Ultra-Processed Food Intake as a Modifiable Behavior in Substance Use Disorder Recovery: Implications for Recovery and Long-Term Health

Substance use disorder (SUD) is a chronic, treatable condition with wide-ranging effects on health and functioning, and recovery involves restoring the biological, psychological, and social systems affected by substance use. Diet influences many biological and behavioral processes relevant to recovery, yet nutrition remains largely absent from SUD care, and existing research has focused primarily on nutrient deficiencies and overall diet quality rather than food processing. In this Perspective, we propose that early recovery represents a critical nutritional transition during which ultra-processed food (UPF) intake may influence recovery trajectories and long-term health. After the acute withdrawal phase, appetite and energy intake often increase, but diet quality frequently remains poor. Limited evidence, largely from alcohol use disorder, suggests that UPFs contribute a substantial proportion of total energy intake during early abstinence. We examine how UPF intake may influence four recovery-relevant domains affected by chronic substance use: neurobehavioral function, cardiometabolic health, gut-immune interactions, and affective well-being. We also discuss structural, clinical, workforce, and evidentiary barriers to integrating nutrition into SUD care, including challenges in dietary assessment, limited treatment reach, and food-access constraints, particularly in rural settings. At the same time, emerging opportunities in policy, patient engagement, digital health, and food-is-medicine initiatives may support greater integration of nutrition into recovery care. Although direct evidence remains limited and no trial has evaluated UPF reduction as an adjunct to SUD treatment, the biological plausibility, observed dietary patterns, and broader health implications warrant investigation. We conclude by outlining research priorities, including improved assessment of UPF exposure, prospective cohorts beginning at treatment entry, and intervention trials extending beyond discharge, to determine whether reducing UPF intake can support recovery and long-term health.