ArticleLiterature Review

Compulsive overeating as an addiction disorder. A review of theory and evidence

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Abstract

In this paper we argue that compulsive overeating has compelling similarities to conventional drug addiction. Our case is based on their comparable clinical features, the biological mechanisms they have in common, and on evidence that the two disorders have a shared diathesis. In making the argument for overeating as an addictive behaviour, it is clearly not appropriate to include all cases of excessive food consumption in this taxon. Nor are we claiming that obesity and addiction are one and the same. However, it is proposed that Binge Eating Disorder (BED) is a phenotype particularly well-suited to such a conceptualization, and that sound clinical and scientific evidence exists to support this viewpoint. We have provided some recommendations for treatment modifications that recognize the similarities between treating drug dependence and compulsive overeating.

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... Furthermore, brain imaging of obese subjects showed lower levels of dopamine receptors compared to control subjects (Joranby, Frost Pineda & Gold, 2005). Davis and Carter (2009) described a Reward Deficiency Syndrome based on the concept of reduced dopamine receptors stating that people who overeat may be compensating for hypo-dopaminergic or sluggish functioning. Low D2 receptors are believed to predate addictive behavior and constitute a vulnerability factor (Miller & Carroll, 2006). ...
... This is notable because it demonstrates that fat and sugar act on the reward system (i.e., one receives pleasure from its ingestion). This makes evolutionary sense, as diets high in fat are calorie dense, and thus metabolically efficient and reinforced for their selective preference (Davis & Carter, 2009). ...
... 32). Davis and Carter (2009) expanded the definition to include tolerance as measured by a diminished satiety response and withdrawal. This is anecdotally observed in humans as headaches, irritability and flu-like symptoms. ...
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Rates of obesity have steadily increased, with 30% of the U.S. population having met criteria for “obese” in 2002 and 33% in 2006. Through a medical model, obesity is treated through Very Low Calorie Diets (VLCD), lifestyle changes, and increased physical activity. However, this model often proves insufficient for treating obesity long term, as the goals of dieting and exercise are philosophically and physiologically opposed. Additionally, rates of binge eating disorder (BED) in obese and morbidly obese people are estimated at 10-50%, which fails to account for deleterious eating behavior in a significant segment of this population. This study explored adjacent factors contributing to obesity, including the neurological response to food, chronic overeating as affect regulation, and food addiction. Participants responded to the Shorter PROMIS Questionnaire and a demographic measure, and were scored with regard to body mass index (BMI) and self-reported endorsement of addictive behaviors. There was a significant, positive relationship between BMI greater than 30 (i.e., obese or morbidly obese) and scores on the food bingeing, caffeine, and submissive relationships subscales. These findings suggest that a cluster of addictive behaviors exist concurrently with food and obesity. Therefore, in the assessment and treatment of obesity, a more holistic consideration of the individual is indicated to facilitate more effective management.
... Even though the concept of food addiction (FA) was introduced more than sixty years ago [1], its definition and implications are still fiercely debated [2,3]. Highly palatable foods [4,5], such as processed foods with added sugars and fat, could be as addictive as drugs [6,7], acting via the same neurocognitive and hedonic processes [8,9]. Therefore, through the alteration of the neurocognitive systems involved in food intake control [10], FA could be involved in the obesity pathogenesis. ...
... As previously mentioned, highly palatable foods [4,5], such as processed foods with added sugars and fat, could be as addictive as drugs [6,7], acting via the same neurocognitive and hedonic processes [8,9]. Therefore, through the alteration of the neurocognitive systems involved in food intake control [10], FA could be involved in obesity pathogenesis ( Figure 1). ...
... Kiyici et al. found that 32% of obese patients with a mean BMI of 41.6 and seeking treatment for weight loss had FA [75]. As previously mentioned, highly palatable foods [4,5], such as processed foods with added sugars and fat, could be as addictive as drugs [6,7], acting via the same neurocognitive and hedonic processes [8,9]. Therefore, through the alteration of the neurocognitive systems involved in food intake control [10], FA could be involved in obesity pathogenesis ( Figure 1). ...
Article
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This review, focused on food addiction (FA), considers opinions from specialists with different expertise in addiction medicine, nutrition, health psychology, and behavioral neurosciences. The concept of FA is a recurring issue in the clinical description of abnormal eating. Even though some tools have been developed to diagnose FA, such as the Yale Food Addiction Scale (YFAS) questionnaire, the FA concept is not recognized as an eating disorder (ED) so far and is even not mentioned in the Diagnostic and Statistical Manuel of Mental Disorders version 5 (DSM-5) or the International Classification of Disease (ICD-11). Its triggering mechanisms and relationships with other substance use disorders (SUD) need to be further explored. Food addiction (FA) is frequent in the overweight or obese population, but it remains unclear whether it could articulate with obesity-related comorbidities. As there is currently no validated therapy against FA in obese patients, FA is often underdiagnosed and untreated, so that FA may partly explain failure of obesity treatment, addiction transfer, and weight regain after obesity surgery. Future studies should assess whether a dedicated management of FA is associated with better outcomes, especially after obesity surgery. For prevention and treatment purposes, it is necessary to promote a comprehensive psychological approach to FA. Understanding the developmental process of FA and identifying precociously some high-risk profiles can be achieved via the exploration of the environmental, emotional, and cognitive components of eating, as well as their relationships with emotion management, some personality traits, and internalized weight stigma. Under the light of behavioral neurosciences and neuroimaging, FA reveals a specific brain phenotype that is characterized by anomalies in the reward and inhibitory control processes. These anomalies are likely to disrupt the emotional, cognitive, and attentional spheres, but further research is needed to disentangle their complex relationship and overlap with obesity and other forms of SUD. Prevention, diagnosis, and treatment must rely on a multidisciplinary coherence to adapt existing strategies to FA management and to provide social and emotional support to these patients suffering from highly stigmatized medical conditions, namely overweight and addiction. Multi-level interventions could combine motivational interviews, cognitive behavioral therapies, and self-help groups, while benefiting from modern exploratory and interventional tools to target specific neurocognitive processes.
... 1 Previous research suggests there is a relationship between food and beverage over-consumption and substance use disorders 7 as palatable foods containing high concentrations of sugar and fat activate the same dopamine pathways in the brain's reward system as addictive drugs. 8 Some studies suggest that people with obesity have a higher risk of substance use disorders following metabolic and bariatric surgery (MBS) due to the "addiction transfer" phenomenon. 9 There are limited studies on the relationship between substance use disorder and obesity. ...
... This association is thought to be related to the parallels that exist between eating behaviours and addictive behaviours found in substance dependence based on the shared behavioural features and dopaminergic reward pathways in the brain. 8,23 Studies show that stress in early life increases the risk of developing obesity through complex mechanisms that are not entirely understood. 24 ...
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Background: Millions of Americans qualify for metabolic and bariatric surgery (MBS) based on the proportion of the population with severe obesity. Simultaneously, the use of electronic nicotine/non-nicotine delivery systems (ENDS) has become epidemic. Objective: We conducted a timely systematic review to examine the impact of tobacco and ENDS use on post-operative health outcomes among MBS patients. Methods: PRISMA guidelines were used as the search framework. Keyword combinations of either "smoking," "tobacco," "e-cigarette," "vaping," or "ENDS" and "bariatric surgery," "RYGB," or "sleeve gastrectomy" were used as search terms in PUBMED, Science Direct, and EMBASE. Studies published in English between January 1990 and June 2020 were screened. Results: From the 3251 articles found, a total of 48 articles were included in the review. No articles described a relationship between ENDS and post-operative health outcomes in MBS patients. Seven studies reported smokers had greater post-MBS weight loss, six studies suggested no relationship between smoking and post-MBS weight loss, and one study reported smoking cessation pre-MBS was related to post-MBS weight gain. Perioperative use of tobacco is positively associated with several post-surgery complications and mortality in MBS patients. Conclusions: Combustible tobacco use among MBS patients is significantly related to higher mortality risk and complication rates, but not weight loss. No data currently is available on the impact of ENDS use in these patients. With ENDS use at epidemic levels, it is imperative to determine any potential health effects among patients with severe obesity, and who complete MBS.
... 1 Previous research suggests there is a relationship between food and beverage over-consumption and substance use disorders 7 as palatable foods containing high concentrations of sugar and fat activate the same dopamine pathways in the brain's reward system as addictive drugs. 8 Some studies suggest that people with obesity have a higher risk of substance use disorders following metabolic and bariatric surgery (MBS) due to the "addiction transfer" phenomenon. 9 There are limited studies on the relationship between substance use disorder and obesity. ...
... This association is thought to be related to the parallels that exist between eating behaviours and addictive behaviours found in substance dependence based on the shared behavioural features and dopaminergic reward pathways in the brain. 8,23 Studies show that stress in early life increases the risk of developing obesity through complex mechanisms that are not entirely understood. 24 ...
Article
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Studies have shown the negative impact of COVID-19 lockdown orders on mental health and substance use in the general population. The aim of this study was to examine the impact of the COVID-19 pandemic onsubstance use, mental health and weight-related behaviors in a sample of adults with obesity after lockdown orders were lifted (June-September 2020). A retrospective medical chart review identified patients with obesity from one university-based obesity medicine clinic, and two metabolic and bariatric surgery (MBS) practices. Patients who completed an online survey from June 1, 2020 to September 30, 2020 were included. The primary outcome measure was substance use (various drugs, alcohol, tobacco). Substance use and mental health survey questions were based on standardized, validated instruments. A total of 589 patients (83.3% female, mean age 53.6 years [SD 12.8], mean BMI 35.4 [SD 9.1], 54.5% Non-Hispanic white, 22.3% post-MBS) were included. Seventeen patients (2.9%) tested positive for SARS-CoV-2 and 13.5% reported symptoms. Nearly half (48.4%) of the sample reported recreational substance use and 9.8% reported increased use since the start of the pandemic. There was substantial drug use reported (24.3% opioids, 9.5% sedative/tranquilizers, 3.6% marijuana, and 1% stimulants). Patients who reported stockpiling food more (adjusted Odds Ratio [aOR] 1.50, 95% CI 1.03-2.18), healthy eating more challenging (aOR 1.47, 95% CI 1.01-2.16), difficulty falling asleep (aOR 1.64, 95% CI 1.14-2.34), and anxiety (aOR 1.47, 95% CI 1.01-2.14) were more likely to report substance use versus non-users. Results here show that the COVID-19 pandemic is having a deleterious impact on substance use, mental health and weight-related health behaviors in people with obesity regardless of infection status.
... Such neurotransmitter effects lead to "cue-induced anticipation" of these sugars and fatty food consumption (Smith and Robbins, 2013). This, thereafter, leads to "elevated activity in the fronto-limbic circuitry to correspond with striatal dopamine D2 receptor release" (Pelchat et al., 2004;Small et al., 2003;Stice et al., 2008) which leads to excessive impulsive consumption of foods and sugary substances owing to the known reward "after-effect" of feeling well based on the food consumption (Davis and Carter, 2009). In due course, this impulsiveness becomes compulsive owing to the neurobiological mechanism and law of effect attributable to the consumption (Smith and Robbins, 2013). ...
... Second, an extensive elucidation of how theory of reasoned action from a food consumption perspective encapsulates pure impulse buying from an affective standpoint (Smith and Robbins, 2013) which in terms of consumer obesity has not been addressed (Epel et al., 2019;Robinson et al., 2020). Third, due to the understanding of the cognitive mechanisms of the law of effect in relation to stress, the paper accentuates how stressful eating becomes a habitual practice after the first instancei.e. a cyclical process within Zers (Davis and Carter, 2009;Pelchat et al., 2004). This demonstrates the difference in cognition for Zers to previous generations (APA, 2010;Epel et al., 2019). ...
Article
Purpose This study aims to delineate the phenomenon of stressful eating within generation Z due to the times they are living in and to extract propositions which elucidate phases of stressful eating within Zers. Design/methodology/approach Based on relevant literature on consumer obesity, theories of pure impulse buying and reasoned action, cognitive constructs eminent for reasoned conditioned behaviour are extracted. Followed by extraction of the reasoned conditioned behaviour and its cognitive constructs within Zers. Thereafter, a conceptual framework is developed with propositions of stressful eating within Zers. Findings Zers indulge in reasoned conditioned behaviour initially owing to their healthy understanding insights, and the activations of cognitive capacities within them due to the law of effect. The law of effect is cyclical after the first reasoned consumption among Zers, leading to obesity and constricting self-controlling behaviour. Originality/value To the best of the authors’ knowledge, this is the first study that provides a deep understanding of the cognitive mechanism orienting generation Z’s stressful eating indulgence even though they have higher healthy lifestyle understandings.
... The reasons why some people chronically overeat and are unable to limit their food intake have been examined. A growing number of clinical and neurobiological evidence has shown that, in vulnerable subjects, persistent overeating may lead to a pattern of compulsive behavior similar to that of drug abuse and other addictive disorders [1][2][3][4]. ...
... Additionally, even if without a systematic evaluation, some studies attest an association between FA and BN ranging from 81 to 97% [26,27]. Even with fundamental differences, in fact, common overlapping symptoms between FA, BED and BN exist (e.g., reduced feeding control, continued use despite negative consequences) [1,11]. ...
Article
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Background and aims The concept of "Food Addiction" has been based on criteria of Substance Use Disorder. Several studies suggested a relationship between food addiction and eating disorders, but little is known about its extent or role. We aim at exploring if food addiction is coincident with a specific eating disorder (binge eating disorder appears the closest) or it is a separate diagnostic entity that afflicts in comorbidity with eating disorders or other conditions like obesity or even in the general population. Methods This systematic review and meta-analysis analyzed observational studies with a comparative estimation on rates of subjects affected by binge eating disorder and food addiction. Results Binge eating disorder shows higher comorbidity with food addiction compared to other eating disorders (OR = 1.33, 95% CI, 0.64–2.76; c ² = 4.42; p = 0.44;I ² = 0%), or each eating disorder [anorexia nervosa purging type (OR = 1.93, 95% CI, 0.20–18.92; p = 0.57) and restrictive type (OR = 8.75, 95% CI, 1.08–70.70; p = 0.04)], obese patients (OR = 5.72, 95% CI, 3.25–10.09; p = < 0.0001) and individuals from the general population (OR = 55.41, 95% CI, 8.16–376.10; c ² = 18.50; p < 0.0001; I ² = 0%)but has decreased prevalence when compared to bulimia nervosa (OR = 0.85, 95% CI, 0.33–2.22; c ² = 0.35; p = 0.74; I ² = 0%). Discussion and conclusions Our data show that the prevalence of food addiction in binge eating disorder is higher than in other eating disorders except in bulimia nervosa. Moreover, it is a separate diagnostic reality and can be detected in people without mental illness and in the general population. Food addiction might have a prognostic value, since in comorbidity, and should be addressed to boost treatment efficacy and patient’s recovery. Level of evidence I: Evidence obtained systematic reviews and meta-analyses.
... [15][16][17] Araştırma sonuçlarına göre, BYT'nin etiyolojisinde tek bir neden yerine çoklu etmenin rol oynadığı düşünülmektedir. 18 Ebeveyne güvensiz bağlanma tarzları ve ÇÇT'ye maruz kalma dahil olmak üzere çeşitli faktörlerin BYT'nin patogenezine katkıda bulunduğu ortaya konmuştur. 18,9,19 Pek çok kuramsal yaklaşım, ebeveynlik tarzı ve bağlanma örüntülerinin BYT'nin gelişiminde etkili olabileceğini ileri sürmektedir. ...
... 18 Ebeveyne güvensiz bağlanma tarzları ve ÇÇT'ye maruz kalma dahil olmak üzere çeşitli faktörlerin BYT'nin patogenezine katkıda bulunduğu ortaya konmuştur. 18,9,19 Pek çok kuramsal yaklaşım, ebeveynlik tarzı ve bağlanma örüntülerinin BYT'nin gelişiminde etkili olabileceğini ileri sürmektedir. 20,21 Algılanan düşük ilgi ve aşırı koruyucu ebeveynlik örüntülerinin BYT gelişiminde önemli sorunlar oluştuğuna dair bulgular ortaya konmuştur. ...
Article
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Objectives:Childhood trauma and parental bonding are accepted as non-specific risk factors in eating disorders. However, the interaction of childhood neglect and abuse during childhood; and parental bonding are not yet fully understood. This study tested the hypothetical model in which the parental bonding moderate the relationship between childhood traumas and eating disorder psychopathology.Materials and Methods:The data was collected from a sample group of university students (n=1.100) using the Childhood Trauma scale, the Parental Bonding scale, Eating Attitudes scale and Demographic Information form. Correlation and regression analyzes were used to evaluate the data.Results:The results of the analysis demonstrated that the childhood trauma directly affects eating disorders symptoms. Also, it was determined that the amount of perceived attention/control from mother has a regulatory effect on the relationship between eating attitudes; and physical, sexual, emotional abuse and neglect.Conclusion:Clinicians may evaluate deterioration in eating attitudes as childhood trauma and parental bonding. Findings demonstrate the importance of the curative effect of therapists’ attention and control behavior.
... FA is associated with low self-esteem, high psychological distress, lower quality of life and depressive symptoms (Gearhardt et al., 2012;Burmeister et al., 2013;Minhas et al., 2021;Vidmar et al., 2021). From a psychobiological perspective, there is the assumption that similar processes in FA and other addiction disorders may be operating, which might explain the similarities and the high comorbidity of FA with substance-related disorders and behavioural addictions (Davis and Carter, 2009;García-García et al., 2014;Marmet et al., 2019). ...
... FA severity was associated with increased BMI, which is in line with findings of previous studies (Pedram et al., 2013;Gearhardt et al., 2014). A variety of studies reports associations between FA and SUDs (Davis and Carter, 2009;García-García et al., 2014;Tinghino et al., 2020). In our study, AUD severity was not associated with FA. ...
Article
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Background and Aims: It is assumed that a relevant subgroup of individuals experiences an addiction-like eating behaviour (Food Addiction), characterized by an impaired control over eating behaviour, emotional eating and food craving. Individuals experiencing Food Addiction partially share common symptomatology with Binge-Eating-Disorder and Bulimia Nervosa. The aim of this study was to investigate the prevalence of Food Addiction, general psychopathology, and associations with weight- and addiction-related constructs in individuals with overweight and obesity, who did not suffer from Binge-Eating-Disorder or Bulimia Nervosa. Methods: N =213 (67.1% female; M BMI =33.35kg/m ² , SD BMI =3.79kg/m ² ) participants who were included in a weight loss program (I-GENDO project) reported BMI and completed questionnaires before the start of the treatment. Food Addiction severity, depressive symptoms, alcohol use disorder, internet use disorder, psychological distress, impulsivity personality trait, impulsive and emotional eating behaviour, food related inhibitory control, weight bias internalization, and self-efficacy were assessed. Results: The prevalence of Food Addiction was 15% with higher, although not statistically significant, prevalence in female (18.2%) compared to male (8.6%) participants. Food Addiction was associated with higher BMI at baseline assessment, low self-esteem, impulsive and emotional eating behaviour, weight bias internalization, and deficits in food-related inhibitory control. In addition, correlations were found between Food Addiction and severity of depressive symptoms, internet use disorder, and psychological distress. Conclusion: A relevant subgroup of participants experiences Food Addiction even when controlling for Binge-Eating-Disorder and Bulimia Nervosa. Future studies are warranted that investigate whether Food Addiction affects treatment success.
... Una adicción es un trastorno físico y mental manifestada por una dependencia hacia sustancias, se caracteriza por presentar signos y síntomas como falta de control, abstinencia y tolerancia, en los que se involucran factores biológicos, genéticos, psicológicos y sociales (OMS, 2013). En el contexto de la alimentación existen similitudes neurobiológicas y de comportamiento entre comer en exceso compulsivamente y la dependencia de drogas psicoactivas, determinando el uso del término AC, el patrón de ingesta de alimentos en la AC puede ser paralelo a la dependencia de sustancias y este fenómeno podría entenderse con la misma neurobiología (Davis & Carter, 2009;Pedram et al., 2013). ...
Thesis
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Propósito y métodos de estudio: El propósito fue determinar la influencia de la sensibilidad a la recompensa, la adicción a la comida y el estado nutricional materno sobre la sensibilidad a la recompensa, la adicción a la comida y el estado nutricional del hijo escolar. El diseño fue descriptivo correlacional. El tamaño de la muestra fue de 703 diadas, calculada a través del paquete nQuery Advisor® versión V7.0, se estimó a partir de un Modelo de Regresión Lineal Múltiple con un nivel de significancia de .05, una potencia del .90 y un Coeficiente de Determinación R2 de .08. El muestreo fue probabílistico por conglomerados unietápico realizado en una institución educativa de Cienega de Flores, Nuevo León. Para medir las variables se aplicaron los instrumentos de lápiz y papel: cédula de datos sociodemográficos, la Escala del Sistema de Activación Conductual, la Escala del Sistema de Activación Conductual versión para padres, la Escala de Adicción a la Comida de Yale y la Escala de Adicción a la Comida de Yale para Niños y se realizó medición de peso y talla mediante una báscula SECA 750 y un estadímetro portátil SECA 213. Contribución y conclusiones: Se identificó una alta SR, un porcentaje prevalente de AC y SP/OB en madres e hijos. No hay diferencia entre la SR y la AC según edad de la madre, tampoco por edad y sexo del hijo. La SR y la AC se relacionaron positivamente con el IMC y SP/OB de la madre e hijo. Las variables de la madre (SR, AC e IMC) que influyen en la SR del hijo fue la SR de la madre, en la AC del hijo fueron la SR y la AC de la madre y en el IMC del hijo fueron la SR, la AC y el IMC de la madre. Las madres con SP/OB presentaron alta SR y AC, así mismo los hijos con SP/OB presentaron alta SR y AC. Los hijos con madres que presentaron alta SR presentaban el mismo puntaje de SR, de igual manera los hijos con madres que presentaron AC presentaban el mismo nivel de adicción.
... A wealth of research has documented the behavioral and neurophysiological evidence for the existence of food addiction (FA) as a construct, although it continues to be somewhat controversial [1][2][3][4][5][6]. Some research has suggested that highly palatable foods stimulate neural reward centers similarly to psychoactive substances triggering release of dopamine and leading to pleasurable experiences and continued consumption despite negative consequences or attempts to stop or cut down on the behavior [4]. ...
Article
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Background The Yale Food Addiction Scale (YFAS) was developed in 2009 to assess food addiction (FA); a revised version was released in 2016 (YFAS 2.0). The objective of this study was to determine the statistical and clinical validity of the YFAS 2.0 in adults seeking bariatric surgery.Methods Patients who underwent a preoperative psychological evaluation in preparation for bariatric surgery from 2015 to 2018 were included. The YFAS 2.0 was administered as part of routine clinical care and validated against an assessment battery of standardized clinical measures. Statistical analyses included chi-square and Wilcoxon rank sum tests and calculation of Spearman’s rank correlation coefficients.ResultsOverall, 1061 patients were included. Mean age and BMI were 47.5 ± 12.9 years and 46.9 ± 13.4 kg/m2, respectively. There were 196 (18%) patients who screened positive on the YFAS 2.0 (21% mild, 23% moderate, and 56% severe FA). The YFAS 2.0 demonstrated strong convergent validity where patients who met criteria for FA had significantly increased levels of binge eating (p < 0.001), emotional eating (p < 0.001), and lower self-efficacy (p < 0.001). Discriminant validity was demonstrated by lack of association with alcohol use (p = 0.319). The YFAS 2.0 was significantly correlated with total scores for depression (p < 0.001), anxiety (p < 0.001), bipolar disorder symptoms (p < 0.001), and trauma history (p < 0.001).Conclusions The prevalence of FA in a large sample of patients seeking bariatric surgery was consistent with previous literature. These data suggest that the YFAS 2.0 is psychometrically valid, demonstrating strong construct validity, and is a clinically useful measure of FA severity in patients pursuing bariatric surgery.
... Indeed, they found similarities between addictive behaviors and compulsive overeating, namely behavioural and neurobiological [1][2][3][4]. These similarities led to the concept of food addiction (FA) [5]. Although there is no universal definition of FA, it is known as an excessive and abnormal intake of highly palatable foods [2,3]. ...
Article
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This study aimed to examine cognitive factors associated to food addiction (FA) symptoms in a non-clinical sample of adolescents. A group of 25 adolescents (12-18 years; Mean age = 15.2 years) with a high level of FA symptoms (two and more) were compared to a control group without FA symptoms (n = 25), matched on sex and age, on four Cambridge Neuropsychological Test Automated Battery (CANTAB) neuropsychological tasks (MT: Multitasking Test; OTS: One Touch Stockings of Cambridge; SST: Stop Signal Task; RVP: Rapid Visual Information Processing). They were also compared on self-reported questionnaires assessing binge eating, depressive and anxiety symptoms, impulsivity levels, as well as executive functioning difficulties. Group comparisons did not show significant differences on neuropsychological tasks' performances. However, effect sizes' estimates showed small to medium effect sizes on three scores: adolescents with a high level of FA symptoms showed a higher probability of an error following an incorrect answer (OTS), a higher probability of false alarm, and a poorer target sensitivity (RVP). When referring to self-reported measurements, they reported significantly more executive functioning difficulties, more binge eating, depressive symptoms and higher impulsivity levels. Overall, results suggested that cognitive difficulties related to FA symptoms seem to manifest themselves more clearly when assessing daily activities with a self-reported questionnaire, which in turn are strongly related to overeating behaviors and psychological symptoms. Future longitudinal research is needed to examine the evolution of those variables, their relationships, and contribution in obesity onset. More precisely, the present findings highlighted the importance of affective difficulties related to this condition, as well as the need to take them into account in its assessment.
... Since binge eating is associated with other disordered eating behaviours, it is important to investigate addictive-like processes in them as well. Binge eating strongly overlaps with an addictive-like behaviour termed food addiction (Davis & Carter, 2009;Meadows et al., 2017). Food addiction has been discussed for some time, but only recently received scientific attention (Cassin & von Ranson, 2007;de Vries & Meule, 2016;Gearhardt et al., 2014). ...
Article
Introduction: Binge eating is a common behaviour that is strongly linked to both obesity and eating disorder. There is evidence that binge eating commonly co-occurs with other problematic and addictive-like behaviours; however, this has not been explored systematically. The present study aimed to examine the relationship between binge eating, body weight, disordered eating behaviours and associated addictive-like behaviours, with particular attention paid to gender differences. Method: A community sample (N¼500; 75% female, Mage¼32.5 years) reported disordered eating behaviours (i.e. binge eating, purging, restriction of eating, compulsive exercise), body mass index (BMI), food addiction, starvation addiction, exercise dependence, tobacco use and alcohol consumption. Results: 42% of females and 21% of males reported binge eating during the past four weeks. Binge eating was significantly associated with all investigated behaviours in females, and with purging, compulsive exercise and overweight/obesity in males. Controlling for BMI, self-starvation predicted binge eating in males (OR¼1.07), while food addiction (OR¼1.73) and alcohol dependence (OR¼1.11) predicted binge eating in females. Conclusions: The multiple associations between binge eating and addictive-like behaviors supports broad screening and generalized prevention efforts. Prevention efforts should reflect gender differences.
... Several reports previously proposed compulsivity as a transdiagnostic marker overlapping different eating disorders (5,7,25,48). Our findings taken together with observations by Davis et al. (48,49) suggest that increased habit formation could be a transdiagnostic marker for subgroups of anorexia nervosa as well as bulimia nervosa patients. Interestingly, excessive goal-directed behavior has also been proposed as a transdiagnostic marker for subgroups of eating disorders patients (44). ...
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Dysregulation of habit formation has been recently proposed as pivotal to eating disorders. Here, we report that a subset of patients suffering from restrictive anorexia nervosa have enhanced habit formation compared with healthy controls. Habit formation is modulated by striatal cholinergic interneurons. These interneurons express vesicular transporters for acetylcholine (VAChT) and glutamate (VGLUT3) and use acetylcholine/glutamate cotransmission to regulate striatal functions. Using mice with genetically silenced VAChT (VAChT conditional KO, VAChTcKO) or VGLUT3 (VGLUT3cKO), we investigated the roles that acetylcholine and glutamate released by cholinergic interneurons play in habit formation and maladaptive eating. Silencing glutamate favored goal-directed behaviors and had no impact on eating behavior. In contrast, VAChTcKO mice were more prone to habits and maladaptive eating. Specific deletion of VAChT in the dorsomedial striatum of adult mice was sufficient to phenocopy maladaptive eating behaviors of VAChTcKO mice. Interestingly, VAChTcKO mice had reduced dopamine release in the dorsomedial striatum but not in the dorsolateral striatum. The dysfunctional eating behavior of VAChTcKO mice was alleviated by donepezil and by l-DOPA, confirming an acetylcholine/dopamine deficit. Our study reveals that loss of acetylcholine leads to a dopamine imbalance in striatal compartments, thereby promoting habits and vulnerability to maladaptive eating in mice.
... The phenomena of calories in vs. calories out, which was previously thought to be a simple problem has now been turned into a complex and multifactorial condition that is influenced not only by genes but also by current obesogenic environment [1][2][3]. One of the most important factors in obesity is overeating in response to obesogenic environment in which, different highly palatable foods are available [4]. Some forms of overeating have the characteristics similar to addicted behavior. ...
Article
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PurposeThe present study was performed to develop the Persian version of food craving inventory (FCI) (FCI-P) and to assess food craving in Iranian adult population. In addition, individual differences, including sex and body mass index (BMI) in food craving were assessed.Methods Eight hundred and twenty subjects who participated in the same study Hill (Proc Nutr Soc 66: 277–285, 2007) were studied (540 women and 280 men). The FCI-P, International Physical Activity Questionnaire (IPAQ), Three-Factor Eating Questionnaire (TFEQ), and a questionnaire pertaining to demographic characteristics were completed for all participants.ResultsGood content, construct, and convergent validity was observed for the FCI-P. A good reliability was found for both aggregate scores of the FCI-P and scores of its five factors. Exploratory factor analysis showed a five-factor model including “sweets,” “high-fat foods,” “fast food fats,” “carbohydrates/starches” and “high-fat meats”. These five factors accounted for 47.31% of the total variance. The scores of “uncontrolled eating” and “emotional eating” of the TFEQ were significantly correlated with the scores of the FCI-P factors and its total score. A significant correlation was found between BMI and the FCI-P score (r = 0.199). Significant differences were observed in the mean age and physical activity score among normal weight, overweight, and obese participants. Normal weight and overweight groups were more active than obese group. Obese participants had higher FCI-P score (P < 0.001) than the normal and overweight groups. FCI-P score was significantly higher in women than men.ConclusionsFCI-P can be used as a valid and reliable measure to assess food craving in Iranian populations. Obese individuals experienced food craving more than normal weight subjects. Similarly, women may experience food craving more than men.Level of evidenceLevel V, cross sectional study.
... Food addiction assumes behavioral and biological parallels between excess food consumption and drug addiction (Davis and Carter, 2009;Fletcher and Kenny, 2018;Randolph, 1956). It refers to the idea that palatable food (e.g. ...
Article
The contribution of an addictive process to anorexia nervosa (AN) is an area of growing interest. Yet, little is known about how the food addiction concept (FA) may be of interest in understanding AN. This study investigates prevalence of FA diagnostic and its association with markers of severity in individuals with AN. We conducted a retrospective study in a sample of 73 patients with AN. We assessed FA with the Yale Food Addiction Scale 2.0, depressive and anxiety disorders, impulsivity (Beck Depression Inventory, STAI, BIS-11) and eating behavior (BITE, EDE-Q). Prevalence of FA in our sample was 47%. FA was significantly associated and positively correlated with the binge-eating/purging subtype of AN, higher levels of depression, anxiety and greater eating psychopathology. FA was not associated with level of impulsivity nor leptin and IGF-1 blood levels. The relationship between FA severity and AN severity was mediated by the severity of binge eating behaviors Our results suggest that the presence of FA may represent a more severe variant of AN. Longitudinal studies are needed to better understand the etiologic process between FA and AN.
... Binge eating shares similarities with addictions, including a lack of control over behaviour, the behaviour's use to regulate emotions, and its accompaniment by increased dopamine activity in the limbic system (C. Davis & Carter, 2009;el-Guebaly, Mudry, Zohar, Tavares, & Potenza, 2012). However, some researchers (e.g., von Ranson & Cassin, 2007) are reluctant to conceptualise eating pathology as an addiction because addiction models tend to ignore critical symptoms that co-occur with disordered eating (i.e., body image disturbances, preoccupation with weight and shape, food restriction) and because eating is fundamental to life, unlike psychoactive substances or gambling. ...
Preprint
To elucidate similarities and differences between binge eating and a behavioral addiction, this prospective study compared facets of emotion regulation that were associated with problem gambling, the only formally recognized behavioral addiction, and binge eating. Community-based women (N = 202) who engaged in at-risk binge eating (n = 79), at-risk gambling (n = 36), or both (n = 87) completed four online assessments over six months. Baseline and six-month surveys assessed self-reported emotion dysregulation (using the DERS and UPPS-P), binge eating (using the EDE-Q), and gambling (using the PGSI); abbreviated two- and four-month surveys assessed only binge eating and gambling. Binge eating and problem gambling were both associated with emotion dysregulation, and greater positive urgency was correlated with more severe problem gambling but less frequent binge eating. Negative urgency explained no unique variance in binge eating or problem gambling changes over time, once other facets of emotion dysregulation (i.e., positive urgency and facets assessed by the DERS) were included. Thus, previous cross-sectional research may have overestimated the association of negative urgency with both binge eating and problem gambling. Overall, these findings suggest that binge eating and problem gambling are associated with common as well as distinct emotion regulation deficits.
... The idea that individuals with overweight and obesity are unable to control their weight is part of the stigma involving this population, and may have contributed to the frequent association between BED and food addiction [67]. In the area of substancerelated and addictive disorders, the loss of control in limiting intake and consumption of high doses is considered a stage for intoxication, which presents harmful effects and, together with a specific vulnerability, can generate dependence [68]. ...
Article
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Background Research on food addiction (FA) has been growing and increasing interest has been seen in comprehending its mechanisms and clinical and psychological correlates of this phenomena. This field of study is specially apply to understand obesity and eating behavior issues related to eating disorders (ED). Objectives We performed a literature review that describe recent research using the updated version of the Yale Food Addiction Scale (YFAS 2.0) or modified-YFAS (mYFAS 2.0), from the date of its publication. Methods Search were performed in Web of Science, Pubmed and PsycNET databases for studies that used the YFAS 2.0 and mYFAS 2.0. Results The studies (n = 53) investigated adaptation and validation of the scale in different cultures (n = 13), prevalence on nonclinical populations and representative samples (n = 5), food addiction in obesity samples (n = 11), in samples with ED and disordered eating (n = 10) and studies that investigated FA in association with other clinical and psychological variables (n = 14). Discussion Studies with the YFAS 2.0 reveal higher prevalence of FA in different samples, and a great association between FA and BED, BN and obesity. Implications for diagnostic of this phenomena and the overlap between FA and other disorders are discussed. Conclusions The field of FA remains an open subject and effort must be implied to understand the subjective experience of addiction related to eating and food.
... This inclusion of pornography veiwing is supported by empirical research showing that individuals who endorse problematic sexual behaviors or identify as "sex addicts" report excessive pornography use with significant frequency (Kafka, 2010). Binge eating was included due to strong preclinical and clinical evidence of neurobiological similarities to substance use disorders (Davis & Carter, 2009), while the evidence was less strong for other behaviors related to eating (e.g. restriction or exercise as addictions (Szabo et al, 2015)). ...
Article
Objective Substance use disorders and behavioral addictions commonly co-occur. However, few available self-report measures reliably and validly assess the full range of addictive conditions. The development and initial validation of a new measure—Recognizing Addictive Disorders (RADs) scale addresses a significant gap in the literature. Method: After items were generated and evaluated in Study 1, Study 2 (N = 300), applied exploratory factor analysis to the item pool using an online-based community sample. In Study 3 (N = 427), the factor structure was validated using an independent online-based community sample and confirmatory factor analysis. Results: The scale demonstrated good internal consistency (a = .92) and construct validity, including replication of the factor structure (χ² (553) = 760.83, p < .001, CFI = .997, TLI = .997, RMSEA = .030) and correlation with a related transdiagnostic measure of addiction (r = .72). Discussion: Overall, results support the preliminary validity of a brief transdiagnostic measure of addiction that considers a diverse range of behaviors. For patients presenting to substance abuse treatment, this tool may be useful in identifying symptoms of other types of non-substance problems, which could ultimately aid in treatment planning.
... [10,11] Instinctive behaviors such as eating that give people happiness and are necessary for the survival of life are called "natural rewards." [12] Gearhardt et al. listed the common characteristics of addictive substances and hyperpalatable foods as follows: they increase dopamine and opioid neural system activity, trigger artificially high levels of reward, enter the bloodstream rapidly, stimulate the neurobiological systems, lead to the continued consumption despite negative consequences, and are difficult to quit although the person is willing to quit. [13] Studies suggest that foods containing excess fat/sugar overstimulate reward pathways, and increase dopamine release, which leads to compulsive food consumption, i.e. to food addiction. ...
Article
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Background: People may develop addiction to hyperpalatable foods, which may be a cause of obesity. This study aimed to determine the prevalence of obesity among adolescents and the effect of food addiction on obesity. Materials and methods: In this cross-sectional study, food addiction and obesity status of high school students were investigated. Among 17,000 10th and 11th grade students, assuming the design effect as 2.0, with obesity prevalence of 10%, with 3% error, and 95% confidence interval, at least 752 participants were included. Obesity was the dependent variable, whereas sociodemographic characteristics, body image, eating habits, and food addiction were the independent variables. Food addiction was assessed using the Yale Food Addiction Scale. Obesity was determined by age- and sex-specific body mass index (BMI) percentiles for adolescents < 18 years of age and BMI ≥ 30.0 for those aged ≥ 18. Data were collected through face-to-face interviews. Statistical analyses were performed using SPSS 25.0. After adjustment for age, sex, and other variables, the effect of food addiction on obesity was determined through logistic regression. P <0.05 was deemed statistically significant. Results: Among adolescents (n = 874), 18.9% were food addict, 25.1% were overweight, and 12.1% were obese. After adjusted for age, sex, and other variables, food addiction significantly increased the risk of obesity (odds ratio: 1.9; 95% confidence interval: 1.167-3.335). Having a fragmented family, working mother, overweight father, and participants not knowing their weight correctly significantly increased obesity. Conclusion: While quarter of the adolescents had weight problems, one-fifth suffered from food addiction. After adjusting for confounders, food addiction significantly increased obesity. Identifying individuals with food addiction, providing treatment to overcome that, paying special attention to adolescents with obese parents or living in fragmented families, and providing support to both parents and adolescents could be useful in tackling obesity.
... These behaviors include hoarding disorder, body-focused repetitive behavior disorders (e.g., trichotillomania, excoriation disorder), obsessive-compulsive disorder (in the 'Obsessive-Compulsive and Related Disorders' class), and 'Impulse Control Disorders', such as pyromania, kleptomania, and compulsive sexual behavior disorder (e.g., Blum, Badgaiyan, & Gold, 2015;Fontenelle, Oostermeijer, Harrison, Pantelis, & Y€ ucel, 2011;Odlaug, & Potenza, 2007;Kraus, Voon, & Potenza, 2016). Furthermore, there are approaches that focus on the potentially addictive characteristics of eating disorders such as anorexia nervosa, bulimia nervosa, binge eating disorder or becoming obese (e.g., Blum, Thanos, & Gold, 2014b;Cassin & von Ranson, 2007;Davis & Carter, 2009;Davis & Claridge, 1998). There are also other problematic behaviors that are not classified as disorders in the DSM or the ICD, but are often considered as potential behavioral addictions including buying-shopping disorder (i.e., compulsive shopping) (e.g., M€ uller et al., 2019), exercise addiction (e.g., Archer, Badgaiyan, & Blum, 2017;Berczik et al., 2012;Freimuth, Moniz, & Kim, 2011), social networking addiction (e.g., Andreassen, 2015;Griffiths, Kuss, & Demetrovics, 2014b), and work addiction (e.g., Griffiths, 2011;Sussman, 2012). ...
Article
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Background and aims: Changes in the nomenclature of addictions suggest a significant shift in the conceptualization of addictions, where non-substance related behaviors can also be classified as addictions. A large amount of data provides empirical evidence that there are overlaps of different types of addictive behaviors in etiology, phenomenology, and in the underlying psychological and biological mechanisms. Our aim was to investigate the co-occurrences of a wide range of substance use and behavioral addictions. Methods: The present epidemiological analysis was carried out as part of the Psychological and Genetic Factors of the Addictive Behaviors (PGA) Study, where data were collected from 3,003 adolescents and young adults (42.6% males; mean age 21 years). Addictions to psychoactive substances and behaviors were rigorously assessed. Results: Data is provided on lifetime occurrences of the assessed substance uses, their co-occurrences, the prevalence estimates of specific behavioral addictions, and co-occurrences of different substance use and potentially addictive behaviors. Associations were found between (i) smoking and problematic Internet use, exercising, eating disorders, and gambling (ii) alcohol consumption and problematic Internet use, problematic online gaming, gambling, and eating disorders, and (iii) cannabis use and problematic online gaming and gambling. Conclusions: The results suggest a large overlap between the occurrence of these addictions and behaviors and underlies the importance of investigating the possible common psychological, genetic and neural pathways. These data further support concepts such as the Reward Deficiency Syndrome and the component model of addictions that propose a common phenomenological and etiological background of different addictive and related behaviors.
... Yeme bağımlılığı 2019 yılında potansiyel bağımlılık yapıcı besinlerin etkisi ile uyuşturucu ve alkol bağımlılığına benzer şekilde, bireyler üzerinde kontrol kaybı oluşturan, oldukça lezzetli gıdaların zayıf kontrollü tüketimi ile karakterize bir durum olarak tanımlanmıştır. Başka bir ifade ile yeme bağımlılığı olan bireylerde, istenmeyen biyolojik sonuçlara rağmen, bağımlılık uyandıran besin maddesinin tüketilmesi ile beyinde besine yönelik bir saldırı, besin maddesinin aşırı tüketilmesi ve devam eden aşırı kullanım gibi klasik bağımlılık belirtileri sergilendiği ortaya çıkarılmıştır(Gearhardt vd., 2009).Yeme bağımlılığı "Belirli gıdalara, özellikle yağ ve rafine karbonhidratlardan zengin olan gıdalara fiziksel ve psikolojik bağımlılığı içeren bir süreçtir" olarak ifade edilmiştir(Davis ve Carter, 2009). Bu nedenle, gıda bağımlılığı, yeme bozuklukları ve obezite de dahil olmak üzere sorunlu yeme davranışlarına katkıda bulunan bir faktör olabilir. ...
Chapter
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Yeme bağımlılığı, obezitenin oluşmasında ve gelişmesinde önemli bir risk faktörü olabilir. Bunun önlenmesi için bireylerde yeme bağımlılığına yol açan besinlerin saptanması ve bunların alımlarının azaltılmasına yönelik çalışmalar yararlı olabilir. Bilinen görüşlerin aksine obezitenin çevresel uyaranlara duyarlı nörodavranışsal bir bozukluk olduğu da savunulmaktadır. Duygu durumu ile beslenme arasındaki ilişkiyi inceleyen çalışmalar, farklı duygu durumlarının besin alımını azaltma veya arttırma yönünde etki ettiğini ortaya koymuştur. Bağımlılık davranışlarında önemli bir etken olan duygu durumunun yeme davranışı ve bozuklukları üzerinde de etkisinin olacağı açıktır. Tıkanırcasına yeme bozukluğu (TYB) olan bireylerde olumsuz duygu durumlarının varlığı tespit edilmiştir. Yapılan çalışmalar duygusal durumun besin alımını etkilediği, normal kilolu insanlarda daha az besin alımına neden olurken fazla kilolu insanlarda daha fazla besin alımına neden olduğunu ortaya koymuştur . Genetik ve biyolojik etmenlerin yanı sıra çevresel etmenlerin de yeme bağımlılığı üzerinde ciddi bir etkisi vardır. Araştırmalar bu etkinin çoğunun besin endüstrisi ile ilişkili olduğunu ortaya koymuştur. Okul kantinleri, market ve restoranlarda yağ ve şeker içeriği yüksek fast-food türü besinlerinin daha fazla bulundurulması, satışı ve tüketimini de teşvik etmektedir. Bundan başka, sosyal medya araçları aracılığı ile yüksek yağlı ve şekerli hazır besin tüketiminin empoze edilmesi, yatkın bireylerde yeme bağımlılığının temelini hazırlayarak obezite gelişimini de kolaylaştırmaktadır. Bu tür sağlıksız çevresel uyaranlara duyarlı ve ödül merkezinde işlevsel sorunları olan bireylerde fast-food tüketimlerinin ve obezite riskinin daha fazla olduğu gösterilmiştir.
... In the brain, there are patterns of activation that are similar across addictions, whether it be to alcohol, drugs, or gambling. In recent years it has been suggested that overeating, and perhaps binge eating, may result in a state that resembles an "addiction" to food (Avena et al. 2012), stemming from the idea that binge eating shares similarities with conventional drug addiction (Davis and Carter 2009). This has been supported by clinical research demonstrating that food craving, or the urge to consume palatable food in the absence of homeostatic hunger, in normal weight and obese adults activates areas of the brain similar to those activated by drug craving in individuals with SUD (Pelchat et al. 2004;Wang et al. 2004). ...
Chapter
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With emerging evidence of a biological basis to binge eating, questions about the role of food addiction (FA) have stimulated scholarly debate. A major criticism of the FA construct is its failure to account for dietary restraint and weight suppression, known contributors to binge eating. In this chapter, we examine animal and human models of addiction-like eating in the context of binge eating. Overlapping mechanisms such as reward dysfunction, craving, impulsivity, and attentional bias from animal and human studies are discussed. Directionality of the binge eating cascade is explored across different theoretical models with empirical support for multiple pathways. We offer a “Diet Drives the Binge” theory of food addiction, and a “Food Environment Drives Addiction” theory of binge eating. While FA research highlights the neurobiological vulnerability of certain people, there is less consensus about effective interventions at the individual level. We discuss current controversies surrounding FA and important findings that may have public health implications.
... In addition, it cares about the child's autonomy findings also include inability to express emotions (such as anger, joy or sadness), failure to fulfil social expectations, depressive moods, loneliness, self-pity, and lack of motivation, lack of strong will, and assertiveness (Wronka and Jezierska-Kazberuk, 2011). Purging behaviours are linked to self-confidence, low self-esteem, loneliness, life in constant tension, need for praise and approval from the environment, submissiveness, and impulsiveness (Davis and Carter, 2009). It has also been proven that the prevalence of eating disorders, regardless of their type, increases in the presence of another mental illness (Wasik et al., 2012). ...
Article
Although research into the aetiology and pathogenesis of eating disorders has been ongoing for many years, it has not yet been possible to identify all the factors responsible for their development. Current research does not focus on a single risk factor, but looks for correlations between them. This article presents selected aspects of the pathogenesis and risk factors of specific eating disorders. Family and individual factors, social and cultural factors, and biological factors are described. Particular attention has been paid to the aspect of parenting styles and behaviours exhibited, e.g. excessive punishment and emotional coldness. The coexistence of personality disorders with specific and non-specific eating disorders is also described. The social aspect highlights the development of social media and their impact on selfesteem, body dissatisfaction, and promotion of pathological thinness. Cultural factors include progressive “westernisation” and the rapid increase in the prevalence of eating disorders in the areas of the world where they did not previously exist. Among biological factors, publications on appetite neuromodulators, genetic factors, gut microbiota disorders, and the so-called brain-gut axis were analysed. Modern science is not as yet able to answer the question of which of the mentioned factors has the greatest impact on the development of eating disorders, however, ongoing research offers hope for effective treatment of these diseases in the future. Knowing the factors predisposing to their occurrence will allow early identification of risk groups and undertaking preventive and therapeutic actions, including psychotherapy and pharmacotherapy.
... Against this background, recent literature supports neurobiological and behavioral similarities between compulsive overeating and substances abuse, leading researchers to use the term 'food addiction' to describe this pattern of overeating (Blumenthal & Gold, 2010;Davis & Carter, 2009;Smith & Robbins, 2013;Volkow et al., 2013). These similarities are based on common brain mechanisms mediating the rewarding properties of natural rewards (like eating) and addictive drugs, leading to impaired decision-making (choice of short-term rewards) in both domains. ...
Article
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Impairments in decision-making have been suggested as a predisposing factor to obesity development. Individuals with excess weight display riskier decisions than normal weight people. Furthermore, adolescence is a period of life in which risky behavior may increase. We aimed to investigate decision making applying the Outcome-Representation-Learning (ORL) model to the Iowa Gambling Task (IGT) in adolescents with excess weight. Twenty-nine excess weight and twenty-eight normal weight adolescents, classified according to their age-adjusted body mass index (BMI) percentile, participated in the study. Decision-making was measured using the IGT. A Bayesian computational ORL model was applied to assess reward learning, punishment learning, forgetfulness, win perseverance and deck perseverance. The IGT net score was lower in excess weight than normal weight adolescents (β = 2.85; p < .027). Reward learning (95% HDI [0.011, 0.232]) was higher, while forgetfulness (95% HDI [− 0.711, − 0.181]) and deck perseverance (95% HDI [− 3.349, − 0.203]) were lower, in excess weight than normal weight adolescents. Excess weight adolescents seemed better at learning the most rewarding choices and showed a random strategy based on reward and novelty seeking. Consequently, excess weight adolescents made more disadvantageous selections, and performed worse in the IGT.
... Against this background, recent literature supports neurobiological and behavioral similarities between compulsive overeating and substances abuse, leading researchers to use the term 'food addiction' to describe this pattern of overeating (Blumenthal & Gold, 2010;Davis & Carter, 2009;Smith & Robbins, 2013;Volkow et al., 2013). These similarities are based on common brain mechanisms mediating the rewarding properties of natural rewards (like eating) and addictive drugs, leading to impaired decision-making (choice of short-term rewards) in both domains. ...
Preprint
Background: Impairments in decision-making have been suggested as a predisposing factor to obesity development. Individuals with excess weight display higher risk-taking in their decisions than normal weight people. Adolescence is a period of life in which risk-taking behavior may increase. However, no study to date has analyzed underlying impairments on decision-making process in this population. Methods: This is the first study to apply the Outcome-Representation-Learning (ORL) model to the Iowa Gambling Task (IGT) for a better understanding of the decision-making process in adolescents with excess weight. Twenty-nine excess weight and twenty-eight normal weight adolescents (age range: 13 to 18 years), classified according to their age-adjusted body mass index (BMI) percentile, participated in the study. Decision-making was measured using the IGT. A Bayesian computational ORL model was applied to assess different components of decision-making: reward learning, punishment learning, forgetfulness, win perseverance and deck perseverance. Results: Regarding global performance, the net IGT score was lower in the excess weight group than normal weight adolescents (β = 2.85; p < .027). Respecting to underlying processes of the task, reward learning (95% HDI [0.011, 0.232]) was higher, while forgetfulness (95% HDI [− 0.711, − 0.181]) and deck perseverance (95% HDI [− 3.349, − 0.203]) were lower, in excess weight than normal weight adolescents. Conclusions: Excess weight adolescents seemed better at learning and remembering the most rewarding choices; furthermore, they showed a more random strategy based on reward and novelty seeking. Consequently, excess weight adolescents made more disadvantageous selections, and therefore performed worse in the IGT. These results improve knowledge of the cognitive processes underlying IGT performance in excess weight adolescents and confirm roles for reward sensitivity and lack of perseveration in decision-making strategies.
... Notably, the prevalence of food addiction is higher among individuals with obesity (25%) [12••] and most elevated among those with binge-type eating disorders (e.g., 42-92% of individuals with binge eating disorder (BED) [15][16][17]). Individuals who meet criteria for food addiction and an eating disorder, such as BED, appear to exhibit more severe binge eating and psychopathology compared to those with only BED [15,18,19]. In addition, persons who meet criteria for food addiction in the absence of other eating disorders present with significant impairment, distress, and depressive symptoms [20], suggesting unique psychological features of food addiction. ...
Article
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Purpose of Review To summarize recent neurobiological evidence for (1) the addictive potential of ultra-processed foods and (2) the utility of food addiction, defined by behavioral criteria, as a clinically meaningful type of disordered eating. Recent Findings Ultra-processed foods appear to be capable of triggering biobehavioral mechanisms associated with addiction (e.g., dopaminergic sensitization, enhanced motivation), whereas naturally occurring foods do not appear to produce addictive-like responses. Neuroimaging studies have elucidated parallel mechanisms in food addiction and substance-use disorders, including dopaminergic dysfunction, emotion dysregulation, and impulsivity. Emerging data has also suggested biological distinctions for individuals with food addiction evident by the brain-gut-microbiome connection, hormones, and genetics. Summary Existing evidence has yielded convincing findings for overlapping features of ultra-processed foods and drugs of abuse. Preliminary findings from neurobiological studies of individuals with food addiction have revealed similar neural pathways triggered by food and related stimuli as observed in prior studies of persons with substance-use disorders.
... These powerful neurobiological and psychological effects therefore offer possible causes for addiction and escalating drug use, as well as relapse that occurs long after drug-use subsides. Further, incentive sensitization and accompanying dopamine system sensitization can occur even without drug use for very vulnerable individuals, which could lead to behavioral addictions such as eating disorders or gambling addictions(Davis and Carter 2009;Devoto et al. 2018;Gearhardt et al. 2011;Hartston 2012;Linnet et al. 2012;O'Sullivan et al. 2011;Olney et al. 2018;Pfaus et al. 1990;Ray et al. 2012;Stice et al. 2012;Voon et al. 2017;Zeeb et al. 2017).These motivational mechanisms could underlie the surprising behavioral addictions that can be observed in some Parkinson's patients following treatment with dopamine direct agonists.For certain individuals receiving supplemental dopamine medications, who therefore produce heightened dopaminergic responses similar to incentive sensitization, intense addictive behaviors such as compulsive gambling, compulsive sex, or compulsive shopping can occur, even for individuals who never displayed these behaviors pre-treatment(Bostwick et al. 2009;O'Sullivan et al. 2011;Vela et al. 2016;Voon et al. 2017;Warren et al. 2017;Weintraub et al. 2010).Sensitization of incentive salience for drug or reward cues can also be dynamic across different situations. For example, particular states such as stress, hunger, etc. are capable of amplifying that peak of incentive salience elicited by cues, thus suggesting that momentary experiences of stress or heightened emotions can enhance 'wanting'(Lemos and Alvarez 2020;Lemos et al. 2012;Peciña et al. 2006). ...
Thesis
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Striatal-level structures such as the nucleus accumbens (NAc) and central amygdala (CeA) are capable of generating intense incentive and aversive motivated behaviors (Baumgartner et al. 2020; Warlow et al. 2020). NAc may have two modes for motivation, as inhibition and excitation of NAc can both produce motivated behaviors. For example, NAc medial shell inhibition through AMPA receptor antagonist (DNQX) microinjections can produce both intense eating and defensive behaviors (Baumgartner et al., 2020). Chapter 2 of this dissertation investigates the inhibition hypothesis of accumbens motivation generation by testing whether local pairing of optogenetic excitation can disrupt ‘desire’ and ‘dread’ behaviors generated by DNQX microinjections. Incentive and aversive motivation generated by NAc and other limbic structures are flexible and able to respond to external stressors. Chapter 3 therefore investigates a previously untested neuronal population in NAc that expresses corticotropin-releasing factor (CRF), a stress-related peptide heavily implicated in aversive motivation and distressing drug-withdrawal states in CeA and bed nucleus of stria terminalis (BNST). Like NAc, the CeA is also capable of producing intense positive and negative motivated behaviors and we investigate the flexibility of incentive or aversive motivation in CRF neurons using new Crh-Cre+ rats to optogenetically stimulate NAc, CeA, or BNST CRF-containing neurons. This work finds that excitation of CRF-expressing neurons is capable of biasing and amplifying motivation for sucrose rewards in both NAc shell and lateral CeA (Baumgartner et al. 2021). Conversely, it also demonstrates that optogenetic excitation of pallidal-like bed nucleus of stria terminalis (BNST) CRF-containing neurons produces only negative affect and aversive motivation, filling the traditional role that CRF has been hypothesized to play in aversive withdrawal and affect (Koob 2013). Following the demonstrated positive role of NAc and CeA CRF-containing neurons for sucrose rewards, Chapter 4 of this dissertation examines whether this influence on incentive motivation also applies to drug rewards. CRF in CeA and BNST is posited to underlie aversive withdrawal states, causing negative distress that leads to addictive relapse through attempts at hedonic self-medication to relieve this state (Koob 2013). Chapter 4 therefore tests whether optogenetic excitation of CRF neurons in NAc, CeA, and BNST are capable of biasing and amplifying motivation for self-administered intravenous cocaine infusions. Understanding whether CRF-mediated incentive motivation also can drive drug motivation is therefore integral. We find that NAc and CeA CRF-expressing neurons are indeed capable of biasing motivation for cocaine infusions, while rats given the option between BNST CRF-containing neuron-paired cocaine and cocaine alone show no drug escalation or preferences between cocaine options. Altogether this dissertation demonstrates the limbic generation of intense motivation in structures such as NAc and CeA, and how both incentive and aversive motivation can be modulated by stress and brain CRF systems. The neural mechanisms underlying these different motivational valences provide important insight into cases where motivation can become pathological, such as in addiction, schizophrenia, and other psychological disorders.
... Although S-IAT strongly correlated with the BFAS in both ED groups (Table 5), its effect among women with other EDs was greater-S-IAT predicted 66% and 88% of the variance in the BFAS in women with AN and other EDs, respectively. In fact, pathological overeating (e.g., BED and BN) represents a phenotype of addictive disorders [65]. EDs characterized by excessive eating, especially when associated with obesity, display multiple alterations in signal transduction, metabolism, and immune response, which increase addictive vulnerability [66,67]. ...
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Objective Facebook addiction is increasing, giving rise to limited real-life social networks, loneliness, poor work and academic performance, psychopathology, and low well-being. Facebook entails numerous factors that increase the risk for disordered eating attitudes and behaviors (e.g., use time and Facebook activities such as social grooming and photo sharing). This study aimed to evaluate the psychometric properties of the Bergen Facebook Addiction Scale (BFAS) among patients with eating disorders (EDs) given lack of validation of Facebook addiction measures in this population. Methods A cross-sectional study involving 123 inpatient and outpatient women with EDs (Mean age = 27.3, SD = 10.6, range = 14–59 years) used confirmatory factor analysis (CFA), multigroup CFA, structural equation modeling (SEM), Spearman’s rho Spearman’s analysis, McDonald's Omega (ω), Cronbach’s alpha (α), and item-total correlations to examine the structure, invariance, criterion validity, reliability, and discriminant validity of the BFAS. Results Correlating the residuals of items 2, 3, and 5 resulted in an excellent fit of a one-factor structure of the BFAS ( χ ² (7) = 8.515, p = .289, CFI = .998, TLI = .996, RMSEA = .042, SRMR = .0099). The BFAS was invariant at the configural, metric, and scalar levels across groups of EDs, age, education, and marital status. High values of ω and α (.96) as well as item-total correlations (.851–.929) indicated excellent reliability and high discrimination index of the BFAS. Criterion validity is noted by strong positive correlation with the Six-item Internet Addiction Test (S-IAT, r = .88) and SEM using the S-IAT to predict the BFAS (χ2(49) = 103.701, p = .001, CFI = .975, TLI = .966, RMSEA = .096, SRMR = .0317).. Conclusion The BFAS is a reliable unidimensional measure. Its high discrimination index and invariance across different groups make it useful for detecting Facebook addiction among patients with ED.
... There are some scientific evidence which indicates that beside the above-mentioned causes, psychological factors are also attributed to overeating and obesity (Davis & Carter, 2009;Khan et al., 2018). In this regard, several studies investigated the predictability of psychological and behavioral risk factors for obesity onset. ...
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The Multidimensional item response theory (MIRT) is a powerful modeling approach which could provide an ideal foundation for health psychologists to improve their survey-development and assessment. The current study aimed to illustrate the advantages of applying the MIRT models in investigating psychometric quality of the Dutch Eating Behavior Questionnaire (DEBQ). The Persian version of DEBQ questionnaire was administered to a sample of 509 Iranian university students. The three-factor MIRT model was applied to model the observed scores for each item of the DEBQ as a probability function of the individual’s latent traits (here eating behaviors) while taking the correlation among questionnaire’s dimensions into account. Strength of fit of MIRT model was reported based on multiple indices and individual items were illustrate in detail through item characteristic curves. Item information curves were also described the amount of information carried by different items. The goodness of fit indices which extracted from the result of MIRT model indicated acceptable structural validity of DEBQ with three factor to support for the dominant three-dimensional structure. Item discrimination parameters ranged from 0.56 to 3.39, 0.77 to 3.56 and 0.67 to 2.14 for restrained eating, emotional eating, and external eating, respectively. Moreover, items 4, item 23 and item 30 provided the least information in restrained, emotional, and external eating subscales.
... According to Gearhardt et al. (2016), some people could develop addictive-like eating behaviors related to highly palatable foods (i.e., foods rich in refined carbohydrates, sugar, fat and/or salt). Food craving (FC) could be considered to be the core mechanism of FA (Davis & Carter, 2009;Gearhardt et al., 2016). FC is an intense and uncontrollable need to eat highly palatable foods, accompanied by intrusive thoughts, multi-sensory imagery, strong urges to seek and consume the substance of addiction and poor self-control about high palatable food (Taylor, 2019). ...
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Abstract Objectives The aim of this study was to investigate the association between food addiction severity (FA) and ADHD symptomatology. Furthermore, we investigated whether emotional distress, and the mentalization deficits could mediate this relationship. Methods Three hundred eighty-five Italian adults (307 women and 78 men) participated in the study and completed the Italian versions of the Modified Yale Food Addiction Scale version 2.0, the Adult ADHD Self-Report Scale, the Depression Anxiety Stress Scales 21 and the Mentalization Questionnaire. Results ADHD symptoms severity and general distress were significantly and independently associated with FA. Emotional distress partly mediated the relationship between FA and ADHD symptoms severity. In addition, mentalization deficits partly mediated this relationship only when evaluating the influence of FA on ADHD symptoms severity. Limitations This is a cross-sectional study and causal interpretations of the relationships among the variables are speculative. Conclusions It is important to assess emotional distress and mentalization deficits in individuals at risk of ADHD and FA because these conditions could increase the risk for the presence of disordered eating patterns.
... In addition, a substantial subset of prebariatric obese individuals exhibited a behavioral pattern similar to substance addiction and characterized by the loss of control over the consumption of sugary, salty, and fatty foods (Meule, Heckel, Jurowich, Vögele, & Kübler, 2014). It has suggested that binge eating may itself be an addictive behavior, as it shares some psychological mechanisms with substance-use disorders (i.e., loss of control; Davis & Carter, 2009). Davis (2017) has also suggested the existence of a considerable overlap between binge eating and food addiction. ...
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Objective: The current study investigates the hypothesis that the effect of low self-esteem on binge eating in bariatric candidates was mediated by both difficulties in the perception of bodily signals and impulse regulation after accounting for gender, age, and body mass index. Method: 59 preoperative patients (both male and female) were screened by means of self-report measures of self-esteem, interoceptive deficits, impulse dysregulation, and severity of binge eating. Results: Results indicated that all direct effects were significant, except for the self-esteem on impulse dysregulation and the interoceptive deficits on binge eating. Self-esteem had a significant indirect effect on impulse dysregulation mediated by interoceptive deficits. Impulse dysregulation, in turn, mediates the effect of interoceptive deficits on binge eating. Moreover, the path starting from self-esteem, going first to interoceptive deficits, then going via impulse regulation difficulties to binge eating was significant. Results and conclusions: A potential underlying mechanism through which self-esteem is linked to binge eating has been suggested. Obese individuals who perceived themselves as inadequate may carry a stronger burden by the confusion and mistrust related to bodily functioning and, consequently, may act more impulsively, through binge eating.
... Reduced cortico-basal ganglia reward sensitivity is likely to increase risky behaviors including overconsumption of highly palatable foods [82]. Given that multiple lines of evidence have documented associations between ELA and SUDs [26,83,84] and strong neurobiological overlap between SUDs and FA exists [85][86][87][88], it is likely that individuals develop addiction-like eating following exposure to sexual abuse along a similar pathway. ...
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In addition to its immediate negative consequences, childhood sexual abuse is associated with lifelong deleterious mental and physical health outcomes. This review employs a biopsychosocial perspective to better understand pathways from childhood sexual abuse to eating disorders, food and drug addictions, and obesity across the life course. Guided by an updated conceptual model, this review delineates how the biological embedding of childhood sexual abuse triggers a cascade of interrelated conditions that often result in failed attempts at weight suppression and eventually obesity. Such biological embedding involves pathways such as inflammation, allostatic load, reward sensitivity, activation of the hypothalamic–pituitary–adrenal axis, epigenetics, and structural and functional changes in the brain. These pathways are in turn theorized to lead to food addiction, substance use disorder, and eating disorders—each with potential pathways toward obesity over time. Predisposing factors to childhood sexual abuse including gender, culture, and age are discussed. This model calls into question the longstanding “protective measure” theory that purports individuals exposed to sexual abuse will deliberately or subconsciously gain weight in attempt to prevent future victimization. A more comprehensive understanding of the mechanisms by which childhood sexual abuse becomes biologically embedded may help clinicians and survivors normalize and/or address disordered eating and weight-related outcomes, as well as identify intervention strategies. Level of evidence: Level V: opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.
... CB2 receptor mRNA expression increased in the nucleus accumbens of rats on high-sugar diet while CB1 receptor mRNA expression decreased in obesity-prone rats [85]. Indeed, EDs characterized by compulsive overeating (e.g., binge EDs and bulimia nervosa) are considered a phenotype of addictive disorders [86]. Neurotransmitters known to inhibit eating behaviors such as norepinephrine are deficient in adolescents with IA, and they correlate with symptoms of depression and anxiety in those adolescents compared with healthy controls [87]. ...
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Internet addiction (IA) is widespread, comorbid with other conditions, and commonly undetected, which may impede recovery. The Internet Addiction Test (IAT) is widely used to evaluate IA among healthy respondents, with less agreement on its dimensional structure. This study investigated the factor structure, invariance, predictive validity, criterion validity, and reliability of the IAT among Spanish women with eating disorders (EDs, N = 123), Chinese school children (N = 1072), and Malay/Chinese university students (N = 1119). In school children, four factors with eigen values > 1 explained 50.2% of the variance, with several items cross-loading on more than two factors and three items failing to load on any factor. Among 19 tested models, CFA revealed excellent fit of a unidimensional six-item IAT among ED women and university students (χ 2 (7) = 8.695, 35.038; p = 0.275, 0.001; CFI = 0.998, 981; TLI = 0.996, 0.960; RMSEA = 0.045, 0.060; SRMR = 0.0096, 0.0241). It was perfectly invariant across genders, academic grades, majors, internet use activities, nationalities (Malay vs. Chinese), and Malay/Chinese female university students vs. Spanish women with anorexia nervosa, albeit it was variant at the scalar level in tests involving other EDs, signifying increased tendency for IA in pathological overeating. The six-item IAT correlated with the effects of internet use on academic performance at a greater level than the original IAT (r = −0.106, p < 0.01 vs. r = −0.78, p < 0.05), indicating superior criterion validity. The six-item IAT is a robust and brief measure of IA in healthy and diseased individuals from different cultures.
... However, the possibility of food addiction being a cause, co-morbidity or a consequence of obesity is still under discussion. Indeed, some researchers have suggested that the phenomenon of weight gain could result from an addictive tendency to consume food [46,47]. However, caution against merely attributing the development of this pathology to food addiction should be exercised [48]. ...
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The adolescence period is characterized by a considerable risk to weight gain due to the high consumption of food rich in sugar. A promising strategy to reduce sugar consumption may lie in exploiting the ability of our senses to interact to each other (cross-modal interactions). The aims were to investigate the cross-modal interactions and gustatory function in normal-weight and overweight adolescents. Fifty adolescents (25 overweight and 25 normal-weight) were involved. Subjects rated liking and attribute intensity in pudding samples obtained by adding vanilla aroma (0.1%; 0.3%), butter aroma (0.05%; 0.1%) or a thickener agent (1%; 1.5%) to a base formulation. The gustatory function was also measured through the “taste strips” methodology. Overweight adolescents were found to have a significantly (p < 0.001) worse ability to correctly identify all tastes. Cross-modal interactions occurred differently according to their body mass index, with a significant increase (p < 0.05) in sensory desirable characteristics (e.g., sweet and creaminess) due to aroma addition, especially in overweight subjects. Furthermore, butter aroma significantly increased hedonic responses only in overweight subjects. Tricking our senses in the way of perceiving sensory attributes could be a promising strategy to develop innovative food formulations with a reduced sugar amount, which will lead to a potential decrease in caloric intake and help to tackle the obesity epidemic.
... Further, some researchers have suggested that addictive-like responses are associated with the brain's neurochemical changes and reward systems, which suggest that some food alone can be addictive (like substances such as alcohol, tobacco, heroin, cocaine, or marijuana; Schulte et al., 2015;Schulte et al., 2016;Ziauddeen & Fletcher, 2013). Other researchers have argued that individuals with food addiction may not be addicted to all foods, rather they may be addicted to some foods that negatively impact one's overall health and well-being Davis & Carter, 2009;Davis et al., 2011;Goldstein & Volkow, 2011;Pelchat, 2009;Volkow et al., 2011). Therefore, some researchers have supported the notion that food addiction should be viewed as more of a substance use disorder as opposed to as an eating disorder. ...
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The purpose of this study was to explore Marriage and Family Therapy students’ perspectives regarding food addiction and associated eating disorders, as a clinical treatment issue. In a standard addictions course housed in a Marriage and Family Therapy program approved by the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE), 20 students completed a qualitative survey where they reflected on the topic of food addiction, Binge Eating Disorder, and Bulimia Nervosa, within the context of individual, couple, and family relationships. In the study four major themes emerged, which included (1) Defining Food Addiction, (2) Perceptions of Eating Disorders, (3) Conceptualizing Systemic Treatment, and (4) Experiences in clinical training. Clinical implications, recommendations for MFT education, clinical practice, and future research are discussed. Findings suggest that while MFT students in the study were well versed in conceptualized systemic treatment, it was of a general treatment and understanding using MFT theory, and not in relation to or specifically concerning food addictions and their connection or distinction from Binge Eating Disorder and/or other eating disorders found in the Diagnostic and Statistical Manual, potentially impacting the level of skillfully and appropriately working with clients.
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Exceso de peso en adolescentes: influencia del estrés social en el rendimiento neuropsicológico y efecto de la visualización de imágenes de alimentos en la activación cerebral y toma de riesgos.
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Obesity is a worldwide pandemic and theories propose that attentional bias (AB) for food triggers craving and overeating, especially for people with obesity. However, empirical evidence is inconsistent, which may be due to methodological diversity and the double-sided nature of high-caloric palatable foods. That is, these foods simultaneously have a high hedonic and a low health value. So, depending on context and/or emotional state, people’s 'mindset' while viewing foods may alternate between hedonic (taste) and health (calories) values, possibly affecting AB for food in opposite directions. This study tests how mindset and BMI (Body Mass Index) influences AB and food intake. We expect greater AB for food and more food intake in the hedonic compared to the health mindset, especially for people with obesity. Mindsets were induced using short video-clips in two sessions in counterbalanced order. Participants (35 with a healthy-weight-category BMI, 31 with obesity) performed a modified 'Additional Singleton' paradigm where they searched for a neutral target among neutral fillers. On 90% of the trials, either a food or a neutral distractor appeared. Response latencies to the target and eye-movements to the distractor were recorded. Dependent variables included: response latencies, and eye-movement variables on the distractor: fixations (%), 1st fixation duration, dwell-time. Food intake was assessed in a bogus taste test. No significant effects emerged from the eye-movements analysis, whereas the analysis of response latencies showed an AB for food, not significantly moderated by BMI or mindset. Food intake was affected by mindset partly as expected, as participants ate more in the hedonic than in the health mindset when the hedonic mindset was induced in the second session. One AB measure (fixations) correlated positively with food intake. Finally, food captured attention – but not the eyes – and mindset affects food intake partly as expected.
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Common consumption behaviors may become harmful to consumers. Maladaptive consumption is the result of an increase in frequency or amount of everyday, normal consumption (adaptive) behaviors, which may cause significant harm to consumers and society. The authors explore maladaptive behavior and investigate how important insights about maladaptive consumption may lie at the intersection of harm. Consequently, the discussion focuses on how marketers and policymakers, through their strategic approach, can both encourage and mitigate maladaptive behavior. Understanding the transition from adaptive to maladaptive behaviors, and the return to adaptive consumption patterns, is critical for marketers, consumer advocates and policy researchers, focused on dampening overconsumption with its corresponding harm. A discussion of the implications of maladaptive consumption on consumer health and well‐being sets the foundation for rethinking marketing practice and public policy. Finally, a set of research propositions are offered for future research. This article is protected by copyright. All rights reserved.
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Objective To evaluate the state of the literature for whether food addiction may warrant consideration as a distinct psychiatric disorder in the Diagnostic and Statistical Manual (DSM) using Blashfield et al.'s (1990; Comprehensive Psychiatry , 31 (1), 15–19) five criteria. This framework was utilized because it has recently been applied to examine the diagnostic utility of several eating disorder phenotypes. The criteria are: (a) at least 50 journal articles published on the proposed syndrome in the past 10 years; (b) proposal of diagnostic criteria and assessment measures; (c) clinician reliability in diagnosis; (d) cohesiveness of the proposed diagnostic criteria; and (e) differentiation from similar, existing diagnostic categories. Method For each criterion, a literature review was conducted to examine if the minimum qualification had been met, and key findings were discussed. Results Two of the criteria (literature and differentiation) have been empirically supported to extent specified. Two criteria (diagnostic criteria and syndrome) have been partially fulfilled, due to only having self‐report assessment measures and no examination of the odds ratios for meeting more than one symptom, respectively. Clinician reliability has not yet been evaluated. Discussion The existing literature suggests that food addiction may warrant consideration as a proposed diagnostic category in the DSM, though future research is needed to fulfill Blashfield et al.'s (1990; Comprehensive Psychiatry , 31 (1), 15–19) criteria. The development of a semi‐structured interview would be an impactful contribution for addressing these gaps.
Article
Highly palatable foods and substance of abuse have intersecting neurobiological, metabolic and behavioral effects relevant for understanding vulnerability to conditions related to food (e.g., obesity, binge eating disorder) and drug (e.g., substance use disorder) misuse. Here, we review data from animal models, clinical populations and epidemiological evidence in behavioral, genetic, pathophysiologic and therapeutic domains. Results suggest that consumption of highly palatable food and drugs of abuse both impact and conversely are regulated by metabolic hormones and metabolic status. Palatable foods high in fat and/or sugar can elicit adaptation in brain reward and withdrawal circuitry akin to substances of abuse. Intake of or withdrawal from palatable food can impact behavioral sensitivity to drugs of abuse and vice versa. A robust literature suggests common substrates and roles for negative reinforcement, negative affect, negative urgency, and impulse control deficits, with both highly palatable foods and substances of abuse. Candidate genetic risk loci shared by obesity and alcohol use disorders have been identified in molecules classically associated with both metabolic and motivational functions. Finally, certain drugs may have overlapping therapeutic potential to treat obesity, diabetes, binge-related eating disorders and substance use disorders. Taken together, data are consistent with the hypotheses that compulsive food and substance use share overlapping, interacting substrates at neurobiological and metabolic levels and that motivated behavior associated with feeding or substance use might constitute vulnerability factors for one another. This article is part of the special issue on ‘Vulnerabilities to Substance Abuse’.
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Evolutionary medicine is a concept that arose mainly in the 1990s, and which applies evolutionary biological principles to human medical fields. For instance, evolutionary medicine proposed that there is an evolutionary mismatch between the human anatomy and physiology and novel, man‐made environments, leading to the so‐called diseases of civilization. Constraints exist on the process of natural selection, and evolutionary trade‐offs can prevent traits from being optimal, leaving humans with traits that at first sight seem maladaptive, such as the very narrow birth canal of humans. More generally, certain traits can increase reproduction at the cost of health and longevity. Other traits, such as pain and fever, are related to protective physiological defences, and not diseases. Some medical topics have biological roots in the field of ethology, particularly human ethology, such as the behavioural aspects of psychiatry and addiction. Compulsive overeating and binge eating show similarities to substance‐linked addictions and behavioural addictions. Interactions between behaviour, stress and diseases have ancient evolutionary roots, which may lead to a mismatch to the modern human environment. A subject of high, topical interest is the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pandemic, as the behavioural aspects of population compliance are crucial for the success in fighting the pandemic. Ethology, and evolutionary biology in general, can substantially contribute to improving the biological understanding of medical phenomena, and therefore of medical and public health interventions. This applies not only to research but also to education.
Chapter
The idea of food addiction (FA) has grown in popularity over the last half a century, as a result, in part, of the increasing amount of published research showing the common neurobiological, behavioral, and psychological mechanisms behind compulsive consumption of highly palatable (HP) foods, such as those high in fat and sugar, and the use of addictive drugs. Increasingly, research shows that, similar to what is seen in substance use disorders (SUD), there is a cyclical nature underlying syndromes characterized by food overconsumption, wherein “addictive” food triggers overuse which causes further changes in the brain that lead to escalation of use (Gordon et al. Nutrients 10(4):477, 2018; Carter et al. Annu Rev Nutr 36:105–128, 2016; Volkow et al. Obes Rev. 14(1):2–18, 2013) (Chaps. 6, 7, 8, 9, and 11). Despite the massive amount of research showing parallels between traditional “addiction” models to describe substance use and some forms of overeating, the FA construct remains controversial and highly debated (Gordon et al. Nutrients 10(4):477, 2018; Gordon et al. Curr Nutr Rep. 9(2):75–82, 2020; Meule. Curr Obes Rep 8(1):11–17, 2019; Ziauddeen et al. Nat Rev Neurosci 13(4):279–286, 2012; Burrows et al. Nutrients 12(9):2860, 2020; Wiss and Brewerton. Nutrients 12(10):2937, 2020; Hauck et al. Proc Nutr Soc 9(1):103–112, 2020; Lacroix et al. Appetite. 130:286–292, 2018). The arguments against it fall into one of two categories: that of validity (is the FA construct real) and that of utility (if FA is a valid concept, is it necessary or helpful for the improvement of human health and well-being) (Meule. Curr Obes Rep 8(1):11–17, 2019; Rogers. Pharmacol Biochem Behav 153:182–190, 2017). There are several key arguments against widespread adoption of the FA model, followed by arguments supporting the validity and utility of the FA concept, and some possible promises for the future. Regardless, because of increasing community acceptance, providers need to have some base knowledge about FA.
Article
Many of the various factors, characteristics, and variables involved in the addictive process can determine an individual's vulnerability to develop drug addiction. Hedonic eating, based on pleasure rather than energy needs, modulates the same reward circuits, as do drugs of abuse. According to the last report of the World Health Organization, the worldwide obesity rate has more than doubled since 1980, reaching especially critical levels in children and young people, who are overexposed to high-fat, high-sugar, energy-dense foods. Over the past few decades, there has been an increase in the number of studies focused on how eating disorders can lead to the development of drug addiction and on the comorbidity that exists between the two disorders. Herein, we review the most recent research on the subject, focusing especially on animal models of binge eating disorders and drug addiction. The complex profile of patients with substance use and binge eating disorders requires an integrated response to dually diagnosed patients. Nutritional patterns should be considered an important variable in the treatment of substance use disorders, and future studies need to focus on specific treatments and interventions in individuals who show a special vulnerability to shift from one addiction to the other.
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Binge eating is a behavioral component of some eating disorders, and it is also noted in overweight and obese as well as nonclinical populations. Given its increasing prevalence in society, understanding the behavioral, physiological, and neurochemical components of binge eating is important. Both sugars and fats have been identified as common macronutrients consumed by humans during binge-eating episodes and are thus of interest to study. This chapter describes animal models of sugar and fat bingeing as well as the combination of sugar and fat, which allow for a detailed analysis of these behaviors and their concomitant physiological effects. These particular models of binge eating have been shown to elicit behavioral and neurochemical signs of drug-like dependence in rats, including indices of opiate-like withdrawal, increased intake after abstinence, cross-sensitization with drugs of abuse, and the repeated release of dopamine in the nucleus accumbens following repeated bingeing. These findings support the hypothesis that some palatable foods may have addiction potential when they are consumed in excess.
Article
Background In the context of obesity, little is known about the prevalence of food addiction nor about the phenotype of obese patients with food addiction. Objectives: To assess: (i) the prevalence of food addiction among obese patients eligible for obesity surgery; (ii) the relationship between clinical features and the complications of obesity. Methods: Consecutive patients consulting for the first time were included. The Yale Food Addiction Scale (YFAS) 2.0 questionnaire was used to diagnose food addiction and its severity. Demographics, clinical features, and obesity complications were systematically collected. Statistics: Student's test was used for numerical variables and Chi-square test or Fisher’s exact test for categorical variables. Results: A total of 292 patients were included: 79% female, age (mean ± SD) 42.6 ± 13.0 yrs., body mass index (BMI) 43.2 ± 6.8 kg/m². One hundred and eight patients (37%) had food addiction: 58% severe, 33% moderate, 9% mild. Food addiction prevalence was 39% (n = 61/156) among patients eligible for obesity surgery. Food addiction was more frequent among the unemployed, compared to professionally active patients (41.0% vs. 33.5%, p = 0.046). Clinical and metabolic phenotypes and obesity complications were similar between patients with and without food addiction. Conclusion: Food addiction was present in 37% of obese patients, but was not associated with clinical features or obesity complications. Therefore, it should be systemically assessed for appropriate management.
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Dynamic changes in modern society generate new situations in the lives of believers, which require pastoral care. The Church should respond to the spiritual needs of all those in need, but with the decreasing number of ordained priests in Europe, organizational capacity in this part of the world is becoming increasingly limited. This article is an attempt to respond to the above problems and, using the example of the Catholic Church in Poland, shows the possibility of instilling a model of self-help groups for specialist pastoral care involving people experiencing life crises and wanting more intense religious development.
Article
Effort-based decision-making provides a framework to understand the mental computations estimating the amount of work ("effort") required to obtain a reward. The aim of the current review is to systematically synthesize the available literature on effort-based decision-making across the spectrum of eating and weight disorders. More specifically, the current review summarises the literature examining whether 1) individuals with eating disorders and overweight/obesity are willing to expend more effort for rewards compared to healthy controls, 2) if particular components of effort-based decision-making (i.e. risk, discounting) relate to specific binge eating conditions, and 3) how individual differences in effort and reward -processing measures relate to eating pathology and treatment measures. A total of 96 studies were included in our review, following PRISMA guidelines. The review suggests that individuals with binge eating behaviours 1) are more likely to expend greater effort for food rewards, but not monetary rewards, 2) demonstrate greater decision-making impairments under risk and uncertainty, 3) prefer sooner rather than delayed rewards for both food and money, and 4) demonstrate increased implicit 'wanting' for high fat sweet foods. Finally, individual differences in effort and reward -processing measures relating to eating pathology and treatment measures are also discussed.
Chapter
In preceding chapters we have established that the food addiction (FA) construct is valid and useful, and we reviewed the extensive neurobiological evidence that highly palatable (HP) food operates on brain reward pathways in a similar manner as substances of abuse. Now we will shift our discussion to more practical questions about FA, namely, why it is important to consider an underlying diagnosis of FA in our patients with food-related complaints, how to identify and diagnose FA, and what we can do to treat it. In this chapter, we will first speak to why it is important to screen and evaluate for it, given its epidemiology and associated comorbidities. Then we will talk about how to assess for FA. Finally, we will make suggestions about what additional information should be gathered in the initial assessment interviews. In Chaps. 13 and 14, we will discuss treatment options.
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Highest rates of obesity and diabetes in the United States are found among the lower-income groups. The observed links between obesity and socioeconomic position may be related to dietary energy density and energy cost. Refined grains, added sugars, and added fats are among the lowest-cost sources of dietary energy. They are inexpensive, good tasting, and convenient. In contrast, the more nutrient-dense lean meats, fish, fresh vegetables, and fruit generally cost more. An inverse relationship between energy density of foods (kilojoules per gram) and their energy cost (dollars per megajoule) means that the more energy-dense diets are associated with lower daily food consumption costs and may be an effective way to save money. However, economic decisions affecting food choice may have physiologic consequences. Laboratory studies suggest that energy-dense foods and energy-dense diets have a lower satiating power and may result in passive overeating and therefore weight gain. Epidemiologic analyses suggest that the low-cost energy-dense diets also tend to be nutrient poor. If the rise in obesity rates is related to the growing price disparity between healthy and unhealthy foods, then the current strategies for obesity prevention may need to be revised. Encouraging low-income families to consume healthier but more costly foods to prevent future disease can be construed as an elitist approach to public health. Limiting access to inexpensive foods through taxes on frowned upon fats and sweets is a regressive measure. The broader problem may lie with growing disparities in incomes and wealth, declining value of the minimum wage, food imports, tariffs, and trade. Evidence is emerging that obesity in America is a largely economic issue.
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"The reward cascade" is the release of serotonin, which in turn at the hypothalamus stimulates enkephalin, which in turn inhibits gamma-aminobutyric acid (GABA) at the substantia nigra, which in turn fine tunes the amount of dopamine (DA) released at the nucleus accumbens or "reward site." When DA is released into the synapse, it stimulates a number of DA receptors which results in increased feelings of well-being and stress reduction. It is suggested that when there is a dysfunction in the brain reward cascade, especially in the DA system causing a hypodopaminergic trait, the brain of that person requires a DA fix to feel good. This trait leads to multiple drug-seeking behavior. This is so because alcohol, cocaine, heroin, marijuana, nicotine, and glucose all cause activation and neuronal release of brain DA, which could heal the abnormal cravings. The lack of D₂ receptors causes individuals to have a high risk of multiple addictive, impulsive and compulsive behavioral propensities, such as severe alcoholism, cocaine, heroin, marijuana and nicotine use, glucose bingeing, pathological gambling, sex addiction, attention deficit hyperactivity disorder (ADHD), Tourette's syndrome, autism, chronic violence, posttraumatic stress disorder (PTSD), schizoid/avoidant cluster, conduct disorder, and antisocial behavior. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The paper traces the different history of the concept of addiction in relation to the use of opiates from its history in relation to the use of nicotine. Addiction had its origin in the 19th century, specifically through the concept of inebriety, so far as opium was concerned. For nicotine, the concept of addiction is a more recent arrival. The paper identifies a number of factors which have contributed to the different trajectories. These include different roles within popular culture and consumption; and the establishment of policy round the acceptance of addiction for drugs as early as the 1920s. Smoking, by contrast, remained on the fringes of the ‘medical model’ at that time. Different concepts were subsequently supported by different medical coalitions. There has, in the post-war period, been psychiatric ownership of drug addiction by comparison with the initial public health/epidemiologic route for smoking. The paper argues that recent events—AIDS for drug use and the concepts both of passive smoking and of addiction for smoking, are bringing the public health and addiction constituencies closer together for both substances. © 1997 John Wiley & Sons, Ltd.
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This article describes how recent advances in understanding the evolutionary functions of emotions can help to reconcile diverse approaches to substance abuse. Emotions can be understood as specialized states that prepare individuals to cope with opportunities and threats. Drugs that artificially induce pleasure or block normal suffering disrupt these evolved mechanisms, and thus should tend to interfere with adaptive behavior, even if the drugs are medically safe. Nonetheless, we routinely use drugs quite safely to block defenses like pain, cough, and anxiety. This apparent contradiction is explained by the relatively small costs of defenses compared to the potentially huge costs of not expressing a defensive response when it is needed. An evolutionary perspective has implications for substance abuse research, treatment, and social policy. This perspective suggests that the search for etiology needs to address the human tendency to abuse drugs separately from individual differences in these tendencies, that clinical treatments that take account of the broad range of patients' emotional life are well justified, and that social policies need to address substance use and abuse not as diseases to be cured but as human tendencies that need to be managed. To prepare for future drugs that will likely alter emotions safely, we urgently need a better understanding of the adaptive function of the emotions.
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Many attribute the rise in obesity since the early 1980's to the overconsumption of fast food. A dynamic model of a different-product industry equilibrium shows that a firm with market power will price below marginal cost in a steady-state equilibrium. A spatial hedonic pricing model is used to test whether fast food firms set prices in order to exploit their inherent addictiveness. The results show that firms price products dense in addictive nutrients below marginal cost, but price products high in nonaddictive nutrients higher than would be the case in perfect competition.
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Cognitive-behavioral therapy (CBT) is applicable to all eating disorders but has been most intensively studied in the treatment of bulimia nervosa (BN). CBT is designed to alter abnormal attitudes about body shape and weight, replace dysfunctional dieting with normal eating habits, and develop coping skills for resisting binge eating and purging. CBT is effective in reducing all core features of BN and shows good maintenance of therapeutic improvement. Although superior to therapy with antidepressant drugs, CBT has not been shown to be consistently superior to alternative psychological treatments. Different hypotheses about CBT's mechanisms of action are discussed.
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Many of the studies linking anorexia nervosa and bulimia nervosa to substance use disorders suffer from problems with small samples; some lack rigorous definitions of the syndromes, and it is difficult to determine whether eating problems were primarily temporary consequences of heavy substance use or drugs were temporarily used in an effort to control appetite. The goal of this study was to evaluate the relationship between alcohol dependence and eating disorders. Structured interviews were carried out with 2,283 women and 1,982 men as part of the Collaborative Study on the Genetics of Alcoholism. Data on drug abuse and dependence, psychiatric disorders, and symptoms of anorexia and bulimia were evaluated among alcohol-dependent probands, their relatives, comparison probands, and their relatives. Lifetime rates for anorexia and bulimia were 1.41% and 6.17%, respectively, for the alcohol-dependent women, and bulimia was observed in 1.35% of the alcoholic men. However, once the impact of additional primary diagnoses was controlled for, anorexia was seen in only 1.26% of the women with primary alcohol dependence and none of the alcohol-dependent men; the rates for bulimia were 3.46% and 0.72%, respectively. There was no evidence of a strong familial crossover between alcohol dependence and anorexia or bulimia. While the rate of anorexia was not elevated in alcoholics after controlling for other disorders, bulimia did occur at a greater than expected rate. However, both eating disorders were relatively rare, and much of the association with alcoholism occurred in the context of additional preexisting or secondary psychiatric disorders.