Background/Aims: To assess the prevalence and correlates of addictive-like eating behavior in Germany. Methods: The German version of the Yale Food Addiction Scale (YFAS) 2.0 was used to investigate, for the first time, the prevalence of ‘food addiction' in a representative sample aged 18-65 years (N = 1,034). Results: The prevalence of ‘food addiction' measured by the YFAS 2.0 was 7.9%. Individuals meeting criteria for ‘food addiction' had higher BMI and were younger than individuals not meeting the threshold. Underweight (15.0%) and obese (17.2%) individuals exhibited the highest prevalence rate of ‘food addiction'. Addictive-like eating was not associated with sex, education level, or place of residence. Conclusion: YFAS 2.0 ‘food addiction' was met by nearly 8% of the population. There is a non-linear relationship between addictive-like eating and BMI, with the highest prevalence among underweight and obese persons. These findings suggest that ‘food addiction' may be a contributor to overeating but may also reflect a distinct phenotype of problematic eating behavior not synonymous with obesity. Further, the elevated prevalence of YFAS 2.0 ‘food addiction' among underweight individuals may reflect an overlap with eating disorders and warrants attention in future research.

The concept of food addiction is currently a highly debated subject within both the general public and the scientific communities. The term food addiction suggests that individuals may experience addictive-like responses to food, similar to those seen with classic substances of abuse. An increasing number of studies have established the prevalence and correlates of food addiction. Moreover, food addiction may be associated with obesity and disordered eating. Thus, intervening on food addiction may be helpful in the prevention and therapy of obesity and eating disorders. However, controversy exists about if this phenomenon is best defined through paradigms reflective of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) substance-related disorders (e.g. food addiction) or non-substance-related disorders (e.g. eating addiction) criteria. This review paper will give a brief summarisation of the current state of research on food addiction, a more precise definition of its classification, its differentiation from eating addiction and an overview on potential overlaps with eating disorders. Based on this review, there is evidence that food addiction may represent a distinct phenomenon from established eating disorders such as bulimia nervosa or binge-eating disorder. Future studies are needed to further examine and establish orthogonal diagnostic criteria specific to food addiction. Such criteria must differentiate the patterns of eating and symptoms that may be similar to those of eating disorders to further characterise food addiction and develop therapy options. To date, it is too premature to draw conclusions about the clinical significance of the concept of food addiction.

No abstract

Purpose Examine the prevalence and potential relationships among food addiction (FA)-as measured by Yale Food Addiction Scale 2.0 (YFAS 2.0), eating disorders (ED)-as measured by Eating Disorder Diagnostic Scale (EDDS)-and exercise dependence (EXD)-as measured by Questionnaire to Diagnose Exercise Dependence in Endurance Sports (FESA), for the first time worldwide, in amateur endurance athletes. Methods A total of 1022 German-speaking endurance athletes (44% male, Ø 36 years, Ø BMI 23 kg/m 2) replied to an online questionnaire consisting of demographics, related parameters, and the German versions of YFAS 2.0, EDDS, and FESA. Results Prevalence of FA, ED, and EXD was 6.2, 6.5, and 30.5%. The probability for FA increases with BMI, thoughts about food and EXD score, and decreases with age and when an ED is present. People with FA and people with ED vs. people with both, FA&ED, differed significantly in this cohort. Strong significant relationships were found between FA and EXD (X 2 (1) = 15.117, p < 0.001, n = 1022). Conclusions A considerable number of amateur endurance athletes may suffer from FA. The association between FA and EXD is stronger than between ED and EXD, indicating FA as a potentially more relevant subject-than ED-for prevention or therapy in people with EXD. Further studies are needed to investigate parameters and relationships between the possibly involved types of ED, FA, and EXD. Level of evidence Level III, well-designed cohort analytic study.

ZusammenfassungSüßgetränke erfahren eine große wissenschaftliche und politische Aufmerksamkeit. Ihr Konsum ist in vielen Ländern in den letzten Jahrzehnten stark angestiegen. In Deutschland hat sich der Absatz zwischen 1970 und 2010 mehr als verdoppelt. Es gibt gute Evidenz dafür, dass ein regelmäßiger Konsum von Süßgetränken eine Gewichtszunahme fördert, wofür physiologische und psychologische Faktoren verantwortlich gemacht werden. In Beobachtungsstudien wurde zudem eine Assoziation zwischen regelmäßigem Süßgetränkekonsum und dem Risiko für Diabetes mellitus Typ 2, kardiovaskuläre Erkrankungen und Karies festgestellt. Angesichts der nachweislich negativen gesundheitlichen Auswirkungen werden diverse Interventionsmöglichkeiten diskutiert. Hier sind insbesondere Steuern, Werbebeschränkungen und Veränderungen des Getränkeangebots in Schulen und Kindergärten zu nennen, welche in vielen Ländern bereits umgesetzt oder beschlossen wurden. In Deutschland konnten entsprechende Maßnahmen trotz des im internationalen Vergleich hohen Süßgetränkekonsums bislang noch nicht verwirklicht werden.