What If Reducing Ultra-Processed Foods Does Not Make Binge Eating Worse? Part 2

In the first blog in this series, I introduced our Liberate feasibility and acceptability study, which explored whether an online, peer-supported, psychoeducational programme for ultra-processed food addiction was practical, acceptable and meaningful to participants.

This second blog looks at the next question: what happened to binge eating symptoms?

This matters because many people who identify with ultra-processed food addiction also describe binge eating patterns. Yet, in eating disorder care, abstinence from specific foods or carbohydrate reduction is often viewed with caution because of concerns that restriction may worsen binge eating. Our secondary analysis explored whether this concern was reflected in the Liberate data.

In short: Blog 1 says Liberate appears feasible, acceptable and psychologically safe. Blog 2 says that, within that supportive framework, binge eating symptoms improved rather than worsened.

Why binge eating and UPFA need to be discussed together

Binge Eating Disorder involves recurrent episodes of eating large amounts of food with a sense of loss of control and distress, without compensatory behaviours such as purging.

Ultra-processed food addiction and binge eating are not the same thing, but they overlap. Both can involve cravings, loss of control, distress and repeated relapse. However, UPFA places more emphasis on the specific addictive potential of ultra-processed foods, while Binge Eating Disorder diagnostic frameworks also include factors such as restraint, body image and shape or weight concerns.

Some people may have Binge Eating Disorder, some may have UPFA, and some may experience both. If clinicians only look through one lens, they may miss part of the picture.

The clinical fear: will abstinence or carbohydrate reduction make binge eating worse?

Many eating disorder frameworks caution against food restriction, particularly when restriction is understood as dieting, deprivation or rigid weight-loss behaviour. This caution is important, especially where restriction increases shame, hunger, obsession or rebound bingeing.

However, the paper asks whether all forms of food boundary-setting should be treated the same. Is a psychologically supported, real-food, low-carbohydrate approach the same as unsupervised dieting? Is abstaining from personally addictive ultra-processed foods always harmful, or might it help some people feel safer and more in control?

This is not an argument for blanket restriction. It is an argument for nuance, clinical curiosity and informed choice.

What did this study examine?

This paper was a secondary analysis of data from the Liberate feasibility study, with an additional cohort included.

The study included 117 adults with self-reported ultra-processed food addiction. Binge eating symptoms were measured using the Binge Eating Scale at three timepoints: baseline, after the 8-week intervention, and at 6-month follow-up.

The analysis used an intention-to-treat approach, meaning baseline scores were carried forward where post-intervention or follow-up data were missing. This is important because it avoids making the results look artificially better by only analysing people who completed all measures.

What was Liberate?

Liberate is an online, coach-led, community-based programme for people living with ultra-processed food addiction. It includes addiction-informed psychoeducation, peer support, psychologically informed coaching, and a real-food, low-carbohydrate, abstinence-oriented dietary approach.

The focus is not simply weight loss. The focus is understanding addictive-like eating patterns and supporting behavioural change within a safe and non-shaming environment.

What happened to binge eating symptoms?

Mean Binge Eating Scale scores reduced from 26.5 at baseline to 18.0 post-intervention. At 6-month follow-up, the mean score was 19.2, suggesting that much of the improvement was maintained.

The proportion of participants in the severe binge eating category reduced from 48.7% at baseline to 24.8% post-intervention and remained lower at 30.8% at 6 months.

The proportion with no binge eating symptoms increased from 18.8% at baseline to 54.7% post-intervention and remained higher than baseline at 48.7% at follow-up.

The key message is that symptoms improved, and there was no signal that the intervention worsened binge eating symptoms over 6 months.

Why this finding matters

This finding challenges a common assumption: that reducing carbohydrate intake or abstaining from specific foods must necessarily worsen binge eating symptoms.

For some people, especially those who experience ultra-processed foods as addictive, removing or reducing trigger foods may not feel like deprivation. It may feel like relief. It may reduce food noise, craving, decision fatigue and the repeated cycle of trying to moderate foods that repeatedly lead to loss of control.

This does not mean abstinence is right for everyone. It means it should not be dismissed automatically when someone describes an addictive relationship with ultra-processed foods.

What this means for eating disorder and obesity care

Binge eating and UPFA can overlap, but they are not identical. Some people may need eating disorder treatment, some may need addiction-informed support, and some may need both.

Clinicians should ask about cravings, loss of control, withdrawal-like symptoms, tolerance and specific trigger foods. Food boundaries should be assessed by function, not ideology. The question should not simply be, "Is this restriction?" but, "Is this supporting recovery, safety, nourishment and reduced harm?"

Abstinence or low-carbohydrate approaches should be delivered carefully, with psychological support, monitoring and safeguarding.

What this study does not prove

This was not a randomised controlled trial. There was no comparison group, and participants self-reported ultra-processed food addiction. The sample was predominantly female and White, so findings may not generalise to all populations.

The findings are promising, but they should be understood as preliminary. Controlled trials are needed to compare this approach with usual care and to identify who benefits most.

Conclusion

For too long, conversations about binge eating have often been framed around either restraint or loss of control. But for some people, the missing piece may be the addictive potential of ultra-processed foods.

Our findings suggest that an addiction-informed, psychologically supportive, real-food approach was associated with reductions in binge eating symptoms, with improvements largely maintained at 6 months. Crucially, there was no evidence that this approach worsened binge eating symptoms over the follow-up period.

This does not mean abstinence or carbohydrate reduction is right for everyone. It does mean that people with binge eating symptoms and ultra-processed food addiction deserve more nuanced care, informed choice and treatment pathways that reflect the reality of their experience.

For clinicians: before assuming that abstinence from ultra-processed trigger foods is harmful, ask the person what happens when they try to moderate them.

For readers with lived experience: if your binge eating feels driven by craving, food noise and loss of control around specific ultra-processed foods, you are not alone and your experience deserves to be taken seriously.

References

Bennett EB, Bellamy EL, Lycett D, Unwin J, Whelan M, Wiss DA, Patel R. Changes in binge eating symptoms following an online community-based ultra-processed food addiction intervention: Liberate. Frontiers in Public Health. 2026;14:1807450. doi:10.3389/fpubh.2026.1807450.

Bennett E, Lycett D, Whelan M, Bellamy EL, Banks S, Patel R. A feasibility and acceptability study of Liberate: an online, peer-supported, psychoeducational intervention for ultra processed food addiction. Frontiers in Psychiatry. 2025;16:1620372. doi:10.3389/fpsyt.2025.1620372.

Kessler RC, Berglund PA, Chiu WT, Deitz AC, Hudson JI, Shahly V, et al. The prevalence and correlates of binge eating disorder in the World Health Organization world mental health surveys. Biological Psychiatry. 2013;73:904-914. doi:10.1016/j.biopsych.2012.11.020.

Monteiro CA, Cannon G, Levy RB, Moubarac JC, Louzada ML, Rauber F, et al. Ultra-processed foods: what they are and how to identify them. Public Health Nutrition. 2019;22:936-941. doi:10.1017/S1368980018003762.

Hall KD, Ayuketah A, Brychta R, Cai H, Cassimatis T, Chen KY, et al. Ultra-processed diets cause excess calorie intake and weight gain: an inpatient randomized controlled trial of ad libitum food intake. Cell Metabolism. 2019;30:67-77.e3. doi:10.1016/j.cmet.2019.05.008.

Carmen M, Safer DL, Saslow LR, Kalayjian T, Mason AE, Westman EC, et al. Treating binge eating and food addiction symptoms with low-carbohydrate ketogenic diets: a case series. Journal of Eating Disorders. 2020;8:2. doi:10.1186/s40337-020-0278-7.