Search Results (230)

Food addiction is characterized by compulsive consumption and impaired control over highly palatable foods, with neurobiological mechanisms analogous to substance use disorders. The Yale Food Addiction Scale 2.0 (YFAS 2.0) is the most widely used instrument to assess these symptoms; however, its psychometric properties have not been validated in Mexican adults. This study aimed to perform the cross-cultural adaptation of the YFAS 2.0 and validate its psychometric properties for the identification of food addiction in the Mexican adult population. A cross-sectional study was conducted in 500 Mexican adults aged 20 years or older. Participants completed the cross-culturally adapted YFAS 2.0. Exploratory and hierarchical factor analyses were conducted. Reliability was assessed using Cronbach’s alpha and omega coefficients, and model fit was evaluated through global fit indices. The scale showed high internal consistency (α = 0.88; ωt = 0.87; ωh = 0.89). The Kaiser–Meyer–Olkin index was 0.815 and Bartlett’s test was significant (χ² = 4367.88; df = 595; p < 0.001). Exploratory factor analysis supported a unidimensional structure, with the first factor explaining 21.3% of the total variance. In the hierarchical model, all items loaded substantially onto the general factor. Fit indices indicated excellent model fit (CFI = 0.99; TLI = 0.98; RMSEA = 0.001; RMR = 0.004). The YFAS 2.0 is a valid and reliable instrument for identifying food addiction symptoms in Mexican adults. It may be useful in clinical practice and research on eating disorders. Full article

Food addiction (FA) is an emerging psychiatric condition that presents behavioral and neurobiological similarities with other addictions, and its early identification is essential to prevent the development of more severe disorders. The aim of the present study was to determine the ability of anthropometric measures, eating habits, symptoms related to eating disorders (ED), and lifestyle features to predict the symptoms of food addiction. Methodology: A cross-sectional study was conducted in a sample of 702 university students (77.3% women; age: 22 ± 6 years). The Food Frequency Questionnaire (FFQ), the Yale Food Addiction Scale 2.0 (YFAS 2.0), the Eating Attitudes Test (EAT-26), anthropometric measurements, and a set of self-report questions on substance use, physical activity level, and other questions were administered. A total of 6.4% of participants presented symptoms compatible with food addiction, and 8.1% were at risk for ED. Additionally, 26.5% reported daily smoking, 70.6% consumed alcohol, 2.9% used illicit drugs, and 29.4% took medication; 35.3% did not engage in physical activity. Individuals with food addiction had higher BMI (p = 0.010), waist circumference (p = 0.001), and body fat (p < 0.001) values, and a higher risk of eating disorders (p = 0.010) compared to those without this condition. In the multivariate logistic model, non-dairy beverage consumption (such as coffee or alcohol), vitamin D deficiency, and waist circumference predicted food addiction symptoms (R²_Nagelkerke = 0.349). Indeed, the machine learning approaches confirmed the influence of these variables. Conclusions: The prediction models allowed an accurate prediction of FA in the university students; moreover, the individualized approach improved the identification of people with FA, involving complex dimensions of eating behavior, body composition, and potential nutritional deficits not previously studied. Full article

Background/objectives: In 9/2020, the United States Food and Drug Administration )FDA( posted a black box warning for all benzodiazepines, addressing their association with serious risks of abuse, addiction, physical dependence, and withdrawal reactions. We evaluated changes in benzodiazepine dispensing rate trends after this warning. Methods: The dataset of Clalit Health Services (Israel’s largest insurer, with 5 million members) was used to identify and collect benzodiazepine dispensing data for all patients who were dispensed these drugs at least once during the study period (1/2017–12/2021). The dispensing rate (number of patients who were dispensed benzodiazepines per month divided by the number of patients alive during that month) was calculated for each month in the study period. Linear regression and change point regression were used to review the change in trend before and after the black box warning. New users of benzodiazepines after the black box warning were analyzed by age. Results: A total of 639,515 patients using benzodiazepines were reviewed. The mean benzodiazepine dispensing rate per month was 0.21 and ranged from 0.17 (in 2/2017) to 0.24 (in 3/2020). No significant change in trend was observed before vs. after the black box warning (slopes of 0.00675 percentage points per month and 0.00001 percentage points per month, respectively; p = 0.38). The change point regression analysis identified a change point in 4/2019, which is prior to the black box warning. New users were younger after the black box warning compared to before this warning. Conclusions: The FDA black box warning did not affect the dispensing rate of benzodiazepines. Full article

Background and Objective: Obesity is currently one of the major challenges in medicine. Research indicates that assessing eating habits can contribute significantly to the development of more effective treatment. This study aims to validate the Eating Behaviors Assessment for Obesity (EBA-O) in a sample of Spanish adults with overweight or obesity. Methods: This cross-sectional study included 384 participants. To evaluate the structure, reliability, and measurement invariance of the Spanish EBA-O, we conducted a confirmatory factor analysis (CFA), calculated McDonald’s omega for reliability, and carried out a hierarchical sequence of multigroup CFAs. Two-way MANOVA was used to assess the effects of sex and body mass index (BMI) categories on EBA-O scores. Results: CFA supported a second-order five-factor structure for the EBA-O, demonstrating excellent fit indices. It respected the configural, metric, and scalar invariance. The Spanish version of the EBA-O exhibited significant correlations with measures of binge eating, food addiction, and eating disorder psychopathology. Internal consistency was high (ω = 0.80). Significant effects of sex and BMI were observed across EBA-O subscales. Conclusions: The EBA-O appears to be a valid, reliable, and easy-to-use instrument for assessing eating behaviors among Spanish-speaking individuals with overweight or obesity. Its strong psychometric properties support its use in both clinical settings and research, enhancing the development of tailored interventions for this population. Full article

Background: Food addiction (FA) is an emerging construct that mirrors the behavioral and neurobiological characteristics of substance use disorders. Despite growing interest, its association with specific psychiatric disorders among bariatric patients remains understudied. Objective: Our aim was to examine the prevalence and strength of associations between FA and seven major psychiatric disorders in individuals who underwent bariatric surgery. Methods: In a sample of 100 post-bariatric patients referred for psychiatric evaluation, FA was assessed using the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0), and psychiatric disorders were diagnosed using the Mini International Neuropsychiatric Interview (MINI). Logistic regression models were used to estimate adjusted odds ratios (aORs) for the association between FA and each psychiatric disorder, controlling for sex, age, body mass index (BMI), employment status, the number of children, clinical comorbidities, physical activity, family psychiatric history, and region of residence. Results: FA was present in 51% of the sample. Descriptive analyses revealed a significantly higher prevalence of major depressive disorder, panic disorder, generalized anxiety disorder, social anxiety disorder, agoraphobia, obsessive–compulsive disorder, and bulimia nervosa among individuals with FA. Multivariate models showed robust associations between FA and bulimia nervosa (aOR = 19.42, p < 0.05), generalized anxiety disorder (aOR = 2.88, p < 0.05), obsessive–compulsive disorder (aOR = 6.64, p < 0.05), agoraphobia (aOR = 3.14, p < 0.05), social anxiety disorder (aOR = 4.28, p < 0.05) and major depressive disorder (aOR = 2.79, p < 0.05). Conclusions: FA is strongly associated with a range of psychiatric comorbidities in post-bariatric patients, reinforcing the need for comprehensive mental health screening in this population. These findings underscore the potential role of FA as a clinical marker for stratified risk assessment, supporting more personalized approaches to mental health monitoring and intervention following bariatric surgery. Full article

American adults struggle with accurately assessing the quality of their diet, with the majority overrating their diet quality. Thus, the objective of the study was to explore what individuals think about when asked to rate their diet quality. Virtual focus groups were conducted from October 2023 to April 2024, using a semi-structured interview with open-ended questions. Convenience samples of small-scale farmers, school food service directors, health clinic patients, and university students and staff in Mississippi and Arkansas participated (N = 27). Themes and subthemes from NVivo-transcribed discussions were identified and coded inductively. Four subthemes emerged for description of diet: balance, consideration for others, convenience, and location. Four subthemes emerged for quality of diet: availability/access, culture/tradition, health considerations, and making better choices. Three subthemes emerged for healthy food: composition/preparation, nourishing benefits, and taste/flavor. Three subthemes emerged for unhealthy food: addicting/overconsumption, composition/preparation, and undesirable effects. Three subthemes emerged for nutrition knowledge: audience specific, general knowledge, and ambivalence. Three subthemes emerged for food shopping: food types, family influence/preference, and planning. Factors shaping how individuals perceive their diet quality are complex with intertwining components. Understanding the complexity involved in self-perceptions of diet quality will help us better quantify perceptions and link them to measurable outcomes. Full article

Background/Objectives: A faster eating rate is associated with increased energy intake and risk of obesity. High consumption of ultra-processed foods (UPFs) is associated with a faster eating rate. Psychobehavioral aspects, such as body image self-perception, eating disorders, and anxiety, may modulate this eating behavior. Therefore, this study examined the moderating role of psychobehavioral factors in the association between meal type (UPF vs non-UPF) and eating rate among individuals with obesity. Methods: It is a secondary analysis of a randomized, parallel clinical trial conducted with 39 adults who have obesity. Participants were assigned to consume either a UPF-only composed meal or a UPF-free meal, both of which were isoenergetic (~550 kcal). Psychobehavioral variables (food addiction—mYFAS 2.0, body image perception and satisfaction—Silhouette Rating Scale, eating disorders—EAT-26, and anxiety—GAD-7) were assessed. Eating rate was measured in kcal/min. Results: Body image perception and satisfaction significantly interacted with the type of meal. In the UPF group, lower body image dissatisfaction was associated with a higher eating rate (β = 4.79 kcal/min; 95% CI: 1.40; 8.19; p = 0.007), while a higher body image perception score was associated with a lower eating rate (β = −4.61 kcal/min; 95% CI: −8.57; −0.65; p = 0.024). No significant associations were observed for food addiction scores, eating disorders or anxiety. Conclusions: Body image modulates the eating rate in the context of UPF consumption. These findings suggest that interventions against obesity should consider individual psychobehavioral characteristics. Full article

Background/Objectives: Food addiction (FA) and binge eating disorder share many overlapping features. Many individuals with binge eating disorder experience stigma; however, less is known about the stigma associated with food addiction. The current study examined the weight-based stigma and mental illness stigma associated with attributing disordered eating behaviours to an FA diagnosis or binge eating disorder diagnosis. Methods: Undergraduate students (N = 177) were randomly assigned to read one of three vignettes (FA, binge eating disorder, or control), all of which described a character experiencing the overlapping features of FA and binge eating disorder; the vignettes differed only regarding the diagnosis to which the eating behaviours were attributed. Participants then completed questionnaires assessing their attitudes towards mental illness and obesity followed by questionnaires assessing their own eating behaviours. Results: There were no significant between-group differences in mental illness stigma or weight-based stigma. Significant differences in stigma were found based on the perceived gender of the vignette character and participants’ own FA and binge eating disorder symptoms. Conclusions: Stigma may not differ based on the diagnosis ascribed to addictive-like eating behaviours. Women may be more stigmatized for addictive-like eating behaviours, and individuals who experience addictive-like eating may be more stigmatizing towards others with these behaviours. Full article

Background: Food addiction (FA) is prevalent among individuals with severe obesity and has been associated with poorer weight loss (WL) outcomes after dietary interventions. However, its long-term impact after bariatric surgery (BS) remains unclear. Objective: This study aimed to evaluate the effect of preoperative FA on WL and weight regain (WR) three years after different BS techniques. Methods: An ambispective study was conducted in 165 patients undergoing BS (41.1% sleeve gastrectomy [SG], 13.3% Roux-en-Y gastric bypass [RYGB], and 45.6% hypoabsorptive procedures [HA]). FA was assessed preoperatively using the Yale Food Addiction Scale 2.0. WL outcomes were evaluated at 1 and 3 years postoperatively. Mixed-effects models were used to assess longitudinal changes, adjusted for baseline weight, sex, type 2 diabetes (T2D), and height. Results: FA was present in 17.6% of patients. At 3 years, total WL was lower in FA patients compared to those without FA (−27.1% vs. −31.0%; p = 0.023), driven by greater WR from nadir (+8.3% vs. +1.7%; p = 0.03). The effect was particularly pronounced after RYGB and HA, but not after SG. Nevertheless, a substantial proportion of FA patients (58%) were no longer classified as having obesity at 3 years. The presence of FA was not associated with insufficient WL or lower T2D remission rates. Mixed models confirmed a significant interaction between FA and time, indicating a trend toward reduced WL over time in FA patients. Conclusions: Preoperative FA was not associated with a reduced likelihood of achieving satisfactory WL following BS. Our data does not support the use of preoperative FA as a decisive factor in guiding the choice of BS type. Although FA was associated with increased WR over time, clinically meaningful WL was achieved in most patients. Long-term multidisciplinary follow-up remains essential in this subgroup. Full article

Food can help release and promote neurotransmitters. As a result, the food’s effect in this regard is of great interest to individuals who have experienced dysregulation of the brain reward circuit due to addiction to drugs or other substances. This is one of the chief reasons why dietary choices can influence the success of drug addiction programs. While the general importance of nutrition was known previously—although it has been applied on few occasions—this review provides new knowledge that has emerged in recent years, which reinforces earlier findings regarding food’s importance in overcoming addiction. In the last 15 years, there has been great progress in the understanding of the human intestinal microbiota, its importance for health, and its connections with the brain. However, since this area of nutrition is such a new field of study, it has rarely been applied to or considered in treatment programs. At the same time, it is important to avoid a diet based on ultra-processed foods, which deteriorate the microbiome and consequently harm the restoration of the natural reward system. Although ongoing research will undoubtedly provide a wealth of information in the coming years, the knowledge currently available is enough to confirm the importance of diet in a person’s addiction recovery process. For this reason, it is important for patients and programs to follow a diet that regulates the brain’s natural neurotransmitters through the microbiota and restores the natural functioning of the reward circuit, helping to overcome cravings. Full article

Background: The rising consumption of ultra-processed foods, especially those high in added sugars, poses a growing public health concern. Although several tools exist to assess food addiction, there is a lack of validated instruments specifically designed to measure addiction-like behaviors related to sweet food intake. Objectives: This study evaluates the psychometric properties of the FitMIND Foundation Sweets Addiction Scale (FFSAS), adapted from the Yale Food Addiction Scale 2.0 (YFAS 2.0), using data from Polish adults recruited through the FitMIND Foundation. Methods: The FFSAS was evaluated by 11 expert judges on four criteria: clarity, content validity, linguistic appropriateness, and construct representativeness. Afterwards, 344 adult volunteers (mean age 40.6 ± 10.7 years, 78% female, mean body mass index (BMI) 27.86 kg/m²) completed online FFSAS and provided demographic data, BMI, and self-reported sweets consumption. Internal consistency was assessed with Cronbach’s alpha and external validity was examined through Spearman’s correlations. Moreover, we conducted Exploratory and Confirmatory Factor Analyses (EFA and CFA). Results: Content validity of the FFSAS was supported by expert validation. The scale demonstrated good overall internal consistency (α = 0.85), with specific criteria such as tolerance (α = 0.916) and withdrawal (α = 0.914) showing particularly high reliability. The FFSAS total score was moderately correlated with sweets consumption frequency (ρ = 0.39, p < 0.05) and feelings of guilt (ρ = 0.35, p < 0.05). Exploratory factor analysis (EFA) revealed a robust three-factor structure, explaining 68.6% of the variance; the individual factors (subscales) derived from this structure demonstrated excellent internal consistency (Cronbach’s α ranging from 0.951 to 0.962). Sampling adequacy was high based on Kaiser–Meyer–Olkin measure (KMO = 0.956). Confirmatory factor analysis (CFA) indicated suboptimal model fit (Comparative Fit Index (CFI) = 0.74, Tucker–Lewis Index (TLI) = 0.69, Root Mean Square Error of Approximation (RMSEA) = 0.14), with a significant chi-square test (χ² = 3761.76, p < 0.001). Conclusions: This pilot study demonstrated that the FFSAS may be a promising tool for assessing sweet food addiction in adults. Future research should focus on assessing the FFSAS’ suitability on more diverse populations in other countries for further validation. Full article

Introduction: Childhood emotional maltreatment, which includes emotional abuse and neglect, has been identified as a significant risk factor for the development of disordered eating behaviors related to overeating and reduced dietary control. At the same time, the literature suggests that childhood emotional maltreatment appears to be linked to deficits in reflective functioning which, in turn, may increase vulnerability to dysregulated, impulsive, and addictive behaviors. However, to date, the role of a key factor, such as food addiction (FA), within this model has not yet been investigated. Therefore, the aim of this study was to test a mediation model in which emotional abuse and neglect predict overeating and reduced dietary control through deficits in reflective functioning and FA symptoms. Method: Using a cross-sectional design, a conventional non-clinical sample of 543 participants was recruited and completed a set of standardized questionnaires. A multiple mediation model with observed variables was specified (10,000 bootstrap resampling). Results: The multiple mediation model showed good results, confirming the initial hypotheses. Specifically, emotional abuse and neglect were associated with FA symptoms through deficits in reflective functioning. In turn, FA symptoms predicted overeating behaviors and poor dietary control. Discussion: These findings highlight the central role of FA in linking reflective functioning deficits to disordered eating patterns associated with excessive food consumption. This study advances our understanding of the psychological mechanisms underlying disordered eating behaviors and underscores the need for targeted interventions addressing reflective functioning deficits and food addiction in individuals with a history of childhood emotional maltreatment. Full article

There is growing evidence that public hospitals in high-income countries—in particular, Anglo-Saxon neoliberal countries (USA, UK, Canada, New Zealand, and Australia)—have been engaging with food retailers to attract private capital and maximise their incomes in a drive to reduce costs. Added to which, public hospital food can have a substantial influence on the health of children and young people. However, there is still relatively little research on food for young people in healthcare settings. This is concerning, as an appropriate food intake is vital not only for the prevention of and recovery from diseases, but also for the physical growth and psychological development of young people. This critical narrative review examined the available evidence on hospital food provision, practices, and environments, as well as children’s experiences of hospitalization in high-income countries, drawing on both peer-reviewed articles and the grey literature. Our analytical lens for this review was the Commercial Determinants of Health (CDOH), a framework that necessitates a critical examination of commercial influences on individual, institutional, and policy practices relevant to health. Our findings illustrate the mechanisms through which the CDOH act as a barrier to healthy food and eating for children in hospitals in high-income countries. Firstly, hospital food environments can be characterised as obesogenic. Secondly, there is a lack of culturally inclusive and appropriate foods on offer in healthcare settings and an abundance of processed and convenience foods. Lastly, individualised eating is fostered in healthcare settings at the expense of commensal eating behaviours that tend to be associated with healthier eating. Public hospitals are increasingly facing commercial pressures. It is extremely important to resist these pressures and to protect patients, especially children and adolescents, from the marketing and selling of foods that have been proven to be addictive and harmful. Full article

Background/Objectives: Recently, interest in studying food addiction (FA) in the context of behavioral addictions (BAs) has increased. However, research remains limited to determine the FA prevalence among various BAs. The current study aimed to investigate FA in a clinical sample of patients seeking treatment for gaming disorder, compulsive buying-shopping disorder (CBSD), compulsive sexual behavior disorder, and the comorbid presence of multiple BAs, as well as to determine the sociodemographic characteristics, personality traits, and general psychopathology of this clinical population. In addition, we analyzed whether FA is linked to a higher mean body mass index (BMI). Methods: The sample included 209 patients (135 men and 74 women) attending a specialized behavioral addiction unit. The assessment included a semi-structured clinical interview for the diagnosis of the abovementioned BAs, in addition to self-reported psychometric assessments for FA (using the Yale Food Addiction Scale 2. 0, YFAS-2), CBSD (using the Pathological Buying Screener, PBS), general psychopathology (using the Symptom Checklist-Revised, SCL-90-R), personality traits (using the Temperament and Character Inventory-Revised, TCI-R), emotional regulation (using Difficulties in Emotion Regulation Strategies, DERS), and impulsivity (using Impulsive Behavior Scale, UPPS-P). The comparison between the groups for the clinical profile was performed using logistic regression (categorical variables) and analysis of covariance (ANCOVA), adjusted based on the patients’ gender. The sociodemographic profile was based on chi-square tests for categorical variables and analysis of variance (ANOVA) for quantitative measures. Results: The prevalence of FA in the total sample was 22.49%. The highest prevalence of FA was observed in CBSD (31.3%), followed by gaming disorder (24.7%), and the comorbid presence of multiple BAs (14.3%). No group differences (FA+/−) were found in relation to sociodemographic variables, but the comorbidity between FA and any BA was associated more with females as well as having greater general psychopathology, greater emotional dysregulation, higher levels of impulsivity, and a higher mean BMI. Conclusions: The comorbidity between FA and BA is high compared to previous studies (22.49%), and it is also associated with greater severity and dysfunctionality. Emotional distress levels were high, which suggests that the group with this comorbidity may be employing FA behaviors to cope with psychological distress. However, a better understanding of the latent mechanisms that contribute to the progression of this multifaceted comorbid clinical disorder is needed. One aspect that future studies could consider is to explore the existence of FA symptoms early and routinely in patients with BAs. Full article

Background/Objectives: Over the past decade, numerous studies have explored the bidirectional relationship between obesity and mental health, mainly eating disorders (EDs). This study aimed to assess the prevalence and characteristics of altered eating behaviors (AEBs) in a cohort of people with obesity (PwO) using the validated Eating Behaviors Assessment for Obesity (EBA-O). Methods: We conducted a cross-sectional study from May 2023 to April 2024, recruiting consecutive PwO seeking weight loss. Participants completed the 18-item EBA-O questionnaire, which focuses on five primary eating behaviors: night eating, food addiction, sweet eating, hyperphagia, and binge eating. Unlike other validated tools, the EBA-O is specifically designed to capture these behaviors in PwO and is easy for patients to self-administer. We also collected sociodemographic and clinical data. Results: A total of 127 participants were included (76 women, median age 52 years, median BMI 42.9 kg/m²). We found a significant prevalence of AEBs: 33.1% for sweet eating, 23.6% for hyperphagia, 15.7% for food addiction, 14.2% for binge eating, and 7.1% for night eating. The EBA-O scores correlated positively with BMI (r = 0.201, p = 0.024) and increased across BMI categories (p = 0.001). Males had higher scores for night eating and hyperphagia (p = 0.01), and active smokers had higher hyperphagia scores (p = 0.043) than ex-smokers and non-smokers. The night eating scores were inversely correlated with sleep hours (r = −0.197, p = 0.026), and food addiction was positively correlated with age (r = 0.261, p = 0.003); conversely, hyperphagia (r = −0.198, p = 0.025) and binge eating (r = −0.229, p = 0.010) were inversely correlated with age. PwO without diabetes had higher scores for food addiction (p = 0.01) and binge eating (p = 0.004) compared to those with diabetes. Conclusions: These results highlight the potential to characterize PwO based on their AEBs, offering new opportunities to tailor treatment strategies for PwO by targeting specific eating behaviors. Full article