Investigating Sex Differences in Rates and Correlates of Food Addiction Status in Women and Men with PTSD

Monika M Stojek,Sheila A M Rauch,Justyna Lipka,Barbara O Rothbaum,Vasiliki Michopoulos,Kathryn Black,Jessica M Maples-Keller

doi:10.3390/nu13061840

Abstract

Background: Food addiction (FA) is a dysregulated eating pattern characterized by difficulties in controlling the intake of certain foods. There is an overlap in physical and mental health correlates of FA and post-traumatic stress disorder (PTSD). The purpose of this study was to examine sex differences in the rates of positive FA status in individuals with threshold/subthreshold PTSD, and to examine sex differences in the physical and mental health correlates of FA. Methods: Post-9/11 veterans/service members seeking PTSD treatment were recruited. Participants were diagnosed with PTSD via the administration of a clinical interview. FA status was determined using Modified Yale Food Addiction Scale-2, binary sex and body mass index were assessed with demographics questions. Results: Nearly half (43%) of the sample were women. There were no sex differences in the rates of FA, with an overall FA prevalence of 18%. There were no sex differences in FA symptom count in the whole sample (M = 1.63) or those with FA status (M = 6.21). Individuals with FA reported higher frequency of disordered eating, higher severity of PTSD, and depression symptoms. Conclusions: FA should be assessed in tandem with PTSD symptoms, as its prevalence in that sample is higher than in the general population, and it appears to affect both sexes at similar rates.

Highlights

Food addiction (FA) refers to a constellation of dysregulated eating behaviors analogous to behaviors traditionally associated with substance misuse, such as eating larger amounts or for longer periods than planned, tolerance to certain foods, and persistent and unsuccessful attempts to cut down on eating certain types of food [1,2]
We examined sex differences in rates and the following correlates of FA in that sample: body mass index (BMI), frequency of loss of control over (LOC) eating, frequency of compensatory behaviors, severity of post-traumatic stress disorder (PTSD) symptoms, severity of depression symptoms, suspected alcohol use disorder (AUD) severity, and frequency of alcohol use
The findings of the current study suggest that PTSD symptoms overlap with a positive FA status at relatively high rates compared to the general population, and that it is important to assess FA in both men and women with PTSD

Summary

Introduction

Food addiction (FA) refers to a constellation of dysregulated eating behaviors analogous to behaviors traditionally associated with substance misuse, such as eating larger amounts or for longer periods than planned, tolerance to certain foods, and persistent and unsuccessful attempts to cut down on eating certain types of food [1,2]. While FA is not a mental health diagnosis, the instrument validated and widely used to measure this construct can be used to generate a cut-off score for identifying individuals at high risk for negative consequences from maladaptive eating patterns (i.e., those with positive FA status vs those without FA) based on the criteria analogous to those used to identify individuals with alcohol and substance use disorders [1,2]. Many researchers consider FA a useful construct in identifying individuals at risk for obesity and negative health outcomes related to maladaptive eating patterns, and its clinical utility is increasingly recognized [6]. The purpose of this study was to examine sex differences in the rates of positive FA status in individuals with threshold/subthreshold PTSD, and to examine sex differences in the physical and mental health correlates of FA.

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Discussion

Conclusion