Food addiction comorbid to mental disorders: A nationwide survey and register‐based study

Abstract

Objective Substance use disorder is highly prevalent among individuals with mental disorders. However, it remains largely unknown whether this is also the case for “food addiction”—a phenotype characterized by an addiction‐like attraction to predominantly highly processed foods with a high content of refined carbohydrates and fat. Therefore, the primary aim of this study was to estimate the weighted prevalence of food addiction among individuals with mental disorders. Method A total of 5,000 individuals aged 18–62 were randomly drawn from eight categories of major mental disorders from the Danish Psychiatric Central Research Register and invited to participate in an online questionnaire‐based survey, which included the Yale Food Addiction Scale 2.0. Data on health care and sociodemographics from the Danish registers were linked to all invitees—enabling comprehensive attrition analysis and calculation of the weighted prevalence of food addiction. Results A total of 1,394 (27.9%) invitees participated in the survey. Across all diagnostic categories, 23.7% met the criteria for food addiction. The weighted prevalence of food addiction was highest among individuals with eating disorders (47.7%, 95%CI: 41.2–54.2), followed by affective disorders (29.4%, 95%CI: 22.9–36.0) and personality disorders (29.0%, 95%CI: 22.2–35.9). When stratifying on sex, the prevalence of food addiction was higher among women in most diagnostic categories. Discussion Food addiction is highly prevalent among individuals with mental disorders, especially in those with eating disorders, affective disorders and personality disorders. Food addiction may be an important target for efforts aimed at reducing obesity among individuals with mental disorders.

Psychometric properties and convergent and divergent validity of the Portuguese Yale Food Addiction Scale 2.0 (P-YFAS 2.0)

“…Our results showed a signi cant but small positive association between YFAS 2.0 symptom count scores and BMI, as well as positive associations between FA and eating disordered behavior and binge eating episodes. In another study, Horsager, Faerk, Lauritsen, and Østergaard (2021) found that participants with moderate and severe YFAS scores and comorbid mental disorders had elevated BMI. These results support the conclusion that those meeting an FA diagnosis are more likely to be overweight.…”

Mechanisms by which adverse childhood experiences, other traumas and PTSD influence the health and well-being of individuals with eating disorders throughout the life span

“…In summary, such biological embedding involves chronic disruption in a variety of interrelated neurodevelopmental pathways, including activation of the HPA axis, increased allostatic load, enhanced inflammation, altered reward sensitivity, consequential epigenetic changes, as well as profound structural and functional changes in the brain [303][304][305][306]. These pathways are in turn theorized to lead to EDs, food addiction, and SUDs, each of which have been linked to obesity and other related comorbidities [298,299,[307][308][309][310][311][312]. V. Social, emotional and cognitive impairment Traumatic sequelae as a result of maltreatment, including PTSD, involve impairments in the ability to process social, emotional and cognitive information [313][314][315][316][317][318][319][320].…”

Psychometric validation of the full Yale food addiction scale for children 2.0 among adolescents from the general population and adolescents with a history of mental disorder

“…The convergent and discriminant validity of the YFAS‐C 2.0 was tested by calculating Pearson's correlation coefficient between the YFAS‐C 2.0 total scores and measures representing constructs considered to be either convergent or discriminant with food addiction (Aloi et al., 2017; Borisenkov et al., 2018; Erzsébet Magyar et al., 2018; Gearhardt et al., 2009, 2013a, 2016; Granero et al., 2018; Meule et al., 2017a; Meule & Gearhardt, 2019; Pursey et al., 2014; Schulte et al., 2017b) (Horsager et al., 2020, 2021c). For convergent validity, the EDE‐Q subscales on eating, weight, and shape concern, as well as the total score and binge eating frequency, were used (Aloi et al., 2017; Meule et al., 2017a).…”