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. 2021 May 27;13(6):1840.
doi: 10.3390/nu13061840.

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

Monika M Stojek  1   2 , Justyna Lipka  1 , Jessica M Maples-Keller  2   3   4 , Sheila A M Rauch  2   3   5 , Kathryn Black  2   3 , Vasiliki Michopoulos  2   4   6 , Barbara O Rothbaum  2   3
Affiliations

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

Monika M Stojek et al. Nutrients. .

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.

Keywords: eating dysregulation; food addiction; obesity; posttraumatic stress disorder (PTSD); sex differences; trauma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Estimated marginal means of body mass index (BMI) for a 2 × 2 factorial ANOVA with sex (female, male) and FA status (1 = positive, 0 = negative, on the X-axis) adjusted for age, race, and PTSD status (threshold vs. subthreshold).
Figure 2
Figure 2
Estimated marginal means of loss of control over eating frequency for a 2 × 2 factorial ANOVA with sex (female, male) and FA status (1 = positive, 0 = negative, on the X-axis) adjusted for age, race, and PTSD status (threshold vs. subthreshold).
Figure 3
Figure 3
Estimated marginal means of compensatory behaviors frequency for a 2 × 2 factorial ANOVA with sex (female, male) and FA status (1 = positive, 0 = negative, on the X-axis) adjusted for age, race, and PTSD status (threshold vs. subthreshold).
Figure 4
Figure 4
Estimated marginal means of PTSD severity for a 2 × 2 factorial ANOVA with sex (female, male) and FA status (1 = positive, 0 = negative, on the X-axis) adjusted for age, race, and PTSD status (threshold vs. subthreshold). Note: PCL-5 = PTSD Symptom Checklist for DSM-5.
Figure 5
Figure 5
Estimated marginal means of depression severity for a 2 × 2 factorial ANOVA with sex (female, male) and FA status (1 = positive, 0 = negative, on the X-axis) adjusted for age, race, and PTSD status (threshold vs. subthreshold). Note: PHQ-9 = Patient Health Questionnaire.
Figure 6
Figure 6
Estimated marginal means of alcohol use severity for a 2 × 2 factorial ANOVA with sex (female, male) and FA status (1 = positive, 0 = negative, on the X-axis) adjusted for age, race, and PTSD status (threshold vs. subthreshold). Note: AUDIT-C = Alcohol Use Disorder Identification Test-Consumption.
Figure 7
Figure 7
Estimated marginal means of alcohol use frequency for a 2 × 2 factorial ANOVA with sex (female, male) and FA status (1 = positive, 0 = negative, on the X-axis) adjusted for age, race, and PTSD status (threshold vs. subthreshold).
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