Ultra-processed foods linked to disordered eating and poor diet quality in adults with obesity

Daniela Barros, special student at the Department of Public Health, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.

A study published in the Archives of Endocrinology and Metabolism journal (vol. 70, no. 2, 2026) found that adults with obesity who consume higher amounts of ultra-processed foods are more likely to present symptoms related to eating disorders and poorer diet quality.

The research named Higher consumption of ultra-processed foods is associated with disordered eating symptoms and low-quality diet in adults with obesity (FAVARON, C.M., et al., 2026) was conducted by investigators from the Interdisciplinary Graduate Program in Health Sciences at the Federal University of São Paulo (UNIFESP) and evaluated the relationship between dietary patterns and eating behavior in individuals with obesity.

Ultra-processed foods have become increasingly prevalent in modern diets and have been associated with obesity, cardiometabolic diseases, and mental health outcomes. The authors hypothesized that these foods may also influence eating behavior by promoting patterns such as emotional eating and binge-type behaviors.

To investigate this association, the researchers conducted a cross-sectional study including 77 adults with obesity recruited in São Paulo, Brazil. Participants had an average body mass index of 39.14 kg/m², and most were women (77.9%).

Dietary intake was assessed using three 24-hour dietary recalls, and foods were classified according to the NOVA classification system, which categorizes foods based on their degree of industrial processing. Eating behavior was evaluated using validated questionnaires, including the Bulimic Investigatory Test Edinburgh (BITE), the Dutch Eating Behaviour Questionnaire (DEBQ), and the Three-Factor Eating Questionnaire (TFEQ-21).

Participants were divided into three groups according to the proportion of calories derived from ultra-processed foods. Individuals in the highest consumption group showed significantly higher scores for binge eating and bulimia symptoms, as well as increased emotional eating, external eating, and uncontrolled eating compared with those consuming fewer ultra-processed foods.

Overall, more than half of the participants (51.9%) showed unusual eating behavior, while 23.4% had scores suggesting binge eating with possible bulimia symptoms.

Diet quality was also affected. Participants with the highest intake of ultra-processed foods had significantly lower scores on the Diet Quality Index and consumed fewer unprocessed or minimally processed foods.

On average, ultra-processed foods accounted for 32% of total caloric intake, a proportion higher than that observed in the Brazilian population overall.

Image: Via RaniRamli

It is worth mentioning that the authors noted several limitations. The cross-sectional design prevents establishing causal relationships between ultra-processed food consumption and eating disorder symptoms. In addition, the sample was relatively small and recruited from a single urban center, which may limit the generalizability of the findings to broader populations. Dietary intake and eating behaviors were assessed through self-reported questionnaires and 24-hour dietary recalls, methods that may be subject to recall bias or underreporting, particularly among individuals with obesity. Finally, the classification of foods according to the NOVA system required researcher interpretation, which may introduce some degree of subjectivity in food categorization.

Even so, the findings reinforce growing evidence that ultra-processed food consumption may influence eating behavior beyond its nutritional composition. Diets high in these foods are typically rich in refined carbohydrates, added sugars, and fats, which can enhance palatability and stimulate reward-related pathways in the brain, potentially promoting overeating and loss of control over food intake. In this context, the observed association between ultra-processed food consumption and higher scores for emotional, external, and uncontrolled eating may reflect the interaction between environmental exposure to highly palatable foods and psychological or behavioral vulnerabilities.

Previous studies have also reported links between ultra-processed food intake and eating disorder symptoms. Cross-sectional analyses in adult populations have shown that higher consumption of ultra-processed foods is associated with increased risk of binge eating and bulimia-related symptoms (FIGUEIREDO, N., et al., 2022). Similarly, research involving patients with obesity has suggested that emotional eating and food disinhibition may contribute to the consumption of highly palatable foods and to difficulties in maintaining dietary control (ERDEN, ŞÖ., et al., 2022; BENZEROUK, F., et al., 2020).

Another important finding of the present study is the association between ultra-processed food intake and poorer diet quality. Diets with higher proportions of ultra-processed foods tend to be characterized by lower intake of protein, fiber, vitamins, and minerals and higher intake of sugars and fats. These patterns may further contribute to metabolic dysregulation and to the persistence of obesity-related behaviors.

Taken together, the results highlight the importance of considering both dietary patterns and behavioral aspects of eating in obesity management. Interventions focused solely on calorie restriction may overlook behavioral drivers of food choice and consumption. Addressing emotional and uncontrolled eating, while promoting greater consumption of minimally processed foods, may therefore represent a more comprehensive strategy for improving nutritional quality and supporting long-term weight management.

According to the authors, obesity treatment strategies should therefore address not only caloric intake but also diet quality and behavioral dimensions of eating, including emotional and uncontrolled eating patterns. In addition, they highlight the importance of public policies aimed at reducing the consumption of ultra-processed foods and promoting healthier dietary patterns. Strategies such as improving food labeling, regulating advertising of ultra-processed products, and increasing access to minimally processed foods may help support healthier food choices.

To read the article, access

FAVARON, C.M. et al. Higher consumption of ultra-processed foods is associated with disordered eating symptoms and low-quality diet in adults with obesity. Arch. Endocrinol. Metab. [online]. 2026, vol. 70, no. 2, e260010. [viewed 16 April 2026]. https://doi.org/10.20945/2359-4292-2026-0010. Available from: https://www.scielo.br/j/aem/a/VnD97hjjP3ML8MdwK9pjVLP/

Referências

BENZEROUK, F. et al. Contributions of Emotional Overload, Emotion Dysregulation, and Impulsivity to Eating Patterns in Obese Patients with Binge Eating Disorder and Seeking Bariatric Surgery. Nutrients [online]. 2020, vol. 12, no. 10, pp. 3099. [viewed 16 April 2026].
https://doi.org/10.3390/nu12103099. Available from: https://www.mdpi.com/2072-6643/12/10/3099

ERDEN AKI, Ş.Ö., et al. Relationship of depression, impulsivity, distress intolerance and coping styles with maladaptive eating patterns in bariatric candidates. Eat Weight Disord [online]. 2022, vol. 27, no. 8, pp. 3351-3366. [viewed 16 April 2026]. https://doi.org/10.1007/s40519-022-01465-9. Available from: https://link.springer.com/article/10.1007/s40519-022-01465-9

FIGUEIREDO, N. et al. Ultra-processed food intake and eating disorders: Cross-sectional associations among French adults. Journal of Behavioral Addictions [online]. 2022, vol. 2, pp. 588-599 [viewed 16 April 2026]. https://doi.org/10.1556/2006.2022.00009. Available from: https://akjournals.com/view/journals/2006/11/2/

External links

Archives of Endocrinology and Metabolism – AEM