Is Food Addictive? A Review of the Science.

As ultraprocessed foods (i.e., foods composed of mostly cheap industrial sources of dietary energy and nutrients plus additives) have become more abundant in our food supply, rates of obesity and diet-related disease have increased simultaneously. Food addiction has emerged as a phenotype of significant empirical interest within the past decade, conceptualized most commonly as a substance-based addiction to ultraprocessed foods. We detail (a) how approaches used to understand substance-use disorders may be applicable for operationalizing food addiction, (b) evidence for the reinforcing potential of ingredients in ultraprocessed foods that may drive compulsive consumptions, (c) the utility of conceptualizing food addiction as a substance-use disorder versus a behavioral addiction, and (d) clinical and policy implications that may follow if ultraprocessed foods exhibit an addictive potential. Broadly, the existing literature suggests biological and behavioral parallels between food addiction and substance addictions, with ultraprocessed foods high in both added fat and refined carbohydrates being most implicated in addictive-like eating. Future research priorities are also discussed, including the need for longitudinal studies and the potential negative impact of addictive ultraprocessed foods on children.

A cross-sectional examination of reported changes to weight, eating, and activity behaviors during the COVID-19 pandemic among United States adults with food addiction.

Prior studies have demonstrated the effects of the COVID-19 pandemic on weight management and lifestyle behaviors, though identification of who may be at greatest risk for negative consequences has not been fully explored. Addictive-like eating behavior, or food addiction, has been associated with an array of problematic eating behaviors, which may suggest heightened susceptibility to poorer outcomes. In this online, cross-sectional study, adults (ages 18-78; M = 42.36, SD = 13.08) living in the United States (n = 288) completed questionnaires assessing food addiction and reported changes to their weight, eating, and physical activity before and during the COVID-19 pandemic. Individuals with food addiction gained an average of 12.42 lb (5.63 kg) since March 2020, compared to an average weight gain of 2.14 lb (0.97 kg) for those without food addiction (p < .001). Linear regression analyses controlling for age and body mass index (BMI) showed that food addiction was independently associated with higher weight gain (B = 9.28, t = 4.97, p < .001), greater intake of ultra-processed foods before and during COVID-19 (B = 1.08, t = 5.71, p < .001; B = 1.18, t = 6.42, p < .001, respectively), greater attribution of their overall current eating behaviors to COVID-19 circumstances (B = 23.19, t = 4.62, p < .001), and higher distress about their overall current eating behaviors (B = -22.12, t = -2.50, p = .01). Interaction effects demonstrated that individuals with food addiction who are older may be at particularly high risk for weight gain and distress. The present research suggests that food addiction is a uniquely meaningful phenotype, beyond the effects of BMI, to identify risk for the negative consequences of COVID-19. Individuals with food addiction, particularly those who are older, may benefit from support with weight management and addictive-like eating as the COVID-19 pandemic persists and resolves.

Psychometric properties of the Chinese version of the modified Yale Food Addiction Scale version 2.0 (C-mYFAS 2.0): Prevalence of food addiction and relationship with resilience and social support.

PURPOSE: This study aimed to examine the psychometric properties of the Chinese version of the modified Yale Food Addiction Scale 2.0 (C-mYFAS 2.0) and to analyze the prevalence of food addiction among Chinese college students and its relationship with resilience and social support. METHODS: A total of 1132 Chinese college students completed the C-mYFAS 2.0, BES, EAT-26, PHQ-9, GAD-7, TFEQ-18, CD-RISC-10, and PSSS. Confirmatory factor analysis was used to evaluate the factor structure of the C-mYFAS 2.0 and psychometric properties were assessed. Test-retest reliability was evaluated in a sub-sample (n = 62). Spearman correlation and logistic regression were used to examine the relationship between resilience, social support, and food addiction. RESULTS: The prevalence of food addiction according to the C-mYFAS 2.0 was 6.2%. Confirmatory factor analyses suggested a single-factor structure (comparative fit index = 0.961). The C-mYFAS 2.0 had good test-retest reliability and internal consistency (Kuder-Richardson's α = 0.824). Good convergent validity was indicated by correlations with binge eating, eating disorder symptoms, depressive symptoms, generalized anxiety symptoms, uncontrolled eating, emotional eating, and BMI (ps < 0.001). Appropriate divergent validity was reflected by no association with cognitive restraint. Finally, binge eating was significantly predicted by C-mYFAS 2.0, depressive symptoms, and eating disorder symptoms (ps < 0.001), confirming incremental validity. In addition, our study found that poorer resilience and social support were related to food addiction (ps < .001). CONCLUSIONS: The C-mYFAS 2.0 is a brief but reliable and valid screening instrument for food addiction among Chinese college students. In addition, we found that resilience and social support were negatively associated with food addiction. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Attributes of the food addiction phenotype within overweight and obesity.

PURPOSE: Previous studies have demonstrated overlapping behavioral features between substance-use disorders and food addiction, the latter of which is particularly prevalent among individuals with overweight or obesity. However, the unique attributes of food addiction as a possible phenotype within overweight and obesity are not fully understood. METHODS: This cross-sectional study recruited participants (n = 46) with overweight or obesity, nearly half (n = 20) of whom met the criteria for food addiction based on the Yale Food Addiction Scale 2.0 (YFAS 2.0) and examined responses to self-report questionnaires that indexed behavioral characteristics relevant to addictive disorders. RESULTS: Individuals with food addiction exhibited significantly higher scores on the Palatable Eating Motives Scale overall score (p < .001) and subscales for coping (p < .001) and enhancement (p < .001) of emotions, Dutch Eating Behavior Questionnaire Emotional Eating subscale (p < .001), UPPS-P Impulsivity Scale negative urgency (p < .001) and lack of perseverance (p = .01) subscales, and the Food Craving Inventory overall score (p = .02) and subscales of cravings for sweets (p < .01) and fast food fats (p = .02). CONCLUSION: Food addiction appears to represent a distinct phenotype within overweight and obesity, marked by greater emotion dysregulation, impulsivity, and cravings, which have been observed in prior studies examining features of individuals with addictive disorders. LEVEL OF EVIDENCE: Level III: Evidence obtained from well-designed cohort or case-control analytic studies.

Changes in weight control behaviors and hedonic hunger in a commercial weight management program adapted for individuals with type 2 diabetes.

BACKGROUND: A WW (formerly Weight Watchers) program adapted for persons with type 2 diabetes mellitus (T2DM) previously was found to be more effective than standard care (SC) intervention for weight loss, improved glycemic control, and weight- and diabetes-related quality of life measures. With data from the same national trial, this study examined whether WW adapted for persons with T2DM also increased engagement in weight control behaviors and decreased hedonic hunger, each of which could contribute to improved diabetes management. INTERVENTION AND METHODS: Individuals with T2DM (n = 563) and overweight or obesity participated in a 12-month, 16-site, randomized trial of WW with diabetes counseling or SC. Hierarchical linear modeling (HLM) evaluated whether 12-month changes in weight control behaviors (Eating Behavior Inventory; EBI) and hedonic hunger (Power of Food Scale; PFS) differed by treatment condition. If a significant treatment effect was found, 12-month changes in EBI/PFS were regressed on 12-month changes in HbA1c and percent weight loss to explore potential treatment differences in these associations. RESULTS: EBI scores increased significantly over the 12-months (p < 0.001), with greater improvements in WW than SC (p < 0.001). PFS decreased significantly in the 12-months (p < 0.001), with no differences between treatment groups (p = 0.15). HLM analyses that followed up on the significant treatment effect for 12-month change in EBI revealed no significant differences by treatment condition for the relationship between change in EBI scores and change in HbA1c (p = 0.14) or percent weight loss (p = 0.32). Across all participants, 12-month improvements in EBI and PFS were related to improved HbA1c (r = 0.22; -0.13, respectively) and greater percent weight loss (r = 0.41; -0.18, respectively) (ps < 0.01). CONCLUSIONS: WW with diabetes counseling produced greater engagement in weight control behaviors in those with T2DM than did SC. Across both groups, improved weight control behaviors and hedonic hunger were related to improved glycemic control and weight loss.

An evaluation of food addiction as a distinct psychiatric disorder.

OBJECTIVE: To evaluate the state of the literature for whether food addiction may warrant consideration as a distinct psychiatric disorder in the Diagnostic and Statistical Manual (DSM) using Blashfield et al.'s (1990; Comprehensive Psychiatry, 31(1), 15-19) five criteria. This framework was utilized because it has recently been applied to examine the diagnostic utility of several eating disorder phenotypes. The criteria are: (a) at least 50 journal articles published on the proposed syndrome in the past 10 years; (b) proposal of diagnostic criteria and assessment measures; (c) clinician reliability in diagnosis; (d) cohesiveness of the proposed diagnostic criteria; and (e) differentiation from similar, existing diagnostic categories. METHOD: For each criterion, a literature review was conducted to examine if the minimum qualification had been met, and key findings were discussed. RESULTS: Two of the criteria (literature and differentiation) have been empirically supported to extent specified. Two criteria (diagnostic criteria and syndrome) have been partially fulfilled, due to only having self-report assessment measures and no examination of the odds ratios for meeting more than one symptom, respectively. Clinician reliability has not yet been evaluated. DISCUSSION: The existing literature suggests that food addiction may warrant consideration as a proposed diagnostic category in the DSM, though future research is needed to fulfill Blashfield et al.'s (1990; Comprehensive Psychiatry, 31(1), 15-19) criteria. The development of a semi-structured interview would be an impactful contribution for addressing these gaps.

Development of the Highly Processed Food Withdrawal Scale for Children.

INTRODUCTION: Highly processed foods (with added fats and/or refined carbohydrates) may trigger an addictive-like process, including withdrawal when these foods are reduced. Withdrawal is marked by affective, cognitive, and physical symptoms that may hinder dietary change. A recently developed scale of highly processed food withdrawal in adults (ProWS) provides evidence for this construct. Children commonly consume highly processed foods, but no measures currently exist to examine highly processed food withdrawal in children. The purpose of this study was to develop a measure (ProWS-C) to assess for signs of highly processed food withdrawal in children. METHODS: Parents who had recently attempted to reduce their child's highly processed food consumption were recruited through an online crowdsourcing platform. 304 parents (56.9% mothers) reported on their 3-11-year-old children (63.8% male). The ProWS-C was designed to reflect parents' observations of child behavior. Internal consistency and validity were evaluated using the Dimensional Yale Food Addiction Scale Version 2.0 for Children (dYFAS-C 2.0.), Children's Food Neophobia Scale-Modified (CFNS), and body mass index (BMI) silhouettes. RESULTS: Exploratory factor analysis revealed a one-factor structure with 21 items (α = 0.94). The ProWS-C demonstrated convergent validity with more child food addiction symptoms (r = 0.55, p < 0.001) and higher child BMI (r = 0.24, p < 0.001) and discriminant validity with child food neophobia (r = -0.10, p = 0.08). The ProWS-C was associated with less success in reducing child highly processed food intake independent of child addictive-like eating and BMI (p = 0.001). DISCUSSION: The ProWS-C provides preliminary evidence for highly processed food withdrawal in children and appears to be a psychometrically sound tool for assessing parent-reported withdrawal symptoms in children. Illuminating specific challenges families face when reducing highly processed foods may improve parents' ability to help their children make sustainable dietary changes.

Development of the Highly Processed Food Withdrawal Scale.

Food addiction posits that highly processed foods may be capable of triggering addictive-like symptoms in some individuals, including withdrawal. The current study developed and assessed the psychometric properties of the first self-report measure of highly processed food withdrawal. Individuals (n = 231) aged 19-68 (51.9% female) were recruited online through Amazon Mechanical Turk and reported cutting down on highly processed foods in the past year. The Highly Processed Food Withdrawal Scale (ProWS) was adapted from self-report measures of drug withdrawal and internal consistency and validity were evaluated. Paralleling the course of drug withdrawal, symptoms assessed by the ProWS were reported as most intense between days 2-5 during an attempt to cut down. The ProWS demonstrated convergent validity with addictive-like eating (r = 0.48, p < .001), body mass index (BMI) (r = 0.16, p = .02), and weight cycling (r = 0.29, p < .001) and discriminant validity with dietary restraint: (r = -0.13, p = .04). The ProWS explained 11.2% of variance in self-reported success in last diet attempt beyond addictive-like eating and BMI. The ProWS seems to be a psychometrically sound tool for future research investigating highly processed food withdrawal in humans, and the present data may provide preliminary insight into the plausibility of withdrawal symptoms occurring in response to cutting down on highly processed foods.

Associations of Food Addiction in a Sample Recruited to Be Nationally Representative of the United States.

The current study investigated the prevalence of food addiction and its associations with obesity and demographic factors in a sample recruited to be more nationally representative of the United States than previous research. Individuals (n = 1050) were recruited through Qualtrics' qBus, which sets demographic quotas developed using the United States census reference population. Participants (n = 986) self-reported food addiction, measured by the modified Yale Food Addiction Scale 2.0, height, weight, age, gender, race and income. Food addiction was observed in 15% of participants, with greater prevalence in individuals who were younger, Hispanic and/or reported higher annual income. Food addiction prevalence was higher in persons who were underweight or obese, relative to normal weight or overweight. Food addiction was associated with higher body mass index in women and persons who were older, White and/or reported lower income. Identifying the scope of food addiction and individual risk groups may inform public policy initiatives and early intervention efforts. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

A commentary on the "eating addiction" versus "food addiction" perspectives on addictive-like food consumption.

The food addiction construct posits that vulnerable individuals may experience an addictive-like response to certain foods, such as those high in fat and refined carbohydrates. Recently, an alternative model to food addiction was proposed, suggesting that the act of eating may be a behavioral addiction that can trigger an addictive-like response in susceptible individuals. One major rationale for the eating addiction framework is that the assessment of food addiction is based on behavioral indicators, such as consuming greater quantities of food than intended and eating certain foods despite negative consequences. It is also suggested that the lack of investigation into which foods and food attributes (e.g., sugar) may have an addictive potential is evidence that food addiction does not parallel a substance-based addiction and more closely resembles a behavioral addiction. The present paper provides a commentary suggesting that the substance-based, food-addiction framework is more appropriate than the behavioral-addiction, eating-addiction perspective to conceptualize addictive-like food consumption. In order to illustrate this point, this manuscript will discuss behavioral components characteristic of all substance-use disorders, preliminary evidence to suggest that all foods are not equally associated with addictive-like eating, and key differences between the hypothesized eating addiction phenotype and the only existing behavioral addiction in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), gambling disorder. Further, this paper will consider implications of applying an addiction label to food versus eating and suggest future research directions to evaluate whether food addiction is a valid and clinically useful construct.

Wanting and liking: Separable components in problematic eating behavior?

Some individuals may have an addictive-like response to certain foods, possibly contributing to problematic eating. Highly processed foods, with added fats and/or refined carbohydrates, are suggested to be most associated with addictive-like eating. The incentive sensitization theory suggests that wanting (e.g. craving) may drive compulsive drug use rather than liking (e.g. enjoyment), but it is unknown whether highly processed foods elicit similar wanting and liking patterns as drugs of abuse, or whether individual differences exist. The current study examines the association of highly processed foods with craving and liking, and whether these relationships differ by food addiction symptomology, cognitive restraint, or body mass index (BMI). Participants (n = 216) reported craving and liking for 35 foods and completed the Yale Food Addiction Scale (YFAS) and Three Factor Eating Questionnaire (TFEQ). Highly processed foods were craved more overall. Craving of highly processed foods was predicted negatively by restraint and positively by YFAS score. Liking of highly processed foods was predicted negatively by restraint and positively by BMI. In conclusion, craving and liking appear distinct with respect to highly processed foods, and may be influenced by addictive-like eating, cognitive restraint, and BMI. This suggests that the incentive sensitization framework may also be relevant for problematic food consumption, especially for individuals reporting food addiction symptoms.

Development of the Modified Yale Food Addiction Scale Version 2.0.

The Yale Food Addiction Scale (YFAS) operationalizes indicators of addictive-like eating, originally based on the Diagnostic and Statistical Manual of Mental Disorders 4th edition Text Revision (DSM-IV-TR) criteria for substance-use disorders. The YFAS has multiple adaptations, including a briefer scale (mYFAS). Recently, the YFAS 2.0 was developed to reflect changes to diagnostic criteria in the DSM-5. The current study developed a briefer version of the YFAS 2.0 (mYFAS 2.0) using the participant sample from the YFAS 2.0 validation paper (n = 536). Then, in an independent sample recruited from Mechanical Turk, 213 participants completed the mYFAS 2.0, YFAS 2.0, and measures of eating-related constructs in order to evaluate the psychometric properties of the mYFAS 2.0, relative to the YFAS 2.0. The mYFAS 2.0 and YFAS 2.0 performed similarly on indexes of reliability, convergent validity with related constructs (e.g. weight cycling), discriminant validity with distinct measures (e.g. dietary restraint) and incremental validity evidenced by associations with frequency of binge eating beyond a measure of disinhibited eating. The mYFAS 2.0 may be an appropriate choice for studies prioritizing specificity when assessing for addictive-like eating or when a briefer measurement of food addiction is needed. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Current considerations regarding food addiction.

"Food addiction" is an emerging area, and behavioral and biological overlaps have been observed between eating and addictive disorders. Potential misconceptions about applying an addiction framework to problematic eating behavior may inhibit scientific progress. Critiques of "food addiction" that focus on descriptive differences between overeating and illicit drugs are similar to early criticisms of the addictiveness of tobacco. Although food is necessary for survival, the highly processed foods associated with addictive-like eating may provide little health benefit. Individual differences are important in determining who develops an addiction. If certain foods are addictive, the identification of possible risk factors for "food addiction" is an important next step. Not all treatments for addiction require abstinence. Addiction interventions that focus on moderation or controlled use may lead to novel approaches to treating eating-related problems. Finally, addiction-related policies that focus on environmental (instead of educational) targets may have a larger public health impact in reducing overeating.

Weight Bias During the COVID-19 Pandemic.

PURPOSE OF REVIEW: This review explores potential sources of weight bias and stigma during the COVID-19 pandemic, including "quarantine-15" messages and discussion of obesity in media and public health campaigns. We examine evidence of the effects of weight bias on well-being during the pandemic and highlight unanswered questions to be addressed in future research. RECENT FINDINGS: Studies that have investigated weight change during stay-at-home orders have yielded mixed findings and relied predominantly on self-reported retrospective recall, thus providing weak evidence of a widespread "quarantine-15" effect. No studies to date have evaluated the effects on weight stigma and health of obesity-focused COVID-19 media and public health messages. Individuals with a history of experiencing weight bias may be more vulnerable to binge eating and psychological distress during the pandemic. Weight bias and stigma during the COVID-19 pandemic, and their effects on health and well-being, warrant greater investigation and consideration in public health efforts.

Adverse Childhood Experiences and Weight Stigma: Co-Occurrence and Associations with Psychological Well-Being.

Prior research has demonstrated that individuals with a higher body weight (i.e., obesity) have a relatively high incidence of adverse childhood experiences (ACEs) (e.g., abuse, neglect). Individuals with obesity are also susceptible to experiencing and internalizing weight stigma. Negative physical and mental health consequences have been associated with both ACEs and weight stigma, yet the interplay between these factors has not been explored. The current study examined ACEs in a sample of 105 treatment-seeking adults with obesity who all reported having experienced and internalized weight stigma (90.5% women, 70.5% non-Hispanic White, mean age=49.1 years). The study aimed to 1) provide a descriptive overview of rates of ACEs in this unique sample of adults with potentially high psychological vulnerability and 2) assess associations between ACEs, weight stigma, and psychological well-being. Over three-fourths of participants (76.2%) reported experiencing at least one ACE. The total number of ACEs was significantly associated with more frequent experiences of and greater distress about weight stigma during childhood, as well as higher current perceived stress. Experiencing weight stigma for the first time in childhood was also associated with more reported ACEs. ACEs of abuse were associated with more lifetime reported experiences of weight stigma and greater internalization, use of eating as a strategy to cope with weight stigma, and higher perceived stress. These findings have implications for early identification of and tailored interventions for individuals who have experienced adverse events and weight stigma at a young age.

Pilot evaluation of a personalized commercial program on weight loss, health outcomes, and quality of life.

WW is a validated behavioral weight management program that encourages healthy habits. WW developed a method of personalizing the SmartPoints® budget depending on dietary and lifestyle preferences, and participants were placed into one of three plans as a pilot evaluation of this new program. In this 6-month, single-arm pilot study, participants attended weekly workshops and used an app to monitor eating and physical activity. Baseline and 6-month assessments included weight, waist circumference, blood pressure, energy intake, cravings, happiness, health-related quality of life, hunger, and fullness. Of 145 adults assessed at baseline, 126 (87%) provided follow-up data. Pre-post changes showed significant reductions in body weight (7.39% ± 5.93%), calories consumed (24.79% ± 32.35%) and significant improvements in cravings, happiness, all SF-36 scales and hunger but not in fullness. Greater % weight loss was related to greater improvements in happiness (r = .38, p < .001), general health perceptions (r = .29, p = .001), and health change (r = .31, p = .001), and greater reduction in role limitations due to personal or emotional problems (r = .24, p = .01). Greater % reduction in caloric intake was associated with greater reductions in cravings (r = .23, p = .01), as well as with greater improvements in happiness (r = .23, p = .01), physical functioning (r = .23, p = .01), and general health perceptions (r = .23, p = .01). Participants in this modified program achieved significant weight loss, regardless of dietary plan, as well as improvements in a variety of other physical and psychological constructs. Those who achieved greater reductions in weight also reported greater improvements in cravings, happiness and some quality of life measures.

Measurement Invariance of the Modified Yale Food Addiction Scale 2.0 Across Gender and Racial Groups.

Objective: Food addiction reflects a substance use disorder framework, suggesting certain foods (e.g., high-fat, high-sugar foods) may trigger an addictive-like eating response in vulnerable individuals. This study explored whether the Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0), a newly validated and shortened measure of food addiction, is appropriate for use in heterogeneous samples. Assessment of mYFAS 2.0 invariance is essential, as this measure was developed for use as a brief screener in large epidemiological samples that are likely demographically diverse. Method: Multigroup confirmatory factor analysis examined measurement invariance across racial/ethnic (White, Black, and Hispanic) and gender (male, female) groups. Participants were recruited through Qualtrics qBus, which uses demographic quotas to recruit a sample representative of the U.S. census reference population. Individuals were included in analyses if they identified their race/ethnicity as White, Black, or Hispanic (N = 923). Results: Results supported full and partial measurement invariance across racial and gender groups, respectively. Discussion: Results increase confidence in the generalizability of findings using the mYFAS 2.0 and indicate that observed differences in prevalence rates, such as the higher rates of food addiction observed for women and Hispanic individuals, are likely due to true differences in the population rather than due to measurement bias.

Subjective experiences of highly processed food consumption in individuals with food addiction.

Highly processed foods (e.g., pizza, chocolate) have been more associated with indicators of food addiction than have minimally processed foods (e.g., fruits, vegetables), although findings have been primarily self-reported. The present study utilized behavioral methods from the addiction literature to assess whether (a) foods differ in their associations with subjective experience indicators of abuse liability and (b) individual differences in subjective experiences and eating behavior emerge using the Yale Food Addiction Scale 2.0 (YFAS 2.0). Women (n = 44) with overweight or obesity, 38.6% with YFAS 2.0 food addiction, rated facets of subjective experience (e.g., craving) during a taste test task and ad libitum consumption period. A hierarchical linear model assessed whether foods were differentially associated with each subjective experience (Level 1) and individual differences by food addiction (Level 2). Associations between subjective experiences and eating behavior were also examined. Highly processed, relative to minimally processed, foods were more associated with indicators of abuse liability, although individuals with food addiction reported decreased enjoyment for and intentions to consume highly processed foods. Subjective experiences were associated with greater consumption of highly processed foods for participants with food addiction. The present work provides further support for the rewarding nature of highly processed foods, evidenced by closer associations with subjective experiences reported for drugs of abuse compared to minimally processed foods. In addition, highly processed food intake was related to elevated subjective experience reports for these foods for those with food addiction, paralleling findings in individuals with a substance-use disorder for the relevant drug. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Food cue reactivity in food addiction: A functional magnetic resonance imaging study.

BACKGROUND: While neuroimaging studies have revealed that reward dysfunction may similarly contribute to obesity and addiction, no prior studies have examined neural responses in individuals who meet the "clinical" food addiction phenotype. METHODS: Women (n = 44) with overweight and obesity, nearly half of whom (n = 20) met criteria for moderate-to-severe Yale Food Addiction Scale 2.0 (YFAS 2.0) food addiction, participated in a functional magnetic resonance imaging cue reactivity task. Participants viewed images of highly processed foods, minimally processed foods, and household objects while thinking about how much they wanted each item. Differences in neural responses by YFAS 2.0 food addiction to highly processed and minimally processed food cues were investigated. RESULTS: There was a significant interaction between participant group and neural response in the right superior frontal gyrus to highly versus minimally processed food cues (r = 0.57). Individuals with YFAS 2.0 food addiction exhibited modest, elevated responses in the superior frontal gyrus for highly processed food images and more robust, decreased activations for minimally processed food cues, whereas participants in the control group showed the opposite responses in this region. Across all participants, the household items elicited greater activation than the food cues in regions associated with interoceptive awareness and visuospatial attention (e.g., insula, inferior frontal gyrus, inferior parietal lobe). CONCLUSIONS: Women with overweight or obesity and YFAS 2.0 food addiction, compared to those with only overweight or obesity, exhibited differential responses to highly and minimally processed food cues in a region previously associated with cue-induced craving in persons with a substance-use disorder. Overall, the present work provides further support for the utility of the food addiction phenotype within overweight and obesity.