Addicting consumers leads to poor public health 

Tying together concerns around food addiction and its harmful effects, Ashley Gearhardt, professor of psychology at the University of Michigan and a leading expert in food addiction, wrote in 2023 testimony before the U.S. Senate Committee on Health, Education, Labor and Pensions titled, What is Fueling the Diabetes Epidemic?:

A “scientific body of evidence suggests that addictive processes play an important role in contributing to patterns of ultra-processed food intake implicated in poor health, obesity, and diabetes.

If addictive mechanisms are being triggered by ultra-processed foods, this may be an overlooked reason why it can be challenging to reduce intake of ultra-processed foods even in the face of health conditions like diabetes.”

What is the evidence ultra-processed foods are addictive? 

A 2026 review in Milbank Quarterly “synthesizes findings from addiction science, nutrition, and public health history to identify structural and sensory features that increase the reinforcing potential of both cigarettes and UPFs.” The review finds:

“Cigarettes and UPFs are not simply natural products but highly engineered delivery systems designed specifically to maximize biological and psychological reinforcement and habitual overuse.

Both industries have used similar strategies to increase product appeal, evade regulation, and shape public perception, including adding sensory additives, accelerating reward delivery, expanding contextual access, and deploying health-washing claims.

These design features collectively hijack human biology, undermine individual agency, and contribute heavily to disease and health care costs.

”The researchers conclude that “UPFs should be evaluated not only through a nutritional lens but also as addictive, industrially engineered substances. Lessons from tobacco regulation, including litigation, marketing restrictions, and structural interventions, offer a roadmap for reducing UPF-related harm.”

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Using criteria for tobacco addiction to measure food addiction

In 1988, the Surgeon General concluded that cigarettes and other tobacco products are addictive by using three criteria: “(1) they trigger compulsive use, (2) they have psychoactive effects and (3) they are reinforcing, ” writes Gearhardt in a 2022 analysis published in Addiction.

And since then, a fourth criteria was also added to addictive identification—the product’s ability to “trigger strong urges or craving”. Using this same standard of criteria for tobacco products, Gearhardt argues that ultra-processed foods can be considered addictive.

And, “to identify the key addictive components in [highly processed foods], the same care and control employed in understanding the addictive potential of drugs needs to be applied to studies of [highly processed foods].”

The Yale Food Addiction Scale (YFAS)

Because food addiction has been controversial to define, Gearhardt, then a doctoral student at Yale University, created The Yale Food Addiction Scale (YFAS) in 2009 as a standardized tool to measure the signs of addictive eating behaviors.

The self-reported questionnaire uses questions based on criteria used for substance disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

It is meant to evaluate behavior with questions similar to those that would ask about other substance abuse issues, including drugs and alcohol,  regarding cravings, withdrawal symptoms, and failed efforts to stop. The scale has become a staple for food research around the world, and has been translated into many languages.

Gearhardt explained to the Guardian, “I took the standard diagnostic criteria for alcohol, nicotine, cocaine and heroin, and translated them to food.”

The YFAS is the basis for much of the research conducted on food addiction in the past 15 years.

Read the complete article at The Final Call