Food addiction and its impact on weight-based stigma and the treatment of obese individuals in the U.S. and Australia.

Natalia Lee,Wayne Hall,Jayne Lucke,Cynthia Forlini,Adrian Carter

doi:10.3390/nu6115312

Natalia Lee, Wayne Hall + Show 3 more

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https://doi.org/10.3390/nu6115312

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Abstract

It is argued that food addiction explanations of obesity may reduce the significant stigma levelled at obese and overweight individuals. We surveyed 479 adults to determine the prevalence of food addiction in the U.S. (n = 215) and, for the first time, in Australia (n = 264) using the Yale Food Addiction Scale (YFAS). We also assessed the level of weight-based stigma in this population. The prevalence of food addiction in our Australian sample was 11%, similar to U.S. participants and consistent with previous studies. Those who met criteria for diagnosis had a larger mean BMI (33.8 kg/m2) than those who did not (26.5 kg/m2). Overall, the level of stigma towards others was low and differed significantly based on BMI, predominately among normal weight and obese participants (p = 0.0036). Obese individuals scored higher on certain measures of stigma, possibly reflecting individual experiences of stigma rather than negative attitudes towards other obese individuals (p = 0.0091). Despite significant support for a “food addiction” explanation of obesity, participants still valued personal responsibility in overcoming obesity and did not support coercive approaches to treat their “addiction”.

Highlights

Neurobiological research on overeating in animals and humans [1,2,3] has identified many of the mechanisms and dysregulated neural pathways that are involved in overconsumption and satiety
While the core components of food addiction still strongly resemble those of substance-related and addictive disorders [5], additional research is needed to assess how well food addiction resembles substance-related and addictive disorders or non-substance-related behavioural disorders based on the DSM-5
The aims of this study were to: (1) determine and compare the prevalence of individuals meeting the criteria for food addiction as measured by the Yale Food Addiction Scale (YFAS) in samples of U.S and Australian residents; (2) assess whether levels of weight-based stigma varied with body mass index (BMI) or food addiction diagnosis; and (3) compare responses based on country of residence in two Westernized countries with high population rates of obesity

Summary

Introduction

Neurobiological research on overeating in animals and humans [1,2,3] has identified many of the mechanisms and dysregulated neural pathways that are involved in overconsumption and satiety. An addiction model of obesity has been proposed in which both the neurobiological and behavioural mechanisms of overeating mirror those operating in substance dependence based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria [2]. Modifications to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) raise additional questions to food addiction’s relevance with the newly defined “substance-related and addictive disorders”. While significant advancements have been made in the understanding of food addiction via animal models and behavioural and neuroimaging studies in humans, the development and application of an addiction model of obesity is still largely nascent

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