Questioning the role of food addiction in pediatric obesity: Comment on An et al. (2025)

The study by An et al. (2025) [1] investigated the association between food addiction (FA), obesity, and emotional and behavioral problems in Korean children and adolescents with overweight or obesity. While FA was linked to higher BMI, lower self-esteem, and increased emotional difficulties, critical methodological limitations challenge the clinical relevance of these findings. Cross-sectional designs require careful control of confounding variables, yet essential factors such as genetic predispositions, socioeconomic status, food environment, and family dynamics were not fully addressed. Additionally, behavioral traits like food neophobia, shown by Dos Anjos et al. (2021) [9] to influence unhealthy eating patterns in children, and neurodevelopmental conditions, such as ADHD and autism spectrum disorder, frequently co-occur with disordered eating behaviors and may confound FA classifications. Recent data from Nyholmer et al. (2024) [15] further highlight the overlap between restrictive eating profiles and psychiatric comorbidities, underscoring the need for comprehensive assessment. The study's lack of dietary pattern analysis, particularly concerning ultra-processed food intake, and absence of age-stratified reliability in dietary reporting limit its interpretability. Future research should integrate neurodevelopmental and psychiatric evaluations to clarify whether FA reflects a distinct clinical entity or broader emotional and behavioral dysregulation within pediatric obesity. Without this, the application of FA as an isolated construct remains questionable.