Addictions
January 10, 2025
TLDR: Intuitive Eating & Ultra-Processed Food Addiction
This article explores the intersection of intuitive eating and food addiction.
Key takeaways:
Ultra-processed food addiction is gaining scientific support
Intuitive eating principles can help but may need modification
Traditional intuitive eating may not work for everyone
Some need a transition period with less processed foods
Recovery approaches should be personalized, not one-size-fits-all
Wise Mind Nutrition emphasizes the importance of:
Balancing food freedom with biological realities
Avoiding black-and-white thinking about food philosophies
Supporting body positivity while acknowledging addiction science
Making recovery sustainable and individualized
The article concludes that intuitive eating can be helpful for those with ultra-processed food addiction when modified appropriately and combined with other evidence-based approaches.
[Read full article for detailed discussion of food addiction science and modified intuitive eating principles]
Can Intuitive Eating Be Helpful to Individuals with Ultra-Processed Food Addiction?
Evidence supporting the concept of ultra-processed food addiction continues to grow, but safe and effective intervention strategies are less clear. In the eating disorder field, food addiction has been not only controversial but, among some groups, vehemently opposed.
This article explores the dialectics associated with divergent food philosophies: one that implicates ultra-processed foods as problematic for health and one that aims to legitimize ultra-processed foods and implicates “diet culture” as the intervention target.
Modifications to Intuitive Eating principles are offered for individuals with ultra-processed food addiction. There are ways to embrace and encourage food and body-positive messages while also honoring the neurobiological implications of substance-related disorders, including ultra-processed food addiction. For some people with ultra-processed food addiction, intuition may become more accessible by eating mostly unprocessed foods.
There is great value in recognizing hedonic eating not only as relevant to society but also for some subtypes of eating disorders, particularly binge-type. Integrating this science into food policy and treatment paradigms should be done with sensitivity to the non-diet movement, for example, discussing the impact of ultra-processed foods on mood and brain health without perpetuating diet culture.
Ultra-Processed Foods
The NOVA classification system [1] categorizes food into:
Unprocessed and minimally processed foods
Processed culinary ingredients
Processed foods
Ultra-processed foods
Ultra-processed foods are formulations of ingredients (mostly of industrial use) typically manufactured by a series of industrial practices (e.g., soda, packaged snack cakes, reconstituted meats, etc.).
Among individuals screening positive for ultra-processed food addiction, the most problematic foods included chocolate, ice cream, French fries, pizza, and cookies [2]. Not surprisingly, higher intakes of ultra-processed food have been associated with ultra-processed food addiction [3].
Considerable debate exists on ultra-processed foods' role in contributing to eating pathology. Some authors contend that this concept is counterproductive to addressing global food production challenges [4]; others posit that there is sufficient evidence to recommend avoiding or minimizing ultra-processed foods for optimal health [5]. In the context of eating disorders, the prominent perspective holds that “demonizing” foods perpetuates black-and-white thinking.
Controversies Surrounding Ultra-Processed Food Addiction
Diet culture promotes a pervasive belief that appearance and body shape are more important than physical, psychological, and general well-being and that controlling one’s body through diet is normative behavior. In addition to being rejected by the mainstream eating disorder community as a source of diet culture, the concept of ultra-processed food addiction has remained unembraced by the Academy of Nutrition and Dietetics [6], the parent organization of registered dietitian nutritionists (who lead nutrition departments in most eating disorder programs).
Given the rise in diet culture and the discovery of weight stigma as a driver of poor health and an important social justice issue [7,8], many have mistaken ultra-processed food addiction for a pro-stigmatizing condition that promotes unnecessary caloric restriction. While some of the food addiction science can be triggering for those with restrictive tendencies, research suggests that the concept of addiction-like eating can reduce the stigma associated with weight and eating behavior [9,10].
Intuitive Eating
Intuitive Eating is a non-diet revolution that promotes attunement to the body and is the counter to much of eating disorder symptomatology [11]. Intuitive eating is based on ten principles that were originally published in 1995 by two registered dietitian nutritionists [12]:
Reject the diet mentality (non-diet).
Honor your hunger (stay well-fed).
Make peace with food (unconditional permission to eat).
Challenge the food police (eliminate old rules).
Respect your fullness (body trust).
Discover the satisfaction factor (eat what you want).
Honor your feelings without using food (find real healing).
Respect your body (body neutrality).
Exercise – feel the difference (no math).
Honor your health (progress not perfection).
Intuitive eating opposes efforts to control weight through diet and supports the inclusion of ultra-processed foods. This philosophical approach is ideal for chronic dieters with internalized weight bias and who may be at risk for developing a clinically significant eating disorder. However, there is limited data on using intuitive eating-based interventions to treat eating disorders, and there is no data that intuitive eating is useful among those with ultra-processed food addiction. However, intuitive eating may be best conceptualized as a long-term treatment goal rather than a treatment.
Fortunately, a growing number of registered dietitian nutritionists are moving toward weight-neutral approaches to health [13–15]. This may be one of the biggest contributions of the intuitive eating revolution. The most baffling part of the movement is the insistence that ultra-processed food addiction does not exist.
Can Intuitive Eating Be Helpful to Individuals with Ultra-Processed Food Addiction?
Yes. In principle, the tenets of intuitive eating might be a helpful harm-reduction approach to individuals with ultra-processed food addiction, particularly when there is a co-occurring eating disorder.
However, it is prudent also to ask: can intuitive eating be harmful to individuals with ultra-processed food addiction? In principle, intuitive eating can appear to promote (rather than just normalize) a harmful consumption of food via “the unconditional permission to eat” and “eat what you want” tenets. The assumption is that, eventually, the drive to eat will normalize, but this assumption is not consistent with what is known about addictive disorders.
Impairments in satiety signaling among those with binge-type eating disorders [16,17] suggest that the biology of hedonic eating can make intuitive eating feel out of reach for some, particularly in the early phases of treatment and when there is significant trauma history [18,19]. Failed attempts to eat intuitively might decrease inclination for non-diet approaches that could otherwise be very helpful once a sense of safety has been achieved and gut-brain physiology has improved.
To maximize the utility of intuitive eating for individuals with true ultra-processed food addiction (not false positive chronic dieters), modifications can be made:
Principle three (unconditional permission to eat) can be modified for individuals with addiction-like eating: grant unconditional permission but maintain the autonomy to opt out from foods that hijack brain reward circuitry. Some people choose to avoid ultra-processed foods not out of fear of weight gain but rather an interest in fewer obsessive thoughts, not wanting to feel defeated by uncontrollable behaviors, or simply to feel better.
Principle six (eat what you want) can be modified: once the gut-brain axis is improved, many will want to eat new and different foods (foods they love but that also love them back), and this can be an acceptable goal of treatment and recovery.
Intuitive eating can be used in conjunction with other treatment modalities as a harm reduction approach to decrease the negative effects of chronic dieting and promote positive body image. However, this philosophy systematically excludes individuals who suffer from ultra-processed food addiction, a marginalized group likely searching for recognition of the mental health challenges they face.
If one of the goals of eating disorder treatment is to reduce black-and-white thinking around food, eating disorder providers should also reduce black-and-white thinking around food philosophies. There is more than one way to recover!
We are not married to a single food philosophy at Wise Mind Nutrition. We integrate wisdom from multiple domains and encourage you to find your own nutritional identity. Our personalized program is designed to help you accomplish that goal, one bite at a time!
References
1. Monteiro CA, Cannon G, Lawrence M, Louzada ML de C, Machado PP. Ultra-Processed Foods, Diet Quality, and Health Using the NOVA Classification System. FAO; 2019. https://www.fao.org/3/ca5644en/ca5644en.pdf
2. Schulte EM, Avena NM, Gearhardt AN. Which foods may be addictive? The roles of processing, fat content, and glycemic load. Plos One. 2015;10(2):e0117959. doi:10.1371/journal.pone.0117959
3. Whatnall M, Clarke E, Collins CE, Pursey K, Burrows T. Ultra-processed food intakes associated with ‘food addiction’ in young adults. Appetite. 2022;178:106260. doi:10.1016/j.appet.2022.106260
4. Astrup A, Monteiro CA. Does the concept of “ultra-processed foods” help inform dietary guidelines, beyond conventional classification systems? NO. Am J Clin Nutrition. Published online 2022. doi:10.1093/ajcn/nqac123
5. Monteiro CA, Astrup A. Does the concept of “ultra-processed foods” help inform dietary guidelines, beyond conventional classification systems? YES. Am J Clin Nutrition. Published online 2022. doi:10.1093/ajcn/nqac122
6. Freeland-Graves JH, Nitzke S, Dietetics A of and. Position of the Academy of Nutrition and Dietetics: Total Diet Approach to Healthy Eating. Journal of the Academy of Nutrition and Dietetics. 2013;113(2):307-317. doi:10.1016/j.jand.2012.12.013
7. Hunger JM, Smith JP, Tomiyama AJ. An Evidence‐Based Rationale for Adopting Weight‐Inclusive Health Policy. Soc Iss Policy Rev. 2020;14(1):73-107. doi:10.1111/sipr.12062
8. Tomiyama AJ, Carr D, Granberg EM, et al. How and why weight stigma drives the obesity ‘epidemic’ and harms health. Bmc Med. 2018;16(1):123. doi:10.1186/s12916-018-1116-5
9. O’Brien, Puhl, Latner, et al. The Effect of a Food Addiction Explanation Model for Weight Control and Obesity on Weight Stigma. Nutrients. 2020;12(2):294. doi:10.3390/nu12020294
10. Latner JD, Puhl RM, Murakami JM, O’Brien KS. Food addiction as a causal model of obesity. Effects on stigma, blame, and perceived psychopathology. Appetite. 2014;77:79-84. doi:10.1016/j.appet.2014.03.004
11. Tylka TL, Wilcox JA. Are Intuitive Eating and Eating Disorder Symptomatology Opposite Poles of the Same Construct? J Couns Psychol. 2006;53(4):474-485. doi:10.1037/0022-0167.53.4.474
12. Tribole E, Resch E. Intuitive Eating: A Revolutionary Program That Works. Saint Martin’s Paperbacks; 1995.
13. Schaefer JT, Zullo MD. US Registered Dietitian Nutritionists’ Knowledge and Attitudes of Intuitive Eating and Use of Various Weight Management Practices. J Acad Nutr Diet. 2017;117(9):1419-1428. doi:10.1016/j.jand.2017.04.017
14. Willer F, Hannan‐Jones M, Strodl E. Australian dietitians’ beliefs and attitudes towards weight loss counselling and health at every size counselling for larger‐bodied clients. Nutr Diet. 2019;76(4):407-413. doi:10.1111/1747-0080.12519
15. Hoare JK, Lister NB, Garnett SP, Baur LA, Jebeile H. Weight‐neutral interventions in young people with high body mass index: A systematic review. Nutr Diet. Published online 2022. doi:10.1111/1747-0080.12729
16. Sysko R, Devlin MJ, Walsh BT, Zimmerli E, Kissileff HR. Satiety and test meal intake among women with binge eating disorder. Int J Eat Disord. 2007;40(6):554-561. doi:10.1002/eat.20384
17. Brewerton TD, Murphy DL, Jimerson DC. Testmeal Responses Following m-Chlorophenylpiperazine and L-Tryptophan in Bulimics and Controls. Neuropsychopharmacol. 1994;11(1):63-71. doi:10.1038/npp.1994.36
18. Wiss DA, Brewerton TD, Tomiyama AJ. Limitations of the protective measure theory in explaining the role of childhood sexual abuse in eating disorders, addictions, and obesity: an updated model with emphasis on biological embedding. Eat Weight Disord - Stud Anorexia Bulimia Obes. Published online 2021:1-19. doi:10.1007/s40519-021-01293-3
19. Wiss DA, Brewerton TD. Adverse Childhood Experiences and Adult Obesity: A Systematic Review of Plausible Mechanisms and Meta-Analysis of Cross-Sectional Studies. Physiol Behav. 2020;223:112964. doi:10.1016/j.physbeh.2020.112964
