State of the Science on Ultra-processed Foods and the Ultra-processed Food Addiction Construct

We synthesize recent developments across two linked literatures, ultra-processed foods (UPFs) and the construct of UPF addiction, engaging contested questions of health harm, classification, assessment, and recognition.

Advances include: 1) feeding trials and diet-quality-adjusted cohorts indicating harm from processing itself; 2) analyses linking critiques of UPF classification predominantly to industry-affiliated authors; 3) findings consistent with the addictive-substance hypothesis: GLP-1 agonists reduce UPF intake and addictive-substance use, and analyses identify UPF attributes driving addictive-like eating; 4) the first clinician-administered UPF addiction interview extends assessment beyond self-report; and 5) Delphi consensus and regulatory and legislative attention signaling recognition of UPF addiction. Evidence increasingly supports treating UPFs and UPF addiction as one problem, the substance and the disorder, reshaping research and policy priorities. The evidence base for recognition rivals that of some recognized disorders, though its sufficiency remains debated. Gaps include targeted interventions and clinician-administered assessment data.