0 (mYFAS2.0) at admission and discharge. Changes in EDE-Q global scores and EDE-Q restraint subscale scores were analyzed using repeated-measures analysis of variance (RANOVA) with ED diagnosis as a between-subjects factor and age, gender identity, sexual orientation, and admission BMI as covariates. Pearson correlations between mYFAS2.0 and EDE-Q scores were calculated at both time points to assess construct overlap.

Results

Both EDE-Q global and EDE-Q restraint scores decreased significantly in the ED patients (p ≤ 0.001) and remained low in the non-ED patients. mYFAS2.0 scores were not significantly correlated with EDE-Q restraint scores at either admission or discharge, while they were weakly correlated with EDE-Q global scores at both time points.

Conclusions

UPFA-informed assessment, psychoeducation and/or treatment did not increase EDE-Q restraint scores. Instead, they declined significantly in ED patients, with no worsening observed. Modest post-treatment correlations between UPFA and EDE-Q global scores but not EDE-Q restraint scores suggest partial but incomplete overlap between EDs and UPFA symptomatology, with caloric restraint confined to EDs alone. These results support their nosological distinction and the feasibility of concurrent treatment without worsening ED-related dietary restraint.