Towards consensus: Using the Delphi Method to form an International Expert Consensus statement on Ultra-Processed Food Addiction

Jen Unwin^1*Heidi Giaever¹Nicole Avena²Clarissa Kennedy¹Molly Painschab¹Erica M. LaFata³

• ¹The Collaborative Health Community, Hove, United Kingdom
• ²Icahn School of Medicine at Mount Sinai, New York, New York, United States
• ³Drexel University, Philadelphia, Pennsylvania, United States

The recognition of an addictive disorder relating to the harmful use of certain foods is being called for by clinicians and researchers, which evidence supports as being distinct from eating disorders (EDs) and obesity. Critics cite a lack of consensus on the validity of associating the term addiction with food, claiming that characteristics of addiction 'are not observed in the context of eating behaviours' as a reason to dispute its consideration as a novel diagnosis. To move this field forward, Iit was decided to consult international scientific and clinical experts to review whether it would be possible to reach a consensus around this subject. and result in an improved application. The 12-month project, using a Delphi method, involved 40 clinicians, researchers and academics, from 10 countries and a team of four facilitators. Consensus was achieved between 37 out of the 40 participants. The discussions during the process demonstrated that it was not only possible to achieve several areas of agreement related to the clinical observation of addiction-like symptoms related to certain foods but also, that existing extensive scientific research findings confirm the biochemical, neurological and behavioural aspects of a substance-use disorder relating specifically to ultra-processed foods, exhibiting strong similarities with other acknowledged substance-use disorders. The consensus may provide a platform for future attempts for formal recognition of ultra-processed food addiction as a diagnosis. Areas for future research are discussed.