There is growing interest in conceptualizing obesity as a ‘‘food addiction.’’ The current study investigated
the prevalence and correlates of ‘‘food addiction’’ (FA), as defined by the Yale Food Addiction Scale (YFAS)
in 178 (133 F, 45 M) persons seeking weight loss treatment. Participants had a mean age of 51.2 ± 11.7 years and a body mass index of 36.1 ± 4.8 kg/m2 . Fifteen percent of individuals met the YFAS proposed diagnostic criteria for FA. Those who met criteria for FA reported significantly greater depressive symptomatology. There were no differences in BMI, age, race, or gender between participants with
and without FA. Among those not meeting criteria, 35% reported 3 or more symptoms in the absence of
self-reported clinical distress or impairment. YFAS symptom count was also significantly correlated with
depressive symptoms. These findings suggest that 15% of adults presenting for weight loss treatment
meet YFAS criteria for FA. The clinical significance of this classification is unknown and needs to be validated in prospective studies.
‘‘Food addiction’’ (FA) is a phrase increasingly used by the public (Huget, 2011) but continues to garner debate in the scientific literature (Brownell & Gold, 2012; Ziauddeen, Farooqi, & Fletcher, 2012). FA refers to a behavioral phenotype of food consumption that mirrors the clinical criteria for substance dependence
(Gearhardt, Corbin, & Brownell, 2009). There is some preliminary evidence for the addictive potential of food, including similarities between the effects of palatable foods and drugs of abuse on the dopamine and opiate systems (Blumenthal & Gold, 2010), and decreased dopamine (D2) receptor availability in obese individuals which parallels D2 findings in drug addicted individuals (Johnson & Kenny, 2010; Wang, Volkow, Logan, et al., 2001). The clinical significance of these associative data is unknown given the difficulties
of operationalizing criteria for tolerance, withdrawal and functional impairment in regards to eating behavior (Gearhardt et al., 2009).
Abstract
Summary
FA was diagnosed in 15.2% of individuals using the YFAS criteria. FA participants had significantly higher BDI-II scores.
Exploration of "food addiction" in overweight and obese treatment-seeking adults
Eichen DM, Lent MR, Goldbacher E, Foster GD.
Treatments were delivered in group format and focused on behavioral strategies. Clinical Measures included the Yale Food Addiction Scale (YFAS), the Beck Depression Inventory (BDI-II), and Body Mass Index (BMI).
Methodology
Sample Size
178 obese (92%) and overweight people with a mean BMI of 36.1 kg/m2 who sought weight loss treatment were studied. Most were female (74.7%) and African American (69.1%). Exclusion criteria included current substance abuse or dependence, a serious medical condition, binge eating disorder, and severe depression.
Conclusion
These data suggest that characteristics of FA exist in individuals seeking weight-loss treatment regardless of the level of obesity. This is the first examination of FA in overweight and obese treatment seekers not selected for binge eating or bariatric surgery (Gearhardt, White, et al., 2011; Meule et al., 2012).
Additionally, our sample is larger and more racially diverse than several of the previous studies (Gearhardt, White, et al., 2011; Meule et al., 2012). We used a ‘‘diagnostic,’’ categorical indicator of FA as well as an index of the number of symptoms endorsed by individuals in this sample. A limitation of this study is that we excluded individuals with severe depressive symptoms, BED and serious medical conditions. We also did not examine previous history of eating disorders, eating disorder behaviors, and other characteristics related to disordered eating such as dietary restraint and impulsivity which have previously been associated with food addiction symptomatology (Davis et al., 2011; Gearhardt, White, et al., 2011). Additional studies are needed to evaluate the YFAS in more diverse samples (e.g., other minority populations, individuals with additional medical co-morbidities, across socioeconomic statuses), and to examine the validity and reliability of the YFAS over time, including the YFAS as it was modified for the current study. It is important to better understand the heterogeneity of FA and to explore differences between individuals who meet criteria and individuals who endorse symptoms but do not meet criteria for clinical significance. Similarly, future research should explore the relationship between FA and weight loss and/or attrition during obesity treatment.
URL
Food addiction, Obesity, Depressive symptomatology
Key Words
Eichen, D. M., Lent, M. R., Goldbacher, E., & Foster, G. D. (2013). Exploration of “Food Addiction” in overweight and obese treatment-seeking adults. Appetite, 67, 22–24. doi:10.1016/j.appet.2013.03.008