The dark side of food addiction

Activation of α7 nicotinic receptors attenuated hyperalgesia and anxiety induced by palatable obesogenic diet withdrawal

Consumption of palatable food (PF) can alleviate anxiety, and pain in humans. Contrary, spontaneous withdrawal of long-term PF intake produces anxiogenic-like behavior and abnormal pain sensation, causing challenges to weight-loss diet and anti-obesity agents. Thus, we examined α7-nicotinic acetylcholine receptors (α7nAChR) involvement since it plays essential role in nociception and psychological behaviors.

METHODS

Adult male C57BL/6 mice were placed on a Standard Chow (SC) alone or with PF on intermittent or continuous regimen for 6 weeks. Then, mice were replaced with normal SC (spontaneous withdrawal). Body weight, food intake, and calories intake with and without the obesogenic diet were measured throughout the study. During PF withdrawal, anxiety-like behaviors and pain sensitivity were measured with PNU-282987 (α7nAChR agonist) administration.

RESULTS

Six weeks of SC + PF-intermittent and continuous paradigms produced a significant weight gain. PF withdrawal displayed hyperalgesia and anxiety-like behaviors. During withdrawal, PNU-282987 significantly attenuated hyperalgesia and anxiety-like behaviors.

CONCLUSION

The present study shows that a PF can increase food intake and body weight. Also, enhanced pain sensitivity and anxiety-like behavior were observed during PF withdrawal. α7nAChR activation attenuated anxiolytic-like behavior and hyperalgesia in PF abstinent mice. These data suggest potential therapeutic effects of targeting α7 nAChRs for obesity-withdrawal symptoms in obese subjects.

The Association Between Prenatal Maternal Stress and Adolescent Affective Outcomes is Mediated by Childhood Maltreatment and Adolescent Behavioral Inhibition System Sensitivity

Prenatal maternal stress is linked to offspring outcomes; however, there is little research on adolescents, behavioral, transdiagnostic outcomes, or the mechanisms through which relations operate. We examined, in N = 268 adolescents (Mage = 15.31 years; SD = 1.063; 57.8% boys) whether prenatal maternal stress is associated with adolescent affective outcomes; whether this association is mediated, serially, by childhood home atmosphere and adolescent behavioral inhibition system (BIS) sensitivity; and whether mediational effects are moderated by adolescent attention-deficit/hyperactivity disorder or maternal internalizing symptomology. Prenatal maternal daily stress and major life events were associated with adolescent outcomes through childhood negative atmosphere/neglect and BIS sensitivity, with no evidence of moderation. Results have implications regarding the effect of prenatal maternal stress on offspring outcomes and regarding corresponding sensitive periods.

Habenula Volume and Functional Connectivity Changes Following Laparoscopic Sleeve Gastrectomy for Obesity Treatment

BACKGROUND

Neuroimaging studies have revealed alterations in habenular (Hb) structure and functional connectivity (FC) in psychiatric conditions. The Hb plays a particularly critical role in regulating negative emotions, which trigger excessive food intake and obesity. However, obesity and weight loss intervention (i.e., laparoscopic sleeve gastrectomy [LSG])-associated changes in Hb structure and FC have not been studied.

METHODS

We used voxel-based morphometry analysis to measure changes in gray matter volume (GMV) in the Hb in 56 patients with obesity at pre-LSG and 12 months post-LSG and in 78 normal-weight (NW) control participants. Then, we conducted Hb seed-based resting-state FC (RSFC) to examine obesity-related and LSG-induced alterations in RSFC. Finally, we used mediation analysis to characterize the interrelationships among Hb GMV, RSFC, and behaviors.

RESULTS

Compared with NW participants, Hb GMV was smaller in patients at pre-LSG and increased at 12 months post-LSG to levels equivalent to that of NW; in addition, increases in Hb GMV were correlated with reduced body mass index (BMI). Compared with NW participants, pre-LSG patients showed greater RSFCs of the Hb-insula, Hb-precentral gyrus, and Hb-rolandic operculum and weaker RSFCs of the Hb-thalamus, Hb-hypothalamus, and Hb-caudate; LSG normalized these RSFCs. Decreased RSFC of the Hb-insula was correlated with reduced BMI, Yale Food Addiction Scale rating, and emotional eating; reduced hunger levels were correlated with increased RSFCs of the Hb-thalamus and Hb-hypothalamus; and reduced BMI and Yale Food Addiction Scale ratings were correlated with increased RSFCs of the Hb-thalamus and Hb-hypothalamus, respectively. The bidirectional relationships between Hb GMV and RSFC of the Hb-insula contributed to reduced BMI.

CONCLUSIONS

These findings indicate that LSG increased Hb GMV and that its related improvement in RSFC of the Hb-insula may mediate long-term benefits of LSG for eating behaviors and weight loss.

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.

Linking drug and food addiction: an overview of the shared neural circuits and behavioral phenotype

Despite a lack of agreement on its definition and inclusion as a specific diagnosable disturbance, the food addiction construct is supported by several neurobiological and behavioral clinical and preclinical findings. Recognizing food addiction is critical to understanding how and why it manifests. In this overview, we focused on those as follows: 1. the hyperpalatable food effects in food addiction development; 2. specific brain regions involved in both food and drug addiction; and 3. animal models highlighting commonalities between substance use disorders and food addiction. Although results collected through animal studies emerged from protocols differing in several ways, they clearly highlight commonalities in behavioral manifestations and neurobiological alterations between substance use disorders and food addiction characteristics. To develop improved food addiction models, this heterogeneity should be acknowledged and embraced so that research can systematically investigate the role of specific variables in the development of the different behavioral features of addiction-like behavior in preclinical models.

From Reward to Anhedonia-Dopamine Function in the Global Mental Health Context

When "hijacked" by compulsive behaviors that affect the reward and stress centers of the brain, functional changes in the dopamine circuitry occur as the consequence of pathological brain adaptation. As a brain correlate of mental health, dopamine has a central functional role in behavioral regulation from healthy reward-seeking to pathological adaptation to stress in response to adversity. This narrative review offers a spotlight view of the transition from healthy reward function, under the control of dopamine, to the progressive deregulation of this function in interactions with other brain centers and circuits, producing what may be called an anti-reward brain state. How such deregulation is linked to specific health-relevant behaviors is then explained and linked to pandemic-related adversities and the stresses they engendered. The long lockdown periods where people in social isolation had to rely on drink, food, and digital rewards via the internet may be seen as the major triggers of changes in motivation and reward-seeking behavior worldwide. The pathological adaptation of dopamine-mediated reward circuitry in the brain is discussed. It is argued that, when pushed by fate and circumstance into a physiological brain state of anti-reward, human behavior changes and mental health is affected, depending on individual vulnerabilities. A unified conceptual account that places dopamine function at the centre of the current global mental health context is proposed.

The neuromedin U system: Pharmacological implications for the treatment of obesity and binge eating behavior

Neuromedin U (NMU) is a bioactive peptide produced in the gut and in the brain, with a role in multiple physiological processes. NMU acts by binding and activating two G protein coupled receptors (GPCR), the NMU receptor 1 (NMU-R1), which is predominantly expressed in the periphery, and the NMU receptor 2 (NMU-R2), mainly expressed in the central nervous system (CNS). In the brain, NMU and NMU-R2 are consistently present in the hypothalamus, commonly recognized as the main "feeding center". Considering its distribution pattern, NMU revealed to be an important neuropeptide involved in the regulation of food intake, with a powerful anorexigenic ability. This has been observed through direct administration of NMU and by studies using genetically modified animals, which revealed an obesity phenotype when the NMU gene is deleted. Thus, the development of NMU analogs or NMU-R2 agonists might represent a promising pharmacological strategy to treat obese individuals. Furthermore, NMU has been demonstrated to influence the non-homeostatic aspect of food intake, playing a potential role in binge eating behavior. This review aims to discuss and summarize the current literature linking the NMU system with obesity and binge eating behavior, focusing on the influence of NMU on food intake and the neuronal mechanisms underlying its anti-obesity properties. Pharmacological strategies to improve the pharmacokinetic profile of NMU will also be reported.

Food reinforcement architecture: A framework for impulsive and compulsive overeating and food abuse

Few reward-based theories address key drivers of susceptibility to food cues and consumption beyond fullness. Decision-making and habit formation are governed by reinforcement-based learning processes that, when overstimulated, can drive unregulated hedonically motivated overeating. Here, a model food reinforcement architecture is proposed that uses fundamental concepts in reinforcement and decision-making to identify maladaptive eating habits that can lead to obesity. This model is unique in that it identifies metabolic drivers of reward and incorporates neuroscience, computational decision-making, and psychology to map overeating and obesity. Food reinforcement architecture identifies two paths to overeating: a propensity for hedonic targeting of food cues contributing to impulsive overeating and lack of satiation that contributes to compulsive overeating. A combination of those paths will result in a conscious and subconscious drive to overeat independent of negative consequences, leading to food abuse and/or obesity. Use of this model to identify aberrant reinforcement learning processes and decision-making systems that can serve as markers of overeating risk may provide an opportunity for early intervention in obesity.

Anxiety associated with palatable food withdrawal is reversed by the selective FAAH inhibitor PF-3845: A regional analysis of the contribution of endocannabinoid signaling machinery

OBJECTIVE

Consumption of energy-dense palatable "comfort" food can alleviate stress and negative emotions, while abrupt withdrawal from a palatable diet can worsen these symptoms, causing difficulties with adherence to weight-loss diets. Currently, no pharmacological treatment is effective for obesity-related anxiety, so we investigated the endocannabinoid system (ECS), and specifically the fatty acid amide hydrolase (FAAH), as an interesting emerging target in this context because of its key role in the regulation of both energy homeostasis and emotional behavior.

METHODS

Rats were subjected to exposure and subsequent abstinence from a palatable cafeteria diet. During abstinence period, rats were treated with the selective FAAH inhibitor PF-3845 (10 mg/kg; intraperitoneal administration every other day).

RESULTS

Abstinent rats displayed an anxiogenic-like behavior and changes in the proteins of ECS signaling machinery in brain areas involved both in anxiety and food intake regulation. In particular, withdrawal caused a reduction of the expression of cannabinoid receptors in the nucleus accumbens and of enzymes diacylglycerol lipase alpha and monoacylglycerol lipase (MAGL) in the amygdala. Pharmacological inhibition of FAAH exerted an anxiolytic-like effect in abstinent animals and increased both MAGL expression in amygdala and CB2 expression in prefrontal cortex.

DISCUSSION

Overall, our results suggest that emotional disturbances associated with dieting are coupled with region-specific alterations in the cerebral expression of the ECS and that the enhancement of the endocannabinoid signaling by FAAH inhibition might represent a novel pharmacological strategy for the treatment of anxiety related to abstinence from palatable food.

PUBLIC SIGNIFICANCE

The present study focused on evaluating the role of the endocannabinoid system in modulating withdrawal from naturally rewarding activities that have an impact on mood, such as feeding. The variations observed in the emotional behavior of abstinent rats was linked to neuroadaptations of the ECS in specific brain areas.

Effects of Personality Traits Concerning Media Use Decisions on Fear of Missing Out and Social Media Use Behavior

We could view the phenomenon of fear of missing out (FoMO) as a dilemma of too many choices about social media. Although there are already various studies on FoMO, there is still a lack of studies on what personality traits concerning media use decisions will contribute to FoMO or how FoMO mediates these personality traits and people's social media use behavior, and, thus, corresponding negative emotions. This study explored the causes of FoMO in a FoMO moderated mediation model using maximizing tendency before the choice was made, social comparison orientation when making choices, and regrets tendency after the choice was made. The results showed that (1) there is a non-significant influence between maximizing tendency and FoMO, (2) regret tendency is a positive influence on FoMO, (3) social comparison orientation is a positive influence on FoMO, (4) FoMO is a positive influence on the compulsive use of social media and surveillance use of social media, (5) FoMO exhibited a full mediating effect on the relationship between regret tendency and social media surveillance use, (6) FoMO exhibited a full mediating effect on the relationship between social comparison orientation and social media compulsive use.

Withdrawal: A key consideration in evaluating whether highly processed foods are addictive

Researchers are currently debating whether theories of addiction explain compulsive overeating of highly processed (HP) foods (i.e., industrially created foods high in refined carbohydrates and/or fat), which contributes to obesity and diet-related disease. A subset of individuals consumes HP foods with behavioral phenotypes that mirror substance use disorders. Withdrawal, the emergence of aversive physical and psychological symptoms upon reduction or cessation of substance use, is a core component of addiction that was central to historical debates about other substances' addictive potential (e.g., nicotine and cocaine). However, no one has systematically considered evidence for whether HP foods cause withdrawal, which represents a key knowledge gap regarding the utility of addiction models for understanding compulsive overeating. Thus, we reviewed evidence for whether animals and humans exhibit withdrawal when reducing or eliminating HP food intake. Controlled experimental evidence indicates animals experience HP food withdrawal marked by neural reward changes and behaviors consistent with withdrawal from other addictive substances. In humans, preliminary evidence supports subjective withdrawal-like experiences. However, most current human research is limited to retrospective recall. Further experimental research is needed to evaluate this construct. We outline future research directions to investigate HP food withdrawal in humans and consider potential clinical implications.

Eating-to-Cope Motives and Uncontrolled Eating as Mediators Between Negative Emotional States and Food Addiction Among Argentinean Young Adults

Negative emotional states (NES; i.e., depression, anxiety and stress) are likely contributors to the development of food addiction (FA). The association between NES and FA symptoms may be mediated by altered eating behaviors or by eating-to-cope motives. This study examined, in a sample of Argentinean young adults, the association between NES and FA symptoms via eating-to-cope motives and three patterns of eating behaviors. We also examined whether the model was invariant across college status. The transition from high school to college is usually associated with increased exposure to stress, which promotes the probability of engaging in altered eating behaviors. A sample of 499 Argentinean young adults (mean age = 24.9 ± 3.51 years) completed a survey that assessed FA symptoms, eating behaviors (i.e., uncontrolled, emotional, and restrained eating), eating-to-cope motives and NES. A path analysis tested the indirect association between NES and FA symptoms via uncontrolled, emotional or restrained eating, or by eating-to-cope. Stress and depression symptoms were indirectly associated with FA symptoms via uncontrolled eating and eating-to-cope motives. The model was invariant across college status. The findings suggest that NES are associated with FA symptoms by increasing uncontrolled eating and eating-to-cope motives. Young adults exhibiting greater depressive or stress symptoms, higher eating-to-cope, or higher uncontrolled eating may be at risk for FA. Future research should examine the significance of this pattern by tailoring interventions to these characteristics.

The Modified Yale Food Addiction Scale May Be Simplified and Diagnostically Improved: The Same Prevalence but Different Severity and Risk Factors of Food Addiction among Female and Male Students

The Yale Food Addiction Scale (YFAS) is the most commonly used scale for measuring food addiction (FA). The previous approach to the YFAS and its subsequent versions assumed dichotomization of items, separating addiction symptoms and clinical significance items, and factorial validity testing on a subset of items. In this paper, we discuss the drawbacks associated with these procedures. In addition, we present a different analytical approach to investigate the validity of the modified YFAS (mYFAS) along with an alternative scoring method that overcomes limitations related to the previous approach. After establishing the structure of the mYFAS, we investigated the potential antecedents and consequences of FA separately for men and women. The sample consisted of 1182 Polish undergraduate students (613 women, 559 men, 10 missing values on gender) with a mean age of 20.33 years (SD = 1.68; range: 18–36). They were asked to complete self-report questionnaires measuring FA, personality traits (Big Five), self-esteem, narcissism, self-efficacy, social anxiety, loneliness, and well-being indicators. Due to the low content, factorial, and clinical validity, the first three items were excluded from the Polish version of the mYFAS. The six-item mYFAS demonstrated measurement invariance, allowing for meaningful comparisons between genders and yielded almost identical prevalence rates for men and women. The hierarchical multiple regression analysis showed that, narcissism, and social anxiety predicted FA in both genders, whereas important gender differences in antecedents were also noted. In addition, FA was associated with body mass index (BMI) and most of the well-being indicators, even after controlling for relevant variables. The findings suggest that our modified analytical approach allows researchers to measure FA using a valid, useful, and simple tool.

A possible anti-anxiety effect of appetitive aggression and a possible link to the work of Donald Winnicott

Various pleasant sensations that give a particularly intense pleasure are able to improve anxiety. In the present study I consider the possibility that their anti-anxiety action depends on the strong pleasure they provide, and I propose a possible mechanism of this action. According to some studies, also appetitive aggression (an aggression that provokes a strong pleasure and that is performed only for the pleasure it provides) can improve anxiety, and in this article I consider the possibility that the pleasure of appetitive aggression is able to reduce anxiety by the same mechanism I have proposed for other intense pleasurable sensations.

The aggression performed by a child against the mother or against a substitute for the mother in the first period of life (a period in which this aggression is not dangerous) is a recurring theme throughout the work of of Donald Winnicott. Winnicott stresses that this aggression is necessary for the normal development of the child, and that the child must be free to practise it. According to Winnicott, this aggression is highly pleasurable and is not a response to unpleasant or hostile external situations. For these characteristics it seems to correspond to appetitive aggression in the adult that has been found to be able to reduce anxiety. Consequently, aggression performed by the child in the first period of life may also relieve anxiety, in the same way that appetitive aggression helps against anxiety in the adult.

In his writings, Winnicott returns several times to an unthinkable or archaic anxiety that children experience when they feel abandoned by their mother for a period that is too long for them, and all children, according to Winnicott, live on the brink of this anxiety. In this study I propose the hypothesis that aggression in the early period of life may be necessary for children because the intense pleasure it provides may help them against this continuously impending anxiety.

Validation of the Arabic version of the modified Yale Food Addiction Scale in the general population in Lebanon

BACKGROUND

Although the definition of food addiction is not agreed upon, it is characterized by eating more than expected without being hungry, not being able to visit certain places associated with overeating or unsuccessfully trying to cut down on the consumption of certain foods. The modified YFAS (mYFAS 2.0) version, instrument available to evaluate food addiction, was shown to have good psychometric properties. Our objective was to assess the psychometric properties of the Arabic version of the mYFAS (mYFAS-Ar-Leb) in the Lebanese population.

METHODS

This cross-sectional study enrolled 1268 persons residing in Lebanon (September-November 2020). The mean age of the participants was 26.18 years (SD = 11.17; min: 18; max: 85), with 65.1% females. The percentage of participants with food addiction was 226 (17.8%) in the total sample. A confirmatory factor analysis was run on the one-factor structure among the total sample.

RESULTS

The fit indices of the confirmatory factor analysis of the scale were excellent. The Cronbach's alpha value was good for the total scale. The mYFAS-Ar-Leb score was positively and strongly associated with stress, anxiety and depression.

CONCLUSION

Our study findings highlighted that the use of the mYFAS-Ar-Leb in Lebanese population might help estimate food addiction prevalence and stress on the need for effective treatment and preventive measures to craving for addictive foods.

Neutrophil-to-lymphocyte ratio (NLR) variations in relationship with childhood maltreatment in patients with anorexia nervosa: a retrospective cohort study

PURPOSE

Anorexia nervosa (AN) is a serious mental illness. It is frequently accompanied by a history of childhood maltreatment (CM) that may constitute a specific ecophenotype in patients with eating disorders necessitating special assessment and management. This retrospective study tested whether in patients with AN, CM-related chronic stress may manifest through low-grade inflammation reflected by an increase in white blood cell ratios (neutrophil-to-lymphocyte ratio, NLR, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio).

METHODS

Participants (N = 206) were enrolled at an eating disorder daycare unit in Montpellier, France, from March 2013 and January 2020. CM was assessed using the childhood trauma questionnaire (CTQ). The Eating Disorder Examination Questionnaire (EDE-Q) and the MINI were used to assess AN severity and the other clinical characteristics, respectively.

RESULTS

NLR was higher in patients with AN and history of CM (p = 0.029) and in patients with AN and history of emotional abuse (p = 0.021), compared with patients with AN without history of CM. In multivariate analysis, emotional abuse (β = 0.17; p = 0.027) contributed significantly to NLR variability.

CONCLUSION

In patients with AN, NLR is a low-grade inflammation marker that is influenced by various sociodemographic, clinical and biological factors. It is more directly affected by some CM types, especially emotional abuse, than by the presence/absence of CM history. Future studies should focus on mediators between CM and increased inflammation, such as interoceptive awareness, emotional dysregulation, food addiction, and stress sensitization.

LEVEL OF EVIDENCE

III. Evidence obtained from well-designed cohort or case-control analytic studies.

Assessment of Binge-Like Eating of Unsweetened vs. Sweetened Chow Pellets in BALB/c Substrains

Binge eating disorder (BED) is defined as chronic episodes of consuming large amounts of food in less than 2 h. Binge eating disorder poses a serious public health problem, as it increases the risk of obesity, type II diabetes, and heart disease. Binge eating is a highly heritable trait; however, its genetic basis remains largely unexplored. We employed a mouse model for binge eating that focused on identifying heritable differences between inbred substrains in acute and escalated intake of sucrose-sweetened palatable food vs. unsweetened chow pellets in a limited, intermittent access paradigm. In the present study, we examined two genetically similar substrains of BALB/c mice for escalation in food consumption, incubation of craving after a no-food training period, and compulsive-like food consumption in an aversive context. BALB/cJ and BALB/cByJ mice showed comparable levels of acute and escalated consumption of palatable food across training trials. Surprisingly, BALB/cByJ mice also showed binge-like eating of the unsweetened chow pellets similar to the escalation in palatable food intake of both substrains. Finally, we replicated the well-documented decrease in anxiety-like behavior in BALB/cByJ mice in the light-dark conflict test that likely contributed to greater palatable food intake than BALB/cJ in the light arena. To summarize, BALB/cByJ mice show binge-like eating in the presence and absence of sucrose. Possible explanations for the lack of selectivity in binge-like eating across diets (e.g., novelty preference, taste) are discussed.

Brain regulation of hunger and motivation: The case for integrating homeostatic and hedonic concepts and its implications for obesity and addiction

Obesity and other eating disorders are marked by dysregulations to brain metabolic, hedonic, motivational, and sensory systems that control food intake. Classic approaches in hunger research have distinguished between hedonic and homeostatic processes, and have mostly treated these systems as independent. Hindbrain structures and a complex network of interconnected hypothalamic nuclei control metabolic processes, energy expenditure, and food intake while mesocorticolimbic structures are though to control hedonic and motivational processes associated with food reward. However, it is becoming increasingly clear that hedonic and homeostatic brain systems do not function in isolation, but rather interact as part of a larger network that regulates food intake. Incentive theories of motivation provide a useful route to explore these interactions. Adapting incentive theories of motivation can enable researchers to better how motivational systems dysfunction during disease. Obesity and addiction are associated with profound alterations to both hedonic and homeostatic brain systems that result in maladaptive patterns of consumption. A subset of individuals with obesity may experience pathological cravings for food due to incentive sensitization of brain systems that generate excessive 'wanting' to eat. Further progress in understanding how the brain regulates hunger and appetite may depend on merging traditional hedonic and homeostatic concepts of food reward and motivation.

Effect of time restricted feeding on anthropometric measures, eating behavior, stress, and brain-derived neurotrophic factor (BDNF) and lipopolysaccharide-binding protein (LBP) levels in women with overweight/obesity and food addiction: a study protocol for a randomized clinical trial

Background

Food addiction is one of the behavioral factors that play an important role in the pathogenesis of obesity. Much evidence is available suggesting intestinal microbiomes can play a role in eating behavior, body composition, and BDNF levels, and they can be modified by time-restricted feeding (TRF). So, this study will aim to evaluate the effect of TRF on anthropometric measures, eating behavior, stress, and serum BDNF and LBP levels in women with overweight/obesity and food addiction.

Methods

We will carry out a randomized clinical trial for 8 weeks to evaluate the effect of a TRF on anthropometric measures, eating behavior, stress level, serum BDNF and LBP levels in women with overweight/obesity and food addiction.

Discussion

Given the effect of BDNF on regulating eating behavior and body weight and the effect of dietary restrictions on BDNF and the gut microbiome, the TRF diet could possibly be a new way to successfully manage weight through modifying BDNF in people with eating disorders, including food addiction.

Trial registration

Iranian Registry of Clinical Trials IRCT20131228015968N7. Registered on 25 October 2020.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-022-06439-x.

Decreased excitability of leptin-sensitive anterior insula pyramidal neurons in a rat model of compulsive food demand

Compulsive eating is an overlapping construct with binge eating that shares many characteristics with substance use disorders. Compulsive eating may impact millions of Americans; presenting in some cases of binge eating disorders, overweight/obesity, and among individuals who have not yet been diagnosed with a recognized eating disorder. To study the behavioral and neurobiological underpinnings of compulsive eating, we employ a published rodent model using cyclic intermittent access to a palatable diet to develop a self-imposed binge-withdrawal cycle. Here, we further validated this model of compulsive eating in female Wistar rats, through the lens of behavioral economic analyses and observed heightened demand intensity, inelasticity and essential value as well as increased food-seeking during extinction. Using electrophysiological recordings in the anterior insular cortex, a region previously implicated in modulating compulsive-like eating in intermittent access models, we observed functional adaptations of pyramidal neurons. Within the same neurons, application of leptin led to further functional adaptations, suggesting a previously understudied, extrahypothalamic role of leptin in modulating feeding-related cortical circuits. Collectively, the findings suggest that leptin may modulate food-related motivation or decision-making via a plastic cortical circuit that is influenced by intermittent access to a preferred diet. These findings warrant further study of whether behavioral economics analysis of compulsive eating can impact disordered eating outcomes in humans and of the translational relevance of a leptin-sensitive anterior insular circuit implicated in these behaviors.

Nutrient Intake and Gut Microbial Genera Changes after a 4-Week Placebo Controlled Galacto-Oligosaccharides Intervention in Young Females

Recent interest in the gut-brain-axis has highlighted the potential of prebiotics to impact wellbeing, and to affect behavioral change in humans. In this clinical trial, we examined the impact of four-weeks daily supplementation of galacto-oligosaccharides (GOS) on self-reported nutrient intake and relationships on gut microbiota in a four-week two-armed parallel double-blind placebo controlled GOS supplement trial in young adult females. Food diaries and stool samples were collected prior to and following 28 days of supplement consumption. It was found that four weeks of GOS supplementation influenced macronutrient intake, as evident by reduced carbohydrate and sugars and increased fats intake. Further analysis showed that the reduction in carbohydrates was predicted by increasing abundances of Bifidobacterium in the GOS group in comparison to the placebo group. This suggests that Bifidobacterium increase via GOS supplementation may help improve the gut microbiota composition by altering the desire for specific types of carbohydrates and boosting Bifidobacterium availability when fiber intake is below recommended levels, without compromising appetite for fiber from food.

The Assessment of Food Addiction and the Yale Food Addiction Scale in Bariatric Surgery Populations

Food addiction (FA) appears among bariatric weight loss surgery candidates who struggle to control the intake of hyperpalatable/refined foods have high rates of psychopathology and related health problems. Despite this, prevalence rates of FA in the bariatric sector are reported as low or variable. We investigated the prevalence of FA and the applicability of conventionally used metrics for 166 pre-surgery candidates from a weight management centre (USA) and a major metropolitan hospital (Australia). Self-report measures assessed FA (Yale Food Addiction Scale (YFAS)), body mass index (BMI), disordered eating, addictive personality, psychopathology, and diet. Consistent with prior research, standard YFAS scoring, requiring the endorsement of a distress/impairment (D/I) criterion (FA + D/I), yielded a FA prevalence rate of 12.7%, compared to 37.3% when D/I was omitted (FA − D/I). We compared profiles for those with FA using each scoring method against those ‘without’, who did not meet a minimum of three YFAS symptoms (non-FA ≤ 2). Both methods differentiated those with and without FA on addictive traits, disordered eating and hyperpalatable food consumption. Only FA + D/I differentiated markers of psychological distress or impairment, including depression, anxiety and quality of life. Results indicate a need for further FA research in bariatric settings.

Depression, dietary intake, and body image during coronavirus disease 2019 quarantine in Peru: An online cross-sectional study

Objective:

The coronavirus disease 2019 affects the psychological well-being of populations. In the same way, it can be a potential threat to body image. The aim of the study was to explore associations between depressive symptoms, dietary intake, and body image during coronavirus disease 2019 quarantine.

Methods:

An online cross-sectional study was conducted in 589 Peruvian adults, 297 men (50.4%) and 292 women (49.6%). The mean age was 30.2 ± 9.4 years (range: 18–59 years). Participants completed three questionnaires, including a food frequency questionnaire, the Body Shape Questionnaire, and the Patient Health Questionnaire-9. Moreover, sociodemographic data were collected. The data were analyzed using the statistical software IBM SPSS version 24, and the chi-square test was used. A significance level of 5% was considered.

Results:

A total of 37.7% and 43.6% of the women reported depressive symptoms and dissatisfaction with body image, respectively. Depressive symptoms were associated with dietary intake and dissatisfaction with body image (p < 0.05). Dissatisfaction with body image was associated with dietary intake (p < 0.01).

Conclusions:

Depressive symptomatology plays an important role in the dietary intake and body image of the study population. It is suggested to address these factors through the implementation of health campaign programs and personalized therapeutic interventions.

Food Addiction and Its Relationship to Weight- and Addiction-Related Psychological Parameters in Individuals With Overweight and Obesity

Background and Aims: It is assumed that a relevant subgroup of individuals experiences an addiction-like eating behaviour (Food Addiction), characterized by an impaired control over eating behaviour, emotional eating and food craving. Individuals experiencing Food Addiction partially share common symptomatology with Binge-Eating-Disorder and Bulimia Nervosa. The aim of this study was to investigate the prevalence of Food Addiction, general psychopathology, and associations with weight- and addiction-related constructs in individuals with overweight and obesity, who did not suffer from Binge-Eating-Disorder or Bulimia Nervosa.

Methods:N=213 (67.1% female; M_BMI=33.35kg/m², SD_BMI=3.79kg/m²) participants who were included in a weight loss program (I-GENDO project) reported BMI and completed questionnaires before the start of the treatment. Food Addiction severity, depressive symptoms, alcohol use disorder, internet use disorder, psychological distress, impulsivity personality trait, impulsive and emotional eating behaviour, food related inhibitory control, weight bias internalization, and self-efficacy were assessed.

Results: The prevalence of Food Addiction was 15% with higher, although not statistically significant, prevalence in female (18.2%) compared to male (8.6%) participants. Food Addiction was associated with higher BMI at baseline assessment, low self-esteem, impulsive and emotional eating behaviour, weight bias internalization, and deficits in food-related inhibitory control. In addition, correlations were found between Food Addiction and severity of depressive symptoms, internet use disorder, and psychological distress.

Conclusion: A relevant subgroup of participants experiences Food Addiction even when controlling for Binge-Eating-Disorder and Bulimia Nervosa. Future studies are warranted that investigate whether Food Addiction affects treatment success.

Perfectionism Patterns, Dark Personality, and Exercise Addiction Trend in High-Intensity Sports

The present work tries to describe the relationships among perfectionism, dark traits of personality, and exercise addiction and according to highly intense sports. Following research on perfectionism in sport, its dysfunctional facet is based on a continuous and negative cognitive-evaluative judgement about the difficulties to achieve the accomplishment of tasks or behaviors that improve their sport performance, describing how athletes configure altered thoughts or cognitive resources in their sport experiences. The Spanish versions of the Multidimensional Perfectionism Scale, the Short Dark Triad Scale, and the Exercise Addiction Inventory were applied in a sample of 462 Spanish amateur athletes (39.6% women and 60.4% men). The findings show that a more maladaptive perfectionist pattern (concern over mistakes and external criticism) is related to higher levels of dark personality traits and a greater risk of exercise addiction. However, there are no differences between runners and CrossFit users on the subject of perfectionism, dark traits, and exercise addiction scores.

Diet-induced obesity leads to alterations in behavior and gut microbiota composition in mice

The high prevalence of obesity and associated metabolic disorders are one of the major public health problems worldwide. Among the main causal factors of obesity, excessive consumption of food rich in sugar and fat stands out due to its high energy density. The regulation of food intake relies on hypothalamic control by the action of several neuropeptides. Excessive consumption of hypercaloric diets has impact in the behavior and in the gut microbiota. In the present study, we used a high-sugar and fat (HSB) diet for 12 weeks to induce obesity in C57BL/6 mice and to investigate its effects on the gut microbiota, hypothalamic peptides, and behavior. We hypothesize that chronic consumption of HSB diet can change the behavior. Additionally, we also hypothesize that changes in gut microbiota can be associated with changes in the transcriptional regulation of hypothalamic peptides and behavior. To evaluate the gut microbiota, we performed the sequencing of 16S rRNA gene, which demonstrate that HSB diet modulates the gut microbiota with an increase in the Firmicutes and Actinobacteria phylum and a decrease of Bacteroidetes phylum. The real time qPCR revealed that HSB-fed mice presented changes in the transcriptional regulation of hypothalamic neuropeptides genes such as Npy, Gal and Galr1. The Marble-burying and Light/dark box tests also showed an alteration in anxiety and impulsive behaviors for the HSB-fed mice. Our data provides evidence that obesity induced by HSB diet consumption is associated with alterations in gut microbiota and behavior, highlighting the multifactorial characteristics of this disease.

Converging vulnerability factors for compulsive food and drug use

Highly palatable foods and substance of abuse have intersecting neurobiological, metabolic and behavioral effects relevant for understanding vulnerability to conditions related to food (e.g., obesity, binge eating disorder) and drug (e.g., substance use disorder) misuse. Here, we review data from animal models, clinical populations and epidemiological evidence in behavioral, genetic, pathophysiologic and therapeutic domains. Results suggest that consumption of highly palatable food and drugs of abuse both impact and conversely are regulated by metabolic hormones and metabolic status. Palatable foods high in fat and/or sugar can elicit adaptation in brain reward and withdrawal circuitry akin to substances of abuse. Intake of or withdrawal from palatable food can impact behavioral sensitivity to drugs of abuse and vice versa. A robust literature suggests common substrates and roles for negative reinforcement, negative affect, negative urgency, and impulse control deficits, with both highly palatable foods and substances of abuse. Candidate genetic risk loci shared by obesity and alcohol use disorders have been identified in molecules classically associated with both metabolic and motivational functions. Finally, certain drugs may have overlapping therapeutic potential to treat obesity, diabetes, binge-related eating disorders and substance use disorders. Taken together, data are consistent with the hypotheses that compulsive food and substance use share overlapping, interacting substrates at neurobiological and metabolic levels and that motivated behavior associated with feeding or substance use might constitute vulnerability factors for one another. This article is part of the special issue on 'Vulnerabilities to Substance Abuse'.

The manifestation of emotional distress: Correlations between self-compassion and self-mutilation in Brazilian women with disordered eating behavior

BACKGROUND

The functions or motives for self-mutilation behavior (SMB) in Eating Disorders are diverse, and the relationship with self-compassion is unclear. Objectives This study aims to evaluate the relationship between SMB and Self-compassion.

METHODS

251 women aged 25.8 years (SD=5.94) and 73.54kg (SD=19.33) completed measures for Binge Eating (BE), Self-Compassion, and SMB.

RESULTS

In the total evaluated, 83.27% (n=209) presented BE and 94.02% (n=236) presented at least 1 type of SMB. In comparison between groups, the BE-purging one's reached higher values for BE, and less self-compassion, while BE group presented higher self-compassion values. For the BE-purging group, the behaviors "Cut or carving skin", "Hitting self", "Pulling out one's hair", "Burning skin" and "Picking areas of the body to the point of drawing blood" showed inverse correlations with self-compassion.

CONCLUSION

There is an inverse correlation between self-compassion and SMB, and SMB seems to have different functions between BE-purging group vs. BE group.

The FODRAT study (FOod addiction, DRugs, Alcohol and Tobacco): first data on food addiction prevalence among patients with addiction to drugs, tobacco and alcohol

OBJECTIVES

The main focus of this study was to evaluate the prevalence of food addiction (FA) in a population of 575 subjects, all affected by drugs, alcohol and/or tobacco addiction.

METHODS

Patients were enrolled in Addiction Service Centers and 25 items YFAS questionnaire was administered. Prevalence of FA was studied among patients who already have an addiction and then this prevalence was compared between groups of abusers (by type of substance), comparing mono abusers with polyabusers, as well as regressions by age, BMI, sex, through multiple regression analysis.

RESULTS

Prevalence of FA in the sample is 20.17%. Risk of FA increases with the number of substances used (polyabuse). Results show a positive correlation, in addicted people, between BMI values and FA, with significant values (OR 1.08; 95% CI 1.04-1.13; p = 0.006). Age is inversely correlated with FA (OR 0.97; 95% CI 0.95-0.99; p = 0.01). Female sex is positively associated (OR 2.60; 95% CI 1.59-4.27, p = 0.000). No significant association appears with any substance, even if the highest prevalence is recorded among cannabis users (31.03%), and heroin (21.07%), followed by cocaine (18.53%), alcohol (14.49%) and tobacco (11.61%). A comparison between the FA prevalence in our study and that from another study in the Italian general population (11%) shows a significant difference (p < 0.001).

CONCLUSIONS

Prevalence of FA among addicted people is greater than in the general population. Risk of FA increases with the increase in number of used substances (polyabuse). Age is inversely correlated with FA. There is a positive and significant correlation between BMI and FA among substance/tobacco abusers.

LEVEL OF EVIDENCE

Level V, observational cross-sectional descriptive study.

Anxiety: phenomenology, epidemiology, and risk factors during the novel coronavirus SARS-CoV-2 (COVID-19) pandemic

The COVID-19 coronavirus pandemic in 2020 led to significant negative social consequences associated inter alia with adverse effects on mental health. One of the most common mental illness is anxiety disorders, the rise in which is characteristic of social upheaval periods. This paper analyzes the problem of anxiety, reviews information on the epidemiology of anxiety, on the factors and mechanisms of its development. It unveils the association of anxiety with addictive disorders, lifestyle factors, and traumatic childhood experience and highlights the problem of increased anxiety in the context of the novel coronavirus COVID-19 pandemics in Russia.

The Effectiveness of Supportive Psychotherapy in Weight Loss in a Group of Young Overweight and Obese Women

Overweight and obesity are among the most widespread health problems worldwide. The primary cause of obesity is an inability to control overeating. Therefore, today, obesity needs to be treated more as an eating disorder, i.e., a mental disorder, and thus, it should be approached as such. Taking the above together, this study aimed to assess the impact of supportive psychotherapy on reducing body weight in young overweight and obese women who attempted slimming therapy and, additionally, the possibility of maintaining the weight-loss effect in the long term. Sixty young women aged 20–30 were randomized into three groups that differed in therapeutic management. With the help of an individually selected diet plan, the highest effectiveness in weight loss was demonstrated in people whose weight reduction was supported by goal-oriented psychotherapy. In this group, a sustained effect of slimming and even further weight loss were observed six months following the discontinuation of the therapy. In conclusion, traditional slimming therapies using an individual diet plan and a dietitian’s care are effective; however, supportive psychotherapeutic work provides more beneficial results and maintains the change from a long-term perspective.

Psychiatric morbidity and dietary habits during COVID-19 pandemic: a cross-sectional study among Egyptian Youth (14–24 years)

Background

The coronavirus disease 2019 (COVID-19) is influencing all segments of society, including youth. Although the physical complaints in the time of COVID-19 are broadly-studied, a paucity of research targeted psychological ones on the precious youth population. This study aimed to describe the real-time state of Egyptian youth’s psychiatric morbidity, dietary changes, and coping methods during this pandemic and explore probable factors influencing them. A descriptive cross-sectional study was conducted using an online survey among 447 Egyptian participants aged 14–24 years. Sociodemographic data, dietary habits, and coping methods during COVID-19 were collected. The Arabic versions of the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder Scale (GAD-7), and the Insomnia Severity Index (ISI) were used to assess depression, anxiety and insomnia, respectively.

Results

Overall, 80.5%, 74.0%, and 73.8% of the participants had different grades of depression, anxiety, and insomnia symptoms. 37.4% gained weight. Emotional and night eating emerged as new habits during the pandemic among 17.9% and 29.3% of the participants, respectively. Each of depression, anxiety, and insomnia was significantly associated with each other, female gender and having a COVID-19 infected relative. Adolescents had significantly higher scores of depression and anxiety. Those with a history of physical illness had significantly higher scores of anxiety and insomnia. Bodyweight and dietary changes were significantly associated with depression, anxiety, and insomnia. Participants reported various positive and negative coping methods.

Conclusion

Psychiatric morbidity and dietary changes are evident in young people during COVID-19 pandemic. Psychological well-being and dietary habits are important but often overlooked components of youth well-being especially in challenging times. Depression, anxiety, and insomnia were almost always present and dietary changes were significantly associated with the presence of them.

Vulnerability to addiction

Addiction is a chronic brain disease that has dramatic health and socioeconomic consequences worldwide. Multiple approaches have been used for decades to clarify the neurobiological basis of this disease and to identify novel potential treatments. This review summarizes the main brain networks involved in the vulnerability to addiction and specific innovative technological approaches to investigate these neural circuits. First, the evolution of the definition of addiction across the Diagnostic and Statistical Manual of Mental Disorders (DSM) is revised. We next discuss several innovative experimental techniques that, combined with behavioral approaches, have allowed recent critical advances in understanding the neural circuits involved in addiction, including DREADDs, calcium imaging, and electrophysiology. All these techniques have been used to investigate specific neural circuits involved in vulnerability to addiction and have been extremely useful to clarify the neurobiological basis of each specific component of the addictive process. These novel tools targeting specific brain regions are of great interest to further understand the different aspects of this complex disease. This article is part of the special issue on 'Vulnerabilities to Substance Abuse.'.

On the Role of Central Type-1 Cannabinoid Receptor Gene Regulation in Food Intake and Eating Behaviors

Different neuromodulatory systems are involved in long-term energy balance and body weight and, among these, evidence shows that the endocannabinoid system, in particular the activation of type-1 cannabinoid receptor, plays a key role. We here review current literature focusing on the role of the gene encoding type-1 cannabinoid receptors in the CNS and on the modulation of its expression by food intake and specific eating behaviors. We point out the importance to further investigate how environmental cues might have a role in the development of obesity as well as eating disorders through the transcriptional regulation of this gene in order to prevent or to treat these pathologies.

Locked on salt? Excessive consumption of high-sodium foods during COVID-19 presents an underappreciated public health risk: a review

Abrupt changes in food preferences and eating habits have induced an overlooked health risk during the coronavirus disease pandemic (COVID-19). Indeed, emerging evidence points to a major shift to consumption of high-sodium foods during the pandemic lockdowns in the population from different countries and cultures. High-sodium foods have sodium contents exceeding 500 mg per 100 g, and many processed and preserved foods fall into this category. Excessive dietary sodium intake is associated with chronic diseases including hypertension, cardiovascular diseases, and kidney diseases, and thus poses confounding risks during the pandemic. Here, we review food categories in consumers' shopping lists and food parcels delivered to people who needed assistance during the pandemic, when frozen meals, canned foods, instant foods, snacks, and other high-sodium foods gained substantial popularity. Such change in consumers' behavior is driven by several factors: the perceived risk of viral infection in grocery shopping trips, limited supplies and inflated prices of fresh produce, preference on foods with long shelf lives, and emotional eating. Moreover, the general low awareness of sodium contents in food has contributed to the increased consumption of high-sodium foods during the pandemic. We also discuss the possible effects on COVID-19 infection and severity caused by excessive sodium intake. We conclude that the public should be educated to maintain a healthy sodium intake during the pandemic, and measures should be adopted by governments and private donors in procuring food parcels with more balanced sodium contents to lower the risks of prolonged and excessive sodium intakes in the vulnerable population.

Substance Use Disorders and Behavioral Addictions During the COVID-19 Pandemic and COVID-19-Related Restrictions

COVID-19 was first identified in Wuhan, China in December of 2019 and appeared in the United States 1 month later. Between the onset of the pandemic and January 13, 2021, over 92 million people have tested positive for the virus and over 1.9 million people have died globally. Virtually every country in the world has been impacted by this virus. Beginning in March 2020, many U.S. state governments enforced a "quarantine" to respond to the growing health crisis. Citizens were required to remain at home; schools, restaurants, and non-essential businesses were forced to close, and large gatherings were prohibited. Americans' lives were transformed in a span of days as daily routines were interrupted and people were shuttered indoors. Mounting fear and unpredictability coupled with widespread unemployment and social isolation escalated anxiety and impacted the mental health of millions across the globe. Most (53%) U.S. adults reported that the coronavirus outbreak has had a negative impact on their mental health, including inducing or exacerbating use of alcohol, drugs, gambling and overeating as coping mechanisms. In this paper, we will examine substance use and addictive behaviors that have been used to manage the stress and uncertainty wrought by the COVID-19 pandemic. We review the changing treatment landscape as therapy pivoted online and telemedicine became the norm.

Existe uma relação entre autocompaixão e adição à comida em mulheres com comportamentos alimentares disfuncionais?

RESUMO Objetivo: Verificar a relação entre autocompaixão e adição à comida em mulheres com comportamento alimentar disfuncional. Métodos: Mulheres de um grupo de apoio completaram as escalas de compulsão alimentar, restrição cognitiva, autocompaixão, Escala de Adição à Comida de Yale versão modificada 2.0 (YFAS 2.0) e questionário de Hay para práticas compensatórias. Foram identificados a prevalência de adição à comida e sintomas segundo a YFAS. Para serem incluídas, as participantes deveriam atingir pontuação para compulsão alimentar e, para análises, foram divididas em função da presença de práticas compensatórias. O grupo foi analisado por meio de testes de correlação de Pearson entre variáveis de interesse, e os grupos bulímico e compulsivo foram comparados com teste t de Student (p < 0,05; software JASP). Resultados: Participaram do estudo 190 mulheres. De acordo com a YFAS, 95,3% (n = 181) tinham adição à comida, e os escores da escala apresentaram correlação negativa com a autocompaixão e com a compulsão alimentar (p = 0,014 em ambas). Os níveis de autocompaixão apresentaram correlação negativa com as questões #3, #5, #6, #8 e #9 da YFAS (p < 0,05). Conclusões: Este estudo traz dados para a discussão da necessidade de analisar como a autocrítica atrelada ao sofrimento de quem apresenta comportamento alimentar disfuncional afeta o preenchimento da escala, trazendo identificação com a noção de vício, já que esta é culturalmente aceita.

Mid-adolescent stress differentially affects binge-like intake of sucrose across estrous cycles in female rats✰

Binge eating disorder (BED), characterized by excessive food consumption within a discrete period of time, is the most prevalent of all eating disorders, with higher rates in women than men. Chronic stress, particularly during adolescence, is a significant risk factor for BED in women, but the mechanism underlying this relationship remains elusive. We investigated the phenomenon by testing the impact of mid-adolescent intermittent physical stress (IPS) on binge-like intake of sucrose in adult female rats, assessing how the behavior changed across reproductive cycles. One hundred and nineteen Long-Evans rats were exposed to IPS (n = 59) or no stress (NS; n = 60) for 12 days during mid-adolescence (PD35-46). Binge-like eating was induced in adult animals using an intermittent access protocol: animals were provided with 12 h or 24 h access to sucrose, 12 h access to saccharin, or 12 h access to food over 28 days. After 1- or 28-day abstinence, compulsive responding for sucrose was measured using a conditioned suppression paradigm. Rats given 12 h access to sucrose developed binge-like intake, measured as increased consumption during the first hour; the effect was magnified in IPS animals and most pronounced during proestrous. Solution intake in IPS rats was predicted by open arm entries in the elevated plus maze, suggesting that increased risk-taking behavior is associated with greater binge-like eating. IPS blocked conditioned suppression after 28 days of abstinence, pointing to a role of mid-adolescent stress in compulsivity. Collectively, these findings emphasize the impact of stress on the emergence of binge eating in females and suggest that intervention programs for women with a history of adolescent adversity should be investigated as a means to reduce risk for BED.

The Psycho-Affective Roots of Obesity: Results from a French Study in the General Population

The aim of the study was to examine the extent to which obese people differ in their emotionally driven and addictive-like eating behaviors from normal-weight and overweight people. A total of 1142 participants were recruited from a general population, by a web-based cross-sectional survey assessing anxiety/depression (Hospital Anxiety and Depression Scale), emotional eating (Emotional Appetite Questionnaire), food addiction (modified Yale Food Addiction Scale), and intuitive eating (Intuitive Eating Scale-2). The statistical design was based on analyses of (co)variance, correlograms, and mediations. A set of Body Mass Index (BMI) group comparisons showed that obese people reported higher levels of depression and emotional eating and that they experienced more severe and frequent food addiction symptoms than overweight and normal-weight people. Associations between anxiety, depression, food addiction symptoms’ count, and the difficulties to rely on hunger and satiety cues were found across all weight classes, suggesting that addictive-like eating may represent a unique phenotype of problematic eating behavior that is not synonymous with high BMI or obesity. Conversely, the interrelation between anxiety/depression, emotional eating, and the difficulties to rely on hunger and satiety cues was found only among obese participants, and negative emotional eating mediated the association between depression and anxiety and the difficulties to rely on hunger and satiety cues. This study emphasizes the necessity to develop more comprehensive approaches integrating emotional dysregulation and addictive-like eating behaviors to improve weight management and quality of life of obese people.

Underlying Susceptibility to Eating Disorders and Drug Abuse: Genetic and Pharmacological Aspects of Dopamine D4 Receptors

The dopamine D4 receptor (DRD4) has a predominant expression in the prefrontal cortex (PFC), brain area strictly involved in the modulation of reward processes related to both food and drug consumption. Additionally, the human DRD4 gene is characterized by a variable number of tandem repeats (VNTR) in the exon 3 and, among the polymorphic variants, the 7-repeat (7R) allele appears as a contributing factor in the neurobiological mechanisms underlying drug abuse, aberrant eating behaviors and related comorbidities. The 7R variant encodes for a receptor with a blunted intracellular response to dopamine, and carriers of this polymorphism might be more tempted to enhance dopamine levels in the brain, through the overconsumption of drugs of abuse or palatable food, considering their reinforcing properties. Moreover, the presence of this polymorphism seems to increase the susceptibility of individuals to engage maladaptive eating patterns in response to negative environmental stimuli. This review is focused on the role of DRD4 and DRD4 genetic polymorphism in these neuropsychiatric disorders in both clinical and preclinical studies. However, further research is needed to better clarify the complex DRD4 role, by using validated preclinical models and novel compounds more selective for DRD4.

Psychological Aspects and Eating Habits during COVID-19 Home Confinement: Results of EHLC-COVID-19 Italian Online Survey

The COVID-19 pandemic has had a huge impact on the population with consequences on lifestyles. The aim of the study was to analyse the relationship between eating habits, mental and emotional mood. A survey was conducted online during social isolation, from 24 April to 18 May 2020, among the Italian population. A total of 602 interviewees were included in the data analysis. A high percentage of respondents experienced a depressed mood, anxious feelings, hypochondria and insomnia (61.3%, 70.4%, 46.2% and 52.2%). Almost half of the respondents felt anxious due to the fact of their eating habits, consumed comfort food and were inclined to increase food intake to feel better. Age was inversely related to dietary control (OR = 0.971, p = 0.005). Females were more anxious and disposed to comfort food than males (p < 0.001; p < 0.001). A strength of our study was represented by the fact that the survey was conducted quickly during the most critical period of the Italian epidemic lockdown. As the COVID-19 pandemic is still ongoing, our data need to be confirmed and investigated in the future with larger population studies.

Consensus among experts on healthy eating and diet quality index

Abstract The article aims to achieve a consensus about Healthy Eating and Diet Quality Index to enable a validation study on the Diet Quality Index. Experts were identified among authors of articles published from 2010 to 2015 that presented the key worlds healthy eating index and diet quality index. The query was carried out by combining the Delphi technique with the Likert method. To determine a consensus, at least three of the following criteria had to be met: minimum score in each statement (≥ 3,00); standard deviation (< 1,5); frequency of agreement (≥ 51%) and differences between interquartile ranges (< 1,0). Topics regarding Highly palatable foods, oilseeds, and Meat and eggs did not arrived at a consensus in the first round. Experts proposed new themes: Gluten, Meal frequency, Alcohol consumption, and Including nutrients in the diet quality index. Although quality and risk markers in diet are periodically studied, it was only possible to reach consensus on subjects such as fruits, vegetables, milk and dairy products, legumes, and oilseeds as quality markers after theoretical justification. Processed and ready-to-eat foods, highly palatable foods, excessive sweets and fats, and alcohol were readily identified as risk factors.

Pre-clinical models of reward deficiency syndrome: A behavioral octopus

Individuals with mood disorders or with addiction, impulsivity and some personality disorders can share in common a dysfunction in how the brain perceives reward, where processing of natural endorphins or the response to exogenous dopamine stimulants is impaired. Reward Deficiency Syndrome (RDS) is a polygenic trait with implications that suggest cross-talk between different neurological systems that include the known reward pathway, neuroendocrine systems, and motivational systems. In this review we evaluate well-characterized animal models for their construct validity and as potential models for RDS. Animal models used to study substance use disorder, major depressive disorder (MDD), early life stress, immune dysregulation, attention deficit hyperactivity disorder (ADHD), post traumatic stress disorder (PTSD), compulsive gambling and compulsive eating disorders are discussed. These disorders recruit underlying reward deficiency mechanisms in multiple brain centers. Because of the widespread and remarkable array of associated/overlapping behavioral manifestations with a common root of hypodopaminergia, the basic endophenotype recognized as RDS is indeed likened to a behavioral octopus. We conclude this review with a look ahead on how these models can be used to investigate potential therapeutics that target the underlying common deficiency.

Food addiction in young adult residents of Russia: Associations with emotional and anthropometric characteristics

The incidence of food addiction (FA) and associations between FA and anthropometric and psycho-emotional characteristics of young Russian adults were studied. In this study, 1,237 students (age, M = 20.6, SD = 4.6 years; 79% females) of universities located in four cities of Russia were attended. They provided demographics and filled in the Yale Food Addiction Scale (YFAS), the Dutch Eating Behavior Questionnaire, and the Zung Self-Rating Depression Scale. Data were analysed via Chi-squared tests, logistic regression analysis, and an analysis of covariance. 13.2% of participants met diagnostic criteria for FA based on the YFAS. On average, the participants reported 2.6 FA symptoms (SD = 1.5). FA was more commonly detected in females (OR = 1.86, 95% CI = 1.10, 3.15, p = .021). No relationship was found between age and the incidence of FA. Significant positive associations between FA, the severity of depression (OR = 2.31, 95% CI = 1.91, 2.80, p = .000), and an emotional eating behaviour (OR = 1.45, 95% CI = 1.20, 1.76, p = .000) were found. The waist-to-height ratio was found to be the anthropometric indicator most closely associated with FA (OR = 1.49, 95% CI = 1.27, 1.76, p = .000). HIGHLIGHTS: The prevalence of food addiction in the current sample was 13.2%. In young Russian adults, emotional eating behaviour and depression are associated with food addiction. In young Russian adults, the waist-to-height ratio is the anthropometric indicator most closely associated with food addiction.

Insula to ventral striatal projections mediate compulsive eating produced by intermittent access to palatable food

Compulsive eating characterizes many binge-related eating disorders, yet its neurobiological basis is poorly understood. The insular cortex subserves visceral-emotional functions, including taste processing, and is implicated in drug craving and relapse. Here, via optoinhibition, we implicate projections from the anterior insular cortex to the nucleus accumbens as modulating highly compulsive-like food self-administration behaviors that result from intermittent access to a palatable, high-sucrose diet. We identified compulsive-like eating behavior in female rats through progressive ratio schedule self-administration and punishment-resistant responding, food reward tolerance and escalation of intake through 24-h energy intake and fixed-ratio operant self-administration sessions, and withdrawal-like irritability through the bottle brush test. We also identified an endocrine profile of heightened GLP-1 and PP but lower ghrelin that differentiated rats with the most compulsive-like eating behavior. Measures of compulsive eating severity also directly correlated to leptin, body weight and adiposity. Collectively, this novel model of compulsive-like eating symptoms demonstrates adaptations in insula-ventral striatal circuitry and metabolic regulatory hormones that warrant further study.

Reward sensitivity deficits in a rat model of compulsive eating behavior

Compulsive eating behavior is hypothesized to be driven in part by reward deficits likely due to neuroadaptations to the mesolimbic dopamine (DA) system. Therefore, the aim of this study was to assess deficits in reward system functioning and mesolimbic DA after alternating a standard chow with palatable diet, a model of compulsive eating. In this model, rats in the control group (Chow/Chow) are provided a standard chow diet 7 days a week, while the experimental group (Chow/Palatable) is provided chow for 5 days a week ("C Phase"), followed by 2 days of access to a highly palatable sucrose diet ("P Phase"). We first tested the sensitivity to d-Amphetamine's stimulatory, reward-enhancing, and primary rewarding effects using a locomotor activity assay, an intracranial self-stimulation (ICSS) procedure, and a conditioned place preference test, respectively. We then quantified DA release in the nucleus accumbens (NAc) shell after treatment with d-Amphetamine using in vivo microdialysis, quantified levels of tyrosine hydroxylase (TH) and dopamine transporter (DAT) mRNA using quantitative polymerase chain reaction (qPCR), and lastly, quantified baseline extracellular DA and function of DAT in vivo using quantitative "no-net-flux" microdialysis. Chow/Palatable rats displayed blunted d-Amphetamine-induced locomotor activity, insensitivity to d-Amphetamine potentiation of ICSS threshold, and decreased place preference for d-Amphetamine during the P Phase. We found that Chow/Palatable rats had blunted DA efflux following d-Amphetamine treatment. Furthermore, DAT mRNA was increased in Chow/Palatable rats during the P Phase. Finally, quantitative "no-net-flux" microdialysis revealed reduced extracellular baseline DA and DAT function in Chow/Palatable rats. Altogether, these results provide evidence of reduced reward system functioning and related neuroadaptations in the DA and DAT systems in this model of compulsive eating. Reward deficits, resulting from repeated overeating, may in turn contribute to the perpetuation of compulsive eating behavior.

Development of the Modified Yale Food Addiction Scale Version 2.0 summary version in a representative sample of Czech population

BACKGROUND

Food addiction receives attention because of its participation in the rising obesity prevalence that affects the quality of life. The Czech Republic's prevalence of obesity belongs to the highest in Europe.

METHODS

We used the nationally representative non-clinical sample of 1841 respondents (N = 1841; 48,8% of men and 51.2% of women). Participants filled the sociodemographic questionnaire, Czech version of mYFAS 2.0 and the Relationship Questionnaire (RQ) to test the hypothesis.

RESULTS

Confirmatory Factor Analysis showed that the single-factor model of Czech version of mYFAS 2.0 had adequate fit indices (χ² (55) = 9670.8, p <  0.001; CFI, TLI > 0.95; SRMR < 0.07; and RMSEA < 0.08). The sample reliability in our research corresponded to Cronbach's α = 0.89 (95% CI 0.88-0.90). The youngest population (aged 15-19) had a significantly higher score of mYFAS 2.0, than the older age groups. People living alone scored significantly higher than the married respondents. The middle-income groups scored significantly lower in mYFAS 2.0 than the lowest income group. Occasional (social) smokers showed a higher mYFAS 2.0 score in comparison with non-smokers. A difference regarding attachment styles has also been revealed, respondents characterized by insecure attachment styles showed a higher YFAS score.

CONCLUSION

The findings reinforce future work on the Czech version of mYFAS 2.0, including validation and using mYFAS 2.0 to explore food addiction and its related variables and attachment styles in the Czech environment.

Pleiotropic pituitary adenylate cyclase-activating polypeptide (PACAP): Novel insights into the role of PACAP in eating and drug intake

Pituitary adenylate cyclase-activating polypeptide (PACAP) was discovered thirty years ago, but its role in eating and drug use disorders has only recently begun to be investigated. The present review develops the hypothesis that, although PACAP normally functions to tightly regulate intake, inhibiting it through negative feedback, this relationship can become dysregulated with the development of dependence, such that PACAP instead acts through positive feedback to promote excessive intake. We propose that repeated exposure to palatable food and drugs of abuse can alter the downstream responses of specific populations of neurons to stimulation by PACAP, leading to the perpetuation of the addiction cycle. Thus, this review will first describe published literature on homeostatic food intake, which shows that PACAP suppresses food intake, while its levels are themselves increased by overfeeding. Next, it will present literature on palatable food, cocaine, alcohol, and nicotine, which overall demonstrates that PACAP in specific limbic brain regions can promote their seeking and intake and itself is stimulated by their intake. Then, it will present literature on affective behavior, which shows that chronic stress increases levels of PACAP, which then promotes anxiety and depression, factors that can trigger substance seeking. Finally, the review will address mechanisms through which chronic substance exposure may dysregulate the PACAP system, proposing that it alters expression of PACAP receptor splice variants. While many questions remain to be addressed, the current evidence suggests that PACAP could be a viable medication target for the treatment of binge eating and drug and alcohol use disorders.