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Food addiction (FA) is a new terminology that simulates craving for food to drug addiction. It is recently measured by the Yale Food Addiction Scale (YFAS). It was speculated that FA is incriminated in the current obesity epidemic. Egypt is one of the highest African countries in the prevalence of obesity.



The prevalence of FA in the studied adolescents was 15.7%. This study showed that the most prevalent FA symptom was tolerance (52.1%). The relationship of the diagnosis of FA to age, gender and BMI ihows that the diagnosis of FA showed significant differences in relation to age; the mean age of adolescents without FA was 14.36 ± 1.7 years while those with FA had a mean age of 14.86 ± 1.76 years. Thus adolescents with FA were clustered in the age range of more than 14.5 years. The relationships of the different symptomatology of food addiction and the diagnosis of FA according to the YFAS to the different BMI categories; normal, overweight and obese show that all symptoms differed significantly in the different BMI categories except tolerance.

The prevalence of FA in Egyptian adolescents was 15.7% in consistence with the results of a systematic review which showed a prevalence of 19.9% in the general population. Studies evaluating FA in obese subjects showed a higher prevalence; 38%, 40% and up to 71% in some studies. The most prevalent symptom in our study was tolerance which is getting larger amount of food progressively to feel its psychologically rewarding effect. The next most common symptom was feeling of withdrawal symptoms when not getting the desired food. Each of tolerance and withdrawal symptoms was present in nearly half of the study subjects. This contrasts what was found in middle aged and older women who showed that persistent desire and unsuccessful efforts to cut down or control eating to be the most prevalent symptoms. Our data and others showed that FA does occur in obese, overweight, normal and underweight individuals.

Data on gender differences regarding FA diagnosis were scarce. However, our results and others showed no gender differences in FA diagnosis. This study adds to the knowledge about gender and racial variations in the prevalence of FA diagnosis as well as its various symptomatology as data in this regard are still evolving particularly in community samples.

Longitudinal studies are needed to assess whether or not lean individuals with FA will develop obesity and study the factors aiding or combating this evolution so as to direct proper interventional strategies and to answer the question of whether the presence of addictive behaviour to food will result in escalation of food intake to achieve satiety due to the development of tolerance in non-obese subjects and the effect of this behaviour on
their weight gain.

Prevalence of food addiction and its relationship to body mass index

Ahmed, Alaa Youssef, and Amany Mohammed Sayed

We measured the weight of all participants in kilograms with a digital scale with minimal clothing. Height was measured to the nearest 0.1 cm on a portable stadiometer (Secastadiometer 213). The BMI was calculated as weight (kg)/height (m)2 and standard deviation scores were calculated according to the norms. All measurements were done between 9 am and 12 pm. All subjects had been interviewed to assess food addiction by the Yale Food Addiction Scale. Translation of the YFAS into Arabic was done by an accredited translation office then checked by the researchers and reviewed by three experts to be sure of its validity. The diagnosis of food addiction was made if there were more than or equal to 3 symptoms with clinically significant impairment or distress.


Sample Size

801 Egyptian adolescents recruited randomly from public and private schools in Cairo over 6 months from December 2014 to May 2015. Their ages ranged from 11 to 18 years. Their mean age was 14.4 ± 1.7 years. We had a multistage cluster sample to get a representative sample of students in the 4 zones of Cairo; eastern, western, northern and southern Cairo. In the first stage, we stratified the sample according to school types (governmental and private) then schools were selected randomly from the list of schools that were obtained from the Ministry of Education. In the second stage, inside each school, school grades were stratified into (1st, 2nd and 3rd) then
classes were randomly selected from each grade and all students in selected classes were eligible to participate.

So, the sample size of each group after correction was approximately 100 individuals. By multiplication of 100 by 2 types of schools in 4 districts, the whole sample was calculated as 800 students. All adolescents in the defined age range were eligible for inclusion according to randomization unless they were receiving any medications, having neurologic, neurodevelopmental, or psychiatric problems, declaring or showing signs of substances dependence or medical disease.


FA prevalence was 15.7% in the studied sample. The most prevalent FA symptom was tolerance which was present in 52.1% of the sample. FA diagnosis didn’t differ across the different BMI categories; however, all of the FA symptoms showed significant differences in relation to the BMI when classified as normal, overweight and obese except for the symptom of tolerance.

FA exists in one sixth of Egyptian adolescents. FA symptoms rather than FA diagnosis differed in the different BMI categories.


Food addiction, Body mass index, Adolescents, Egypt

Key Words

Ahmed, Alaa Youssef, and Amany Mohammed Sayed. “Prevalence of Food Addiction and Its Relationship to Body Mass Index.” Egyptian Journal of Medical Human Genetics, vol. 18, no. 3, July 2017, pp. 257–60. (Crossref),


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