Is food addiction a predictor of treatment outcome among patients with eating disorder?

Romero, Xandra; Agüera, Zaida; Granero, Roser; Sánchez, Isabel; Riesco, Nadine; Jiménez‐Murcia, Susana; Gisbert‐Rodriguez, Montserrat; Sánchez‐González, Jéssica; Casalé, Gemma; Baenas, Isabel; Valenciano‐Mendoza, Eduardo; Menchón, José M.; Gearhardt, Ashley N.; Diéguez, Carlos; Fernández‐Aranda, Fernando

doi:10.1002/erv.2705

Cited by 30 publications

(29 citation statements)

References 64 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…BED + FA requires tailored treatment approaches [ 60 ]. One study suggested that when diagnostic subtypes are considered separately, FA is associated with a poor prognosis in the BED group [ 61 ]. It is possible that poor BED outcomes stem from the transdiagnostic assumption that BED patients do not need to emphasize the quality of their food (“it’s not about the food”).…”

Section: Eating Disordersmentioning

confidence: 99%

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

Wiss

Brewerton

2020

Nutrients

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Converging evidence from both animal and human studies have implicated hedonic eating as a driver of both binge eating and obesity. The construct of food addiction has been used to capture pathological eating across clinical and non-clinical populations. There is an ongoing debate regarding the value of a food addiction “diagnosis” among those with eating disorders such as anorexia nervosa binge/purge-type, bulimia nervosa, and binge eating disorder. Much of the food addiction research in eating disorder populations has failed to account for dietary restraint, which can increase addiction-like eating behaviors and may even lead to false positives. Some have argued that the concept of food addiction does more harm than good by encouraging restrictive approaches to eating. Others have shown that a better understanding of the food addiction model can reduce stigma associated with obesity. What is lacking in the literature is a description of a more comprehensive approach to the assessment of food addiction. This should include consideration of dietary restraint, and the presence of symptoms of other psychiatric disorders (substance use, posttraumatic stress, depressive, anxiety, attention deficit hyperactivity) to guide treatments including nutrition interventions. The purpose of this review is to help clinicians identify the symptoms of food addiction (true positives, or “the signal”) from the more classic eating pathology (true negatives, or “restraint”) that can potentially elevate food addiction scores (false positives, or “the noise”). Three clinical vignettes are presented, designed to aid with the assessment process, case conceptualization, and treatment strategies. The review summarizes logical steps that clinicians can take to contextualize elevated food addiction scores, even when the use of validated research instruments is not practical.

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Section: Discussionmentioning

confidence: 99%

Section: Eating Disordersmentioning

confidence: 99%

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

Wiss

Brewerton

2020

Nutrients

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“…Other studies had already associated negative urgency with bingeing (Claes et al, 2015; Racine et al, 2015; Steward et al, 2017) and it was the only predictor of food addiction (FA) in patients with binge eating symptomatology (Wolz, Granero, & Fernández‐Aranda, 2017). This is important because FA is a highly comorbid condition in patients with BED which may contribute to greater general and eating disorder‐specific psychopathology (Linardon & Messer, 2019) and could be a predictor of treatment outcome in BED (Romero et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

The role of self‐monitoring metacognition sub‐function and negative urgency related to binge severity

Aloi

Rania

Carbone

et al. 2020

Euro Eating Disorders Rev

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Objective This study aims to test a model where low self‐monitoring (a sub‐function of first‐person domain of metacognition) and high negative urgency lead to a worsening of binge severity through the mediation of emotional dysregulation in patients with binge eating disorder (BED). Method Forty non‐BED‐obese and 46 BED‐obese patients completed a battery of tests assessing metacognition and psychopathology. To test our hypothesized model, a structural equation model (SEM) using maximum likelihood estimation was conducted. Results BED‐obese patients had significantly higher scores in BES, UPPS‐P Negative urgency, and DERS total score, and lower MSAS self‐monitoring than non‐BED‐obese, while no differences emerged in the MSAS others‐monitoring subscale. The structural model demonstrated very good fit indexes (χ2 = 1.377, df = 2; p = .502, CMIN/DF = 0.688, CFI = 1.000, RMSEA = 0.000, TLI = 1.047) and all paths were significant in the predicted directions. Conclusions These preliminary findings show that, low self‐monitoring and high negative urgency lead BED‐obese patients to express the worsening of binge severity through the mediation of emotional dysregulation. This knowledge may be helpful in the clinical practice to develop a tailor‐made treatment. Accordingly, an approach through Metacognitive Interpersonal Therapy could be attempted in BED‐obese patients with these characteristics. Patients with BED exhibited low self‐monitoring and high negative urgency. Binge severity was mediated by high level of emotional dysregulation. Metacognitive Interpersonal Therapy may be useful for BED patients.

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“…For this reason, a number of studies have investigated the association between food addiction and symptoms of mental disorders, especially depression, anxiety, and eating disorders, and have quite consistently found positive associations (please see reviews by Burrows et al (Burrows, Kay‐Lambkin, Pursey, Skinner, & Dayas, 2018) and Meule and Gearhardt (Meule & Gearhardt, 2019)). However, the few studies that are based on clinical samples have almost exclusively focused on eating disorders of the bingeing subtype (bulimia nervosa and binge‐eating disorder) (Granero et al, 2014, 2018; Hilker et al, 2016; Ivezaj, Wiedemann, Lawson, & Grilo, 2019; Jiménez‐Murcia et al, 2019; Romero et al, 2019; Wolz et al, 2016; Wolz, Granero, & Fernandez‐Aranda, 2017) with the exception of two studies in schizophrenia (Goluza, Borchard, Kiarie, Mullan, & Pai, 2017; Kucukerdonmez, Urhan, Altin, Haciraifoglu, & Yildiz, 2019) and one in ADHD (Brunault et al, 2019). All of these studies have reported that the prevalence of food addiction was higher among individuals with mental disorders compared to (general population) controls.…”

Section: Introductionmentioning

confidence: 99%

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

Horsager

Færk

Lauritsen

et al. 2021

Intl J Eating Disorders

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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.

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Is food addiction a predictor of treatment outcome among patients with eating disorder?

Cited by 30 publications

References 64 publications

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

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

The role of self‐monitoring metacognition sub‐function and negative urgency related to binge severity

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

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