Abstract
Interest in food addiction (FA) has increased, but little is known about its clinical implications or potential treatments. Using secondary analyses from a randomized controlled trial, we evaluated the associations between changes in FA, body weight, and “problem food” consumption during a 22-month behavioral weight-loss program consisting of an initial four-month in-person intervention, 12-month extended-care, and six-month follow-up (n = 182). Food addiction was measured using the Yale Food Addiction Scale. “Problem foods” were identified from the literature and self-reporting. Multilevel modeling was used as the primary method of analysis. We hypothesized that reductions in problem food consumption during the initial treatment phase would be associated with long-term (22-month) FA reductions. As expected, we found that reductions in problem foods were associated with greater initial reductions in FA symptoms; however, they were also associated with a sharper rebound in symptoms over time (p = 0.016), resulting in no significant difference at Month 22 (p = 0.856). Next, we hypothesized that long-term changes in FA would be associated with long-term changes in body weight. Although both FA and weight decreased over time (ps < 0.05), month-to-month changes in FA were not associated with month-to-month changes in weight (p = 0.706). Instead, higher overall FA (i.e., mean scores over the course of the study) were associated with less weight loss (p = 0.008) over time. Finally, we hypothesized that initial reductions in problem food consumption would be associated with long-term reductions in weight, but this relationship was not significant (ps > 0.05). Given the complexity of the findings, more research is needed to identify interventions for long-term changes in FA and to elucidate the associations between problem foods, FA, and weight.
Highlights
Prior research has suggested that certain foods and eating behaviors can be associated with addiction-like symptoms
No other demographic variables were significantly related to Yale Food Addiction Scale (YFAS) scores or body mass indexes (BMIs)
We hypothesized that reductions in problem food consumption during the initial phase of treatment would be associated with long-term reductions in food addiction (FA) symptoms, that long-term changes in FA would be associated with long-term changes in body weight, and that initial reductions in problem food consumption would be associated with long-term reductions in body weight
Summary
Prior research has suggested that certain foods (e.g., processed foods high in fat and/or sugar) and eating behaviors (e.g., binge eating) can be associated with addiction-like symptoms. High-fat and/or high-sugar processed foods, such as ice cream, pizza, potato chips, or chocolate, are most commonly associated with addiction-like changes both behaviorally and neurobiologically [9,11,12]. In 2009, Gearhardt et al [13] published the Yale Food Addiction Scale (YFAS), a validated self-report questionnaire that adapts the DSM-IV substance dependence criteria toward “certain foods”. For which respondents may have difficulty controlling their intake Using this scale, Schulte and Gearhardt [14] estimated that approximately 15% of adults in the United States met the YFAS criteria for food addiction (FA; ≥3 symptoms, plus distress/impairment), with higher prevalence among adults with obesity (19%). FA symptoms have been associated with increased risk for disordered eating [8,15,16,17], depression [15,16,17,18], emotional eating [15,17], impulsivity [16], lower self-esteem [16], and poorer quality of life [19]
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