An examination of the food addiction construct in obese patients with binge eating disorder

This study provides further support for the operationalization of ‘‘food addiction’’ as defined by the
YFAS. Based on this definition, BED and ‘‘food addiction’’ are related, but do not totally overlap. An important area for future research will be the treatment implications of ‘‘food addiction’’ for individuals with BED and signs of addictive-like eating behavior. These findings also have broader relevance to the emerging literature on the nature of ‘‘food addiction’’ and various resultant controversies and questions.33 Although food intake is necessary for survival, the marginal nutritional benefit of food consumption in some circumstances (e.g., calorically dense but nutritionally poor foods) may be outweighed by deleterious longer term consequences to health. This type of food consumption appears perhaps most strongly associated with certain food types, notably highly processed foods with unusually high levels of added fat and sugar, which some evidence suggests are most likely to engender consumption patterns reminiscent of
addictive behaviors.33 The YFAS asks specifically about eating behaviors with high fat/sugar foods but without use or reference to ‘‘addiction’’ terms to decrease possible response biases.

Although this study has implications about the relation between BED and ‘‘food addiction’’ as measured by the YFAS, these must be considered within the context of several limitations. First, this data are cross-sectional in nature and this precludes any comments either about causality or whether ‘‘food addiction’’ predicts a more chronic or severe course of BED. Prospective studies would be necessary to determine developmental trajectories and longitudinal studies would be needed to test the predictive utility of the measurement of ‘‘food addiction’’ for the course and outcome of BED.34 In addition, we did not include a comparison group of obese patients who do not binge eat.

Future research should examine ‘‘food addiction’’ in different samples of obese persons with and
without coexisting BED. Further, a sample of participants with and without BED will allow for a greater understanding of the sensitivity and specificity of the YFAS in detecting a diagnosis of BED. Finally, our participants were treatment seeking and therefore generalizability to community samples or to nontreatment-seeking obese persons with and without BED is unknown.