Special Issue "The Clinical Utility of Food Addiction and Eating Addiction"

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (1 November 2020) | Viewed by 31014

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Special Issue Editors

Dr. Stephanie Cassin
E-Mail Website
Guest Editor
1. Ryerson University, Department of Psychology, 350 Victoria St, Toronto, ON M5B 2K3, Canada;
2. University of Toronto, Department of Psychiatry, Toronto, ON M5T 1R8, Canada;
3. University Health Network, Centre for Mental Health, Toronto, ON M5G 2C4, Canada
Interests: bariatric surgery; obesity; food addiction; binge eating; disordered eating; psychosocial interventions; cognitive behavioral therapy
Prof. Dr. Sanjeev Sockalingam
E-Mail Website
Guest Editor
1. Centre for Addiction and Mental Health, 33 Russell Street, Suite 2065, Toronto, ON M5G 2C4,Canada;
2 .Department of Psychiatry,University of Toronto, Toronto, ON M5T 1R8, Canada;
3. University Health Network, Centre for Mental Health, Toronto, ON M5G 2C4, Canada
Interests: bariatric surgery; obesity; mental health; integrated care; binge eating disorder; behavioral medicine; medical education; capacity building

Special Issue Information

Dear Colleagues,

In comparison to the large body of research that has examined the validity of food addiction and eating addiction, research on their clinical utility has lagged far behind. Although neither food addiction nor eating addiction are officially recognized diagnoses, many individuals self-identify as “food addicts” and/or exceed the cut-offs on measures of addictive-like eating. To be clinically useful, a diagnosis should inform the treatment plan and predict clinical outcomes. This Special Issue will explore the clinical utility of food addiction and eating addiction. Does the presence of food or eating addiction impact outcomes among individuals seeking treatment for obesity or for eating disorders such as bulimia nervosa or binge eating disorder? If an individual seeks treatment for food or eating addiction, which treatments should be recommended? Are existing evidence-based treatments for eating disorders or substance-related and addictive disorders effective among individuals with food or eating addiction? What is the evidence for abstinence-based versus moderation approaches? What are the treatment preferences of individuals with food or eating addiction? What factors predict treatment seeking among individuals with food or eating addiction? This Special Issue calls for papers that advance knowledge on the clinical utility of food addiction and eating addiction. Empirical studies examining treatments for food or eating addiction, and those examining the impact of food or eating addiction on response to treatments for obesity or eating disorders are particularly encouraged.

Assoc. Prof. Stephanie Cassin
Prof. Sanjeev Sockalingam
Guest Editors

Manuscript Submission Information

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Keywords

  • Food addiction
  • Eating addiction
  • Clinical utility
  • Treatment
  • Intervention

Published Papers (12 papers)

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Editorial

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Editorial
Advances and Future Directions in the Clinical Utility of Food Addiction
Nutrients 2021, 13(2), 708; https://doi.org/10.3390/nu13020708 - 23 Feb 2021
Cited by 3 | Viewed by 1545
Abstract
The body of research examining the validity of food addiction and eating addiction far exceeds the research examining their clinical utility [...] Full article
(This article belongs to the Special Issue The Clinical Utility of Food Addiction and Eating Addiction)

Research

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Article
Examining Self-Weighing Behaviors and Associated Features and Treatment Outcomes in Patients with Binge-Eating Disorder and Obesity with and without Food Addiction
Nutrients 2021, 13(1), 29; https://doi.org/10.3390/nu13010029 - 23 Dec 2020
Cited by 4 | Viewed by 1598
Abstract
Food addiction (FA) has been linked to clinical features in binge-eating disorder (BED) and obesity. A feature of behavioral weight loss (BWL) treatment involves frequent weighing. However, little is known regarding how frequency of self-weighing and related perceptions are associated with BWL outcomes [...] Read more.
Food addiction (FA) has been linked to clinical features in binge-eating disorder (BED) and obesity. A feature of behavioral weight loss (BWL) treatment involves frequent weighing. However, little is known regarding how frequency of self-weighing and related perceptions are associated with BWL outcomes among individuals with BED and obesity stratified by FA status. Participants (n = 186) were assessed with the Eating Disorder Examination before and after BWL treatment. Mixed effects models examined FA (presence/absence) before and after (post-treatment and 6- and 12-month follow-up) treatment and associations with frequency of weighing and related perceptions (reactions to weighing, sensitivity to weight gain and shape/weight acceptance). Participants with FA reported more negative reactions to weighing and less acceptance of shape/weight throughout treatment and follow-ups, and both variables were associated with greater disordered eating at follow-ups among participants with FA. Sensitivity to weight gain decreased over time independent of FA status. Frequency of weighing was associated with a greater likelihood of achieving 5% weight loss only among those without FA. Reactions to weighing and sensitivity to weight gain are associated with FA and poorer treatment outcomes in individuals with BED and obesity. Targeting these features may improve BWL outcomes among individuals with BED, obesity and FA. Full article
(This article belongs to the Special Issue The Clinical Utility of Food Addiction and Eating Addiction)
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Article
Longitudinal Changes in Food Addiction Symptoms and Body Weight among Adults in a Behavioral Weight-Loss Program
Nutrients 2020, 12(12), 3687; https://doi.org/10.3390/nu12123687 - 29 Nov 2020
Cited by 5 | Viewed by 1536
Abstract
Interest in food addiction (FA) has increased, but little is known about its clinical implications or potential treatments. Using secondary analyses from a randomized controlled trial, we evaluated the associations between changes in FA, body weight, and “problem food” consumption during a 22-month [...] Read more.
Interest in food addiction (FA) has increased, but little is known about its clinical implications or potential treatments. Using secondary analyses from a randomized controlled trial, we evaluated the associations between changes in FA, body weight, and “problem food” consumption during a 22-month behavioral weight-loss program consisting of an initial four-month in-person intervention, 12-month extended-care, and six-month follow-up (n = 182). Food addiction was measured using the Yale Food Addiction Scale. “Problem foods” were identified from the literature and self-reporting. Multilevel modeling was used as the primary method of analysis. We hypothesized that reductions in problem food consumption during the initial treatment phase would be associated with long-term (22-month) FA reductions. As expected, we found that reductions in problem foods were associated with greater initial reductions in FA symptoms; however, they were also associated with a sharper rebound in symptoms over time (p = 0.016), resulting in no significant difference at Month 22 (p = 0.856). Next, we hypothesized that long-term changes in FA would be associated with long-term changes in body weight. Although both FA and weight decreased over time (ps < 0.05), month-to-month changes in FA were not associated with month-to-month changes in weight (p = 0.706). Instead, higher overall FA (i.e., mean scores over the course of the study) were associated with less weight loss (p = 0.008) over time. Finally, we hypothesized that initial reductions in problem food consumption would be associated with long-term reductions in weight, but this relationship was not significant (ps > 0.05). Given the complexity of the findings, more research is needed to identify interventions for long-term changes in FA and to elucidate the associations between problem foods, FA, and weight. Full article
(This article belongs to the Special Issue The Clinical Utility of Food Addiction and Eating Addiction)
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Article
Ultraprocessed Food: Addictive, Toxic, and Ready for Regulation
Nutrients 2020, 12(11), 3401; https://doi.org/10.3390/nu12113401 - 05 Nov 2020
Cited by 24 | Viewed by 8646
Abstract
Past public health crises (e.g., tobacco, alcohol, opioids, cholera, human immunodeficiency virus (HIV), lead, pollution, venereal disease, even coronavirus (COVID-19) have been met with interventions targeted both at the individual and all of society. While the healthcare community is very aware that the [...] Read more.
Past public health crises (e.g., tobacco, alcohol, opioids, cholera, human immunodeficiency virus (HIV), lead, pollution, venereal disease, even coronavirus (COVID-19) have been met with interventions targeted both at the individual and all of society. While the healthcare community is very aware that the global pandemic of non-communicable diseases (NCDs) has its origins in our Western ultraprocessed food diet, society has been slow to initiate any interventions other than public education, which has been ineffective, in part due to food industry interference. This article provides the rationale for such public health interventions, by compiling the evidence that added sugar, and by proxy the ultraprocessed food category, meets the four criteria set by the public health community as necessary and sufficient for regulation—abuse, toxicity, ubiquity, and externalities (How does your consumption affect me?). To their credit, some countries have recently heeded this science and have instituted sugar taxation policies to help ameliorate NCDs within their borders. This article also supplies scientific counters to food industry talking points, and sample intervention strategies, in order to guide both scientists and policy makers in instituting further appropriate public health measures to quell this pandemic. Full article
(This article belongs to the Special Issue The Clinical Utility of Food Addiction and Eating Addiction)
Article
The Clinical Utility of Food Addiction: Characteristics and Psychosocial Impairments in a Treatment-Seeking Sample
Nutrients 2020, 12(11), 3388; https://doi.org/10.3390/nu12113388 - 04 Nov 2020
Cited by 8 | Viewed by 1709
Abstract
Little is known about the characteristics of individuals seeking treatment for food addiction (FA), and the clinical utility of FA has yet to be established. To address these gaps, we examined (i) the demographic, eating pathology, and psychiatric conditions associated with FA and [...] Read more.
Little is known about the characteristics of individuals seeking treatment for food addiction (FA), and the clinical utility of FA has yet to be established. To address these gaps, we examined (i) the demographic, eating pathology, and psychiatric conditions associated with FA and (ii) whether FA is associated with psychosocial impairments when accounting for eating-related and other psychopathology. Forty-six patients seeking treatment for FA completed self-report questionnaires and semi-structured clinical interviews. The majority of the sample were women and self-identified as White, with a mean age of 43 years. Most participants (83.3%) presented with a comorbid psychiatric condition, most commonly anxiety and mood disorders, with a mean of 2.31 comorbid conditions. FA was associated with binge eating severity and anxiety symptoms, as well as psychological, physical, and social impairment. In regression analyses controlling for binge eating severity, food cravings, depression, and anxiety, FA remained a significant predictor only of social impairment. Taken together, the results suggest that individuals seeking treatment for FA are likely to present with significant comorbid conditions, in particular anxiety disorders. The results of the present research provide evidence for the clinical utility of FA, particularly in explaining social impairment. Full article
(This article belongs to the Special Issue The Clinical Utility of Food Addiction and Eating Addiction)
Article
Food Addiction Is Associated with Binge Eating and Psychiatric Distress among Post-Operative Bariatric Surgery Patients and May Improve in Response to Cognitive Behavioural Therapy
Nutrients 2020, 12(10), 2905; https://doi.org/10.3390/nu12102905 - 23 Sep 2020
Cited by 6 | Viewed by 2042
Abstract
The current study examined clinical correlates of food addiction among post-operative bariatric surgery patients, compared the clinical characteristics of patients with versus without food addiction, and examined whether a brief telephone-based cognitive behavioural therapy (Tele-CBT) intervention improves food addiction symptomatology among those with [...] Read more.
The current study examined clinical correlates of food addiction among post-operative bariatric surgery patients, compared the clinical characteristics of patients with versus without food addiction, and examined whether a brief telephone-based cognitive behavioural therapy (Tele-CBT) intervention improves food addiction symptomatology among those with food addiction. Participants (N = 100) completed measures of food addiction, binge eating, depression, and anxiety 1 year following bariatric surgery, were randomized to receive either Tele-CBT or standard bariatric post-operative care, and then, repeated the measure of food addiction at 1.25 and 1.5 years following surgery. Thirteen percent of patients exceeded the cut-off for food addiction at 1 year post-surgery, and this subgroup of patients reported greater binge eating characteristics and psychiatric distress compared to patients without food addiction. Among those with food addiction, Tele-CBT was found to improve food addiction symptomatology immediately following the intervention. These preliminary findings suggest that Tele-CBT may be helpful, at least in the short term, in improving food addiction symptomatology among some patients who do not experience remission of food addiction following bariatric surgery; however, these findings require replication in a larger sample. Full article
(This article belongs to the Special Issue The Clinical Utility of Food Addiction and Eating Addiction)
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Article
Health Professionals’ and Health Professional Trainees’ Views on Addictive Eating Behaviours: A Cross-Sectional Survey
Nutrients 2020, 12(9), 2860; https://doi.org/10.3390/nu12092860 - 18 Sep 2020
Cited by 5 | Viewed by 1467
Abstract
Despite increasing research on the concept of addictive eating, there is currently no published evidence on the views of health professionals who potentially consult with patients presenting with addictive eating behaviours, or of students training to become health professionals. This study aimed to [...] Read more.
Despite increasing research on the concept of addictive eating, there is currently no published evidence on the views of health professionals who potentially consult with patients presenting with addictive eating behaviours, or of students training to become health professionals. This study aimed to explore the views and understanding of addictive eating behaviours among health professionals and health professionals in training and to identify potential gaps in professional development training. An international online cross-sectional survey was conducted in February–April 2020. The survey (70 questions, 6 key areas) assessed participants’ opinions and clinical experience of addictive eating; opinions on control, responsibility, and stigma relating to addictive eating; and knowledge of addictive eating and opinions on professional development training. In total, 142 health professionals and 33 health professionals in training completed the survey (mean age 38.1 ± 12.5 years, 65% from Australia/16% from the U.K.) Of the health professionals, 47% were dietitians and 16% were psychologists. Most participants (n = 126, 72%) reported that they have been asked by individuals about addictive eating. Half of the participants reported that they consider the term food addiction to be stigmatising for individuals (n = 88). Sixty percent (n = 105) reported that they were interested/very interested in receiving addictive eating training, with the top two preferred formats being online and self-paced, and face-to-face. These results demonstrate that addictive eating is supported by health professionals as they consult with patients presenting with this behaviour, which supports the views of the general community and demonstrates a need for health professional training. Full article
(This article belongs to the Special Issue The Clinical Utility of Food Addiction and Eating Addiction)
Article
Does Eating Addiction Favor a More Varied Diet or Contribute to Obesity?—The Case of Polish Adults
Nutrients 2020, 12(5), 1304; https://doi.org/10.3390/nu12051304 - 02 May 2020
Cited by 1 | Viewed by 1656
Abstract
The rapidly increasing prevalence of overweight and obesity indicates a need to search for their main causes. Addictive-like eating and associated eating patterns might result in overconsumption, leading to weight gain. The aim of the study was to identify the main determinants of [...] Read more.
The rapidly increasing prevalence of overweight and obesity indicates a need to search for their main causes. Addictive-like eating and associated eating patterns might result in overconsumption, leading to weight gain. The aim of the study was to identify the main determinants of food intake variety (FIV) within eating addiction (EA), other lifestyle components, and sociodemographic characteristics. The data for the study were collected from a sample of 898 Polish adults through a cross-sectional survey in 2019. The questionnaire used in the study included Food Intake Variety Questionnaire (FIVeQ), Eating Preoccupation Scale (EPS), and questions regarding lifestyle and sociodemographic factors. High eating addiction was found in more than half of the people with obesity (54.2%). In the study sample, physical activity at leisure time explained FIV in the greatest manner, followed by the EPS factor: eating to provide pleasure and mood improvement. In the group of people with obesity, the score for this EPS factor was the best predictor of FIV, in that a higher score was conducive to a greater variety of food intake. Sociodemographic characteristics differentiated FIV only within groups with normal body weight (age) and with overweight (education). In conclusion, food intake variety (FIV) was associated with physical activity at leisure time, and then with EPS factor “Eating to provide pleasure and mood improvement”, whereas sociodemographic characteristics were predictors of FIV only within groups identified by body mass index (BMI). Nevertheless, our observations regarding the eating to provide pleasure and mood improvement factor and its associations with food intake variety indicate a need for further research in this area. Future studies should also use other tools to explicitly explain this correlation. Full article
(This article belongs to the Special Issue The Clinical Utility of Food Addiction and Eating Addiction)
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Review

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Review
Exploring Patterns of Disturbed Eating in Psychosis: A Scoping Review
Nutrients 2020, 12(12), 3883; https://doi.org/10.3390/nu12123883 - 18 Dec 2020
Cited by 9 | Viewed by 2104
Abstract
Disturbed eating behaviours have been widely reported in psychotic disorders since the early 19th century. There is also evidence that antipsychotic (AP) treatment may induce binge eating or other related compulsive eating behaviours. It is therefore possible that abnormal eating patterns may contribute [...] Read more.
Disturbed eating behaviours have been widely reported in psychotic disorders since the early 19th century. There is also evidence that antipsychotic (AP) treatment may induce binge eating or other related compulsive eating behaviours. It is therefore possible that abnormal eating patterns may contribute to the significant weight gain and other metabolic disturbances observed in patients with psychosis. In this scoping review, we aimed to explore the underlying psychopathological and neurobiological mechanisms of disrupted eating behaviours in psychosis spectrum disorders and the role of APs in this relationship. A systematic search identified 35 studies that met our eligibility criteria and were included in our qualitative synthesis. Synthesizing evidence from self-report questionnaires and food surveys, we found that patients with psychosis exhibit increased appetite and craving for fatty food, as well as increased caloric intake and snacking, which may be associated with increased disinhibition. Limited evidence from neuroimaging studies suggested that AP-naïve first episode patients exhibit similar neural processing of food to healthy controls, while chronic AP exposure may lead to decreased activity in satiety areas and increased activity in areas associated with reward anticipation. Overall, this review supports the notion that AP use can lead to disturbed eating patterns in patients, which may contribute to AP-induced weight gain. However, intrinsic illness-related effects on eating behaviors remain less well elucidated, and many confounding factors as well as variability in study designs limits interpretation of existing literature in this field and precludes firm conclusions from being made. Full article
(This article belongs to the Special Issue The Clinical Utility of Food Addiction and Eating Addiction)
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Review
Food Addiction and Tobacco Use Disorder: Common Liability and Shared Mechanisms
Nutrients 2020, 12(12), 3834; https://doi.org/10.3390/nu12123834 - 15 Dec 2020
Cited by 6 | Viewed by 1562
Abstract
As food addiction is being more commonly recognized within the scientific community, parallels can be drawn between it and other addictive substance use disorders, including tobacco use disorder. Given that both unhealthy diets and smoking are leading risk factors for disability and death, [...] Read more.
As food addiction is being more commonly recognized within the scientific community, parallels can be drawn between it and other addictive substance use disorders, including tobacco use disorder. Given that both unhealthy diets and smoking are leading risk factors for disability and death, a greater understanding of how food addiction and tobacco use disorder overlap with one another is necessary. This narrative review aimed to highlight literature that investigated prevalence, biology, psychology, and treatment options of food addiction and tobacco use disorder. Published studies up to August 2020 and written in English were included. Using a biopsychosocial lens, each disorder was assessed together and separately, as there is emerging evidence that the two disorders can develop concurrently or sequentially within individuals. Commonalities include but are not limited to the dopaminergic neurocircuitry, gut microbiota, childhood adversity, and attachment insecurity. In addition, the authors conducted a feasibility study with the purpose of examining the association between food addiction symptoms and tobacco use disorder among individuals seeking tobacco use disorder treatment. To inform future treatment approaches, more research is necessary to identify and understand the overlap between the two disorders. Full article
(This article belongs to the Special Issue The Clinical Utility of Food Addiction and Eating Addiction)
Review
Food Addiction and Psychosocial Adversity: Biological Embedding, Contextual Factors, and Public Health Implications
Nutrients 2020, 12(11), 3521; https://doi.org/10.3390/nu12113521 - 16 Nov 2020
Cited by 11 | Viewed by 3338
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue The Clinical Utility of Food Addiction and Eating Addiction)
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Review
Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint
Nutrients 2020, 12(10), 2937; https://doi.org/10.3390/nu12102937 - 25 Sep 2020
Cited by 12 | Viewed by 2984
Abstract
Converging evidence from both animal and human studies have implicated hedonic eating as a driver of both binge eating and obesity. The construct of food addiction has been used to capture pathological eating across clinical and non-clinical populations. There is an ongoing debate [...] Read more.
Converging evidence from both animal and human studies have implicated hedonic eating as a driver of both binge eating and obesity. The construct of food addiction has been used to capture pathological eating across clinical and non-clinical populations. There is an ongoing debate regarding the value of a food addiction “diagnosis” among those with eating disorders such as anorexia nervosa binge/purge-type, bulimia nervosa, and binge eating disorder. Much of the food addiction research in eating disorder populations has failed to account for dietary restraint, which can increase addiction-like eating behaviors and may even lead to false positives. Some have argued that the concept of food addiction does more harm than good by encouraging restrictive approaches to eating. Others have shown that a better understanding of the food addiction model can reduce stigma associated with obesity. What is lacking in the literature is a description of a more comprehensive approach to the assessment of food addiction. This should include consideration of dietary restraint, and the presence of symptoms of other psychiatric disorders (substance use, posttraumatic stress, depressive, anxiety, attention deficit hyperactivity) to guide treatments including nutrition interventions. The purpose of this review is to help clinicians identify the symptoms of food addiction (true positives, or “the signal”) from the more classic eating pathology (true negatives, or “restraint”) that can potentially elevate food addiction scores (false positives, or “the noise”). Three clinical vignettes are presented, designed to aid with the assessment process, case conceptualization, and treatment strategies. The review summarizes logical steps that clinicians can take to contextualize elevated food addiction scores, even when the use of validated research instruments is not practical. Full article
(This article belongs to the Special Issue The Clinical Utility of Food Addiction and Eating Addiction)
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