Food Addiction in Eating Disorders and Obesity: Analysis of Clusters and Implications for Treatment

Abstract

Food addiction (FA) has been associated with greater psychopathology in individuals with eating disorders (ED) and obesity (OBE). The current study aims to provide a better phenotypic characterization of the FA construct by conducting a clustering analysis of FA in both conditions (ED and OBE). The total sample was comprised of 234 participants that scored positive on the Yale Food Addiction Scale 2.0. (YFAS-2) (119 bulimia nervosa (BN), 50 binge eating disorder (BED), 49 other specified feeding or eating disorder (OSFED) and 16 OBE). All participants completed a comprehensive battery of questionnaires. Three clusters of FA participants were identified. Cluster 1 (dysfunctional) was characterized by the highest prevalence of OSFED and BN, the highest ED severity and psychopathology, and more dysfunctional personality traits. Cluster 2 (moderate) showed a high prevalence of BN and BED and moderate levels of ED psychopathology. Finally, cluster 3 (adaptive) was characterized by a high prevalence of OBE and BED, low levels of ED psychopathology, and more functional personality traits. In conclusion, this study identified three distinct clusters of ED-OBE patients with FA and provides some insight into a better phenotypic characterization of the FA construct when considering psychopathology, personality and ED pathology. Future studies should address whether these three food addiction categories are indicative of therapy outcome.

Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint

“…The present review suggests that it would be effective to identify FA phenotypes based on the presence of other psychiatric disorders such as ED, AUD/SUD, PTSD, depression, anxiety, and ADHD as part of a comprehensive biopsychosocial assessment, and to assign nutrition treatment based on the relative strength of the FA signal amidst the noise (true versus false positive). Recent studies have identified different phenotypic characterizations of the FA construct [ 60 , 61 , 202 , 203 ]. However, Table 1 suggests a guide for clinicians to consider in settings where the use of extensive validated instruments is not always practical.…”

The Impact of Retrospective Childhood Maltreatment on Eating Disorders as Mediated by Food Addiction: A Cross-Sectional Study

“…This is further in line with findings of relatively recent studies in which FA was found in as many as 96% of patients with BN with a tendency for FA severity to decrease over the course of effective management of BN [ 30 , 31 ]. In a recent study aiming to characterizing FA as a phenotypical construct in patients with different types of EDs and obesity via a factor analysis, results suggested that patients with FA and BN presented with more severe ED psychopathology [ 32 ]. Moreover, other work suggested that, among women with a high BMI, the presence of a relationships between early life adversities and FA may be underpinned by specificities in brain regions implicated in reward and emotional regulation [ 33 , 34 , 35 ].…”

Food Addiction and Eating Addiction: Scientific Advances and Their Clinical, Social and Policy Implications

“…This study by Jimenez-Murcia et al [5] identified three distinct clusters of food addiction in those with eating disorders and obesity. The study was conducted in 234 participants who scored positive on the Yale Food Addiction Scale 2.0.…”