Both global and restraint scores on the Eating Disorder Examination Questionnaire (EDE-Q) decreased significantly in patients with eating disorders (p ≤ 0.001).
Integrating ultra-processed food addiction (UPFA) assessment and psychoeducation into residential treatment did not lead to increased in eating disorder patients.
EDE-Q global scores and restraint subscale scores showed significant reductions in eating disorder patients from admission to discharge.
No significant correlation was found between UPFA scores and dietary restraint scores at either admission or discharge.
Weak correlations were observed between UPFA scores and EDE-Q global scores at both time points, indicating some overlap in symptomatology.
The findings suggest that UPFA-informed treatment can be implemented without exacerbating dietary restraint among eating disorder patients.
Simplified
OBJECTIVE: Ultra-processed food addiction (UPFA) is increasingly recognized but remains controversial among eating disorder (ED) clinicians, partly due to concerns that introducing food addiction concepts might intensify , a core feature of EDs. This study examined whether integrating UPFA assessment, psychoeducation and treatment into residential treatment (RT) impacts ED symptomatology, particularly dietary restraint.
METHODS: Adults (N = 132) admitted to RT completed the Eating Disorder Examination Questionnaire (EDE-Q) and the modified Yale Food Addiction Scale 2.0 (mYFAS2.0) at admission and discharge. Changes in EDE-Q global scores and EDE-Q restraint subscale scores were analyzed using repeated-measures analysis of variance (RANOVA) with ED diagnosis as a between-subjects factor and age, gender identity, sexual orientation, and admission BMI as covariates. Pearson correlations between mYFAS2.0 and EDE-Q scores were calculated at both time points to assess construct overlap.
RESULTS: Both EDE-Q global and EDE-Q restraint scores decreased significantly in the ED patients (p ≤ 0.001) and remained low in the non-ED patients. mYFAS2.0 scores were not significantly correlated with EDE-Q restraint scores at either admission or discharge, while they were weakly correlated with EDE-Q global scores at both time points.
CONCLUSIONS: UPFA-informed assessment, psychoeducation and/or treatment did not increase EDE-Q restraint scores. Instead, they declined significantly in ED patients, with no worsening observed. Modest post-treatment correlations between UPFA and EDE-Q global scores but not EDE-Q restraint scores suggest partial but incomplete overlap between EDs and UPFA symptomatology, with caloric restraint confined to EDs alone. These results support their nosological distinction and the feasibility of concurrent treatment without worsening ED-related dietary restraint.
Key numbers
EDE-Q restraint scores
Decrease in
Measured using the EDE-Q restraint subscale in both and patients.
n = 132
Sample size
Total number of participants included in the study.
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Declarations. Ethics approval and consent to participate: The study was conducted in accordance with the Declaration of Helsinki and approved by the Brany Institutional Review Board (File # 23-12-396-1474, approved 6 June 2023) for studies involving humans. Informed consent was obtained from all subjects involved in the study. Competing interests: The authors declare no competing interests.
