The impact of food addiction on the treatment of eating disorders and obesity: A systematic review

Food addiction (FA) is a complex clinical condition that refers to addiction to highly palatable foods, represented by compulsive eating behavior and an incapacity to control food consumption, similar to other forms of addiction. This review examines the literature on FA and its impact on eating disorders and obesity. Using databases, such as PubMed, Cochrane Library and Google Scholar, recent studies were analyzed to show how FA may reduce treatment effectiveness, increase symptom severity, promote resistance to nutritional or pharmacological interventions, and elevate the risk of relapse. The search strategy used the keywords 'food addiction', 'obesity', 'eating disorders', 'psychotherapy', and 'dietary therapy', limiting the reference period to studies published in the last five years. In reviewing the available articles, several nuances emerged that are fundamental to understanding FA, including neurobiological mechanisms, psychiatric comorbidities, environmental determinants, alterations in the gut microbiota, and the pervasive influence of ultra-processed foods. Taken together, the data indicate that FA not only intensifies symptom manifestation but also contributes to worse outcomes, with reduced compliance to standard treatments and an increased likelihood of relapse. These observations underscore the importance of recognizing FA as a critical component in clinical practice; neglecting its role and symptoms may compromise therapeutic efficacy. Further research is needed to establish integrative treatment models that include FA as a fundamental component of clinical patient care.