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Nicolau J, Tamayo MI, Sanchís P, Pujol A, Pérez-Bec G, Sfondrini G, Masmiquel L. Short-term effects of semaglutide among patients with obesity with and without food addiction: an observational study. J Addict Dis 2024:1-9. [PMID: 38369467 DOI: 10.1080/10550887.2024.2315365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Food addiction (FA) is highly prevalent among people with obesity (PwO) and may constitute a key factor in weight loss failure or weight regain. GLP-1 analogues have been shown to act on the mesolimbic system, which is related to hedonic overeating and substance abuse. We aimed to study the effects of low doses of semaglutide on FA symptomatology and to evaluate whether the presence of FA have a negative impact on weight loss despite treatment with semaglutide. METHODS One hundred and thirteen PwO (45.5 ± 10.2 years) were evaluated anthropometrically baseline and after four months of treatment with semaglutide. PwO were evaluated for the presence of FA by completing The Spanish version of the Yale Food Addiction Scale 2.0 questionnaire (YFAS 2.0). RESULTS Baseline BMI and fat mass (%) were greater among PwO with FA (35.8 ± 4.5 vs 33 ± 3.9 kg/m2and 44.2 ± 6.5 vs 40.1 ± 7.9%; p = .01). After four months of treatment with semaglutide, the prevalence of FA diminished from 57.5% to 4.2% (p < .001). The percentage of weight loss (6.9 ± 12.7 vs 5.3 ± 4.6%; p = .4) and the proportion of fat mass loss (2 ± 9 vs 1.6 ± 3.1%; p = .7) were comparable between PwO with and without FA. No differences regarding side effects and treatment discontinuations were seen between the two groups. CONCLUSION Semaglutide is an effective tool for the amelioration of FA symptomatology among PwO. Despite PwO with FA had greater basal BMI and fat mass, semaglutide showed similar results compared to PwO without FA in terms of weight and fat mass loss at short term.
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Affiliation(s)
- Joana Nicolau
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer and Clinica Quiron Rotger. Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Baleares, Spain
- Clínica Rotger (Grupo Quirón), Palma de Mallorca, Baleares, Spain
| | - María Isabel Tamayo
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer and Clinica Quiron Rotger. Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Baleares, Spain
| | - Pilar Sanchís
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer and Clinica Quiron Rotger. Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Baleares, Spain
| | - Antelm Pujol
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer and Clinica Quiron Rotger. Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Baleares, Spain
| | - Guadalupe Pérez-Bec
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer and Clinica Quiron Rotger. Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Baleares, Spain
| | - Guido Sfondrini
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer and Clinica Quiron Rotger. Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Baleares, Spain
| | - Lluís Masmiquel
- Endocrinology and Nutrition Department, Hospital Universitario Son Llàtzer and Clinica Quiron Rotger. Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Baleares, Spain
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Horton AL, Campbell EJ, Aumann TD, O'Brien KR, Lawrence AJ, Brown RM. Addiction-like behaviour towards high-fat high-sugar food predicts relapse propensity in both obesity prone and obesity resistant C57BL/6 J mice. Prog Neuropsychopharmacol Biol Psychiatry 2023; 121:110654. [PMID: 36209772 DOI: 10.1016/j.pnpbp.2022.110654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 07/11/2022] [Accepted: 10/02/2022] [Indexed: 11/07/2022]
Abstract
Compulsive overeating of palatable food is thought to underlie some forms of obesity. Similarities are often observed in the behavioural symptomology and the neuropathophysiology underlying substance use disorder and compulsive overeating. As such, preclinical animal models which assess addiction-like behaviour towards food may assist the understanding of the neurobiology underlying overeating behaviour. Further, the relationship between these behaviours and the propensity for diet-induced obesity warrants examination. In this study we investigated the relationship between the propensity for diet-induced obesity (DIO) and addiction-like behaviour towards highly palatable food in C57BL/6 J mice as measured by a 3-criteria model. We also examined the extent to which performance on this 3-criteria model predicted two key hallmark features of addiction - resistance to extinction and relapse propensity (as measured by reinstatement of lever pressing). C57BL/6 J mice were allowed free access to a palatable diet for 8 weeks then separated by weight gain into DIO-prone and DIO-resistant subgroups. Access to palatable food was then restricted to daily operant self-administration sessions whereby addiction-like behaviour towards a high-fat high-sugar food reward was assessed using a 3-criteria model similar to that used to assess addiction-like behaviour towards drugs of abuse. In contrast to findings in rats, no difference in addiction-like behaviour towards food was observed between obesity prone (OP) and obesity resistant (OR) mice. Similarly, principal components analysis found no distinct patterns in the relationship between addiction-like behaviours across treatment groups. This suggests that the strain and species of rodent may be critical for studying the mechanisms underlying pathological overconsumption. Further analysis revealed that the extent of performance on the 3-criteria model correlated with the propensity for C57BL/6 J mice to both extinguish food seeking behaviour and "relapse" after a period of withdrawal. This finding was evident across all groups, regardless of DIO. Collectively, these data validate the 3-criteria model as a robust model to comprehensively assess food addiction-like behaviour in mice, regardless of prior food intake history.
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Affiliation(s)
- Anna L Horton
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, VIC, Australia; Department of Biochemistry and Pharmacology, University of Melbourne, VIC, Australia; Florey Department of Neuroscience & Mental Health, University of Melbourne, VIC, Australia
| | - Erin J Campbell
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, VIC, Australia; Florey Department of Neuroscience & Mental Health, University of Melbourne, VIC, Australia; School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Timothy D Aumann
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, VIC, Australia
| | - Katrina R O'Brien
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, VIC, Australia
| | - Andrew J Lawrence
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, VIC, Australia; Florey Department of Neuroscience & Mental Health, University of Melbourne, VIC, Australia
| | - Robyn M Brown
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, VIC, Australia; Department of Biochemistry and Pharmacology, University of Melbourne, VIC, Australia; Florey Department of Neuroscience & Mental Health, University of Melbourne, VIC, Australia.
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Mason TB, Dolgon-Krutolow A, Smith KE, Leventhal AM. Body Dissatisfaction and Binge Eating: The Moderating Roles of Sweet Taste Reward Sensitivity and Dietary Restraint among Tobacco Product Users. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15523. [PMID: 36497598 PMCID: PMC9740665 DOI: 10.3390/ijerph192315523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/12/2022] [Accepted: 11/20/2022] [Indexed: 06/17/2023]
Abstract
Body dissatisfaction is a key predictor of binge eating, yet less is known about factors that may potentiate the association between body dissatisfaction and binge eating. This study examined self-reported dietary restraint and sweet taste reward sensitivity as candidate moderators of the association between body dissatisfaction and binge eating in adults. A convenience sample of 221 tobacco product users completed measures of eating disorder pathology and sweet taste reward sensitivity. Results revealed that elevated sweet taste reward sensitivity strengthened the positive association between higher body dissatisfaction and binge eating. However, there was no main effect, or moderation effect, of dietary restraint on binge eating. The findings of this study demonstrate the key role of sweet taste reward sensitivity in potentiating the association between body dissatisfaction and binge eating. Sweet taste reward sensitivity may serve as a key dispositional factor for uncontrolled eating.
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Affiliation(s)
- Tyler B. Mason
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA 90032, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA 90032, USA
| | - Anna Dolgon-Krutolow
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA 90032, USA
| | - Kathryn E. Smith
- Institute for Addiction Science, University of Southern California, Los Angeles, CA 90032, USA
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA 90032, USA
| | - Adam M. Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA 90032, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, CA 90032, USA
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4
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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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5
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USTA E, PEHLİVAN M. Mediation Effect of Depression on the Association between Food Addiction and Body Image in Individuals with Obesity. KONURALP TIP DERGISI 2021. [DOI: 10.18521/ktd.897251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Schulte EM, Wadden TA, Allison KC. An evaluation of food addiction as a distinct psychiatric disorder. Int J Eat Disord 2020; 53:1610-1622. [PMID: 32725769 DOI: 10.1002/eat.23350] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/25/2020] [Accepted: 06/25/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To evaluate the state of the literature for whether food addiction may warrant consideration as a distinct psychiatric disorder in the Diagnostic and Statistical Manual (DSM) using Blashfield et al.'s (1990; Comprehensive Psychiatry, 31(1), 15-19) five criteria. This framework was utilized because it has recently been applied to examine the diagnostic utility of several eating disorder phenotypes. The criteria are: (a) at least 50 journal articles published on the proposed syndrome in the past 10 years; (b) proposal of diagnostic criteria and assessment measures; (c) clinician reliability in diagnosis; (d) cohesiveness of the proposed diagnostic criteria; and (e) differentiation from similar, existing diagnostic categories. METHOD For each criterion, a literature review was conducted to examine if the minimum qualification had been met, and key findings were discussed. RESULTS Two of the criteria (literature and differentiation) have been empirically supported to extent specified. Two criteria (diagnostic criteria and syndrome) have been partially fulfilled, due to only having self-report assessment measures and no examination of the odds ratios for meeting more than one symptom, respectively. Clinician reliability has not yet been evaluated. DISCUSSION The existing literature suggests that food addiction may warrant consideration as a proposed diagnostic category in the DSM, though future research is needed to fulfill Blashfield et al.'s (1990; Comprehensive Psychiatry, 31(1), 15-19) criteria. The development of a semi-structured interview would be an impactful contribution for addressing these gaps.
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Affiliation(s)
- Erica M Schulte
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Thomas A Wadden
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Kelly C Allison
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Kircaburun K, Ünübol H, Sayar GH, Stavropoulos V, Griffiths MD. Measurement, prevalence, and psychological risk factors associated with addictive food consumption: Development of a new food addiction scale and evidence from a national largescale sample. J Behav Addict 2020; 9:836-852. [PMID: 32903203 PMCID: PMC8943666 DOI: 10.1556/2006.2020.00052] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 04/28/2020] [Accepted: 08/10/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND AND AIMS To date, a number of studies have investigated the prevalence and correlates of addictive food consumption. However, these studies have mostly relied on models that comprised a narrow range of variables in often small and heterogenous samples. The purpose of the present study was to comprehensively examine the measurement aspects, the prevalence, and the psychological correlates of addictive eating among a largescale national sample of Turkish adults. METHOD Participants (N = 24,380, 50% men, Mage = 31.79 years, age range = 18-81 years) completed a battery of tests including the Food Addiction Risk Questionnaire (FARQ), the Brief Symptom Inventory, the Toronto Alexithymia Scale, the Positive and Negative Affect Schedule, and the Experiences in Close Relationships-Revised. RESULTS According to analyses conducted, the FARQ had a uni-dimensional factor structure. Based on Item Response Theory (IRT) calculated cut-off scores, 2.3% of the participants were at risk of addictive eating patterns, whilst criteria varied in their discriminating ability. The correlates of addictive food consumption were being male, being younger, having lower education, presenting with higher alcohol use, psychiatric symptoms, alexithymia, positive/negative affect, and anxious attachment. CONCLUSION These results suggest that a minority of Turkish community are at risk for addictive food consumption and that adverse psychological states promote this problematic behavior.
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Affiliation(s)
- Kagan Kircaburun
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK,Educational Sciences Department, Düzce University, Düzce, Turkey,Corresponding author. E-mail:
| | - Hüseyin Ünübol
- Institute of Social Sciences, Psychology Department, Üsküdar University, Istanbul, Turkey
| | - Gökben H. Sayar
- Institute of Social Sciences, Clinical Psychology Department, Üsküdar University, Istanbul, Turkey
| | | | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
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8
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Nicolau J, Romerosa JM, Rodríguez I, Sanchís P, Bonet A, Arteaga M, Fortuny R, Masmiquel L. Associations of food addiction with metabolic control, medical complications and depression among patients with type 2 diabetes. Acta Diabetol 2020; 57:1093-1100. [PMID: 32277296 DOI: 10.1007/s00592-020-01519-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 03/17/2020] [Indexed: 12/18/2022]
Abstract
AIMS Food addiction (FA) is conceptualized as a behavioral pattern that is similar in some ways to addictions to alcohol and other substances. This disorder has not been well studied among patients with type 2 diabetes (T2DM). We aimed to analyze if there is any relationship between FA and clinical or psychological variables among patients with T2DM. METHODS Three hundred patients with T2DM were analyzed cross-sectionally. Participants were evaluated for the presence of FA by completing the Yale Food Addiction Scale 2.0 questionnaire. RESULTS 29.3% of patients screened positive for FA. Patients with FA had a greater BMI (33.41 ± 7.5 vs. 31.6 ± 5.9 kg/m2; p = 0.04). HbA1c was higher among individuals with FA (7.9 ± 4.4 vs. 7.6 ± 1.4%, p = 0.008). The proportion of subjects with diabetic retinopathy, neuropathy and nephropathy was greater among patients with criteria for FA compared with patients without this condition (25% vs. 13.2%, 29.5% vs. 21.8% and 32% vs. 22.3%; p = 0.03, p = 0.05 and p = 0.05, respectively). The percentage of patients with FA with significant depressive symptoms was also greater (36.4% vs. 18.5%; p = 0.002). CONCLUSIONS The presence of FA among T2DM patients implied a worse glycaemic control. Microvascular complications and depressive symptoms were higher among these patients.
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Affiliation(s)
- Joana Nicolau
- Endocrinology and Nutrition Department, Hospital Son Llàtzer, University Institute of Health Science Research (IUNICS) and Health Research Institute of Balearic Islands (IdISBA), Ctra Manacor km 4, 07198, Palma de Mallorca, Baleares, Spain.
| | - Juan Manuel Romerosa
- Endocrinology and Nutrition Department, Hospital Son Llàtzer, University Institute of Health Science Research (IUNICS) and Health Research Institute of Balearic Islands (IdISBA), Ctra Manacor km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - Irene Rodríguez
- Endocrinology and Nutrition Department, Hospital Son Llàtzer, University Institute of Health Science Research (IUNICS) and Health Research Institute of Balearic Islands (IdISBA), Ctra Manacor km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - Pilar Sanchís
- Endocrinology and Nutrition Department, Hospital Son Llàtzer, University Institute of Health Science Research (IUNICS) and Health Research Institute of Balearic Islands (IdISBA), Ctra Manacor km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - Aina Bonet
- Endocrinology and Nutrition Department, Hospital Son Llàtzer, University Institute of Health Science Research (IUNICS) and Health Research Institute of Balearic Islands (IdISBA), Ctra Manacor km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - Magdalena Arteaga
- Endocrinology and Nutrition Department, Hospital Son Llàtzer, University Institute of Health Science Research (IUNICS) and Health Research Institute of Balearic Islands (IdISBA), Ctra Manacor km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - Regina Fortuny
- Hormonal Laboratory, Hospital Son Llàtzer, Ctra Manacor km 4, 07198, Palma de Mallorca, Baleares, Spain
| | - Lluís Masmiquel
- Endocrinology and Nutrition Department, Hospital Son Llàtzer, University Institute of Health Science Research (IUNICS) and Health Research Institute of Balearic Islands (IdISBA), Ctra Manacor km 4, 07198, Palma de Mallorca, Baleares, Spain
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9
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Psychiatric Aspects of Obesity: A Narrative Review of Pathophysiology and Psychopathology. J Clin Med 2020; 9:jcm9082344. [PMID: 32717793 PMCID: PMC7463475 DOI: 10.3390/jcm9082344] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/14/2020] [Accepted: 07/22/2020] [Indexed: 12/16/2022] Open
Abstract
In the last decades, obesity has become a major concern for clinical and public health. Despite the variety of available treatments, the outcomes remain—by and large—still unsatisfactory, owing to high rates of nonresponse and relapse. Interestingly, obesity is being associated with a growing surge of neuropsychiatric problems, certainly related to the pathogenesis of this condition, and likely to be of great consequence as for its treatment and prognosis. In a neurobiologic direction, a sturdy body of evidence has recently shown that the immune–metabolic–endocrine dyscrasias, notoriously attached to excess body weight/adiposity, affect and impair the morpho-functional integrity of the brain, thus possibly contributing to neuroprogressive/degenerative processes and behavioral deviances. Likewise, in a neuropsychiatric perspective, obesity displays complex associations with mood disorders and affective temperamental dimensions (namely cyclothymia), eating disorders characterized by overeating/binge-eating behaviors, ADHD-related executive dysfunctions, emotional dysregulation and motivational–addictive disturbances. With this review, we attempt to provide the clinician a synoptic, yet exhaustive, tool for a more conscious approach to that subset of this condition, which could be reasonably termed “psychiatric” obesity.
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10
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Romero X, Agüera Z, Granero R, Sánchez I, Riesco N, Jiménez-Murcia S, Gisbert-Rodriguez M, Sánchez-González J, Casalé G, Baenas I, Valenciano-Mendoza E, Menchon JM, Gearhardt AN, Dieguez C, Fernández-Aranda F. Is food addiction a predictor of treatment outcome among patients with eating disorder? EUROPEAN EATING DISORDERS REVIEW 2020; 27:700-711. [PMID: 31637816 DOI: 10.1002/erv.2705] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The study aimed to examine whether food addiction (FA) was associated with greater severity in both binge eating disorders (BED) and bulimia nervosa and, therefore, to determine if FA was predictive of treatment outcome. METHOD Seventy-one adult patients with bulimia nervosa and BED (42 and 29, respectively) participated in the study. FA was assessed by means of the Yale Food Addiction Scale. RESULTS The results confirmed a high prevalence of FA in patients with binge disorders (around 87%) and also its association with a greater severity of the disorder (i.e., related to an increased eating psychopathology and greater frequency of binge eating episodes). Although FA did not appear as a predictor of treatment outcome in general terms, when the diagnostic subtypes were considered separately, FA was associated with poor prognosis in the BED group. In this vein, FA appeared as a mediator in the relationship between ED severity and treatment outcome. DISCUSSIONS Our findings suggest that FA may act as an indicator of ED severity, and it would be a predictor of treatment outcome in BED but not in BN.
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Affiliation(s)
- Xandra Romero
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Zaida Agüera
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain.,Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain.,Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Isabel Sánchez
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Nadine Riesco
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | | | - Jéssica Sánchez-González
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Gemma Casalé
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Isabel Baenas
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | | | - Jose M Menchon
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,CIBER Salud Mental (CIBERSAM), Instituto Salud Carlos III, Barcelona, Spain
| | | | - Carlos Dieguez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain.,Department of Physiology, CIMUS, University of Santiago de Compostela-Instituto de Investigación Sanitaria, Santiago de Compostela, Spain
| | - Fernando Fernández-Aranda
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
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11
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Imperatori C, Bianciardi E, Niolu C, Fabbricatore M, Gentileschi P, Di Lorenzo G, Siracusano A, Innamorati M. The Symptom-Checklist-K-9 (SCL-K-9) Discriminates between Overweight/Obese Patients with and without Significant Binge Eating Pathology: Psychometric Properties of an Italian Version. Nutrients 2020; 12:E674. [PMID: 32121618 PMCID: PMC7146623 DOI: 10.3390/nu12030674] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/23/2020] [Accepted: 02/28/2020] [Indexed: 02/06/2023] Open
Abstract
A general personality and psychopathology evaluation is considered to be crucial part of the multidisciplinary assessment for weight-related problems. The Symptom Checklist-90-Revised (SCL-90-R) is commonly used to assess general psychopathology in both overweight and obese patients seeking weight-loss treatment. The main purpose of the present research was to investigate the psychometric properties of the brief form of the SCL-90-R (i.e., the SCL-K-9) in a clinical sample (N = 397) of patients seeking weight-loss treatment (i.e., bariatric surgery and a nutritional weight-loss program). The results of the confirmatory factor analysis supported a one-factor solution of the SCL-K-9, with all nine items loading significantly on the common latent factor (lambdas ≥ 0.587). The ordinal α (= 0.91), the inter-item mean indices of correlation (rii = 0.53), and the convergent validity were also satisfactory. A receiver operating characteristic curves procedure showed that both SCL-90-R and SCL-K-9 were able to classify patients with and without significant binge eating pathology according to the Binge Eating Scale (BES) total score. Overall, our results suggest that the SCL-K-9 has adequate psychometric properties and can be applied as a short screening tool to assess general psychopathology in overweight/obese individuals seeking weight-loss treatment and at follow-up interviews when time restraints preclude the use of the full-length form.
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Affiliation(s)
- Claudio Imperatori
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, Via degli Aldobrandeschi 190, 00163 Roma, Italy; (M.F.); (M.I.)
| | - Emanuela Bianciardi
- Psychiatric Chair, Department of Systems Medicine, University of Rome “Tor Vergata”, Via Cracovia, 50, 00133 Roma, Italy; (E.B.); (C.N.); (G.D.L.); (A.S.)
| | - Cinzia Niolu
- Psychiatric Chair, Department of Systems Medicine, University of Rome “Tor Vergata”, Via Cracovia, 50, 00133 Roma, Italy; (E.B.); (C.N.); (G.D.L.); (A.S.)
| | - Mariantonietta Fabbricatore
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, Via degli Aldobrandeschi 190, 00163 Roma, Italy; (M.F.); (M.I.)
| | - Paolo Gentileschi
- Bariatric Surgery Unit, Department of Experimental Medicine and Surgery, University of Rome “Tor Vergata”, Via Cracovia, 50, 00133 Roma, Italy;
| | - Giorgio Di Lorenzo
- Psychiatric Chair, Department of Systems Medicine, University of Rome “Tor Vergata”, Via Cracovia, 50, 00133 Roma, Italy; (E.B.); (C.N.); (G.D.L.); (A.S.)
- IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Roma, Italy
| | - Alberto Siracusano
- Psychiatric Chair, Department of Systems Medicine, University of Rome “Tor Vergata”, Via Cracovia, 50, 00133 Roma, Italy; (E.B.); (C.N.); (G.D.L.); (A.S.)
| | - Marco Innamorati
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, Via degli Aldobrandeschi 190, 00163 Roma, Italy; (M.F.); (M.I.)
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12
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Kiyici S, Koca N, Sigirli D, Aslan BB, Guclu M, Kisakol G. Food Addiction Correlates with Psychosocial Functioning More Than Metabolic Parameters in Patients with Obesity. Metab Syndr Relat Disord 2020; 18:161-167. [PMID: 32027557 DOI: 10.1089/met.2019.0108] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Aim: To investigate the association of food addiction (FA) with the psychosocial functioning and metabolic parameters in obese patients seeking weight-loss treatment. Methods: Two hundred twenty-four obese patients (male/female: 28/196) with a mean age of 44.5 ± 13.4 years and body mass index (BMI) of 41.6 ± 7.2 were included in the study. After receiving sociodemographic data and medical history, detailed physical examination, including anthropometric measurements, was performed by an experienced physician. Blood samples were taken after 8-12 hr of fasting. The presence of FA was evaluated by using Yale Food Addiction Scale (YFAS). Psychological evaluation was performed by using a self-reported Patient Health Questionnaire-9 (PHQ-9) and health-related quality of life using the 36-item short-form health survey (SF-36). Results: Seventy-two of 224 (32.1%) patients met the criteria for FA, according to YFAS. The mean age of patients with FA was younger compared with patients without FA (P < 0.001). There was no statistically significant difference between the patients with and without FA in terms of BMI, fat percentage, and waist circumference (P = 0.440, P = 0.644, and P = 0.144, respectively). The depression frequency was significantly higher (61.1%, P < 0.001), while the SF-36 score of mental health was lower (P = 0.027) in patients with FA than in the patients without FA. Age- and sex-adjusted mean fasting plasma glucose level was lower in patients with FA (P = 0.021), but serum insulin levels, HOMA-IR (homeostasis model assessment of insulin resistance), HbA1c (hemoglobin A1c), lipid parameters, and vascular adiposity index were comparable. Conclusions: We found that FA frequency was very high in obese patients seeking treatment for weight loss, and it correlates with psychosocial functioning more than metabolic parameters.
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Affiliation(s)
- Sinem Kiyici
- Department of Endocrinology and Metabolism, Bursa Yuksek Ihtisas Education and Training Hospital, University of Health Sciences, Bursa, Turkey
| | - Nizameddin Koca
- Department of Internal Medicine, Bursa Yuksek Ihtisas Education and Training Hospital, University of Health Sciences, Bursa, Turkey
| | - Deniz Sigirli
- Department of Bio-Statistics, Uludag University Medical Faculty, Bursa, Turkey
| | - Bilal Burçak Aslan
- Department of Internal Medicine, Bursa Yuksek Ihtisas Education and Training Hospital, University of Health Sciences, Bursa, Turkey
| | - Metin Guclu
- Department of Endocrinology and Metabolism, Bursa Yuksek Ihtisas Education and Training Hospital, University of Health Sciences, Bursa, Turkey
| | - Gurcan Kisakol
- Department of Endocrinology and Metabolism, Bursa Yuksek Ihtisas Education and Training Hospital, University of Health Sciences, Bursa, Turkey
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Taymur İ, Budak E, Demirci H, Karayürek Y, Önen S, Bicer Kanat B. Night Eating Syndrome and Food Addiction in Turkish Population. ANKARA MEDICAL JOURNAL 2019. [DOI: 10.17098/amj.624712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract
PURPOSE OF REVIEW The purpose of this review was to examine different forms of disordered eating among individuals with excess weight, including their rates, correlates, and psychosocial treatments. RECENT FINDINGS Binge eating/binge eating disorder, loss of control eating, emotional eating, and food addiction are all fairly prevalent among individuals with excess weight. They appear to share many of the same correlates, including broader eating disorder psychopathology, body/shape/weight concerns, depression, anxiety, and low self-esteem. Behavioral, cognitive-behavioral, and third-wave (e.g., acceptance, mindfulness) therapies appear effective in improving binge eating, loss of control eating, emotional eating, associated features (e.g., weight and shape concerns), and psychological distress (e.g., depression). Certain forms of disordered eating are elevated among individuals with excess weight, and psychosocial interventions have been found effective in improving symptomatology. Empirical research examining the efficacy of treatments for food addiction is lacking, and greatly needed given both its rate and controversy.
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Affiliation(s)
- Bethany A Nightingale
- Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON, M5B 2K3, Canada.
| | - Stephanie E Cassin
- Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON, M5B 2K3, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- Centre for Mental Health, University Health Network, Toronto, ON, Canada.
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15
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Escrivá-Martínez T, Galiana L, Rodríguez-Arias M, Baños RM. The Binge Eating Scale: Structural Equation Competitive Models, Invariance Measurement Between Sexes, and Relationships With Food Addiction, Impulsivity, Binge Drinking, and Body Mass Index. Front Psychol 2019; 10:530. [PMID: 30967808 PMCID: PMC6440315 DOI: 10.3389/fpsyg.2019.00530] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 02/22/2019] [Indexed: 12/18/2022] Open
Abstract
Introduction: The Binge Eating Scale (BES) is a widely used self-report questionnaire to identify compulsive eaters. However, research on the dimensions and psychometric properties of the BES is limited. Objective: The aim of this study was to examine the properties of the Spanish version of the BES. Methods: Confirmatory Factor Analyses (CFAs) were carried out to verify the BES factor structure in a sample of Spanish college students (N = 428, 75.7% women; age range = 18–30). An invariance measurement routine was carried out across sexes, the latent means were compared, and estimates of reliability and convergent and discriminant validity were presented. Results: A one-factor model fit the data best and was also equivalent between sexes. The scalar invariance model showed statistically significant differences across sexes, with a higher prevalence in women. Regarding reliability, the results were excellent. Finally, high statistically significant correlations were obtained with other measures of binge eating (BE), food addiction, impulsivity, binge drinking, and body mass index (BMI). Conclusion: The Spanish 16-item BES is a valid and reliable scale to evaluate BE in the youth population.
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Affiliation(s)
- Tamara Escrivá-Martínez
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain.,Polibienestar Institute, University of Valencia, Valencia, Spain
| | - Laura Galiana
- Department of Methodology for the Behavioral Sciences, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Marta Rodríguez-Arias
- Department of Psychobiology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Rosa M Baños
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain.,Polibienestar Institute, University of Valencia, Valencia, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto Carlos III, Madrid, Spain
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16
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Penzenstadler L, Soares C, Karila L, Khazaal Y. Systematic Review of Food Addiction as Measured with the Yale Food Addiction Scale: Implications for the Food Addiction Construct. Curr Neuropharmacol 2019; 17:526-538. [PMID: 30406740 PMCID: PMC6712300 DOI: 10.2174/1570159x16666181108093520] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 05/03/2018] [Accepted: 10/30/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The concept of food addiction attracts much interest in the scientific community. Research is mainly based on the Yale Food Addiction Scale (YFAS), a tool developed to assess food addiction. Substance use disorder criteria have been used to develop this scale. OBJECTIVE The aim of this paper was to review the clinical significance of food addiction diagnoses made with the YFAS and to discuss the results in light of the current debate on behavioral addictions. METHODS We performed a systematic review of the studies that assessed food addiction with the YFAS published between January 2014 and July 2017 by searching the electronic databases PsycINFO, MEDLINE, and PsycARTICLES. RESULTS Sixty publications were included in the analysis. Thirty-three studies examined nonclinical samples and 27 examined clinical samples. All studies used YFAS scoring results to define food addiction. The prevalence of food addiction according to the YFAS varied largely by the studied samples. In general, a higher body mass index and the presence of eating disorders (EDs), especially binge eating disorder (BED), were associated with higher YFAS scores. CONCLUSION The concept of food addiction has not been established to this day although it can be grouped with other EDs such as BED. More research is needed to understand this behavior and the differences between food addiction and other EDs. The criteria for food addiction should be revisited in light of the concepts currently used to examine behavioral addictions.
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Affiliation(s)
- Louise Penzenstadler
- Address correspondence to this author at the Geneva University Hospitals, Rue de Grand-Pré, 70 C, 1202 Geneva, Switzerland; Tel: +41 22 372 57 50; Fax: +41 22 372 55 70; E-mail:
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17
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Psychopathological correlates of eating behavior among Portuguese undergraduate students. Nutrition 2018; 48:33-39. [PMID: 29469017 DOI: 10.1016/j.nut.2017.10.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/15/2017] [Accepted: 10/05/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVES The aim of this study was to explore the relationships between eating behavior dimensions and psychopathological symptoms among Portuguese undergraduate students. METHODS We studied 258 participants (62.4% women) regarding eating behavior dimensions (emotional, external and binge eating, flexible and rigid control of eating behavior, and eating self-efficacy), psychopathological distress (as assessed by the Brief Symptom Inventory), and body mass index. In addition to studying bivariate associations between eating behavior dimensions and psychopathological subscales and indexes, what we believe to be a novel analytical approach, considering simultaneously the effects of the overall level of psychopathological distress and the relevance of specific symptoms on the eating behavior dimensions. RESULTS Emotional, external, and binge eating had positive correlations with psychopathological symptomatology, whereas eating self-efficacy was negatively associated. CONCLUSIONS Multivariate analysis showed that the overall level of psychopathological distress (combined with body mass index, among women) had a larger effect on eating behavior than the relevance of specific symptoms.
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Burrows T, Kay-Lambkin F, Pursey K, Skinner J, Dayas C. Food addiction and associations with mental health symptoms: a systematic review with meta-analysis. J Hum Nutr Diet 2018; 31:544-572. [DOI: 10.1111/jhn.12532] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- T. Burrows
- School of Health Sciences; Faculty of Health and Medicine; Priority Research Centre of Physical Activity and Nutrition; University of Newcastle; Newcastle NSW Australia
| | - F. Kay-Lambkin
- Faculty Health and Medicine; NHMRC Centre for Research Excellence in Mental Health and Substance Use; National Drug and Alcohol Research Centre; University of Newcastle; Newcastle NSW Australia
| | - K. Pursey
- School of Health Sciences; Faculty of Health and Medicine; Priority Research Centre of Physical Activity and Nutrition; University of Newcastle; Newcastle NSW Australia
| | - J. Skinner
- School of Health Sciences; Faculty of Health and Medicine; Priority Research Centre of Physical Activity and Nutrition; University of Newcastle; Newcastle NSW Australia
| | - C. Dayas
- School of Biomedicine and Pharmacy; Faculty of Health and Medicine; University of Newcastle; Newcastle NSW Australia
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Albayrak Ö, Föcker M, Kliewer J, Esber S, Peters T, de Zwaan M, Hebebrand J. Eating-related Psychopathology and Food Addiction in Adolescent Psychiatric Inpatients. EUROPEAN EATING DISORDERS REVIEW 2017; 25:214-220. [PMID: 28402068 DOI: 10.1002/erv.2509] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 01/31/2017] [Accepted: 02/12/2017] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Our aims were to investigate the relationship between food addiction and mental disorders including eating disorders (ED), eating-related psychopathology and body mass index-standard deviation score in a sample of adolescent psychiatric inpatients. METHODS Food addiction was assessed with the Yale Food Addiction Scale (YFAS). Eating-related psychopathology was measured with the Three-Factor Eating Questionnaire (TFEQ). Psychiatric diagnoses were assessed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The sample consisted of n = 242 adolescent psychiatric inpatients, of which n = 37 (15.3%) met criteria for an ED. Multiple regression analysis was used to examine the association between YFAS symptom count, TFEQ scales and ED controlling for age and gender. RESULTS Food addiction frequency was 16.5%, and the mean YFAS symptom count was 2.39 (SD: 1.60). In patients with food addiction, TFEQ scale scores were significantly higher than patients without food addiction. Frequency of ED was 42.9% in patients with and 9.9% in patients without food addiction. The TFEQ subscales disinhibition and hunger as well as diagnosis of ED were associated with YFAS symptom count. DISCUSSION Food addiction in adolescent psychiatric inpatients occurs with rates higher than those seen in community samples of children, adolescents and adults. Food addiction might be associated with eating styles related to susceptibility to hunger and feelings of loss of control. The implications of high-YFAS scores in restricting-type anorexia nervosa warrant further investigations to explore which and how the respective items are interpreted in this ED subgroup. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Özgür Albayrak
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School (MHH), Hannover, Germany.,Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, LVR Klinikum, Universitätsklinikum Essen (AöR), Essen, Germany
| | - Manuel Föcker
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, LVR Klinikum, Universitätsklinikum Essen (AöR), Essen, Germany
| | - Josephine Kliewer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, LVR Klinikum, Universitätsklinikum Essen (AöR), Essen, Germany
| | - Simon Esber
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, LVR Klinikum, Universitätsklinikum Essen (AöR), Essen, Germany
| | - Triinu Peters
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, LVR Klinikum, Universitätsklinikum Essen (AöR), Essen, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School (MHH), Hannover, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, LVR Klinikum, Universitätsklinikum Essen (AöR), Essen, Germany
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The Association between Food Addiction and Early Maladaptive Schemas in Overweight and Obese Women: A Preliminary Investigation. Nutrients 2017; 9:nu9111259. [PMID: 29149076 PMCID: PMC5707731 DOI: 10.3390/nu9111259] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 11/11/2017] [Accepted: 11/14/2017] [Indexed: 12/17/2022] Open
Abstract
In recent years, there has been a growing focus on early maladaptive schemas (EMSs) as core features associated with eating psychopathology. The aims of the present study were to assess in overweight and obese women: (i) the association between dysfunctional eating patterns (i.e., food addiction and binge eating) and EMSs, and (ii) the association between food addiction and EMSs after controlling for potential confounding variables (i.e., binge eating severity and psychopathology). Participants were 70 overweight and obese women seeking low-energy-diet therapy. The patients were administered self-report measures investigating food addiction, binge eating, EMSs, anxiety symptoms, and depressive symptoms. Food addiction severity was strongly associated with all main schema domains. Binge eating severity was positively related to disconnection/rejection (r = 0.41; p < 0.01), impaired limits (r = 0.26; p < 0.05), and other-directedness domains (r = 0.27; p < 0.05). The disconnection/rejection schema was independently associated with food addiction severity, after controlling for the presence of other potential confounding variables (i.e., binge eating severity and psychopathology) suggesting that this domain may be a crucial factor for the development of food addiction.
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21
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Neurobiological evidence for attention bias to food, emotional dysregulation, disinhibition and deficient somatosensory awareness in obesity with binge eating disorder. Physiol Behav 2017; 184:122-128. [PMID: 29128522 DOI: 10.1016/j.physbeh.2017.11.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 10/11/2017] [Accepted: 11/05/2017] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To refine the biobehavioral markers of binge eating disorder (BED). METHODS We conducted fMRI brain scans using images of high energy processed food (HEPF), low energy unprocessed food (LEUF), or non-foods (NF) in 42 adults (obese with BED [obese -BED; n=13] and obese with no BED [obese non-BED; n=29]) selected via ads. Two blood oxygenated level dependent (BOLD) signal contrast maps were examined: food versus nonfood, and HEPF versus LEUF. In addition, score differences on the disinhibition scale were correlated with BOLD signals. RESULTS food versus nonfood showed greater BOLD activity for BED in emotional, motivational and somatosensory brain areas: insula, anterior cingulate cortex (ACC), Brodmann areas (BA) 19 & 32, inferior parietal lobule (IPL), posterior cingulate cortex (PCC), and lingual, postcentral, middle temporal and cuneate gyri (p≤0.005; k≥88). HEPF versus LEUF showed greater BOLD activity for BED in inhibitory brain regions: BA 6, middle and superior frontal gyri (p<0.01; k≥119). The groups also differed in the relationships between disinhibition and BOLD activity in the postcentral gyrus (PCG; p=0.04) and ACC-BA 32 (p=0.02). For all participants jointly, PCG BOLD amplitude predicted greater disinhibition (p=0.04). DISCUSSION Food images elicited neural activity indicating attention bias (cuneate & PCG), emotion dysregulation (BA 19 & 32), and disinhibition (MFG, BA6 & SFG) in obese with BED. These may help tailor a treatment for the obesity with BED phenotype.
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Brewerton TD. Food addiction as a proxy for eating disorder and obesity severity, trauma history, PTSD symptoms, and comorbidity. Eat Weight Disord 2017; 22:241-247. [PMID: 28361213 DOI: 10.1007/s40519-016-0355-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 12/20/2016] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Food addiction (FA) is a newly defined yet still controversial condition that has important etiological, developmental, treatment, prevention, and social policy implications. In this review, the case is made that FA (or high scores on the Yale Food Addiction Scale) may be used as a proxy measure for a matrix of interrelated clinical features, including greater eating disorder severity, greater obesity severity, more severe trauma histories, greater symptoms of posttraumatic stress disorder (PTSD), greater psychiatric comorbidity, as well as greater medical morbidity and mortality. METHODS A Medline search was undertaken using the following terms: food addiction cross-referenced with eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder, and binge eating), obesity, trauma, posttraumatic stress disorder, and comorbidity. RESULTS The thesis is that the identification and acknowledgment of the concept of FA, when integrated into an overall, trauma-focused and transdiagnostic treatment approach, are supported and can be useful in understanding clinically the "big picture." CONCLUSIONS Food addiction (FA) may be used as a proxy for (1) bulimic eating disorder severity, (2) complex trauma histories, (3) severity of PTSD and PTSD symptoms, (4) intensity of psychiatric comorbidity, (5) severity of obesity, as well as (6) their combination. Implications for developing treatment strategies are discussed. The case for a comprehensive management that requires careful attention to medical and psychiatric assessment and integrated care that incorporates trauma-focused treatment is made.
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Affiliation(s)
- Timothy D Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, 29425, USA. .,, 216 Scott Street, Mount Pleasant, SC, 29464, USA.
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Eating disorders and food addiction in men with heroin use disorder: a controlled study. Eat Weight Disord 2017; 22:249-257. [PMID: 28434177 DOI: 10.1007/s40519-017-0378-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 02/28/2017] [Indexed: 02/07/2023] Open
Abstract
PURPOSE We aimed to determine the prevalence estimates of binge eating disorder, bulimia nervosa, anorexia nervosa, and food addiction in men with heroin use disorder and a matched sample of control participants. METHODS A group of 100 men with heroin use disorder, consecutively admitted to a detoxification and therapy unit, were screened for DSM-5 eating disorders, along with a group of 100 male controls of similar age, education, and body mass index. The Yale Food Addiction Scale (YFAS), the Barratt Impulsivity Scale-version 11, and the Eating Attitudes Test were used for data collection. Patients were also evaluated for various aspects of heroin use disorder (e.g., craving) using the Addiction Profile Index. RESULTS Binge eating disorder that met DSM-5 criteria was more prevalent in patients with heroin use disorder (21%) than in control subjects (8%) (odds ratio 3.1, 95% confidence interval 1.3-7.3; p < 0.01). Food addiction based on the YFAS was also more common among men with heroin use disorder (28%) than among control participants (12%) (odds ratio 2.9, 95% confidence interval 1.4-6.1; p < 0.01). A current food addiction was associated with more severe craving and having a history of suicide attempts in the patients. CONCLUSIONS Co-occurring binge eating disorder and food addiction are highly frequent in men with heroin use disorder. Screening for binge eating disorder and food addiction in patients with substance use disorder is important, as interventions may improve treatment outcome in this patient group.
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Brown RM, Kupchik YM, Spencer S, Garcia-Keller C, Spanswick DC, Lawrence AJ, Simonds SE, Schwartz DJ, Jordan KA, Jhou TC, Kalivas PW. Addiction-like Synaptic Impairments in Diet-Induced Obesity. Biol Psychiatry 2017; 81:797-806. [PMID: 26826876 PMCID: PMC4889544 DOI: 10.1016/j.biopsych.2015.11.019] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Revised: 11/20/2015] [Accepted: 11/24/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND There is increasing evidence that the pathological overeating underlying some forms of obesity is compulsive in nature and therefore contains elements of an addictive disorder. However, direct physiological evidence linking obesity to synaptic plasticity akin to that occurring in addiction is lacking. We sought to establish whether the propensity to diet-induced obesity (DIO) is associated with addictive-like behavior, as well as synaptic impairments in the nucleus accumbens core considered hallmarks of addiction. METHODS Sprague Dawley rats were allowed free access to a palatable diet for 8 weeks then separated by weight gain into DIO-prone and DIO-resistant subgroups. Access to palatable food was then restricted to daily operant self-administration sessions using fixed ratio 1, 3, and 5 and progressive ratio schedules. Subsequently, nucleus accumbens brain slices were prepared, and we tested for changes in the ratio between α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) and N-methyl-D-aspartate currents and the ability to exhibit long-term depression. RESULTS We found that propensity to develop DIO is linked to deficits in the ability to induce long-term depression in the nucleus accumbens, as well as increased potentiation at these synapses as measured by AMPA/N-methyl-D-aspartate currents. Consistent with these impairments, we observed addictive-like behavior in DIO-prone rats, including 1) heightened motivation for palatable food; 2) excessive intake; and 3) increased food seeking when food was unavailable. CONCLUSIONS Our results show overlap between the propensity for DIO and the synaptic changes associated with facets of addictive behavior, supporting partial coincident neurological underpinnings for compulsive overeating and drug addiction.
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Affiliation(s)
- Robyn Mary Brown
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC 29425,Florey Institute of Neuroscience & Mental Health, University of Melbourne, Parkville, Australia,correspondence: Dr Robyn M Brown, Department of Neurosciences, Medical University of South Carolina, Charleston, SC, 29425, USA., Florey Institute of Neuroscience & Mental Health, University of Melbourne, Parkville, Vic, 3052, Australia, Ph: +61 3 9035 6592, Fax: +61 3 9035 3107,
| | - Yonatan Michael Kupchik
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC 29425,Department of Medical Neurobiology, The Hebrew University, Jerusalem, Israel
| | - Sade Spencer
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC 29425
| | - Constanza Garcia-Keller
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC 29425,Departamento de Farmacología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | | | - Andrew John Lawrence
- Florey Institute of Neuroscience & Mental Health, University of Melbourne, Parkville, Australia
| | | | - Danielle Joy Schwartz
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC 29425
| | - Kelsey Ann Jordan
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC 29425
| | - Thomas Clayton Jhou
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC 29425
| | - Peter William Kalivas
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC 29425
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Self-perceived food addiction: Prevalence, predictors, and prognosis. Appetite 2017; 114:282-298. [PMID: 28385581 DOI: 10.1016/j.appet.2017.03.051] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 03/08/2017] [Accepted: 03/31/2017] [Indexed: 01/04/2023]
Abstract
Food addiction is controversial within the scientific community. However many lay people consider themselves addicted to certain foods. We assessed the prevalence and characteristics of self-perceived "food addiction" and its relationship to a diagnostic measure of "clinical food addiction" in two samples: (1) 658 university students, and (2) 614 adults from an international online crowdsourcing platform. Participants indicated whether they considered themselves to be addicted to food, and then completed the Yale Food Addiction Scale, measures of eating behavior, body image, and explicit and internalized weight stigma. Participants in the community sample additionally completed measures of impulsivity, food cravings, binge eating, and depressive symptomatology. Follow-up data were collected from a subset of 305 students (mean follow-up 280 ± 30 days). Self-perceived "food addiction" was prevalent, and was associated with elevated levels of problematic eating behavior, body image concerns, and psychopathology compared with "non-addicts", although individuals who also received a positive "diagnosis" on the Yale Food Addiction Scale experienced the most severe symptoms. A clear continuum was evident for all measures despite no differences in body mass index between the three groups. Multinomial logistic regression analyses indicated that perceived lack of self-control around food was the main factor distinguishing between those who did and did not consider themselves addicted to food, whereas severity of food cravings and depressive symptoms were the main discriminating variables between self-classifiers and those receiving a positive "diagnosis" on the Yale Food Addiction Scale. Self-perceived "food addiction" was moderately stable across time, but did not appear predictive of worsening eating pathology. Self-classification as a "food addict" may be of use in identifying individuals in need of assistance with food misuse, loss-of-control eating, and body image issues.
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Wolz I, Granero R, Fernández-Aranda F. A comprehensive model of food addiction in patients with binge-eating symptomatology: The essential role of negative urgency. Compr Psychiatry 2017; 74:118-124. [PMID: 28160693 DOI: 10.1016/j.comppsych.2017.01.012] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 12/15/2016] [Accepted: 01/19/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Food addiction has been widely researched in past years. However, there is a debate on the mechanisms underlying addictive eating and a better understanding of the processes associated to these behaviors is needed. Previous studies have found characteristic psychological correlates of food addiction, such as high negative urgency, emotion regulation difficulties and low self-directedness, in different samples of adults with addictive eating patterns. Still, it seems difficult to disentangle effects independent from general eating disorder psychopathology. Therefore, this study aimed to test a comprehensive model under control of eating disorder severity, in order to find independent predictors of food addiction. METHODS 315 patients with eating disorder diagnoses on the binge-eating spectrum were assessed in personality, emotion regulation, negative urgency, eating disorder symptomatology, and food addiction by self-report. Hypothesis-driven structural equation modeling was conducted to test the comprehensive model. RESULTS The only independent predictor found for food addiction was negative urgency, while self-directedness and emotion regulation predicted negative urgency and were highly related to eating disorder symptomatology, but not to food addiction. CONCLUSIONS Altogether the model suggests that low self-directedness and difficulties in emotion regulation are related to higher eating disorder symptomatology in general. Those patients who, in addition to these traits, tend to act impulsively when in negative mood states, are at risk for developing addictive eating patterns. Urgency-based treatments are therefore recommended for this subgroup of patients.
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Affiliation(s)
- Ines Wolz
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Feixa Llarga s/n, 08907 Hospitalet del Llobregat, Barcelona, Spain; Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain
| | - Roser Granero
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain; Dep. Psicobiologia i Metodologia, Facultat de Psicologia, Universitat Autonoma de Barcelona, Carrer de Ca n'Altayó s/n, 08193 Bellaterra, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Feixa Llarga s/n, 08907 Hospitalet del Llobregat, Barcelona, Spain; Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain.
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Yang F, Liu A, Li Y, Lai Y, Wang G, Sun C, Sun G, Shan Z, Teng W. Food Addiction in Patients with Newly Diagnosed Type 2 Diabetes in Northeast China. Front Endocrinol (Lausanne) 2017; 8:218. [PMID: 28912753 PMCID: PMC5582202 DOI: 10.3389/fendo.2017.00218] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 08/14/2017] [Indexed: 01/01/2023] Open
Abstract
AIM The aim of the study was to explore the prevalence of food addiction (FA) in individuals with newly diagnosed type 2 diabetes mellitus (T2DM) in China and to analyze risk factors of FA. METHODS A total of 624 subjects [312 individuals with newly diagnosed T2DM, 312 age-matched and body mass index (BMI)-matched healthy participants] were recruited. All participants were asked to complete the Yale Food Addiction Scale (YFAS) and received physical and lab examinations. The T2DM group was further divided into a FA group and a non-FA group. RESULTS Of the patients with newly diagnosed T2DM, 8.6% (27/312) met the FA diagnostic criteria proposed by the YFAS (7.6% in men and 10.1% in women, P = 0.43), while 1.3% (4/312) met the criteria in the control group. Logistic regression analysis showed that FA in the T2DM group was positively related to BMI and negatively related to age. T2DM with FA had a significantly higher uric acid (UA). CONCLUSION Both men and women with newly diagnosed T2DM, especially in northeast China, were more likely to suffer from FA. T2DM patients with FA were younger and had higher UA.
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Affiliation(s)
- Fan Yang
- Department of Endocrinology and Metabolism, Endocrine Institute, Liaoning Provincial Key Laboratory of Endocrine Diseases, First Hospital of China Medical University, Shenyang, China
| | - Aihua Liu
- Department of Endocrinology and Metabolism, Endocrine Institute, Liaoning Provincial Key Laboratory of Endocrine Diseases, First Hospital of China Medical University, Shenyang, China
| | - Yongze Li
- Department of Endocrinology and Metabolism, Endocrine Institute, Liaoning Provincial Key Laboratory of Endocrine Diseases, First Hospital of China Medical University, Shenyang, China
| | - Yaxin Lai
- Department of Endocrinology and Metabolism, Endocrine Institute, Liaoning Provincial Key Laboratory of Endocrine Diseases, First Hospital of China Medical University, Shenyang, China
| | - Guixia Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Chenglin Sun
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Guang Sun
- Discipline of Medicine, Faculty of Medicine, Memorial University, St. John’s, NL, Canada
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism, Endocrine Institute, Liaoning Provincial Key Laboratory of Endocrine Diseases, First Hospital of China Medical University, Shenyang, China
- *Correspondence: Zhongyan Shan,
| | - Weiping Teng
- Department of Endocrinology and Metabolism, Endocrine Institute, Liaoning Provincial Key Laboratory of Endocrine Diseases, First Hospital of China Medical University, Shenyang, China
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Lemeshow A, Gearhardt A, Genkinger J, Corbin WR. Assessing the psychometric properties of two food addiction scales. Eat Behav 2016; 23:110-114. [PMID: 27623221 PMCID: PMC5124537 DOI: 10.1016/j.eatbeh.2016.08.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 08/23/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND While food addiction is well accepted in popular culture and mainstream media, its scientific validity as an addictive behavior is still under investigation. This study evaluated the reliability and validity of the Yale Food Addiction Scale and Modified Yale Food Addiction Scale using data from two community-based convenience samples. METHODS We assessed the internal and test-retest reliability of the Yale Food Addiction Scale and Modified Yale Food Addiction Scale, and estimated the sensitivity and negative predictive value of the Modified Yale Food Addiction Scale using the Yale Food Addiction Scale as the benchmark. We calculated Cronbach's alphas and 95% confidence intervals (CIs) for internal reliability and Cohen's Kappa coefficients and 95% CIs for test-retest reliability. RESULTS Internal consistency (n=232) was marginal to good, ranging from α=0.63 to 0.84. The test-retest reliability (n=45) for food addiction diagnosis was substantial, with Kappa=0.73 (95% CI, 0.48-0.88) (Yale Food Addiction Scale) and 0.79 (95% CI, 0.66-1.00) (Modified Yale Food Addiction Scale). Sensitivity and negative predictive value for classifying food addiction status were excellent: compared to the Yale Food Addiction Scale, the Modified Yale Food Addiction Scale's sensitivity was 92.3% (95% CI, 64%-99.8%), and the negative predictive value was 99.5% (95% CI, 97.5%-100%). CONCLUSIONS Our analyses suggest that the Modified Yale Food Addiction Scale may be an appropriate substitute for the Yale Food Addiction Scale when a brief measure is needed, and support the continued use of both scales to investigate food addiction.
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Affiliation(s)
- Adina Lemeshow
- Department of Epidemiology, Columbia University, Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, United States of America;
| | - Ashley Gearhardt
- Department of Psychology, University of Michigan, 2268 East Hall, 530 Church Street, Ann Arbor, MI 48109-1043, United States of America;
| | - Jeanine Genkinger
- Department of Epidemiology, Columbia University, Mailman School of Public Health, Herbert Irving Comprehensive Cancer Center, 722 West 168th St, Rm 803, New York, NY 10032, United States of America;
| | - William R. Corbin
- Department of Psychology, University of Arizona, 950 S McAllister, Arizona State University, Tempe, AZ 85287-1104;
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Innamorati M, Quinto RM, Imperatori C, Lora V, Graceffa D, Fabbricatore M, Lester D, Contardi A, Bonifati C. Health-related quality of life and its association with alexithymia and difficulties in emotion regulation in patients with psoriasis. Compr Psychiatry 2016; 70:200-8. [PMID: 27565774 DOI: 10.1016/j.comppsych.2016.08.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 07/27/2016] [Accepted: 08/01/2016] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) in psoriasis patients could be negatively affected by medical (e.g., obesity) and psychological (e.g., depression, anxiety, and alexithymia) conditions the presence of which suggests difficulties in understanding and regulating inner states and emotions. Thus, the aim of this study was to investigate HRQoL and its association with obesity and difficulties in understanding and regulating inner states and emotions in patients with psoriasis. A second objective was to examine whether the presence of difficulties in understanding and regulating inner states and emotions may mediate the association between psoriasis and poor HRQoL. METHOD One hundred adult outpatients and 97 healthy controls were administered a checklist assessing major socio-demographic variables, and measures of HRQoL, difficulties in emotion regulation, alexithymia, anxiety, depression, and food craving. RESULTS Psoriasis patients (compared to controls) reported more frequently obesity, alexithymia, anxiety, depression and food craving, and reported lower scores on the mental and physical components of HRQoL. A mediation model, with mental health as the dependent variable, indicated significant direct and indirect (through BMI, difficulties in emotion regulation, anxiety, depression, and food craving) effects of psoriasis on the quality of life, so that psoriasis was associated with worse mental health. A second mediation model with physical health as dependent variable indicated only a significant indirect effect (through BMI and depression) of psoriasis on the quality of life. CONCLUSIONS Psoriasis is characterized by poor HRQoL and the presence of difficulties in understanding and regulating inner states and emotions. In patients with psoriasis the possible influence of food craving on abnormal eating habits should be carefully assessed.
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Affiliation(s)
- Marco Innamorati
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163 Rome, Italy.
| | - Rossella M Quinto
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163 Rome, Italy
| | - Claudio Imperatori
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163 Rome, Italy
| | - Viviana Lora
- Center for the Study and Treatment of Psoriasis, San Gallicano Dermatologic Institute, IRCCS, Via Elio Chianesi 53, 00144 Rome, Italy
| | - Dario Graceffa
- Center for the Study and Treatment of Psoriasis, San Gallicano Dermatologic Institute, IRCCS, Via Elio Chianesi 53, 00144 Rome, Italy
| | | | | | - Anna Contardi
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163 Rome, Italy
| | - Claudio Bonifati
- Center for the Study and Treatment of Psoriasis, San Gallicano Dermatologic Institute, IRCCS, Via Elio Chianesi 53, 00144 Rome, Italy
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De Ridder D, Manning P, Leong SL, Ross S, Sutherland W, Horwath C, Vanneste S. The brain, obesity and addiction: an EEG neuroimaging study. Sci Rep 2016; 6:34122. [PMID: 27658351 PMCID: PMC5034231 DOI: 10.1038/srep34122] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 09/07/2016] [Indexed: 01/16/2023] Open
Abstract
Obesity is among the greatest challenges facing healthcare systems with 20% of the world’s population afflicted. Great controversy exists whether obesity can be regarded as an addictive disorder or not. Recently the Yale Food Addiction Scale questionnaire has been developed as a tool to identify individuals with traits of addiction towards food. Using clinical and source localized EEG data we dichotomize obesity. Brain activity in food-addicted and non-food-addicted obese people is compared to alcohol-addicted and non-addicted lean controls. We show that food addiction shares common neural brain activity with alcohol addiction. This ‘addiction neural brain activity’ consists of the dorsal and pregenual anterior cingulate cortex, parahippocampal area and precuneus. Furthermore, common neural obesity neural brain activity exists as well. The ‘obesity neural brain activity’ consists of dorsal and pregenual anterior cingulate cortex, posterior cingulate extending into the precuneus/cuneus as well as the parahippocampal and inferior parietal area. However food-addicted differ from non-food-addicted obese people by opposite activity in the anterior cingulate gyrus. This food addiction and non-food-addiction obesity dichotomy demonstrates there is at least 2 different kinds of obesity with overlapping network activity, but different in anterior cingulate cortex activity.
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Affiliation(s)
- Dirk De Ridder
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, New Zealand
| | - Patrick Manning
- Section of Endocrinology, Department of Medicine, Dunedin School of Medicine, University of Otago, New Zealand
| | - Sook Ling Leong
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, New Zealand
| | - Samantha Ross
- Section of Endocrinology, Department of Medicine, Dunedin School of Medicine, University of Otago, New Zealand
| | - Wayne Sutherland
- Section of Endocrinology, Department of Medicine, Dunedin School of Medicine, University of Otago, New Zealand
| | - Caroline Horwath
- Department of Human Nutrition, Dunedin School of Medicine, University of Otago, New Zealand
| | - Sven Vanneste
- School of Behavioral and Brain Sciences, University of Texas at Dallas, USA
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Imperatori C, Fabbricatore M, Innamorati M, Farina B, Quintiliani MI, Lamis DA, Mazzucchi E, Contardi A, Vollono C, Della Marca G. Modification of EEG functional connectivity and EEG power spectra in overweight and obese patients with food addiction: An eLORETA study. Brain Imaging Behav 2016; 9:703-16. [PMID: 25332109 DOI: 10.1007/s11682-014-9324-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
We evaluated the modifications of electroencephalographic (EEG) power spectra and EEG connectivity in overweight and obese patients with elevated food addiction (FA) symptoms. Fourteen overweight and obese patients (3 men and 11 women) with three or more FA symptoms and fourteen overweight and obese patients (3 men and 11 women) with two or less FA symptoms were included in the study. EEG was recorded during three different conditions: 1) five minutes resting state (RS), 2) five minutes resting state after a single taste of a chocolate milkshake (ML-RS), and 3) five minutes resting state after a single taste of control neutral solution (N-RS). EEG analyses were conducted by means of the exact Low Resolution Electric Tomography software (eLORETA). Significant modification was observed only in the ML-RS condition. Compared to controls, patients with three or more FA symptoms showed an increase of delta power in the right middle frontal gyrus (Brodmann Area [BA] 8) and in the right precentral gyrus (BA 9), and theta power in the right insula (BA 13) and in the right inferior frontal gyrus (BA 47). Furthermore, compared to controls, patients with three or more FA symptoms showed an increase of functional connectivity in fronto-parietal areas in both the theta and alpha band. The increase of functional connectivity was also positively associated with the number of FA symptoms. Taken together, our results show that FA has similar neurophysiological correlates of other forms of substance-related and addictive disorders suggesting similar psychopathological mechanisms.
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Affiliation(s)
- Claudio Imperatori
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163, Rome, Italy.
| | | | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163, Rome, Italy
| | - Benedetto Farina
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163, Rome, Italy
| | - Maria Isabella Quintiliani
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163, Rome, Italy
| | - Dorian A Lamis
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Anna Contardi
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163, Rome, Italy
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Şanlier N, Türközü D, Toka O. Body Image, Food Addiction, Depression, and Body Mass Index in University Students. Ecol Food Nutr 2016; 55:491-507. [DOI: 10.1080/03670244.2016.1219951] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Imperatori C, Innamorati M, Lamis DA, Farina B, Pompili M, Contardi A, Fabbricatore M. Childhood trauma in obese and overweight women with food addiction and clinical-level of binge eating. CHILD ABUSE & NEGLECT 2016; 58:180-190. [PMID: 27442689 DOI: 10.1016/j.chiabu.2016.06.023] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 06/19/2016] [Accepted: 06/24/2016] [Indexed: 06/06/2023]
Abstract
Childhood trauma (CT) is considered a major risk factor for several disorders as well as for the development of eating psychopathology and adult obesity. The main aims of the present study were to assess in overweight and obese women: (i) the independent association between CT and food addiction (FA), and (ii) CT in patients with both FA and clinical-level of binge eating (BE), versus patients who only engage in FA or BE. Participants were 301 overweight and obese women seeking low-energy-diet therapy. All of the patients were administered self-report measures investigating FA, BE, CT, anxiety and depressive symptoms. CT severity was moderately and positively associated with both FA (r=0.37; p<0.001) and BE (r=0.36; p<0.001) severity. The association between FA and CT remained significant after controlling for potential confounding variables. Furthermore, compared to patients without dysfunctional eating patterns, the co-occurrence of FA and BE was associated with more severe CT as well as with more severe psychopathology (i.e., anxiety and depressive symptoms) and higher BMI. Our results suggest that clinicians should carefully assess the presence of CT in individuals who report dysfunctional eating patterns in order to develop treatment approaches specifically for obese and overweight patients with a history of CT.
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Affiliation(s)
| | | | - Dorian A Lamis
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Italy
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34
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Karaca S, Saleh A, Canan F, Potenza MN. Comorbidity between Behavioral Addictions and Attention Deficit/Hyperactivity Disorder: a Systematic Review. Int J Ment Health Addict 2016. [DOI: 10.1007/s11469-016-9660-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Frayn M, Sears CR, von Ranson KM. A sad mood increases attention to unhealthy food images in women with food addiction. Appetite 2016; 100:55-63. [DOI: 10.1016/j.appet.2016.02.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 01/26/2016] [Accepted: 02/04/2016] [Indexed: 10/22/2022]
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36
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Wolz I, Hilker I, Granero R, Jiménez-Murcia S, Gearhardt AN, Dieguez C, Casanueva FF, Crujeiras AB, Menchón JM, Fernández-Aranda F. "Food Addiction" in Patients with Eating Disorders is Associated with Negative Urgency and Difficulties to Focus on Long-Term Goals. Front Psychol 2016; 7:61. [PMID: 26869963 PMCID: PMC4735728 DOI: 10.3389/fpsyg.2016.00061] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 01/12/2016] [Indexed: 12/13/2022] Open
Abstract
Objectives: The present study aimed to investigate if eating disorder patients differ in specific personality traits depending on a positive screening of food addiction (FA) and to find a model to predict FA in eating disorder patients using measures of personality and impulsivity. Methods: Two hundred seventy eight patients, having an eating disorder, self-reported on FA, impulsivity, personality, eating and general psychopathology. Patients were then split into two groups, depending on a positive or negative result on the FA screening. Analysis of variance was used to compare means between the two groups. Stepwise binary logistic regression was used to obtain a predictive model for the presence of FA. Results: Patients with FA had lower self-directedness, and more negative urgency and lack of perseverance than patients not reporting addictive eating. The probability of FA can be predicted by high negative urgency, high reward dependence, and low lack of premeditation. Conclusion: Eating disorder patients who have more problems to pursue tasks to the end and to focus on long-term goals seem to be more likely to develop addictive eating patterns.
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Affiliation(s)
- Ines Wolz
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELLBarcelona, Spain; Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos IIIBarcelona, Spain
| | - Ines Hilker
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain
| | - Roser Granero
- Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos IIIBarcelona, Spain; Department of Psychobiology and Methodology, Universitat Autònoma de BarcelonaBarcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELLBarcelona, Spain; Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos IIIBarcelona, Spain; Department of Psychobiology and Methodology, Universitat Autònoma de BarcelonaBarcelona, Spain
| | | | - Carlos Dieguez
- Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos IIIBarcelona, Spain; Department of Physiology, Centro Singular de Investigación en Medicina Molecular y Enfermedades Crónicas, University of Santiago de Compostela-Instituto de Investigación SanitariaSantiago de Compostela, Spain
| | - Felipe F Casanueva
- Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos IIIBarcelona, Spain; Laboratory of Molecular and Cellular Endocrinology, Research Area, Complejo Hospitalario Universitario de Santiago de CompostelaA Coruña, Spain
| | - Ana B Crujeiras
- Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos IIIBarcelona, Spain; Laboratory of Molecular and Cellular Endocrinology, Research Area, Complejo Hospitalario Universitario de Santiago de CompostelaA Coruña, Spain
| | - José M Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELLBarcelona, Spain; Department of Psychobiology and Methodology, Universitat Autònoma de BarcelonaBarcelona, Spain; Ciber Salud Mental, Instituto Salud Carlos IIIBarcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELLBarcelona, Spain; Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos IIIBarcelona, Spain; Department of Clinical Sciences, School of Medicine, University of BarcelonaBarcelona, Spain
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Long CG, Blundell JE, Finlayson G. A Systematic Review of the Application And Correlates of YFAS-Diagnosed 'Food Addiction' in Humans: Are Eating-Related 'Addictions' a Cause for Concern or Empty Concepts? Obes Facts 2015; 8:386-401. [PMID: 26633647 PMCID: PMC5644849 DOI: 10.1159/000442403] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 10/21/2015] [Indexed: 01/10/2023] Open
Abstract
The proposition of so-called 'food addiction' (FA) in the scientific literature has stimulated a recent surge in research and debate. The concept of FA is controversial, and opinion is divided. Many of the findings depend upon the use of a single instrument called the Yale Food Addiction Scale (YFAS). This review systematically examined FA, as defined by the YFAS, reported in 40 experimental human studies published in or after 2009. The results indicated that much of the literature makes the supposition that food addiction is an accepted neurobiological disease, consistent with substance use disorders; an interpretation based on very limited data. This raises the question as to whether those individuals who meet the YFAS criteria for diagnosis are truly 'addicted' to food or if they experience significant impairment to their psychological wellbeing and quality of life as would be expected in clinically recognised addictive disorders. At the present time, little research has investigated the extent to which a psychometric self-assessment of FA symptomatology can elucidate a harmful relationship with target foods in the diet. A positive YFAS diagnosis is usually positively associated with BMI and strongly linked with the presence of binge eating, but certain exceptions within the literature were revealed. Further clarification is required as to whether so-called FA is sufficiently different to existing conditions and traits to warrant classification as a distinctive disease phenotype rather than an expression of strong habits and preferences.
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Affiliation(s)
| | | | - Graham Finlayson
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
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The stability of 'food addiction' as assessed by the Yale Food Addiction Scale in a non-clinical population over 18-months. Appetite 2015; 96:533-538. [PMID: 26482284 DOI: 10.1016/j.appet.2015.10.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 10/12/2015] [Accepted: 10/13/2015] [Indexed: 11/21/2022]
Abstract
The Yale Food Addiction Scale (YFAS) is a widely used tool to assess the behavioural indicators of addictive-like eating. No studies, however, have used a longitudinal design to determine whether these addictive-like eating behaviours are a stable or transient phenomenon in a community-based population. This study aimed to evaluate whether food addiction Diagnosis and Symptom scores as assessed by the YFAS remain stable over 18-months in a non-clinical population. Young adults aged 18-35 years were recruited from the community to a web-based survey in 2013. The survey included demographics, anthropometrics and the YFAS. Participants who volunteered to be recontacted for future research were invited to complete the same survey 18-months later. The YFAS scoring outputs Diagnosis and Symptom scores were tested for agreement and reliability between the two time points. Of the 303 participants who completed the original survey and agreed to be recontacted, 69 participants (22.8% of those recontacted, 94% female, 67% normal weight at baseline) completed the 18-month follow-up survey. At baseline, thirteen participants met the YFAS predefined criteria for Diagnosis, while eleven participants met these criteria at the 18-month follow-up. YFAS Diagnosis was found to have moderate agreement [K = .50, 95% CI (.23, .77)] between the two time points while Symptom scores had good agreement [K = .70, 95% CI (.54, .83)]. Intraclass correlation coefficients were interpreted as moderate over the 18-month period for both the Diagnosis [ICC = .71, 95% CI (.45, .88)] and Symptom scores [ICC = .72, 95% CI (.58, .82)]. YFAS assessed food addiction Diagnosis and Symptom scores were found to be relatively stable over 18-months in a non-clinical population of predominantly female, young adults. Future research is required to determine the impact of behavioural weight loss interventions on YFAS assessed addictive-like eating.
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Imperatori C, Innamorati M, Lamis DA, Contardi A, Continisio M, Castelnuovo G, Manzoni GM, Fabbricatore M. Factor Structure of the Binge Eating Scale in a Large Sample of Obese and Overweight Patients Attending Low Energy Diet Therapy. EUROPEAN EATING DISORDERS REVIEW 2015; 24:174-8. [PMID: 26147590 DOI: 10.1002/erv.2384] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In the present study, we evaluated the dimensionality and psychometric properties of the Italian version of the Binge Eating Scale (BES) in a 669 (127 men and 542 women) obese and overweight patients seeking weight loss treatment. All participants were administered the Italian version of the BES. Fit statistics for the alternative SEM models demonstrated that both the one-factor and competing two-factor models had a comparable fit to the data. Thus, we selected the one-factor model as the most parsimonious. The BES had good internal consistency reliability (α = 0.89) with a moderate mean inter-item correlation (rii = 0.34). Given that we were not able to clearly determine the best model among the competing two-factor models and a comparable fit of these models with the one-factor model, we have suggested that the one-factor model is the best fitting model describing the dimensionality of the BES.
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Affiliation(s)
| | - Marco Innamorati
- Università Europea di Roma, Rome, Italy.,Istituto Skinner, Rome, Italy
| | - Dorian A Lamis
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Anna Contardi
- Università Europea di Roma, Rome, Italy.,Istituto Skinner, Rome, Italy
| | | | - Gianluca Castelnuovo
- Psychology Research Laboratory, Ospedale San Giuseppe, Istituto Auxologico Italiano IRCCS, Piancavallo (Oggebbio), Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milano, Italy
| | - Gian Mauro Manzoni
- Psychology Research Laboratory, Ospedale San Giuseppe, Istituto Auxologico Italiano IRCCS, Piancavallo (Oggebbio), Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milano, Italy
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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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41
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Prevalence of and risk factors for binge eating behaviour in 6930 adults starting a weight loss or maintenance programme. Public Health Nutr 2015; 19:71-7. [DOI: 10.1017/s1368980015001068] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveConflicting data are available on the prevalence of binge eating behaviour (BE) in individuals seeking to lose or maintain weight. The present study aimed to estimate the prevalence of and the risk factors for BE in a large sample of men and women starting a weight loss or maintenance programme.DesignCross-sectional study. BE was defined as a Binge Eating Scale (BES) score ≥18. The State-Trait Anxiety Inventory and the Italian Depression Questionnaire were used to assess anxiety and depression. Besides sex, age and BMI, marital status, educational level, smoking and physical activity were evaluated as potential risk factors for BE. Uni- and multivariable Poisson working regression models were used to estimate prevalence ratios (PR) and marginal probabilities.SettingNutritional research centre.SubjectsAdults (n 6930; 72 % women) with a median age of 46 years (range 18–81 years) were consecutively studied.ResultsBE prevalence in the pooled sample was 17 %. At multivariable analysis, being a woman (PR=2·70), smoking (PR=1·15) and increasing BMI (PR=1·05 for 1 kg/m2 increase) were risk factors for BE. On the contrary, being older (PR=0·99 for 1-year increase), performing physical activity (PR=0·89) and being married (PR=0·88) were protective factors for BE. Anxiety and depression were more common in subjects with BE.ConclusionsBE is common in individuals seeking to lose or maintain weight. The prevalence of BE is higher in young obese women. However, BE is present also in men, elders and normal-weight subjects.
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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: 306] [Impact Index Per Article: 30.6] [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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