Advances and Future Directions in the Clinical Utility of Food Addiction

Cassin, Stephanie E.; Sockalingam, Sanjeev

doi:10.3390/nu13020708

Cited by 6 publications

(5 citation statements)

References 12 publications

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“…We examined sex differences in rates and the following correlates of FA in that sample: body mass index (BMI), frequency of loss of control over (LOC) eating, frequency of compensatory behaviors, severity of PTSD symptoms, severity of depression symptoms, suspected alcohol use disorder (AUD) severity, and frequency of alcohol use. Based on past research, we hypothesized that (1) women would have higher prevalence of positive FA status, compared to men; (2) individuals with positive FA status would have higher BMI than those without FA, regardless of sex; (3) there would be a significant interaction between FA status and sex, such that women with FA would report significantly higher frequency of LOC eating and compensatory behaviors compared to men and to women without FA; (4) there would be a significant interaction between FA status and sex, such that women with FA would report significantly higher PTSD symptom severity compared to men and women without FA; (5) individuals with positive FA status would report significantly higher depression severity, regardless of sex; (6) there would be no significant differences between individuals with and without FA in alcohol use.…”

Section: Study Aimsmentioning

confidence: 99%

“…FA remains a controversial construct: there are arguments that eating, not food itself, has addictive properties (similar to other behavioral addictions), hence making "eating addiction" a more useful construct than "food addiction" [3][4][5]. However, many researchers consider FA a useful construct in identifying individuals at risk for obesity and negative health outcomes related to maladaptive eating patterns, and its clinical utility is increasingly recognized [6]. Positive FA status has been linked to obesity [7] and the presence of eating disorders [8]; it is more prevalent than the DSM-5 eating disorders.…”

Section: Introductionmentioning

confidence: 99%

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Investigating Sex Differences in Rates and Correlates of Food Addiction Status in Women and Men with PTSD

et al. 2021

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Background: Food addiction (FA) is a dysregulated eating pattern characterized by difficulties in controlling the intake of certain foods. There is an overlap in physical and mental health correlates of FA and post-traumatic stress disorder (PTSD). The purpose of this study was to examine sex differences in the rates of positive FA status in individuals with threshold/subthreshold PTSD, and to examine sex differences in the physical and mental health correlates of FA. Methods: Post-9/11 veterans/service members seeking PTSD treatment were recruited. Participants were diagnosed with PTSD via the administration of a clinical interview. FA status was determined using Modified Yale Food Addiction Scale-2, binary sex and body mass index were assessed with demographics questions. Results: Nearly half (43%) of the sample were women. There were no sex differences in the rates of FA, with an overall FA prevalence of 18%. There were no sex differences in FA symptom count in the whole sample (M = 1.63) or those with FA status (M = 6.21). Individuals with FA reported higher frequency of disordered eating, higher severity of PTSD, and depression symptoms. Conclusions: FA should be assessed in tandem with PTSD symptoms, as its prevalence in that sample is higher than in the general population, and it appears to affect both sexes at similar rates.

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Section: Study Aimsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Investigating Sex Differences in Rates and Correlates of Food Addiction Status in Women and Men with PTSD

et al. 2021

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“…Food addiction has been identified as a key barrier to the effectiveness of nutrition and weight loss interventions ( Cassin and Sockalingam, 2021 ; Schiestl et al, 2021 ), and is often comorbid with DSM-recognised eating disorders ( Gearhardt et al, 2014 ; Sanchez et al, 2022 ), which are highly prevalent among Australian adolescents ( Mitchison et al, 2020 ). As such, food addiction should be considered in the design, implementation and evaluation of nutrition interventions.…”

Section: Discussionmentioning

confidence: 99%

“…While not yet recognised as a disorder in the DSM, food addiction has some symptom overlap and comorbidity with recognised eating disorders, including binge eating disorder and anorexia nervosa (bulimic-purgative subtype) ( Gearhardt et al, 2014 ; Sanchez et al, 2022 ). Despite this overlap, food addiction is present in individuals who do not meet the criteria for other eating disorders ( Gearhardt et al, 2014 ), has demonstrated substantial clinical utility ( Cassin and Sockalingam, 2021 ), has unique treatment requirements ( Leary et al, 2021 ), and has been identified as a key barrier to the effectiveness of nutrition and weight loss interventions ( Cassin and Sockalingam, 2021 ; Schiestl et al, 2021 ). Food addiction is also associated with mental ill-health and reduced quality of life and individuals with lived experience describe a ‘cycle’ of distress to addictive eating to further distress ( Lacroix and von Ranson, 2020 ; Skinner et al, 2021 ; Van Ostrand, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and correlates of addictive eating behaviours in a large cohort of Australian adolescents

Smout

Gardner

Champion

et al. 2023

Aust N Z J Psychiatry

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Objective: Research shows highly palatable foods can elicit addictive eating behaviours or ‘food addiction’. Early adolescence is theorised to be a vulnerable period for the onset of addictive eating behaviours, yet minimal research has examined this. This study explored the prevalence and correlates of addictive eating behaviours in a large early adolescent sample. Methods: 6640 Australian adolescents (Mage = 12.7 ± 0.5, 49%F) completed an online survey. Addictive eating was measured with the Child Yale Food Addiction Scale (YFAS-C). Negative-binomial generalised linear models examined associations between addictive eating symptoms and high psychological distress, energy drink consumption, sugar-sweetened beverage (SSB) consumption, alcohol use, and cigarette use. Results: Mean YFAS-C symptom criteria count was 1.36 ± 1.47 (of 7). 18.3% of participants met 3+ symptoms, 7.5% endorsed impairment and 5.3% met the diagnostic threshold for food addiction. All examined behavioural and mental health variables were significantly associated with addictive eating symptoms. Effects were largest for high psychological distress and cigarette use; with those exhibiting high psychological distress meeting 0.65 more criteria (95%CI = 0.58–0.72, p < 0.001) and those who smoked a cigarette meeting 0.51 more criteria (95%CI = 0.26–0.76, p < 0.001). High psychological distress and consumption of SSB and energy drinks remained significant when modelling all predictors together. Conclusion: In this large adolescent study, addictive eating symptoms were common. Further research should establish directionality and causal mechanisms behind the association between mental ill-health, alcohol and tobacco use, and addictive eating behaviours. Cross-disciplinary prevention initiatives that address shared underlying risk factors for addictive eating and mental ill-health may offer efficient yet substantial public health benefits.

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“…Primarily, the app intervention emphasizes behavioural strategies aimed at withdrawal/abstinence from self‐identified problem foods, withdrawal/abstinence from snacking and excessive amounts at meals, and alternative non‐food related activities to displace discomfort 17,18 . Despite controversies over the construct of food addiction, there is growing interest in understanding how addictive‐like eating behaviours in adolescents impact weight loss trajectory in response to interventions 38‐43 . The components of this app intervention harness tools utilized in addiction medicine, such as cognitive behavioural therapy based skills training to assist with identifying and coping with triggers, establish behavioural coping strategies that are incompatible with over‐eating, increase non‐food sources of pleasure and reward, and bolstering social support for reducing addictive‐like eating behaviours.…”

Section: Discussionmentioning

confidence: 99%

An addiction‐based digital weight loss intervention: A multi‐centre randomized controlled trial

et al. 2022

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Summary Objective This randomized clinical trial tested the effectiveness of an addiction‐based digital weight‐loss intervention, focusing on withdrawal/abstinence from self‐identified problem foods, snacking and excessive amounts at meals, and discomfort displacement, with and without coaching, compared to an in‐person, multi‐disciplinary, care model among adolescents with obesity. We hypothesized that the digital intervention with coaching would yield greater weight loss and lower delivery burden than the standard clinical arm, and greater participant engagement than the digital arm without coaching. Methods Adolescents were randomized to app intervention, with or without coaching, or in‐person multidisciplinary obesity intervention for 6 months. The primary outcome was change in %BMIp95 at weeks 12 and 24. A mixed‐effects linear regression model was used to assess the association between change in %BMIp95 and intervention arm. We were also interested in assessing delivery burden, participant engagement and evaluating the relationships between weight change and demographic characteristics, mood, executive function and eating behaviours. Results All adolescents (n = 161; BMI ≥95th%, age 16 ± 2.5 year; 47% Hispanic, 65% female, 59% publicly insured) lost weight over 24‐weeks (−1.29%, [−1.82, −0.76], p < 0.0001), with no significant weight loss difference between groups (p = 0.3). Girls lost more weight than boys, whereas binge eating behaviour at baseline was associated with increase in %BMIp95 when controlling for other covariates. There was no association between ethnicity, mood, timing of intervention in relation to the pandemic, or executive function and change in %BMIp95. Conclusions Contrary with our hypothesis, our results showed no difference in the change in BMI status between treatment arms. Since efficacy of this digital intervention was not inferior to in‐person, multi‐disciplinary care, this could offer a reasonable weight management option for clinicians, based on youth and family specific characteristics, such as accessibility, resources, and communication styles. Clinical Trial Registration: ClinicalTrials.gov identifier: NCT035008353

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Advances and Future Directions in the Clinical Utility of Food Addiction

Abstract: The body of research examining the validity of food addiction and eating addiction far exceeds the research examining their clinical utility [...]

Cited by 6 publications

References 12 publications

Investigating Sex Differences in Rates and Correlates of Food Addiction Status in Women and Men with PTSD

Investigating Sex Differences in Rates and Correlates of Food Addiction Status in Women and Men with PTSD

Prevalence and correlates of addictive eating behaviours in a large cohort of Australian adolescents

An addiction‐based digital weight loss intervention: A multi‐centre randomized controlled trial

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