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Sholl J, De Block A. The vices and virtues of medical models of obesity. Obes Rev 2024:e13828. [PMID: 39262312 DOI: 10.1111/obr.13828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 08/22/2024] [Accepted: 08/22/2024] [Indexed: 09/13/2024]
Abstract
Despite numerous public health organizations supporting the pathologization of obesity and considering recent obesity rates a health crisis, many researchers in the humanities, social sciences, and even in the health sciences remain unconvinced. In this paper, we address a set of arguments coming from these academic fields that criticize medical models of obesity for their supposedly flawed diagnostic categories that shift focus onto individuals and support moralizing judgements. Clarifying some key claims in these models and explicating the view of obesity in terms of energy dysregulation, we aim to tease apart misunderstandings and argue that not only do these models not say what they are often accused of saying, but their apparent vices may actually be virtues in helping to combat stigma. Building on the social psychology of stigma and disease labeling, we then suggest that current medical models are largely supportive of many moral and political aims promoted by critics of these models.
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Affiliation(s)
- Jonathan Sholl
- Collège Sciences de la Santé, ImmunoConcept, Université de Bordeaux, CNRS UMR, Bordeaux, France
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2
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Nicze M, Dec A, Borówka M, Krzyżak D, Bołdys A, Bułdak Ł, Okopień B. Molecular Mechanisms behind Obesity and Their Potential Exploitation in Current and Future Therapy. Int J Mol Sci 2024; 25:8202. [PMID: 39125772 PMCID: PMC11311839 DOI: 10.3390/ijms25158202] [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: 06/28/2024] [Revised: 07/22/2024] [Accepted: 07/25/2024] [Indexed: 08/12/2024] Open
Abstract
Obesity is a chronic disease caused primarily by the imbalance between the amount of calories supplied to the body and energy expenditure. Not only does it deteriorate the quality of life, but most importantly it increases the risk of cardiovascular diseases and the development of type 2 diabetes mellitus, leading to reduced life expectancy. In this review, we would like to present the molecular pathomechanisms underlying obesity, which constitute the target points for the action of anti-obesity medications. These include the central nervous system, brain-gut-microbiome axis, gastrointestinal motility, and energy expenditure. A significant part of this article is dedicated to incretin-based drugs such as GLP-1 receptor agonists (e.g., liraglutide and semaglutide), as well as the brand new dual GLP-1 and GIP receptor agonist tirzepatide, all of which have become "block-buster" drugs due to their effectiveness in reducing body weight and beneficial effects on the patient's metabolic profile. Finally, this review article highlights newly designed molecules with the potential for future obesity management that are the subject of ongoing clinical trials.
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Affiliation(s)
- Michał Nicze
- Department of Internal Medicine and Clinical Pharmacology, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Medyków 18, 40-752 Katowice, Poland (A.B.); (B.O.)
| | | | | | | | | | - Łukasz Bułdak
- Department of Internal Medicine and Clinical Pharmacology, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Medyków 18, 40-752 Katowice, Poland (A.B.); (B.O.)
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Van Zyl N, Lusher J, Meyrick J. A Qualitative Exploration of Postoperative Bariatric Patients' Psychosocial Support for Long-Term Weight Loss and Psychological Wellbeing. Behav Sci (Basel) 2024; 14:122. [PMID: 38392475 PMCID: PMC10886391 DOI: 10.3390/bs14020122] [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: 01/10/2024] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND There is a paucity of research exploring postoperative psychosocial interventions for bariatric surgery patients exceeding 2 years, and therefore, an interdisciplinary postoperative approach is warranted. This qualitative study explored the psychosocial support that bariatric surgery patients feel they need to sustain long-term weight loss and their psychological wellbeing. METHODS Fifteen postoperative patients participated in recorded semi-structured online interviews that were transcribed verbatim and analysed using a reflexive thematic analysis approach. RESULTS Three themes and six subthemes emerged. Theme 1, Journey to surgery, has two subthemes: Deep roots and Breaking point. Theme 2, The precipice of change, has two sub-themes: Continuity of care and Can't cut the problem out. Theme 3, Bridging the Gap, has two subthemes: Doing it together and Taking back the reigns. The inconsistencies participants experienced in their pre- and postoperative care led to dissonance, and they felt unprepared for the demands of life postoperatively. CONCLUSIONS Bariatric surgery is a catalyst for physical change, but surgery alone is insufficient to ensure sustained change. Surgical and psychosocial interventions are interdependent rather than mutually exclusive. Patients favour an integrative, personalised, stepped-care approach pre- and postoperatively, with active participation fostering autonomy and access to ongoing support extending into the long-term.
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Affiliation(s)
- Natascha Van Zyl
- Department of Psychology, University of Portsmouth, Portsmouth PO1 2DY, UK
| | - Joanne Lusher
- Provost's Group, Regent's University, London NW1 4NS, UK
| | - Jane Meyrick
- Department of Health and Social Sciences, The University of West England, Bristol BS16 1QY, UK
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Ferreira-Hermosillo A, de Miguel Ibañez R, Pérez-Dionisio EK, Villalobos-Mata KA. Obesity as a Neuroendocrine Disorder. Arch Med Res 2023; 54:102896. [PMID: 37945442 DOI: 10.1016/j.arcmed.2023.102896] [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: 05/31/2023] [Revised: 09/28/2023] [Accepted: 10/05/2023] [Indexed: 11/12/2023]
Abstract
Obesity is one of the most prevalent diseases in the world. Based on hundreds of clinical and basic investigations, its etiopathogenesis goes beyond the simple imbalance between energy intake and expenditure. The center of the regulation of appetite and satiety lies in the nuclei of the hypothalamus where peripheral signals derived from adipose tissue (e.g., leptin), the gastrointestinal tract, the pancreas, and other brain structures, arrive. These signals are part of the homeostatic control system (eating to survive). Additionally, a hedonic or reward system (eating for pleasure) is integrated into the regulation of appetite. This reward system consists of a dopaminergic circuit that affects eating-related behaviors influencing food preferences, food desires, gratification when eating, and impulse control to avoid compulsions. These systems are not separate. Indeed, many of the hormones that participate in the homeostatic system also participate in the regulation of the hedonic system. In addition, factors such as genetic and epigenetic changes, certain environmental and sociocultural elements, the microbiota, and neuronal proinflammatory effects of high-energy diets also contribute to the development of obesity. Therefore, obesity can be considered a complex neuroendocrine disease, and all of the aforementioned components should be considered for the management of obesity.
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Affiliation(s)
- Aldo Ferreira-Hermosillo
- Endocrine Research Unit, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
| | - Regina de Miguel Ibañez
- Endocrinology Service, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Enid Karina Pérez-Dionisio
- Endocrinology Service, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Karen Alexandra Villalobos-Mata
- Endocrinology Service, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
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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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Galanis CR, Weber N, Delfabbro PH, Billieux J, King DL. Gaming disorder and stigma-related judgements of gaming individuals: An online randomized controlled trial. Addiction 2023; 118:1687-1698. [PMID: 37070481 DOI: 10.1111/add.16211] [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: 11/15/2022] [Accepted: 04/02/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND AND AIMS The inclusion of gaming disorder (GD) in the International Classification of Diseases 11th Revision (ICD-11) has generated scholarly debate, including claims about its potential stigmatizing effects on the wider gaming population. The present study aimed to estimate the effect of addiction-based and non-addiction-based conceptualizations of problem gaming on stigma of gamers. DESIGN This preregistered experiment involved a 2 (health information: addiction-related or non-addiction-related) × 3 (vignette: problem, regular or casual gamer) randomized, between-subjects design. SETTING An international sample of participants was recruited via Prolific in June and July 2021. PARTICIPANTS Participants were eligible (n = 1228) if they were aged 35 to 50 years, played video games for no more than 6 hours per week and did not endorse DSM-5 or ICD-11 criteria for GD. INTERVENTION AND COMPARATOR Participants were provided with an explanation of problem gaming as related to either an addictive disorder (i.e. 'addiction' explanation) or personal choice and lifestyle factors (i.e. 'non-addiction' explanation). MEASUREMENTS The Attribution Questionnaire (AQ) and Universal Stigma Scale (USS) assessed stigma toward each gamer vignette. Vignettes described a problem gamer (with features of GD); a regular gamer (frequent gaming; some life interference); and a casual gamer (infrequent gaming; no life interference). FINDINGS Problem gamer vignettes (mean [M] = 113.3; 95% CI = 111.5-115.4) received higher AQ stigma ratings than regular (M = 94.0; 95% CI = 91.9-95.9) and casual gamers (M = 80.1; 95% CI = 78.2-82.1). Although significant, the effect of health information type on AQ stigma ratings was negligible (addiction group [M = 97.6; 95% CI = 95.9-99.1], non-addiction group [M = 94.1; 95% CI = 92.6-95.8]). However, the addiction information group scored lower on USS blame and responsibility than the non-addiction information group with at least a small effect (99.1% confidence). CONCLUSIONS Framing of problem gaming as an addictive disorder or non-addictive activity appears to have a negligible effect on stigma of different gamers among middle-age adults with minimal gaming experience. The concept of 'gaming addiction' seems unlikely to be an important influence on public stigma of gaming.
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Affiliation(s)
- Christina R Galanis
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Nathan Weber
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Paul H Delfabbro
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Joel Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- Centre for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals, Lausanne, Switzerland
| | - Daniel L King
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
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Huang PC, Lee CH, Griffiths MD, O’Brien KS, Lin YC, Gan WY, Poon WC, Hung CH, Lee KH, Lin CY. Sequentially mediated effects of weight-related self-stigma and psychological distress in the association between perceived weight stigma and food addiction among Taiwanese university students: A cross-sectional study. J Eat Disord 2022; 10:177. [PMID: 36414956 PMCID: PMC9682751 DOI: 10.1186/s40337-022-00701-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/09/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Weight-related stigma has negative physiological and psychological impacts on individuals' quality of life. Stigmatized individuals may experience higher psychological distress and therefore increase the potential risk to develop obesity and/or food addiction. The present study examined the associations and mediated effect between perceived weight stigma, weight-related self-stigma, and psychological distress in explaining food addiction among Taiwanese university students. METHODS All participants (n = 968) completed an online survey which included the Perceived Weight Stigma Questionnaire, Weight Self-Stigma Questionnaire, Depression, Anxiety, Stress Scale-21, and Yale Food Addiction Scale Version 2. RESULTS After controlling for demographic variables, significant associations were found in the paths from (1) perceived weight stigma to weight-related self-stigma ([Formula: see text] = 0.23), psychological distress ([Formula: see text] = 0.35), and food addiction ([Formula: see text] = 0.23); (2) weight-related self-stigma to psychological distress ([Formula: see text] = 0.52) and food addiction ([Formula: see text] = 0.59); and (3) psychological distress to food addiction ([Formula: see text] = 0.59) (all p-values < 0.001). The mediation model showed the sequential mediated effect of weight-related self-stigma and psychological distress in the association between perceived weight stigma and food addiction. CONCLUSIONS The results provide novel insights that weight-related self-stigma and psychological distress sequentially mediated the relationship between perceived weight stigma and food addiction among Taiwanese university students. The findings of the present study could be implemented into interventions that aim to reduce food addiction derived from weight-related stigma. Future studies should consider group analysis to consider confounding factors or other populations to provide more evidence regarding the mechanism of weight-related stigma.
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Affiliation(s)
- Po-Ching Huang
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Dist., Tainan, 701401 Taiwan
| | - Chiu-Hsiang Lee
- Department of Nursing, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd., South Dist., Taichung, 402306 Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., South Dist., Taichung, 402306 Taiwan
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ UK
| | - Kerry S. O’Brien
- School of Social Sciences, Faculty of Arts, Monash University, 20 Chancellors Walk, Clayton, VIC 3800 Australia
| | - Yi-Ching Lin
- Department of Early Childhood and Family Education, National Taipei University of Education, No. 134, Sec. 2, Heping E. Rd., Da’an Dist., Taipei, 106320 Taiwan
| | - Wan Ying Gan
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Wai Chuen Poon
- Sunway University Business School, Sunway University, Selangor Darul Ehsan, No. 5, Jalan Universiti, 47500 Bandar Sunway, Malaysia
| | - Ching-Hsia Hung
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Dist., Tainan, 701401 Taiwan
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, No. 1, Daxue Rd., East Dist., Tainan, 701401 Taiwan
| | - Kuo-Hsin Lee
- Department of Emergency Medicine, E-Da Hospital, I-Shou University, No.1, Yida Rd, Yanchao District, Kaohsiung City, 824 Taiwan
- School of Medicine, I-Shou University, No. 8, Yi-Da Road, Jiao-Su Village, Yan-Chao District, Kaohsiung City, 824 Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Dist., Tainan, 701401 Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Dist., Tainan, 701401 Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Dist., Tainan, 701401 Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Dist., Tainan, 701401 Taiwan
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Abstract
Food addiction is associated with dysfunctions in the reward circuit, such as hyperresponsiveness during the exposure to high-calorie flavors in overweight and obese individuals. Similar to drug addiction, there is also impaired self-regulatory control supported by deregulation of the frontostriatal circuit. The inclusion of validated measures of food addiction in clinical research, such as the Yale Food Addiction Scale, has increased the understanding of the clinical utility of this concept. Furthermore, food addiction, eating disorders, and obesity are interrelated. Thus, it is important to recognize food addiction among individuals affected by obesity and candidates for bariatric surgery (ie, preoperative and postoperative assessment). In this context, it has been reported that food addiction may impede weight loss and increase the likelihood of regaining weight when associated with personality traits such as neuroticism and impulsiveness, which are also related to mood disorders, anxiety, and addictive behaviors.
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Speirs DP, Kuijer RG, Yogeeswaran K. Examining how framing obesity as disease vs. food addiction influences stigma among fitness practitioners. Obes Res Clin Pract 2022; 16:429-433. [PMID: 36058838 DOI: 10.1016/j.orcp.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/27/2022] [Accepted: 08/18/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To determine if framing the etiology of obesity as a disease, food addiction, or caloric imbalance would increase or decrease anti-fat attitudes (AFA) and challenge the belief that obesity is caused by a lack of personal responsibility or willpower. METHODS Two hundred and forty-nine fitness practitioners (Mage = 37.49 years) were randomly assigned to one of four experimental conditions and asked to read a short article describing obesity as either: (a) food addiction, (b) disease, or (c) caloric imbalance, while a control group read an unrelated article. All practitioners then completed a measure of AFA. RESULTS Practitioners in the food addiction condition recorded significantly lower AFA than practitioners in the disease condition, specifically on the subscale relating to the belief that obesity is a matter of personal responsibility and willpower, or lack thereof. The differing etiologies of obesity had no impact on fitness practitioners' dislike for people with obesity or their personal fears about gaining weight CONCLUSION: Presenting the etiology of obesity as a food addiction may be more effective than the disease or caloric imbalance etiologies at reducing obesity stigma relating to the belief that obesity results from a lack of willpower. Such an understanding can help reduce obesity stigma and may encourage governments to implement obesity reduction policies as recommended by organisations such as the WHO.
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Affiliation(s)
- Daniel P Speirs
- Department of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand; New Zealand Institute of Health and Fitness, New Zealand.
| | - Roeline G Kuijer
- Department of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Kumar Yogeeswaran
- Department of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
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Liu X, Liu Y, Song S, Xiang G, Du X, Li Q, Xiao M, Ling Y, Chen H. "Free won't" of food in overweight and normal-weight adults: Comparison of neurocognitive correlates of intentional and reactive inhibitions. Neuropsychologia 2022; 174:108351. [PMID: 35995241 DOI: 10.1016/j.neuropsychologia.2022.108351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 08/11/2022] [Accepted: 08/11/2022] [Indexed: 11/20/2022]
Abstract
Food-related inhibition plays a critical role in the manifestation of overweight. Previous research has focused exclusively on stimulus-driven (reactive) inhibition, which is different from intentional inhibition that refers to an internally generated decision to "stop". This study investigated the food-related neurophysiological correlates of intentional and reactive inhibitions in overweight and normal-weight adults. We compared 35 overweight participants (OWs) and 34 normal-weight participants (NWs) on performance and electroencephalography-based measures during a food-related go/no-go/choose task. In this task, participants made reactive responses to an instructed go/no-go target or made intentional choices whether to execute or inhibit a keypress when presented with a free-choice target. Our results mainly showed, 1) for group-difference, N2a amplitudes of OWs were less negative than that of NWs in the intentional trials; 2) for source difference, N2a amplitudes were less negative in reactive condition than in intentional condition uniquely in OWs. Moreover, comparison across intentional responses revealed that P2 amplitudes in no-go trials were lower than in go trials. Additionally, a greater body mass index correlated with lower intentional no-go-P2 and reactive go/no-go-P2 amplitudes. These findings suggest that overweight is associated with deficits in food-related intentional inhibition, which is segregated from reactive inhibition. The individual differences in premotor inhibition during free-choice situations might provide an explanation for overeating behaviors in overweight adults' daily life. Further, our results refine the ERP marker of intentional inhibition from N2 to N2a, which could be an essential neural mechanism underlying the "free won't" of food in OWs.
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Affiliation(s)
- Xinyuan Liu
- Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715, China.
| | - Yong Liu
- Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715, China.
| | - Shiqing Song
- Faculty of Psychology, Shaanxi Normal University, Xi'an, 710062, China.
| | - Guangcan Xiang
- Tian Jiabing College of Education, China Three Gorges University, Yichang, 443002, China.
| | - Xiaoli Du
- Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715, China.
| | - Qingqing Li
- School of Psychology, Central China Normal University, Wuhan, 430079, China.
| | - Mingyue Xiao
- Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715, China.
| | - Ying Ling
- Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715, China.
| | - Hong Chen
- Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715, China.
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Clinical Considerations of Ultra-processed Food Addiction Across Weight Classes: an Eating Disorder Treatment and Care Perspective. CURRENT ADDICTION REPORTS 2022; 9:255-267. [PMID: 35531579 PMCID: PMC9058754 DOI: 10.1007/s40429-022-00411-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2022] [Indexed: 12/27/2022]
Abstract
Purpose of Review To examine the prevalence rates of ultra-processed food addiction across different weight classes and offer guidelines for diagnosis and treatment. Clinicians are provided with practical considerations in the assessment of ultra-processed food addiction beyond the use of validated instruments. Recent Findings The weighted mean prevalence of ultra-processed food addiction is approximately 20% worldwide and varies widely based on the sample. At first glance, there appears a linear relationship between ultra-processed food addiction and BMI class. Further investigation indicates a J-shaped curve with heightened prevalence among the underweight. These findings highlight the need to assess for additional factors that may increase objective or subjective food addiction symptoms including eating disorders, dietary restraint, and other mental health diagnoses. Summary While clinical considerations across different weight classes vary, overemphasis on weight status may detract from the clinical utility of the ultra-processed food addiction construct. Considering weight status in conjunction with other psychiatric symptoms helps to better understand the various biopsychosocial mechanisms that influence eating behavior and can inform individualized treatment strategies.
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Jones A, Hardman CA, Devlin N, Pennington CR, Robinson E. Weight-based discrimination in financial reward and punishment decision making: causal evidence using a novel experimental paradigm. Int J Obes (Lond) 2022; 46:1288-1294. [PMID: 35338259 PMCID: PMC9239905 DOI: 10.1038/s41366-022-01109-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Cross-sectional research has demonstrated weight-related stigma and discrimination, however experimental research providing causal evidence of financial-based weight discrimination is lacking. The aim of these preregistered experiments was to examine whether a novel paradigm in which participants attributed financial rewards and punishments could be used to detect weight bias. SUBJECTS/METHODS One-hundred and twenty-one individuals participated in experiment 1 and one-hundred and sixty-six individuals participated in experiment 2. Both studies were conducted online, and participants were provided with biographies of hypothetical individuals in which weight-status was manipulated (normal weight vs. overweight/obesity) before being asked to provide rewards and punishments on their cognitive performance. In experiment 1 (within-participants design) participants observed one individual they believed to be normal weight and one individual they believed to be overweight/have obesity. In experiment 2 (between-participants design) participants observed one individual whilst also being provided with information about food addiction (Food addiction is real + individual with overweight/obesity vs. food addiction is a myth + individual with overweight/obesity vs control + individual with normal weight). RESULTS In experiment 1, participants punished individuals who were described as having overweight/obesity to a greater extent to individuals who were normal weight (Hedge's g = -0.21 [95% CI: -0.02 to -0.41], p = 0.026), but there was no effect on rewards. They were also less likely to recommend individuals with overweight/obesity to pass the tasks (X2(1) = 10.05, p = 0.002). In experiment 2, participants rewarded individuals whom they believed were overweight/obese to a lesser extent than normal-weight individuals (g = 0.49 [95% CI: 0.16 to 0.83]. There was no effect on punishment, nor any impact of information regarding food addiction as real vs a myth. CONCLUSION Using a novel discrimination task, these two experiments demonstrate causal evidence of weight-based discrimination in financial decision making.
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Affiliation(s)
- Andrew Jones
- Psychology, University of Liverpool, Liverpool, UK.
| | | | - Niamh Devlin
- Psychology, University of Liverpool, Liverpool, UK
| | - Charlotte R Pennington
- School of Psychology, Aston University, Birmingham, UK.,Institute of Health & Neurodevelopment, Aston University, Birmingham, England
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Unwin J, Delon C, Giæver H, Kennedy C, Painschab M, Sandin F, Poulsen CS, Wiss DA. Low carbohydrate and psychoeducational programs show promise for the treatment of ultra-processed food addiction. Front Psychiatry 2022; 13:1005523. [PMID: 36245868 PMCID: PMC9554504 DOI: 10.3389/fpsyt.2022.1005523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/22/2022] [Indexed: 11/26/2022] Open
Abstract
Food addiction, specifically ultra-processed food addiction, has been discussed in thousands of peer-reviewed publications. Although 20% of adults meet criteria for this condition, food addiction is not a recognized clinical diagnosis, leading to a dearth of tested treatment protocols and published outcome data. Growing numbers of clinicians are offering services to individuals on the basis that the food addiction construct has clinical utility. This audit reports on clinical teams across three locations offering a common approach to programs delivered online. Each team focused on a whole food low-carbohydrate approach along with delivering educational materials and psychosocial support relating to food addiction recovery. The programs involved weekly sessions for 10-14 weeks, followed by monthly support. The data comprised pre- and post- program outcomes relating to food addiction symptoms measured by the modified Yale Food Addiction Scale 2.0, ICD-10 symptoms of food related substance use disorder (CRAVED), mental wellbeing as measured by the short version of the Warwick Edinburgh Mental Wellbeing Scale, and body weight. Sample size across programs was 103 participants. Food addiction symptoms were significantly reduced across settings; mYFAS2 score -1.52 (95% CI: -2.22, -0.81), CRAVED score -1.53 (95% CI: -1.93, -1.13) and body weight was reduced -2.34 kg (95% CI: -4.02, -0.66). Mental wellbeing showed significant improvements across all settings; short version Warwick Edinburgh Mental Wellbeing Scale 2.37 (95% CI: 1.55, 3.19). Follow-up data will be published in due course. Further research is needed to evaluate and compare long-term interventions for this complex and increasingly burdensome biopsychosocial condition.
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Affiliation(s)
- Jen Unwin
- Public Health Collaboration, London, United Kingdom
| | | | - Heidi Giæver
- Public Health Collaboration, London, United Kingdom
| | - Clarissa Kennedy
- Sweet Sobriety, Belgrade, MT, United States.,Sweet Sobriety, Parry Sound, ON, Canada
| | - Molly Painschab
- Sweet Sobriety, Belgrade, MT, United States.,Sweet Sobriety, Parry Sound, ON, Canada
| | | | | | - David A Wiss
- Nutrition in Recovery LLC, Los Angeles, CA, United States
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Parnarouskis L, Jouppi RJ, Cummings JR, Gearhardt AN. A randomized study of effects of obesity framing on weight stigma. Obesity (Silver Spring) 2021; 29:1625-1634. [PMID: 34431611 PMCID: PMC10826923 DOI: 10.1002/oby.23247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 06/04/2021] [Accepted: 06/08/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Growing evidence suggests highly processed foods may trigger an addictive-like process, which is associated with obesity. Other research suggests an addictive-like process occurs in response to eating itself, rather than specific foods. Addiction-based obesity explanations raise concerns about double stigmatization of people with obesity and addiction. This study compared effects of obesity framings on external and internalized weight stigma. METHODS The study was preregistered via Open Science Framework. Four hundred and forty-seven adults read an informational passage that described food addiction, eating addiction, or calorie balance explanations for obesity or a control passage about memory. Participants then completed external and internalized weight stigma measures. RESULTS Participants in the food addiction condition reported higher internalized weight stigma compared with those in the control condition. Obesity framing did not significantly affect external weight stigma compared with the control. CONCLUSIONS These findings suggest that food addiction explanations for obesity may elicit greater internalized weight stigma than non-obesity-related messages. Addiction-based and traditional obesity explanations do not appear to influence external weight stigma. Illuminating the effects of obesity framing on stigma will help researchers communicate discoveries in ways that mitigate stigma.
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Affiliation(s)
| | | | - Jenna R. Cummings
- Jenna R. Cummings is now at the Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, of the Eunice Kennedy Shriver National Institute of Child Health and Human Development
| | - Ashley N. Gearhardt
- Jenna R. Cummings is now at the Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, of the Eunice Kennedy Shriver National Institute of Child Health and Human Development
- The University of Michigan, Department of Psychology, Ann Arbor, MI, USA
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15
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Galanis CR, Delfabbro PH, King DL. Stigma-related arguments against gaming disorder: a call for research. Addiction 2021; 116:2921-2922. [PMID: 33998096 DOI: 10.1111/add.15561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Christina R Galanis
- College of Education, Psychology and Social Work, Flinders University, Bedford Park, SA, Australia
| | - Paul H Delfabbro
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Daniel L King
- College of Education, Psychology and Social Work, Flinders University, Bedford Park, SA, Australia
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16
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Prevalence and correlates of food addiction: Systematic review of studies with the YFAS 2.0. Obes Res Clin Pract 2021; 15:191-204. [PMID: 33846067 DOI: 10.1016/j.orcp.2021.03.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 03/19/2021] [Accepted: 03/28/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Research on food addiction (FA) has been growing and increasing interest has been seen in comprehending its mechanisms and clinical and psychological correlates of this phenomena. This field of study is specially apply to understand obesity and eating behavior issues related to eating disorders (ED). OBJECTIVES We performed a literature review that describe recent research using the updated version of the Yale Food Addiction Scale (YFAS 2.0) or modified-YFAS (mYFAS 2.0), from the date of its publication. METHODS Search were performed in Web of Science, Pubmed and PsycNET databases for studies that used the YFAS 2.0 and mYFAS 2.0. RESULTS The studies (n = 53) investigated adaptation and validation of the scale in different cultures (n = 13), prevalence on nonclinical populations and representative samples (n = 5), food addiction in obesity samples (n = 11), in samples with ED and disordered eating (n = 10) and studies that investigated FA in association with other clinical and psychological variables (n = 14). DISCUSSION Studies with the YFAS 2.0 reveal higher prevalence of FA in different samples, and a great association between FA and BED, BN and obesity. Implications for diagnostic of this phenomena and the overlap between FA and other disorders are discussed. CONCLUSIONS The field of FA remains an open subject and effort must be implied to understand the subjective experience of addiction related to eating and food.
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Montemarano V, Cassin SE. The effect of a food addiction explanatory model of eating behaviours on weight-based stigma: An experimental investigation. Eat Behav 2021; 41:101507. [PMID: 33862467 DOI: 10.1016/j.eatbeh.2021.101507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 03/24/2021] [Accepted: 04/05/2021] [Indexed: 10/21/2022]
Abstract
Weight stigmatization and discrimination are pervasive issues that have numerous adverse consequences for those with excess weight. It has been proposed that some individuals may be addicted to hyperpalatable processed foods, resulting in weight promoting eating behaviours. The current study replicated and extended a study examining the effect of a food addiction explanation for eating behaviours on weight-based stigma and weight-controllability beliefs. Undergraduate students (N = 757) were randomly assigned to one of four conditions where they read a newspaper article accompanied by a photo of a woman 1) who was either of a higher body mass index (BMI) or a lower BMI, and 2) that attributed her eating behaviours to either food addiction or poor dietary and lifestyle choices. Stigma towards the woman and individuals with a higher BMI in general were assessed. Results indicated that the woman with a higher BMI elicited greater weight stigma. Attributing weight to food addiction increased perceptions of psychopathology towards the woman, whereas attributing weight to poor dietary and lifestyle choices elicited judgment towards the woman. Neither explanation about eating behaviours elicited stigma towards individuals with a higher BMI in general. Findings suggest that a food addiction explanation alone may not be sufficient to reduce weight stigma.
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Affiliation(s)
- Vanessa Montemarano
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto M5B 2K3, Ontario, Canada.
| | - Stephanie E Cassin
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto M5B 2K3, Ontario, Canada
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18
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Gearhardt AN, Hebebrand J. The concept of "food addiction" helps inform the understanding of overeating and obesity: YES. Am J Clin Nutr 2021; 113:263-267. [PMID: 33448279 DOI: 10.1093/ajcn/nqaa343] [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] [Accepted: 10/26/2020] [Indexed: 12/15/2022] Open
Abstract
Addictive substances such as opiates and other drugs are highly reinforcing and some (but not all) individuals consume them compulsively. Highly processed (HP) foods have unnaturally high concentrations of refined carbohydrates and fat. These foods are highly reinforcing and some (but not all) individuals consume them compulsively. HP foods, like addictive substances, are more effective in activating reward-related neural systems than minimally processed foods. More importantly, HP foods are associated with the behavioral indicators of addiction: diminished control over consumption, strong craving, continued use despite negative consequences, and repeated failed attempts to reduce or eliminate intake. Thus, HP foods are key in addictive patterns of food intake. Like addictive drugs, HP foods are complex, human-made substances designed to effectively deliver reinforcing ingredients (e.g., refined carbohydrates, fat). Withdrawal and tolerance are not necessary for an addiction classification; however, HP foods can trigger both these processes. On a public health level, the negative consequences of HP foods are high, even for those without clinically relevant levels of addictive eating. The recognition that some foods can be addictive will inform clinical obesity treatment and underscore the importance of environmentally focused policy interventions.
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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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19
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Wiss DA, Avena N, Gold M. Food Addiction and Psychosocial Adversity: Biological Embedding, Contextual Factors, and Public Health Implications. Nutrients 2020; 12:E3521. [PMID: 33207612 PMCID: PMC7698089 DOI: 10.3390/nu12113521] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 12/13/2022] Open
Abstract
The role of stress, trauma, and adversity particularly early in life has been identified as a contributing factor in both drug and food addictions. While links between traumatic stress and substance use disorders are well documented, the pathways to food addiction and obesity are less established. This review focuses on psychosocial and neurobiological factors that may increase risk for addiction-like behaviors and ultimately increase BMI over the lifespan. Early childhood and adolescent adversity can induce long-lasting alterations in the glucocorticoid and dopamine systems that lead to increased addiction vulnerability later in life. Allostatic load, the hypothalamic-pituitary-adrenal axis, and emerging data on epigenetics in the context of biological embedding are highlighted. A conceptual model for food addiction is proposed, which integrates data on the biological embedding of adversity as well as upstream psychological, social, and environmental factors. Dietary restraint as a feature of disordered eating is discussed as an important contextual factor related to food addiction. Discussion of various public health and policy considerations are based on the concept that improved knowledge of biopsychosocial mechanisms contributing to food addiction may decrease stigma associated with obesity and disordered eating behavior.
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Affiliation(s)
- David A. Wiss
- Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, USA;
| | - Nicole Avena
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
- Department of Psychology, Princeton University, Princeton, NJ 08540, USA
| | - Mark Gold
- School of Medicine, Washington University in St. Louis, St. Louis, MO 63130, USA
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20
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Wiss D, Brewerton T. Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint. Nutrients 2020; 12:E2937. [PMID: 32992768 PMCID: PMC7600542 DOI: 10.3390/nu12102937] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 02/07/2023] Open
Abstract
Converging evidence from both animal and human studies have implicated hedonic eating as a driver of both binge eating and obesity. The construct of food addiction has been used to capture pathological eating across clinical and non-clinical populations. There is an ongoing debate regarding the value of a food addiction "diagnosis" among those with eating disorders such as anorexia nervosa binge/purge-type, bulimia nervosa, and binge eating disorder. Much of the food addiction research in eating disorder populations has failed to account for dietary restraint, which can increase addiction-like eating behaviors and may even lead to false positives. Some have argued that the concept of food addiction does more harm than good by encouraging restrictive approaches to eating. Others have shown that a better understanding of the food addiction model can reduce stigma associated with obesity. What is lacking in the literature is a description of a more comprehensive approach to the assessment of food addiction. This should include consideration of dietary restraint, and the presence of symptoms of other psychiatric disorders (substance use, posttraumatic stress, depressive, anxiety, attention deficit hyperactivity) to guide treatments including nutrition interventions. The purpose of this review is to help clinicians identify the symptoms of food addiction (true positives, or "the signal") from the more classic eating pathology (true negatives, or "restraint") that can potentially elevate food addiction scores (false positives, or "the noise"). Three clinical vignettes are presented, designed to aid with the assessment process, case conceptualization, and treatment strategies. The review summarizes logical steps that clinicians can take to contextualize elevated food addiction scores, even when the use of validated research instruments is not practical.
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Affiliation(s)
- David Wiss
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90025, USA
| | - Timothy Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA;
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21
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O’Brien KS, Puhl RM, Latner JD, Lynott D, Reid JD, Vakhitova Z, Hunter JA, Scarf D, Jeanes R, Bouguettaya A, Carter A. The Effect of a Food Addiction Explanation Model for Weight Control and Obesity on Weight Stigma. Nutrients 2020; 12:nu12020294. [PMID: 31978983 PMCID: PMC7071011 DOI: 10.3390/nu12020294] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 12/15/2019] [Accepted: 01/07/2020] [Indexed: 11/22/2022] Open
Abstract
There is increasing scientific and public support for the notion that some foods may be addictive, and that poor weight control and obesity may, for some people, stem from having a food addiction. However, it remains unclear how a food addiction model (FAM) explanation for obesity and weight control will affect weight stigma. In two experiments (N = 530 and N = 690), we tested the effect of a food addiction explanation for obesity and weight control on weight stigma. In Experiment 1, participants who received a FAM explanation for weight control and obesity reported lower weight stigma scores (e.g., less dislike of ‘fat people’, and lower personal willpower blame) than those receiving an explanation emphasizing diet and exercise (F(4,525) = 7.675, p = 0.006; and F(4,525) = 5.393, p = 0.021, respectively). In Experiment 2, there was a significant group difference for the dislike of ‘fat people’ stigma measure (F(5,684) = 5.157, p = 0.006), but not for personal willpower weight stigma (F(5,684) = 0.217, p = 0.81). Participants receiving the diet and exercise explanation had greater dislike of ‘fat people’ than those in the FAM explanation and control group (p values < 0.05), with no difference between the FAM and control groups (p > 0.05). The FAM explanation for weight control and obesity did not increase weight stigma and resulted in lower stigma than the diet and exercise explanation that attributes obesity to personal control. The results highlight the importance of health messaging about the causes of obesity and the need for communications that do not exacerbate weight stigma.
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Affiliation(s)
- Kerry S. O’Brien
- School of Social Sciences, Faculty of Arts, Monash University, Melbourne 3800, Australia
- Correspondence:
| | - Rebecca M. Puhl
- Department of Human Development and Family Sciences, Rudd Center for Food Policy & Obesity, University of Connecticut, Storrs, CT 06269, USA
| | - Janet D. Latner
- Department of Psychology, College of Social Sciences, University of Hawaii, Manoa, HI 96822, USA
| | - Dermot Lynott
- Department of Psychology, Faculty of Science and Technology University of Lancaster, Lancaster LA1 4YW, UK
| | - Jessica D. Reid
- School of Social Sciences, Faculty of Arts, Monash University, Melbourne 3800, Australia
| | - Zarina Vakhitova
- School of Social Sciences, Faculty of Arts, Monash University, Melbourne 3800, Australia
| | - John A. Hunter
- Division of Sciences, Department of Psychology, University of Otago, Dunedin 9016, New Zealand
| | - Damian Scarf
- Division of Sciences, Department of Psychology, University of Otago, Dunedin 9016, New Zealand
| | - Ruth Jeanes
- Curriculum & Pedagogy, Faculty of Education, Monash University, Melbourne 3800, Australia
| | - Ayoub Bouguettaya
- School of Social Sciences, Faculty of Arts, Monash University, Melbourne 3800, Australia
| | - Adrian Carter
- School of Psychology, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne 3800, Australia
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22
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Adams RC, Sedgmond J, Maizey L, Chambers CD, Lawrence NS. Food Addiction: Implications for the Diagnosis and Treatment of Overeating. Nutrients 2019; 11:E2086. [PMID: 31487791 PMCID: PMC6770567 DOI: 10.3390/nu11092086] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 08/14/2019] [Accepted: 08/21/2019] [Indexed: 12/14/2022] Open
Abstract
With the obesity epidemic being largely attributed to overeating, much research has been aimed at understanding the psychological causes of overeating and using this knowledge to develop targeted interventions. Here, we review this literature under a model of food addiction and present evidence according to the fifth edition of the Diagnostic and Statistical Manual (DSM-5) criteria for substance use disorders. We review several innovative treatments related to a food addiction model ranging from cognitive intervention tasks to neuromodulation techniques. We conclude that there is evidence to suggest that, for some individuals, food can induce addictive-type behaviours similar to those seen with other addictive substances. However, with several DSM-5 criteria having limited application to overeating, the term 'food addiction' is likely to apply only in a minority of cases. Nevertheless, research investigating the underlying psychological causes of overeating within the context of food addiction has led to some novel and potentially effective interventions. Understanding the similarities and differences between the addictive characteristics of food and illicit substances should prove fruitful in further developing these interventions.
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Affiliation(s)
- Rachel C Adams
- CUBRIC, School of Psychology, Cardiff University, Maindy Road, Cardiff CF24 4HQ, UK.
| | - Jemma Sedgmond
- CUBRIC, School of Psychology, Cardiff University, Maindy Road, Cardiff CF24 4HQ, UK
| | - Leah Maizey
- CUBRIC, School of Psychology, Cardiff University, Maindy Road, Cardiff CF24 4HQ, UK
| | | | - Natalia S Lawrence
- School of Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter EX4 4QG, UK
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23
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Obesity Stigma: Is the 'Food Addiction' Label Feeding the Problem? Nutrients 2019; 11:nu11092100. [PMID: 31487868 PMCID: PMC6770691 DOI: 10.3390/nu11092100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 08/27/2019] [Accepted: 08/30/2019] [Indexed: 02/06/2023] Open
Abstract
Obesity is often attributed to an addiction to high-calorie foods. However, the effect of "food addiction" explanations on weight-related stigma remains unclear. In two online studies, participants (n = 439, n = 523, respectively, recruited from separate samples) read a vignette about a target female who was described as 'very overweight'. Participants were randomly allocated to one of three conditions which differed in the information provided in the vignette: (1) in the "medical condition", the target had been diagnosed with food addiction by her doctor; (2) in the "self-diagnosed condition", the target believed herself to be a food addict; (3) in the control condition, there was no reference to food addiction. Participants then completed questionnaires measuring target-specific stigma (i.e., stigma towards the female described in the vignette), general stigma towards obesity (both studies), addiction-like eating behavior and causal beliefs about addiction (Study 2 only). In Study 1, participants in the medical and self-diagnosed food addiction conditions demonstrated greater target-specific stigma relative to the control condition. In Study 2, participants in the medical condition had greater target-specific stigma than the control condition but only those with low levels of addiction-like eating behavior. There was no effect of condition on general weight-based stigma in either study. These findings suggest that the food addiction label may increase stigmatizing attitudes towards a person with obesity, particularly within individuals with low levels of addiction-like eating behavior.
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Cassin SE, Buchman DZ, Leung SE, Kantarovich K, Hawa A, Carter A, Sockalingam S. Ethical, Stigma, and Policy Implications of Food Addiction: A Scoping Review. Nutrients 2019; 11:E710. [PMID: 30934743 PMCID: PMC6521112 DOI: 10.3390/nu11040710] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/08/2019] [Accepted: 03/20/2019] [Indexed: 12/12/2022] Open
Abstract
The concept of food addiction has generated much controversy. In comparison to research examining the construct of food addiction and its validity, relatively little research has examined the broader implications of food addiction. The purpose of the current scoping review was to examine the potential ethical, stigma, and health policy implications of food addiction. Major themes were identified in the literature, and extensive overlap was identified between several of the themes. Ethics sub-themes related primarily to individual responsibility and included: (i) personal control, will power, and choice; and (ii) blame and weight bias. Stigma sub-themes included: (i) the impact on self-stigma and stigma from others, (ii) the differential impact of substance use disorder versus behavioral addiction on stigma, and (iii) the additive stigma of addiction plus obesity and/or eating disorder. Policy implications were broadly derived from comparisons to the tobacco industry and focused on addictive foods as opposed to food addiction. This scoping review underscored the need for increased awareness of food addiction and the role of the food industry, empirical research to identify specific hyperpalatable food substances, and policy interventions that are not simply extrapolated from tobacco.
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Affiliation(s)
- Stephanie E Cassin
- Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON M5B 2K3, Canada.
- Centre for Mental Health, University Health Network, Network - Toronto General Hospital, 200 Elizabeth Street, 8th Floor, Toronto, ON M5G 2C4, Canada.
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada.
| | - Daniel Z Buchman
- University of Toronto Joint Centre of Bioethics, 155 College Street, Suite 754, Toronto, ON M5T 1P8, Canada.
- Bioethics Program and Krembil Brain Institute, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Toronto, ON M5T 1P8, Canada.
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON M5T 1R8, Canada.
| | - Samantha E Leung
- Centre for Mental Health, University Health Network, Network - Toronto General Hospital, 200 Elizabeth Street, 8th Floor, Toronto, ON M5G 2C4, Canada.
- Bariatric Surgery Program, University Health Network - Toronto Western Hospital, 399 Bathurst Street, East Wing ⁻ 4th Floor, Toronto, ON M5T 2S8, Canada.
| | - Karin Kantarovich
- Centre for Mental Health, University Health Network, Network - Toronto General Hospital, 200 Elizabeth Street, 8th Floor, Toronto, ON M5G 2C4, Canada.
- Bariatric Surgery Program, University Health Network - Toronto Western Hospital, 399 Bathurst Street, East Wing ⁻ 4th Floor, Toronto, ON M5T 2S8, Canada.
| | - Aceel Hawa
- Department of Education, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON M5S 2S1, Canada.
| | - Adrian Carter
- School of Psychological Sciences, Monash University, Melbourne, VIC 3181, Australia.
- UQ Centre for Clinical Research, University of Queensland, Herston, QLD 4029, Australia.
| | - Sanjeev Sockalingam
- Centre for Mental Health, University Health Network, Network - Toronto General Hospital, 200 Elizabeth Street, 8th Floor, Toronto, ON M5G 2C4, Canada.
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada.
- Bariatric Surgery Program, University Health Network - Toronto Western Hospital, 399 Bathurst Street, East Wing ⁻ 4th Floor, Toronto, ON M5T 2S8, Canada.
- Department of Education, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON M5S 2S1, Canada.
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26
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Figueroa-Quiñones J, Cjuno J. Food addiction in Latin America. Medwave 2018; 18:e7171. [PMID: 29499034 DOI: 10.5867/medwave.2018.01.7171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 01/09/2018] [Indexed: 11/27/2022] Open
Abstract
Food addiction is a disorder characterized by an uncontrollable desire to eat foods high in fats and sugars. These foods activate the brain reward system in a similar way to drugs generating the release of neurotransmitters such as dopamine and oxytocin which trigger a need to repeat the behavior. In developed countries in Europe, Asia, and North America, there are reports of food addiction in children, adolescents, university students, sexual minorities, women and the adult population that suffer from obesity or overweight. In Latin America, studies conducted in Chile report that 10% of university students suffer food addiction, while in Brazil 4% of adults have the same disorder. There are few studies on the prevalence of food addiction. Likewise, validations of diagnostic instruments and studies on the effectiveness of psychotherapy are required to modify behaviors in this disorder.
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Affiliation(s)
- Joel Figueroa-Quiñones
- Centro de Estudios de Población, Universidad Católica los Ángeles de Chimbote, Ancash, Perú. Address: Jirón Tumbes 247, Casco Urbano Chimbote, Ancash, Perú, CP: 02800.
| | - Julio Cjuno
- Centro de Estudios de Población, Universidad Católica los Ángeles de Chimbote, Ancash, Perú
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27
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Corrales-Reyes IE, Dorta-Contreras AJ. Students scientific production: a proposal to encourage it. Medwave 2018; 18:e7166. [PMID: 29385119 DOI: 10.5867/medwave.2018.01.7166] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 01/09/2018] [Indexed: 11/27/2022] Open
Abstract
The scientific production of medical students in Latin America, is poor and below their potential. The reason for this is the low theoretical and practical knowledge of scientific writing, a low margin for new knowledge generation, a heavy academic and clinical load, and the expected profile of the medical school graduate. In the present short communication, we propose teaching courses in research methodology, scientific writing in English and Spanish, a personalized search for students and mentors with research aptitudes. Also, we propose academic and material stimuli for publishing, rewards for the best papers made by students and the development and support of scientific student journals. Other proposals are the requirement to publish a paper for graduation, and sharing the most outstanding experiences.
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Affiliation(s)
- Ibraín Enrique Corrales-Reyes
- Clínica Estomatológica de Especialidades Manuel de Jesús Cedeño Infante, Universidad de Ciencias Médicas de Granma, Bayamo, Cuba. Address: Ignacio Pérez 12ª, Jiguaní, Granma, Cuba.
| | - Alberto Juan Dorta-Contreras
- Laboratorio Central del Líquido Cefalorraquídeo, Facultad de Ciencias Médicas Dr. Miguel Enríquez, Universidad de Ciencias Médicas de La Habana, La Habana, Cuba
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Abstract
PURPOSE OF REVIEW This review examines the food addiction model and the role of food hedonic pathways in the pathogenesis and treatment of obesity. RECENT FINDINGS The hedonic pathway interacts with the obesogenic environment to override homeostatic mechanisms to cause increase in body weight. Weight gain sustained over time leads to "upward setting" of defended level of body-fat mass. There are neurobiological and phenotypic similarities and differences between hedonic pathways triggered by food compared with other addictive substances, and the entity of food addiction remains controversial. Treatment for obesity including pharmacotherapy and bariatric surgery impacts on neural pathways governing appetite and hedonic control of food intake. The food addiction model may also have significant impact on public health policy, regulation of certain foods, and weight stigma and bias. Recent rapid progress in delineation of food hedonic pathways advances our understanding of obesity and facilitates development of effective treatment measures against the disease.
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Affiliation(s)
- Phong Ching Lee
- Obesity and Metabolism Unit, Department of Endocrinology, Singapore General Hospital, Bukit Merah, Singapore
| | - John B Dixon
- Clinical Obesity Research, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Victoria, 3004, Australia.
- Iverson Health Innovation Research Institute, Swinburne University, Melbourne, Australia.
- Primary Care Research Unit, Monash University, Melbourne, Australia.
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Vallgårda S, Nielsen MEJ, Hansen AKK, Cathaoir KÓ, Hartlev M, Holm L, Christensen BJ, Jensen JD, Sørensen TIA, Sandøe P. Should Europe follow the US and declare obesity a disease?: a discussion of the so-called utilitarian argument. Eur J Clin Nutr 2017; 71:1263-1267. [PMID: 28952605 DOI: 10.1038/ejcn.2017.103] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 04/26/2017] [Accepted: 05/19/2017] [Indexed: 02/06/2023]
Abstract
In 2013, the American Medical Association (AMA) decided to recognize obesity as a disease. One of the main arguments presented in favor of this was broadly 'utilitarian': the disease label would, it was claimed, provide more benefits than harms and thereby serve the general good. Several individuals and groups have argued that this reasoning is just as powerful in the European context. Drawing mainly on a review of relevant social science research, we discuss the validity of this argument. Our conclusion is that in a Western European welfare state, defining obesity as a disease will not on balance serve the general good, and that it is therefore more appropriate to continue to treat obesity as a risk factor. The main reasons presented in favor of this conclusion are: It is debatable whether a disease label would lead to better access to care and preventive measures and provide better legal protection in Europe. Medicalization and overtreatment are possible negative effects of a disease label. There is no evidence to support the claim that declaring obesity a disease would reduce discrimination or stigmatization. In fact, the contrary is more likely, since a disease label would categorically define the obese body as deviant.
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Affiliation(s)
- S Vallgårda
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - M E J Nielsen
- Department of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark.,Department of Media Cognition, Communication, University of Copenhagen, Copenhagen, Denmark
| | - A K K Hansen
- The SAXO Institute, University of Copenhagen, Copenhagen, Denmark
| | - K Ó Cathaoir
- Faculty of Law, University of Copenhagen, Copenhagen, Denmark
| | - M Hartlev
- Faculty of Law, University of Copenhagen, Copenhagen, Denmark
| | - L Holm
- Department of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark
| | - B J Christensen
- Department of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark
| | - J D Jensen
- Department of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark
| | - T I A Sørensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen The Novo Nordisk Foundation Centre for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | - P Sandøe
- Department of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark.,Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
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30
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Cullen A, Barnett A, Komesaroff P, Brown W, O'Brien K, Hall W, Carter A. A qualitative study of overweight and obese Australians' views of food addiction. Appetite 2017; 115:62-70. [DOI: 10.1016/j.appet.2017.02.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 01/31/2017] [Accepted: 02/08/2017] [Indexed: 12/25/2022]
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31
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Ruddock HK, Hardman CA. Food Addiction Beliefs Amongst the Lay Public: What Are the Consequences for Eating Behaviour? CURRENT ADDICTION REPORTS 2017; 4:110-115. [PMID: 28580228 PMCID: PMC5435771 DOI: 10.1007/s40429-017-0136-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW The current paper reviews recent research on perceptions of food addiction in the lay public. It also examines the potential consequences of such beliefs for eating behaviour. RECENT FINDINGS Surveys suggest that, within community samples, the majority of individuals believe that certain foods are addictive, and that food addiction causes obesity. Further, many people believe themselves to be 'food addicts', and these individuals demonstrate increased patterns of aberrant eating. However, there is also initial experimental evidence to suggest that believing oneself to be a food addict leads to short-term food restriction. SUMMARY To reconcile these findings, a self-perpetuating relationship between food addiction beliefs and aberrant eating is proposed. Specifically, in the short term, food addiction beliefs may encourage individuals to avoid certain foods. However, attempts at restriction may eventually lead to increased cravings and disinhibition, thus reinforcing perceptions of oneself as a food addict. These possibilities merit scrutiny in future research.
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Affiliation(s)
- Helen K. Ruddock
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
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33
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Nolan LJ. Is it time to consider the "food use disorder?". Appetite 2017; 115:16-18. [PMID: 28130152 DOI: 10.1016/j.appet.2017.01.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/12/2017] [Accepted: 01/20/2017] [Indexed: 10/20/2022]
Abstract
In the contemporary milieu, the term "addiction" brings to mind issues of physical dependence, uncontrolled behavior, psychoactive substances, and disease. Thus, the use of the term "food addiction" which has become common in research on binge eating and obesity, suggests a disease state characterized by craving, compulsive eating and, possibly, the presence of food constituents with drug-like properties which weaken the will power to abstain from consumption. In this commentary, the case is made that, following the trends in substance use disorder terminology, adoption of "food use disorder" as a term for compulsive eating associated with subjective loss of control may foster continued research in this area without the connotations suggested by "food addiction."
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Affiliation(s)
- Laurence J Nolan
- Department of Psychology, Wagner College, Staten Island, NY 10301, USA.
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34
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Roberto CA, Galbraith K, Lydecker JA, Ivezaj V, Barnes RD, White MA, Grilo CM. Preferred descriptions for loss of control while eating and weight among patients with binge eating disorder. Psychiatry Res 2016; 246:548-553. [PMID: 27821368 PMCID: PMC5161684 DOI: 10.1016/j.psychres.2016.09.045] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 07/11/2016] [Accepted: 09/25/2016] [Indexed: 11/19/2022]
Abstract
Patients with binge eating disorder (BED) typically also have excess weight, making them vulnerable to stigmatizing attitudes about mental illness and obesity. Further, one of the diagnostic features of BED is experiencing a loss of control during binge eating episodes. It is possible that patients feel negatively judged when clinicians assess for loss of control as it may activate stereotypes of patients with obesity lacking willpower. We developed a questionnaire to assess preferences for common loss of control descriptions and gathered data on preferences for weight-related terms among 46 patients with BED. Analyses revealed the majority of common descriptors for loss of control eating were viewed neutrally, with loss of control being the most preferred term. Descriptions suggesting patients were addicted to food or did not consider stopping eating once they started binge eating were viewed negatively. The following weight descriptions were viewed negatively: heaviness, large size, obesity, excess fat, and fatness. Terms such as BMI, and unhealthy body weight or BMI were viewed more favorably and weight was the most preferred term. These findings provide empirical support for healthcare providers' use of terms to use and terms to avoid when talking to patients with BED about eating and weight.
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Affiliation(s)
- Christina A Roberto
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA, USA.
| | | | - Janet A Lydecker
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Valentina Ivezaj
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Rachel D Barnes
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Marney A White
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Carlos M Grilo
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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35
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Diversi TM, Hughes R, Burke KJ. The prevalence and practice impact of weight bias amongst Australian dietitians. Obes Sci Pract 2016; 2:456-465. [PMID: 28090351 PMCID: PMC5192547 DOI: 10.1002/osp4.83] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 10/18/2016] [Accepted: 10/21/2016] [Indexed: 11/30/2022] Open
Abstract
Objectives This study explored weight bias amongst Australian Accredited Practising Dietitians (APDs) and the effect of client weight status on dietetic practice. Methods Participants were 201 APDs, recruited using purposive sampling. A self‐administered questionnaire, the fat phobia scale (FPS), was completed to assess explicit weight bias. Participants were then randomized to receive either a female within the healthy weight range or female with obesity, accompanied by an identical case study for a condition unrelated to weight. Participants assessed the client based on data provided, provided recommendations and rated their perception of the client. Results Mean FPS scores indicated mild fat phobia. However, dietetic practice was significantly affected by the client's weight status. Dietitians presented with the female with obesity assessed the client to have significantly lower health and were more likely to provide unsolicited weight management recommendations. In addition, dietitians rated the client as less receptive, less motivated and as having a lower ability to understand and sustain recommendations. Conclusions The contribution of this study is the exploration of how weight status may impact dietetic practice including assessment, recommendations and perceptions of the client. Dietitians may practice in a manner that represents or could be perceived as negative implicit weight bias, despite the explicit FPS assessing only mild fat phobia. Further research to understand the extent of the problem and how it impacts client outcomes and to test possible solutions is required.
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Affiliation(s)
- T M Diversi
- Faculty of Health Science and Medicine, Nutrition and Dietetics Department Bond University Robina QLD Australia; School of Human, Health and Social Sciences Central Queensland University Rockhampton QLD Australia
| | - R Hughes
- Faculty of Health Science and Medicine, Nutrition and Dietetics Department Bond University Robina QLD Australia; School of Public Health Massey University Wellington New Zealand
| | - K J Burke
- School of Human, Health and Social Sciences Central Queensland University Rockhampton QLD Australia
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36
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Criscitelli K, Avena NM. The neurobiological and behavioral overlaps of nicotine and food addiction. Prev Med 2016; 92:82-89. [PMID: 27509870 DOI: 10.1016/j.ypmed.2016.08.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 08/01/2016] [Accepted: 08/06/2016] [Indexed: 12/19/2022]
Abstract
Both cigarette smoking and obesity are significant public health concerns and are associated with increased risk of early mortality. It is well established that the mesolimbic dopamine pathway is an important component of the reward system within the brain and is implicated in the development of addiction. Indeed, nicotine and highly palatable foods are capable of altering dopamine release within this system, engendering addictive like responses in susceptible individuals. Although additional research is warranted, findings from animal and human literature have elucidated many of neuroadaptions that occur from exposure to nicotine and highly palatable foods, leading to a greater understanding of the underlying mechanisms contributing to these aberrant behaviors. In this review we present the findings taken from preclinical and clinical literature of the known effects of exposure to nicotine and highly palatable foods on the reward related circuitry within the brain. Further, we compare the neurobiological and behavioral overlaps between nicotine, highly palatable foods and obesity. Lastly, we examine the stigma associated with smoking, obesity and food addiction, and the consequences stigma has on the overall health and wellbeing of an individual.
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Affiliation(s)
- Kristen Criscitelli
- Department of Pharmacology and Systems Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Nicole M Avena
- Department of Pharmacology and Systems Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
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37
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Schulte EM, Potenza MN, Gearhardt AN. A commentary on the "eating addiction" versus "food addiction" perspectives on addictive-like food consumption. Appetite 2016; 115:9-15. [PMID: 27984189 DOI: 10.1016/j.appet.2016.10.033] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 10/20/2016] [Accepted: 10/26/2016] [Indexed: 12/21/2022]
Abstract
The food addiction construct posits that vulnerable individuals may experience an addictive-like response to certain foods, such as those high in fat and refined carbohydrates. Recently, an alternative model to food addiction was proposed, suggesting that the act of eating may be a behavioral addiction that can trigger an addictive-like response in susceptible individuals. One major rationale for the eating addiction framework is that the assessment of food addiction is based on behavioral indicators, such as consuming greater quantities of food than intended and eating certain foods despite negative consequences. It is also suggested that the lack of investigation into which foods and food attributes (e.g., sugar) may have an addictive potential is evidence that food addiction does not parallel a substance-based addiction and more closely resembles a behavioral addiction. The present paper provides a commentary suggesting that the substance-based, food-addiction framework is more appropriate than the behavioral-addiction, eating-addiction perspective to conceptualize addictive-like food consumption. In order to illustrate this point, this manuscript will discuss behavioral components characteristic of all substance-use disorders, preliminary evidence to suggest that all foods are not equally associated with addictive-like eating, and key differences between the hypothesized eating addiction phenotype and the only existing behavioral addiction in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), gambling disorder. Further, this paper will consider implications of applying an addiction label to food versus eating and suggest future research directions to evaluate whether food addiction is a valid and clinically useful construct.
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Affiliation(s)
- Erica M Schulte
- Department of Psychology, University of Michigan, 2268 East Hall, 530 Church Street, Ann Arbor, MI 48109, USA.
| | - Marc N Potenza
- Department of Psychiatry, The National Center on Addiction and Substance Abuse, Yale University School of Medicine, CMHC Room S-104, 34 Park Street, New Haven, CT 06519, USA; Department of Child Study, The National Center on Addiction and Substance Abuse, Yale University School of Medicine, CMHC Room S-104, 34 Park Street, New Haven, CT 06519, USA; Department of Neuroscience, The National Center on Addiction and Substance Abuse, Yale University School of Medicine, CMHC Room S-104, 34 Park Street, New Haven, CT 06519, USA.
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, 2268 East Hall, 530 Church Street, Ann Arbor, MI 48109, USA.
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38
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Murakami JM, Essayli JH, Latner JD. The relative stigmatization of eating disorders and obesity in males and females. Appetite 2016; 102:77-82. [DOI: 10.1016/j.appet.2016.02.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 02/10/2016] [Accepted: 02/11/2016] [Indexed: 10/22/2022]
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39
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Ruddock HK, Christiansen P, Jones A, Robinson E, Field M, Hardman CA. Believing in food addiction: Helpful or counterproductive for eating behavior? Obesity (Silver Spring) 2016; 24:1238-43. [PMID: 27146787 PMCID: PMC5084740 DOI: 10.1002/oby.21499] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 02/10/2016] [Accepted: 02/14/2016] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Obesity is often attributed to an addiction to food, and many people believe themselves to be "food addicts." However, little is known about how such beliefs may affect dietary control and weight management. The current research examined the impact of experimentally manipulating participants' personal food addiction beliefs on eating behavior. METHODS In two studies, female participants (study 1: N = 64; study 2: N = 90) completed food-related computerized tasks and were given bogus feedback on their performance which indicated that they had high, low, or average food addiction tendencies. Food intake was then assessed in an ad libitum taste test. Dietary concern and time taken to complete the taste test were recorded in study 2. RESULTS In study 1, participants in the high-addiction condition consumed fewer calories than those in the low-addiction condition, F(1,60) = 7.61, P = 0.008, ηp (2) = 0.11. Study 2 replicated and extended this finding, showing that the effect of the high-addiction condition on food intake was mediated by increased dietary concern, which reduced the amount of time participants willingly spent exposed to the foods during the taste test, b = -0.06 (0.03), 95% confidence interval = -0.13 to -0.01. CONCLUSIONS Believing oneself to be a food addict is associated with short-term dietary restriction. The longer-term effects on weight management now warrant attention.
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Affiliation(s)
- Helen K Ruddock
- Department of Psychological Sciences, University of Liverpool, UK
| | - Paul Christiansen
- Department of Psychological Sciences, University of Liverpool, UK
- UK Centre for Tobacco and Alcohol Studies, UK
| | - Andrew Jones
- Department of Psychological Sciences, University of Liverpool, UK
- UK Centre for Tobacco and Alcohol Studies, UK
| | - Eric Robinson
- Department of Psychological Sciences, University of Liverpool, UK
- UK Centre for Tobacco and Alcohol Studies, UK
| | - Matt Field
- Department of Psychological Sciences, University of Liverpool, UK
- UK Centre for Tobacco and Alcohol Studies, UK
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40
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Carter A, Hendrikse J, Lee N, Yücel M, Verdejo-Garcia A, Andrews ZB, Hall W. The Neurobiology of "Food Addiction" and Its Implications for Obesity Treatment and Policy. Annu Rev Nutr 2016; 36:105-28. [PMID: 27296500 DOI: 10.1146/annurev-nutr-071715-050909] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is a growing view that certain foods, particularly those high in refined sugars and fats, are addictive and that some forms of obesity can usefully be treated as a food addiction. This perspective is supported by a growing body of neuroscience research demonstrating that the chronic consumption of energy-dense foods causes changes in the brain's reward pathway that are central to the development and maintenance of drug addiction. Obese and overweight individuals also display patterns of eating behavior that resemble the ways in which addicted individuals consume drugs. We critically review the evidence that some forms of obesity or overeating could be considered a food addiction and argue that the use of food addiction as a diagnostic category is premature. We also examine some of the potential positive and negative clinical, social, and public policy implications of describing obesity as a food addiction that require further investigation.
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Affiliation(s)
- Adrian Carter
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton Victoria 3800, Australia; .,University of Queensland Centre for Clinical Research, University of Queensland, Herston, Queensland 4029 Australia
| | - Joshua Hendrikse
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton Victoria 3800, Australia;
| | - Natalia Lee
- Neuroscience Interdepartmental Graduate Program, University of California, Los Angeles, California 90095
| | - Murat Yücel
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton Victoria 3800, Australia;
| | - Antonio Verdejo-Garcia
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton Victoria 3800, Australia;
| | - Zane B. Andrews
- School of Physiology, Monash University, Clayton, Victoria 3800, Australia
| | - Wayne Hall
- University of Queensland Centre for Clinical Research, University of Queensland, Herston, Queensland 4029 Australia.,Centre for Youth Substance Abuse Research, University of Queensland, Herston, Queensland 4006 Australia
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41
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Belief in Food Addiction and Obesity-Related Policy Support. PLoS One 2016; 11:e0147557. [PMID: 26808427 PMCID: PMC4726792 DOI: 10.1371/journal.pone.0147557] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 01/04/2016] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES This study examines whether belief in the food addiction construct is associated with support for obesity-related policies (e.g., restrictions on foods served in schools and workplace cafeterias, subsidies on fruits and vegetables), while simultaneously examining other factors associated with policy support (e.g., political party affiliation). DESIGN Cross-sectional. SETTING Online Community. PARTICIPANTS 200 individuals were recruited through Amazon Mechanical Turk. MEASUREMENTS Participants (n = 193) responded to three questions about belief in food addiction and a measure evaluating support for 13 obesity-related policy initiatives. Individuals also completed the modified Yale Food Addiction Scale (mYFAS), self-reported height and weight, and provided demographic information (age, gender, race, political party affiliation). RESULTS Belief in food addiction was significantly associated with greater support for obesity-related initiatives, even when accounting for the significant associations of age, gender, and political party. Belief in food addiction and political party both had moderate effect sizes for predicting support for obesity-related policy. There was an interaction between age and belief in food addiction, with significant associations with policy support for both younger and older individuals, though the effect was larger for younger participants. CONCLUSION The current study provides evidence that belief in food addiction is associated with increased obesity-related policy support, comparable to the influence of one's political party. Growing evidence for the role of an addictive process in obesity may have important implications for public support of obesity-related policy initiatives.
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42
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Murakami JM, Latner JD. Weight acceptance versus body dissatisfaction: Effects on stigma, perceived self-esteem, and perceived psychopathology. Eat Behav 2015; 19:163-7. [PMID: 26418164 DOI: 10.1016/j.eatbeh.2015.09.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 08/11/2015] [Accepted: 09/17/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE It is unknown whether weight acceptance or body dissatisfaction impact anti-fat stigma. Therefore, this study utilized a 2×2 between-subject experimental design to examine of the relationship between body acceptance and stigmatization. METHOD Participants were university undergraduates (N=394, 70% women, mean age=20.8 years, mean BMI=23.61 kg/m(2)) who were randomly assigned to read vignettes describing an obese or normal-weight target described as either accepting or not accepting of her weight. Participants completed measures of stigma (the Fat Phobia Scale (FPS), the modified Anti-fat Attitudes Scale (AFA)), perceived self-esteem (assessed with the modified Rosenberg Self-Esteem Scale (RSE)), and perceived psychopathology. RESULTS Analyses revealed significant main effects for acceptance. Notably, targets who accepted their weight were less stigmatized on the FPS (F(1, 354)=66.82, p<.001) and the AFA willpower subscale (F(1, 373)=37.90, p<.001), and they were perceived as having better self esteem (F(1, 371)=166.16, p<.001) and fewer psychological problems (F(1, 381)=123.19, p<.001) than those who did not accept their weight. CONCLUSION Results from this study suggest that size acceptance, even when practiced by obese targets, was significantly less stigmatized than body dissatisfaction and associated with better perceived self esteem and mental health.
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Affiliation(s)
- Jessica M Murakami
- University of Hawaii at Manoa, Department of Psychology, 2530 Dole Street, Sakamaki C400, Honolulu, HI 96822, USA.
| | - Janet D Latner
- University of Hawaii at Manoa, Department of Psychology, 2530 Dole Street, Sakamaki C400, Honolulu, HI 96822, USA.
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Allison DB, Bassaganya-Riera J, Burlingame B, Brown AW, le Coutre J, Dickson SL, van Eden W, Garssen J, Hontecillas R, Khoo CSH, Knorr D, Kussmann M, Magistretti PJ, Mehta T, Meule A, Rychlik M, Vögele C. Goals in Nutrition Science 2015-2020. Front Nutr 2015; 2:26. [PMID: 26442272 PMCID: PMC4563164 DOI: 10.3389/fnut.2015.00026] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 08/14/2015] [Indexed: 12/12/2022] Open
Affiliation(s)
- David B Allison
- Office of Energetics and Nutrition Obesity Research Center, School of Public Health, University of Alabama at Birmingham , Birmingham, AL , USA ; Section on Statistical Genetics, University of Alabama at Birmingham , Birmingham, AL , USA ; Department of Nutrition Sciences, University of Alabama at Birmingham , Birmingham, AL , USA ; Department of Biostatistics, University of Alabama at Birmingham , Birmingham, AL , USA
| | - Josep Bassaganya-Riera
- Nutritional Immunology and Molecular Medicine Laboratory, Virginia Bioinformatics Institute, Virginia Tech , Blacksburg, VA , USA
| | - Barbara Burlingame
- Deakin University , Melbourne, VIC , Australia ; American University of Rome , Rome , Italy
| | - Andrew W Brown
- Office of Energetics and Nutrition Obesity Research Center, School of Public Health, University of Alabama at Birmingham , Birmingham, AL , USA
| | - Johannes le Coutre
- Nestlé Research Center , Lausanne , Switzerland ; Organization for Interdisciplinary Research Projects, The University of Tokyo , Tokyo , Japan ; École Polytechnique Fédérale de Lausanne , Lausanne , Switzerland
| | - Suzanne L Dickson
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg , Gothenburg , Sweden
| | - Willem van Eden
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University , Utrecht , Netherlands
| | - Johan Garssen
- Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University , Utrecht , Netherlands
| | - Raquel Hontecillas
- Nutritional Immunology and Molecular Medicine Laboratory, Virginia Bioinformatics Institute, Virginia Tech , Blacksburg, VA , USA
| | - Chor San H Khoo
- North American Branch of International Life Sciences Institute , Washington, DC , USA
| | | | - Martin Kussmann
- École Polytechnique Fédérale de Lausanne , Lausanne , Switzerland ; Nestlé Institute of Health Sciences SA , Lausanne , Switzerland
| | - Pierre J Magistretti
- Division of Biological and Environmental Sciences and Engineering, King Abdullah University of Science and Technology , Thuwal , Saudi Arabia ; Laboratory of Neuroenergetics and Cellular Dynamics, Brain Mind Institute, École Polytechnique Fédérale de Lausanne , Lausanne , Switzerland
| | - Tapan Mehta
- Department of Health Services Administration, Nutrition Obesity Research Center, University of Alabama at Birmingham , Birmingham, AL , USA
| | - Adrian Meule
- Department of Psychology, University of Salzburg , Salzburg , Austria
| | - Michael Rychlik
- Analytical Food Chemistry, Technische Universität München , Freising , Germany
| | - Claus Vögele
- Research Unit INSIDE, Institute for Health and Behaviour, University of Luxembourg , Luxembourg , Luxembourg
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Hardman CA, Rogers PJ, Dallas R, Scott J, Ruddock HK, Robinson E. “Food addiction is real”. The effects of exposure to this message on self-diagnosed food addiction and eating behaviour. Appetite 2015; 91:179-84. [DOI: 10.1016/j.appet.2015.04.052] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 03/18/2015] [Accepted: 04/14/2015] [Indexed: 10/23/2022]
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Ziauddeen H, Alonso-Alonso M, Hill JO, Kelley M, Khan NA. Obesity and the neurocognitive basis of food reward and the control of intake. Adv Nutr 2015; 6:474-86. [PMID: 26178031 PMCID: PMC4496739 DOI: 10.3945/an.115.008268] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
With the rising prevalence of obesity, hedonic eating has become an important theme in obesity research. Hedonic eating is thought to be that driven by the reward of food consumption and not metabolic need, and this has focused attention on the brain reward system and how its dysregulation may cause overeating and obesity. Here, we begin by examining the brain reward system and the evidence for its dysregulation in human obesity. We then consider the issue of how individuals are able to control their hedonic eating in the present obesogenic environment and compare 2 contrasting perspectives on the control of hedonic eating, specifically, enhanced control of intake via higher cognitive control and loss of control over intake as captured by the food addiction model. We conclude by considering what these perspectives offer in terms of directions for future research and for potential interventions to improve control over food intake at the population and the individual levels.
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Affiliation(s)
- Hisham Ziauddeen
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Wellcome Trust-MRC, Institute of Metabolic Science, Cambridge, United Kingdom; Cambridgeshire and Peterborough Foundation Trust, Cambridge, United Kingdom;
| | - Miguel Alonso-Alonso
- Laboratory of Bariatric and Nutritional Neuroscience, Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - James O Hill
- Anschutz Health and Wellness Center, University of Colorado, Anschutz Medical Campus, Aurora, CO
| | - Michael Kelley
- Scientific and Regulatory Affairs, Wm. Wrigley Jr. Company, Chicago, IL; and
| | - Naiman A Khan
- Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, IL
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Hurt RT, Edakkanambeth Varayil J, Mundi MS, Martindale RG, Ebbert JO. Designation of obesity as a disease: lessons learned from alcohol and tobacco. Curr Gastroenterol Rep 2015; 16:415. [PMID: 25277042 DOI: 10.1007/s11894-014-0415-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Obesity is a leading cause of preventable death in the USA. The American Medical Association recently recognized obesity as meeting the definition of a chronic disease. This declaration had the intention of improving screening and long-term treatment and is historically similar to the designation of tobacco and alcohol dependence as a chronic disease. Nevertheless, it has ignited a nationwide debate in both academia and public opinion. The current article reviews the implications of treating obesity as a chronic disease, comparing the similarities in pathophysiology of obesity and other addictions, and discusses the pros and cons of this designation as it pertains to health care workers and patients.
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Affiliation(s)
- Ryan T Hurt
- Division of General Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA,
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Ifland J, Preuss HG, Marcus MT, Rourke KM, Taylor W, Theresa Wright H. Clearing the Confusion around Processed Food Addiction. J Am Coll Nutr 2015; 34:240-3. [DOI: 10.1080/07315724.2015.1022466] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Rasmussen N. Stigma and the addiction paradigm for obesity: lessons from 1950s America. Addiction 2015; 110:217-25. [PMID: 25331486 DOI: 10.1111/add.12774] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 07/07/2014] [Accepted: 10/13/2014] [Indexed: 11/30/2022]
Abstract
AIMS To discuss an historical episode in which obesity was conceptualized as an addictive disorder and declared to be a major epidemic in the early postwar United States. This history illuminates past consequences of framing obesity as an addiction in ways that may inform constructive policy responses today. METHODS Review of secondary and primary sources, including archival documents, relating to obesity in biomedical and popular thought of the 1940s and 1950s. RESULTS In the United States in the late 1940s and 1950s, new medical thinking about obesity reinterpreted overweight and obesity as chiefly the consequence of addiction (understood in the then dominant psychodynamic theory as a psychological defect, oral fixation). This new conception was rapidly taken up in popular discourse and clinical practice, with adverse effects through amplification of weight stigma. Further, in the conservative political context, the addiction concept contributed to an ineffective policy response to the alarming new epidemiological evidence about obesity's consequences. Despite a lack of evidence for efficacy of the intervention, public health efforts focused on correcting individual eating behaviour among obese people by encouraging self-help in lay groups modelled, in part, on Alcoholics Anonymous. Population-level intervention was neglected. CONCLUSIONS Current public health policy initiatives must be mindful of the risks of reframing obesity as an addiction. These include inadvertently reinforcing stigma, narrowing responses to those aiming to modify individual behaviour and biology and neglecting population policies aiming to reduce the consumption of energy-dense foods, as all occurred in the 1950s United States.
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Affiliation(s)
- Nicolas Rasmussen
- School of Humanities and Languages, University of New South Wales, Sydney, NSW, Australia
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Pursey KM, Stanwell P, Gearhardt AN, Collins CE, Burrows TL. The prevalence of food addiction as assessed by the Yale Food Addiction Scale: a systematic review. Nutrients 2014; 6:4552-90. [PMID: 25338274 PMCID: PMC4210934 DOI: 10.3390/nu6104552] [Citation(s) in RCA: 307] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 08/11/2014] [Accepted: 10/09/2014] [Indexed: 01/06/2023] Open
Abstract
Obesity is a global issue and it has been suggested that an addiction to certain foods could be a factor contributing to overeating and subsequent obesity. Only one tool, the Yale Food Addiction Scale (YFAS) has been developed to specifically assess food addiction. This review aimed to determine the prevalence of food addiction diagnosis and symptom scores, as assessed by the YFAS. Published studies to July 2014 were included if they reported the YFAS diagnosis or symptom score and were published in the English language. Twenty-five studies were identified including a total of 196,211 predominantly female, overweight/obese participants (60%). Using meta-analysis, the weighted mean prevalence of YFAS food addiction diagnosis was 19.9%. Food addiction (FA) diagnosis was found to be higher in adults aged >35 years, females, and overweight/obese participants. Additionally, YFAS diagnosis and symptom score was higher in clinical samples compared to non-clinical counterparts. YFAS outcomes were related to a range of other eating behavior measures and anthropometrics. Further research is required to explore YFAS outcomes across a broader spectrum of ages, other types of eating disorders and in conjunction with weight loss interventions to confirm the efficacy of the tool to assess for the presence of FA.
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Affiliation(s)
- Kirrilly M Pursey
- School of Health Sciences, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Peter Stanwell
- School of Health Sciences, Priority Research Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Clare E Collins
- School of Health Sciences, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Tracy L Burrows
- School of Health Sciences, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.
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Davis C, Loxton NJ. A psycho-genetic study of hedonic responsiveness in relation to "food addiction". Nutrients 2014; 6:4338-53. [PMID: 25325253 PMCID: PMC4210920 DOI: 10.3390/nu6104338] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 09/29/2014] [Accepted: 10/01/2014] [Indexed: 12/28/2022] Open
Abstract
While food addiction has no formally-recognized definition, it is typically operationalized according to the diagnostic principles established by the Yale Food Addiction Scale-an inventory based on the symptom criteria for substance dependence in the DSM-IV. Currently, there is little biologically-based research investigating the risk factors for food addiction. What does exist has focused almost exclusively on dopaminergic reward pathways in the brain. While brain opioid signaling has also been strongly implicated in the control of food intake, there is no research examining this neural circuitry in the association with food addiction. The purpose of the study was therefore to test a model predicting that a stronger activation potential of opioid circuitry-as indicated by the functional A118G marker of the mu-opioid receptor gene-would serve as an indirect risk factor for food addiction via a heightened hedonic responsiveness to palatable food. Results confirmed these relationships. In addition, our findings that the food-addiction group had significantly higher levels of hedonic responsiveness to food suggests that this bio-behavioral trait may foster a proneness to overeating, to episodes of binge eating, and ultimately to a compulsive and addictive pattern of food intake.
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Affiliation(s)
- Caroline Davis
- School of Kinesiology & Health Sciences, 343 Bethune College, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada.
| | - Natalie J Loxton
- School of Applied Psychology, Griffith University, 176 Messines Ridge Road Mt Gravatt, Queensland 4122, Australia.
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