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Collombat J, Chapron SA, Sarram S, Fatseas M, Serre F, Auriacombe M. [Anorexia nervosa: An addiction? Application of the addiction model to eating disorders. A narrative commented review]. L'ENCEPHALE 2024:S0013-7006(24)00068-X. [PMID: 38755028 DOI: 10.1016/j.encep.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/28/2024] [Accepted: 03/12/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVES Addiction offers a framework for the understanding of eating disorders, particularly those characterized by hyperphagia, with growing interest in food addiction. However, the application of the addiction model to anorexia nervosa remains more controversial. In this commented narrative review, we examine and discuss the addictive features of anorexia nervosa. METHODS Commented narrative review of the literature. RESULTS Anorexia nervosa could be the consequence of the loss of control of several objects of positive reinforcement: food restriction, physical hyperactivity, and food itself. Craving has been little studied in the field of eating disorders. When investigated, studies mainly focus on food cravings and tend to highlight food cravings that are inversely correlated with the restrictive nature of the disorder. This would thus be less found in anorexia nervosa, in which it is nevertheless reported. The existence of a pre-existing food craving, or its appearance secondary to food restriction, is currently under discussion. In the meantime, the question of a craving for food restriction, underpinned by the gratifying effect of fasting, is raised. CONCLUSIONS The management of eating disorders has its place within the addiction care sectors. An integrative approach should be favored, for anorexia nervosa, combining, on the one hand, classic nutritional care, and, on the other hand, care within the framework of addiction treatment. Finally, in people with an eating disorder, the search for an addiction to food, food restriction and physical activity, including a systematic assessment of craving, should be systematized.
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Affiliation(s)
- Julie Collombat
- Laboratoire sommeil, addiction et neuropsychiatrie (SANPSY), CNRS UMR 6033, université de Bordeaux, 33076 Bordeaux, France; Pôle interétablissement d'addictologie, CH Charles-Perrens et CHU de Bordeaux, 33076 Bordeaux, France
| | - Sophie-Athéna Chapron
- Université de Bordeaux, 33076 Bordeaux, France; Laboratoire sommeil, addiction et neuropsychiatrie (SANPSY), CNRS UMR 6033, université de Bordeaux, 33076 Bordeaux, France; Pôle interétablissement d'addictologie, CH Charles-Perrens et CHU de Bordeaux, 33076 Bordeaux, France; Service d'addictologie, CH de la Côte Basque, 64109 Bayonne, France
| | - Saman Sarram
- Laboratoire sommeil, addiction et neuropsychiatrie (SANPSY), CNRS UMR 6033, université de Bordeaux, 33076 Bordeaux, France; Pôle interétablissement d'addictologie, CH Charles-Perrens et CHU de Bordeaux, 33076 Bordeaux, France
| | - Mélina Fatseas
- Université de Bordeaux, 33076 Bordeaux, France; Pôle interétablissement d'addictologie, CH Charles-Perrens et CHU de Bordeaux, 33076 Bordeaux, France; Institut de neurosciences cognitives et intégratives d'Aquitaine (INCIA), CNRS UMR 5287, 33076 Bordeaux, France
| | - Fuschia Serre
- Université de Bordeaux, 33076 Bordeaux, France; Laboratoire sommeil, addiction et neuropsychiatrie (SANPSY), CNRS UMR 6033, université de Bordeaux, 33076 Bordeaux, France; Pôle interétablissement d'addictologie, CH Charles-Perrens et CHU de Bordeaux, 33076 Bordeaux, France
| | - Marc Auriacombe
- Université de Bordeaux, 33076 Bordeaux, France; Laboratoire sommeil, addiction et neuropsychiatrie (SANPSY), CNRS UMR 6033, université de Bordeaux, 33076 Bordeaux, France; Pôle interétablissement d'addictologie, CH Charles-Perrens et CHU de Bordeaux, 33076 Bordeaux, France.
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2
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Meule A. On the prevalence of 'food addiction' in persons with bulimia nervosa. EUROPEAN EATING DISORDERS REVIEW 2024; 32:490-492. [PMID: 38200630 DOI: 10.1002/erv.3061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
A meta-analysis by Praxedes and colleagues published in this journal reports that the prevalence of 'food addiction' as measured with the Yale Food Addiction Scale is lower than 50% in persons with bulimia nervosa and higher in persons with binge eating disorder. However, closely examining the supplementary material of that article reveals that these numbers cannot possibly be correct. Instead, most studies indicate that the prevalence of 'food addiction' is higher than 80% in persons with bulimia nervosa and, thus, higher than in persons with other eating disorders.
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Affiliation(s)
- Adrian Meule
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
- Faculty of Medicine, Institute of Medical Psychology, LMU Munich, Munich, Germany
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3
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Cobbaert L, Hay P, Mitchell PB, Roza SJ, Perkes I. Sensory processing across eating disorders: A systematic review and meta-analysis of self-report inventories. Int J Eat Disord 2024. [PMID: 38511825 DOI: 10.1002/eat.24184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 02/22/2024] [Accepted: 02/22/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVE This review investigated the extant literature regarding the relationship between eating disorder diagnoses and sensory processing as measured by validated and reliable self-report inventories. Increasing evidence highlights the role of sensory processing in cognitive functions. Sensory processing is implicated in mental-ill health, including eating disorders (ED) and body image disturbances. However, the pathophysiological underpinnings of sensory processing, encompassing exteroception and interoception, in relation to ED remain underexplored. METHOD We included studies involving participants aged 15 years or older with an eating disorder diagnosis confirmed by semi-structured or structured interviews. We further limited inclusion to articles using validated and reliable self-report instruments to measure sensory processing. Our meta-analysis focused on studies using the interoceptive awareness subscale from the second version of the Eating Disorder Inventory. We used the Critical Appraisal checklist for quasi-experimental studies to assess the quality of included articles. RESULTS There were 19 studies that met our inclusion criteria. Most studies showed moderate-to-high quality. Anorexia nervosa (AN) and bulimia nervosa (BN) were associated with heightened exteroception. Moreover, people with AN reported a heightened sense of taste compared to those with BN. Our meta-analysis comprising 10 studies, 19 samples, and 6382 participants revealed that AN (binge-purge subtype) and BN were associated with increased interoceptive difficulties compared to AN (restrictive subtype) or binge-eating disorder. DISCUSSION Overall, this review emphasizes the need for a deeper investigation into sensory processing, spanning both exteroception and interoception, in relation to ED. This may prove important for individualizing person-centered care. PUBLIC SIGNIFICANCE How people process internal, for example, hunger, and external, for example, taste and sensations is known to influence cognition and mental-ill health, including ED and body image disturbances. However, the ways in which sensory processing may contribute to ED are incompletely understood. We found that individuals with AN or BN experienced heightened exteroception, while people with an eating disorder characterized by purging reported increased interoceptive difficulties. These patterns could inform the development of more personalized treatments.
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Affiliation(s)
- Laurence Cobbaert
- Faculty of Medicine and Health, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Phillipa Hay
- School of Medicine, Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
- Mental Health Services, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Philip B Mitchell
- Faculty of Medicine and Health, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Sabine J Roza
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Iain Perkes
- Faculty of Medicine and Health, Discipline of Paediatrics and Child Health, University of New South Wales, Sydney, New South Wales, Australia
- Department of Psychological Medicine, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
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4
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Butt M, Ssentongo P, Rogers AM, Rigby A. Associations of Food Addiction Symptomatology and Disordered Eating Behaviors in a Pre-Surgical Bariatric Population. Nutrients 2023; 15:3474. [PMID: 37571411 PMCID: PMC10421096 DOI: 10.3390/nu15153474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 07/31/2023] [Accepted: 08/04/2023] [Indexed: 08/13/2023] Open
Abstract
The construct of food addiction (FA) has been highly debated in recent years particularly in the fields of disordered eating, medical weight management, and bariatric surgery. Some researchers have argued that FA symptoms are distinct, highly prevalent, and present a barrier for patients seeking medical treatment for obesity. The purpose of this study is to evaluate the cross-sectional associations between FA symptomatology, binge eating disorder (BED) and other appetitive traits, as well as dietary quality in a sample of adults with obesity seeking bariatric surgery. This post hoc analysis was conducted on a prospectively collected dataset from August 2020 to August 2022 at a single academic medical center. Descriptive statistics were used to characterize the sample. Additional analyses included: correlation coefficients, multivariable linear regression, and analysis of variance. A total of 587 patients were included in this analysis with low average scores for FA symptoms (mean: 1.48; standard deviation (SD): 2.15). Those with no BED symptoms had the lowest average FA symptoms scores (mean: 0.87; SD: 1.52) and those with both bingeing and LOCE had the highest average scores (mean: 3.35; SD: 2.81). This finding supports the hypothesis that, while related, FA and BED may represent different cognitions and behaviors.
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Affiliation(s)
- Melissa Butt
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA 17033, USA
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (P.S.); (A.R.)
| | - Paddy Ssentongo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (P.S.); (A.R.)
- Department of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Ann M. Rogers
- Division of Minimally Invasive Surgery, Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA;
| | - Andrea Rigby
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (P.S.); (A.R.)
- Division of Minimally Invasive Surgery, Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA;
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Miranda-Olivos R, Agüera Z, Granero R, Jiménez-Murcia S, Puig-Llobet M, Lluch-Canut MT, Gearhardt AN, Fernández-Aranda F. The Role of Food Addiction and Lifetime Substance Use on Eating Disorder Treatment Outcomes. Nutrients 2023; 15:2919. [PMID: 37447246 DOI: 10.3390/nu15132919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/04/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
Food addiction (FA) and substance use (SU) in eating disorders (ED) have been associated with a more dysfunctional clinical and psychopathological profile. However, their impact on treatment outcomes has been poorly explored. Therefore, this transdiagnostic study is aimed at examining whether the presence of FA and/or SU is associated with treatment outcomes in patients with different ED types. The results were not able to reveal significant differences in treatment outcomes between patients with and without FA and/or SU; however, the effect sizes suggest higher dropout rates in the group with both FA and SU. The predictive models of treatment outcomes showed different features associated with each group. High persistence (i.e., tendency to perseverance and inflexibility) was the personality trait most associated with poor treatment outcomes in patients without addictions. High harm avoidance and younger age at ED onset were the variables most related to poor outcomes in patients with FA or SU. Finally, in the group with both addictive behaviors (FA and SU), the younger patients presented the poorest outcomes. In conclusion, our results suggest that, regardless of presenting addictive behaviors, patients with ED may similarly benefit from treatment. However, it may be important to consider the differential predictors of each group that might guide certain treatment targets.
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Affiliation(s)
- Romina Miranda-Olivos
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Clinical Psychology Unit, L'Hospitalet de Llobregat, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Zaida Agüera
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain
- Departament d'Infermeria de Salut Pública, Salut Mental i Materno-Infantil, Escola d'Infermeria, Facultat de Medicina i Ciències de la Salut, L'Hospitalet de Llobregat, Universitat de Barcelona (UB), 08007 Barcelona, Spain
- Research Group in Mental Health, Psychosocial and Complex Nursing Care (NURSEARCH), Facultat de Medicina i Ciències de la Salut, L'Hospitalet de Llobregat, Universitat de Barcelona (UB), 08007 Barcelona, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Susana Jiménez-Murcia
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Clinical Psychology Unit, L'Hospitalet de Llobregat, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08007 Barcelona, Spain
| | - Montserrat Puig-Llobet
- Departament d'Infermeria de Salut Pública, Salut Mental i Materno-Infantil, Escola d'Infermeria, Facultat de Medicina i Ciències de la Salut, L'Hospitalet de Llobregat, Universitat de Barcelona (UB), 08007 Barcelona, Spain
- Research Group in Mental Health, Psychosocial and Complex Nursing Care (NURSEARCH), Facultat de Medicina i Ciències de la Salut, L'Hospitalet de Llobregat, Universitat de Barcelona (UB), 08007 Barcelona, Spain
| | - Maria Teresa Lluch-Canut
- Departament d'Infermeria de Salut Pública, Salut Mental i Materno-Infantil, Escola d'Infermeria, Facultat de Medicina i Ciències de la Salut, L'Hospitalet de Llobregat, Universitat de Barcelona (UB), 08007 Barcelona, Spain
- Research Group in Mental Health, Psychosocial and Complex Nursing Care (NURSEARCH), Facultat de Medicina i Ciències de la Salut, L'Hospitalet de Llobregat, Universitat de Barcelona (UB), 08007 Barcelona, Spain
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Clinical Psychology Unit, L'Hospitalet de Llobregat, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08007 Barcelona, Spain
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6
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Escrivá-Martínez T, Galiana L, Herrero R, Rodríguez-Arias M, Fernández-Aranda F, Gearhardt AN, Baños RM. Food addiction and its relationship with other eating behaviours among Spanish university students. J Eat Disord 2023; 11:60. [PMID: 37046319 PMCID: PMC10100167 DOI: 10.1186/s40337-023-00772-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/14/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Food addiction (FA) is characterised by symptoms such as loss of control over food consumption, inability to reduce consumption despite the desire to do so, and continued consumption despite negative consequences. The modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) is a widely used instrument to assess FA. OBJECTIVES To validate the Spanish mYFAS 2.0; to analyse the relationships between FA with other eating behaviours, sociodemographic variables, and Body Mass Index (BMI); and to test the eating-related variables that account for the variance in FA. METHODS The sample consisted of 400 university students (Mage = 24.16, SDage = 6.12; 51% female), who completed the mYFAS 2.0 and measures of eating-related constructs. RESULTS A confirmatory factor analysis (CFA) supported the one-factor structure of the mYFAS 2.0. The scale showed good internal consistency (α = .78), and good convergent validity with the mYFAS. FA was related to eating styles, binge eating, and bulimia. No differences in FA were observed between males and females, and there was no association between FA and BMI. In addition, younger participants scored higher on FA than older participants. The eating-related variables explain 54.7% of the variance in FA. CONCLUSIONS The mYFAS 2.0 is a valid and reliable scale to assess FA in the Spanish population. The positive and significant relationship of variables related to eating (eating styles, binge eating and bulimia) with FA was demonstrated. These variables were indicated by those at high risk of FA.
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Affiliation(s)
- Tamara Escrivá-Martínez
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, 46010, Valencia, Spain.
- Polibienestar Research Institute, University of Valencia, 46022, Valencia, Spain.
- CIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, 28029, Madrid, Spain.
| | - Laura Galiana
- Department of Methodology for the Behavioural Sciences, Faculty of Psychology, University of Valencia, 46010, Valencia, Spain
| | - Rocío Herrero
- CIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Psychology and Sociology, University of Zaragoza, 44003, Teruel, Spain
| | - Marta Rodríguez-Arias
- Department of Psychobiology, Faculty of Psychology, University of Valencia, 46010, Valencia, Spain
| | - Fernando Fernández-Aranda
- CIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, 530 Church St., Ann Arbor, MI, 48109, USA
| | - Rosa M Baños
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, 46010, Valencia, Spain
- Polibienestar Research Institute, University of Valencia, 46022, Valencia, Spain
- CIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, 28029, Madrid, Spain
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Celeghin A, Palermo S, Giampaolo R, Di Fini G, Gandino G, Civilotti C. Brain Correlates of Eating Disorders in Response to Food Visual Stimuli: A Systematic Narrative Review of FMRI Studies. Brain Sci 2023; 13:brainsci13030465. [PMID: 36979275 PMCID: PMC10046850 DOI: 10.3390/brainsci13030465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/28/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023] Open
Abstract
This article summarizes the results of studies in which functional magnetic resonance imaging (fMRI) was performed to investigate the neurofunctional activations involved in processing visual stimuli from food in individuals with anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). A systematic review approach based on the PRISMA guidelines was used. Three databases—Scopus, PubMed and Web of Science (WoS)—were searched for brain correlates of each eating disorder. From an original pool of 688 articles, 30 articles were included and discussed. The selected studies did not always overlap in terms of research design and observed outcomes, but it was possible to identify some regularities that characterized each eating disorder. As if there were two complementary regulatory strategies, AN seems to be associated with general hyperactivity in brain regions involved in top-down control and emotional areas, such as the amygdala, insula and hypothalamus. The insula and striatum are hyperactive in BN patients and likely involved in abnormalities of impulsivity and emotion regulation. Finally, the temporal cortex and striatum appear to be involved in the neural correlates of BED, linking this condition to use of dissociative strategies and addictive aspects. Although further studies are needed, this review shows that there are specific activation pathways. Therefore, it is necessary to pay special attention to triggers, targets and maintenance processes in order to plan effective therapeutic interventions. Clinical implications are discussed.
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Affiliation(s)
- Alessia Celeghin
- Department of Psychology, University of Turin, 10124 Turin, Italy
| | - Sara Palermo
- Department of Psychology, University of Turin, 10124 Turin, Italy
- Neuroradiology Unit, Department of Diagnostic and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | | | - Giulia Di Fini
- Department of Psychology, University of Turin, 10124 Turin, Italy
| | | | - Cristina Civilotti
- Department of Psychology, University of Turin, 10124 Turin, Italy
- Faculty of Educational Science, Salesian University Institute (IUSTO), 10155 Turin, Italy
- Correspondence:
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8
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Cabelguen C, Saillard A, Vanier A, Laslandes M, Leboucher J, Rousselet M, Thiabaud E, Grall-Bronnec M, Challet-Bouju G. Is history of abuse predictive of eating disorders with binge-eating episodes through an effect mediated by impulsivity? A French longitudinal study. J Psychiatry Neurosci 2023; 48:E13-E22. [PMID: 36627120 PMCID: PMC9833835 DOI: 10.1503/jpn.210218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 04/19/2022] [Accepted: 09/22/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND In recent years, many studies have explored the associations among impulsivity, history of abuse, the emergence of eating disorders with episodes of binge eating (EDBE) and their severity. Nevertheless, factors associated with successful clinical outcomes of EDBE are still unknown. Our study aimed to test the hypothesis that a history of abuse is associated with unsuccessful clinical outcomes of EDBE through an effect mediated by impulsivity. METHODS We assessed patients older than 15 years, 3 months with EDBE at inclusion and at 1 year. Recovery was defined as the absence of eating disorders at 1 year. A mediation analysis was performed by means of structural equation modelling. RESULTS We included 186 patients in our analyses (54% bulimia nervosa, 29% anorexia nervosa binge eating/purging type and 17% binge-eating disorder); 179 (96%) were female. One-third (n = 63) of patients reported a history of abuse, and recovery was observed for 20% of the sample (n = 38). Contrary to our assumption, a history of abuse was not associated with the absence of recovery of EDBE at 1 year. Factors unfavourable for achieving recovery were anxiety disorders (odds ratio [OR] 0.41), vomiting (OR 0.39), physical hyperactivity (OR 0.29), negative urgency and a lack of perseverance (OR 0.85 for both). Only positive urgency was positively associated with recovery (OR 1.25). LIMITATIONS We excluded 219 patients lost to the 1-year follow-up. CONCLUSION Our findings may help to deconstruct the empirical belief that traumatic events may interfere with the successful course of treatment for eating disorders. A high level of positive urgency may be associated with more receptivity to care.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Gaëlle Challet-Bouju
- From Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France (Cabelguen, Saillard, Laslandes, Leboucher, Rousselet, Thiabaud, Grall-Bronnec, Challet-Bouju); Nantes Université, Université de Tours, CHU Nantes, CHU Tours, Institut national de la santé et de la recherche médicale, SPHERE, Nantes, France (Vanier, Grall-Bronnec, Challet-Bouju); and the Pharmaceutical Drugs Assessment Department, Assessment and Access to Innovation Direction, Haute Autorité de Santé, Saint-Denis, France (Vanier)
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9
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Disentangling binge eating disorder and food addiction: a systematic review and meta-analysis. Eat Weight Disord 2022; 27:1963-1970. [PMID: 35041154 PMCID: PMC9287203 DOI: 10.1007/s40519-021-01354-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/23/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND AIMS The concept of "Food Addiction" has been based on criteria of Substance Use Disorder. Several studies suggested a relationship between food addiction and eating disorders, but little is known about its extent or role. We aim at exploring if food addiction is coincident with a specific eating disorder (binge eating disorder appears the closest) or it is a separate diagnostic entity that afflicts in comorbidity with eating disorders or other conditions like obesity or even in the general population. METHODS This systematic review and meta-analysis analyzed observational studies with a comparative estimation on rates of subjects affected by binge eating disorder and food addiction. RESULTS Binge eating disorder shows higher comorbidity with food addiction compared to other eating disorders (OR = 1.33, 95% CI, 0.64-2.76; c2 = 4.42; p = 0.44;I2 = 0%), or each eating disorder [anorexia nervosa purging type (OR = 1.93, 95% CI, 0.20-18.92; p = 0.57) and restrictive type (OR = 8.75, 95% CI, 1.08-70.70; p = 0.04)], obese patients (OR = 5.72, 95% CI, 3.25-10.09; p = < 0.0001) and individuals from the general population (OR = 55.41, 95% CI, 8.16-376.10; c2 = 18.50; p < 0.0001; I2 = 0%)but has decreased prevalence when compared to bulimia nervosa (OR = 0.85, 95% CI, 0.33-2.22; c2 = 0.35; p = 0.74; I2 = 0%). DISCUSSION AND CONCLUSIONS Our data show that the prevalence of food addiction in binge eating disorder is higher than in other eating disorders except in bulimia nervosa. Moreover, it is a separate diagnostic reality and can be detected in people without mental illness and in the general population. Food addiction might have a prognostic value, since in comorbidity, and should be addressed to boost treatment efficacy and patient's recovery. LEVEL OF EVIDENCE I: Evidence obtained systematic reviews and meta-analyses.
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10
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Clinical Considerations of Ultra-processed Food Addiction Across Weight Classes: an Eating Disorder Treatment and Care Perspective. CURRENT ADDICTION REPORTS 2022; 9:255-267. [PMID: 35531579 PMCID: PMC9058754 DOI: 10.1007/s40429-022-00411-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2022] [Indexed: 12/27/2022]
Abstract
Purpose of Review To examine the prevalence rates of ultra-processed food addiction across different weight classes and offer guidelines for diagnosis and treatment. Clinicians are provided with practical considerations in the assessment of ultra-processed food addiction beyond the use of validated instruments. Recent Findings The weighted mean prevalence of ultra-processed food addiction is approximately 20% worldwide and varies widely based on the sample. At first glance, there appears a linear relationship between ultra-processed food addiction and BMI class. Further investigation indicates a J-shaped curve with heightened prevalence among the underweight. These findings highlight the need to assess for additional factors that may increase objective or subjective food addiction symptoms including eating disorders, dietary restraint, and other mental health diagnoses. Summary While clinical considerations across different weight classes vary, overemphasis on weight status may detract from the clinical utility of the ultra-processed food addiction construct. Considering weight status in conjunction with other psychiatric symptoms helps to better understand the various biopsychosocial mechanisms that influence eating behavior and can inform individualized treatment strategies.
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Sanchez I, Lucas I, Munguía L, Camacho‐Barcia L, Giménez M, Sánchez‐González J, Granero R, Solé‐Morata N, Gearhard A, Diéguez C, Jiménez‐Murcia S, Fernández‐Aranda F. Food addiction in anorexia nervosa: Implications for the understanding of crossover diagnosis. EUROPEAN EATING DISORDERS REVIEW 2022; 30:278-288. [PMID: 35306714 PMCID: PMC9314799 DOI: 10.1002/erv.2897] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 12/14/2022]
Abstract
Objective Food addiction (FA) construct was introduced to reflect abnormal eating patterns that resemble behavioural ones found in substance use disorders. FA has been barely explored in anorexia nervosa (AN). This study evaluated FA occurrence and associated factors in a sample of patients with AN, distinguishing between restrictive and binge–purging subtypes and focussing on the influence of FA in the crossover diagnosis between them. Method A sample of 116 patients with AN admitted for treatment seeking at an Bellvitge Hospital Eating Disorders Unit were included (72 restrictive [AN‐R]; 44 binge‐purge AN [AN‐BP]), and eating‐related, personality and psychopathological variables were assessed. Most participants were women (92.2%), mean age 27.1 years old (SD = 10.5). Results FA was more prevalent in patients with AN‐BP compared to the AN‐R group (75.0% and 54.2%, respectively). The patients with AN‐R FA+, presented more similar ED symptomatology, general psychopathology and personality traits, with the AN‐BP patients, than with the AN‐R FA‐. Conclusions Patients with AN‐R FA+, exhibit more similarities with the AN‐BP subgroup than with the AN‐R FA‐. Thus, it is possible to hypothesise that the presence of FA might be an indicator of the possible crossover from AN‐R to AN‐BP. Patients with anorexia nervosa – restrictive subtype (AN‐R) and patients with anorexia nervosa – bulimic‐purgative subtype (AN‐BP) present a prevalence of food addiction (FA) of 54% and 75%, respectively. Patients with AN‐R FA+ have more clinical and personality similarities with AN‐BP than with AN‐R FA−. The presence of FA could be associated with the possible crossover from AN‐R to AN‐BP.
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Affiliation(s)
- Isabel Sanchez
- Department of Psychiatry University Hospital of Bellvitge Barcelona Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn) Instituto de Salud Carlos III Madrid Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group Neurosciences Programme Bellvitge Biomedical Research Institute (IDIBELL) Barcelona Spain
| | - Ignacio Lucas
- Department of Psychiatry University Hospital of Bellvitge Barcelona Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn) Instituto de Salud Carlos III Madrid Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group Neurosciences Programme Bellvitge Biomedical Research Institute (IDIBELL) Barcelona Spain
| | - Lucero Munguía
- Department of Psychiatry University Hospital of Bellvitge Barcelona Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group Neurosciences Programme Bellvitge Biomedical Research Institute (IDIBELL) Barcelona Spain
| | - Lucia Camacho‐Barcia
- Department of Psychiatry University Hospital of Bellvitge Barcelona Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn) Instituto de Salud Carlos III Madrid Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group Neurosciences Programme Bellvitge Biomedical Research Institute (IDIBELL) Barcelona Spain
| | - Mónica Giménez
- Department of Psychiatry University Hospital of Bellvitge Barcelona Spain
| | - Jessica Sánchez‐González
- Department of Psychiatry University Hospital of Bellvitge Barcelona Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group Neurosciences Programme Bellvitge Biomedical Research Institute (IDIBELL) Barcelona Spain
| | - Roser Granero
- Department of Psychiatry University Hospital of Bellvitge Barcelona Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn) Instituto de Salud Carlos III Madrid Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group Neurosciences Programme Bellvitge Biomedical Research Institute (IDIBELL) Barcelona Spain
- Department of Psychobiology and Methodology Autonomous University of Barcelona Barcelona Spain
| | - Neus Solé‐Morata
- Department of Psychiatry University Hospital of Bellvitge Barcelona Spain
| | - Ashley Gearhard
- Department of Psychology University of Michigan Ann Arbor Michigan USA
| | - Carlos Diéguez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn) Instituto de Salud Carlos III Madrid Spain
- Department of Physiology CIMUS University of Santiago de Compostela‐Instituto de Investigación Sanitaria Santiago de Compostela Spain
| | - Susana Jiménez‐Murcia
- Department of Psychiatry University Hospital of Bellvitge Barcelona Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn) Instituto de Salud Carlos III Madrid Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group Neurosciences Programme Bellvitge Biomedical Research Institute (IDIBELL) Barcelona Spain
- Department of Clinical Sciences School of Medicine and Health Sciences University of Barcelona Barcelona Spain
| | - Fernando Fernández‐Aranda
- Department of Psychiatry University Hospital of Bellvitge Barcelona Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn) Instituto de Salud Carlos III Madrid Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group Neurosciences Programme Bellvitge Biomedical Research Institute (IDIBELL) Barcelona Spain
- Department of Clinical Sciences School of Medicine and Health Sciences University of Barcelona Barcelona Spain
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12
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Miranda-Olivos R, Agüera Z, Granero R, Vergeer RR, Dieguez C, Jiménez-Murcia S, Gearhardt AN, Fernández-Aranda F. Food addiction and lifetime alcohol and illicit drugs use in specific eating disorders. J Behav Addict 2022; 11:102-115. [PMID: 35029544 PMCID: PMC9109624 DOI: 10.1556/2006.2021.00087] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 10/21/2021] [Accepted: 12/16/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Food addiction (FA) and substance use (SU) have frequently been reported in patients with eating disorders (EDs). Our study aimed to assess the prevalence rates of FA and/or lifetime problematic alcohol and illicit drug use among patients with specific ED, such as: bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorder (OSFED). We sought to identify clinical, psychopathological, and personality profiles involved in these addictive behavior-based phenotypes. METHODS The total sample was 527 patients (176 BN, 115 BED, and 236 OSFED). FA was assessed through the Yale Food Addiction Scale 2.0. To determine lifetime SU, a semi-structured clinical interview was carried out. RESULTS Patients with BN had the highest rates of FA both with and without SU. No gender differences were obtained for the prevalence of current FA and/or lifetime SU. Patients reporting at least one addictive-related behavior exhibited increased clinical severity compared to those who reported none. Increased impulsivity (such as high lack of premeditation, sensation seeking, and positive urgency) and low self-directedness were differentiating factors for presenting one or two addictive behaviors. DISCUSSION AND CONCLUSIONS Overall, patients presenting with at least one addictive-like behavior reported a poorer clinical status than those without. Also, patients with FA and SU exhibited a more dysfunctional profile characterized by high impulsivity and low self-directedness. These findings would support the need for targeted treatments to reduce impulsivity and increase self-directedness, especially in patients with any addictive-related behavior, as a step towards improving their treatment outcome.
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Affiliation(s)
- Romina Miranda-Olivos
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain
| | - Zaida Agüera
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain,Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, L’Hospitalet de Llobregat, Spain,Corresponding author. E-mail:
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain,Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rhianna R. Vergeer
- Laboratory on Human Psychopharmacology, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Carlos Dieguez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain,Instituto de Investigaciones Sanitarias (IDIS), Department of Physiology (CIMUS), Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Susana Jiménez-Murcia
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | | | - Fernando Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain,Corresponding author. E-mail:
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13
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Unwin J, Delon C, Giæver H, Kennedy C, Painschab M, Sandin F, Poulsen CS, Wiss DA. Low carbohydrate and psychoeducational programs show promise for the treatment of ultra-processed food addiction. Front Psychiatry 2022; 13:1005523. [PMID: 36245868 PMCID: PMC9554504 DOI: 10.3389/fpsyt.2022.1005523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/22/2022] [Indexed: 11/26/2022] Open
Abstract
Food addiction, specifically ultra-processed food addiction, has been discussed in thousands of peer-reviewed publications. Although 20% of adults meet criteria for this condition, food addiction is not a recognized clinical diagnosis, leading to a dearth of tested treatment protocols and published outcome data. Growing numbers of clinicians are offering services to individuals on the basis that the food addiction construct has clinical utility. This audit reports on clinical teams across three locations offering a common approach to programs delivered online. Each team focused on a whole food low-carbohydrate approach along with delivering educational materials and psychosocial support relating to food addiction recovery. The programs involved weekly sessions for 10-14 weeks, followed by monthly support. The data comprised pre- and post- program outcomes relating to food addiction symptoms measured by the modified Yale Food Addiction Scale 2.0, ICD-10 symptoms of food related substance use disorder (CRAVED), mental wellbeing as measured by the short version of the Warwick Edinburgh Mental Wellbeing Scale, and body weight. Sample size across programs was 103 participants. Food addiction symptoms were significantly reduced across settings; mYFAS2 score -1.52 (95% CI: -2.22, -0.81), CRAVED score -1.53 (95% CI: -1.93, -1.13) and body weight was reduced -2.34 kg (95% CI: -4.02, -0.66). Mental wellbeing showed significant improvements across all settings; short version Warwick Edinburgh Mental Wellbeing Scale 2.37 (95% CI: 1.55, 3.19). Follow-up data will be published in due course. Further research is needed to evaluate and compare long-term interventions for this complex and increasingly burdensome biopsychosocial condition.
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Affiliation(s)
- Jen Unwin
- Public Health Collaboration, London, United Kingdom
| | | | - Heidi Giæver
- Public Health Collaboration, London, United Kingdom
| | - Clarissa Kennedy
- Sweet Sobriety, Belgrade, MT, United States.,Sweet Sobriety, Parry Sound, ON, Canada
| | - Molly Painschab
- Sweet Sobriety, Belgrade, MT, United States.,Sweet Sobriety, Parry Sound, ON, Canada
| | | | | | - David A Wiss
- Nutrition in Recovery LLC, Los Angeles, CA, United States
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14
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The Assessment of Food Addiction and the Yale Food Addiction Scale in Bariatric Surgery Populations. BEHAVIOUR CHANGE 2021. [DOI: 10.1017/bec.2021.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Food addiction (FA) appears among bariatric weight loss surgery candidates who struggle to control the intake of hyperpalatable/refined foods have high rates of psychopathology and related health problems. Despite this, prevalence rates of FA in the bariatric sector are reported as low or variable. We investigated the prevalence of FA and the applicability of conventionally used metrics for 166 pre-surgery candidates from a weight management centre (USA) and a major metropolitan hospital (Australia). Self-report measures assessed FA (Yale Food Addiction Scale (YFAS)), body mass index (BMI), disordered eating, addictive personality, psychopathology, and diet. Consistent with prior research, standard YFAS scoring, requiring the endorsement of a distress/impairment (D/I) criterion (FA + D/I), yielded a FA prevalence rate of 12.7%, compared to 37.3% when D/I was omitted (FA − D/I). We compared profiles for those with FA using each scoring method against those ‘without’, who did not meet a minimum of three YFAS symptoms (non-FA ≤ 2). Both methods differentiated those with and without FA on addictive traits, disordered eating and hyperpalatable food consumption. Only FA + D/I differentiated markers of psychological distress or impairment, including depression, anxiety and quality of life. Results indicate a need for further FA research in bariatric settings.
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15
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Cabelguen C, Rocher B, Leboucher J, Schreck B, Challet-Bouju G, Hardouin JB, Grall-Bronnec M. Attention deficit hyperactivity disorder and gaming disorder: Frequency and associated factors in a clinical sample of patients with Gaming Disorder. J Behav Addict 2021; 10:1061-1067. [PMID: 34710057 PMCID: PMC8987425 DOI: 10.1556/2006.2021.00074] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/30/2021] [Accepted: 10/03/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND AND AIMS Since June 2018, gaming disorder (GD) has been recognized as a disease. It is frequently associated with attention deficit hyperactivity disorder (ADHD), as there are common vulnerability factors and bidirectional interactions between the two disorders. This study aims to evaluate the presence of ADHD symptoms and predictive factors of ADHD among patients with GD. METHODS Ninety-seven patients ≥16 years old referred to the University Hospital of Nantes between 2012 and 2020 for GD were included. The diagnosis of GD was given a posteriori in accordance with the new ICD-11 GD definition. ADHD was screened using the Adult-ADHD Self-Report Scale and the Wender-Utah Rating Scale. A multivariate logistic regression model was used to identify explanatory factors for ADHD-GD comorbidity. RESULTS The rate of GD patients who screened positive for ADHD was 39%. Predictive factors of ADHD-GD comorbidity were impulsivity (higher score on the negative urgency dimension) and low self-esteem. DISCUSSION The rate of ADHD found among patients with GD is consistent with that from the literature on internet GD but higher than that found for other behavioural addictions. The identification of a higher negative urgency score and low self-esteem as predictive factors of AHDH-GD comorbidity indicates that gaming could be considered a dysfunctional way to cope with emotional dysregulation in ADHD or to virtually escape. CONCLUSIONS Comorbid ADHD must be taken into consideration to minimize its functional impact on GD patients and gaming-related damage. In contrast, the evaluation of gaming habits in patients with ADHD could be useful for both prevention and care.
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Affiliation(s)
- Clémence Cabelguen
- Department of Addiction Science and Liaison Psychiatry, Nantes University Hospital, Nantes, France
| | - Bruno Rocher
- Department of Addiction Science and Liaison Psychiatry, Nantes University Hospital, Nantes, France
| | - Juliette Leboucher
- Clinical Investigation Unit “Behavioral Addictions/Complex Affective Disorders”, Addictology and Psychiatry Department, Nantes University Hospital, Nantes, France
| | - Benoît Schreck
- Department of Addiction Science and Liaison Psychiatry, Nantes University Hospital, Nantes, France
- SPHERE, Inserm 1246, University of Nantes and Tours, Nantes, France
| | - Gaëlle Challet-Bouju
- Clinical Investigation Unit “Behavioral Addictions/Complex Affective Disorders”, Addictology and Psychiatry Department, Nantes University Hospital, Nantes, France
- SPHERE, Inserm 1246, University of Nantes and Tours, Nantes, France
| | | | - Marie Grall-Bronnec
- Department of Addiction Science and Liaison Psychiatry, Nantes University Hospital, Nantes, France
- Clinical Investigation Unit “Behavioral Addictions/Complex Affective Disorders”, Addictology and Psychiatry Department, Nantes University Hospital, Nantes, France
- SPHERE, Inserm 1246, University of Nantes and Tours, Nantes, France
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16
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Sommer LM, Halbeisen G, Erim Y, Paslakis G. Two of a Kind? Mapping the Psychopathological Space between Obesity with and without Binge Eating Disorder. Nutrients 2021; 13:3813. [PMID: 34836069 PMCID: PMC8625654 DOI: 10.3390/nu13113813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Obesity (OB) is a frequent co-morbidity in Binge Eating Disorder (BED), suggesting that both conditions share phenotypical features along a spectrum of eating-related behaviors. However, the evidence is inconsistent. This study aimed to comprehensively compare OB-BED patients against OB individuals without BED and healthy, normal-weight controls in general psychopathological features, eating-related phenotypes, and early life experiences. (2) Methods: OB-BED patients (n = 37), OB individuals (n = 50), and controls (n = 44) completed a battery of standardized questionnaires. Responses were analyzed using univariate comparisons and dimensionality reduction techniques (linear discriminant analysis, LDA). (3) Results: OB-BED patients showed the highest scores across assessments (e.g., depression, emotional and stress eating, food cravings, food addiction). OB-BED patients did not differ from OB individuals in terms of childhood traumatization or attachment styles. The LDA revealed a two-dimensional solution that distinguished controls from OB and OB-BED in terms of increasing problematic eating behaviors and attitudes, depression, and childhood adversities, as well as OB-BED from OB groups in terms of emotional eating tendencies and self-regulation impairments. (4) Conclusions: Findings support the idea of a shared spectrum of eating-related disorders but also highlight important distinctions relevant to identifying and treating BED in obese patients.
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Affiliation(s)
- Laura Marie Sommer
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (L.M.S.); (Y.E.)
| | - Georg Halbeisen
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westfalia, Ruhr-University Bochum, Virchowstr. 65, 32312 Luebbecke, Germany;
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (L.M.S.); (Y.E.)
| | - Georgios Paslakis
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westfalia, Ruhr-University Bochum, Virchowstr. 65, 32312 Luebbecke, Germany;
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17
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Aguirre T, Meier N, Koehler A, Bowman R. Highly processed food addiction: A concept analysis. Nurs Forum 2021; 57:152-164. [PMID: 34657289 DOI: 10.1111/nuf.12662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/17/2021] [Accepted: 10/04/2021] [Indexed: 12/19/2022]
Abstract
AIM This concept analysis aims to clarify the highly processed food addiction (HPFA) concept and discuss its implications for treating obesity. BACKGROUND Emerging empirical evidence suggests addictive-like eating may contribute to obesity in some individuals, increasing interest in HPFA's role in obesity. Clarifying the HPFA concept will aid in developing individualized interventions for patients with obesity and HPFA. DESIGN This concept analysis followed Walker and Avant's approach. The case studies are of participants in a study that included individuals with and without HPFA (Yale Food Addiction Scale 2.0-diagnosed). DATA SOURCE We searched PubMed, CINAHL, PsychInfo, and Ebscohost databases. Keywords were "food addiction" and "food addiction concept." REVIEW METHODS Criteria included recent reviews and empirical studies that measured HPFA and focused on HPFA characteristics and/or treatment implications. RESULTS The model case displayed all 11-substance use disorder (SUD) symptoms and clinical significance, supporting a severe HPFA diagnosis. The contrary case was negative for all YFAS 2.0 symptoms and clinical significance and did not eat compulsively or experience cravings. The borderline case met the minimum symptom criteria for severe HPFA but not clinical significance. Clinical interviews may help determine whether such individuals truly exhibit addictive-like eating behaviors. CONCLUSIONS Growing empirical evidence and our case studies support the HPFA concept and the utility of the YFAS/YFAS 2.0 for identifying a distinct subset of individuals with overweight/obesity who may benefit from interventions developed to treat established SUDs. Future research should examine HPFA separately and in relation to obesity and eating disorders and include longitudinal studies and gender-balanced samples.
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Affiliation(s)
- Trina Aguirre
- College of Nursing-West Nebraska Division, University of Nebraska Medical Center, Scottsbluff, Nebraska, USA
| | - Nancy Meier
- College of Nursing-West Nebraska Division, University of Nebraska Medical Center, Scottsbluff, Nebraska, USA
| | - Ann Koehler
- College of Nursing-West Nebraska Division, University of Nebraska Medical Center, Scottsbluff, Nebraska, USA
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Kidd C, Loxton NJ. A narrative review of reward sensitivity, rash impulsivity, and food addiction in adolescents. Prog Neuropsychopharmacol Biol Psychiatry 2021; 109:110265. [PMID: 33545225 DOI: 10.1016/j.pnpbp.2021.110265] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 01/10/2021] [Accepted: 01/26/2021] [Indexed: 02/06/2023]
Abstract
Adolescence represents a neurodevelopmental period characterised by heightened reward drive and weaker inhibitory control that may increase vulnerability to compulsive overconsumption of highly-palatable foods and food addiction. This narrative review aimed to summarise research investigating the presence of food addiction in adolescents and establish the role that impulsivity traits (i.e., reward sensitivity and rash impulsivity), previously linked to substance and behavioural addictions, play in contributing to food addiction in this cohort. It was found that the prevalence of food addiction was typically higher in studies that recruited adolescents who were overweight/obese or from clinical populations. Overall, impulsivity was found to be more consistently associated with food addiction, while the relationships between measures of reward sensitivity and food addiction were mixed. Findings of this review suggest trait impulsivity may contribute to food addiction in adolescents, however, further longitudinal and prospective research is recommended to confirm these findings and to investigate the potential interactive effects of reward sensitivity and rash impulsivity.
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Affiliation(s)
- Chloe Kidd
- School of Applied Psychology, Griffith University, Mt Gravatt Campus, Brisbane, Queensland, Australia
| | - Natalie J Loxton
- School of Applied Psychology, Griffith University, Mt Gravatt Campus, Brisbane, Queensland, Australia.
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Brunault P, Ballon N. Inter-Individual Differences in Food Addiction and Other Forms of Addictive-Like Eating Behavior. Nutrients 2021; 13:nu13020325. [PMID: 33498612 PMCID: PMC7912266 DOI: 10.3390/nu13020325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 12/15/2022] Open
Affiliation(s)
- Paul Brunault
- UMR 1253, iBrain, Université de Tours, Inserm, 37000 Tours, France;
- CHRU de Tours, Service d’Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, 37000 Tours, France
- Qualipsy EE 1901, Université de Tours, 37000 Tours, France
- Correspondence: ; Tel.: +33-247-478043; Fax: +33-247-478402
| | - Nicolas Ballon
- UMR 1253, iBrain, Université de Tours, Inserm, 37000 Tours, France;
- CHRU de Tours, Service d’Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, 37000 Tours, France
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Food Addiction and Tobacco Use Disorder: Common Liability and Shared Mechanisms. Nutrients 2020; 12:nu12123834. [PMID: 33334010 PMCID: PMC7765398 DOI: 10.3390/nu12123834] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/04/2020] [Accepted: 12/10/2020] [Indexed: 02/07/2023] Open
Abstract
As food addiction is being more commonly recognized within the scientific community, parallels can be drawn between it and other addictive substance use disorders, including tobacco use disorder. Given that both unhealthy diets and smoking are leading risk factors for disability and death, a greater understanding of how food addiction and tobacco use disorder overlap with one another is necessary. This narrative review aimed to highlight literature that investigated prevalence, biology, psychology, and treatment options of food addiction and tobacco use disorder. Published studies up to August 2020 and written in English were included. Using a biopsychosocial lens, each disorder was assessed together and separately, as there is emerging evidence that the two disorders can develop concurrently or sequentially within individuals. Commonalities include but are not limited to the dopaminergic neurocircuitry, gut microbiota, childhood adversity, and attachment insecurity. In addition, the authors conducted a feasibility study with the purpose of examining the association between food addiction symptoms and tobacco use disorder among individuals seeking tobacco use disorder treatment. To inform future treatment approaches, more research is necessary to identify and understand the overlap between the two disorders.
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Bou Khalil R, Sleilaty G, Richa S, Seneque M, Iceta S, Rodgers R, Alacreu-Crespo A, Maimoun L, Lefebvre P, Renard E, Courtet P, Guillaume S. The Impact of Retrospective Childhood Maltreatment on Eating Disorders as Mediated by Food Addiction: A Cross-Sectional Study. Nutrients 2020; 12:nu12102969. [PMID: 32998411 PMCID: PMC7601309 DOI: 10.3390/nu12102969] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/25/2020] [Accepted: 09/25/2020] [Indexed: 12/17/2022] Open
Abstract
Background: The current study aimed to test whether food addiction (FA) might mediate the relationship between the presence of a history of childhood maltreatment and eating disorder (ED) symptom severity. Methods: Participants were 231 patients with ED presenting between May 2017 and January 2020 to a daycare treatment facility for assessment and management with mainly the Eating Disorder Inventory-2 (EDI-2), the Child Trauma Questionnaire (CTQ), and the Yale Food Addiction Scale (YFAS 2.0). Results: Participants had a median age of 24 (interquartile range (IQR) 20–33) years and manifested anorexia nervosa (61.47%), bulimia nervosa (16.88%), binge-eating disorders (9.09%), and other types of ED (12.55%). They were grouped into those likely presenting FA (N = 154) and those without FA (N = 77). The group with FA reported higher scores on all five CTQ subscales, as well as the total score of the EDI-2 (p < 0.001). Using mediation analysis; significant indirect pathways between all CTQ subscales and the EDI-2 total score emerged via FA, with the largest indirect effect emerging for physical neglect (standardized effect = 0.208; 95% confidence interval (CI) 0.127–0.29) followed by emotional abuse (standardized effect = 0.183; 95% CI 0.109–0.262). Conclusion: These results are compatible with a model in which certain types of childhood maltreatment, especially physical neglect, may induce, maintain, and/or exacerbate ED symptoms via FA which may guide future treatments.
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Affiliation(s)
- Rami Bou Khalil
- Department of Psychiatry, Saint Joseph University-Hôtel Dieu de France Hospital, Beirut BP 166830, Lebanon;
- PSNREC, University of Montpellier, INSERM, CHU de Montpellier, 34295 Montpellier, France; (M.S.); (A.A.-C.); (P.C.); (S.G.)
- Correspondence: ; Tel.: +96-1142-1000
| | - Ghassan Sleilaty
- Clincal Research Center and Department of Cardiac and Thoracic Surgery, Saint Joseph University-Hôtel Dieu de France Hospital, Beirut BP 166830, Lebanon;
| | - Sami Richa
- Department of Psychiatry, Saint Joseph University-Hôtel Dieu de France Hospital, Beirut BP 166830, Lebanon;
| | - Maude Seneque
- PSNREC, University of Montpellier, INSERM, CHU de Montpellier, 34295 Montpellier, France; (M.S.); (A.A.-C.); (P.C.); (S.G.)
- Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295 Montpellier, France;
| | - Sylvain Iceta
- Quebec Heart and Lung Institute (IUCPQ), Québec, QC G1V 4G5, Canada;
- School of Nutrition, Laval University, Québec, QC G1V 0A6, Canada
- Referral Center for Eating Disorder, Hospices Civils de Lyon, F-69677 Bron, France
| | - Rachel Rodgers
- Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295 Montpellier, France;
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, MA 02115, USA
| | - Adrian Alacreu-Crespo
- PSNREC, University of Montpellier, INSERM, CHU de Montpellier, 34295 Montpellier, France; (M.S.); (A.A.-C.); (P.C.); (S.G.)
| | - Laurent Maimoun
- PhyMedExp, University of Montpellier, INSERM, CNRS, 34295 Montpellier, France;
- Département de Médecine Nucléaire, Hôpital Lapeyronie, Centre Hospitalier Régional Universitaire (CHRU) Montpellier, 34295 Montpellier, France
| | - Patrick Lefebvre
- Department of Endocrinology, Diabetes, and Nutrition, CHRU, 34295 Montpellier, France; (P.L.); (E.R.)
| | - Eric Renard
- Department of Endocrinology, Diabetes, and Nutrition, CHRU, 34295 Montpellier, France; (P.L.); (E.R.)
- UMR CNRS 5203, INSERM U1191, Institute of Functional Genomics, University of Montpellier, 34295 Montpellier, France
| | - Philippe Courtet
- PSNREC, University of Montpellier, INSERM, CHU de Montpellier, 34295 Montpellier, France; (M.S.); (A.A.-C.); (P.C.); (S.G.)
- Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295 Montpellier, France;
| | - Sebastien Guillaume
- PSNREC, University of Montpellier, INSERM, CHU de Montpellier, 34295 Montpellier, France; (M.S.); (A.A.-C.); (P.C.); (S.G.)
- Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295 Montpellier, France;
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Wiss D, Brewerton T. Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint. Nutrients 2020; 12:E2937. [PMID: 32992768 PMCID: PMC7600542 DOI: 10.3390/nu12102937] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 02/07/2023] Open
Abstract
Converging evidence from both animal and human studies have implicated hedonic eating as a driver of both binge eating and obesity. The construct of food addiction has been used to capture pathological eating across clinical and non-clinical populations. There is an ongoing debate regarding the value of a food addiction "diagnosis" among those with eating disorders such as anorexia nervosa binge/purge-type, bulimia nervosa, and binge eating disorder. Much of the food addiction research in eating disorder populations has failed to account for dietary restraint, which can increase addiction-like eating behaviors and may even lead to false positives. Some have argued that the concept of food addiction does more harm than good by encouraging restrictive approaches to eating. Others have shown that a better understanding of the food addiction model can reduce stigma associated with obesity. What is lacking in the literature is a description of a more comprehensive approach to the assessment of food addiction. This should include consideration of dietary restraint, and the presence of symptoms of other psychiatric disorders (substance use, posttraumatic stress, depressive, anxiety, attention deficit hyperactivity) to guide treatments including nutrition interventions. The purpose of this review is to help clinicians identify the symptoms of food addiction (true positives, or "the signal") from the more classic eating pathology (true negatives, or "restraint") that can potentially elevate food addiction scores (false positives, or "the noise"). Three clinical vignettes are presented, designed to aid with the assessment process, case conceptualization, and treatment strategies. The review summarizes logical steps that clinicians can take to contextualize elevated food addiction scores, even when the use of validated research instruments is not practical.
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Affiliation(s)
- David Wiss
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90025, USA
| | - Timothy Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA;
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