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Schiestl ET, Wolfson JA, Gearhardt AN. The qualitative evaluation of the Yale Food addiction scale 2.0. Appetite 2022; 175:106077. [PMID: 35537659 PMCID: PMC9663207 DOI: 10.1016/j.appet.2022.106077] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 04/07/2022] [Accepted: 05/02/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND The Yale Food Addiction Scale 2.0 (YFAS 2.0) operationalizes food addiction (FA) by applying the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM 5) criteria for substance use disorder (SUD) to the overconsumption of highly processed foods. The YFAS 2.0 has been quantitatively validated across numerous populations, but has never undergone qualitative analysis. AIMS Using qualitative methods we aimed to determine if the interpretation YFAS 2.0 is aligned with the DSM 5 conceptualization of SUD, to determine if any items are perceived as irrelevant to the lived-experience of FA, and to determine if there are constructs central to the lived-experience of FA that are not captured by the scale. METHODS We interviewed 16 participants who met criteria for FA on the modified YFAS 2.0 using semi-structured interviews to understand each participants' interpretation of items on the scale and their perceptions of how the scale matched their lived-experience of FA. Reflexive thematic analysis was used to code responses and identify themes. RESULTS Most interpretations aligned with the DSM 5 conceptualization of SUDs. Withdrawal and tolerance-related items were subject to some misinterpretations. Participants viewed problem-focused symptoms (e.g., interpersonal problems) as the least relevant to their lived-experience. Novel themes not included on the YFAS 2.0 (e.g., emotional eating) emerged. SUMMARY Our study supports the validity of the YFAS 2.0 by showing consistency with the DSM 5 conceptualization of SUDs and consistency with the lived-experience of individuals who endorse FA. Future research should explore the novel themes that emerged in this study.
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Affiliation(s)
| | - Julia A Wolfson
- Department of International Health, Ann Arbor, USA; Department of Health Policy and Management, USA
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Camacho-Barcia L, Munguía L, Lucas I, de la Torre R, Salas-Salvadó J, Pintó X, Corella D, Granero R, Jiménez-Murcia S, González-Monje I, Esteve-Luque V, Cuenca-Royo A, Gómez-Martínez C, Paz-Graniel I, Forcano L, Fernández-Aranda F. Metabolic, Affective and Neurocognitive Characterization of Metabolic Syndrome Patients with and without Food Addiction. Implications for Weight Progression. Nutrients 2021; 13:nu13082779. [PMID: 34444940 PMCID: PMC8398101 DOI: 10.3390/nu13082779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 12/18/2022] Open
Abstract
According to the food addiction (FA) model, the consumption of certain types of food could be potentially addictive and can lead to changes in intake regulation. We aimed to describe metabolic parameters, dietary characteristics, and affective and neurocognitive vulnerabilities of individuals with and without FA, and to explore its influences on weight loss progression. The sample included 448 adults (55-75 years) with overweight/obesity and metabolic syndrome from the PREDIMED-Plus cognition sub-study. Cognitive and psychopathological assessments, as well as dietary, biochemical, and metabolic measurements, were assessed at baseline. Weight progression was evaluated after a 3-year follow up. The presence of FA was associated with higher depressive symptomatology, neurocognitive decline, low quality of life, high body mass index (BMI), and high waist circumference, but not with metabolic comorbidities. No differences were observed in the dietary characteristics except for the saturated and monounsaturated fatty acids consumption. After three years, the presence of FA at baseline resulted in a significantly higher weight regain. FA is associated with worse psychological and neurocognitive state and higher weight regain in adults with metabolic syndrome. This condition could be an indicator of bad prognosis in the search for a successful weight loss process.
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Affiliation(s)
- Lucía Camacho-Barcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet de Llobregat, 08907 Barcelona, Spain or (L.C.-B.); (L.M.); or (I.L.); (S.J.-M.)
| | - Lucero Munguía
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet de Llobregat, 08907 Barcelona, Spain or (L.C.-B.); (L.M.); or (I.L.); (S.J.-M.)
| | - Ignacio Lucas
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet de Llobregat, 08907 Barcelona, Spain or (L.C.-B.); (L.M.); or (I.L.); (S.J.-M.)
| | - Rafael de la Torre
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Integrative Pharmacology and Neurosciences Systems, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), 08003 Barcelona, Spain
- Department of Experimental and Health Sciences (CEXS-UPF), Universitat Pompeu Fabra, 08002 Barcelona, Spain
| | - Jordi Salas-Salvadó
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Universitat Rovira i Virgili, Department of Biochemistry and Biotechnology, Human Nutrition Unit, Reus, 43201 Tarragona, Spain
- Institut d’Investigació Pere Virgili (IISPV), Reus, 43204 Tarragona, Spain
- The Sant Joan University Hospital, Human Nutrition Unit, 43201 Reus, Spain
| | - Xavier Pintó
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Lipids and Vascular Risk Unit, Internal Medicine, University Hospital of Bellvitge-IDIBELL, Hospitalet de Llobregat, 08907 Barcelona, Spain;
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Dolores Corella
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
| | - Roser Granero
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Department of Psychobiology and Methodology, Autonomous University of Barcelona, 08193 Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet de Llobregat, 08907 Barcelona, Spain or (L.C.-B.); (L.M.); or (I.L.); (S.J.-M.)
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Inmaculada González-Monje
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
| | - Virginia Esteve-Luque
- Lipids and Vascular Risk Unit, Internal Medicine, University Hospital of Bellvitge-IDIBELL, Hospitalet de Llobregat, 08907 Barcelona, Spain;
| | - Aida Cuenca-Royo
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Integrative Pharmacology and Neurosciences Systems, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), 08003 Barcelona, Spain
| | - Carlos Gómez-Martínez
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Universitat Rovira i Virgili, Department of Biochemistry and Biotechnology, Human Nutrition Unit, Reus, 43201 Tarragona, Spain
- Institut d’Investigació Pere Virgili (IISPV), Reus, 43204 Tarragona, Spain
| | - Indira Paz-Graniel
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Universitat Rovira i Virgili, Department of Biochemistry and Biotechnology, Human Nutrition Unit, Reus, 43201 Tarragona, Spain
- Institut d’Investigació Pere Virgili (IISPV), Reus, 43204 Tarragona, Spain
| | - Laura Forcano
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Integrative Pharmacology and Neurosciences Systems, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), 08003 Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet de Llobregat, 08907 Barcelona, Spain or (L.C.-B.); (L.M.); or (I.L.); (S.J.-M.)
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.d.l.T.); (J.S.-S.); (X.P.); (D.C.); (R.G.); (I.G.-M.); (A.C.-R.); (C.G.-M.); (I.P.-G.); (L.F.)
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Hospitalet de Llobregat, 08907 Barcelona, Spain
- Correspondence: ; Tel.: +349-3260-7227
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The Clinical Utility of Food Addiction: Characteristics and Psychosocial Impairments in a Treatment-Seeking Sample. Nutrients 2020; 12:nu12113388. [PMID: 33158105 PMCID: PMC7694167 DOI: 10.3390/nu12113388] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 10/29/2020] [Accepted: 11/02/2020] [Indexed: 01/06/2023] Open
Abstract
Little is known about the characteristics of individuals seeking treatment for food addiction (FA), and the clinical utility of FA has yet to be established. To address these gaps, we examined (i) the demographic, eating pathology, and psychiatric conditions associated with FA and (ii) whether FA is associated with psychosocial impairments when accounting for eating-related and other psychopathology. Forty-six patients seeking treatment for FA completed self-report questionnaires and semi-structured clinical interviews. The majority of the sample were women and self-identified as White, with a mean age of 43 years. Most participants (83.3%) presented with a comorbid psychiatric condition, most commonly anxiety and mood disorders, with a mean of 2.31 comorbid conditions. FA was associated with binge eating severity and anxiety symptoms, as well as psychological, physical, and social impairment. In regression analyses controlling for binge eating severity, food cravings, depression, and anxiety, FA remained a significant predictor only of social impairment. Taken together, the results suggest that individuals seeking treatment for FA are likely to present with significant comorbid conditions, in particular anxiety disorders. The results of the present research provide evidence for the clinical utility of FA, particularly in explaining social impairment.
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