Study Finds Mediterranean Diet Reduces Food Addiction Symptoms Among Older Adults

Led by Lucía Camacho-Barcia and Fernando Fernández-Aranda from Bellvitge University Hospital in Barcelona, alongside Jordi Salas-Salvadó from Universitat Rovira i Virgili, the team analyzed data from 448 participants aged 65.3 years on average. Participants were divided into two groups: one received an energy-reduced Mediterranean diet combined with a physical activity program and behavioral support, while the control group was instructed to follow a Mediterranean diet ad libitum, without specific calorie restrictions or structured support. Food addiction was measured using the Yale Food Addiction Scale 2.0, which aligns with criteria used for substance-related disorders, along with evaluations of diet and physical activity adherence and quality of life.

Although food addiction is not formally classified in current psychiatric manuals, it encompasses behaviors such as loss of control over eating and persistent consumption despite negative consequences. The trial's findings suggest that while food addiction severity declined in both groups over the follow-up period, only those in the intensive intervention group maintained reduced symptoms by the three-year mark, achieving significantly lower food addiction scores compared to the control group.

The study revealed distinct outcomes based on initial food addiction status. Participants who did not exhibit food addiction at the outset showed dramatically increased odds of achieving meaningful health outcomes, with nearly triple the likelihood of losing at least eight percent of body weight. For those with food addiction, the intervention yielded some positive effects, but the overall benefits for weight loss and dietary adherence were not as pronounced as in the non-food addiction group.

Improvements in adherence to the Mediterranean diet explained the long-term benefits in body weight, waist circumference, and quality of life for participants without food addiction, while this mediation effect was significantly reduced for those with food addiction.

These results carry significant implications for personalized obesity treatment. They suggest that screening for food addiction at the beginning of treatment could help identify patients who might require enhanced support, potentially incorporating techniques from addiction treatment. The authors emphasize that the trial offers a much-needed longitudinal perspective in a debate often dominated by cross-sectional studies.

Additionally, the findings contribute to discussions regarding ultra-processed foods, which are believed to trigger addictive eating behaviors. The Mediterranean diet stands as a nutritional counterpoint to ultra-processed foods and shows promise in improving adherence and dietary habits, even among older adults facing significant health challenges.

While the study presents compelling findings, it has limitations. Participants were older adults with metabolic syndrome involved in a cardiovascular prevention trial, which may limit applicability to younger populations or individuals with severe obesity. Furthermore, food addiction was assessed via self-reported questionnaires rather than clinical interviews, and the study's methods cannot definitively establish causal relationships.

Overall, this research reframes a common issue in weight-loss programs, indicating that food addiction may be a key factor in determining treatment success. The trial provides evidence that food addiction can both hinder standard treatment responses and be targeted through appropriate interventions, signaling a potential shift towards more tailored approaches in obesity care.