A new study published in the Archives of Endocrinology and Metabolism has found a link between high consumption of ultra-processed foods (UPFs) and disordered eating patterns among adults with obesity in São Paulo, Brazil. The research highlights potential areas for nutritional intervention to improve health outcomes.
Researchers conducted a cross-sectional analysis involving 77 adults aged 18-59 years with obesity, defined as having a body mass index (BMI) of 30 kg/m² or higher. Participants were recruited from a clinical obesity treatment service and through social media. Those who were pregnant, had diagnosed eating disorders, cardiac or renal disease, genetic forms of obesity, used certain medications, smoked, abused alcohol, or were on pharmacological weight loss treatments were excluded.
Dietary habits were assessed using three non-consecutive 24-hour dietary recalls. Foods consumed were classified according to the NOVA system to determine their level of processing. Diet quality was measured using the Diet Quality Index associated with the Digital Food Guide. Eating behaviors were evaluated through self-administered online questionnaires.
The participants were grouped into tertiles based on the proportion of calories from UPFs. Only about one-quarter exhibited normal eating behavior; over half showed unusual eating patterns and nearly a quarter reported binge eating episodes. The highest UPF intake group scored significantly higher on measures related to binge eating symptoms compared to those with lower UPF consumption.
Overall, 40% of participants displayed clinically significant symptoms related to disordered eating, while 13% had severe symptoms. Emotional and external eating scores were elevated in more than one-third of the sample.
The study found that greater UPF intake was linked with higher levels of binge eating and bulimia-related symptoms as measured by standardized tools such as BITE (Bulimic Investigatory Test Edinburgh). There was also an association between high UPF consumption and increased emotional eating, external eating, and uncontrolled eating behaviors.
Diet quality was generally rated as intermediate across all groups but was lowest among those consuming the most UPFs. Individuals in this group also had lower protein intake compared to others, which may impact satiety and appetite regulation.
"These findings suggest that higher consumption of ultra-processed foods is associated with eating behaviors characterized by reduced self-regulation and heightened responsiveness to emotional and environmental cues," according to the study authors.
The researchers note that these results point toward considering both diet quality and behavioral aspects when developing obesity treatment strategies. They suggest that addressing underlying behavioral drivers alongside dietary changes could improve weight management efforts.
However, they caution that because this is a cross-sectional study based on self-reported data from a single urban center with a small predominantly female sample size, causality cannot be established and generalizability may be limited.
"Overall, the results highlight the need to consider ultra-processed food consumption within a broader behavioral and nutritional framework for obesity management, while acknowledging the observational nature of the findings," said the authors.
