Food addiction and lifetime alcohol and illicit drugs use in specific eating disorders

Background and aims Food addiction (FA) and substance use (SU) have frequently been reported in patients with eating disorders (EDs). Our study aimed to assess the prevalence rates of FA and/or lifetime problematic alcohol and illicit drug use among patients with specific ED, such as: bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorder (OSFED). We sought to identify clinical, psychopathological, and personality profiles involved in these addictive behavior-based phenotypes. Methods The total sample was 527 patients (176 BN, 115 BED, and 236 OSFED). FA was assessed through the Yale Food Addiction Scale 2.0. To determine lifetime SU, a semi-structured clinical interview was carried out. Results Patients with BN had the highest rates of FA both with and without SU. No gender differences were obtained for the prevalence of current FA and/or lifetime SU. Patients reporting at least one addictive-related behavior exhibited increased clinical severity compared to those who reported none. Increased impulsivity (such as high lack of premeditation, sensation seeking, and positive urgency) and low self-directedness were differentiating factors for presenting one or two addictive behaviors. Discussion and Conclusions Overall, patients presenting with at least one addictive-like behavior reported a poorer clinical status than those without. Also, patients with FA and SU exhibited a more dysfunctional profile characterized by high impulsivity and low self-directedness. These findings would support the need for targeted treatments to reduce impulsivity and increase self-directedness, especially in patients with any addictive-related behavior, as a step towards improving their treatment outcome.

Current Status of Evidence for a New Diagnosis: Food Addiction-A Literature Review

Food addiction is considered an important link for a better understanding of psychiatric and medical problems triggered by dysfunctions of eating behaviors, e. g., obesity, metabolic syndrome, binge eating disorder, or bulimia nervosa. At behavioral level, food addiction has high degrees of similarity with other eating disorders, a phenomenon that creates difficulties in finding specific diagnostic criteria. Food addiction has been also described as “eating addiction” or “eating dependence” by several researchers, who placed the emphasis on the behavior and not on the food itself. High-sodium foods, artificially flavored-foods, rich carbohydrate- and saturated fats-containing foods are triggers for the activation of the same neural pathways, therefore they act similarly to any drug of abuse. Food addiction is considered a disorder based on functional negative consequences, associated distress and potential risks to both psychological well-being and physical health. A clinical scale was validated for the quantification of the eating addiction severity, namely the Yale Food Addiction Severity Scale (YFAS), constructed to match DSM IV criteria for substance dependence. Using this instrument, a high prevalence of food addiction was found in the general population, up to 20% according to a meta-analytic research. The pathogenesis of this entity is still uncertain, but reward dysfunction, impulsivity and emotion dysregulation have been considered basic mechanisms that trigger both eating dysfunctions and addictive behaviors. Genetic factors may be involved in this dependence, as modulators of higher carbohydrate and saturate fat craving. Regarding the existence of potential therapeutic solutions, lorcaserin, antiepileptic drugs, opioid antagonists, antiaddictive agents are recommended for obesity and eating disorders, and they may be intuitively used in food addiction, but clinical trials are necessary to confirm their efficacy. In conclusion, a better understanding of food addiction's clinical profile and pathogenesis may help clinicians in finding prevention- and therapeutic-focused interventions in the near future.

Chocolate craving: does it affect eating attitude and body mass index?

Purpose Some kinds of foods, by producing an effect like addiction, may trigger overeating. This paper aims to investigate whether excessive chocolate consumption and hunger cause food addiction. Design/methodology/approach Food cravings questionnaire-trait-reduced (FCQ-T-r), food cravings questionnaire-state (FCQ-S) and eating attitude test-26 (EAT-26) scales were used. The relation between chocolate addiction, anthropometric measurements, demographic characteristics, eating behavior of the people were analyzed. The study was conducted on 864 individuals between 17 and 64 years old (men = 327, women = 537). Findings As the body mass index (BMI) of the individuals increased, chocolate craving, chocolate hunger, thought of eating chocolate, lack of control of chocolate increased. Also, significant correlations were determined with BMI, respectively, (r = 0.39; r = 0.32; r = 0.33; r = 0.29; p < 0.001). The lack of control overeating chocolate, craving for chocolate was found to be higher in female participants than in male participants. It was seen that craving for chocolate decreases (r = −0.17; p < 0.001) with increasing age; this was more apparent in male participants compared to female participants. Besides, significant correlation was found (r = 0.76, p < 0.05) between the EAT-26, the craving to eat chocolate in this study. It was seen that individual, who were excessively eager to consume chocolate, exhibited abnormal eating behavior (29.50 ± 12.09). This showed that there is a positive relation (r = 0.08, p < 0.001) between food addiction, eating attitude disorder. Originality/value Food craving increases the consumption of food, especially chocolate, sugar, with high carbohydrate content and energy. This can lead to overeating and being overweight.

The Relationship between Addictive Eating and Dietary Intake: A Systematic Review

(1) Background: Research suggests that certain foods may have addictive effects; however, no reviews have systematically appraised studies in this area. The aims of this review were to determine the nutrients, foods and dietary patterns associated with addictive eating. (2) Methods: Published studies up to November 2020 were identified through searches of 6 electronic databases. Eligible studies included those in in children and adults that reported dietary intakes of individuals with ‘food addiction’. (3) Results: Fifteen studies (n = 12 in adults and n = 3 in children/adolescents with Yale Food Addiction Scale defined ‘food addiction’) were included. Foods commonly associated with addictive eating were those high in a combination of fat and refined carbohydrates. Generally, intakes of energy, carbohydrates and fats were significantly higher in individuals with addictive eating compared to those without. (4) Conclusions: Due to the heterogeneity in study methodologies and outcomes across included studies, it is difficult to conclude if any specific foods, nutrients or dietary patterns facilitate an addictive process. Further research is needed to elucidate potential associations. However, present addictive eating treatment approaches could incorporate individualised dietary advice targeting foods high in fat and refined carbohydrates.