EDeology Podcast

Finding Common Ground: Ultra-Processed Food Use Disorder and the Eating Disorder Field

In a recent interview on the EDeology podcast, I had the opportunity to delve deep into one of the most polarizing topics in my field: the intersection between ultra-processed food addiction and eating disorders. This conversation offered a chance to explore not just the clinical aspects of these conditions but also the personal and professional challenges that arise when advocating for a marginalized perspective within the eating disorder community.

Defining Ultra-Processed Food Use Disorder

When discussing what many call “food addiction,” I prefer the term “ultra-processed food use disorder.” This terminology helps remove some of the emotional charge while maintaining clinical accuracy. We’re looking at applying the 11 criteria from the DSM-5 for substance use disorders specifically to ultra-processed foods as defined by the NOVA classification system.

To illustrate this classification: corn on the cob represents NOVA 1 (minimally processed), canned corn is NOVA 3 (processed), and Doritos fall into NOVA 4 (ultra-processed). These ultra-processed foods are “corporate foods designed for profit rather than for public health,” created through industrial practices that someone generally couldn’t replicate at home.

What makes these foods particularly concerning isn’t just what’s added—the sugars, salts, and fats—but what’s lost through processing. “When you process foods… it does compromise the integrity of the nutrients that are in the food. So a lot of people think that the contention around ultra-processed foods is just about the added sugars, salts and the type of oils. But I think people like myself are more interested in what’s lost from the food rather than what’s added.”

Understanding Different Addiction Phenotypes

Through my clinical work, I’ve identified two distinct phenotypes of addictive eating patterns:

1. The Classic Binge Pattern: This involves clear biological responses leading to loss of control episodes—the traditional understanding of binge eating where someone starts eating and can’t stop.
2. The Subtle, Mind-Dominant Pattern: This is characterized by consistent, predictable use that creates negative affect when discontinued. Think of someone who has ice cream every night at 10 PM—if they skip it on the 11th night, their brain asks, “Where is my ice cream?”

“What characterizes addictions or use disorders is that the substance ingestion and the substance seeking behavior actually in return drives the negative affect. So that’s what gets people to return to it.”

This distinction is crucial because the second pattern often goes unrecognized, yet it can be equally problematic for those experiencing it.

My Personal Journey and Professional Mission

My understanding of these processes comes from clinical observation and lived experience. In my early 20s, I struggled with severe substance use disorders, going through multiple treatment centers and hospital detoxes. During recovery, I experienced what I call “cross addiction”—the same addictive patterns manifesting around food.

“I can remember very clearly eating against my will. Having dinner, having seconds, not feeling great, wanting to lie down, microwaving Kraft Mac and cheese, having ice cream and then a piece of candy and being disgusted with myself.”

This experience, combined with my academic training in public health and health psychology, positioned me to recognize and advocate for clients who present with similar patterns but feel misunderstood by mainstream eating disorder treatment.

The Professional Divide and Its Human Cost

One of the most challenging aspects of this work has been navigating the polarization within the eating disorder field. Many professionals view food addiction concepts as harmful remnants of diet culture, while those of us advocating for recognition see it as an advancement, integrating neuroscience with treatment.

“I think one of the bigger reasons why the divide is so prevalent is because people that work in eating disorder treatment, they see a lot of people that unsuccessfully tried some food addiction coach… and then the food addiction world gets all the people that were told to eat intuitively and eat in moderation, and that went to eating disorder treatment and got metabolic syndrome.”

This creates a vicious cycle in which each side sees the failures of the other’s approach, further entrenching positions and making collaboration difficult.

The personal cost of this divide has been significant. “I really appreciate the opportunity to hold space for those people that have tormented souls that have been trying to find their way, have bounced around, done a lot of treatment, have never felt fully understood by providers… And then have other eating disorder professionals point fingers and throw stones. It feels like high school.”

A Biopsychosocial Approach

Rather than taking sides in this polarization, I advocate for a comprehensive biopsychosocial assessment that considers:

• Genetic vulnerability
• Early life adversity and trauma
• Environmental exposures
• Social and cultural factors
• Individual psychiatric profiles

“There are clearly different phenotypes of addiction symptomatology… There are people that have a very clear biological response to the food that leads to loss of control… But that is one phenotype, which I believe is different than the person who is more so using low dose substances very consistently.”

This nuanced approach recognizes that different people may need different interventions, and that forcing everyone into a single treatment model serves no one well.

The Wise Mind Nutrition Approach

My work has culminated in developing the Wise Mind Nutrition app to bridge these divides. The name comes from dialectical behavior therapy’s concept of the “wise mind”—the intersection between logical and emotional thinking.

“I built a mental health app that uses nutrition to help people recover without it being a very clearly defined road map. It’s a choose-your-own-adventure… It’s agnostic in terms of food philosophy and promotes people to do some deep dives and do their own work to figure out what might work for them.”

Moving Toward Integration

The ultimate goal isn’t to prove one approach right and another wrong, but to create space for multiple perspectives and treatment pathways. Many established treatment modalities for both substance use disorders and eating disorders work well—what’s often missing is simply acknowledgment and space for different experiences.

“The only thing that seems missing at this point is the acknowledgement and the holding space. I think people feel gaslit.”

As I reflected during our conversation, this work requires integration at multiple levels—individual, professional, and systemic. We need to move beyond the high school dynamics of in-groups and out-groups toward “harmonious action” that serves the diverse needs of the people seeking our help.

By recognizing that recovery paths can look different for different people, and that both biological and psychological factors play important roles, we can create more inclusive and effective approaches to treating the full spectrum of disordered eating patterns, including ultra-processed food use disorder.