Reframing food addiction in childhood obesity: Cultural relevance and digital innovation needed

This letter responds to the article by An et al. on the link between food addiction and emotional and behavioral problems in children with obesity. We highlight two key points. First, most research on food addiction comes from Western countries, yet childhood obesity is rising quickly in low- and middle-income countries (LMICs), especially in Southeast Asia. Cultural differences in food habits, family roles, and emotional expression may affect how food addiction appears and should be studied. Second, tools like the Yale Food Addiction Scale for Children (YFAS-C) must be carefully adapted and validated for different cultures-not just translated. We also suggest using digital tools, like apps and games, to support treatment, but these should be designed ethically and tested properly. We call for global research partnerships and culturally sensitive approaches to better understand and address food addiction in children worldwide.