Thompson Susan Peirce, Jacobs M Joy, Wiss David A
Department of Brain and Cognitive Sciences, University of Rochester, Rochester, NY, United States.
Bright Line Eating Solutions, LLC, Rochester, NY, United States.
Front Psychiatry. 2025 Jul 8;16:1586490. doi: 10.3389/fpsyt.2025.1586490. eCollection 2025.
While not officially recognized as a clinical diagnosis, ultra-processed food addiction (UPFA) is an increasingly observed phenomenon that frequently co-occurs with eating disorders (EDs). Yet, treatment remains both understudied and controversial. Many challenges exist when treating patients with comorbid UPFA/ED, particularly in the context of the polarizing debate between abstinence-based and moderation-based approaches to nutrition intervention. We present three vignettes illustrating diverse trajectories of recovery when an abstinence-based approach is explored by a patient presenting with ED symptoms. Ultimately, some patients will recover with abstinence, while others may be harmed and fare better with a moderation-based approach. This dichotomy appears difficult for many patients and clinicians to navigate, particularly since integrative middle-ground approaches remain less characterized. Patients deserve individualized treatment plans from open-minded, experienced clinicians who can comprehensively assess genetic vulnerability; upbringing; and current neurobiological, psychological, and social/cultural presentation. We argue for a nuanced, multidisciplinary approach that may combine elements of both abstinence and moderation, tailored to the patient's specific needs, emphasizing the importance of cross-disciplinary collaboration. More research is needed to develop evidence-based, patient-centered treatment options for UPFA in the context of other food- and body-related pathology.
虽然超加工食品成瘾（UPFA）尚未被正式确认为一种临床诊断，但它是一种越来越常见的现象，经常与饮食失调（EDs）同时出现。然而，对其治疗的研究仍然不足且存在争议。在治疗患有UPFA/ED共病的患者时存在许多挑战，特别是在基于禁欲和基于适度的营养干预方法之间两极分化的辩论背景下。我们展示了三个案例，说明当出现ED症状的患者探索基于禁欲的方法时，不同的康复轨迹。最终，一些患者通过禁欲会康复，而另一些患者可能会受到伤害，采用基于适度的方法会恢复得更好。这种二分法似乎让许多患者和临床医生难以应对，特别是因为综合的中间立场方法仍不太明确。患者应该得到思想开放、经验丰富的临床医生制定的个性化治疗方案，这些医生能够全面评估遗传易感性、成长经历以及当前的神经生物学、心理和社会/文化表现。我们主张采用一种细致入微的多学科方法，该方法可能结合禁欲和适度的要素，根据患者的具体需求进行调整，强调跨学科合作的重要性。在其他与食物和身体相关的病理学背景下，需要更多研究来开发基于证据、以患者为中心的UPFA治疗方案。
