The idea that certain ultra-processed foods — such as candy, cookies, and chips — can be addictive is receiving increasing attention in the USA and elsewhere. During the past two years, Congressional hearings have addressed the role of addictive ultra-processed foods in escalating rates of childhood chronic diseases. In December 2024, a lawsuit was filed in Philadelphia, accusing 11 ultra-processed-food companies of designing addictive food products and aggressively marketing them toward children.

Reflecting the growing consensus that addiction science could inform food policy, the US Food and Drug Administration (FDA) and National Institutes of Health (NIH) have announced a new initiative modeled on the successful Tobacco Regulatory Science Program, which will unite both agencies’ expertise to “transform nutrition and food-related research”. That certain foods can trigger addictive behavior consistent with substance-use disorders (SUDs) is accepted by many addiction scientists and supported by evidence of neurobiological overlap with the brain circuits and molecular targets implicated in ‘classical’ drug addictions1. Yet addiction to ultra-processed food is not formally recognized by medical classification systems, including the Diagnostic and Statistical Manual of Mental Disorders (DSM)2 and the International Classification of Diseases (ICD). This is an oversight with major consequences for public health.

The DSM defines SUDs as a problematic pattern of intake marked by characteristics such as intense cravings, repeated attempts to cut back, and continued use despite harm. Compulsive consumption of ultra-processed food and an inability to self-regulate despite negative consequences unquestionably meets the DSM SUD criteria. In 2007, we argued that the DSM-5 should include obesity as a brain disorder with similar symptom presentation to the one described in the DSM-IV for substance abuse and drug dependence3. At the time, the DSM-5 committee did not feel there was sufficient evidence to substantiate obesity as an addiction.

Read the full article on nature medicine.