Food Addiction and Bulimia Nervosa

Abstract

In individuals with obesity and binge eating disorder (BED), eating patterns can show addictive qualities, with similarities to substance use disorders on behavioural and neurobiological levels. Bulimia nervosa (BN) has received less attention in this regard, despite their regular binge eating symptoms. The Yale Food Addiction Scale (YFAS) was developed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria for substance use disorders, and food addiction can be diagnosed when at least three addiction symptoms are endorsed and a clinically significant impairment or distress is present. Although the prevalence of food addiction diagnoses is increased in individuals with obesity and BED, recent studies which used the YFAS showed that there are also individuals with normal weight who can be classified as being 'food addicted'. Based on self-reported eating disorder symptoms, women with current (n=26) or remitted (n=20) BN, and a control group of women matched for age and body mass index (n=63) completed the YFAS and other measures. Results revealed that all patients with current BN received a food addiction diagnosis according to the YFAS while only six (30%) women with remitted BN did. None of the women in the control group received a food addiction diagnosis. Results provide support for the notion that BN can be described as addiction-like eating behaviour and suggest that food addiction most likely improves when BN symptoms remit.

The prevalence of food addiction as assessed by the Yale Food Addiction Scale: A systematic review

“…Age of included participants ranged from four to ninety years. Fourteen studies included older adults aged >35 years [27,35,[37][38][39][44][45][46][49][50][51][52]56], ten studied younger adults aged from 18-35 years [11,26,[32][33][34]36,[40][41][42][43]47,53,54,57], and one studied children and adolescents <18 years [48]. Seven studies investigated a healthy weight population (18.5-25 [58].…”

“…Four studies specifically noted that the YFAS was translated into a language other than English (Italian, German and French) [32,37,40,54], and one study changed the reporting period of twelve months used in the original YFAS to the previous one month [38,39] to give a more proximal indication of YFAS outcomes following an intervention. Fifteen studies investigated both the YFAS diagnosis and symptom score [26,27,32,[36][37][38][39][40]43,44,46,48,49,51,56,57], five used the symptom score exclusively [11,33,41,42,45,53,54] and four used the diagnosis exclusively [34,35,47,50]. Two studies grouped participants as "high" or "low" FA based on the number of YFAS symptoms endorsed [11,41,42].…”

“…Binge eating behaviors were higher in individuals meeting the diagnostic criteria for FA [32,36,37,40,46,47,57] and the YFAS diagnosis accounted for 5.8% unique variance in binge eating scores above and beyond other measures of eating pathology [26]. FA symptom scores were also positively associated with binge eating behaviors [27,32,37,40,45,46,49], with symptom scores accounting for 6%-14.8% unique variance in BED scores [26,46,49].…”

“…Mean symptoms: current BN 6.27 ± 1.04, remitted The weighted mean prevalence of FA across all studies was 19.9% ( Figure 2a) [26,27,32,[34][35][36][37]39,40,[43][44][45][46][47][49][50][51]53,56,57]. Prevalence of FA diagnosis was meta-analyzed by sex with a higher mean prevalence of FA in six samples of females exclusively of 12.2% [35,40,45,47,51,57] compared to 6.4% in four samples of males [45,47,51,57].…”

Verlangen nach Süßem: Eine Evaluation der Suchtperspektive auf Zucker- und Süßstoffkonsum

“…Beispielsweise geht Substanzgebrauch häufig ein starkes Verlangen voraus, die Substanz zu konsumieren ("craving" [18][19][20]. Entsprechend erhalten auch fast alle Menschen mit Bulimie eine YFAS-Diagnose, obwohl diese meist normalgewichtig sind [21,22]. Obwohl unter übergewichtigen Menschen YFASDiagnosen häufiger vorkommen als bei nomalgewichtigen, scheint das suchtartige Essverhalten also eher sekundär mit dem Körpergewicht zusammenzuhän-gen und überschneidet sich primär eher mit Essverhalten, das durch Essanfälle (d. h. "binge eating") geprägt ist [23].…”