Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023;16(5):465-474.
doi: 10.1159/000531528. Epub 2023 Aug 4.

Correlates of Food Addiction and Eating Behaviours in Patients with Morbid Obesity

Pia Schankweiler  1 , Dirk Raddatz  2 , Thomas Ellrott  1 , Carolin Hauck Cirkel  1
Affiliations

Correlates of Food Addiction and Eating Behaviours in Patients with Morbid Obesity

Pia Schankweiler et al. Obes Facts. 2023.

Abstract

Introduction: Food addiction (FA) is a promising construct regarding the multifactorial aetiology of obesity and the search for therapeutic approaches. However, there is an ongoing debate regarding the overlap/differentiation with eating disorders and the classification as a substance- or behaviour-related addiction. Energy-dense foods, especially those combining carbohydrates and fat, are associated with addictive eating and suspected of playing a role in the genesis of FA. This study aims to further understand the clinical significance of FA and to identify possible therapeutic targets. A special focus is set on potentially addictive foods (combination of carbohydrates and fat).

Methods: Based on the Yale Food Addiction Scale 2.0, a cohort of 112 German adults with morbid obesity was divided into two sub-samples (patients with and without FA), which were examined for differences in the variables listed below.

Results: The prevalence of FA was 25%. Patients meeting criteria for FA showed higher degrees of hunger, emotional, binge, and night eating than patients without FA. In addition, hunger and disinhibition were found to be significant predictors of FA. FA was not associated with sex, age, body mass index (BMI), cognitive restraint, rigid and flexible control, prevalence of substance use, age of onset of obesity, stress level, level of social support, reduction of BMI during a weight loss programme, or programme withdrawal rate. There was no significant difference in the consumption of foods rich in both carbohydrates and fat, nor of fat or carbohydrates alone.

Conclusion: FA can be considered as a sub-phenotype of obesity, occurring in approximately 25% of obesity cases. Dysfunctional emotional coping mechanisms associated with low distress tolerance showed to be significantly related to FA and should be targeted therapeutically. Behavioural interventions should include a bio-psycho-social model. Binge eating episodes were found to be characteristic for FA and the already stated overlap between FA and binge eating behaviour can be confirmed. The results do not support a decisive difference due to a substance-related component of FA. Despite this, the existence of FA as a distinct entity cannot be excluded, as not all patients with FA exhibit binges.

Keywords: Behavioural addiction; Eating disorder; Food addiction; Obesity; Substance use.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
Comparison of patients with and without food addiction (FA) with regard to night eating (a), emotional eating (b), and binge eating (c).
Fig. 2.
Fig. 2.
a, b Overlap of food addiction (FA) and night eating (NE) and binge eating behaviour (BE), respectively, in a patient population with morbid obesity.
Fig. 3.
Fig. 3.
Comparison of patients with and without food addiction (FA) with regard to problematic food categories.
See this image and copyright information in PMC

References

    1. Baxter J, Armijo PR, Flores L, Krause C, Samreen S, Tanner T. Updates on monogenic obesity in a multifactorial Disease. Obes Surg. 2019;29(12):4077–83. 10.1007/s11695-019-04200-z. - DOI - PubMed
    1. Kim TJ, Makowski AC, von dem Knesebeck O. Obesity stigma in Germany and the United States: results of population surveys. PLoS One. 2019;14(8):e0221214. 10.1371/journal.pone.0221214. - DOI - PMC - PubMed
    1. Long CG, Blundell JE, Finlayson G. A systematic review of the application and correlates of YFAS-diagnosed “food addiction” in humans: are eating-related “addictions” a cause for concern or empty concepts? Obes Facts. 2015;8(6):386–401. 10.1159/000442403. - DOI - PMC - PubMed
    1. Schulte EM, Avena NM, Gearhardt AN. Which foods may be addictive? The roles of processing, fat content, and glycemic load. PLoS One. 2015;10(2):e0117959. 10.1371/journal.pone.0117959. - DOI - PMC - PubMed
    1. Meule A. Back by popular demand: a narrative review on the history of food addiction research. Yale J Biol Med. 2015;88(3):295–302. - PMC - PubMed

Publication types

MeSH terms