Abstract
Purpose
Understanding the complexities of obesity is important for develo** effective interventions. Evidence is growing that addictive-like tendencies toward foods may contribute to obesity in some individuals. The Yale Food Addiction Scale (YFAS, YFAS 2.0) was developed to identify individuals with addictive-like eating behaviors. Diagnosing food addiction (FA) requires meeting a symptom threshold plus clinically significant impairment/distress (self-perceived), but the utility of the impairment/distress criteria remains controversial. This secondary analysis compared individuals who did not meet the FA symptom criteria, met the symptom, but not the impairment/distress criteria, and met both criteria.
Methods
This secondary analysis of data from a randomized controlled pilot study involving 83 adults with overweight/obesity used descriptive statistics and Univariate ANOVAS to compare YFAS 2.0 and Weight and Lifestyle Inventory responses among the groups.
Results
Twenty-eight individuals did not meet the FA symptom criteria, 20 met the symptom, but not the impairment/distress criteria, and 35 met both criteria. Of the latter, 80.0% had severe, 8.6% had moderate, and 11.4% had mild FA. Age at onset of overweight was lower with severe than with mild FA (p = 0.023).
Conclusions
The YFAS 2.0 identified a distinct group with severe FA and a group who met the FA symptom threshold, but not the impairment/distress criteria. Few participants perceived impairment/distress unless they endorsed ≥ 6 symptoms. Adding clinical interviews may aid in assessing impairment/distress and addictive-like eating behaviors, particularly in those meeting the FA symptom, but not the impairment/distress criteria. Better characterization of these groups may help targeting obesity interventions.
Trial registration number
NCT03431831, 1/30/2018.
Level of evidence
Level III, case-control analytic study.
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Code availability
Not applicable.
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Acknowledgements
We thank the Regional West Physicians Clinic for clinic space and referrals and Dr. Gearhardt for use of the YFAS 2.0.
Funding
This work was funded by a Research & Engagement Competitive Award from the Rural Futures Institute, University of Nebraska.
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The authors declare that they have no conflict of interest.
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Ethical approval was obtained from the University of Nebraska Medical Center Institutional Review Board (IRB protocol 763-16-FB).
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Informed consent was obtained from all individual participants included in the study.
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The datasets generated during and/or analyzed during the current study are available from the principal investigator (TA) on reasonable request.
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This article is part of the Topical Collection on Food and Addiction.
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Koehler, A., Aguirre, T., Schulte, E. et al. Secondary analysis of YFAS 2.0 symptom counts, impairment/distress, and food addiction severity in adults with overweight/obesity. Eat Weight Disord 26, 2393–2399 (2021). https://doi.org/10.1007/s40519-020-01077-1
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DOI: https://doi.org/10.1007/s40519-020-01077-1