Changes in binge eating symptoms following an online community-based ultra-processed food addiction intervention: Liberate
by Ellen Bennett, Erin L. Bellamy, Deborah Lycett, Jen Unwin, Maxine Whelan, David A. Wiss, & Riya Patel
For a subset of individuals with Binge Eating Disorder who also meet criteria for ultra-processed food addiction, conventional treatments like CBT and pharmacotherapy have produced only modest results — with relapse rates that haven’t meaningfully improved in four decades. In our newly published study in Frontiers in Public Health, my co-authors and I report substantial changes in binge eating symptoms following participation in Liberate, an online, community-based intervention that integrates addiction-informed psychoeducation, peer support, and a real-food, low-carbohydrate dietary approach. Among 117 adults with self-reported UPFA, mean Binge Eating Scale scores dropped from 26.5 at baseline to 18.0 post-intervention, with improvements largely sustained at six-month follow-up. The proportion of participants in the “severe” binge eating category nearly halved, while those reporting no binge eating symptoms rose from 18.8% to 54.7%. Critically, these changes in binge eating symptoms occurred without the worsening that conventional eating disorder paradigms have long predicted from carbohydrate reduction — directly challenging the assumption that abstinence-based dietary strategies inevitably exacerbate disordered eating. When embedded within a psychologically supportive, addiction-informed framework, structured abstinence from ultra-processed foods may offer a meaningful path forward for patients whose addiction-like eating patterns have been overlooked or actively dismissed by mainstream treatment models.
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Abstract
Background:
Binge Eating Disorder (BED) is the most prevalent eating disorder worldwide and is associated with significant psychological distress, metabolic risk, and high relapse rates. Standard treatments such as Cognitive Behavioural Therapy and pharmacotherapy offer modest long-term efficacy. Increasing evidence links binge eating behaviours with consumption of ultra-processed foods (UPFs), industrial formulations engineered for hyper-palatability that can activate dopaminergic reward pathways in ways similar to addictive substances. The construct of ultra-processed food addiction (UPFA) provides a conceptual framework for understanding this overlap and exploring addiction-informed treatment models.
Objective:
To evaluate changes in binge eating symptom severity following participation in Liberate, an online, community-based psychoeducational intervention integrating addiction-informed principles with an abstinent, real-food, low-carbohydrate dietary approach.
Methods:
This secondary analysis pooled data from two cohorts of adults (N = 117) with self-reported UPFA enrolled in the Liberate feasibility and acceptability study. Binge eating was measured using the Binge Eating Scale (BES) at baseline, post-intervention (8 weeks), and 6-month follow-up. Repeated measures ANOVA assessed changes in continuous BES scores using an intention-to-treat approach with baseline carried forward. Changes in clinical severity categories (none, moderate, severe) were also examined descriptively.
Results:
Mean BES scores significantly decreased from 26.5 (95% CI 24.9–28.1) at baseline to 18.0 (95% CI 16.1–20.0; p = <0.001) post-intervention, with improvements largely maintained at six-month follow-up (19.2; 95% CI 17.2–21.3; p = <0.001 baseline to post; p = 0.276 post to follow-up). The proportion of participants with severe binge eating halved post-intervention (48.7 to 24.8%) and remained lower at 6 months (30.8%). While, those with no binge eating increased from 18.8 to 54.7% post-intervention and 48.7% at follow-up.
Conclusion:
Participation in an addiction-informed, real food, psychoeducational intervention was associated with significant reductions in binge eating symptoms which were largely maintained over 6 months, with no evidence of worsening. These findings challenge assumptions that carbohydrate reduction exacerbates disordered eating and suggest that abstinence-based dietary strategies, when embedded within a psychologically supportive framework, may be beneficial for some individuals with BED and UPFA. Controlled trials are warranted to establish efficacy and inform clinical guidelines.
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