Abstract
The concept of food addiction (FA) has become central in recent years in understanding the psychological etiology of obesity. In this matched case-control study from Turkey, it was aimed to examine the prevalence of FA and related risk factors in four consecutive body mass index (BMI) categories. The case group consisted of pre-operative bariatric surgery patients with BMI over 35.0 kg/m2 (n = 40) and the control group was composed of age- and gender- matching individuals from the other categories, namely obese (n = 35), overweight (n = 40), and normal weight (n = 40). The Yale Food Addiction Scale (YFAS) and a standardized clinical interview using the DSM-5 substance use disorders criteria adopted for FA, the Eating Disorder Examination Questionnaire (EDEQ) and the Barratt Impulsivity Scale (BIS-11) were used as assessment instruments. It was found that FA was significantly associated with more serious eating pathologies, more frequent weight-cycling and earlier onset of dieting, higher impulsivity, and higher BMI. Motor and total impulsivity scores showed a positive albeit week correlation with the severity of FA but no significant correlation with BMI, indicating a relationship between impulsivity and weight gain in some but not all individuals. The severity of FA predicted the increase in BMI. Our findings suggest that FA is associated with weight gain in a group of individuals, plausibly through impulsive overeating. Emphasis on FA and its clinical implications such as addiction-based treatments may improve outcomes in obesity and facilitate health promotion.
Highlights
Obesity is an escalating epidemic in wealthy countries as well as in developing countries and a major cause of preventable deaths worldwide [1, 2]
The aim of this study was to identify the prevalence of food addiction (FA) in a Turkish sample consisting of different body mass index (BMI) classes and to examine the relationship between FA and BMI, focusing on prominent risk factors in addiction including impulsivity
Tobacco and alcohol use and family history were similar among the groups (Table 2), those with a BMI >30.0 kg/m2 (n = 75) had a significantly higher rate (63.5%) of obesity in family history, when compared to the rest (χ 2 = 23.19, p < 0.01)
Summary
Obesity is an escalating epidemic in wealthy countries as well as in developing countries and a major cause of preventable deaths worldwide [1, 2]. As reported in 2019, more than half of the population in 34 out of 36 OECD member countries is overweight and almost one in four people are obese [4]. The low rate of success of treatments to prevent or reverse obesity and the significant rate of relapses indicate that obesity might be explained as a metabolic disorder and as a behavioral alteration [5, 6]. Recent clinical and neurobiological findings refer to an addictive process contributing to an elevated body mass index (BMI) [7, 8]. The concept of food addiction (FA), namely the idea that certain highly-processed and “hyperpalatable”
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