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Schiestl ET, Gearhardt AN, Wolfson J. The qualitative evaluation of food addiction across the lifespan. Appetite 2024; 194:107170. [PMID: 38147964 DOI: 10.1016/j.appet.2023.107170] [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: 08/02/2023] [Revised: 11/14/2023] [Accepted: 12/13/2023] [Indexed: 12/28/2023]
Abstract
Although it remains controversial, food addiction (FA) research has expanded substantially and empirical evidence for FA is growing. While quantitative studies have explored the prevalence and correlates of FA during childhood and adolescence, little is known about the perceived lived experience of FA across the lifespan, nor how experiences and perceptions of FA may change over time. For this study, 16 participants who met symptom threshold criteria for FA on the Yale Food Addiction Scale 2.0 completed in-depth, semi-structured qualitative interviews focused on their perceptions of the development of FA overtime, and perceived risk and protective factors. Thematic analysis was used to develop themes about the lived experience of FA in childhood, adolescence, and adulthood. Overall, highly palatable foods were viewed as the most problematic, while minimally processed foods were less associated with impairment and distress. Themes in childhood included a strong desire for highly processed foods and the perception that parental control over food choices could be either protective or risky for the later development of FA depending on which foods were available at home. In adolescence and young adulthood, increasing autonomy over food choices and the high availability of highly processed foods in the college environment were viewed as risk factors. Additionally, weight gain was a prominent theme. Finally, adulthood was characterized by more severe manifestations of FA, and the stress of adult responsibilities (e.g., work, parenting) contributed to this perception. This research sets the stage for future quantitative studies to explore these novel findings at the population level.
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Barnhart WR, Cui T, Cui S, Ren Y, Ji F, He J. Exploring the prospective relationships between food addiction symptoms, weight bias internalization, and psychological distress in Chinese adolescents. Int J Eat Disord 2023; 56:2304-2314. [PMID: 37772767 DOI: 10.1002/eat.24066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 09/13/2023] [Accepted: 09/13/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVE Relationships exist between food addiction symptoms, weight bias internalization, and psychological distress, yet previous research is primarily cross-sectional with adults from Western contexts. We examined the prospective relationships between food addiction symptoms, weight bias internalization, and psychological distress in Chinese adolescents. METHODS Over three time points (Time 1, baseline; Time 2, 6-months; Time 3, 12-months) spanning 1 year, we examined cross-sectional and bi-directional relationships between food addiction symptoms, weight bias internalization, and psychological distress in Chinese adolescents (N = 589; aged 14-18 years at baseline). Pearson correlations and cross-lagged models examined the cross-sectional and longitudinal relationships between food addiction symptoms, weight bias internalization, and psychological distress. RESULTS Cross-sectional correlations suggested positive relationships between food addiction symptoms, weight bias internalization, and psychological distress at each time point. Regarding bi-directional relationships, higher psychological distress was associated with both higher weight bias internalization and higher food addiction symptoms at the following time points. However, food addiction symptoms and weight bias internalization were not prospectively associated. Time 2 psychological distress did not significantly mediate the relationship between Time 1 weight bias internalization and Time 3 food addiction symptoms. DISCUSSION Findings suggest no direct longitudinal link between food addiction symptoms and weight bias internalization and vice versa. However, findings do suggest that psychological distress is temporally associated with higher food addiction symptoms and weight bias internalization in Chinese adolescents. Targeting psychological distress may prove useful in treatments of food addiction symptoms and weight bias internalization in Chinese adolescents. PUBLIC SIGNIFICANCE Positive associations exist between food addiction symptoms, weight bias internalization, and psychological distress, but findings are largely cross-sectional and bound to adult populations from Western contexts. Using a longitudinal design in Chinese adolescents, findings suggested that baseline psychological distress was associated with higher food addiction symptoms and higher weight bias internalization at follow-up time points. Treatments targeting psychological distress may be helpful in reducing food addiction symptoms and weight bias internalization in Chinese adolescents.
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Affiliation(s)
- Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA
| | - Tianxiang Cui
- Department of Psychology, University of Macau, Taipa, Macau, China
| | - Shuqi Cui
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, China
| | - Yaoxiang Ren
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, China
| | - Feng Ji
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Ontario, Canada
| | - Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, China
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Collins RA, Duncanson K, Skinner JA, Hay PJ, Paxton SJ, Burrows TL. Exploring Psychological Constructs in People Receiving Treatment for Addictive Eating Behaviours: "I Hate Loving Food as Much as I Do". Behav Sci (Basel) 2023; 13:817. [PMID: 37887467 PMCID: PMC10604454 DOI: 10.3390/bs13100817] [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: 08/07/2023] [Revised: 09/18/2023] [Accepted: 09/28/2023] [Indexed: 10/28/2023] Open
Abstract
Research into the complexities of addictive eating behaviours continues to develop, as a deeper understanding of this construct beyond self-report diagnostic tools emerges. In this study, we undertook structured interviews with 40 participants engaged in a personality-based management program for addictive eating, to gain insight into what situations lead people with addictive eating behaviours to overeat, and how they believe their lives would be different if they had control over their eating. A phenomenological analysis to explore compulsion and control in the context of food experiences for participants was used to construct two main themes of the addictive eating paradox and striving to transition from 'other' to 'normal'. The addictive eating paradox identified multiple contradictory experiences of a situation, e.g., 'loving food' but 'hating food'. Striving to transition from 'other' to 'normal' encompassed the idea that participants envisaged that by gaining control over their eating they could become 'normal'. This study emphasises the need to provide support and strategies to help people navigate paradoxical thoughts and presents new ideas to increase the effectiveness of interventions for individuals struggling with the complex self-beliefs held by those with addictive eating behaviours.
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Affiliation(s)
- Rebecca A. Collins
- School of Health Sciences, The University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.S.); (T.L.B.)
- Food & Nutrition Program, New Lambton, NSW 2305, Australia;
| | - Kerith Duncanson
- Food & Nutrition Program, New Lambton, NSW 2305, Australia;
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Janelle A. Skinner
- School of Health Sciences, The University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.S.); (T.L.B.)
- Food & Nutrition Program, New Lambton, NSW 2305, Australia;
| | - Phillipa J. Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2560, Australia;
- Campbelltown Hospital, South West Sydney Local Health District, Sydney, NSW 2560, Australia
| | - Susan J. Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia;
| | - Tracy L. Burrows
- School of Health Sciences, The University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.S.); (T.L.B.)
- Food & Nutrition Program, New Lambton, NSW 2305, Australia;
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Huang PC, Latner JD, O'Brien KS, Chang YL, Hung CH, Chen JS, Lee KH, Lin CY. Associations between social media addiction, psychological distress, and food addiction among Taiwanese university students. J Eat Disord 2023; 11:43. [PMID: 36945011 PMCID: PMC10031987 DOI: 10.1186/s40337-023-00769-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 03/12/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Worldwide, 60% of people use social media. Excessive and/or addictive use of social media termed "problematic social media use", has been reported to negatively influence psychological and physiological health. Therefore, we proposed an illustrated model to investigate the associations between social media addiction, psychological distress and food addiction among Taiwanese university students. METHODS A total of 598 participants (mean age = 22.8 years) completed an online survey comprising the Bergen Social Media Addiction Scale (BSMAS) assessing social media addiction, the Depression Anxiety and Stress Scale (DASS-21) assessing psychological distress, and the Yale Food Addiction Scale 2.0 (YFAS 2.0) assessing food addiction. RESULTS Structural equation modeling showed the significant associations between BSMAS and DASS-21 (standardized coefficient [β] = 0.45; p < 0.01) and between DASS-21 and YFAS 2.0 (β = 0.43; p < 0.01). In addition, mediation effect with 100 bootstrapping samples showed the indirect effect of DASS-21 in the association between BSMAS and YFAS 2.0 CONCLUSIONS: The present study details the relationships between social media addiction and psychological distress as well as food addiction. The results suggest the need for interventions aimed at reducing these negative outcomes. Coping strategies for improving self-control or reducing weight-related stigma, such as food consumption monitoring or mindfulness, could be adopted for at-risk individuals to address these problems.
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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
| | - Janet D Latner
- Department of Psychology, University of Hawaii at Manoa, 2500 Campus Road, Honolulu, HI, 96822, USA
| | - Kerry S O'Brien
- School of Social Sciences, Monash University, 20 Chancellors Walk, Clayton, VIC, 3800, Australia
| | - Yen-Ling Chang
- Department of Family Medicine, Cardinal Tien Hospital, No. 362, Zhongzheng Rd., Xindian Dist., New Taipei, 231009, Taiwan
| | - 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, University Rd., East Dist., 701401, Tainan, Taiwan
| | - Jung-Sheng Chen
- Department of Medical Research, E-Da Hospital, I-Shou University, No.1, Yida Rd, Yanchao District, 824005, Kaohsiung, Taiwan
| | - Kuo-Hsin Lee
- Department of Emergency Medicine, E-Da Hospital, I-Shou University, No.1, Yida Rd., Yanchao Dist., 840301, Kaohsiung, Taiwan.
- School of Medicine, I-Shou University, No.8, Yida Rd., Yanchao Dist., 824005, Kaohsiung, 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.
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Dist., Tainan, 701401, Taiwan.
- Department of Public Health, National Cheng Kung University Hospital, 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.
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O'Hara L, Alajaimi B, Alshowaikh B. "I was bullied for being fat in every situation, in every outfit, at every celebration": A qualitative exploratory study on experiences of weight-based oppression in Qatar. Front Public Health 2023; 11:1015181. [PMID: 36923042 PMCID: PMC10008867 DOI: 10.3389/fpubh.2023.1015181] [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: 08/09/2022] [Accepted: 02/08/2023] [Indexed: 02/28/2023] Open
Abstract
Introduction Weight-based oppression (WBO) has been documented as a widespread phenomenon in Western countries and is associated with a range of psychological, physiological, and behavioral harms. Research on weight-based oppression is largely absent from the Arab region. Methods We conducted a qualitative exploratory study using semi-structured in-depth interviews to examine the internalized attitudes, values, and beliefs related to body weight, and experiences of external weight-based oppression of 29 staff, faculty, and students at Qatar University. Results Thematic analysis revealed six major themes on the characteristics of internalized WBO, and the nature, timing, source, extent, and impact of external WBO. WBO was regarded as so common in the Arab culture as to be normative, with damaging exposure to WBO beginning in early childhood. Conclusion WBO in the Arab region is an important and unrecognized public health issue. Programs to reduce WBO should be developed in all sectors.
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Affiliation(s)
- Lily O'Hara
- Department of Public Health, QU Health, Qatar University, Doha, Qatar
| | - Bayan Alajaimi
- Department of Public Health, QU Health, Qatar University, Doha, Qatar
| | - Bayan Alshowaikh
- Department of Public Health, QU Health, Qatar University, Doha, Qatar
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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] [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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7
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Meadows A, Higgs S. Challenging oppression: A social identity model of stigma resistance in higher-weight individuals. Body Image 2022; 42:237-245. [PMID: 35816967 DOI: 10.1016/j.bodyim.2022.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 06/07/2022] [Accepted: 06/07/2022] [Indexed: 11/15/2022]
Abstract
Many higher-weight individuals have internalised societal weight stigma, devaluing themselves because of their weight. Rejecting and challenging societal devaluation is generally associated with superior outcomes compared with stigma internalisation or inaction; however, stigma resistance has not been studied in higher-weight individuals, despite ubiquitous weight stigma in daily life. Applying a social identity framework, we utilised decision tree analysis to explore predictors of responses to weight stigma in 931 self-classified higher-weight individuals. While ingroup identification with the group 'Fat' was the major predictor of stigma resistance (versus internalisation), perceived illegitimacy of societal weight stigma defined a subgroup of resisters even in the absence of group identity. Interventions focusing on the illegitimacy of unequal social status and treatment may be effective at reducing internalisation and fostering resistance in a population with characteristically low ingroup identity.
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Affiliation(s)
- Angela Meadows
- Department of Psychology, University of Essex, Colchester CO4 3SQ, UK.
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Birmingham B15 2TT, UK
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Kaya Cebioğlu İ, Dumlu Bilgin G, Kavsara HK, Gül A, Sarioğlu A, Aydin S, Keküllüoğlu M. Food addiction among university students: The effect of mindful eating. Appetite 2022; 177:106133. [PMID: 35753440 DOI: 10.1016/j.appet.2022.106133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 05/13/2022] [Accepted: 06/08/2022] [Indexed: 11/30/2022]
Abstract
Recent evidence indicated that lifestyle modifications, especially mindful eating, might be effective interventions for treating food addiction (FA). Mindful eating practices have been considered to regulate emotional eating, which is one predictor of FA along with automatic eating behaviors, including emotional, impulsive, and habitual eating. Thus, this cross-sectional study aimed to determine the effect of mindful eating on FA of university students. The research team collected the data with 2133 undergraduate students. The Mindful Eating Questionnaire examined the mindfulness status of the students, and the FA diagnosed by using the YALE Food Addiction Scale. 56.9% of participants were women, with a mean age of 21.5 ± 2.2 and a mean body mass index (BMI) of 22.5 ± 3.8 kg/m2. Although no significant differences were observed regarding sex (p > .05), the FA prevalence among men (16.1%) was higher than women. The overall prevalence of FA was 15.3%, which was 1.5 units higher among those with BMI ≥25 kg/m2. Also, FA diagnosis was significantly more prevalent among smokers and ex-smokers (p < .01). In addition, participants diagnosed with FA had a significantly lower mean mindful eating score (p < .001). Furthermore, those with lower mindfulness levels had a 4.96 higher risk of being food addicted (p < .000). Those with FA diagnosis had significantly lower scores regarding subscales of "disinhibition," "emotional eating," "control of eating," "mindfulness," and "interference" (p < .001). Consequently, it should be highlighted that determining the level of individuals' mindful eating may have remarkable and cumulative impacts on both obesity and FA in the long term. Thus, increasing mindful eating may be suggested as an essential strategy to control FA among young individuals.
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Affiliation(s)
- İrem Kaya Cebioğlu
- Yeditepe University, Faculty of Health Sciences, Department of Nutrition and Dietetics, İnönü Mah, Kayışdağı Cad, 34755, İstanbul, Turkey.
| | - Gözde Dumlu Bilgin
- Yeditepe University, Faculty of Health Sciences, Department of Nutrition and Dietetics, İnönü Mah, Kayışdağı Cad, 34755, İstanbul, Turkey.
| | - Hasan Kaan Kavsara
- Yeditepe University, Faculty of Health Sciences, Department of Nutrition and Dietetics, İnönü Mah, Kayışdağı Cad, 34755, İstanbul, Turkey.
| | - Açelya Gül
- Yeditepe University, Faculty of Health Sciences, Department of Nutrition and Dietetics, İnönü Mah, Kayışdağı Cad, 34755, İstanbul, Turkey.
| | - Aybüke Sarioğlu
- Yeditepe University, Faculty of Health Sciences, Department of Nutrition and Dietetics, İnönü Mah, Kayışdağı Cad, 34755, İstanbul, Turkey.
| | - Sema Aydin
- Yeditepe University, Faculty of Health Sciences, Department of Nutrition and Dietetics, İnönü Mah, Kayışdağı Cad, 34755, İstanbul, Turkey.
| | - Melis Keküllüoğlu
- Yeditepe University, Institute of Health Sciences, Physiology, İnönü Mah, Kayışdağı Cad, 34755, İstanbul, Turkey.
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9
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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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Hussenoeder FS, Pabst A, Conrad I, Löbner M, Engel C, Zeynalova S, Reyes N, Glaesmer H, Hinz A, Witte V, Schroeter ML, Wirkner K, Kirsten T, Löffler M, Villringer A, Riedel-Heller SG. Anxiety and Food Addiction in Men and Women: Results From the Longitudinal LIFE-Adult-Study. Front Psychiatry 2022; 13:914358. [PMID: 35774094 PMCID: PMC9239341 DOI: 10.3389/fpsyt.2022.914358] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/25/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Anxiety is a widespread phenomenon, and it is connected to disordered eating and obesity. We want to analyze the connection between anxiety and food addiction (FA) over two points in time to better understand the directionality of the association. Since there are gender differences with regard to anxiety and eating, we are also interested in differences between men and women. METHODS We used data from the population-based LIFE-Adult-Study (N = 1,474) at time 1 (baseline) and time 2 (first follow-up) to analyze the connections between anxiety (GAD-7) and FA (YFAS) using a multiple group latent cross-lagged panel model with female and male participants as groups. We controlled for age, marital status, socioeconomic status and social support. RESULTS Anxiety (women: β = 0.50, p ≤ 0.001; men: β = 0.59, p ≤ 0.001) as well as FA (women: β = 0.37, p ≤ 0.001; men: β = 0.58, p ≤ 0.001) exhibited stability over time for both genders. We found a significant association between anxiety at time 1 and FA at time 2 for women (β = 0.25, p ≤ 0.001) but not for men (β = 0.04, p = 0.10), and significant associations between FA at time 1 and anxiety at time 2 for women (β = 0.23, p ≤ 0.001) as well as men (β = 0.21, p ≤ 0.001). CONCLUSION Food addiction longitudinally affects anxiety, independent of gender and other sociodemographic variables. In addition, anxiety affects subsequent FA as well, but only in women. Interventions that address FA could reduce anxiety in men and women, while interventions that mitigate anxiety could help prevent FA in women.
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Affiliation(s)
- Felix S Hussenoeder
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Ines Conrad
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany.,Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Samira Zeynalova
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - Nigar Reyes
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Veronica Witte
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Kerstin Wirkner
- Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Toralf Kirsten
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany.,Department for Medical Data Science, University Hospital Leipzig, Leipzig, Germany
| | - Markus Löffler
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - Arno Villringer
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
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O'Hara L, Ahmed H, Elashie S. Evaluating the impact of a brief Health at Every Size®-informed health promotion activity on body positivity and internalized weight-based oppression. Body Image 2021; 37:225-237. [PMID: 33744684 DOI: 10.1016/j.bodyim.2021.02.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 02/06/2021] [Accepted: 02/15/2021] [Indexed: 01/28/2023]
Abstract
Weight-based oppression, including negative attitudes about body weight, and harassment, stigma, and discrimination based on body weight, is a widespread phenomenon that leads to considerable distress and poor health and wellbeing outcomes. Conversely, body positivity is a multi-faceted concept that encompasses body acceptance, body appreciation, and body love, and adaptive approaches protective of health and wellbeing. The aim of this study was to evaluate the impact of a brief health promotion activity informed by Health at Every Size® and critical health promotion principles on body positivity and internalized weight-based oppression in female students at Qatar University. A quasi-experimental mixed methods pre-post evaluation design was used, with quantitative assessment of body positivity and internalized weight-based oppression before the activity, immediately afterwards, and 10 weeks later, and qualitative assessment at the 10-week follow up. Measures used were the Body Appreciation Scale 2, Modified Weight Bias Internalization Scale, Fat Attitudes Assessment Toolkit Size Acceptance and Self Reflection on Body Acceptance subscales, and an open-ended questionnaire. Body acceptance and appreciation increased significantly after the activity. Qualitative results suggest that these improvements were sustained at follow up. Brief Health at Every Size® informed health promotion activities show potential to improve health and wellbeing.
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Affiliation(s)
- Lily O'Hara
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, PO Box 2713, Doha, Qatar.
| | - Hanaa Ahmed
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Qatar
| | - Sana Elashie
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Qatar
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Lacroix E, von Ranson KM. Body image disturbance partially explains eating-related psychosocial impairment in food addiction. Eat Behav 2021; 41:101512. [PMID: 33932882 DOI: 10.1016/j.eatbeh.2021.101512] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 03/08/2021] [Accepted: 04/20/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND This study aimed to explore the association of food addiction (FA) with eating-related psychosocial impairment and examine the extent to which this association was explained directly by FA symptoms themselves, versus through body image disturbance. MATERIALS AND METHODS Participants (356 university students and 544 crowdsourced adults) completed self-report measures of FA (Yale Food Addiction Scale; YFAS 2.0), psychosocial impairment (Clinical Impairment Assessment; CIA 3.0), and body image disturbance (Eating Disorders Examination Questionnaire; EDE-Q 6.0), and reported their body mass index (BMI) and gender. RESULTS Endorsement of distress and/or impairment on the YFAS corresponded to ratings on the CIA. Structural equation models indicated the relationship between FA and eating-related psychosocial impairment was partially mediated by body image disturbance. The indirect effect of body image disturbance explained more variance in eating-related psychosocial impairment than did YFAS scores themselves. Neither BMI nor gender significantly moderated any direct or indirect pathways from food addiction to psychosocial impairment. CONCLUSIONS Food addiction is associated with clinical impairment in men and women across the weight spectrum. A large portion of psychosocial impairment associated with food addiction may be explained by body image disturbance. Due to its role in explaining psychosocial impairment, body image disturbance warrants increased attention in FA research.
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Affiliation(s)
- Emilie Lacroix
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada
| | - Kristin M von Ranson
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada.
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Siqueira BB, Assumpção MC, Barroso SM, Japur CC, Penaforte FRDO. Weight stigma and health – Repercussions on the health of adolescents and adults: integrative review of the literature. JORNAL BRASILEIRO DE PSIQUIATRIA 2021. [DOI: 10.1590/0047-2085000000324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To conduct an integrative review in order to understand the repercussions of the social stigma of overweight on the health of adults and adolescents. Methods The international protocol for systematic review and meta-analysis studies PRISMA was adopted to guide the writing of this review. The databases used were PubMed, Psycinfo, SciELO, Medline, Lilacs and Pepsic, considering studies published in the period from 2000 to 2020. Sixty-seven (67) articles were analyzed, and 4 categories emerged: repercussions on physical well-being; repercussions on social well-being; repercussions on mental well-being; and mixed category (physical and psychological impact). Results In the vast majority of studies analyzed, weight stigma had a negative impact on the different spheres that make up the health construct, that is, the physical, social and mental spheres. Conclusions The consequences of weight stigma are a source of intense suffering, with an impact that reduces the quality of life of individuals who experience stigmatization, involving physical, emotional and social aspects.
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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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