Body Image, Food Addiction, Depression, and Body Mass Index in University Students

Determination of body image and self-efficacy levels in patients after cornea transplantation

PURPOSE

The study aimed to determine body image and levels after surgery in cornea transplant patients.

MATERIALS AND METHODS

The population of this cross-sectional study was composed of 383 patients presented to the Eye Bank unit of a University Hospital after corneal transplantation. Sample size of 193 patients was calculated with 0.5 power, a margin of error of 5%, representing 95% of the universe. The data were collected through face-to-face interviews with the patients by the researcher and the study was completed with 178 patients in September-November 2022. The data were collected using a Patient Information Form, the Body Image Scale, and the General Self-Efficacy Scale. Parametric tests, Pearson Correlation, Student's t-test, and One-Way Analysis of Variance tests were performed were used in the data analysis.

RESULTS

It was determined that the mean Body Image Scale score of the transplant patients participating in the study was 159.41 ± 36.99 and the mean Self-Efficacy Scale score was 30.37 ± 8.31. When the comparison of the mean scores was examined, the difference between the mean scores of gender, marital status, occupation, and body image scale was statistically significant (p < .05), while the difference between the self-efficacy mean scores was not statistically significant (p > .05). There was a positive, moderately strong significant relationship between body image and the self-efficacy of the patients (p < .01) (r = .57).

CONCLUSION

It was found that the patient's body image and self-efficacy levels were high, and self-efficacy increased as the body image increased.

Independent associations of food addiction and binge eating measures with real-time eating behaviors and contextual factors: An exploratory ecological momentary assessment study

Food addiction (FA) is a concept centered around the addictive potential of highly palatable processed foods, though there is debate over the discriminative validity of FA as a distinct construct from binge-eating symptomatology. This study explored how trait measures of FA and binge-eating symptoms independently and interactively predicted eating behaviors and posited correlates of FA and binge eating measured via ecological momentary assessment (EMA). Adult participants (N = 49) who met the criteria for FA and/or binge-eating disorder completed baseline measures of FA (Yale Food Addiction Scale [YFAS 2.0]) and binge-eating symptoms (Eating Pathology Symptom Inventory [EPSI] binge eating scale) followed by a 10-day EMA protocol. Generalized linear mixed models examined the independent effects of YFAS 2.0, EPSI, and their interaction predicting EMA outcomes. Higher YFAS 2.0 symptom count scores were uniquely related to greater EMA-measured overeating, loss of control eating, negative and positive affect, and impulsivity when controlling for EPSI scores. Conversely, higher EPSI scores were uniquely related to greater EMA-measured eagerness and urge to eat, and expectancies that eating would improve mood. No interaction effects were significant. These results highlight potential distinctions between phenomena captured by FA and other measures of binge eating, in that FA symptoms may be a marker of heightened binge-eating severity, emotional arousal, and impulsivity.

Effect of body-related information on food attentional bias in women with body weight dissatisfaction

Women with body weight dissatisfaction (BWD) have long-term negative assessments of their body weight, which are often associated with poor eating behavior. In this study, we investigated the effect of body-related information on the food cue processing and attention of women with BWD. Sixty-eight women were recruited and assigned to either a BWD (NPSS-F > 2) (n = 32) or a no body weight dissatisfaction (NBWD) group (NPSS-F < 1) (n = 36). We measured attentional bias to food cues (high- and low-calorie) with a food probe task after exposure to body-related information and recorded eye tracking data. Body-related images were presented prior to a pair of stimulus images (food-neutral or neutral-neutral). Body-related information and food type were repeated measure factors in our study. Our results showed that the first fixation duration bias for high-calorie foods was significantly longer than for low-calorie foods after exposure to overweight cues in the BWD group. Compared with the NBWD group, the BWD group showed longer first fixation duration bias for high-calorie foods after exposure to overweight cues. The direction for high-calorie foods was significantly more often than that for low-calorie foods in the BWD group after exposure to body-related information. Our findings suggest that compared to women with NBWD, women with BWD may be more susceptible to body-related information, resulting in increased attention to high-calorie foods.

Food addiction and dietary restraint in postpartum women: The role of childhood trauma exposure and postpartum depression

The early postpartum period is a sensitive time for understanding women's high-risk eating (i.e., eating behavior associated with negative health outcomes) given potential long-term eating behavior implications for infants. Food addiction and dietary restraint are two high-risk eating phenotypes associated with long-term negative health outcomes that have been theoretically linked. Yet, no research has considered how much these constructs overlap during the early postpartum period. The present study sought to characterize these two high-risk eating phenotypes in postpartum women to examine whether these are distinct constructs with specific etiologies and to inform future targets of intervention. Women (N = 277) in the early postpartum period reported on high-risk eating, childhood trauma exposure, depression symptoms, and pre-pregnancy weight. Women's height was measured and pre-pregnancy BMI was calculated. We conducted bivariate correlations and path analysis to characterize the relationship between food addiction and dietary restraint, controlling for pre-pregnancy BMI. Results showed that food addiction and dietary restraint were not significantly associated and that women's childhood trauma exposure and postpartum depression were associated with food addiction but not dietary restraint. Sequential mediation revealed that higher levels of childhood trauma exposure were associated with worse postpartum depression and, in turn, greater food addiction during the early postpartum period. Findings suggest that food addiction and dietary restraint have distinct psychosocial predictors and etiological pathways, which suggests important construct validity differences between the two high-risk eating phenotypes. Interventions seeking to address food addiction in postpartum women and mitigate the impact of this high-risk eating phenotype on the next generation may benefit from treating postpartum depression, especially in women with histories of childhood trauma exposure.

Childhood environment and adulthood food addiction: Testing the multiple mediations of life history strategies and attitudes toward self

Food addiction is associated with both physical and mental health conditions, such as obesity and depression, and is considered a public health problem. Based on life history (LH) theory, this study aimed to test the association between unpredictable childhood environment and food addiction in adulthood and to examine LH strategies and attitudes toward self as psychological mediators of this association. A random sample of 1010 adults, aged from 18 to 88 years (44.8% male; Mage = 38.52, SDage = 14.53), voluntarily participated in an anonymous telephone survey conducted in Macao, China. The results of a path analysis showed the significant and positive direct effect of childhood unpredictability on food addiction and its negative association with slow LH strategy, which in turn was negatively correlated with food addiction. In addition, slow LH strategy and self-judgment, rather than self-kindness, acted as serial mediators in the association between childhood unpredictability and food addiction. These findings support the applicability of LH theory to understanding food addiction, as well as pointing to the potential risk effect of self-judgment for food addiction in adulthood. Self-judgment reduction may be a potential supplementary approach for future food addiction intervention.

The Impact of Ashwagandha on Stress, Sleep Quality, and Food Cravings in College Students: Quantitative Analysis of a Double-Blind Randomized Control Trial

The purpose of this study was to examine the impact of ashwagandha (ASH) (Withania somnifera) on sleep, perceived stress, and cravings in a college student population. Sixty healthy students were screened/enrolled into a 30-day double-blinded placebo (PLA)-controlled intervention (700 mg daily, full spectrum extract of ASH root). Anthropometrics, demographics, and validated questionnaires assessing physical activity, restorative sleep, perceived stress, and food cravings were assessed before and after the study. Descriptive statistics, Pearson's correlations, and point biserial correlations were used to screen the data. For sleep and stress, a nonsignificant mixed (group × time) multivariate analysis of variance (MANOVA) was followed by one-way MANOVA (time on sleep/stress) and one-way multivariate analysis of covariance (MANCOVA) (group on sleep/stress, using initial sleep as a covariate) as follow-up tests. Further follow-up tests for this MANCOVA showed group membership affected final sleep (58.4 ± 12.4 vs. 48.2 ± 15.0 ASH vs. PLA respectively, P < .05) using initial sleep as a covariate. Initial sleep (confounder) affected final stress, but not final sleep. Mixed analysis of variance (group × time) showed an interaction effect on food cravings, where the ASH group experienced lower cravings than the PLA group over time at end of study. The 30-day intervention was shorter than most other studies where more pronounced stress differences were seen at six weeks, indicating ASH may need the longer time period to show more pronounced stress relieving differences. ASH can be an effective safe intervention in young adult populations to help manage stress and its detrimental impacts on sleep and satiety in as little as 30 days. Clinical Trial Registration number-NCT05430685.

The association between childhood trauma and overweight and obesity in young adults: the mediating role of food addiction

PURPOSE

Childhood trauma is associated with increased risk of obesity during adulthood, which may be associated with the development of food addiction. This study examined whether food addiction mediated the relationship between childhood trauma and obesity in young adults.

METHODS

A sample of 512 young adults, aged 18 to 30 years, living with overweight and obesity (Body Mass Index ≥ 25 kg/m2), from the United Kingdom participated in the study. Participants completed the Childhood Trauma Questionnaire (CTQ), the Yale Food Addiction Scale, and provided their current height and weight to compute their Body Mass Index (BMI).

RESULTS

Using the PROCESS macro, a mediation analysis found that food addiction accounted for 45% of variance in the relationship between childhood trauma and BMI. Post hoc analyses were conducted to examine the mediating effect of food addiction across each of the five subscales of the CTQ (emotional/physical/sexual abuse and emotional/physical neglect). Food addiction accounted for 32% to 51% of the variance in the relationship between each CTQ subscale and BMI.

CONCLUSIONS

These findings suggest that experiences of childhood trauma are associated with the development of overweight and obesity during early adulthood and up to half of this relationship can be attributed to food addiction, which is likely used as a maladaptive coping mechanism in response to trauma. Young adults living with overweight and obesity who report experiences of childhood trauma may benefit from the support of clinical and counselling psychologists to improve their understanding of the underlying psychosocial factors that influence their eating behaviours.

LEVEL OF EVIDENCE

Level V, cross-sectional analytic study.

Food Addiction Problems in College Students: The Relationship between Weight-Related Variables, Eating Habits, and Food Choices

The concept of food addiction, characterized by a strong urge to overeat highly palatable foods, has gained increased research attention over the last decade. College students are a recognized risk group for manifesting an eating pathology and weight gain due to the changes in eating habits experienced during this period. However, there is a gap in the literature connecting food addiction with eating and weight variables in this population. Thus, the present study aims to characterize food addiction in a sample of college students and enlighten the relationship between food addiction, weight-variables, eating habits, and food choices in this population. A sample of 194 college students (89.2% females) aged between 18 and 32 years old (M = 20.85, SD = 2.78) completed a set of self-reported online questionnaires on Google Forms. Namely, a Sociodemographic and Anthropometric Questionnaire, a questionnaire on Food Choices Characterization, the Eating Habits Scale, and the Portuguese Yale Food Addiction Scale 2.0. Thirty (22.2%) participants presented food addiction problems. The logistic regression models utilized suggest that participants in the group with food addiction problems are more likely to seek clinical help to control weight, to consider that they should eat less food high in sugar, and to report lower food adequacy. In sum, this finding highlighted a connection between food addiction, weight dissatisfaction, eating habits, and food choices in college students, a population at risk for developing and retaining eating pathologies. Further research is essential to evaluate and implement interventions regarding food addiction, weight dissatisfaction, eating habits, and food choices in college students.

The influencing factors in food addiction of nursing students: A qualitative study

PURPOSE

This study aims to determine the factors that influence food addiction (FA) in female nursing students.

DESIGN AND METHODS

Twenty-four out of 51 (mean age = 19.8 ± 1.36) women were identified from a sample of 645, who met the diagnostic criteria of FA using the Yale Food Addiction Scale (YFAS), and participated in this qualitative study.

FINDINGS

Results of the study revealed that the factors affecting FA in students were conceptualized under four themes: "Social circle," "Situational and emotional signs," "Cognitive process," and "Weight gain and quality of life."

PRACTICE IMPLICATIONS

It is recommended to offer specific intervention programs including personal or group counseling for those, recognized as having FA based on an addiction model, and to have a successful therapy.

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.

Psychometric properties and convergent and divergent validity of the Portuguese Yale Food Addiction Scale 2.0 (P-YFAS 2.0)

PURPOSE

The construct of food addiction has been gaining increased attention as a research topic. Currently, the Yale Food Addiction Scale 2.0 is the only measure to operationalize the addictive-like eating behavior according to addiction criteria proposed by the Diagnostic and Statistical Manual of Mental Disorders. The present study aimed at examining the psychometric properties of the Portuguese version of the Yale Food Addiction Scale 2.0, as well as investigating the convergent and divergent validity between this scale and the following measures: Eating Disorders Examination Questionnaire, Body Investment Scale, and Difficulties in Emotion Regulation Scale. We also sought to explore the moderator role of difficulties in emotion regulation in the relationship between food addiction and binge eating METHODS: A sample of 302 female college students (M_age = 21.37, SD = 3.24) completed self-report measures.

RESULTS

Sixteen (5.3%) participants were diagnosed as having food addiction. The confirmatory factor analysis suggested that the original one-dimensional structure is adequate to represent the Portuguese Yale Food Addiction Scale 2.0. The symptom count scores of the scale were correlated with body mass index, eating disordered behavior, body investment, and difficulties in emotion regulation. The severity level of the scale also discriminated the severity of eating disordered behaviors, body investment, and difficulties in emotion regulation. Finally, the relationship between food addiction and binge eating was moderated by difficulties engaging in goal-directed behavior when experiencing negative emotions.

CONCLUSION

The Portuguese version of the Yale Food Addiction Questionnaire 2.0 may be a useful tool to investigate food addiction.

LEVEL

IV descriptive studies.

Psychometric properties of the Chinese version of the modified Yale Food Addiction Scale version 2.0 (C-mYFAS 2.0): Prevalence of food addiction and relationship with resilience and social support

PURPOSE

This study aimed to examine the psychometric properties of the Chinese version of the modified Yale Food Addiction Scale 2.0 (C-mYFAS 2.0) and to analyze the prevalence of food addiction among Chinese college students and its relationship with resilience and social support.

METHODS

A total of 1132 Chinese college students completed the C-mYFAS 2.0, BES, EAT-26, PHQ-9, GAD-7, TFEQ-18, CD-RISC-10, and PSSS. Confirmatory factor analysis was used to evaluate the factor structure of the C-mYFAS 2.0 and psychometric properties were assessed. Test-retest reliability was evaluated in a sub-sample (n = 62). Spearman correlation and logistic regression were used to examine the relationship between resilience, social support, and food addiction.

RESULTS

The prevalence of food addiction according to the C-mYFAS 2.0 was 6.2%. Confirmatory factor analyses suggested a single-factor structure (comparative fit index = 0.961). The C-mYFAS 2.0 had good test-retest reliability and internal consistency (Kuder-Richardson's α = 0.824). Good convergent validity was indicated by correlations with binge eating, eating disorder symptoms, depressive symptoms, generalized anxiety symptoms, uncontrolled eating, emotional eating, and BMI (ps < 0.001). Appropriate divergent validity was reflected by no association with cognitive restraint. Finally, binge eating was significantly predicted by C-mYFAS 2.0, depressive symptoms, and eating disorder symptoms (ps < 0.001), confirming incremental validity. In addition, our study found that poorer resilience and social support were related to food addiction (ps < .001).

CONCLUSIONS

The C-mYFAS 2.0 is a brief but reliable and valid screening instrument for food addiction among Chinese college students. In addition, we found that resilience and social support were negatively associated with food addiction.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

The Prevalence of ''Food Addiction'' during the COVID-19 Pandemic Measured Using the Yale Food Addiction Scale 2.0 (YFAS 2.0) among the Adult Population of Poland

The announcement of the coronavirus pandemic by the World Health Organization (WHO), ongoing restrictions and isolation led to a break with the daily routine, and suspension of social contacts, but also imposed new challenges on the population related to maintaining healthy eating habits. The purpose of the study was to assess the prevalence of “food addiction” (FA) during the COVID-19 pandemic in Poland in relation to several variables including depression. The method of analysis was a questionnaire containing original questions and the Yale Food Addiction Scale 2.0 (YFAS). A total of 1022 Polish residents aged 18–75 participated in the study (N = 1022; 93.7% women, 6.3% men). The prevalence of FA during the COVID-19 pandemic measured with the YFAS 2.0 scale was 14.1%. The average weight gain during the pandemic in 39% of respondents was 6.53 kg. Along with the increase in the value of the BMI index, the intensity of “food addiction” increased in the study group. People with depression had statistically significantly more FA symptoms than healthy people. This work may motivate future research to evaluate the association and potential overlap of “food addiction” and problem eating behaviors during the pandemic and the obesity problem.

The Effect of an Obesity Prevention Program on Children's Eating Behaviors, Food Addiction, Physical Activity, and Obesity Status

PURPOSE

This study was carried out to determine the effect of an obesity prevention program on children's eating behaviors, food addiction, physical activity, and obesity prevalence.

DESIGN AND METHODS

A pretest-posttest quasi-experimental design was used in the study. The study was conducted with a total of 128 students, including 55 in the intervention and 73 in the control groups. The obesity prevention program was implemented in the intervention group, and a routine curriculum training program was followed in the control group. The study data were collected before the intervention and in the third, sixth, and fifteenth months after the completion of the intervention. The data were evaluated using the chi-square test, McNeamer test, Cochrane Q test, multivariate analysis of variance in repeated measures, the Bonferroni adjusted paired t-test, power analysis, effect size, and regression analysis.

RESULTS

At the end of the study, it was determined that the body mass index values and food addiction rates of the students in the intervention group were lower than those of the students in the control group (p < .05). There was a significant difference between the mean scores of the students in the intervention and control groups obtained from the eating behavior questionnaire and the physical activity questionnaire in terms of time, group, and group * time interaction (p < .05). Also, the intervention program was found to have a large effect size (0.39) and a strong effect (0.85) on body mass index.

CONCLUSION

The obesity prevention intervention program was found to be effective in increasing children's positive eating behaviors and mean physical activity score and decreasing food addiction rates and body mass index values.

PRACTICE IMPLICATIONS

We recommend that the intervention program implemented in this study should be used widely in the curriculum of the Ministry of Education. This program shows that the school nurse is effective in preventing obesity in children. For this reason, there should be a school nurse in schools for implementing health-promoting education programs.

Association between Subjective Body Image, Body Mass Index and Psychological Symptoms in Chinese Adolescents: A Nationwide Cross-Sectional Study

Background: Conflicting findings were reported about the associations between subjective body image (SBI), body mass index (BMI) and psychological symptoms in China and other countries in the world. In this study, we aim to explore the associations between SBI, BMI, and psychological symptoms based on a large-scale, national wide survey among Chinese adolescents. Methods: The 2014–2015 China Education Panel Survey (CEPS) database, with 8134 middle school students (4137 boys and 3997 girls), was analyzed to explore the association between SBI, BMI and psychological symptoms. SBI was assessed by one question about the perception of own body shape with options “very thin”, “slightly thin”, “average”, “weak heavy”, and “very heavy”. BMI was calculated by the self-reported body weight and height. Psychological symptoms were evaluated by 10 items involving both aspects of depression and anxiety. Results: The results indicated that both boys and girls who perceived weak or very heavy weight were positively associated with psychological symptoms (p < 0.05). For boys, perceiving very thin body image was also in higher risk of psychological symptoms (p < 0.05), after controlling social-demographic variables and BMI. Comparing with normal weight boys or girls, obese boys (β = −2.22, 95% CI −3.37~−1.07) and overweight girls (β = −1.03, 95% CI −2.01~−0.06) were in lower levels of psychological symptoms after controlling for SBI. Other factors associated with psychological symptoms were family economic status, academic performance, and self-rated health status. Conclusions: A deviation from an “average” SBI was positively associated with psychological symptoms, which should be scanned when evaluating the Chinese adolescents’ mental health. These findings provide epidemiological evidence for the association between SBI and psychological symptoms in non-western social contexts.

Translation of the Chinese version of the modified Yale Food Addiction Scale 2.0 and its validation among college students

BACKGROUND

Obesity prevalence has substantially increased in China over the past decade. In China, over 1 in 7 individuals meet the criteria for overall obesity, and 1 in 3 meet the criteria for abdominal obesity, obesity has become a significant problem. Studies have shown that food addiction and obesity are inextricably linked. The modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) is a brief measurement for assessing food addiction. This study aimed to explore the structure of the Chinese version of the mYFAS 2.0 and assess the occurrence of food addiction in a sample of college students in Northeast China.

METHODS

A cross-sectional design was conducted in a sample of 1099 undergraduate students in Northeast China. Participants completed the sociodemographic questionnaire, the Chinese version of the mYFAS 2.0, the Barratt Impulsiveness Scale (BIS-8), and the Self-Esteem Scale (SES) to test the hypothesis. Exploratory factor analysis and confirmatory factor analysis were performed to examine the underlying factor structure of the mYFAS 2.0. Two weeks later, 62 students who participated in the first test were recruited to evaluate the test-retest reliability.

RESULTS

The Chinese version of the mYFAS 2.0 demonstrated adequate internal consistency, good test-retest reliability and satisfactory construct validity. The results of the confirmatory factor analysis found that the Chinese version of the mYFAS 2.0 demonstrated a good fit to the two-factor solution identified by the exploratory factor analysis and showed superior fit indices compared to the one-factor model. The prevalence of food addiction in our sample was found to be in line with rates observed in other Asian and Western samples. The mYFAS 2.0 symptom count scores were correlated with BMI, the idea of dieting to lose weight, the desire to overeat, low self-esteem, and impulsivity.

CONCLUSION

The results indicate that the Chinese version of the mYFAS 2.0 has good reliability and validity, and that it can be considered a tool to evaluate the addictive eating behaviours of undergraduate students.

The relative relation between body satisfaction, body investment, and depression among dutch emerging adults

BACKGROUND

Depression is one of the biggest global health problems, especially among emerging adults (18 to 25). A negative body image is a well-known risk factor for the development of depressive symptoms. However, little is known about how different aspects of body image relate to depressive symptoms. Therefore, the current study explores the relation between body satisfaction, body investment, and depressive symptoms, moderated by sex and physical activity, among a non-clinical sample of emerging adults.

METHODS

Cross-sectional data from 410 Dutch emerging adults (M_age = 21.95 years, SD = 1.98, 80.60% women) within a convenience sample was used within a hierarchical multiple regression analysis.

RESULTS

Results showed that a higher body satisfaction and more body investment were related to fewer depressive symptoms. This relation was somewhat stronger for body investment than for body satisfaction. Furthermore, the relation between lower body satisfaction and more depressive symptoms was stronger for participants with a lower level of physical activity. No other moderation effects were found.

LIMITATIONS

This results should be seen within the light of their limitations. This study used cross-sectional data and therefore no causal relations can be determined. Also, the sample was biased in which mostly highly educated females participated.

CONCLUSIONS

However, this research is unique for adding different concepts of body image in one model. The findings propose that interventions regarding depressive symptoms among emerging adults should focus, next to body satisfaction, on the emotional investment in the body and the enhancement of physical activity.

The Psychology of Food Cravings in Patients With First-Episode Psychosis

Objectives: Food cravings may cause weight gain in patients with schizophrenia. This study investigated psychological characteristics associated with food cravings in patients with first-episode psychosis. Methods: This study analyzed data from a clinical cohort of first-episode psychosis patients taking antipsychotics for 3 months or less. The strength of food cravings was measured using the General Food Cravings Questionnaire-Trait (G-FCQ-T). Psychological characteristics and psychiatric symptoms were investigated with the Positive and Negative Symptom Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Social and Occupational Functioning Assessment Scale, Rosenberg Self-Esteem Scale (RSES), and Perceived Stress Scale (PSS). Clinical characteristics were compared according to significant weight gain (≥10% increase in body weight compared to baseline) over 3 months. Associations between the G-FCQ-T and other psychiatric scales were investigated. We conducted sex-stratified analyses. Results: In total, 182 patients (78 males and 104 females) with first-episode psychosis were enrolled in this study. In females, the G-FCQ-T total score at baseline was associated with baseline body weight and significant weight gain over 3 months. The PSS scales were significantly associated the G-FCQ-T total and all subscale scores in female participants. Scores on the RSES and CDSS were significantly associated with the G-FCQ-T total score and with the preoccupation and loss of control subscale scores. The PANSS negative and general subscales were significantly associated with the positive outcome expectancy and loss of control subscales of the G-FCQ-T, respectively. In males, the only significant association was between the loss of control subscale and RSES scores. Linear regression analysis showed significant associations of PSS scores with the total and all subscale scores of the G-FCQ-T despite the loss of significance for other variables. Conclusion: These results indicate that the food cravings in patients with first-episode psychosis, which were associated with weight gain, were influenced by perceived stress in females. To reduce food cravings in female patients with schizophrenia, interventions aimed at perceived stress should be considered.

Correlations Between Stress, Depression, Body Mass Index, and Food Addiction Among Korean Nursing Students

This study examined the relationships between stress, depression, body mass index, and food addiction in South Korean nursing students. Data from 323 nursing students in Seoul, Gangwon-do, Jeollanam-do, Gyeongsangnam-do, and Jeju-do were collected via self-report questionnaires and analyzed using chi-square tests, Mann-Whitney U tests, logistic regression analyses, and the receiver operating characteristic curve using SPSS 21.0. Overall, 7.1% of students were classified as having a food addiction. Stress and depression affected food addiction, and food addiction influenced obesity. Depression and stress combined were predictors of food addiction. These findings suggest that effective stress management and interventions for depression prevention may be beneficial to prevent food addiction in nursing students.

Association between food addiction and body dissatisfaction among college students: The mediating role of eating expectancies

A positive association between food addiction (i.e., an addiction to compulsively overeat highly palatable foods) and body dissatisfaction in college students exists. However, little is known about the underlying mechanisms. Eating expectancies, one's learning history regarding the association between eating and its consequences, may provide potential pathways linking food addiction and body dissatisfaction. In the current study, five eating expectancies (i.e., eating helps manage negative affect, eating is pleasurable and useful as a reward, eating leads to feeling out of control, eating enhances cognitive competence, and eating alleviates boredom) were evaluated as potential mediators between food addiction and body dissatisfaction in 738 college students (mean age = 19.21 ± 1.63, 61.4% female). Students completed the Eating Pathology Symptoms Inventory, Yale Food Addiction Scale, and Eating Expectancy Inventory. Adjusting for sex, age, race, and body mass index, structural equation modeling was used to examine the bi-directional mediation effects of the eating expectancies between food addiction and body dissatisfaction. Results showed a bi-directional positive association between food addiction and body dissatisfaction (β = 0.12-0.26, standard error [SE] = 0.07-0.03, all p < 0.01) that was partially mediated by the expectancy that eating leads to feeling out of control, regardless of whether body dissatisfaction was included as the independent or dependent variable (β = 0.15-0.36, SE = 0.05-0.02, all p < 0.01). Findings suggest the need to address the influence of expecting eating to lead to feeling out of control in interventions for co-occurring food addiction and body dissatisfaction among college students.

Food addiction: A key factor contributing to obesity?

Background:

People may develop addiction to hyperpalatable foods, which may be a cause of obesity. This study aimed to determine the prevalence of obesity among adolescents and the effect of food addiction on obesity.

Materials and Methods:

In this cross-sectional study, food addiction and obesity status of high school students were investigated. Among 17,000 10^th and 11^th grade students, assuming the design effect as 2.0, with obesity prevalence of 10%, with 3% error, and 95% confidence interval, at least 752 participants were included. Obesity was the dependent variable, whereas sociodemographic characteristics, body image, eating habits, and food addiction were the independent variables. Food addiction was assessed using the Yale Food Addiction Scale. Obesity was determined by age- and sex-specific body mass index (BMI) percentiles for adolescents < 18 years of age and BMI ≥ 30.0 for those aged ≥ 18. Data were collected through face-to-face interviews. Statistical analyses were performed using SPSS 25.0. After adjustment for age, sex, and other variables, the effect of food addiction on obesity was determined through logistic regression. P <0.05 was deemed statistically significant.

Results:

Among adolescents (n = 874), 18.9% were food addict, 25.1% were overweight, and 12.1% were obese. After adjusted for age, sex, and other variables, food addiction significantly increased the risk of obesity (odds ratio: 1.9; 95% confidence interval: 1.167–3.335). Having a fragmented family, working mother, overweight father, and participants not knowing their weight correctly significantly increased obesity.

Conclusion:

While quarter of the adolescents had weight problems, one-fifth suffered from food addiction. After adjusting for confounders, food addiction significantly increased obesity. Identifying individuals with food addiction, providing treatment to overcome that, paying special attention to adolescents with obese parents or living in fragmented families, and providing support to both parents and adolescents could be useful in tackling obesity.

Food Addiction Mediates the Relationship between Perceived Stress and Body Mass Index in Taiwan Young Adults

Perceived stress is the degree of stress experienced by an individual in the face of a stressor. Studies have shown that stress affects emotions, leads to behavioral changes, and is likely to trigger physical illnesses. According to the World Health Organization (WHO), stress is classified as a health epidemic of the 21st century; in the meantime, the percentage of adults being overweight and with obesity has continued to grow after reaching 38.9% in 2016. Hence, it is unclear whether perceived stress has become a factor affecting progressive obesity and whether food addiction (FA) is an intermediate factor. The purposes of this study were to (1) investigate the FA prevalence among young adults in Taiwan, (2) understand correlations among perceived stress, FA, and the body mass index (BMI), and (3) determine the potential mediating effect of FA due to perceived stress on BMI. The study was conducted through an online questionnaire, composed of a basic data form, the Perceived Stress Scale (PSS), and the Yale Food Addiction Scale (YFAS). We received 1994 responses and analyzed 1780 valid samples. Results showed that 231 participants met the FA criteria, accounting for 12.98%. Perceived stress was positively correlated with BMI (95% confidence interval (CI) 0.013~0.088, p-value 7.8 × 10⁻³), and perceived stress was positively associated to FA (95% CI 1.099~1.154, p-value < 10⁻⁴), which was also positively correlated with BMI (95% CI 0.705~2.176, p-value 10⁻⁴). FA significantly mediated the relationship between PSS and BMI with an indirect effect size of 25.18% and 25.48% in the group that scored 31~40 on the PSS. The study concluded that among people seeking weight loss, proper stress management and screening for FA in order to apply related therapies may be an effective method for weight management.

Depressive symptoms among healthcare undergraduate students

Objective:

to identify the intensity of depressive symptoms and their associated factors in healthcare undergraduate students.

Method:

cross-sectional study developed with undergraduate health students from a public higher education institution using the Beck Depression Inventory-version II and a student characterization questionnaire. The study involved 792 participants. For data analysis, we used descriptive statistics, chi-squared test and Poisson regression.

Results:

the intensity of depressive symptoms was moderate to severe in 23.6% of the students, associated with the non-performance of physical and leisure activities and with speech therapy and nursing courses.

Conclusion:

several factors may be associated with depression, thus, further investigation into the related factors that cause its emergence in this period of life is necessary, as well as raising institutional awareness and developing strategies at the personal and group level to promote well-being, improve time management and interpersonal relationships, in order to achieve better academic results and personal development.

Food addiction and its relationship with disordered eating behaviours and obesity

PURPOSE

Food addiction, eating disorders and obesity are all mutually reinforcing factors, or factors that can trigger each other. The aim of this study was to determine the relationship between food addiction, disordered eating behaviours and obesity.

METHODS

The study was conducted with 370 university students. Food addiction was assessed using the Yale Food Addiction Scale (YFAS) and disordered eating behaviours were assessed with the Eating Attitude Test (EAT)-26. A digital scale was used to measure weight, while for the measurement of height, waist and hip circumferences a non-stretching tape measure was used according to standard techniques.

RESULTS

Among the participants, 35.7% scored high on the EAT-26, while 21.1% scored high on the YFAS. Females constituted a higher ratio of those who had high scores on the YFAS and EAT-26 (p < 0.05). Overall, the ratio of YFAS high scorers was higher in the case of EAT-26 high scorers (32.6%) than that of low scorers (14.7%) (p < 0.001). A positive weak relationship existed between YFAS and EAT-26 scores (r = 0.165, p = 0.001) and the same between YFAS scores, weight, and body mass index (r = 0.263, p < 0.001; r = 0.319, p < 0.001, respectively).

CONCLUSION

In summary, a positive relation was found between food addiction, disordered eating behaviours and body mass index. Females were shown to have a higher risk of food addiction and eating disorders than that of males. Further studies can be carried out to analyze these correlations using a wider range of controlling factors.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Relationship between Academic Stress, Physical Activity and Diet in University Students of Education

(1) Background: Several research works have shown the relationship between physical activity (PA), adherence to the Mediterranean diet (MD) and health. Nevertheless, there are few studies that demonstrate the relationship of these habits with academic performance, and specifically with academic stress. (2) Methods: This descriptive, non-experimental, and cross-sectional study aims to analyse the associations between these variables in a sample composed of 515 university students, using as main instruments the KIDMED, PAQ-A and the Scale of Academic Stress. (3) Results: The university students analysed showed higher levels of academic stress for women, and especially in the academic obligations and communication of own ideas. In addition, it was shown that those university students that had a body mass index (BMI) associated with being overweight or under-weight were the respondents with higher levels of stress. Finally, the students with a low adherence to MD had higher scores for stress associated with the communication of their own ideas, while PA was not related to academic stress. When sex and BMI variables were controlled in the regression model, no associations were obtained between stress and diet quality. (4) Conclusions: This study shows interesting implications in the treatment of academic stress. Although stress was not associated with diet and physical activity, it was linked to a worse state of health associated with states of being overweight, being of special interest the treatment of stress in women.

[Validity and Reliability of a Korean Version of Yale Food Addiction Scale for Children (YFAS-C)]

PURPOSE

This study evaluated the psychometric properties of the Korean version of Yale Food Addiction Scale for Children (YFAS-C).

METHODS

Participants were 419 young adolescent students (11~15 years old). The content validity of the expert group was calculated as the content validity index (CVI) after the translation and reverse translation process of the 25 items of the YFAS-C. The multitrait-multimethod matrix (MTMM) method was used to verify the construct validity; the generalized linear model (GLM) was used to evaluate the concurrent and incremental validity. Reliability was calculated as Kuder-Richardson-20 (KR-20) and Spearman-Brown coefficients.

RESULTS

The CVI of the 25 items was greater than the item-level CVI .80 and the scale-level CVI .90. The Korean version of YFAS-C had verified convergent validity in emotional eating and external eating and discriminant validity in restrained eating. In addition, it had verified concurrent validity in emotional eating and external eating. Finally the incremental validity of the Korean version of YFAS-C was statistically significant on BMI. Reliability was KR-20 α=.69 and the Spearman-Brown coefficient was .64.

CONCLUSION

The Korean version of YFAS-C is a valid and reliable scale for measuring the severity of food addiction; it can be a useful scale for preventing obesity by predicting food addiction early.

How does food addiction influence dietary intake profile?

This study aimed to investigate whether there was any difference in eating pattern, abnormal eating behaviour, obesity and the number of food addiction symptoms according to food addiction presence. A total sample of 851 healthy subjects living in Ankara (n = 360 male, n = 491 female) aged 19-65 years were included in this cross-sectional survey. Data on demographic information, 24-hour dietary recalls, Yale Food Addiction Scale (YFAS), Eating Attitudes Test-26 (EAT-26), and anthropometric measurements were collected through face-to-face interviews. Overall, 11.4% of participants were identified as "food addicted" (F: 13.0%; M: 9.2%). Subjects meeting criteria for 'food addiction' had higher body mass index (35.1% were obese and 3.1% were underweight), compared to subjects without food addiction (13.1% were obese and 10.2% were underweight) (p<0.05). Abnormal eating attitudes estimated with EAT-26 were determined as 45.5% in males, 37.5% in females and 40.2% in total, among subjects with food addiction. Daily energy, protein and fat intakes were significantly higher in food addicted females, compared to non-addicted females (p<0.05). Participants with food addiction reported significantly more problems with foods, which contain high amounts of fat and sugar, compared to the participants without food addiction. Food addiction behaviour should be considered as a part of efforts towards reducing food related problems involving obesity.

Prevalence of food addiction among Iranian children and adolescents: Associations with sociodemographic and anthropometric indices

Background: Food addiction has been defined as consuming palatable foods leading to addictive-like behaviors. Little studies have assayed food addiction in children and adolescents. Thus, we aimed at identifying the prevalence of food addiction and the relationship between food addiction, sociodemographic and anthropometric indicators among children and adolescents in southwestern Iran. Methods: This cross-sectional study was conducted on 222 elementary school students aged 7 to 13 years in Ahvaz, Iran, using a random sampling method. Sociodemographic and anthropometric indicators were obtained. The 25-item child version of the Yale Food Addiction Scale (YFAS-C) was applied to provide food addiction diagnosis and symptoms. A nonparametric analysis was used for data analysis. Results: The prevalence of food addiction was 17.3%. Also, the most common symptoms associated with food addiction were (1) inability to cut down, (2) withdrawal, and (3) tolerance. The students with food addiction diagnosis were older than the undiagnosed (p=0.04). The males and students older than 8 years showed a higher food addiction score than females and students under 8 years (p<0.05). In females, significant positive correlations were found between anthropometric indicators, including body mass index and body mass index z-score, with food addiction score (p<0.01). Conclusion: Food addiction diagnosis was more prevalent in males and students over 8 years. Females with higher YFAS-C scores had elevated body mass index z-scores, suggesting that food addiction may be a remarkable problem in childhood and early adolescence and may also be related to a risk of overweight/obesity in Iranian students.

Validation of the Italian version of the Yale Food Addiction Scale 2.0 (I-YFAS 2.0) in a sample of undergraduate students

PURPOSE

Food addiction (FA) refers to a condition characterized by addiction in relation to some high-fat and high-sugar carbohydrate that leads to clinically significant impairment or distress on several areas of functioning. The Yale Food Addiction Scale 2.0 (YFAS 2.0) has been recently updated to measure FA according to the DSM-5 criteria for substance-related and addictive disorders. This study aimed at validating the Italian version of YFAS 2.0.

METHODS

A sample of 574 Italian university students was involved in this research. Confirmatory Factor Analysis (CFA) and Kuder-Richardson's alpha for dichotomous data were run to evaluate scale structure and reliability. Correlations between YFAS 2.0 and eating psychopathology, binge eating, sleep, and mood symptoms were evaluated.

RESULTS

Analogously to the original version, a single factor structure emerged at the CFA. The alpha coefficient was 0.87. Moreover, sound, from moderate to high, correlations were found with other measures.

CONCLUSIONS

The Italian version of the YFAS 2.0 has demonstrated in a sample of university students to be a useful tool to investigate food addictions. Level of evidence Level V, descriptive study.

Disordered Eating Behaviors and Food Addiction among Nutrition Major College Students

Evidence of whether nutrition students are free from food-related issues or at higher risk for eating disorders is inconsistent. This study aimed to assess disordered eating behaviors and food addiction among nutrition and non-nutrition major college students. Students (n = 967, ages 18–25, female 72.7%, white 74.8%) enrolled at a public university completed online demographic characteristics surveys and validated questionnaires measuring specific disordered eating behaviors. Academic major category differences were compared. Additionally, high risk participants were assessed by weight status and academic year. Overall, 10% of respondents were a high level of concern for developing eating disorders. About 10.3% of respondents met criteria for food addiction. In addition, 4.5% of respondents had co-occurrence of eating disorder risk and food addiction risk out of total respondents. There were no significant differences in level of concern for developing an eating disorder, eating subscales, or food addiction among academic majors. The percentage of high risk participants was lower in the underweight/normal weight group than in the overweight/obese group in health-related non-nutrition major students but not in nutrition students. Early screening, increasing awareness, and promoting healthy eating habits could be potential strategies to help treat and prevent the development of disorders or associated health conditions in nutrition as well as non-nutrition students.