Obesity and food addiction: Similarities to drug addiction

Exploring the prospective relationships between food addiction symptoms, weight bias internalization, and psychological distress in Chinese adolescents

OBJECTIVE

Relationships exist between food addiction symptoms, weight bias internalization, and psychological distress, yet previous research is primarily cross-sectional with adults from Western contexts. We examined the prospective relationships between food addiction symptoms, weight bias internalization, and psychological distress in Chinese adolescents.

METHODS

Over three time points (Time 1, baseline; Time 2, 6-months; Time 3, 12-months) spanning 1 year, we examined cross-sectional and bi-directional relationships between food addiction symptoms, weight bias internalization, and psychological distress in Chinese adolescents (N = 589; aged 14-18 years at baseline). Pearson correlations and cross-lagged models examined the cross-sectional and longitudinal relationships between food addiction symptoms, weight bias internalization, and psychological distress.

RESULTS

Cross-sectional correlations suggested positive relationships between food addiction symptoms, weight bias internalization, and psychological distress at each time point. Regarding bi-directional relationships, higher psychological distress was associated with both higher weight bias internalization and higher food addiction symptoms at the following time points. However, food addiction symptoms and weight bias internalization were not prospectively associated. Time 2 psychological distress did not significantly mediate the relationship between Time 1 weight bias internalization and Time 3 food addiction symptoms.

DISCUSSION

Findings suggest no direct longitudinal link between food addiction symptoms and weight bias internalization and vice versa. However, findings do suggest that psychological distress is temporally associated with higher food addiction symptoms and weight bias internalization in Chinese adolescents. Targeting psychological distress may prove useful in treatments of food addiction symptoms and weight bias internalization in Chinese adolescents.

PUBLIC SIGNIFICANCE

Positive associations exist between food addiction symptoms, weight bias internalization, and psychological distress, but findings are largely cross-sectional and bound to adult populations from Western contexts. Using a longitudinal design in Chinese adolescents, findings suggested that baseline psychological distress was associated with higher food addiction symptoms and higher weight bias internalization at follow-up time points. Treatments targeting psychological distress may be helpful in reducing food addiction symptoms and weight bias internalization in Chinese adolescents.

Food addiction as a mediator between depressive symptom severity and body mass index

Depression is associated with an increased risk of cardiometabolic disease linked to weight gain driven by complex interactions between multiple risk factors, including overeating behaviours. However, risk factors that mediate the relationship between depressive symptoms and weight gain remain to be fully elucidated. This study examined food addiction symptoms as a potential mediator on the relationship between depressive symptom severity and adiposity as measured by body mass index (BMI), and evaluated whether this relationship was contingent on appetite symptom profile and sex. In a sample of 628 adults, depressive symptom severity was assessed using the Centre for Epidemiological Studies Depression Scale (CES-D), and food addiction symptoms were measured using the Yale Food Addiction Scale (YFAS, version 2). Participant demographics, including BMI, appetite presentations and sex, were assessed using self-report questions. Mediation and moderated mediation analyses were performed to determine relationships between variables. The prevalence of depressogenic food addiction in the present sample was 21.7%. After accounting for age and averaged amount of exercise, food addiction symptoms fully mediated the relationship between depressive symptom severity and BMI. Appetite symptom profile was a significant moderator of this relationship, with effects more pronounced in those with increased appetite compared to decreased or unchanged appetite. While sex was not a significant moderator, being male or female was associated with higher food addiction scores. This study supports food addiction symptoms as an important behavioural risk factor for increased adiposity linked to greater depressive symptom severity, particularly in those experiencing increased appetite during a depressive episode. Assessment and monitoring of food addiction symptoms may have utility in reducing the risk of increased BMI and adverse health outcomes in those experiencing more severe depressive symptoms.

Prevalence and correlates of addictive eating behaviours in a large cohort of Australian adolescents

OBJECTIVE

Research shows highly palatable foods can elicit addictive eating behaviours or 'food addiction'. Early adolescence is theorised to be a vulnerable period for the onset of addictive eating behaviours, yet minimal research has examined this. This study explored the prevalence and correlates of addictive eating behaviours in a large early adolescent sample.

METHODS

6640 Australian adolescents (Mage = 12.7 ± 0.5, 49%F) completed an online survey. Addictive eating was measured with the Child Yale Food Addiction Scale (YFAS-C). Negative-binomial generalised linear models examined associations between addictive eating symptoms and high psychological distress, energy drink consumption, sugar-sweetened beverage (SSB) consumption, alcohol use, and cigarette use.

RESULTS

Mean YFAS-C symptom criteria count was 1.36 ± 1.47 (of 7). 18.3% of participants met 3+ symptoms, 7.5% endorsed impairment and 5.3% met the diagnostic threshold for food addiction. All examined behavioural and mental health variables were significantly associated with addictive eating symptoms. Effects were largest for high psychological distress and cigarette use; with those exhibiting high psychological distress meeting 0.65 more criteria (95%CI = 0.58-0.72, p < 0.001) and those who smoked a cigarette meeting 0.51 more criteria (95%CI = 0.26-0.76, p < 0.001). High psychological distress and consumption of SSB and energy drinks remained significant when modelling all predictors together.

CONCLUSION

In this large adolescent study, addictive eating symptoms were common. Further research should establish directionality and causal mechanisms behind the association between mental ill-health, alcohol and tobacco use, and addictive eating behaviours. Cross-disciplinary prevention initiatives that address shared underlying risk factors for addictive eating and mental ill-health may offer efficient yet substantial public health benefits.

360-Degree Perspectives on Obesity

Alarming statistics show that the number of people affected by excessive weight has surpassed 2 billion, representing approximately 30% of the world's population. The aim of this review is to provide a comprehensive overview of one of the most serious public health problems, considering that obesity requires an integrative approach that takes into account its complex etiology, including genetic, environmental, and lifestyle factors. Only an understanding of the connections between the many contributors to obesity and the synergy between treatment interventions can ensure satisfactory outcomes in reducing obesity. Mechanisms such as oxidative stress, chronic inflammation, and dysbiosis play a crucial role in the pathogenesis of obesity and its associated complications. Compounding factors such as the deleterious effects of stress, the novel challenge posed by the obesogenic digital (food) environment, and the stigma associated with obesity should not be overlooked. Preclinical research in animal models has been instrumental in elucidating these mechanisms, and translation into clinical practice has provided promising therapeutic options, including epigenetic approaches, pharmacotherapy, and bariatric surgery. However, more studies are necessary to discover new compounds that target key metabolic pathways, innovative ways to deliver the drugs, the optimal combinations of lifestyle interventions with allopathic treatments, and, last but not least, emerging biological markers for effective monitoring. With each passing day, the obesity crisis tightens its grip, threatening not only individual lives but also burdening healthcare systems and societies at large. It is high time we took action as we confront the urgent imperative to address this escalating global health challenge head-on.

Food addiction, hormones and blood biomarkers in humans: A systematic literature review

BACKGROUND

Food addiction may play a role in rising obesity rates in connection with obesogenic environments and processed food availability, however the concept of food addiction remains controversial. While animal studies show evidence for addictive processes in relation to processed foods, most human studies are psychologically focussed and there is a need to better understand evidence for biological mechanisms of food addiction in humans. Several key hormones are implicated in models of food addiction, due to their key roles in feeding, energy metabolism, stress and addictive behaviours. This systematic literature review examines evidence for relationships between food addiction, hormones and other blood biomarkers.

METHODS

A series of literature searches was performed in Scopus, PsychInfo, MedLine, ProQuest, CINAHL and Web of Science. A total of 3111 articles were found, of which 1045 were duplicates. Articles were included if they contained a psychometric measurement of food addiction, such as the Yale Food Addiction Scale, as well as addressed the association between FA and hormones or blood biomarkers in humans. Articles were assessed for eligibility by two independent reviewers.

RESULTS

Sixteen studies were identified that examined relationships between food addiction and blood biomarkers, published between 2015 and 2021. Significant findings were reported for leptin, ghrelin, cortisol, insulin and glucose, oxytocin, cholesterol, plasma dopamine, thyroid stimulating hormone (TSH), haemoglobin A1c (HbA1c), triglyceride (TG), amylin, tumour necrosis factor alpha (TNF- α) and cholecystokinin (CCK). Methodological issues included small sample sizes and variation in obesity status, sex and mental health-related comorbidities. Due to methodological limitations, definite connections between FA, hormones and other blood biomarkers cannot yet be determined.

CONCLUSION

This systematic review identified preliminary evidence linking FA symptoms to hormones and other blood biomarkers related to feeding, addiction, and stress. However, due to the small number of studies and methodological limitations, further research is needed to evaluate biopsychosocial models of FA and to resolve controversies.

Selective Modulation of Hippocampal Theta Oscillations in Response to Morphine versus Natural Reward

Despite the overlapping neural circuits underlying natural and drug rewards, several studies have suggested different behavioral and neurochemical mechanisms in response to drug vs. natural rewards. The strong link between hippocampal theta oscillations (4-12 Hz) and reward-associated learning and memory has raised the hypothesis that this rhythm in hippocampal CA1 might be differently modulated by drug- and natural-conditioned place preference (CPP). Time-frequency analysis of recorded local field potentials (LFPs) from the CA1 of freely moving male rats previously exposed to a natural (in this case, food), drug (in this case, morphine), or saline (control) reward cue in the CPP paradigm showed that the hippocampal CA1 theta activity represents a different pattern for entrance to the rewarded compared to unrewarded compartment during the post-test session of morphine- and natural-CPP. Comparing LFP activity in the CA1 between the saline and morphine/natural groups showed that the maximum theta power occurred before entering the unrewarded compartment and after the entrance to the rewarded compartment in morphine and natural groups, respectively. In conclusion, our findings suggest that drug and natural rewards could differently affect the theta dynamic in the hippocampal CA1 region during reward-associated learning and contextual cueing in the CPP paradigm.

Food Addiction: A Comprehensive Review

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.

Body mass index and attention bias of food cues in women: a mediation model of body weight dissatisfaction

Food attention bias could be used to indicate diet-related diseases in individuals with obesity. The purpose of this study is to explore the relationship between body mass index (BMI) and food attention bias, and the mediating role of body weight dissatisfaction (BWD) on this relationship in women. Seventy-five participants were recruited to complete a visual dot task with eye tracking. The results showed that BMI would positively predict response latency and duration bias on high-calorie foods; the relationship between BMI and response latency of high-calorie food was a complete mediation of BWD; the relationship between BMI and duration bias of high-calorie food was a complete mediation of BWD; and BWD positively predicts response latency and duration bias on high-calorie foods. These findings suggest a positive relationship between BMI and food attention bias, and the effect of a complete mediation of BWD in women.

Gut microbes and food reward: From the gut to the brain

Inappropriate food intake behavior is one of the main drivers for fat mass development leading to obesity. Importantly the gut microbiota-mediated signals have emerged as key actors regulating food intake acting mainly on the hypothalamus, and thereby controlling hunger or satiety/satiation feelings. However, food intake is also controlled by the hedonic and reward systems leading to food intake based on pleasure (i.e., non-homeostatic control of food intake). This review focus on both the homeostatic and the non-homeostatic controls of food intake and the implication of the gut microbiota on the control of these systems. The gut-brain axis is involved in the communications between the gut microbes and the brain to modulate host food intake behaviors through systemic and nervous pathways. Therefore, here we describe several mediators of the gut-brain axis including gastrointestinal hormones, neurotransmitters, bioactive lipids as well as bacterial metabolites and compounds. The modulation of gut-brain axis by gut microbes is deeply addressed in the context of host food intake with a specific focus on hedonic feeding. Finally, we also discuss possible gut microbiota-based therapeutic approaches that could lead to potential clinical applications to restore food reward alterations. Therapeutic applications to tackle these dysregulations is of utmost importance since most of the available solutions to treat obesity present low success rate.

A randomized controlled trial comparing prevention and promotion cognitive strategies in a behavioral weight-loss intervention

OBJECTIVE

Two approaches may shift attention from short-term rewards to longer-term weight-loss goals: focusing on long-term consequences of unhealthy choices (prevention) or benefits of healthy choices (promotion). This randomized controlled trial tested the impact of prevention- versus promotion-focused strategies in an internet-delivered behavioral weight-loss intervention (iBWL).

METHODS

A total of 95 participants with overweight/obesity were randomized to one of three 12-week iBWLs: (1) STANDARD (n = 31), (2) PREVENT (standard iBWL+prevention-focused training; n = 32), or (3) PROMOTE (standard iBWL+promotion-focused training; n = 32). Participants in the two enhanced arms were trained in their assigned strategy, and lessons and weekly feedback featured arm-specific content and reminders.

RESULTS

Intent-to-treat analysis revealed significant differences in weight loss and self-control use at 12 weeks (weight loss p = 0.002, self-control p = 0.0006). PREVENT was associated with 6.6% (±4.5%) weight loss and a 20.3% (±26.5%) increase in self-control, STANDARD and PROMOTE were associated with 4.4% (±4.2%) and 3.1% (±3.1%) weight losses, respectively, and neither STANDARD nor PROMOTE participants exhibited significant changes in self-control. Across arms, increased self-control was associated with greater weight loss (p = 0.0005).

CONCLUSIONS

Cognitive strategies to focus on preventing negative consequences of unhealthy choices led to greater weight loss and self-control compared with both standard iBWL and promotion-focused iBWL. Prevention strategies should be given further attention for overweight/obesity treatment.

Changes in temporal discounting, hedonic hunger, and food addiction during recovery from substance misuse

Substance use disorders (SUDs) and obesity are both chronic, relapsing, remitting disorders that arise from a heightened preference for immediate-focused rewards (i.e., steep temporal discounting). During recovery from SUDs, overweight and obese outcomes are common as individuals may replace drug rewards for food rewards. However, little has been done to investigate the neuropsychological processes underlying food reward and addiction in individuals recovering from SUDs. Using data collected from the International Quit and Recovery Registry and Amazon Mechanical Turk, we aimed to elucidate the factors that influence the attraction to palatable foods in a population in recovery from substance misuse (n = 114) as well as a population with no history of substance misuse (n = 97). We hypothesized that individuals in recovery from substance misuse would have steeper temporal discounting, an increased drive for palatable foods (i.e., hedonic hunger), and greater food addiction symptoms than non-substance users. Contrary to our hypotheses, we found that individuals in recovery from SUDs show improved outcomes in temporal discounting, hedonic hunger, and food addiction symptoms. Moreover, recovery status and temporal discounting significantly predicted these outcomes. Our findings suggest that the enhanced executive control processes needed for successful SUD recovery may transfer to other reward-related processes such as food reward and consumption. Interventions targeted at improving executive function including episodic future thinking, meditation, or exercise, may be excellent ways to support a successful recovery and improve other reward-related processes, including food consumption, to decrease the risk of overweight or obese outcomes during recovery.

Is the development of obesogenic food environments a self-reinforcing process? Evidence from soft drink consumption

BACKGROUND

Understanding how the development of obesogenic food environments and the consumption of ultra-processed foods and beverages influence each other can help policymakers to identify effective ways to curb the current obesity epidemic. This paper was designed to investigate whether, and to what extent, the consumption of soft drinks and the prevalence of obesity are linked through feedback effects.

METHODS

An ecological study design and a simultaneous equation model were used to investigate the existence of a vicious cycle between the consumption of soft drinks and the prevalence of obesity. The analysis was based on a longitudinal dataset covering per capita sales of soft drinks, the age-standardised prevalence rate of obesity and several demographic and socio-economic control variables in a sample of 98 countries worldwide for the period 2005-2019.

RESULTS

Using a Two-Stage Least Squares (2SLS) regression model with fixed effects, we documented a self-reinforcing process that links consumption and obesity. Changes in the spread of obesity were associated with changes in soft drink consumption: a one-unit increase in the age-adjusted prevalence rate of obesity increased consumption by about 2.39 l per person per year. Similarly, as the consumption of soft drinks rose, so did the prevalence of obesity: the age-adjusted rate of obesity increased by 0.07% for every additional litre consumed per capita. Computing the impact multipliers, we found that the outcome of a one-unit decrease in the average price of soft drinks was twofold: a) the prevalence of obesity increased by around 0.17%; and b) consumption increased by around 2.40 l per person, the sum of the increase directly caused by the price reduction (2 l) and the increase due to the interplay between consumption and obesity (0.4 l).

CONCLUSIONS

This study has identified a feedback loop between unhealthy habits (i.e. the consumption of soft drinks) and health outcomes (i.e. the prevalence of obesity). This interplay amplifies the impact of any exogenous changes in the determinants of consumption and obesity. These feedback effects should be considered and exploited in planning effective strategies to tackle the burden of obesity and the global epidemic of non-​communicable diseases.

Precision nutrition based on phenotypical traits and the (epi)genotype: nutrigenetic and nutrigenomic approaches for obesity care

PURPOSE OF REVIEW

The purpose of this article is to rationally review and critically appraise the current knowledge in the most relevant nongenetic and genetic factors influencing obesity predisposition. This information may be translated into the implementation of personalized nutrition approaches involving precision nutrigenetic and nutrigenomic strategies for obesity monitoring and weight management.

RECENT FINDINGS

The importance and influence of several nongenetic contributors to obesity onset and individual responses to weight-loss interventions have been highlighted including the role of age, sex or perinatal feeding and others related to an individual's lifestyle and modifiable. Nutrigenetic studies have analysed potential interactions between polymorphisms influencing energy homeostasis/body composition and dietary factors in relation to adiposity phenotypes and therapy responsiveness. A second approach comprises the Nutrigenomic analysis of gene expression modifications in response to the consumption of specific nutrients or dietary bioactive compounds, which may involve epigenetic mechanisms including deoxyribonucleic acid methylation and micro-ribonucleic acid expression profiles.

SUMMARY

Taken together, these findings encompass the importance of taking into account up-to-date advances in Nutrigenetic and Nutrigenomic hallmarks, globally analysing the risk of weight gain and related outcomes after following nutrition counselling, this contributing to improve obesity care considering phenotypical traits and the genetic make-up for precision obesity care.

Applying the developmental model of use disorders to hedonic hunger: a narrative review

BACKGROUND AND OBJECTIVES

Hedonic hunger (HH) occurs when individuals are driven to consume highly palatable food for pleasure, rather than to satisfy a caloric need. Currently, the Diagnostic and Statistical Manual of Mental Disorders, 5^th edition (DSM-5) does not recognize HH as a use disorder. Previous research has noted physiological, neurobiological, and treatment similarities between HH, binge eating behavior and substance use, leading to the speculation of the existence of food addiction (FA). The purpose of the current review was to explore the literature on the developmental similarities between substance use, HH, binge eating behavior, and other use disorders to provide more evidence for the recognition of FA as an official use disorder, to add to the evidence in favor of a developmental model of use disorders, and to inform the development of interventions that target modifiable symptoms associated with use disorders.

METHODS

We provide a narrative review of the literature on developmental factors associated with both HH and substance use.

RESULTS & DISCUSSION

Adverse childhood experiences and attachment have been previously linked to both substance use and maladaptive eating behaviors. Adverse childhood experiences are linked with insecure attachment and emotion dysregulation, which is linked with compulsive behaviors and substance use. Clinical and research implications are discussed in terms of a developmental model of use disorders and the formal recognition of FA in the next edition of the DSM.

The Effect of Social Isolation during COVID-19 Pandemic on Nutrition and Exercise Behaviors of Nursing Students

This study aims to examine the effect of social isolation during COVID-19 pandemic on nutrition and exercise behaviors of nursing students. This descriptive study was conducted with nursing students of a university in eastern Turkey. The sample of the study consisted of 1,011 nursing students. The data were collected via e-mail using the Questionnaire of Descriptive Characteristics and the Nutrition Exercise Behavior Scale. Nutrition and exercise behaviors were affected by lockdown. During lockdown due to the COVID-19 pandemic, nearly half of students (46.9%) gained weight, and the majority (56.7%) did not exercise regularly. A statistically significant difference was found between the students' psychological/addictive eating behavior and unhealthy nutrition-exercise behavior subscales mean scores according to change in body weight, most intense emotion, status of currently doing regular exercise (p < .001), gender, frequency of eating and status of doing regular exercise before COVID-19 pandemic (p < .05). It is recommended to prepare informative guidelines and educate individuals about dietary habits, meal schedules, regular exercise, and healthy nutrition.

Factors affecting food addiction in adult women: the effect of depression, body mass index, and body image

ABSTRACT Objective Food addiction, an increasingly prevalent disorder, involves multiple physiological and psychological factors. It is often associated with obesity and psychiatric disorders. This study aimed to determine the main factors affecting food addiction in women. Methods In total, 383 adult women were evaluated using an anamnesis form to record participant demographic information and anthropometric measurements, along with the Yale Food Addiction Scale, Beck Depression Inventory, and body perception scale. We created a model according to Beck Depression Inventory, body mass index, age, body perception scale, and marital status, which were thought to influence Yale Food Addiction Scale. Results Mean participant age was 30.13±10.84 years. Food addiction scores of the participants showed significant positive correlations with body weight, body mass index, and depression scores, and significant negative correlations with the body perception scale scores (p<0.05). The results revealed that the Yale Food Addiction Scale score is affected by the Beck Depression Inventory and body mass index. Increase in Beck Depression Inventory and body mass index increased the Yale Food Addiction Scale score by 0.054 and 0.076 units, respectively. Conclusion The main factors affecting emotional eating in women are coexistence of high scores of depression and high body mass index. It is determined that people can have depression, food addiction and obesity at the same time.

COVID-19: How the quarantine could lead to the depreobesity

In this paper, we will introduce coronavirus (COVID-19) and how it spreads around the globe. We will also present the term of quarantine and associated with it requirement of locking down at home in some countries. We will study how frustration related to quarantine relates to several psychological problems including depression. This environment pushes people to consume high sugar foods that increase obesity. In conclusion, countries should be prepared for the upcoming epidemic (depreobesity).

Dietary habits in adults during quarantine in the context of COVID-19 pandemic

•

COVID-19 pandemic lead to stress conditions that can cause a dramatic change in our dietary habits.

•

Eating a well-balanced diet is the best way to get all the essential nutrients we need for normal immune function.

•

Poor quality sleep can negatively affect both physical and mental health.