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LaFata EM, Allison KC, Audrain-McGovern J, Forman EM. Ultra-Processed Food Addiction: A Research Update. Curr Obes Rep 2024; 13:214-223. [PMID: 38760652 DOI: 10.1007/s13679-024-00569-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 05/19/2024]
Abstract
PURPOSE OF REVIEW Detail recent advancements in the science on ultra-processed food (UPF) addiction, focusing on estimated prevalence rates and emerging health disparities; progress towards identifying biological underpinnings and behavioral mechanisms; and implications for weight management. RECENT FINDINGS Notable developments in the field have included: (1) estimating the global prevalence of UPF addiction at 14% of adults and 15% of youths; (2) revealing health disparities for persons of color and those with food insecurity; (3) observing altered functioning across the brain-gut-microbiome axis; (4) providing early evidence for UPF withdrawal; and (5) elucidating poorer weight management outcomes among persons with UPF addiction. The breadth of recent work on UPF addiction illustrates continued scientific and public interest in the construct and its implications for understanding and treating overeating behaviors and obesity. One pressing gap is the lack of targeted interventions for UPF addiction, which may result in more optimal clinical outcomes for this underserved population.
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Affiliation(s)
- Erica M LaFata
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3201 Chestnut Street, Philadelphia, PA, 19104, United States.
| | - Kelly C Allison
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, United States
| | - Janet Audrain-McGovern
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, United States
| | - Evan M Forman
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3201 Chestnut Street, Philadelphia, PA, 19104, United States
- Department of Psychological and Brain Sciences, Drexel University, 3201 Chestnut Street, Philadelphia, PA, 19104, United States
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Landry MJ, Ward CP, Cunanan KM, Fielding-Singh P, Crimarco A, Gardner CD. Switching diets after 6-months does not result in renewed weight loss: a secondary analysis of a 12-month crossover randomized trial. Sci Rep 2024; 14:9865. [PMID: 38684815 PMCID: PMC11058757 DOI: 10.1038/s41598-024-60547-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 04/24/2024] [Indexed: 05/02/2024] Open
Abstract
Weight change trajectory from diet and lifestyle interventions typically involves rapid weight loss followed by a weight plateau after approximately 6 months. Changing from one weight-loss diet to another at the time of the plateau could instigate renewed weight loss. Therefore, our secondary analysis aimed to assess trajectory of weight loss in a 12-month, randomized, cross-over study. Forty-two adults were randomized to eat a healthy low-fat or healthy low-carbohydrate diet for 6 months then switched to the opposite diet for an additional 6 months. Regardless of diet assignment, participants experienced rapid initial weight loss, which slowed between 3 to 6 months. After switching diets at 6 months, weight modestly decreased until 9 months, but at a rate slower than the initial 3 months and slower than the rate from 3 to 6 months. This suggests that the weight loss plateau typically seen at 6 months is physiological and cannot be overcome by simply switching to a different weight-loss diet.
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Affiliation(s)
- Matthew J Landry
- Stanford Prevention Research Center, School of Medicine, Stanford University, Stanford, CA, USA.
- Department of Population Health and Disease Prevention, Program in Public Health, University of California, Irvine, 856 Health Sciences Rd., Irvine, CA, 92697, USA.
| | - Catherine P Ward
- Stanford Prevention Research Center, School of Medicine, Stanford University, Stanford, CA, USA
| | - Kristen M Cunanan
- Quantitative Science Unit, School of Medicine, Stanford University, Stanford, CA, USA
| | | | - Anthony Crimarco
- Division of Gastroenterology and Hepatology, Stanford Center for Clinical Research, Stanford University, Redwood City, CA, USA
| | - Christopher D Gardner
- Stanford Prevention Research Center, School of Medicine, Stanford University, Stanford, CA, USA
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Skinner JA, Leary M, Whatnall M, Collins RA, Pursey KM, Verdejo-Garcia A, Hay PJ, Baker AL, Hides L, Paxton SJ, Wood LG, Colyvas K, Collins CE, Burrows TL. A three-arm randomised controlled trial of a telehealth intervention targeting improvement in addictive eating for Australian adults (the TRACE program). Appetite 2024; 195:107211. [PMID: 38215944 DOI: 10.1016/j.appet.2024.107211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 01/14/2024]
Abstract
There is a substantial research base for addictive eating with development of interventions. The current 3-arm RCT aimed to investigate the efficacy of the TRACE (Targeted Research for Addictive and Compulsive Eating) program to decrease addictive eating symptoms and improve mental health. Participants (18-85 yrs) endorsing ≥3 addictive eating symptoms were randomly allocated to 1) active intervention, 2) passive intervention, or 3) control group. Primary outcome was change in addictive eating symptoms 3-months post-baseline measured by the Yale Food Addiction Scale. Depression, anxiety and stress were also assessed. A total of 175 individuals were randomised. Using Linear Mixed Models, from baseline to 3-months, there was significant improvement in symptom scores in all groups with mean decrease of 4.7 (95% CI: -5.8, -3.6; p < 0.001), 3.8 (95% CI: -5.2, -2.4; p < 0.001) and 1.5 (95% CI: -2.6, -0.4; p = 0.01) respectively. Compared with the control group, participants in the active intervention were five times more likely to achieve a clinically significant change in symptom scores. There was a significant reduction in depression scores in the active and passive intervention groups, but not control group [-2.9 (95% CI: -4.5, -1.3); -2.3 (95% CI: -4.3, -0.3); 0.5 (95% CI: -1.1, 2.1), respectively]; a significant reduction in stress scores within the active group, but not passive intervention or control groups [-1.3 (95% CI: -2.2, -0.5); -1.0 (95% CI: -2.1, 0.1); 0.4 (95% CI: -0.5, 1.2), respectively]; and the reduction in anxiety scores over time was similar for all groups. A dietitian-led telehealth intervention for addictive eating in adults was more effective than a passive or control condition in reducing addictive eating scores from baseline to 6 months. Trial registration: Australia New Zealand Clinical Trial Registry ACTRN12621001079831.
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Affiliation(s)
- Janelle A Skinner
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia
| | - Mark Leary
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia
| | - Megan Whatnall
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia
| | - Rebecca A Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia
| | - Kirrilly M Pursey
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia
| | - Antonio Verdejo-Garcia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, 3800, Australia
| | - Phillipa J Hay
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, 2751, Australia; Mental Health Services, South Western Sydney Local Health District, Camden and Campbelltown Hospitals, NSW, 2560, Australia
| | - Amanda L Baker
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia; School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Leanne Hides
- School of Psychology, University of Queensland, St Lucia, QLD, 4072, Australia
| | - Susan J Paxton
- Department of Psychology and Counselling, Latrobe University, Melbourne, VIC, 3086, Australia
| | - Lisa G Wood
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia; School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Kim Colyvas
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia
| | - Tracy L Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia.
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Aloi M, Liuzza MT, Rania M, Carbone EA, de Filippis R, Gearhardt AN, Segura-Garcia C. Using latent class analysis to identify different clinical profiles according to food addiction symptoms in obesity with and without binge eating disorder. J Behav Addict 2024; 13:262-275. [PMID: 38276994 PMCID: PMC10988405 DOI: 10.1556/2006.2023.00074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/14/2023] [Accepted: 12/03/2023] [Indexed: 01/27/2024] Open
Abstract
Background and aims Existing research suggests that food addiction (FA) is associated with binge eating disorder (BED) and obesity, but the clinical significance of this relationship remains unclear. This study aims to investigate the different clinical profiles of FA symptoms among patients who have obesity with/without BED using latent class analysis (LCA). Methods 307 patients (n = 152 obesity and BED, n = 155 obesity without BED) completed a battery of self-report measures investigating eating psychopathology, depression, emotional dysregulation, alexithymia, schema domains, and FA. LCA and ANOVAs were conducted to identify profiles according to FA symptoms and examine differences between classes. Results LCA identified five meaningful classes labeled as the "non-addicted" (40.4%), the "attempters" (20.2%), the "interpersonal problems" (7.2%), the "high-functioning addicted" (19.5%) and the "fully addicted" (12.7%) classes. Patients with BED and obesity appeared overrepresented in the "high-functioning addicted" and "fully addicted" classes; conversely, patients with obesity without BED were most frequently included in the "non-addicted" class. The most significant differences between the "high-functioning addicted" and "fully addicted" classes versus the "non-addicted" class regarded heightened severity of eating and general psychopathology. Discussion and conclusions The results bring to light distinct clinical profiles based on FA symptoms. Notably, the "high-functioning addicted" class is particularly intriguing as its members demonstrate physical symptoms of FA (i.e., tolerance and withdrawal) and psychological ones (i.e., craving and consequences) but are not as functionally impaired as the "fully addicted" class. Identifying different profiles according to FA symptoms holds potential value in providing tailored and timely interventions.
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Affiliation(s)
- Matteo Aloi
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
- Department of Health Sciences, University “Magna Graecia” of Catanzaro, Italy
| | - Marco Tullio Liuzza
- Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, Italy
| | - Marianna Rania
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
| | - Elvira Anna Carbone
- Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, Italy
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
| | - Renato de Filippis
- Department of Health Sciences, University “Magna Graecia” of Catanzaro, Italy
| | | | - Cristina Segura-Garcia
- Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, Italy
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
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Derrigo K, LaFata EM. Examining the proportions of food addiction among women with and without polycystic ovarian syndrome who do and do not take hormonal birth control. Eat Behav 2023; 51:101824. [PMID: 37950975 DOI: 10.1016/j.eatbeh.2023.101824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 11/13/2023]
Abstract
Polycystic ovarian syndrome (PCOS) is a reproductive disorder driven by insulin resistance. Insulin resistance may increase weight gain and increase the rewarding intake of ultra-processed foods (UPFs). Individuals with PCOS may be more susceptible to the reinforcing properties of UPFs, increasing the risk to consume UPFs in addictive-like ways, operationalized by food addiction (FA). Additionally, hormonal birth control, commonly prescribed to women with PCOS, are found to increase food cravings and overeating. This study examined the relationships between PCOS status, FA, and hormonal birth control use. The study sample (N = 365, assigned female at birth) was drawn from Amazon Mechanical Turk, with half of the sample (n = 181) reporting having PCOS and the other half not (n = 184). Participants answered questions about women's reproductive health (i.e., PCOS, hormonal birth control use) and completed the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0). A chi-square test found that 51.9 % of participants with PCOS (M = 6.23, SD = 3.82) met diagnostic criteria for FA (assessed by the mYFAS 2.0) compared to 16.8 % of participants without PCOS (M = 2.47, SD = 3.39). A hierarchical linear regression found independent main effects of PCOS status (β = 0.40, t(352) = 8.61, p < .001) and hormonal birth control use (β = 0.16, t(351) = 3.59, p < .001), to be associated with higher mYFAS symptom count scores. No differences were found between the types of hormonal birth control participants reported taking. The finding suggests that FA is an overlooked, understudied psychological condition impacting these individuals in weight loss treatments. Future studies are needed to understand the relationship between FA and PCOS in clinical samples.
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Affiliation(s)
- Karly Derrigo
- Department of Psychology, Drexel University, Philadelphia, PA, United States.
| | - Erica M LaFata
- Department of Psychology, Drexel University, Philadelphia, PA, United States.
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Hoover LV, Yu HP, Cummings JR, Ferguson SG, Gearhardt AN. Co-occurrence of food addiction, obesity, problematic substance use, and parental history of problematic alcohol use. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:928-935. [PMID: 35878078 PMCID: PMC10986778 DOI: 10.1037/adb0000870] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The present study investigates the rates of co-occurrence among food addiction (FA), problematic substance use (alcohol, cannabis, cigarettes, nicotine vaping), parental history of problematic alcohol use, and obesity as an important step to understanding whether an addictive-like eating phenotype exists. METHOD A community sample of 357 U.S. adults (49.7% male, 77.6% White, Mage 40.7) completed the Yale Food Addiction Scale 2.0 (YFAS2.0), the Alcohol Use Disorders Identification Test, the Cannabis Use Disorders Identification Test, the Fagerstrom Test for Nicotine Dependence, the E-Cigarette Dependence Scale, the Family Tree Questionnaire, and demographic/self-report body mass index questions through Amazon Mechanical Turk. Risk ratios (RRs; unadjusted and adjusted for sociodemographic covariates) were calculated using modified Poisson's regression. RESULTS Risk of FA was higher in participants with problematic alcohol use (RR = 2.13, 99% CI [1.32, 3.45]), smoking (RR = 1.86, 99% CI [0.82, 3.36]), cannabis use (unadjusted; RR = 2.22, 99% CI [1.17, 4.18]), vaping (RR = 2.71, 99% CI [1.75, 4.21]), and parental history of problematic alcohol use (RR = 2.35, 99% CI [1.46, 3.79]). Risk of FA in participants with obesity was only higher in adjusted models (RR = 1.87, 99% CI [1.06, 3.27]). Obesity was not significantly associated with problematic substance use and parental history of problematic alcohol use. CONCLUSIONS FA, but not obesity, co-occurred with problematic substance use and a parental history of problematic alcohol use. Results support the conceptualization of FA as an addictive disorder. The inclusion of FA as an addictive disorder in diagnostic frameworks is an important area of future consideration. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Hayley P. Yu
- Department of Psychology, University of Michigan, Ann Arbor
| | - Jenna R. Cummings
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development
- Jenna R. Cummings was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Intramural Research Program). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the funding agency
| | - Stuart G. Ferguson
- College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
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Gearhardt AN, Bueno NB, DiFeliceantonio AG, Roberto CA, Jiménez-Murcia S, Fernandez-Aranda F. Social, clinical, and policy implications of ultra-processed food addiction. BMJ 2023; 383:e075354. [PMID: 37813420 PMCID: PMC10561019 DOI: 10.1136/bmj-2023-075354] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Affiliation(s)
- Ashley N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Nassib B Bueno
- Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Brazil
| | - Alexandra G DiFeliceantonio
- Fralin Biomedical Research Institute at VTC, Department of Human, Nutrition Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Christina A Roberto
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Susana Jiménez-Murcia
- Department of Clinical Psychology, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos III, Barcelona, Spain
| | - Fernando Fernandez-Aranda
- Department of Clinical Psychology, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos III, Barcelona, Spain
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Gillies NA, Worthington A, Li L, Conner TS, Bermingham EN, Knowles SO, Cameron-Smith D, Hannaford R, Braakhuis A. Adherence and eating experiences differ between participants following a flexitarian diet including red meat or a vegetarian diet including plant-based meat alternatives: findings from a 10-week randomised dietary intervention trial. Front Nutr 2023; 10:1174726. [PMID: 37388633 PMCID: PMC10305861 DOI: 10.3389/fnut.2023.1174726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/11/2023] [Indexed: 07/01/2023] Open
Abstract
Background Flexitarian, vegetarian and exclusively plant-based diets are increasingly popular, particularly amongst young adults. This is the first randomised dietary intervention to investigate the health, wellbeing, and behavioural implications of consuming a basal vegetarian diet that additionally includes low-to-moderate amounts of red meat (flexitarian) compared to one containing plant-based meat alternatives (PBMAs, vegetarian) in young adults (ClinicalTrials.gov NCT04869163). The objective for the current analysis is to measure adherence to the intervention, nutrition behaviours, and participants' experience with their allocated dietary group. Methods Eighty healthy young adults participated in this 10-week dietary intervention as household pairs. Household pairs were randomised to receive either approximately three serves of red meat (average of 390 g cooked weight per individual, flexitarian group) or PBMAs (350-400 g per individual, vegetarian group) per week on top of a basal vegetarian diet. Participants were supported to adopt healthy eating behaviours, and this intervention was developed and implemented using a behaviour change framework. Adherence (eating allocated red meat or PBMA, abstaining from animal-based foods not provided by researchers) was continuously monitored, with total scores calculated at the end of the 10-week intervention period. Eating experiences were measured by the Positive Eating Scale and a purpose-designed exit survey, and a food frequency questionnaire measured dietary intake. Analyses used mixed effects modeling taking household clustering into account. Results The total average adherence score was 91.5 (SD = 9.0) out of a possible 100, with participants in the flexitarian group scoring higher (96.1, SD = 4.6, compared to 86.7, SD = 10.0; p < 0.001). Those receiving red meat were generally more satisfied with this allocation compared to those receiving the PBMAs, even though a leading motivation for participants joining the study was an opportunity to try plant-based eating (35% expressed that their interest in taking part was related to trying plant-based eating). Participants in both intervention groups had increased vegetable intake (p < 0.001), and reported more positive eating experiences (p = 0.020) and satisfaction with eating (p = 0.021) at the end of the 10-week intervention relative to baseline values. Conclusion Methods to encourage engagement with the trial were successful, as participants demonstrated excellent adherence to the intervention. Observed differences in participants' adherence and experiences between flexitarian and vegetarian groups holds implications for the adoption of healthy, sustainable dietary patterns beyond this study alone.
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Affiliation(s)
- Nicola A. Gillies
- Discipline of Nutrition, School of Medical Sciences, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Anna Worthington
- Discipline of Nutrition, School of Medical Sciences, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Larissa Li
- Discipline of Nutrition, School of Medical Sciences, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Tamlin S. Conner
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Emma N. Bermingham
- Smart Foods and Bioproducts Group, AgResearch Ltd., Palmerston North, New Zealand
| | - Scott O. Knowles
- Smart Foods and Bioproducts Group, AgResearch Ltd., Palmerston North, New Zealand
| | - David Cameron-Smith
- School of Environmental and Life Sciences, College of Engineering, Science and Environment, University of Newcastle, Sydney, NSW, Australia
| | - Rina Hannaford
- Digital Agriculture Group, AgResearch Ltd., Palmerston North, New Zealand
| | - Andrea Braakhuis
- Discipline of Nutrition, School of Medical Sciences, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Gearhardt AN, DiFeliceantonio AG. Highly processed foods can be considered addictive substances based on established scientific criteria. Addiction 2023; 118:589-598. [PMID: 36349900 DOI: 10.1111/add.16065] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 09/15/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND There is growing evidence that an addictive-eating phenotype may exist. There is significant debate regarding whether highly processed foods (HPFs; foods with refined carbohydrates and/or added fats) are addictive. The lack of scientifically grounded criteria to evaluate the addictive nature of HPFs has hindered the resolution of this debate. ANALYSIS The most recent scientific debate regarding a substance's addictive potential centered around tobacco. In 1988, the Surgeon General issued a report identifying tobacco products as addictive based on three primary scientific criteria: their ability to (1) cause highly controlled or compulsive use, (2) cause psychoactive (i.e. mood-altering) effects via their effect on the brain and (3) reinforce behavior. Scientific advances have now identified the ability of tobacco products to (4) trigger strong urges or craving as another important indicator of addictive potential. Here, we propose that these four criteria provide scientifically valid benchmarks that can be used to evaluate the addictiveness of HPFs. Then, we review the evidence regarding whether HPFs meet each criterion. Finally, we consider the implications of labeling HPFs as addictive. CONCLUSION Highly processed foods (HPFs) can meet the criteria to be labeled as addictive substances using the standards set for tobacco products. The addictive potential of HPFs may be a key factor contributing to the high public health costs associated with a food environment dominated by cheap, accessible and heavily marketed HPFs.
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Affiliation(s)
| | - Alexandra G DiFeliceantonio
- Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA.,Department of Human Nutrition Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
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Mindful eating for weight loss in women with obesity: a randomised controlled trial. Br J Nutr 2022:1-10. [PMID: 36529854 DOI: 10.1017/s0007114522003932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Mindful eating (ME) has been linked to improvement in binge eating disorder, but this approach in obesity management has shown conflicting results. Our aim was to assess the effect of ME associated with moderate energy restriction (MER) on weight loss in women with obesity. Metabolic parameters, dietary assessment, eating behaviour, depression, anxiety and stress were also evaluated. A total of 138 women with obesity were randomly assigned to three intervention groups: ME associated with MER (ME + MER), MER and ME, and they were followed up monthly for 6 months. ME + MER joined seven monthly mindfulness-based intervention group sessions each lasting 90 min and received an individualised food plan with MER (deficit of 2092 kJ/d - 500 kcal/d). MER received an individualised food plan with MER (deficit of 2092 kJ/d - 500 kcal/d), and ME joined seven monthly mindfulness-based intervention group sessions each lasting 90 min. Seventy patients completed the intervention. Weight loss was significant, but no statistically significant difference was found between the groups. There was a greater reduction in uncontrolled eating in the ME group than in the MER group and a greater reduction in emotional eating in the ME group than in both the MER and the ME + MER groups. No statistically significant differences were found in the other variables evaluated between groups. The association between ME with energy restriction did not promote greater weight loss than ME or MER.
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Parnarouskis L, Leventhal AM, Ferguson SG, Gearhardt AN. Withdrawal: A key consideration in evaluating whether highly processed foods are addictive. Obes Rev 2022; 23:e13507. [PMID: 36196649 PMCID: PMC9786266 DOI: 10.1111/obr.13507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 07/04/2022] [Accepted: 09/20/2022] [Indexed: 12/30/2022]
Abstract
Researchers are currently debating whether theories of addiction explain compulsive overeating of highly processed (HP) foods (i.e., industrially created foods high in refined carbohydrates and/or fat), which contributes to obesity and diet-related disease. A subset of individuals consumes HP foods with behavioral phenotypes that mirror substance use disorders. Withdrawal, the emergence of aversive physical and psychological symptoms upon reduction or cessation of substance use, is a core component of addiction that was central to historical debates about other substances' addictive potential (e.g., nicotine and cocaine). However, no one has systematically considered evidence for whether HP foods cause withdrawal, which represents a key knowledge gap regarding the utility of addiction models for understanding compulsive overeating. Thus, we reviewed evidence for whether animals and humans exhibit withdrawal when reducing or eliminating HP food intake. Controlled experimental evidence indicates animals experience HP food withdrawal marked by neural reward changes and behaviors consistent with withdrawal from other addictive substances. In humans, preliminary evidence supports subjective withdrawal-like experiences. However, most current human research is limited to retrospective recall. Further experimental research is needed to evaluate this construct. We outline future research directions to investigate HP food withdrawal in humans and consider potential clinical implications.
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Affiliation(s)
| | - Adam M Leventhal
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Stuart G Ferguson
- Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Ashley N Gearhardt
- Department of Psychology, The University of Michigan, Ann Arbor, Michigan, USA
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Pape M, Färber T, Seiferth C, Roth T, Schroeder S, Wolstein J, Herpertz S, Steins-Loeber S. A Tailored Gender-Sensitive mHealth Weight Loss Intervention (I-GENDO): Development and Process Evaluation. JMIR Form Res 2022; 6:e38480. [PMID: 36301614 PMCID: PMC9650578 DOI: 10.2196/38480] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/11/2022] [Accepted: 08/29/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Given the increase in the prevalence of overweight and obesity worldwide, the number of digital weight loss interventions has also risen. However, these interventions often lack theoretical background and data on long-term effectiveness. The consideration of individual and gender differences in weight-related psychological parameters might enhance the efficacy and sustainability of mobile-based weight loss interventions. OBJECTIVE This paper presented an introduction to and the process evaluation of a 12-week gender-sensitive mobile health (mHealth) weight loss intervention (I-GENDO) combining computer-based and self-tailoring features. METHODS Between August 2020 and August 2021, individuals with overweight (BMI 25.0-29.9 kg/m²), those with obesity class I (BMI 30.0-34.9 kg/m²), and those with obesity class II (BMI 35.0-39.9 kg/m²) were recruited to the I-GENDO project, a multicenter study in Germany. The mHealth intervention aimed at targeting individual psychological factors associated with the development and persistence of overweight and obesity (eg, emotional eating) using computer-based tailoring. Moreover, the intervention took a gender-sensitive approach by implementing self-tailoring of gender-targeted module versions. The computer-based assignment of the main modules, self-selection of gender-targeted module versions, and use patterns were evaluated while considering gender. Moreover, gender differences in the usability assessment were analyzed. RESULTS Data from the intervention arm of the study were processed. A total of 116 individuals with overweight and obesity (77/116, 66.4% women; age mean 47.28, SD 11.66 years; BMI mean 33.58, SD 3.79 kg/m2) were included in the analyses. Overall, the compliance (90/109, 82.6%) and satisfaction with the app (mean 86% approval) were high and comparable with those of other mobile weight loss interventions. The usability of the intervention was rated with 71% (5.0/7.0 points) satisfaction. More women obtained the main module that focused on emotion regulation skills. Most men and women selected women-targeted versions of the main modules. Women used the app more frequently and longer than men. However, women and men did not differ in the progress of use patterns throughout the intervention. CONCLUSIONS We developed a tailored gender-sensitive mHealth weight loss intervention. The usability of and engagement with the intervention were satisfactory, and the overall satisfaction with the intervention was also high. Gender differences must be considered in the evaluation of the effectiveness and sustainability of the intervention.
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Affiliation(s)
- Magdalena Pape
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital of the Ruhr-University Bochum, Bochum, Germany
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
| | - Tanja Färber
- Department of Pathopsychology, University of Bamberg, Bamberg, Germany
| | - Caroline Seiferth
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
| | - Tanja Roth
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital of the Ruhr-University Bochum, Bochum, Germany
| | - Stefanie Schroeder
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
- Department of Pathopsychology, University of Bamberg, Bamberg, Germany
| | - Joerg Wolstein
- Department of Pathopsychology, University of Bamberg, Bamberg, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital of the Ruhr-University Bochum, Bochum, Germany
| | - Sabine Steins-Loeber
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
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Parnarouskis L, Gearhardt AN, Mason AE, Adler NE, Laraia BA, Epel ES, Leung CW. Association of Food Insecurity and Food Addiction Symptoms: A Secondary Analysis of Two Samples of Low-Income Female Adults. J Acad Nutr Diet 2022; 122:1885-1892. [PMID: 35598730 PMCID: PMC10044472 DOI: 10.1016/j.jand.2022.04.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 03/17/2022] [Accepted: 04/20/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Household food insecurity persists in the United States and has important implications for health and well-being. Food insecurity in female-identified caregivers is particularly concerning, given its association with their mental health and adverse health outcomes for their children. Food insecurity is associated with disordered eating but, to our knowledge, no prior studies have examined an association between food insecurity and food addiction. OBJECTIVE Our aim was to examine whether food insecurity is associated with higher food addiction symptom endorsement in low-income female adults. DESIGN Secondary analysis of baseline data from a quasi-experimental study of a mindfulness-based intervention on gestational weight gain among low-income pregnant individuals and an observational study of low-income families. PARTICIPANTS/SETTING Participants in study 1 (n = 208) were English-speaking, low-income pregnant individuals with overweight or obesity, recruited in California from 2011 to 2013. Participants in study 2 (n = 181) were English-speaking, low-income female caregivers for children aged 8 through 10 years, recruited in Michigan from 2018 to 2019. Both studies recruited participants from community health clinics, social service agencies, and online advertisements. MAIN OUTCOME MEASURES The primary outcome measure was food addiction symptoms, assessed by the Yale Food Addiction Scale. STATISTICAL ANALYSIS Multivariate Poisson regression was used to examine the association between household food insecurity and food addiction symptoms in each sample, adjusted for sociodemographic characteristics. RESULTS In study 1, pregnant individuals in food-insecure households reported 21% higher food addiction symptoms than pregnant individuals in food-secure households (incidence rate ratio 1.21; 95% CI 1.00 to 1.47; P = .047). In study 2, caregivers in food-insecure households had 56% higher food addiction symptoms than caregivers in food-secure households (incidence rate ratio 1.56; 95% CI 1.01 to 2.40; P = .045). CONCLUSIONS These findings provide preliminary support for a relationship between household food insecurity and food addiction. Future research should examine potential mechanisms and whether interventions to reduce food insecurity lower risk of food addiction.
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Affiliation(s)
| | | | - Ashley E Mason
- Department of Psychiatry, Osher Center for Integrative Medicine, University of California, San Francisco, CA
| | - Nancy E Adler
- Center for Health and Community, University of California, San Francisco, CA; Departments of Psychiatry and Pediatrics, University of California, San Francisco, CA
| | - Barbara A Laraia
- Public Health Nutrition, School of Public Health, University of California, Berkeley, CA
| | - Elissa S Epel
- Department of Psychiatry, University of California-San Francisco Weill Institute for Neurosciences, School of Medicine, San Francisco, CA
| | - Cindy W Leung
- University of Michigan School of Public Health, Ann Arbor, MI
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De Almeida R, Kamath G, Cabandugama P. Food Addiction in Application to Obesity Management. MISSOURI MEDICINE 2022; 119:372-378. [PMID: 36118809 PMCID: PMC9462897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Nascent and rapidly growing research into defining the concept of "food addiction" (FA) in relation to obesity is currently underway. Food addiction is present in a subset of patients who are overweight or have obesity, and its presence is associated with other psychosocial disorders such as depression, anxiety, eating disorders, impulse control disorders, and lower quality of life. Food addiction is associated with higher intake of and preference for highly processed foods that have addictive-like properties such as cravings, reward sensitivity, and impaired control. Food addiction is associated with less weight loss in patients with obesity utilizing diet and lifestyle-related interventions. In clinical practice, identifying the subset of patients with obesity with FA-related psychosocial constraints and continued emphasis on avoiding highly processed foods may improve obesity and weight management outcomes. Food addiction is thought to be an addictive-like phenotype.Food addiction is noted to have significant overlap with substance use disorder (SUD) and other eating disorders, but is currently not classified a diagnosis by DSM-IV and DSM-V criteria.Food addiction has similarities to SUD, such as cravings, reduced control over intake, increased impulsivity and altered reward-sensitivity.The Yale Food Addiction Scale, which is a clinical scale modeled by the DSM-IV and DSM-V criteria for SUD, has been used to quantify and study FA.
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Affiliation(s)
- Reuben De Almeida
- Internal Medicine Resident, University of Missouri-Kansas City-School of Medicine (UMKC-SOM), Kansas City, Missouri
| | - Geetha Kamath
- Assistant Professor of Medicine and Faculty Member of the Endocrinology Fellowship Program at the UMKC-SOM, Kansas City, Missouri
| | - Peminda Cabandugama
- Assistant Professor, Department of Internal Medicine, University Health Weight Management Clinic, UMKCSOM, Kansas City, Missouri
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Ramsey MW, Reese-Smith J, Lemacks JL, Madson MB, Greer T, Bradford L, Aras S, Gipson JA, McLin DB. Key Focus Group Themes to Inform Weight Management Interventions in Deep South African Americans. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:647-659. [PMID: 35568686 PMCID: PMC9351227 DOI: 10.1016/j.jneb.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 03/17/2022] [Accepted: 03/21/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To understand African Americans' perceptions, barriers, and facilitators to recruitment, enrollment, adoption, maintenance, and retention in a nutrition and physical activity promotion program. DESIGN Four focus groups were conducted. SETTING Two community settings located in Jackson and Hattiesburg, Mississippi. PARTICIPANTS Participants (n = 28) were aged 18-50 years. MAIN OUTCOME MEASURE(S) Barriers and facilitators associated with healthy eating, physical activity, achieving a healthy weight, and participation in a health behavior change program. ANALYSIS A conventional thematic content analysis approach includes data familiarization, initial code generation, initial theme generation, themes review, and team review for finalization of themes. RESULTS Major themes related to health behaviors and participation in a behavior change program were identified by participants, including time constraints, costs, social support, consistency and self-efficacy, motivation for longevity and disease prevention, physical appearance, fear of injury/pain, social norms/stigma associated with outdoor physical activity, body criticism from family members, and having empathic and validating program staff support. CONCLUSIONS AND IMPLICATIONS Several social determinants of health were identified as essential considerations for promoting healthy nutrition and physical activity behaviors among African American adult Mississippians. Cultural and spiritual implications were also identified. Study insights inform policy approaches for designing culturally appropriate health behavior change programs in the Deep South.
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Affiliation(s)
- Michael W Ramsey
- Mississippi INBRE Telenutrition Center, Hattiesburg, MS; Department of Psychology, Jackson State University, Jackson, MS.
| | - Jacqueline Reese-Smith
- Mississippi INBRE Telenutrition Center, Hattiesburg, MS; Houston Fire Department-Firefighter Support Network, Houston, TX
| | - Jennifer L Lemacks
- Mississippi INBRE Telenutrition Center, Hattiesburg, MS; University of Southern Mississippi, Hattiesburg, MS; Mississippi INBRE Community Engagement and Training Core, Hattiesburg, MS
| | - Michael B Madson
- Mississippi INBRE Telenutrition Center, Hattiesburg, MS; University of Southern Mississippi, Hattiesburg, MS
| | - Tammy Greer
- Mississippi INBRE Telenutrition Center, Hattiesburg, MS; University of Southern Mississippi, Hattiesburg, MS
| | | | - Sermin Aras
- University of Southern Mississippi, Hattiesburg, MS
| | - June A Gipson
- Mississippi INBRE Community Engagement and Training Core, Hattiesburg, MS
| | - Dawn B McLin
- Department of Psychology, Jackson State University, Jackson, MS
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Camacho-Barcia L, Munguía L, Gaspar-Pérez A, Jimenez-Murcia S, Fernández-Aranda F. Impact of Food Addiction in Therapy Response in Obesity and Eating Disorders. CURRENT ADDICTION REPORTS 2022. [DOI: 10.1007/s40429-022-00421-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Hoover LV, Yu HP, Duval ER, Gearhardt AN. Childhood trauma and food addiction: The role of emotion regulation difficulties and gender differences. Appetite 2022; 177:106137. [PMID: 35738482 DOI: 10.1016/j.appet.2022.106137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/09/2022] [Accepted: 06/11/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE 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. METHOD 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. RESULTS 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. DISCUSSION 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.
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Affiliation(s)
- Lindzey V Hoover
- Department of Psychology, University of Michigan, Ann Arbor, USA.
| | - Hayley P Yu
- Department of Psychology, University of Michigan, Ann Arbor, USA
| | - Elizabeth R Duval
- Department of Psychology, University of Michigan, Ann Arbor, USA; Department of Psychiatry, University of Michigan, Ann Arbor, USA
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Laurent J, Martin AR, Tompkins CL. Persistent and Unsuccessful Attempts to Cut Down on Ultra-Processed Foods and the Associated Challenges for Dietary Adherence. CURRENT ADDICTION REPORTS 2022. [DOI: 10.1007/s40429-022-00418-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Munguía L, Jiménez-Murcia S, Valenciano-Mendoza E, Granero R, Gaspar-Pérez A, Guzmán-Saldaña RME, Sánchez-Gutiérrez M, Fazia G, Gálvez L, Gearhardt AN, Fernández-Aranda F. Risk patterns in food addiction: a Mexican population approach. Eat Weight Disord 2022; 27:1077-1087. [PMID: 34143405 DOI: 10.1007/s40519-021-01240-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/08/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Food addiction (FA) is a construct that has gained interest in recent years but its relevance in Mexican population is still unexplored. AIMS The 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. RESULTS A 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 LEVEL Level III: evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- Lucero Munguía
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet del Llobregat, Barcelona, Spain.
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet del Llobregat, Barcelona, Spain.,Clinical Sciences Department, School of Medicine, Barcelona University, Barcelona, Spain.,CIBER Physiopathology, Obesity and Nutrition (CIBERobn), Health Institute Carlos III, Madrid, Spain
| | - Eduardo Valenciano-Mendoza
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet del Llobregat, Barcelona, Spain
| | - Roser Granero
- Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Anahí Gaspar-Pérez
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet del Llobregat, Barcelona, Spain
| | | | | | - Gilda Fazia
- Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Laura Gálvez
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet del Llobregat, Barcelona, Spain
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet del Llobregat, Barcelona, Spain. .,Clinical Sciences Department, School of Medicine, Barcelona University, Barcelona, Spain. .,CIBER Physiopathology, Obesity and Nutrition (CIBERobn), Health Institute Carlos III, Madrid, Spain.
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20
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Munguía L, Gaspar-Pérez A, Jiménez-Murcia S, Granero R, Sánchez I, Vintró-Alcaraz C, Diéguez C, Gearhardt AN, Fernández-Aranda F. Food Addiction in Eating Disorders: A Cluster Analysis Approach and Treatment Outcome. Nutrients 2022; 14:nu14051084. [PMID: 35268059 PMCID: PMC8912776 DOI: 10.3390/nu14051084] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/25/2022] [Accepted: 03/02/2022] [Indexed: 12/12/2022] Open
Abstract
Background: 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. Methods: 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. Results: 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. Conclusions: 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.
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Affiliation(s)
- Lucero Munguía
- Department of Psychiatry, Universitary Hospital of Bellvitge, 08907 Barcelona, Spain; (L.M.); (A.G.-P.); (S.J.-M.); (I.S.); (C.V.-A.)
- Psychoneurobiology of Eating Disorders and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain;
| | - Anahí Gaspar-Pérez
- Department of Psychiatry, Universitary Hospital of Bellvitge, 08907 Barcelona, Spain; (L.M.); (A.G.-P.); (S.J.-M.); (I.S.); (C.V.-A.)
- Psychoneurobiology of Eating Disorders and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain;
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Universitary Hospital of Bellvitge, 08907 Barcelona, Spain; (L.M.); (A.G.-P.); (S.J.-M.); (I.S.); (C.V.-A.)
- Psychoneurobiology of Eating Disorders and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain;
- Clinical Sciences Department, School of Medicine, Barcelona University, 08907 Barcelona, Spain
- CIBER Physiopatology, Obesity and Nutrition (CIBERobn), Health Institute Carlos III, 28029 Madrid, Spain;
| | - Roser Granero
- Psychoneurobiology of Eating Disorders and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain;
- CIBER Physiopatology, Obesity and Nutrition (CIBERobn), Health Institute Carlos III, 28029 Madrid, Spain;
- Department of Psychobiology and Methodology, Autonomous University of Barcelona, 08907 Barcelona, Spain
| | - Isabel Sánchez
- Department of Psychiatry, Universitary Hospital of Bellvitge, 08907 Barcelona, Spain; (L.M.); (A.G.-P.); (S.J.-M.); (I.S.); (C.V.-A.)
- Psychoneurobiology of Eating Disorders and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain;
- CIBER Physiopatology, Obesity and Nutrition (CIBERobn), Health Institute Carlos III, 28029 Madrid, Spain;
| | - Cristina Vintró-Alcaraz
- Department of Psychiatry, Universitary Hospital of Bellvitge, 08907 Barcelona, Spain; (L.M.); (A.G.-P.); (S.J.-M.); (I.S.); (C.V.-A.)
- Psychoneurobiology of Eating Disorders and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain;
- CIBER Physiopatology, Obesity and Nutrition (CIBERobn), Health Institute Carlos III, 28029 Madrid, Spain;
| | - Carlos Diéguez
- CIBER Physiopatology, Obesity and Nutrition (CIBERobn), Health Institute Carlos III, 28029 Madrid, Spain;
- Department of Physiology, CIMUS, Instituto de Investigación Sanitaria, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | | | - Fernando Fernández-Aranda
- Department of Psychiatry, Universitary Hospital of Bellvitge, 08907 Barcelona, Spain; (L.M.); (A.G.-P.); (S.J.-M.); (I.S.); (C.V.-A.)
- Psychoneurobiology of Eating Disorders and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain;
- Clinical Sciences Department, School of Medicine, Barcelona University, 08907 Barcelona, Spain
- CIBER Physiopatology, Obesity and Nutrition (CIBERobn), Health Institute Carlos III, 28029 Madrid, Spain;
- Correspondence: ; Tel.: +34-93-2607227; Fax: +34-93-2607193
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Findings from Diet Comparison Difficult to Interpret in the Absence of Adherence Assessment. Comment on Tricò et al. Effects of Low-Carbohydrate versus Mediterranean Diets on Weight Loss, Glucose Metabolism, Insulin Kinetics and β-Cell Function in Morbidly Obese Individuals. Nutrients 2021, 13, 1345. Nutrients 2021; 13:nu13113694. [PMID: 34835950 PMCID: PMC8622808 DOI: 10.3390/nu13113694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/25/2021] [Indexed: 12/13/2022] Open
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de Almeida VBP, Filgueiras AR, Nogueira PCK, Sesso RC, Sawaya AL, Domene SMÁ. The impact of food addiction behaviours on the treatment of overweight students. Br J Nutr 2021; 129:1-8. [PMID: 34657642 DOI: 10.1017/s0007114521004189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The present study evaluated the association of food addiction (FA), the change of the BMI/age z-score and the consumption of ultra-processed foods in overweight students undergoing a 16-month, multicomponent intervention in the school environment. FA was investigated using the Yale Food Addiction Scale for Children, and the dietary assessment was estimated using the semi-quantitative FFQ in overweight 9-11-year-old students (BMI/age z-score ≥ 1) of both sexes at their baseline and after the intervention (n 120). Among the schoolchildren, 33·4 % had FA in at least one of the two assessments. The analysis of mixed-effects models to assess the effect of the intervention and the change of the BMI/age z-score between evaluations showed that the occurrence of FA influenced the maintenance of weight (time#FA, β = 0·30, 95 % CI 0·05, 0·54, P = 0·016). Weight loss was observed only in individuals who did not present FA (BMI/age z-score = -0·3). When evaluating the effect of the intervention and the dietary variables, we verified a reduction in the consumption of sugary milk-based drinks -71·13 kJ (-17 kcal), P = 0·04 only in non-FA students at the end of the study. FA has been identified as an underlying factor with therapeutic relevance, and an enhanced understanding of FA can open new paths for the prevention and management of obesity.
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Affiliation(s)
| | | | | | - Ricardo Cintra Sesso
- Department of Medicine, Federal University of São Paulo UNIFESP, São Paulo, SP, Brazil
| | - Ana Lydia Sawaya
- Department of Physiology, Federal University of São Paulo UNIFESP, São Paulo, SP, Brazil
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Aguirre T, Meier N, Koehler A, Bowman R. Highly processed food addiction: A concept analysis. Nurs Forum 2021; 57:152-164. [PMID: 34657289 DOI: 10.1111/nuf.12662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/17/2021] [Accepted: 10/04/2021] [Indexed: 12/19/2022]
Abstract
AIM This concept analysis aims to clarify the highly processed food addiction (HPFA) concept and discuss its implications for treating obesity. BACKGROUND Emerging empirical evidence suggests addictive-like eating may contribute to obesity in some individuals, increasing interest in HPFA's role in obesity. Clarifying the HPFA concept will aid in developing individualized interventions for patients with obesity and HPFA. DESIGN This concept analysis followed Walker and Avant's approach. The case studies are of participants in a study that included individuals with and without HPFA (Yale Food Addiction Scale 2.0-diagnosed). DATA SOURCE We searched PubMed, CINAHL, PsychInfo, and Ebscohost databases. Keywords were "food addiction" and "food addiction concept." REVIEW METHODS Criteria included recent reviews and empirical studies that measured HPFA and focused on HPFA characteristics and/or treatment implications. RESULTS The model case displayed all 11-substance use disorder (SUD) symptoms and clinical significance, supporting a severe HPFA diagnosis. The contrary case was negative for all YFAS 2.0 symptoms and clinical significance and did not eat compulsively or experience cravings. The borderline case met the minimum symptom criteria for severe HPFA but not clinical significance. Clinical interviews may help determine whether such individuals truly exhibit addictive-like eating behaviors. CONCLUSIONS Growing empirical evidence and our case studies support the HPFA concept and the utility of the YFAS/YFAS 2.0 for identifying a distinct subset of individuals with overweight/obesity who may benefit from interventions developed to treat established SUDs. Future research should examine HPFA separately and in relation to obesity and eating disorders and include longitudinal studies and gender-balanced samples.
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Affiliation(s)
- Trina Aguirre
- College of Nursing-West Nebraska Division, University of Nebraska Medical Center, Scottsbluff, Nebraska, USA
| | - Nancy Meier
- College of Nursing-West Nebraska Division, University of Nebraska Medical Center, Scottsbluff, Nebraska, USA
| | - Ann Koehler
- College of Nursing-West Nebraska Division, University of Nebraska Medical Center, Scottsbluff, Nebraska, USA
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Pape M, Herpertz S, Schroeder S, Seiferth C, Färber T, Wolstein J, Steins-Loeber S. Food Addiction and Its Relationship to Weight- and Addiction-Related Psychological Parameters in Individuals With Overweight and Obesity. Front Psychol 2021; 12:736454. [PMID: 34621227 PMCID: PMC8491654 DOI: 10.3389/fpsyg.2021.736454] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/26/2021] [Indexed: 01/20/2023] Open
Abstract
Background and Aims: It is assumed that a relevant subgroup of individuals experiences an addiction-like eating behaviour (Food Addiction), characterized by an impaired control over eating behaviour, emotional eating and food craving. Individuals experiencing Food Addiction partially share common symptomatology with Binge-Eating-Disorder and Bulimia Nervosa. The aim of this study was to investigate the prevalence of Food Addiction, general psychopathology, and associations with weight- and addiction-related constructs in individuals with overweight and obesity, who did not suffer from Binge-Eating-Disorder or Bulimia Nervosa. Methods:N=213 (67.1% female; MBMI=33.35kg/m2, SDBMI=3.79kg/m2) participants who were included in a weight loss program (I-GENDO project) reported BMI and completed questionnaires before the start of the treatment. Food Addiction severity, depressive symptoms, alcohol use disorder, internet use disorder, psychological distress, impulsivity personality trait, impulsive and emotional eating behaviour, food related inhibitory control, weight bias internalization, and self-efficacy were assessed. Results: The prevalence of Food Addiction was 15% with higher, although not statistically significant, prevalence in female (18.2%) compared to male (8.6%) participants. Food Addiction was associated with higher BMI at baseline assessment, low self-esteem, impulsive and emotional eating behaviour, weight bias internalization, and deficits in food-related inhibitory control. In addition, correlations were found between Food Addiction and severity of depressive symptoms, internet use disorder, and psychological distress. Conclusion: A relevant subgroup of participants experiences Food Addiction even when controlling for Binge-Eating-Disorder and Bulimia Nervosa. Future studies are warranted that investigate whether Food Addiction affects treatment success.
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Affiliation(s)
- Magdalena Pape
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany.,Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Stefanie Schroeder
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany.,Department of Pathopsychology, University of Bamberg, Bamberg, Germany
| | - Caroline Seiferth
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
| | - Tanja Färber
- Department of Pathopsychology, University of Bamberg, Bamberg, Germany
| | - Jörg Wolstein
- Department of Pathopsychology, University of Bamberg, Bamberg, Germany
| | - Sabine Steins-Loeber
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
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25
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Abstract
As ultraprocessed foods (i.e., foods composed of mostly cheap industrial sources of dietary energy and nutrients plus additives) have become more abundant in our food supply, rates of obesity and diet-related disease have increased simultaneously. Food addiction has emerged as a phenotype of significant empirical interest within the past decade, conceptualized most commonly as a substance-based addiction to ultraprocessed foods. We detail (a) how approaches used to understand substance-use disorders may be applicable for operationalizing food addiction, (b) evidence for the reinforcing potential of ingredients in ultraprocessed foods that may drive compulsive consumptions, (c) the utility of conceptualizing food addiction as a substance-use disorder versus a behavioral addiction, and (d) clinical and policy implications that may follow if ultraprocessed foods exhibit an addictive potential. Broadly, the existing literature suggests biological and behavioral parallels between food addiction and substance addictions, with ultraprocessed foods high in both added fat and refined carbohydrates being most implicated in addictive-like eating. Future research priorities are also discussed, including the need for longitudinal studies and the potential negative impact of addictive ultraprocessed foods on children. Expected final online publication date for the Annual Review of Nutrition, Volume 41 is September 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Ashley N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109, USA;
| | - Erica M Schulte
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA;
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26
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Wiedemann AA, Carr MM, Ivezaj V, Barnes RD. Examining the construct validity of food addiction severity specifiers. Eat Weight Disord 2021; 26:1503-1509. [PMID: 32725535 PMCID: PMC7855002 DOI: 10.1007/s40519-020-00957-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 07/07/2020] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Food addiction (FA) is related to greater body mass index (BMI), eating-disorder psychopathology, food craving, and psychosocial impairment. Less is known regarding the utility of the FA severity specifiers, as measured by the number of symptoms endorsed on the Yale Food Addiction Scale (YFAS 2.0). METHODS Participants (N = 1854) were recruited from Amazon Mechanical Turk to complete an online survey on eating behaviors. Participants completed self-report measures assessing FA, eating-disorder psychopathology (Eating Disorder Examination Questionnaire), and food craving (Food Craving Inventory). Based on the YFAS 2.0 specifiers, participants were classified into four FA groups: No FA (n = 1643), mild (n = 40), moderate (n = 55), and severe (n = 116). RESULTS There were significant differences found in age, sex, BMI, and frequency of objective binge-eating episodes (OBEs) among the FA groups. Using ANCOVA, adjusted for multiple comparisons and covariates (e.g., BMI, sex, OBEs), the No FA group reported significantly lower levels of shape concern (η2 = 0.05; p < 0.001), weight concern (η2 = 0.04; p < 0.001), eating concern (η2 = 0.15; p < 0.001), and global eating-disorder psychopathology (η2 = 0.06; p < 0.001) than mild, moderate, or severe FA groups. The No FA group reported significantly lower levels of dietary restraint (η2 = 0.01; p < 0.01) than mild and severe FA groups. The severe FA group reported higher food craving scores (η2 = 0.02; p < 0.001) compared to the No FA group. CONCLUSION Our findings parallel the severity specifiers literature for eating and substance use disorders by also indicating the limited utility of severity specifiers based on symptom count. Future research should investigate alternative targets for discriminating among levels of FA. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Ashley A Wiedemann
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT, 06520, USA.
| | - Meagan M Carr
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT, 06520, USA
| | - Valentina Ivezaj
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT, 06520, USA
| | - Rachel D Barnes
- General Internal Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
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27
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Yekaninejad MS, Badrooj N, Vosoughi F, Lin CY, Potenza MN, Pakpour AH. Prevalence of food addiction in children and adolescents: A systematic review and meta-analysis. Obes Rev 2021; 22:e13183. [PMID: 33403795 PMCID: PMC8244111 DOI: 10.1111/obr.13183] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/09/2020] [Accepted: 11/27/2020] [Indexed: 12/14/2022]
Abstract
Food addiction (FA) has been as a construct that is associated with childhood obesity. However, relatively little is known regarding the prevalence of FA among children and adolescents. An instrument designed to assess FA among youth, the Yale Food Addiction Scale for Children and Adolescents (YFAS-C), has been developed and used to estimate FA prevalence among pediatric populations. The present systematic review and meta-analysis aimed to synthesize the results of FA prevalence among youth. Using keywords related to FA and children to search PubMed, Embase, Scopus, and Web of Science, we identified and analyzed 22 cross-sectional studies. No longitudinal studies were identified in the search. Meta-analysis with Freeman-Tukey Double Arcsine transformation was conducted to estimate FA prevalence. Meta-regression was applied to understand whether weight status (i.e., data from community samples vs. overweight/obese samples) is associated with FA. Eligible studies (N = 22) were analyzed using 6,996 participants. The estimated FA prevalence was 15% (95% CI 11-19%) for all samples, 12% (95% CI 8-17%) for community samples, and 19% (95% CI 14-26%) for overweight/obese samples. Meta-regression indicated that weight status was associated with FA severity (p = 0.002) and marginally with FA prevalence (p = 0.056). Healthcare providers should consider and address the high FA prevalence among pediatric population.
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Affiliation(s)
- Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Negin Badrooj
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Fardis Vosoughi
- Department of Orthopaedic and Trauma Surgery, Shariati Hospital and School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mac N Potenza
- Departments of Psychiatry and Neuroscience and the Child Study Center, School of Medicine, Yale University, New Haven, Connecticut, USA.,Connecticut Council on Problem Gambling, Wethersfield, Connecticut, USA
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.,Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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28
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Schiestl ET, Rios JM, Parnarouskis L, Cummings JR, Gearhardt AN. A narrative review of highly processed food addiction across the lifespan. Prog Neuropsychopharmacol Biol Psychiatry 2021; 106:110152. [PMID: 33127423 PMCID: PMC7750273 DOI: 10.1016/j.pnpbp.2020.110152] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/20/2020] [Accepted: 10/21/2020] [Indexed: 12/17/2022]
Abstract
Evidence is growing that highly processed (HP) foods (i.e., foods high in refined carbohydrates and fat) are highly effective in activating reward systems and may even be capable of triggering addictive processes. Unlike traditional drugs of abuse, exposure to HP foods is common very early in development. HP food addiction has been associated with negative outcomes, including higher body mass index (BMI), more frequent binge eating, greater failure in weight loss treatment trials, and poorer mental and physical health. Although most research on HP food addiction has been conducted using adult samples, research on this topic now spans across the life span beginning in utero and extending through older adulthood. HP food addiction and related reward-based changes are associated with negative outcomes at every life stage, which has important implications for developmentally tailored prevention and treatment efforts. Using a developmentally informed approach, the current study comprehensively reviews the existing research on HP food addiction across the lifespan and highlights important areas of future research.
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Affiliation(s)
| | - Julia M Rios
- University of Michigan, United States of America
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29
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Mitchell ES, Yang Q, Behr H, Ho A, DeLuca L, May CN, Michaelides A. Psychosocial Characteristics by Weight Loss and Engagement in a Digital Intervention Supporting Self-Management of Weight. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041712. [PMID: 33578975 PMCID: PMC7916717 DOI: 10.3390/ijerph18041712] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 01/01/2023]
Abstract
There is substantial variability in weight loss outcomes. Psychosocial characteristics underlying outcomes require better understanding, particularly on self-managed digital programs. This cross-sectional study examines differences in psychosocial characteristics by weight loss and engagement outcome, and which characteristics are most associated with weight loss, on a self-managed digital weight loss program. Some underexplored psychosocial characteristics are included, such as flourishing, or a sense of meaning and purpose in life. A questionnaire was emailed to a random sample of 10,000 current users at week 5 in the program and 10,000 current users at week 17. The questionnaire was completed by 2225 users, and their self-reported weight and recorded program engagement data were extracted from the program’s database. Multiple comparison tests indicated that mental health quality of life, depression, anxiety, work-life balance, and flourishing differed by weight loss outcome at program end (week 17; ≥5%, 2–5%, below 2%) and by engagement tertile at program beginning and end (weeks 5 and 17). Only anxiety was associated with weight loss in a backward stepwise regression controlling for engagement and sociodemographic characteristics. Flourishing did not predict weight loss overall but predicted the weight loss outcome group. Our findings have implications for creating more effective interventions for individuals based on psychosocial characteristics and highlight the potential importance of anxiety in underexplored self-managed digital programs.
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Affiliation(s)
- Ellen S. Mitchell
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (Q.Y.); (H.B.); (A.H.); (L.D.); (C.N.M.); (A.M.)
- Correspondence:
| | - Qiuchen Yang
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (Q.Y.); (H.B.); (A.H.); (L.D.); (C.N.M.); (A.M.)
| | - Heather Behr
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (Q.Y.); (H.B.); (A.H.); (L.D.); (C.N.M.); (A.M.)
- Department of Integrative Health, Saybrook University, 55 W Eureka St, Pasadena, CA 91103, USA
| | - Annabell Ho
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (Q.Y.); (H.B.); (A.H.); (L.D.); (C.N.M.); (A.M.)
| | - Laura DeLuca
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (Q.Y.); (H.B.); (A.H.); (L.D.); (C.N.M.); (A.M.)
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Ave, Bronx, NY 10461, USA
| | - Christine N. May
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (Q.Y.); (H.B.); (A.H.); (L.D.); (C.N.M.); (A.M.)
| | - Andreas Michaelides
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (Q.Y.); (H.B.); (A.H.); (L.D.); (C.N.M.); (A.M.)
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30
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Hebebrand J, Gearhardt AN. The concept of "food addiction" helps inform the understanding of overeating and obesity: NO. Am J Clin Nutr 2021; 113:268-273. [PMID: 33448280 DOI: 10.1093/ajcn/nqaa344] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Overeating is a complex behavioral phenotype in terms of both physiology and psychology. The mere transference of the diagnostic criteria for substance use disorders to define food addiction is too simplistic, for the following reasons: 1) a range of somatic and mental disorders require exclusion; 2) food addiction requires distinction from the physiological need to ingest sufficient calories to maintain a high body weight; 3) intentional weight loss can induce an eating behavior mimicking food addiction; 4) the concept lacks validation, especially in light of the high prevalence of "food addiction" in patients with anorexia nervosa; and 5) this construct has not led to novel and successful treatments for overeating and obesity. The concept of food addiction has the potential to distract from the need for focus on environmental influencers to combat the obesity pandemic.
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Affiliation(s)
- Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany
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31
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Examining Self-Weighing Behaviors and Associated Features and Treatment Outcomes in Patients with Binge-Eating Disorder and Obesity with and without Food Addiction. Nutrients 2020; 13:nu13010029. [PMID: 33374870 PMCID: PMC7823454 DOI: 10.3390/nu13010029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/18/2022] Open
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 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.
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