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Food addiction has been widely researched in past years. However, there is a debate on the mechanisms underlying addictive eating and a better understanding of the processes associated to these behaviors is needed. Previous studies have found characteristic psychological correlates of food addiction, such as high negative urgency, emotion regulation difficulties and low self-directedness, in different samples of adults with addictive eating patterns. Still, it seems difficult to disentangle effects independent from general eating disorder psychopathology. Therefore, this study aimed to test a comprehensive model under control of eating disorder severity, in order to find independent predictors of food addiction.
315 patients with eating disorder diagnoses on the binge-eating spectrum were assessed in personality, emotion regulation, negative urgency, eating disorder symptomatology, and food addiction by self-report. Hypothesis-driven structural equation modeling was conducted to test the comprehensive model.
The only independent predictor found for food addiction was negative urgency, while self-directedness and emotion regulation predicted negative urgency and were highly related to eating disorder symptomatology, but not to food addiction.
Altogether the model suggests that low self-directedness and difficulties in emotion regulation are related to higher eating disorder symptomatology in general. Those patients who, in addition to these traits, tend to act impulsively when in negative mood states, are at risk for developing addictive eating patterns. Urgency-based treatments are therefore recommended for this subgroup of patients.
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... The second model (UPPS-P) entails a multidimensional measure addressing five impulsive dispositions consisting of (1) urgency, a predisposition to strong impulses which may come along with negative affect, (2) lack of premeditation, the trouble recognizing potential consequences of a situation or action prior to proceeding to it, (3) lack of perseverance, the incapacity of staying focused on an arduous task, (4) sensation seeking, i.e., participating in precarious novel or stimulating activities, and lastly (5) positive urgency, a dimension that was added later and relates to having strong responses in highly positive emotional settings . When examining the literature, higher rates of impulsivity have been linked to obesity and eating disorders (EDs) such as bulimia nervosa (BN) and binge-eating disorder (BED) , which, in turn, have a higher likelihood of comorbidity with substance use disorders (SUDs) as well as behavioral addictions [14•, 15•]. Additionally, over the years, one concept which has been viewed as rather similar to both EDs and addictive patterns, is that of food addiction (FA) [16,17]. ...
... The self-report instrument which is used to determine FA using the DSM-5 criteria is the Yale Food Addiction Scale 2.0 (YFAS), which was created to offer a validated questionnaire for addictive-like eating behaviors . Studies have shown that individuals with higher YFAS scores are also more impulsive, especially in terms of negative urgency, motor impulsivity, and a lack of perseverance [13,22]; these traits are also found in individuals with obesity . Additionally, there are also other adaptations of this scale, the mYFAS 2.0 (short version), and YFAS-C (version for children) [26,27]. ...
... The concepts of "urgency" (negative and positive, i.e., emotional impulsivity, tendency to act suddenly when experiencing extreme emotions)  and "lack of perseverance" (i.e., cognitive impulsivity, inability to sustain attention and motivation to complete tasks) [1,22,41,42] have been described as relevant in the context of FA in several studies. Thus, individuals with FA may be more likely to act instantaneously by choosing immediate gratification with food rather than waiting, especially in situations of inconsistency between their personal needs and the present condition [1,13,32,43,44]. Difficulties in regulating negative (or positive) emotional states cause food intake, with impulsivity being the mediator of this link in individuals with FA . ...
Food addiction (FA) has been found to be associated with impulsivity, mainly urgency (negative and positive) and lack of perseverance. The present systematic review aimed to identify differences in impulsivity by gender and current implications of treatment regarding FA and impulsivity in clinical populations. The search was conducted in PubMed, Scopus, and Web of Science (WOS) databases, using the following search terms: “food addiction” and “impuls*.” Studies were included if they were written in English, had an observational design (e.g., cross-sectional, longitudinal, case-control), and used a quantitative methodology, without a limited search period to avoid selection bias.
We included twenty-nine articles that aimed to examine whether there is a relationship between FA and impulsivity in clinical populations. Looking at gender differences, attentional and motor impulsivity were found to be related to FA in samples of women with obesity, whereas in the only study in a sample of men with obesity, cognitive and non-planning impulsivity appeared to be more associated with FA. Moreover, we identified three studies on the effects of interventions which included motivational, psychosocial, nutritional, and mindfulness components to address impulsivity and FA in cohorts with overweight/obesity and with substance use disorder (SUD). While some studies reported decreased levels of impulsivity, in other studies only FA decreased, and only one study showed significant changes in both FA and impulsivity after treatment.
Further research is needed to better understand the association between impulsivity and FA. Specifically, more studies with male populations could provide further evidence on how to better tailor treatment designs.
... Despite the scientifically accepted differences between substance abuse disorders and eating disorders, the concept of food "addiction" has been widely adopted by some scientists and the lay press [13,. One basis for this concept comes from a limited number of animal studies . ...
... Brain dopamine, however, was stimulated in patterns similar to those elicited by drugs of abuse . Weight gain was not typically observed . As noted by Markus et al.  " . . . ...
... Review articles both support and counter the concept [12,15,21,24,26,30,31,. Human dietary studies do not, however, support the conclusion that a particular micronutrient or taste such as sugar or low calorie sweeteners cause binge eating and/or weight-gain more so than other food sources . ...
The notion of food “addiction” often focuses on the overconsumption of sweet tasting foods or so-called sugar “addiction”. In the extreme, some have suggested that sugar and sweet tastes elicit neural and behavioral responses analogous to those observed with drugs of abuse. These concepts are complicated by the decades long uncertainty surrounding the validity and reproducibility of functional magnetic resonance imaging (fMRI) methodologies used to characterize neurobiological pathways related to sugar and sweet taste stimuli. There are also questions of whether sweet taste or post-ingestion metabolic consequences of sugar intake would lead to addiction or excessive caloric intake. Here, we present a focused narrative review of literature related to the reward value of sweet taste which suggests that reward value can be confounded with the construct of “addictive potential”. Our review seeks to clarify some key distinctions between these constructs and questions the applicability of the addiction construct to human over-eating behaviors. To adequately frame this broad discussion requires the flexibility offered by the narrative review paradigm. We present selected literature on: techniques used to link sugar and sweet tastes to addiction neurobiology and behaviors; sugar and sweet taste “addiction”; the relationship of low calorie sweetener (LCS) intake to addictive behaviors and total calorie intake. Finally, we examined the reward value of sweet tastes and contrasted that with the literature describing addiction. The lack of reproducibility of fMRI data remains problematic for attributing a common neurobiological pathway activation of drugs and foods as conclusive evidence for sugar or sweet taste “addiction”. Moreover, the complicated hedonics of sweet taste and reward value are suggested by validated population-level data which demonstrate that the consumption of sweet taste in the absence of calories does not increase total caloric intake. We believe the neurobiologies of reward value and addiction to be distinct and disagree with application of the addiction model to sweet food overconsumption. Most hypotheses of sugar “addiction” attribute the hedonics of sweet foods as the equivalent of “addiction”. Further, when addictive behaviors and biology are critically examined in totality, they contrast dramatically from those associated with the desire for sweet taste. Finally, the evidence is strong that responses to the palatability of sweets rather than their metabolic consequences are the salient features for reward value. Thus, given the complexity of the controls of food intake in humans, we question the usefulness of the “addiction” model in dissecting the causes and effects of sweet food over-consumption.
... Food addiction and NSSI -6higher emotion dysregulation amongst individuals with an ED (Gearhardt et al., 2012;Pisetsky, Haynos, Lavender, Crow, & Peterson, 2017;Wolz, Granero, & Fernández-Aranda, 2017). Likewise, affective instability has been linked to dysregulated eating behaviors (i.e. ...
... Food addiction and NSSI -7commonly reported difficulties in emotion regulation in both conditions (Gearhardt et al., 2012;Vieira et al., 2017). There is also evidence for the presence of impulsivity in individuals with FA and NSSI, further suggesting a potential association between these behaviors (Wolz, Granero, & Fernández-Aranda, 2017). Furthermore, emotion dysregulation is also likely to serve as a mediator in the relationship between NSSI and FA. ...
... Previously established associations between NSSI and binge-type ED, increased exhibition of dysregulated behavior amongst individuals with NSSI and ED, and an overlap between FA and binge-type disorders are indicative of several overlaps across behaviors (Gearhardt et al., 2012b;Islam et al., 2015;Steward et al., 2018;Vieira et al., 2017;Wolz, Granero, & Fernández-Aranda, 2017). Furthermore, emotion dysregulation can be considered as a common trait among individuals with NSSI and FA (Muehlenkamp et al., 2012;Wolz et al., 2016;Yurkowski et al., 2017). ...
We examined the association between lifetime nonsuicidal self‐injury (NSSI), emotion regulation, and food addiction (FA) in women (n = 220) with eating disorders (ED) compared with (n = 121) healthy controls (HC).
Participants were assessed via face‐to‐face interviews for ED diagnosis and lifetime NSSI. FA was assessed with Yale Food Addiction Scale 2.0 and emotion regulation using the Difficulty in Emotion Regulation Scale (DERS).
The prevalence of FA was significantly higher among women with an ED when compared with HC (75.9% vs. 4.1%, p < 0.001). Similarly, subjects presenting FA showed a high prevalence of lifetime NSSI, in both ED and HC (40.7% and 60.0%, respectively). Our predictive model revealed FA and DERS total scores as indicators of the presence of lifetime NSSI independent of group assignment, ED diagnosis, and age.
These findings suggest a shared aetiology between ED, NSSI, and FA, explained possibly in part by emotion‐regulation deficits.
... In this regard, negative urgency has been associated with food addiction [20, and grazing behaviors  and refers to the tendency to take impulsive actions in response to negative emotional states . Thus, in the presence of intense emotional states, individuals with higher levels of impulsivity make quicker decisions regarding food cues, engaging in addictive and problematic eating behaviors to avoid feelings such as anxiety or physical withdrawal symptoms. ...
... In this regard, negative urgency has been associated with food addiction [20, and grazing behaviors  and refers to the tendency to take impulsive actions in response to negative emotional states . Thus, in the presence of intense emotional states, individuals with higher levels of impulsivity make quicker decisions regarding food cues, engaging in addictive and problematic eating behaviors to avoid feelings such as anxiety or physical withdrawal symptoms. ...
University students are a vulnerable population to the development of disordered eating, such as food addiction (FA) and grazing. FA is an emerging concept characterized by an intense desire to eat hyper-palatable foods. Grazing is characterized by the repetitive and unplanned inges-tion of food throughout a period of time. Both FA and grazing have been associated with increased scores of negative urgency (NU) and difficulties in emotion regulation (ER). This study aims to evaluate the frequency of FA and grazing in a university population and to test the direct, total, and indirect effects-via FA-of ER and NU on repetitive eating and compulsive grazing. A total of 338 participants responded to a set of psychological measures assessing these variables. Thirty-six (10.7%) participants met the criteria for FA diagnosis and 184 (54.4%) presented grazing. Confirm-atory factor analysis showed acceptable fit indexes for the model tested (χ 2 (1695) = 3167.575; p < 0.001; CFI = 0.955; NFI = 0.908; TLI = 0.953; SRMR = 0.085; RMSEA = 0.051; CI 90% (0.048; 0.053); P[RMSEA ≤ 0.05] = 0.318) and suggested that FA partially mediated the effect of difficulties in ER and NU on grazing, specifically on compulsive grazing. The results indicate that individuals with difficulties in ER and impulse control under negative emotions are more likely to engage in grazing if food addiction scores are higher. These results highlight the importance of assessing these variables, particularly in at-risk populations such as university students.
... Food addiction (FA) is a developing construct, which refers to an overconsumption of highly palatable food sustained by addictive processes 24 . It is highly prevalent (25-30%) in individuals with overweight/obesity 25 and it is associated with high levels of impulsivity 3, . Besides, FA has been described as a mediator of the association between impulsivity and obesity 5 and postulated to share similar neural mechanisms with other addictions (e.g.: greater activation of striatal regions to food/drug cues)  . ...
... However, the decrease of BMI and the improvement of some impulsivity features (negative urgency and inhibitory control) were higher for the patients in the intervention group. As previously stated, it has to be noted that negative urgency is an impulsivity trait highly linked to addictive behaviours, such as FA 27 . Thus, the changes found within these variables reinforce the usefulness of an intensive multimodal psychosocial intervention (promoting a healthy dietary pattern such as the Mediterranean diet, physical activity and behavioural-motivational support) not only on reducing obesity as a risk factor for MetS and cardiovascular diseases 48,91 , but also on decreasing impulsivity and FA (source of distress and highly linked to obesity 3,43 ). ...
This study examines if overweight/obesity are related to higher impulsivity, food addiction and depressive symptoms, and if these variables could be modified after 1 year of a multimodal intervention (diet, physical activity, psychosocial support). 342 adults (55–75 years) with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus Cognition study were randomized to the intervention or to the control group (lifestyle recommendations). Cognitive and psychopathological assessments were performed at baseline and after 1-year follow-up. At baseline, higher impulsivity was linked to higher food addiction and depressive symptoms, but not to body mass index (BMI). Food addiction not only predicted higher BMI and depressive symptoms, but also achieved a mediational role between impulsivity and BMI/depressive symptoms. After 1 year, patients in both groups reported significant decreases in BMI, food addiction and impulsivity. BMI reduction and impulsivity improvements were higher in the intervention group. Higher BMI decrease was achieved in individuals with lower impulsivity. Higher scores in food addiction were also related to greater post-treatment impulsivity. To conclude, overweight/obesity are related to higher impulsivity, food addiction and depressive symptoms in mid/old age individuals with MetS. Our results also highlight the modifiable nature of the studied variables and the interest of promoting multimodal interventions within this population.
... The growing affordability and availability of highly-palatable foods (i.e., foods high in fats, salts, and sugars), representative of our current obesogenic environment, may be one contributing factor to the rising obesity rates (Power, 2012). These foods have been shown to elicit addictive-like responses similar to drugs of abuse (e.g., Volkow et al., 2017;Wolz et al., 2017), which may leave some individuals vulnerable to weight gain driven by the overconsumption of these foods (Lowe et al., 2020). However, despite the abundance of highly-palatable foods and rising obesity rates, marked differences exist in the extent to which some individuals will consume these foods (e.g., from occasional snacking, through to binge eating and food addiction [FA]; Davis, 2013). ...
... Negative urgency is associated with emotional eating, more frequent binge eating episodes, and perceived loss of control over eating (Pink et al., 2019;Rose et al., 2018;Van Malderen et al., 2020b). As studies have also consistently found a relationship between negative urgency and FA in adults (Steward et al., 2018;Wolz et al., 2017), this suggests the predisposition to engage in rash, impulsive actions when experiencing a negative emotional state may be a key factor contributing to the development and maintenance of FA. These findings may be particularly pertinent for adolescence as this developmental period is also characterised by heightened emotional sensitivity and significant emotional dysregulation (Cracco et al., 2017). ...
Adolescence represents a neurodevelopmental period characterised by heightened reward drive and weaker inhibitory control, that may increase vulnerability to compulsive overconsumption of highly-palatable foods and food addiction. This narrative review aimed to summarise research investigating the presence of food addiction in adolescents and establish the role that impulsivity traits (i.e., reward sensitivity and rash impulsivity), previously linked to substance and behavioural addictions, play in contributing to food addiction in this cohort. It was found that the prevalence of food addiction was typically higher in studies that recruited adolescents who were overweight/obese or from clinical populations. Overall, impulsivity was found to be more consistently associated with food addiction, while the relationships between measures of reward sensitivity and food addiction were mixed. Findings of this review suggest trait impulsivity may contribute to food addiction in adolescents, however, further longitudinal and prospective research is recommended to confirm these findings and to investigate the potential interactive effects of reward sensitivity and rash impulsivity.
... Negative urgency is recognizable in children as early as 5th grade and prospectively predicts high school binge eating , which in turn predicts BED in adulthood . Individuals with BED endorse heightened negative urgency compared with controls  and comparable to other eating disorders characterized by binge eating . Importantly, negative urgency level adversely impacts treatment response in individuals with BED , indicating the potential utility of early assessment. ...
... The possibility of food addiction is supported by findings of neurocognitive similarities between BED and substance use disorders, including impaired inhibitory control and reward sensitivity, particularly related to food cues . Recent studies suggest that overlap between food addiction and BED may be explained in part by personality and emotion-based factors, including negative urgency . Notably, there are limitations to the food addiction hypothesis, including the absence of evidence demonstrating food withdrawal or tolerance, as in substance use disorders , and assessments based entirely on self-report . ...
Purpose of Review
Binge eating disorder (BED) is characterized by recurrent binge eating episodes (i.e., eating an objectively large amount of food accompanied by a sense of loss of control while eating) in the absence of regular compensatory behavior. BED follows a chronic course marked by significant dysfunction and impairment. This review focuses on advances in the understanding of BED, including its diagnosis, correlates, risk factors, and treatment, with particular attention to the past 5 to 8 years.
BED remains the most common eating disorder in the USA and globally. BED occurs across the lifespan and among diverse gender, racial, and ethnic groups. Risk for and maintenance of BED results from multiple psychological, biological, and sociocultural factors. First-line treatment for reducing binge eating is cognitive behavioral therapy, with efficacy for interpersonal psychotherapy as well. Lisdexamfetamine is an FDA-approved medication for moderate to severe cases of BED.
Even with advances in its diagnosis and treatment, better assessment and understanding of BED in diverse gender, racial, and ethnic populations is needed. Studies of shared risk factors underlying BED and comorbid disorders may lead to a greater understanding of mechanisms for intervention. Future research should prioritize evaluating the implementation of established treatments among populations in need, as well as establishing new interventions that can be scaled for delivery in real-world settings. Given overlap between BED and overweight/obesity, a continued focus on developing treatments that effectively address binge eating and weight management is warranted.
... Negative urgency has been strongly implicated in the maintenance of BN (Fischer et al. 2013), and in a community sample of adults with BED versus controls (n ¼ 151), the BED group had significantly higher levels of negative urgency (Kenny et al. 2018). However, a recent study found that negative urgency predicted FA independent of eating disorder symptomatology in a large sample of individuals with diagnoses of binge-eating disorders (Wolz et al. 2017). It has been suggested that negative urgency has a biological basis associated with low serotonin and high DA (Wolz et al. 2017). ...
... However, a recent study found that negative urgency predicted FA independent of eating disorder symptomatology in a large sample of individuals with diagnoses of binge-eating disorders (Wolz et al. 2017). It has been suggested that negative urgency has a biological basis associated with low serotonin and high DA (Wolz et al. 2017). Positron emission tomography (PET) data has shown that both BN and BED are associated with abnormalities in the serotonergic system (Majuri et al. 2017;Kaye et al. 1998). ...
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, compared to the FA group, the BED + FA group exhibited greater deficits in emotion dysregulation, more severe emotional eating, and more severe cases of FA than those with only FA. Consistent with previous studies , these results imply that the observed differences relate to more severe symptoms in the case of comorbidity. These findings support our hypothesis that patients in the BED + FA group have more emotional eating and emotional dysregulation than those in the OB and FA groups. ...
Abstract Background Problematic eating behaviors can indicate obesity-related problems. Food addiction (FA) is not classified as an official diagnosis. However, given the many commonalities between FA and binge-eating disorder (BED) within the context of obesity, it is imperative to conduct a comparative investigation. The current study aimed to identify overlapping and distinctive features in emotion dysregulation as an underlying mechanism and emotional eating as a clinical feature among four groups of females with obesity seeking bariatric surgery. Methods Data on emotion dysregulation and emotional eating were derived from the total 128 Females with obesity seeking bariatric surgery (M age = 38.91 ± 10.59, M BMI = 42.10 kg/m2 ± 4.43) divided into four groups: those with FA (n = 35), BED (n = 35), BED + FA (n = 31) and a control group of individuals with obesity only (OB; n = 27), using well-established measures. Results Regarding descriptive statistics, the BED + FA group showed the highest levels of emotional dysregulation (M = 111.09) and emotional eating (M = 46.80), while the OB group acquired the lowest scores (M = 70.44 and M = 27.29, respectively). Univariate analyses of variance revealed significant differences between the four groups in terms of emotion dysregulation F(3, 124) = 24.63, p
... However, Carr et al. (2021) identified insufficient studies addressing compulsivity, and both reviews reported inconsistent evidence in impulsivity domains. This may illustrate the limited utility of impulsivity and compulsivity as umbrella constructs to understand cognitive functioning in BED, as distinct from the well-established relationship between trait impulsivity, in particular negative urgency, and binge eating (Aloi et al., 2020a;Fischer et al., 2008;George et al., 2022;Heather, 2017;Hogarth, 2020;Racine et al., 2015;Sharma et al., 2014;Wolz et al., 2017). Thus, prior reviews have failed to disambiguate research findings, or explain how disparate cognitive functions might integrate in BED symptomology. ...
Binge-Eating Disorder (BED) involves anticipatory craving and urges, subjective loss-of-control during binge-eating episodes, and post-feeding psychological distress and guilt. Evidence indicates neurocognitive dysfunctions contribute to BED onset, maintenance, and treatment response. However, an integrated understanding of how cognitive processes underpin BED symptomology is lacking. We utilised a multi-stage decision-making model defining ten cognitive processes underpinning Preference Formation, Choice Implementation, Feedback Processing, and Flexibility/Shifting, to comprehensively review research published since 2013. We used preregistered PICOS criteria to assess 1,966 articles identified from PubMed, PsycInfo, and Scopus database searches. This yielded 50 studies reporting behavioural cognitive tasks outcomes, comparing individuals with BED to controls with normal and higher weight. Meta-analyses revealed a unique profile of cognitive dysfunctions that spanned all decision-making stages. Significant deficits were evident in Uncertainty Evaluation, Attentional Inhibition, Choice Consistency, and Cognitive Flexibility/Set-shifting. We propose a novel model of dysfunctional decision-making processes in BED and describe their role in binge-eating behaviour. We further highlight the potential for cognitive interventions to target these processes and address the significant treatment gap in BED.
... This evidence corroborates our findings, indicating that the RGS9 gene may be involved in the rewardrelated pathways related to palatable foods, and thus supports its association with sweet food liking. The concept of sweet food liking being an addictive trait in humans is not new; several review articles both support and refute the notion [37,. Future research should endeavour to explore differences in reward-related signalling in humans when presented with palatable foods, based on the rs58931966 genotype, in order to determine the applicability of our findings in disease management. ...
Genetics plays an important role in individual differences in food liking, which influences food choices and health. Sweet food liking is a complex trait and has been associated with increased body mass index (BMI) and related comorbidities. This genome-wide association study (GWAS) aimed to investigate the genetics of sweet food liking using two adult discovery cohorts (n = 1109, n = 373) and an independent replication cohort (n = 1073). In addition, we tested the association of our strongest result on parameters related to behaviour (food adventurousness (FA) and reward dependence (RD) and health status (BMI and blood glucose). The results demonstrate a novel strong association between the Regulator of G-Protein Signalling 9 (RGS9I) gene, strongest single nucleotide polymorphism (SNP) rs58931966 (p-value 7.05 × 10−9 in the combined sample of discovery and replication), and sweet food liking, with the minor allele (A) being associated with a decreased sweet food liking. We also found that the A allele of the rs58931966 SNP was associated with decreased FA and RD, and increased BMI and blood glucose (p-values < 0.05). Differences were highlighted in sex-specific analysis on BMI and glucose. Our results highlight a novel genetic association with food liking and are indicative of genetic variation influencing the psychological–biological drivers of food preference. If confirmed in other studies, such genetic associations could allow a greater understanding of chronic disease management from both a habitual dietary intake and reward-related perspective.
... Two issues may contribute to this association: (1) lack of control over eating and (2) weight stigma. Self-control skills could be a potential explanation for the association  because lack of self-control can result in impulsivity and contribute to food addiction . Psychological distress (e.g., resulting from receiving negative information from social media) may trigger excessive emotional eating to cope with stress, which could result in food addiction, particularly in the presence of poor self-control skills . ...
Worldwide, 60% of people use social media. Excessive and/or addictive use of social media termed “problematic social media use”, has been reported to negatively influence psychological and physiological health. Therefore, we proposed an illustrated model to investigate the associations between social media addiction, psychological distress and food addiction among Taiwanese university students.
A total of 598 participants (mean age = 22.8 years) completed an online survey comprising the Bergen Social Media Addiction Scale (BSMAS) assessing social media addiction, the Depression Anxiety and Stress Scale (DASS-21) assessing psychological distress, and the Yale Food Addiction Scale 2.0 (YFAS 2.0) assessing food addiction.
Structural equation modeling showed the significant associations between BSMAS and DASS-21 (standardized coefficient [β] = 0.45; p < 0.01) and between DASS-21 and YFAS 2.0 (β = 0.43; p < 0.01). In addition, mediation effect with 100 bootstrapping samples showed the indirect effect of DASS-21 in the association between BSMAS and YFAS 2.0
The present study details the relationships between social media addiction and psychological distress as well as food addiction. The results suggest the need for interventions aimed at reducing these negative outcomes. Coping strategies for improving self-control or reducing weight-related stigma, such as food consumption monitoring or mindfulness, could be adopted for at-risk individuals to address these problems.
... This gap in the literature is surprising given that choosing whether to regulate emotions, and selecting an appropriate strategy to do so, are key components of the emotion regulation cycle (see Gross, 2015). Related work indicates that people with NSSI or indirect forms of self-injury report heightened negative urgency (i.e., the tendency to act rashly in response to negative affect; Allen & Hooley, 2019;Wolz et al., 2017) and exhibit difficulty inhibiting behavioral responses when presented with negative stimuli (Allen & Hooley, 2019). These findings suggest that people who engage in self-injury are inclined to engage in maladaptive behaviors when experiencing acute negative affect. ...
Emotion regulation difficulties are implicated prominently in self-injury. Additionally, emotion regulation strategy selection is a core component of the emotion regulation process. Yet it is unclear how people who engage in different forms of self-injury attempt to regulate negative affect when multiple strategies are available to them. This laboratory-based study examined emotion regulation strategy choices in individuals who engage in non-suicidal self-injury (n=40), indirect forms of self-injury (disordered eating and problematic substance use; n=46), and controls (n=48). Following a self-relevant stressor (negative autobiographical memory recall), participants selected one of six strategies based on what they believed would most effectively alter their affect. Strategies spanned behavioral (physical pain, a snack, word activity) and non-behavioral (rumination, reappraisal, doing nothing) domains. Compared to controls, individuals who engage in NSSI and indirect self-injury were more likely to select behavioral strategies. In addition, people with NSSI and indirect self-injury were more likely than controls to choose physical pain and less likely to ruminate. Findings indicate that people with direct and indirect forms of self-injury alike are more likely to take action than engage in further thought when experiencing aversive self-awareness, even when cognitive strategies are made salient. Results illuminate intervention targets for these clinical populations.
... Negative urgency has also been found to be an independent predictor of food addiction among individuals displaying binge-eating symptomology . A further study by Utschig et al.  indicated that fear of negative evaluation from others is a predictor for body dissatisfaction and pressure to be thin, contributing to an internalised 'thin ideal' in individuals with BN and feeding into the state-based model. ...
Risk factors represent a range of complex variables associated with the onset, development, and course of eating disorders. Understanding these risk factors is vital for the refinement of aetiological models, which may inform the development of targeted, evidence-based prevention, early intervention, and treatment programs. This Rapid Review aimed to identify and summarise research studies conducted within the last 12 years, focusing on risk factors associated with eating disorders.
The current review forms part of a series of Rapid Reviews to be published in a special issue in the Journal of Eating Disorders, funded by the Australian Government to inform the development of the National Eating Disorder Research and Translation Strategy 2021-2031. Three databases were searched for studies published between 2009 and 2021, published in English, and comprising high-level evidence studies (meta-analyses, systematic reviews, moderately sized randomised controlled studies, moderately sized controlled-cohort studies, or population studies). Data pertaining to risk factors for eating disorders were synthesised and outlined in the current paper.
A total of 284 studies were included. The findings were divided into nine main categories: (1) genetics, (2) gastrointestinal microbiota and autoimmune reactions, (3) childhood and early adolescent exposures, (4) personality traits and comorbid mental health conditions, (5) gender, (6) socio-economic status, (7) ethnic minority, (8) body image and social influence, and (9) elite sports. A substantial amount of research exists supporting the role of inherited genetic risk in the development of eating disorders, with biological risk factors, such as the role of gut microbiota in dysregulation of appetite, an area of emerging evidence. Abuse, trauma and childhood obesity are strongly linked to eating disorders, however less conclusive evidence exists regarding developmental factors such as role of in-utero exposure to hormones. Comorbidities between eating disorders and mental health disorders, including personality and mood disorders, have been found to increase the severity of eating disorder symptomatology. Higher education attainment, body image-related factors, and use of appearance-focused social media are also associated with increased risk of eating disorder symptoms.
Eating disorders are associated with multiple risk factors. An extensive amount of research has been conducted in the field; however, further studies are required to assess the causal nature of the risk factors identified in the current review. This will assist in understanding the sequelae of eating disorder development and in turn allow for enhancement of existing interventions and ultimately improved outcomes for individuals.
... Furthermore, Emotion Regulation (ER) difficulties and greater impulsivity seem to be an important characteristic in this population with absence of FA (FA-). Negative urgency has been found in the presence of FA (FA+) and binge spectrum disorders patients (8,9). Negative urgency represents the emotional-related aspect of impulsivity, indicating the tendency to act rashly and engage in problematic behavior (in the case of FA, the disorder eating patterns, and excessive food intake) as a response to a negative emotional state (10). ...
Food Addiction (FA) has been related with eating disorders (ED), especially Bulimia Nervosa (BN). BN + FA may have different physical characteristics than patients with BN without the comorbidity, such as body mass index (BMI) or body composition, and psychological as emotion regulation. However, the relationship between psychological and physical aspects, connected by problematic food and its influence on body composition, has been barely studied. Therefore, the aims of the present study are:
(a) To explore the differences in body composition between FA positive (FA+) and negative (FA–) in women with BN; (b) to identify problematic relationship with certain food types, according with the foods mentioned in the YFAS scale questionnaire, between FA+ and FA– patients; (c) to know the psychological characteristic differences between FA+ and FA– patients, considering emotion regulation, personality traits and general psychopathological state; (d) to identify the relationship between physical and psychological traits, and the identified problematic foods, in patients with BN and FA.
N = 81 BN women patients, with a mean age of 29.73 years ± 9.80 SD, who completed the questionnaires: Yale Food Addiction Scale V 1.0 (YFAS 1.0), Eating Disorder Inventory-2 (EDI-2), Symptom Checklist-90 Items-Revised (SCL-90-R), and Difficulties in Emotion Regulation Strategies (DERS). YFAS problematic foods were grouped considering their principal nutrients sources. Body composition and difference in metabolic age was determined using bioimpedance analyzer.
The 88% of patients with BN presented FA+. Patients with BN who were FA+ self-reported more problematic relationships with sweets and starches. Also presented higher emotion regulation difficulties, general psychopathology and eating symptomatology severity, than those without FA. Finally, emotional regulation difficulties were positively associated with higher eating disorder symptomatology and more types of foods self-reported as problematic, which increased indirectly fat mass.
The results suggest that BN + FA presented more eating and psychopathology symptomatology and higher problems with specific food types. As well, the path analysis emphasized that emotion regulation difficulties might be related with problematic food relationship in BN, impacting over the ED severity.
The results may impact the development of precise therapies for patients with BN + FA.
... Moreover, the negative interpretation bias toward social stimuli correlated with clinical symptoms (47). The tendency to act impulsively in response to negative emotions may trigger loss-of-control eating episodes (48). Indeed, negative mood has been found to precede often binge eating episodes and compensatory behaviors in patients with BN (49). ...
Aggressive behaviors have been reported to be more frequent in people with eating disorders (ED), especially bulimia nervosa (BN). Network Analysis (NA) is particularly useful or examining the interactions among symptoms of comorbid conditions through the identification of “bridge symptoms,” defined as those symptoms playing a key role in the connection between two syndromic clusters. The aim of the present study was to investigate the association of ED core symptoms and ED-related psychopathology with aggressiveness in a clinical sample of women with BN through NA. Two hundred and seventy-nine women with BN completed the Eating Disorder Inventory-2 and the Buss-Durkee Hostility Inventory. A NA was conducted, including ED symptoms and aggressiveness measures. The bridge function was implied to identify symptoms bridging ED symptoms and aggressiveness. The most connected nodes among communities were asceticism and impulsivity from ED-related psychopathology, drive for thinness from ED-core psychopathology and guilt and suspicion from aggressiveness domain. In particular, drive for thinness connected ED-core community to verbal hostility, while impulsivity connected ED-related symptoms to guilt and suspicion of aggressiveness community. In conclusion the present study showed that in people with BN guilt is the specific negative emotion of the hostile dimensions that may be bidirectionally associated with ED symptoms.
... Also, since Self-Directedness reflects the ability to adapt and regulate behavior, high Self-Directedness can therefore limit impulsivity in response to emotions' experience. Conversely, low Self-Directedness is associated with deficit in emotion regulation which was associated with "negative urgency" in eating disorder symptomatology . Moreover, "urgency" and "lack of premeditation" have been shown to be associated with gambling behaviors , which we also found associated with higher Novelty Seeking scores in our PD population. ...
There is a growing interest in personality evaluation in Parkinson's disease (PD), following observations of specific temperaments in PD patients. Therefore, our objective was to evaluate personality dimensions from the Temperament and Character Inventory (TCI) in a cohort of fluctuating PD patients considered for deep brain stimulation.
Fluctuating PD patients from the PREDISTIM cohort were included. Description of TCI dimensions and comparison with a French normative cohort were performed. Pearson correlations between TCI dimensions and motor, behavioral and cognitive variables were investigated. Structural and internal consistency analysis of the TCI were further assessed.
The 570 PD patients presented significant higher scores in Harm Avoidance, Reward Dependence, Persistence, Self-Directedness and Cooperativeness and significant lower scores in Self-Transcendence compared to the French normative cohort; only Novelty Seeking scores were not different. Harm Avoidance and Self-directedness scores were correlated with PDQ-39 total, HAMD, HAMA scores, and anxiolytic/antidepressant treatment. Novelty Seeking scores were correlated with impulsivity. Pearson correlations between TCI dimensions, principal component analysis of TCI sub-dimensions and Cronbach's alpha coefficients showed adequate psychometric proprieties.
The TCI seems to be an adequate tool to evaluate personality dimensions in PD with good structural and internal consistencies. These fluctuating PD patients also have specific personality dimensions compared to normative French population. Moreover, Harm Avoidance and Self-Directedness scores are associated with anxio-depressive state or quality of life and, and Novelty Seeking scores with impulsivity.
... Other associated psychological aspects occurring alongside FA, largely explained in the current literature, such as high levels of impulsivity , emotion dysregulation , depression, low self-esteem and psychological distress  could be playing an important role in treatment response. However, based on the aforementioned studies and FA-related literature, no direct associations or predictive relationships had been explored yet. ...
Food Addiction (FA) is frequently observed in populations with obesity, and in eating disorders (ED) related to binge behaviours. However, the influence of FA in the treatment outcome of these conditions has been poorly explored.
Purpose of the Review
The aim of this review, is to reflect the influence of FA in the response to treatment, and other factors with it that could be related, in order to present treatment proposals and future research lines.
FA have been found to have a role in treatment outcome of obesity and ED patients, being as a predictive variable or as a mediator one. For those patients with obesity, FA have a negative influence on the weight loss process; in ED patients was associated with dropouts, and less levels of remission of the ED condition.
... Also, since Self-Directedness reflects the ability to adapt and regulate behavior, high Self-Directedness can therefore limit impulsivity in response to emotions' experience. Conversely, low Self-Directedness is associated with deficit in emotion regulation which was associated with "negative urgency" in eating disorder symptomatology . Moreover, "urgency" and "lack of premeditation" have been shown to be associated with gambling behaviors , which we also found associated with higher Novelty Seeking scores in our PD population. ...
Plusieurs études suggèrent des spécificités de personnalité dans la maladie de Parkinson (MP), principalement sur des populations de faible effectif et assez hétérogènes.
Décrire les dimensions de personnalité du Temperament and Character Inventory (TCI) sur une grande cohorte de patients parkinsoniens fluctuants et vérifier les propriétés psychométriques de ce questionnaire.
Patients et méthodes
Au total, 570 patients issus de la cohorte PREDI-STIM ont répondu au TCI avant la mise en place d’un traitement par stimulation cérébrale profonde. Une description du TCI ainsi que des corrélations entre les sept dimensions de personnalité du TCI et différentes variables motrices, comportementales et cognitives ont été effectuées. Des analyses psychométriques du TCI ont aussi été réalisées.
Évitement du danger, dépendance à la récompense et coopérativité étaient supérieurs chez les femmes. Le TCI n’était pas corrélé à la durée de la maladie, au MDS-UPDRS ni à la LED, mais à la dépression, l’anxiété, la qualité de vie et l’impulsivité (corrélations avec évitement du danger/auto-détermination/recherche de la nouveauté). La recherche de la nouveauté était supérieure chez les patients avec troubles impulsifs-compulsifs. Le TCI présentait une bonne consistance interne et structurelle dans cette cohorte.
Le TCI présente de bonnes propriétés psychométriques chez les patients parkinsoniens et les caractéristiques de la MP (symptômes moteurs, traitements, durée de la maladie, etc.) ne semblent pas influencer les dimensions de personnalité. Seul l’état anxiodépressif, la qualité de vie et l’impulsivité sont corrélées avec certaines dimensions de personnalité, en accord avec la littérature de manière non-spécifique à la MP.
Le TCI semble donc adapté pour l’évaluation de la personnalité des patients parkinsoniens.
... FA has been mentioned as a potential subtype of obesity , and has been associated with Eating Disorders (ED), mainly in binge spectrum disorders as bulimia nervosa (BN) [6,7] and binge eating disorder (BED) [8,9]. It has been associated with higher body mass index (BMI), binge-eating episodes, higher eating psychopathology, more impulsive Nutrients 2022, 14, 1084 2 of 11 personality traits, and craving for highly palatable food , as well as poorer response to therapy [13,14]. ...
A first approach of a phenotypic characterization of food addiction (FA) found three clusters (dysfunctional, moderate and functional). Based on this previous classification, the aim of the present study is to explore treatment responses in the sample diagnosed with Eating Disorder(ED) of different FA profiles.
The sample was composed of 157 ED patients with FA positive, 90 with bulimia nervosa (BN), 36 with binge eating disorder (BED), and 31 with other specified feeding or eating disorders (OSFED). Different clinical variables and outcome indicators were evaluated.
The clinical profile of the clusters present similar characteristics with the prior study, having the dysfunctional cluster the highest ED symptom levels, the worse psychopathology global state, and dysfunctional personality traits, while the functional one the lowest ED severity level, best psychological state, and more functional personality traits. The dysfunctional cluster was the one with lowest rates of full remission, the moderate one the higher rates of dropouts, and the functional one the highest of full remission.
The results concerning treatment outcome were concordant with the severity of the FA clusters, being that the dysfunctional and moderate ones had worst treatment responses than the functional one.
... In another study the levels of FC increase after food exposure in patients with BED . When controlling for baseline FC, chocolate pictures evoked an increase FC response than neutral pictures in participants . Desire-related thoughts can also be induced through semantic cues or instructions, which can create an image of the appetitive target . ...
One of the aspects involved in the motivation for food consumption and the physiological need for food is Desires for food and Food Cravings. Although there are several definitions for Food Craving in the literature, it is currently understood as a cognitive event involving emotional, physiological, and external aspects. Desires, when intense, also involve torture and awareness of a lack (i.e., Food Craving) which is associated with the diet mentality and cognitive restraint and also associations between affectivity, environment present in Disordered Eating and Eating Disorders cases, which suffer from the greater intensity of Food Craving compared to individuals without Eating Disorders. In this chapter, I deal with the history and definition of Food Craving, the description of the cognitive event of appetizing targeting, the associations with the diet mentality as a promoter of moral judgment concerning food, and the twelve primary triggers (external: positive/negative events, food environment, advertising, cultural beliefs about food, specific places, the food itself and internal triggers: dietary restraint, food reward, impulsivity/inflexibility, emotions/thoughts/feelings about food, hunger/satiety/appetite and finally, anxiety and depression symptoms) according to the latest data from studies in the field of Eating Disorders. Finally, it is the nutritional treatment of Food Cravings in cases of Disordered Eating and Eating Disorders that involve cognitive approaches aimed at eating behavior and the involvement of the principles of Intuitive Eating and the satisfaction of food desires and FC’s treatment.
... On the other hand, patients with ED and FAþ and/or SUþ did not show significant gender-related differences. Similarly, previous studies screening FA were not able to find gender differences among participants with ED (Granero et al., 2014;Wolz, Granero, & Fernández-Aranda, 2017). In the same vein, a study in general populations failed to find sex differences in the prevalence of FAþ (Wu, Zimmer, Munn-Chernoff, & Baker, 2020). ...
Background and aims:
Food addiction (FA) and substance use (SU) have frequently been reported in patients with eating disorders (EDs). Our study aimed to assess the prevalence rates of FA and/or lifetime problematic alcohol and illicit drug use among patients with specific ED, such as: bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorder (OSFED). We sought to identify clinical, psychopathological, and personality profiles involved in these addictive behavior-based phenotypes.
The total sample was 527 patients (176 BN, 115 BED, and 236 OSFED). FA was assessed through the Yale Food Addiction Scale 2.0. To determine lifetime SU, a semi-structured clinical interview was carried out.
Patients with BN had the highest rates of FA both with and without SU. No gender differences were obtained for the prevalence of current FA and/or lifetime SU. Patients reporting at least one addictive-related behavior exhibited increased clinical severity compared to those who reported none. Increased impulsivity (such as high lack of premeditation, sensation seeking, and positive urgency) and low self-directedness were differentiating factors for presenting one or two addictive behaviors.
Discussion and conclusions:
Overall, patients presenting with at least one addictive-like behavior reported a poorer clinical status than those without. Also, patients with FA and SU exhibited a more dysfunctional profile characterized by high impulsivity and low self-directedness. These findings would support the need for targeted treatments to reduce impulsivity and increase self-directedness, especially in patients with any addictive-related behavior, as a step towards improving their treatment outcome.
... Emotion regulation strategies are associated with emotion-driven impulsivity (Wolz et al., 2017) and have been implicated in different substance-related behaviors (Blanchard et al., 2019;Dir et al., 2016;Weiss et al., 2018). Overall, these studies suggest that individuals with poor emotion regulation tend to engage in maladaptive behaviors as a way to escape from or to cope with their emotions, a pattern that increases the vulnerability for addictive-related disorders. ...
Use of Social networking sites (SNSs) is a highly prevalent behavior worldwide and, for some individuals, its use can turn maladaptive. There has been growing interest to identify which variables are associated with problematic use of SNSs. Aim
The present study cross-sectionally examined whether the associations between different features of self-control (i.e., impulsivity-like traits, self-regulation and emotion regulation) indirectly relate to two outcomes of SNSs (hours of use and problematic use) via distress tolerance.
A sample of 509 Argentinean college students (70.3% female; Mean age = 21.15±5.15) completed an online survey.
Two significant indirect effects were found: a) higher negative urgency was associated with higher problematic use of SNSs via lower distress tolerance and b) higher self-regulation was associated with lower problematic use of SNSs via higher distress tolerance. Positive urgency, negative urgency and self-regulation had significant direct associations with problematic use of SNSs while neither component of emotion regulation was significantly associated with SNSs outcomes. No significant direct or indirect effects were found between any of the self-control features and time spent using SNSs. Conclusions. The results highlight dysfunctional self-control, particularly emotion-driven impulsivity and low self-regulation, as relevant components of maladaptive SNSs that seem to operate by decreasing the perceived capacity to tolerate negative affect. In this context, interventions targeting the development and improvement of distress tolerance abilities might have a positive impact on problematic use of SNS.
... In contrast, high self-directedness was associated with greater success in weight loss programs (Dalle Grave et al., 2018), which might be explained by the highly relapsing nature of addictive phenomena, and that a subgroup of patients with FA and low self-directedness might be resistant to treatment options. On the other hand, Wolz et al. demonstrated that in a group of patients with various diagnoses on the binge eating spectrum, self-directedness was highly related to eating disorder symptomatology, but not food addiction (Wolz et al., 2017). Future research with more focus on the role of self-directedness in food addiction in this specific group of patients might be useful in enlightening this aspect. ...
Food addiction (FA) has been discussed as a potential contributing factor to the multifactorial aetiology of obesity, and an increasing number of studies have been conducted in recent years to understand this construct. Our aim was to determine the prevalence of FA in a Turkish group of pre-operative bariatric surgery patients and examine the relationship between body mass index, FA and personality traits. In this cross-sectional study, adult pre-operative bariatric surgery patients (n = 140) were evaluated for the presence of FA and related clinical factors. FA and personality traits were assessed using the Turkish versions of the Yale Food Addiction Scale (YFAS) and Temperament and Character Inventory (TCI). 47.1% of the sample was found to show signs of food addiction, as assessed by the YFAS. The mean FA symptom count of the whole sample was 3.92 ± 1.71 out of 7. We found that participants with FA had significantly higher TCI harm avoidance scores and self-transcendence total scores than those without FA (p = 0.04, p = 0.03; respectively), whereas their self-directedness scores and resourcefulness sub-scale scores were significantly lower (p = 0.03, p < 0.01; respectively). In conclusion, lower self-directedness and higher harm avoidance are the major personality traits associated with FA in pre-operative bariatric surgery patients.
... Few studies have been made to clarify the role of each facet on healthy to unhealthy eating styles among young adults. It should therefore be stressed that these studies investigated impulsivity, specifically negative urgency, in an eating disorder context (e.g., Fischer et al., 2013;Racine et al., 2015;Wolz et al., 2017). Mobbs et al. (2010) showed that adult overweight and obese women have higher levels of Urgency and Lack of Perseverance than a control group. ...
Objective. To examine eating styles with 1 a multidimensional perspective considering cognitive, affective and conative (or behavioral) components of eating styles in emerging adulthood, and how they may be related to the Big Five and impulsivity traits. Methods. Self reported questionnaires were used to explore the association between the eating styles, Big five traits and facets of impulsivity among young French adults (n = 450; Mean Age = 20.84 years; SD = 2.4, with 79.6% of women). Results. On the basis of cluster analysis, six eating styles were identified: Healthier, Uninhibited, Dysregulated, Stress-related, Restrictive and Ethical restraint eaters. Results suggest that Uninhibited eaters reported lower scores on Conscientiousness and higher scores on Negative and Positive urgency. The Dysregulated group had lower scores on Extraversion, and high scores on Neuroticism, Negative urgency and Lack of premeditation. Restrictive eaters showed low levels of Openness and Lack of
12 premeditation. The Ethical restraint style was characterized by low scores on Agreeableness and Positive urgency. The ability or inability to cope with both emotional distress and positive and negative impulsive behaviors was related to young adult’s eating cognitions and behaviors. Conclusion. Considering the existence of subtypes of eaters and separate associated personality-related traits, an individual differences perspective (e.g., age, gender, disposition to control one’s emotional experiences) should be incorporated.
... High rates of emotion dysregulation have been found in FA. Even though the precise role of this construct needs to be further explored, FA behaviours could be used to cope negative emotions , related with an emotional eating style . ...
Food addiction (FA) is a construct that has gained interest in recent years but its relevance in Mexican population is still unexplored.AimsThe present study has the aims of explore FA in a community of Mexican population, as well as identifying the risk patterns associated with it, in relation to the different etiological factors that have been described such as impulsivity, emotional regulation and eating styles. Furthermore, to identify a predictive model of FA severity.Methods
The sample consisted of 160 female and male university students of Pachuca city in México, who volunteered to participate in the study. Assessment included multidimensional measures for FA, eating disorder severity, eating disorder styles, emotional regulation and impulsivity.ResultsA screening of FA-probable was registered for 13.8% of the sample, while 8.1% met criteria for FA-present. The FA-present group differed from FA-absent in the impulsivity levels and in emotional eating style. Patients with FA-present differed from FA-probable in the impulsivity levels. Differences between FA-probable versus FA-absent were found in the restrained eating style. Path analysis evidenced that FA severity was directly associated with older age, worse eating style profile and higher impulsivity levels, and indirectly related with the ED symptom levels.Conclusions
Our findings suggest that it is possible to establish a specific predictive model of the development of FA and its severity in Mexican population to implement adequate prevention and treatment strategies.Evidence levelLevel III: evidence obtained from well-designed cohort or case–control analytic studies
... In a small sample of adult community members (n = 52), individuals with FA had significantly higher scores on depressive symptoms, emotion dysregulation, emotional eating, demand characteristics, motives, impulsivity, and family history of mental health problems and addiction . Impulsivity can be defined as decision-making with limited forethought (rash-spontaneous behavior), having strong associations with FA . Impulsivity hinders inhibitory control and is associated with increased intake of food  and drugs , often heightened in response to novel stimuli . ...
The role of stress, trauma, and adversity particularly early in life has been identified as a contributing factor in both drug and food addictions. While links between traumatic stress and substance use disorders are well documented, the pathways to food addiction and obesity are less established. This review focuses on psychosocial and neurobiological factors that may increase risk for addiction-like behaviors and ultimately increase BMI over the lifespan. Early childhood and adolescent adversity can induce long-lasting alterations in the glucocorticoid and dopamine systems that lead to increased addiction vulnerability later in life. Allostatic load, the hypothalamic-pituitary-adrenal axis, and emerging data on epigenetics in the context of biological embedding are highlighted. A conceptual model for food addiction is proposed, which integrates data on the biological embedding of adversity as well as upstream psychological, social, and environmental factors. Dietary restraint as a feature of disordered eating is discussed as an important contextual factor related to food addiction. Discussion of various public health and policy considerations are based on the concept that improved knowledge of biopsychosocial mechanisms contributing to food addiction may decrease stigma associated with obesity and disordered eating behavior.
... Individuals who experience addictive-like eating have demonstrated increased cravings for highly processed foods [6,8,9] and have reported using highly processed foods to cope with negative emotions . Further, those with higher YFAS symptoms of food addiction have endorsed greater impulsivity, particularly in the domains of negative urgency, or acting rashly while having negative emotions, and lack of perseverance in the face of difficult tasks . However, these behavioral characteristics have also been reported among individuals with obesity more broadly . ...
Previous studies have demonstrated overlapping behavioral features between substance-use disorders and food addiction, the latter of which is particularly prevalent among individuals with overweight or obesity. However, the unique attributes of food addiction as a possible phenotype within overweight and obesity are not fully understood.
This cross-sectional study recruited participants (n = 46) with overweight or obesity, nearly half (n = 20) of whom met the criteria for food addiction based on the Yale Food Addiction Scale 2.0 (YFAS 2.0) and examined responses to self-report questionnaires that indexed behavioral characteristics relevant to addictive disorders.
Individuals with food addiction exhibited significantly higher scores on the Palatable Eating Motives Scale overall score (p < .001) and subscales for coping (p < .001) and enhancement (p < .001) of emotions, Dutch Eating Behavior Questionnaire Emotional Eating subscale (p < .001), UPPS-P Impulsivity Scale negative urgency (p < .001) and lack of perseverance (p = .01) subscales, and the Food Craving Inventory overall score (p = .02) and subscales of cravings for sweets (p < .01) and fast food fats (p = .02).
Food addiction appears to represent a distinct phenotype within overweight and obesity, marked by greater emotion dysregulation, impulsivity, and cravings, which have been observed in prior studies examining features of individuals with addictive disorders.
Level of evidence
Level III: Evidence obtained from well-designed cohort or case–control analytic studies.
... No estudo de Gearhardt et al. 16 , os maiores escores na YFAS estavam associados ao excesso de peso precoce e ao histórico do início de dietas restritivas. Foi demonstrada a relação entre a gravidade do transtorno de compulsão alimentar (TCA), urgência negativa e dificuldade na regulação emocional em indivíduos com adição à comida 17 . Ainda, os indivíduos com TCA e coocorrência de adição à comida (41,5%) apresentaram maior gravidade em sintomas depressivos, psicopatologia alimentar e autoestima em relação aos indivíduos que não atingiram a classificação 18 . ...
Objetivo: Verificar a relação entre autocompaixão e adição à comida em mulheres com comportamento alimentar disfuncional.
Métodos: Mulheres de um grupo de apoio completaram as escalas de compulsão alimentar, restrição cognitiva, autocompaixão, escala de adição à comida de Yale versão modificada 2.0 (YFAS 2.0) e questionário de Hay para práticas compensatórias. Foram identificados a prevalência de adição à comida e sintomas segundo a YFAS. Para serem incluídas, as participantes deveriam atingir pontuação para compulsão alimentar e, para análises, foram divididas em função da presença de práticas compensatórias. O grupo foi analisado por meio de testes de correlação de Pearson entre variáveis de interesse, e os grupos bulímico e compulsivo foram comparados com teste t de Student (p < 0,05; Software JASP).
Resultados: Participaram do estudo 190 mulheres. De acordo com a YFAS, 95,3% (n= 181) tinham adição à comida, e os escores da escala apresentaram correlação negativa com a autocompaixão e com a compulsão alimentar (p = 0,014 em ambas). Os níveis de autocompaixão apresentaram correlação negativa com as questões #3, #5, #6, #8 e #9 da YFAS (p < 0,05).
Conclusões: Este estudo traz dados para a discussão da necessidade de analisar como a autocrítica atrelada ao sofrimento de quem apresenta comportamento alimentar disfuncional afeta o preenchimento da escala, trazendo identificação com a noção de vicio, já que esta é culturalmente aceita.
... In general, both food and alcohol may be used by individuals seeking relief and/or craving reward, which are thought to be important mechanisms involved in excessive substance consumption(26). Individuals who act impulsively when experiencing negative emotional states were shown to be more likely to develop addictive eating patterns (62) and at greater risk for other addictive behaviors, including AUD(63). ...
Background and Aims
Binge eating disorder (BED) is correlated with substance use. This study aimed to estimate the lifetime prevalence of alcohol use disorder (AUD) among individuals with non‐compensatory binge eating and determine whether their lifetime prevalence of AUD is higher than in non‐bingeing controls.
A systematic search of databases (PubMed, Embase, and Web of Science) for studies of adults diagnosed with BED or a related behavior that also reported the lifetime prevalence of AUD was conducted. The PRISMA protocol was followed. The protocol was registered on PROSPERO.
Studies originating in Canada, Sweden, the United Kingdom, and the United States.
18 studies meeting the inclusion criteria were found, representing 69,233 individuals.
Measurements: Lifetime prevalence of AUD among individuals with binge eating disorder and their lifetime relative risk of AUD compared with individuals without this disorder.
The pooled lifetime prevalence of AUD in individuals with binge eating disorder was 19.9% (95% CI 13.7‐27.9). The risk of lifetime AUD incidence among individuals with binge eating disorder was over 1.5 times higher than controls (RR 1.59, 95% CI 1.41‐1.79). Lifetime AUD prevalence was higher in community samples than in clinical samples (27.45% vs. 14.45%, p = 0.041) and in studies with a lower proportion of women (β = ‐2.27, p = 0.044).
Lifetime alcohol use disorder appears to be more prevalent with binge eating disorder than among those without.
... BED patients additionally displayed higher negative urgency than non-BED-obese patients. Other studies had already associated negative urgency with bingeing (Claes et al., 2015;Racine et al., 2015;Steward et al., 2017) and it was the only predictor of food addiction (FA) in patients with binge eating symptomatology (Wolz, Granero, & Fernández-Aranda, 2017). This is important because FA is a highly comorbid condition in patients with BED which may contribute to greater general and eating disorder-specific psychopathology (Linardon & Messer, 2019) and could be a predictor of treatment outcome in BED (Romero et al., 2019). ...
Objective: This study aims to test a model where low self-monitoring (a sub-function of first-person domain of metacognition) and high negative urgency lead to a worsening of binge severity through the mediation of emotional dys-regulation in patients with binge eating disorder (BED).
Method: Forty non-BED-obese and 46 BED-obese patients completed a battery of tests assessing metacognition and psychopathology. To test our hypothesized model, a structural equation model (SEM) using maximum likelihood estimation was conducted. Results: BED-obese patients had significantly higher scores in BES, UPPS-P Negative urgency, and DERS total score, and lower MSAS self-monitoring than non-BED-obese, while no differences emerged in the MSAS others-monitoring subscale. The structural model demonstrated very good fit indexes (χ 2 = 1.377, df = 2; p = .502, CMIN/DF = 0.688, CFI = 1.000, RMSEA = 0.000, TLI = 1.047) and all paths were significant in the predicted directions. Conclusions: These preliminary findings show that, low self-monitoring and high negative urgency lead BED-obese patients to express the worsening of binge severity through the mediation of emotional dysregulation. This knowledge may be helpful in the clinical practice to develop a tailor-made treatment. Accordingly, an approach through Metacognitive Interper-sonal Therapy could be attempted in BED-obese patients with these characteristics. K E Y W O R D S binge eating disorder, binge severity, emotional dysregulation, metacognition, negative urgency
... High scores on negative urgency have been associated with vulnerability to stress, reduced capacity to problem solving and poor coping strategies such as escape-avoidance coping . Similarly, the study of Wolz et al.  suggests that low self-directedness and emotion dysregulation predict negative urgency in BED patients and are highly associated with bingeeating symptomatology. ...
Binge eating disorder (BED) is a mental illness characterised by recurrent binge eating episodes in the absence of appropriate compensatory behaviours. Consequently, BED is strongly associated with obesity. The current review aims to provide an update of the most relevant aspects of BED (e.g., clinical profile, aetiology and treatment approaches), in order not only to facilitate a better understanding of the disorder and its clinical consequences, but also to identify potential targets of prevention and intervention. Patients with BED often present high comorbidity with other medical conditions and psychiatric disorders. Numerous risk factors have been associated with the development and maintenance of the disorder. Moreover, although some treatments for BED have proven to be effective in addressing different key aspects of the disorder, the rates of patients that have ever received specific treatment for BED are very low. The factors involved and how to implement effective treatments will be discussed for the purpose of addressing the eating symptomatology and comorbid obesity.
... For that reason, we expected women with BN to have higher scores on negative urgency than women with PD. Further, given that individuals with BN and individuals with binge eating disorder (BED) report similar levels of negative urgency (Wolz, Granero, & Fernández-Aranda, 2017), it may be that negative urgency is elevated in those with purging (Fischer, Peterson, & McCarthy, 2013) and loss of control eating (Forney et al., 2014;Forney, Bodell, et al., 2016)), but those with Table 1 Comparison of groups on impulsigenic traits. Note. ...
There is extensive evidence for the clinical significance of Purging Disorder (PD), an eating disorder characterized by recurrent purging behavior (self-induced vomiting, laxative use, and diuretic use) in the absence of binge eating and low weight (Smith, Crowther, & Lavender, 2017). Research on the personality profile of PD is still developing but evidence supports an association with impulsivity (Brown, Haedt-Matt, & Keel, 2011). The personality underpinnings of impulsive behavior include several different impulsigenic traits. To investigate personality contributors to impulsive behavior among women with PD, we compared 31 women with PD to 57 women with bulimia nervosa (BN) and 31 healthy control women on four impulsigenic traits: negative urgency, lack of premeditation, lack of perseverance, and sensation seeking. Compared to healthy controls, women with PD reported significantly greater levels of negative urgency, but no significant differences on the other traits. Compared to BN, PD was associated with significantly lower levels of negative urgency, but no other significant differences. Compared with controls, women in the BN group had significantly higher scores on lack of premeditation and lack of perseverance, but no significant difference on sensation seeking. Findings indicate negative urgency is a potentially important personality trait for distinguishing those with PD.
... In another study in undergraduates, negative urgency, impulsivity when under distress, and emotion dysregulation positively predicted symptom count on the YFAS . Similar findings were shown in a clinical ED cohort, although negative urgency appeared to be the only independent predictor for FA, while self-directedness and emotion dysregulation predicted negative urgency and were highly related to ED-related symptomatology, but not to food addiction itself [32,33]. In individuals with OBE awaiting bariatric surgery, FA was associated with personality traits such as neuroticism, impulsivity, and alexithymia , but also more emotion dysregulation, more harm avoidance, and less self-directedness . ...
Food addiction (FA) has been associated with greater psychopathology in individuals with eating disorders (ED) and obesity (OBE). The current study aims to provide a better phenotypic characterization of the FA construct by conducting a clustering analysis of FA in both conditions (ED and OBE). The total sample was comprised of 234 participants that scored positive on the Yale Food Addiction Scale 2.0. (YFAS-2) (119 bulimia nervosa (BN), 50 binge eating disorder (BED), 49 other specified feeding or eating disorder (OSFED) and 16 OBE). All participants completed a comprehensive battery of questionnaires. Three clusters of FA participants were identified. Cluster 1 (dysfunctional) was characterized by the highest prevalence of OSFED and BN, the highest ED severity and psychopathology, and more dysfunctional personality traits. Cluster 2 (moderate) showed a high prevalence of BN and BED and moderate levels of ED psychopathology. Finally, cluster 3 (adaptive) was characterized by a high prevalence of OBE and BED, low levels of ED psychopathology, and more functional personality traits. In conclusion, this study identified three distinct clusters of ED-OBE patients with FA and provides some insight into a better phenotypic characterization of the FA construct when considering psychopathology, personality and ED pathology. Future studies should address whether these three food addiction categories are indicative of therapy outcome.
... Negative urgency was also associated with more frequent snacking in adolescents (Smith and Cyders, 2016;Coumans et al., 2018). A path analysis study of 315 patients with eating disorders on the binge spectrum found that low self-directedness and emotional regulation were broadly associated with eating psychopathology, whereas negative urgency was uniquely associated with food addiction (Wolz et al., 2017). From a treatment standpoint, a multicomponent behavior therapy intervention in obese adolescents reduced body mass index relative to the degree to which it reduced negative urgency . ...
Negative urgency is a unique dimension of impulsivity that involves acting rashly when in extreme distress and impairments in inhibitory control. It has been hypothesized to derive from stress that is related to negative emotional states that are experienced during the withdrawal/negative affect stage of the addiction cycle. Classically, a transition to compulsive drug use prevents or relieves negative emotional states that result from abstinence or stressful environmental circumstances. Recent work suggests that this shift to the "dark side" is also implicated in impulsive use that derives from negative urgency. Stress and anxious, depressed, and irritable mood have high comorbidity with addiction. They may trigger bouts of drug seeking in humans via both negative reinforcement and negative urgency. The neurocircuitry that has been identified in the "dark side" of addiction involves key neuropeptides in the central extended amygdala, including corticotropin-releasing factor. The present review article summarizes empirical and conceptual advances in the field to understand the role of the "dark side" in driving the risky and detrimental substance use that is associated with negative urgency in addiction.
... Specifically, individuals with BED show higher levels of impulsivity, anxiety, and depression compared to individuals without eating or addictive disorders (for a review, see ). Importantly, impulsivity is increasingly understood as a multidimensional construct (e.g., ) and food addiction has exhibited particularly notable associations with two forms of impulsivity: negative urgency (e.g., [76,77]) and delay discounting . In the first case, negative urgency refers to a tendency to act out in response to negative affect and it is an impulsive personality trait that has been robustly associated with substance use disorders in numerous previous studies (for meta-analyses, see ). ...
Purpose of Review
With the literature on food addiction expanding rapidly, we aim to provide an overview of what is known about this topic, including its assessment, prevalence, and associated behavioral, clinical, and neurobiological characteristics.
The literature presents compelling evidence for the validity of the concept of food addiction, revealing numerous substantive parallels between compulsive overeating and substance use disorders. Research published since the introduction of a formal measure of food addiction has examined neurobiological characteristics associated with food addiction, providing evidence of similarities between neural responses in individuals with food addiction and those with substance use disorders. Furthermore, food addiction has been associated with heightened depression, anxiety, and eating psychopathology. There is also evidence of poorer treatment outcomes in clinical populations, highlighting the importance of continued investigation of this condition.
The extent to which food addiction is equivalent to substance use disorders remains an open question; however, it is clear that the presence of food addiction has implications for physical and psychological health outcomes. A focus for future research should be identifying specific symptoms of food addiction that contribute to these poor outcomes and greater psychopathology, to inform the development of therapeutic interventions for food addiction.
... Other studies have identified a link between decision-making impairment and binge eating severity (Danner et al., 2012), and it is plausible that similar impairments are present in subthreshold binge ED patients who present food addiction symptoms. In line with our UPPS-P findings, numerous studies have indicated that individuals with food addiction experience difficulty controlling impulses when experiencing a negative mood, that is, negative urgency (Rose, Nadler, & Mackey, 2017;Wolz et al., 2016;Wolz et al., 2017), and future studies should examine how decision-making is influenced in "hot" and "cold" executive function settings (Appelhans, French, Pagoto, & Sherwood, 2016). Our results also point to an association between food addiction severity levels and diminished attentional capacity in individuals with OB. ...
Individuals with obesity (OB) often report suffering from addiction‐like symptoms. As in addictions, deficits in executive function domains, such as decision‐making and sustained attention, are found in OB. No study to date has examined the associations between food addiction, OB, and neuropsychological performance.
Thirty‐three adult women with OB and 36 healthy weight controls completed the Yale Food Addiction Scale Version 2.0, a validated instrument used to assess food‐related addictive behaviours. Additionally, participants completed computerized versions of the Iowa Gambling Task (IGT) and Conners' Continuous Performance Test, second edition (CPT‐II) to examine decision‐making and attentional control, respectively.
Food addiction criteria were met in 24.2% of the participants with OB and in 2.8% of the control group. In the OB group, food addiction severity levels were negatively correlated with overall scores on the IGT. Participants with OB meeting criteria for food addiction committed more omissions and perseveration errors on the CPT‐II compared with those without food addiction.
Our results point to an association between food addiction severity levels and impairments in decision‐making and attentional capacity in individuals with OB. Given the heterogeneity found in OB, it stands to reason that this subset of patients with food addiction could potentially benefit from interventions targeting neuropsychological deficits.
... Prior findings suggest strong associations between FA and obesity, depression, health-related quality of life, † These authors contributed equally to this work. and disordered eating behaviours, including emotional eating and binge eating (Burrows, Kay-Lambkin, Pursey, Skinner, & Dayas, 2018;Chao et al., 2017;de Vries & Meule, 2016;Gearhardt et al., 2009;Gearhardt et al., 2012;Gearhardt, Boswell, & White, 2014a;Pursey, Stanwell, Gearhardt, Collins, & Burrows, 2014;Schulte, Grilo, & Gearhardt, 2016;Wolz, Granero, & Fernandez-Aranda, 2017). FA appears more common in women, whereas studies examining the association of FA and racial/ethnic identity have been mixed (Burrows et al., 2018). ...
This study aimed to address a cultural gap in the food addiction (FA) literature by examining FA and associated clinical features in a nonclinical group of men and women residing in India.
Participants (N = 415) were recruited from Amazon Mechanical Turk to complete an online survey about weight and eating. Participants completed self‐report measures assessing FA (Yale Food Addiction Scale [YFAS]), eating‐disorder psychopathology (Eating Disorder Examination‐Questionnaire [EDE‐Q]), health‐related quality of life (Short Form Health Survey—12‐item version [SF‐12]), and depression (Patient Health Questionnaire‐2).
The FA symptom mean was 3.53 (SD = 1.90); 32.5% (n = 129) met FA clinical threshold on the YFAS. Groups categorized with and without FA on the YFAS did not differ significantly in sex or body mass index. YFAS scores were significantly correlated with greater frequency of binge eating, higher severity scores on all EDE‐Q subscales, higher depression, and poorer functioning scores on the SF‐12 (all ps < 0.05).
FA, as conceptualized and measured by the YFAS, appears to be common among individuals residing in India.
Neuroticism is one of the most robust risk factors for addictive behaviors including food addiction (a key contributor to obesity), although the associated mechanisms are not well understood. A transdiagnostic approach was used to identify the neuroticism-related neuropsychological and gut metabolomic patterns associated with food addiction. Predictive modeling of neuroticism was implemented using multimodal features (23 clinical, 13,531 resting-state functional connectivity (rsFC), 336 gut metabolites) in 114 high body mass index (BMI ≥25 kg/m2) (cross-sectional) participants. Gradient boosting machine and logistic regression models were used to evaluate classification performance for food addiction. Neuroticism was significantly associated with food addiction (P < 0.001). Neuroticism-related features predicted food addiction with high performance (89% accuracy). Multimodal models performed better than single-modal models in predicting food addiction. Transdiagnostic alterations corresponded to rsFC involved in the emotion regulation, reward, and cognitive control and self-monitoring networks, and the metabolite 3-(4-hydroxyphenyl) propionate, as well as anxiety symptoms. Neuroticism moderated the relationship between BMI and food addiction. Neuroticism drives neuropsychological and gut microbial signatures implicated in dopamine synthesis and inflammation, anxiety, and food addiction. Such transdiagnostic models are essential in identifying mechanisms underlying food addiction in obesity, as it can help develop multiprong interventions to improve symptoms.
Childhood trauma has been associated with substance use disorders (SUDs), but less research has investigated its association with food addiction (i.e., compulsive intake of highly processed foods containing refined carbohydrates and/or added fat). Existing research on childhood trauma and food addiction has focused primarily on women from restricted samples. Further, emotion dysregulation difficulties are implicated in both childhood trauma and food addiction, but research has not explored whether it may play a mediating role.
Thus, the current study utilizes a sample of 310 participants recruited from Amazon Mechanical Turk (mean age = 41.3 years old, 47.4% men, 78.7% white) to investigate the mediating role of emotion dysregulation in the association between childhood trauma and food addiction. We also conducted exploratory analyses to investigate for gender differences in these associations. Gender-stratified correlational matrixes were conducted to investigate association between childhood trauma, food addiction, and emotional dysregulation. Moderated mediation models and multilevel regressions were also conducted to identify the role of gender in the association between childhood trauma, food addiction, and emotion dysregulation.
Emotion dysregulation was found to partially mediate the associations between food addiction and childhood trauma and gender was found to moderate associations between childhood trauma and emotion dysregulation, as well as childhood trauma and food addiction. Both moderating pathways were significantly stronger for men compared to women.
Results suggests that emotion dysregulation may be one important mediator in the association between childhood trauma and food addiction, particularly for men. The identification of other potential mechanisms contributing to the association between childhood trauma and food addiction and the use of longitudinal measurement strategies will be important in future research.
Sporting role models (SRM) can inspire and influence attitude and behavior. This chapter examines the influence of six Indigenous Australian sportswomen: cricketers Faith Thomas and Ashleigh Gardner, netballers Marcia Ella-Duncan and Jemma MiMi, and tennis players Evonne Goolagong-Cawley and Ashleigh Barty. By applying and extending Marianne Meier’s (2015) theoretical lens, it unearths and examines their role as SRMs for women and girls. Meier (2015) recognizes and describes nine functions of SRMs: participation, leadership, advocacy, challenging gender stereotypes, inspiration, ethics, safeguarding and prevention, media and corporates, and giving back. Correspondingly, Meier also identifies three categories on a ‘continuum of interaction’ between an observer and a successful SRM. Metaphorically the women start in silence; however, the evidence suggests that they gain—and sometimes regain—voice, often beyond their sport careers. Understanding Indigenous sportswomen’s SRM status enables a layered and deep understanding of the unique platform provided by sport, which serves to strengthen their influence. The research recognizes a tenth function of female Indigenous SRMs—that of cultural maintenance. Findings illuminate how Indigenous Australian sportswomen are constructed in complex and sometimes contradictory ways, at times portrayed as advocates, deviants, sporting ambassadors, and political activists. Further research is needed to untangle the complexities and fluidity of female Indigenous Australian SRMs in the evolving worlds of both professional and community sport.
Recall, food addiction (FA) was considered for inclusion in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), although the final decision was to not include it as an official diagnosis (Adams, Nutrients 11(9):2086, 2019; Schulte, Int J Eat Disord 53:1610–22 2020) (Chap. 5). But since this determination, there have been an increasing number of clinical studies published that support the construct’s validity. Many of the behaviors that manifest in substance use disorders (SUD) in relationship to substances of abuse also exist in relation to highly palatable (HP; generally highly processed, sweet, and high fat) food, and it is increasingly evident that DSM diagnostic criteria for SUD apply to food-related behaviors, as well (Adams, Nutrients 11(9):2086, 2019; Gordon, 2018;10(4):477, Nutrients; Meule, Curr Obes Rep 8(1):11–7, 2019; Tobore, Behav Brain Res 384:112560, 2020; Morin, Front Behav Neurosci 11:19, 2017). SUD-like symptoms in relation to HP food cluster together in a variety of populations, including in normal weight, obese, eating disordered, and non-disordered individuals, which has led to the successful development of a validated and widely utilized scale in FA studies to assess for FA called the Yale Food Addiction Scale (YFAS). Further support for the validity of an FA construct includes the following: (1) higher rates of SUD are seen in people with overeating problems and vice- versa; (2) people with SUD often have preferences for sweet or even fatty food, and cross-sensitization and addiction transfer (otherwise known as cross-addiction) can occur; (3) higher rates of certain neuropsychological, emotional and personality traits, psychiatric diagnoses, and predisposing conditions (trauma, stress) are seen in both SUD and disorders associated with overeating.
Substance use disorder is highly prevalent among individuals with mental disorders. However, it remains largely unknown whether this is also the case for “food addiction”—a phenotype characterized by an addiction‐like attraction to predominantly highly processed foods with a high content of refined carbohydrates and fat. Therefore, the primary aim of this study was to estimate the weighted prevalence of food addiction among individuals with mental disorders.
A total of 5,000 individuals aged 18–62 were randomly drawn from eight categories of major mental disorders from the Danish Psychiatric Central Research Register and invited to participate in an online questionnaire‐based survey, which included the Yale Food Addiction Scale 2.0. Data on health care and sociodemographics from the Danish registers were linked to all invitees—enabling comprehensive attrition analysis and calculation of the weighted prevalence of food addiction.
A total of 1,394 (27.9%) invitees participated in the survey. Across all diagnostic categories, 23.7% met the criteria for food addiction. The weighted prevalence of food addiction was highest among individuals with eating disorders (47.7%, 95%CI: 41.2–54.2), followed by affective disorders (29.4%, 95%CI: 22.9–36.0) and personality disorders (29.0%, 95%CI: 22.2–35.9). When stratifying on sex, the prevalence of food addiction was higher among women in most diagnostic categories.
Food addiction is highly prevalent among individuals with mental disorders, especially in those with eating disorders, affective disorders and personality disorders. Food addiction may be an important target for efforts aimed at reducing obesity among individuals with mental disorders.
People with gambling disorder (GD) often experience co-occurring addictive behaviors, especially at young ages. This paper aims at examining cognitive biases, emotion dysregulation, and coping strategies in people with and without GD, as well as comparing the comorbid addictions profiles of those in clinical versus community-based sites. A sample from the general population comprising 250 adolescents and young individuals, and a clinical sample of 31 patients with problematic gambling or GD were recruited. Results showed that GD severity was positively related to alcohol abuse, drugs abuse (in the women group) and buying-shopping (in the men group) in the community sample. In the clinical sample, GD severity was positively related to gaming and instant messaging, and the highest levels in cognitive biases were related to gambling behaviors. Also, the highest emotion dysregulation scores and the highest scores for difficulties in coping strategies were associated with the comorbid presence of GD and other addictions, closely followed by GD presence without other addictions. These results provide evidence of the existence of underlying risk factors shared by GD and its comorbid addictions, which suggests the understanding and treatment of co-occurring addictions in a comprehensive rather than individual manner.
By definition, restricting (ANR) and binge‐eating/purging (ANBP) subtypes of anorexia nervosa (AN) differ in some manifestations of maladaptive eating behavior. This study aimed to determine whether the groups differ in the choices they make about what to eat, and whether there are differences in valuation related to food choice, using an experimental paradigm.
Inpatients with ANR (n = 40) and ANBP (n = 46) participated in a Food Choice Task. During the task, participants rated 76 food images for healthiness and tastiness, and choice preferences. Groups were compared in percent selection of high‐fat and low‐fat foods, value ratings of foods, and engagement of self‐control in food choice.
There were no differences between AN subtypes in healthiness or tastiness ratings, or in tendency to limit choice of high‐fat foods. There was no difference between the groups in measures of self‐control in food choice.
Individuals with ANR and ANBP similarly manifest reduced choices of high‐fat foods, with similar tendencies to undervalue the tastiness of high‐fat foods. These results suggest that while individuals with ANR and ANBP differ across a range of clinical characteristics, the decision‐making process associated with the maladaptive restriction of high‐fat foods characteristic of AN is shared by both subtypes.
The aim of the current research was to identify the extent to which reward sensitivity and impulsivity were related to food addiction.
Forty-five studies, published from 2009 to June 2019, investigating reward sensitivity and/or impulsivity with food addiction as measured by the Yale Food Addiction Scale were reviewed.
Reward sensitivity, as measured by the Sensitivity to Reward (SR) scale, was positively associated with food addiction in two studies, but failed to yield consistent results in other studies when measured with the Behavioral Inhibition/Behavioral Activation Scales. Self-report impulsivity, as measured by the Barratt Impulsiveness Scale (BIS-11), was consistently associated with food addiction, with attentional impulsivity and motor impulsivity the most consistent subscales. Similarly, food addiction was also consistently associated with Negative Urgency, Positive Urgency, and Lack of Perseverance as measured by the UPPS-P Impulsive Behavior Scale. Food addiction was inconsistently associated with disinhibition, as measured by behavioral tasks, indicating food addiction appears more aligned with self-report measures of impulsivity.
Research in this field is dominated by university student, overweight and obese samples. Additional research is required to further tease out these relationships.
Eating disorder (ED) symptoms often co-occur with non-suicidal self-injury (NSSI). This comorbidity is consistent with evidence that trait negative urgency increases risk for both of these phenomena. We previously found that impaired late-stage negative emotional response inhibition (i.e., negative emotional action termination or NEAT) might represent a neurocognitive mechanism for heightened negative urgency among people with NSSI history. The current study evaluated whether relations between negative urgency and ED symptoms similarly reflect deficits in this neurocognitive process. A total of 105 community adults completed an assessment of ED symptoms, negative urgency, and an emotional response inhibition task. Results indicated that, contrary to predictions, negative urgency and NEAT contributed independent variance to the prediction of ED symptoms, while controlling for demographic covariates and NSSI history. Worse NEAT was also uniquely associated with restrictive eating, after accounting for negative urgency. Our findings suggest that difficulty inhibiting ongoing motor responses triggered by negative emotional reactions (i.e., NEAT) may be a shared neurocognitive characteristic of ED symptoms and NSSI. However, negative urgency and NEAT dysfunction capture separate variance in the prediction of ED-related cognitions and behaviors, distinct from the pattern of results we previously observed in NSSI.
Commonalities in the biobehavioral determinants of ingestive behavior and psychoactive drug addiction have given rise to the concept of food addiction (FA). This chapter examines the relationship between FA and diverse of self-regulation, often also referred to as impulsivity. Consistent evidence was present for statistically significant, medium-to-large magnitude associations between FA and deficits in emotional regulation, often measured as negative urgency (i.e., proneness to act out during negative affective states). Significant associations were also present for other indices of impulsive personality traits, albeit with less consistency and smaller effect sizes. Beyond personality, small numbers of studies examined self-regulation defined as impulsive discounting of future rewards or behavioral inhibition, with significant associations for the former but not the latter. Collectively, these findings reveal many parallels to the relationships between impulsivity and drug involvement, further supporting the hypothesis that FA is substantively similar to drug addiction.
Recent studies on food addiction (FA) provided a better understanding of this condition in various populations. Indeed, authors have shown that FA was nearly as prevalent in adolescents as in adults, and similar correlates were observed in both populations (disordered eating behaviors, depressive and anxiety symptoms, impulsivity). The aim of the present study was to characterize FA in adolescents, according to psychological symptoms and executive functioning difficulties. A sample of 969 adolescents, aged between 12 and 18 years old, was recruited in the Quebec City area. They completed a series of questionnaires, including the Yale Food Addiction Scale 2.0 to measure FA symptoms, the Behaviour Rating Inventory of Executive Function to measure executive functioning difficulties, as well as other self-reported questionnaires assessing psychological symptoms (depressive and anxiety symptoms, impulsivity). Group comparisons showed that adolescents with a high level of FA symptoms reported significantly more psychological symptoms (binge eating, depression, anxiety, impulsivity), and more executive functioning difficulties. Finally, the relationship between FA symptoms and executive functioning difficulties was moderated by age and sex. More precisely, the previously mentioned relationship was stronger in young teen girls. The present work provides a preliminary framework in the developmental study of FA.
Recent theoretical models and empirical research have indicated that momentary negative affect increases the likelihood of binge eating episodes for individuals with bulimia nervosa and binge eating disorder. However, relatively little research has explored the potential for positive mood to serve a protective effect in reducing the likelihood of overeating behaviour in bulimia nervosa and binge eating disorder. The current study included 30 women with bulimia nervosa or binge eating disorder in a within-subjects crossover design. Following exposure to a video designed to induce food craving, we found that a positive mood vodcast was associated with significantly lower levels of negative mood and food consumption in a taste test meal, when compared to a neutral vodcast (p = 0.002). These findings support a role for decreasing negative mood in reducing the likelihood of binge eating behaviour in women with bulimia nervosa and binge eating disorder.
Previous research on 'food addiction' as measured with the Yale Food Addiction Scale (YFAS) showed a large overlap between addiction-like eating and bulimia nervosa. Most recently, a revised version of the YFAS has been developed according to the changes made in the diagnostic criteria for substance use disorder in the Diagnostic and Statistical Manual of Mental Disorders fifth edition. The current study examined prevalence and correlates of the YFAS2.0 in individuals with bulimia (n = 115) and controls (n = 341). Ninety-six per cent of participants with bulimia and 14% of controls received a YFAS2.0 diagnosis. A higher number of YFAS2.0 symptoms was associated with lower interoceptive awareness, higher depressiveness, and higher impulsivity in both groups. However, a higher number of YFAS2.0 symptoms was associated with higher body mass and weight suppression in controls only and not in participants with bulimia. The current study is the first to show a large overlap between bulimia and 'food addiction' as measured with the YFAS2.0, replicating and extending findings from studies, which used the previous version of the YFAS. Compensatory weight control behaviours in individuals with bulimia likely alleviate the association between addiction-like eating and higher body mass. Thus, the large overlap between bulimia and 'food addiction' should be taken into consideration when examining the role of addiction-like eating in weight gain and obesity.
Problematic alcohol use is common among university students and personality might account for individual differences in developing this maladaptive behavior. Two personality dispositions implicated in problematic alcohol use are negative urgency and neuroticism. However, the relationship of these traits to problematic alcohol use is unclear. In college students high neuroticism is not directly linked to problematic alcohol use. On the other hand, the experience of emotional distress in people high in neuroticism could impair the capacity for impulse control. Loss of impulse control under conditions of negative affect could trigger impulsive drinking and problematic alcohol use in the long run.
We investigated this idea by testing whether negative urgency mediates the relationship of neuroticism to problematic alcohol use.
Participants were 60 undergraduate university students who completed the Urgency subscale of the Urgency, (lack of) Premeditation, (lack of) Perseverance, Sensation Seeking, and Positive Urgency Impulsive Behaviour scale (UPPS-P), the Alcohol Use Disorders Identification Test (AUDIT), and the Neuroticism subscale of the Eysenck Personality Questionnaire Revised short form (EPQ-RSS).
The results confirmed our hypothesis as we found an indirect effect of negative urgency on the relationship between neuroticism and problematic alcohol use.
It appears that it is not distress but the tendency to act rashly when distressed that is important in developing problematic alcohol drinking in university students.
Obese children are at higher risk of being obese as adults, and adult obesity is associated with an increased risk of morbidity. This systematic review and meta-analysis investigates the ability of childhood body mass index (BMI) to predict obesity-related morbidities in adulthood. Thirty-seven studies were included. High childhood BMI was associated with an increased incidence of adult diabetes (OR 1.70; 95% CI 1.30-2.22), coronary heart disease (CHD) (OR 1.20; 95% CI 1.10-1.31) and a range of cancers, but not stroke or breast cancer. The accuracy of childhood BMI when predicting any adult morbidity was low. Only 31% of future diabetes and 22% of future hypertension and CHD occurred in children aged 12 or over classified as being overweight or obese. Only 20% of all adult cancers occurred in children classified as being overweight or obese. Childhood obesity is associated with moderately increased risks of adult obesity-related morbidity, but the increase in risk is not large enough for childhood BMI to be a good predictor of the incidence of adult morbidities. This is because the majority of adult obesity-related morbidity occurs in adults who were of healthy weight in childhood. Therefore, targeting obesity reduction solely at obese or overweight children may not substantially reduce the overall burden of obesity-related disease in adulthood.
In recent years, the concept of food addiction has gained more and more popularity. This approach acknowledges the apparent parallels between substance use disorders and overeating of highly palatable, high-caloric foods. Part of this discussion includes that ‘hyperpalatable’ foods may have an addictive potential because of increased potency due to certain nutrients or additives. Although this idea seems to be relatively new, research on food addiction actually encompasses several decades, a fact that often remains unrecognized. Scientific use of the term addiction in reference to chocolate even dates back to the 19th century. In the 20th century, food addiction research underwent several paradigm shifts, which include changing foci on anorexia nervosa, bulimia nervosa, obesity, or binge eating disorder. Thus, the purpose of this review is to describe the history and state of the art of food addiction research and to demonstrate its development and refinement of definitions and methodologies.
The aims of the study were to (1) validate the Difficulties in Emotion Regulation Scale (DERS) in a sample of Spanish adults with and without eating disorders, and (2) explore the role of emotion regulation difficulties in eating disorders (ED), including its mediating role in the relation between key personality traits and ED severity.
One hundred and thirty four patients (121 female, mean age = 29 years) with anorexia nervosa (n = 30), bulimia nervosa (n = 54), binge eating (n = 20), or Other Specified Feeding or Eating Disorders (n = 30) and 74 healthy control participants (51 female, mean age = 21 years) reported on general psychopathology, ED severity, personality traits and difficulties in emotion regulation. Exploratory and confirmatory factor analyses were conducted to examine the psychometrics of the DERS in this Spanish sample (Aim 1). Additionally, to examine the role of emotion regulation difficulties in ED (Aim 2), differences in emotion regulation difficulties across eating disorder subgroups were examined and structural equation modeling was used to explore the interrelations among emotion regulation, personality traits, and eating disorder severity.
RESULTS support the validity and reliability of the DERS within this Spanish adult sample and suggest that this measure has a similar factor structure in this sample as in the original sample. Moreover, emotion regulation difficulties were found to differ as a function of eating disorder subtype and to mediate the relation between two specific personality traits (i.e., high harm avoidance and low self-directedness) and ED severity.
Personality traits of high harm avoidance and low self-directedness may increase vulnerability to ED pathology indirectly, through emotion regulation difficulties.
To evaluate self-reported outcomes after a brief course of skills-based individual therapy for inpatients with anorexia nervosa (AN).
In this case series study 37 adults with AN participated in cognitive remediation and emotion skills training (CREST) sessions, and completed social anhedonia, alexithymia and motivational measures before and after the intervention.
The CREST primary outcome measures were total scores on the Revised Social Anhedonia Scale (RSAS), which decreased significantly (p = 0.03) with an effect size of 0.31, and the Toronto Alexithymia Scale (TAS), which also decreased significantly (p = 0.05) with an effect size of 0.35. The secondary outcome measures focused on motivation: perceived ‘importance to change’ and ‘ability to change’; the second of which increased significantly (p < 0.001) with a medium effect size (d = 0.71).
The individual format of CREST led to a decrease in patients’ self-reported social anhedonia, an improvement in the ability to label their emotions, and increased confidence in their ability to change. Considering the limited number of individual sessions, this is a promising preliminary finding which warrants further research.
Some forms of overeating closely resemble addictive behaviour. The Yale Food Addiction Scale (YFAS) was developed to measure such addiction-like eating in humans and has been employed in numerous studies for examining food addiction in adults. Yet, little is known about food addiction in children and adolescents. Fifty adolescents were recruited at the beginning of treatment in a weight-loss hospital and completed the YFAS among other questionnaires. Nineteen participants (38%) received a YFAS diagnosis, who did not differ in age, body mass and gender distribution from those not receiving a diagnosis. However, those with food addiction reported more binge days, more frequent food cravings, higher eating, weight and shape concerns, more symptoms of depression and higher attentional and motor impulsivity. Eating restraint and nonplanning impulsivity did not differ between groups. Results replicate findings from studies in obese adults such that food addiction is not related to age, gender, body mass or eating restraint, but to higher eating pathology, more symptoms of depression and higher impulsivity. Furthermore, results highlight that particularly attentional impulsivity is related to 'food addiction'. Addiction-like eating appears to be a valid phenotype in a substantial subset of treatment-seeking, obese adolescents.
We propose that highly processed foods share pharmacokinetic properties (e.g. concentrated dose, rapid rate of absorption) with drugs of abuse, due to the addition of fat and/or refined carbohydrates and the rapid rate the refined carbohydrates are absorbed into the system, indicated by glycemic load (GL). The current study provides preliminary evidence for the foods and food attributes implicated in addictive-like eating.
University (Study One) and community (Study Two).
120 undergraduates participated in Study One and 384 participants recruited through Amazon MTurk participated in Study Two.
In Study One, participants (n = 120) completed the Yale Food Addiction Scale (YFAS) followed by a forced-choice task to indicate which foods, out of 35 foods varying in nutritional composition, were most associated with addictive-like eating behaviors. Using the same 35 foods, Study Two utilized hierarchical linear modeling to investigate which food attributes (e.g., fat grams) were related to addictive-like eating behavior (at level one) and explored the influence of individual differences for this association (at level two).
In Study One, processed foods, higher in fat and GL, were most frequently associated with addictive-like eating behaviors. In Study Two, processing was a large, positive predictor for whether a food was associated with problematic, addictive-like eating behaviors. BMI and YFAS symptom count were small-to-moderate, positive predictors for this association. In a separate model, fat and GL were large, positive predictors of problematic food ratings. YFAS symptom count was a small, positive predictor of the relationship between GL and food ratings.
The current study provides preliminary evidence that not all foods are equally implicated in addictive-like eating behavior, and highly processed foods, which may share characteristics with drugs of abuse (e.g. high dose, rapid rate of absorption) appear to be particularly associated with "food addiction."
Obesity is a global issue and it has been suggested that an addiction to certain foods could be a factor contributing to overeating and subsequent obesity. Only one tool, the Yale Food Addiction Scale (YFAS) has been developed to specifically assess food addiction. This review aimed to determine the prevalence of food addiction diagnosis and symptom scores, as assessed by the YFAS. Published studies to July 2014 were included if they reported the YFAS diagnosis or symptom score and were published in the English language. Twenty-five studies were identified including a total of 196,211 predominantly female, overweight/obese participants (60%). Using meta-analysis, the weighted mean prevalence of YFAS food addiction diagnosis was 19.9%. Food addiction (FA) diagnosis was found to be higher in adults aged >35 years, females, and overweight/obese participants. Additionally, YFAS diagnosis and symptom score was higher in clinical samples compared to non-clinical counterparts. YFAS outcomes were related to a range of other eating behavior measures and anthropometrics. Further research is required to explore YFAS outcomes across a broader spectrum of ages, other types of eating disorders and in conjunction with weight loss interventions to confirm the efficacy of the tool to assess for the presence of FA.
In individuals with obesity and binge eating disorder (BED) eating patterns can show addictive qualities, with similarities to substance use disorders (SUDs) on behavioral and neurobiological levels. Bulimia nervosa (BN) has received less attention in this regard, despite their regular binge eating symptoms. The Yale Food Addiction Scale (YFAS) was developed according to the DSM-IV diagnostic criteria for SUDs and food addiction can be diagnosed when at least three addiction symptoms are endorsed and a clinically significant impairment or distress is present. Although the prevalence of food addiction diagnoses is increased in individuals with obesity and BED, recent studies which used the YFAS showed that there are also individuals with normal weight who can be classified as being ‘food addicted’. Based on self-reported eating disorder symptoms, women with current (n = 26) or remitted (n = 20) BN, and a control group of women matched for age and body mass index (n = 63) completed the YFAS and other measures. Results revealed that all patients with current BN received a food addiction diagnosis according to the YFAS while only six (30%) women with remitted BN did. None of the women in the control group received a food addiction diagnosis. Results provide support for the notion that BN can be described as addiction-like eating behavior and suggest that food addiction most likely improves when BN symptoms remit.
A psychobiological dimension of eating behaviour is proposed, which is anchored at the low end by energy intake that is relatively well matched to energy output and is reflected by a stable body mass index (BMI) in the healthy range. Further along the continuum are increasing degrees of overeating (and BMI) characterized by more severe and more compulsive ingestive behaviours. In light of the many similarities between chronic binge eating and drug abuse, several authorities have adopted the perspective that an apparent dependence on highly palatable food-accompanied by emotional and social distress-can be best conceptualized as an addiction disorder. Therefore, this review also considers the overlapping symptoms and characteristics of binge eating disorder (BED) and models of food addiction, both in preclinical animal studies and in human research. It also presents this work in the context of the modern and "toxic" food environment and therein the ubiquitous triggers for over-consumption. We complete the review by providing evidence that what we have come to call "food addiction" may simply be a more acute and pathologically dense form of BED.
Difficulties in executive functioning and emotional processing are reported in anorexia nervosa (AN).This case study describes the application of cognitive remediation and emotion skills training (CREST), an intervention that has been piloted in an inpatient eating disorders (EDs) unit. CREST is a 10-session treatment package, which primarily addresses emotion processing difficulties, one of the maintaining features of AN. The stages of CREST are described, which includes targeting thinking styles, recognizing emotions in the self and others, strategies to manage emotions, and practice of emotion expression. Clinical and self-report data collected before and after CREST indicate improvements in identifying emotions and using healthier emotion regulation strategies, alongside an increase in body mass index (BMI) and reduction in ED symptomatology. This case study provides preliminary evidence for the acceptability and effectiveness of CREST as a low-intensity intervention before proceeding to more comprehensive therapies, such as cognitive behavior therapy to address the ED more fully.
With the rise in worldwide rates of obesity in the past few decades, scientists and clinicians have focused con-siderable attention on trying to understand the causes of excessive and compulsive food intake – patterns of overeating that are highly correlated with body mass index (BMI). Given that prominent psycho-behavioral similarities exist between chronic binge eating and drug abuse, many have adopted the perspective that an apparent dependence on highly palatable food -accompanied by marked emotional and social distress and deficiency – is, in essence, an addiction disorder. This narrative review considers the overlapping symptoms and characteristics of binge eating disorder (BED), and models of food addiction, both in preclini-cal animal studies and in human research. It is conclud-ed that overeating may best be viewed along a dimension reflecting degrees of severity and compulsiveness and that the high end of the continuum marks the clinically significant impairment seen in BED. We further suggest that what we have come to call 'food addiction' may simply be a more acute and pathologically-dense form of BED.
Cloninger's psychobiological model identifies 4 dimensions of temperament and 3 dimension of character. The Five-Factor Model (FFM) of personality proposes the domains of Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness as the basic dimensions underlying individual differences. Five-factor scores are obtained with the NEO-PI-R. Cloninger's personality dimensions are assessed with the Temperament and Character Inventory (TCI). This study describes the relationships between Cloninger's 7-dimensional model and the FFM of personality at the phenotypic domain and fact level. A random sample of 130 15–78 yr old patients admitted for observation and diagnosis to the psychiatric unit of a large university hospital participated in the study. Ss were administered Dutch translations of the NEO-PI-R and the TCI. Considerable overlap with the FFM dimensions is demonstrated and the results show that each TCI factor is substantially covered by the FFM. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The present project utilized the Five Factor Model of personality (FFM; McCrae & Costa, 1990) to clarify the multi-faceted nature of impulsivity. The NEO-PI-R and a number of commonly used impulsivity measures were administered to over 400 young adults. Exploratory factor analyses identified four distinct personality facets associated with impulsive-like behavior which were labeled urgency, (lack of) premeditation, (lack of) perseverance, and sensation seeking. Each of these traits was marked by a different facet of the FFM. Following the initial factor identification, scales to measure each of the personality facets were created and combined to form the UPPS Impulsive Behavior scale. Implications for the understanding of impulsive behavior and the FFM are discussed, as are future applications of the UPPS impulsive behavior scale.
For journal editors, reviewers, and readers of research articles, structural equation model (SEM) fit has recently become a confusing and contentious area of evaluative methodology. Proponents of two kinds of approaches to model fit can be identified: those who adhere strictly to the result from a null hypothesis significance test, and those who ignore this and instead index model fit as an approximation function. Both have principled reasons for their respective course of action. This paper argues that the chi-square exact-fit test is the only substantive test of fit for SEM, but, its sensitivity to discrepancies from expected values at increasing sample sizes can be highly problematic if those discrepancies are considered trivial from an explanatory-theory perspective. On the other hand, suitably scaled indices of approximate fit do not possess this sensitivity to sample size, but neither are they “tests” of model fit. The proposed solution to this dilemma is to consider the substantive “consequences” of accepting one explanatory model over another in terms of the predictive accuracy of theory-relevant-criteria. If there are none to be evaluated, then it is proposed that no scientifically worthwhile distinction between “competing” models can thus be made, which of course begs the question as to why such a SEM application was undertaken in the first place.
Both drug addiction and obesity can be defined as disorders in which the saliency value of one type of reward (drugs and food, respectively) becomes abnormally enhanced relative to, and at the expense of others. This model is consistent with the fact that both drugs and food have powerful reinforcing effects-partly mediated by dopamine increases in the limbic system-that, under certain circumstances or in vulnerable individuals, could overwhelm the brain's homeostatic control mechanisms. Such parallels have generated significant interest in understanding the shared vulnerabilities and trajectories between addiction and obesity. Now, brain imaging discoveries have started to uncover common features between these two conditions and to delineate some of the overlapping brain circuits whose dysfunctions may explain stereotypic and related behavioral deficits in human subjects. These results suggest that both obese and drug-addicted individuals suffer from impairments in dopaminergic pathways that regulate neuronal systems associated not only with reward sensitivity and incentive motivation, but also with conditioning (memory/learning), impulse control (behavioural inhibition), stress reactivity, and interoceptive awareness. Here, we integrate findings predominantly derived from positron emission tomography that shed light on the role of dopamine in drug addiction and in obesity, and propose an updated working model to help identify treatment strategies that may benefit both of these conditions.
Under heightened emotional states, individuals are more inclined to engage in ill-considered or rash actions than at other times. The authors present evidence for the existence of 2 related traits called positive and negative urgency. The traits refer to individual differences in the disposition to engage in rash action when experiencing extreme positive and negative affect, respectively. The authors provide evidence that these traits are distinct from other dispositions toward rash action and that they play distinct roles in predicting problem levels of involvement in behaviors such as alcohol consumption, binge eating, drug use, and risky sexual behavior. The authors identify facilitative conditions for the emergence of the urgency traits from neuroscience. Certain gene polymorphisms are associated with low levels of serotonin and high levels of dopamine; that pattern of neurotransmitter activity in a brain system linking the orbitofrontal cortex and the amygdala appears to facilitate the development of positive and negative urgency. The authors discuss the implications of this theory.
In 3 studies, the authors developed and began to validate a measure of the propensity to act rashly in response to positive affective states (positive urgency). In Study 1, they developed a content-valid 14-item scale, showed that the measure was unidimensional, and showed that positive urgency was distinct from impulsivity-like constructs identified in 2 models of impulsive behavior. In Study 2, they showed that positive urgency explained variance in risky behavior not explained by measures of other impulsivity-like constructs, differentially explained positive mood-based risky behavior, differentiated individuals at risk for problem gambling from those not at risk, and interacted with drinking motives and expectancies as predicted to explain problem drinking behavior. In Study 3, they confirmed the hypothesis that positive urgency differentiated alcoholics from both eating-disordered and control individuals.
Background and objectives:
In an era where obesity remains an important public health concern, food addiction has emerged as a possible contributor to obesity. The DRD2 gene is the most studied polymorphism. The aim of this study was to investigate a relationship between food addiction questionnaires, body composition measurements, and a dopamine- resistant receptor polymorphism (DRD2 A1) among Asian Americans.
Methods and study design:
A total of 84 Asian American college students were recruited. Participants underwent body composition measurement via bioelectrical impedance, answered questionnaires (Food Craving Inventory and Power of Food Scale), and had blood drawn for genotyping (PCR).
There was no difference in body composition (BMI, percent body fat) between the A1 (A1A1 or A1A2) and A2 (A2A2) groups. There were statistically significant differences in food cravings of carbohydrates and fast food on the Food Craving Inventory between the A1 and A2 groups (p=0.03), but not for sugar or fat. Among Asian college females, there was also a difference on the Power of Food questionnaire (p=0.04), which was not seen among men. 13 out of 55 women also had >30% body fat at a BMI of 21.4 to 28.5 kg/m2.
Greater carbohydrate and fast food craving was associated with the DRD2 A1 versus A2 allele among Asian Americans. Further studies examining the ability of dopamine agonists to affect food craving and to reduce body fat in Asian American are warranted. More studies in food addiction among obese Asian Americans are needed with careful definition of obesity, specifically for Asian women.
Currently, there is an ongoing debate about whether it is possible to be addicted to food. There are several indications pointing in this direction, but research is scarce. Up to this date it is not exactly known whether this "food addiction" shares common neurocognitive deficits observed in the more classical types of addictions such as substance use disorders (SUDs). One commonly observed finding in SUD patients is that there is an impaired cognitive control. One of the essential components of cognitive control is performance monitoring. In the present study it is studied whether persons with "food addiction" have impaired error monitoring. For this purpose the performance monitoring of persons meeting the criteria for "food addiction" (n=34) according to the Yale Food Addiction Scale (YFAS) were compared with a control group (n=34) while performing an Eriksen flanker task and EEG measurement. Both electrophysiological (ERN and Pe component) and behavioral measures were compared between the two groups. The present study indicates that the "food addicted" persons have reduced ERN and Pe waves. In addition, the "food addiction" group demonstrates a higher number of errors on the flanker task. In general, the results provide indications that persons with a "food addiction" display impaired performance monitoring. These findings provide an indication that food addiction, similar to other addictions, is characterized by impaired cognitive control.
The present study aimed to investigate if eating disorder patients differ in specific personality traits depending on a positive screening of food addiction (FA) and to find a model to predict FA in eating disorder patients using measures of personality and impulsivity.
Two hundred seventy eight patients, having an eating disorder, self-reported on FA, impulsivity, personality, eating and general psychopathology. Patients were then split into two groups, depending on a positive or negative result on the FA screening. Analysis of variance was used to compare means between the two groups. Stepwise binary logistic regression was used to obtain a predictive model for the presence of FA.
Patients with FA had lower self-directedness, and more negative urgency and lack of perseverance than patients not reporting addictive eating. The probability of FA can be predicted by high negative urgency, high reward dependence, and low lack of premeditation.
Eating disorder patients who have more problems to pursue tasks to the end and to focus on long-term goals seem to be more likely to develop addictive eating patterns.
The development and validation of a new measure, the Eating Disorder Inventory (EDI) is described. The EDI is a 64 item, self-report, multiscale measure designed for the assessment of psychological and behavioral traits common in anorexia nervosa (AN) and bulimia. The EDI consists of eight subscales measuring: Drive for Thinness, Bilimia, Body Dissatisfaction, Ineffectiveness, Perfectionism, Interpersonal Distrust, Interoceptive Awareness and Maturity Fears. Reliability (internal consistency) is established for all subscales and several indices of validity are presented. First, AN patients (N=113) are differentiated from femal comparison (FC) subjects (N=577) using a cross-validation procedure. Secondly, patient self-report subscale scores agree with clinician ratings of subscale traits. Thirdly, clinically recovered AN patients score similarly to FCs on all subscales. Finally, convergent and discriminant validity are established for subscales. The EDI was also administered to groups of normal weight bulimic women, obese, and normal weight but formerly obese women, as well as a male comparison group. Group differences are reported and the potential utility of the EDI is discussed.
Childhood maltreatment is an important risk factor for problems with alcohol and other drugs such as cannabis. Although this link has been well established, the mechanisms in this association require further study. High levels of impulsivity and difficulties with emotion regulation are often associated with childhood maltreatment. Negative urgency--an emotion-based facet of impulsivity--is a strong predictor of substance use problems and may be a particularly relevant facet of impulsivity in the link between childhood maltreatment and alcohol and cannabis outcomes. However, few studies have examined the specific mediational pathway from childhood maltreatment to alcohol and cannabis problems through negative urgency.
We tested the hypothesis that the associations between history of childhood maltreatment and current alcohol and cannabis problems would be mediated by negative urgency, but not other facets of impulsivity.
Participants (N=232), who were in late adolescence (mean age=19.75), completed self-report measures of different facets of impulsivity, past childhood maltreatment, and current alcohol and cannabis use and problems.
In analyses including several facets of impulsivity as simultaneous mediators, negative urgency was the only facet to mediate the associations of childhood maltreatment severity with alcohol and cannabis problems.
These findings provide support for negative urgency as a unique mediator of the associations between childhood maltreatment and both alcohol and cannabis problems, suggesting that future work on mechanisms in these associations should focus on mood-based impulsivity.