Type 2 diabetes mellitus is associated with food addiction in Brazilian women living in poverty.

Food addiction (FA) has been widely investigated. For the first time, two studies reported its association with type 2 diabetes mellitus (DM2) in the general population and populations with mental disorders and undergoing bariatric surgery. However, the relationship between FA and DM2 needs to be better explored in different social contexts and population groups. Given this, the present study aims to evaluate whether DM2 diagnosis is associated with FA diagnosis in women living in poverty. This is a cross-sectional, population-based study conducted in a Brazilian capital city. FA was assessed by the modified Yale Food Addiction Scale (mYFAS) 2.0, and DM2 diagnosis was assessed by self-reporting of previous medical diagnosis. The association was assessed by multivariable Poisson regression with robust variance estimation adjusted for age, poverty situation, race/skin colour, physical activity and BMI. A total of 1878 women were included, of whom 15·1 % had FA and 3·2 % had a medical diagnosis of DM2. In the multivariable analysis, the medical diagnosis of DM2 was associated with FA (prevalence ratio, PR: 2·18; 95 % CI (1·26, 3·76)). The DM2 diagnosis was also identified to be associated with role interference (PR: 1·93; 95 % CI (1·01, 3·67)) symptom of FA. In conclusion, a positive association between FA and DM2 in women living in poverty was observed, information that adds to the current evidence already available in the literature, pointing to a new line of research and integrated care.

Investigating gender differences in the co-occurrence of PTSD and food addiction.

OBJECTIVE: Post-traumatic stress disorder (PTSD) commonly co-occurs with substance use disorders (SUDs). Past studies suggest PTSD is also associated with food addiction (compulsive intake of highly processed foods containing refined carbohydrates and/or added fat). However, research investigating gender differences has been limited (e.g., restricted samples) and mixed. We aim to investigate the risk of co-occurring PTSD and food addiction in a community sample for all participants and stratified by gender. Additionally, we conducted risk ratios for problematic substance use and obesity to allow for within-sample comparisons. METHOD: We utilized a sample of 318 participants recruited from Amazon Mechanical Turk (mean age = 41.2, 47.8% men, 78.0% white) to address existing gaps in the literature on PTSD and food addiction. We calculated risk ratios (adjusted for sociodemographic covariates) using modified Poisson regression with 95% confidence intervals. Results were also gender stratified. RESULTS: Risk of food addiction (Risk Ratio (RR) = 6.42, 95% CI [4.10, 10.07], problematic alcohol use (RR) = 3.86, 95% CI [2.25,6.62], problematic smoking (RR) = 3.93, 95% CI [2.22, 6.97], and problematic nicotine vaping (RR) = 5.41, 95% CI [2.41, 11.14] were higher for those meeting criteria for PTSD. Risk of problematic cannabis use, and risk of obesity were not significantly higher for those meeting criteria for PTSD. Gender-stratified results suggest risk of food addiction may be higher for men (RR) = 8.54, 95% CI [4.49, 16.25] compared to women (RR) = 4.32, 95% CI [2.16, 8.62]. DISCUSSION: Food addiction, but not obesity, appears to co-occur with PTSD more strongly than other types of problematic substance use (alcohol, cannabis, cigarettes, nicotine vaping). This risk appears to be particularly high for men compared to women. Assessing for food addiction in those with PTSD, particularly in men, may assist in identifying high-risk groups.

Food addiction behavior in patients with newly-diagnosed type 2 diabetes.

BACKGROUND: The concept of food addiction describes the difficulties of some individuals with regard to food consumption. OBJECTIVE: To determine the frequency of food addiction and its association with body mass index (BMI), calorie consumption and therapeutic control in patients with newly-diagnosed type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS: A total of 1,080 patients with T2DM were included. The degree of metabolic control was determined with the levels of glycated hemoglobin, low-density lipoprotein cholesterol and blood pressure. Daily caloric consumption was estimated with a semi-quantitative questionnaire of food consumption frequency. RESULTS: Nearly all patients showed overweight (40.5 %) and obesity (49.1 %). The frequency of food addiction was 54.2 % (56.9 % in women and 48.9 % in men). Food addiction was associated with BMI (OR = 1.89, p ≤ 0.05), high caloric intake (OR = 1.14, p ≤ 0.05) and glycated hemoglobin > 7 % (OR = 1.43, p ≤ 0.05). CONCLUSIONS: Food addiction is common in patients with overweight/obesity and newly-diagnosed T2DM, and is associated with higher-than-recommended caloric consumption, obesity degree and poor metabolic control.

ANTECEDENTES: El concepto de adicción a la comida describe las dificultades de algunos individuos respecto al consumo de comida. OBJETIVO: Determinar la frecuencia de la adicción a la comida y su asociación con el índice de masa corporal (IMC), consumo de calorías y control terapéutico en pacientes con diabetes mellitus tipo 2 (DMT2) de diagnóstico reciente. MATERIAL Y MÉTODOS: Se incluyeron 1080 pacientes con DMT2. Se determinó el grado de control terapéutico con niveles de hemoglobina glicada, colesterol de baja densidad y presión arterial. El consumo diario de calorías fue estimado con un cuestionario semicuantitativo de frecuencia de consumo de alimentos. RESULTADOS: Casi todos los pacientes mostraron sobrepeso (40.5 %) y obesidad (49.1 %). La frecuencia de adicción a la comida fue de 54.2 % (56.9 % en mujeres y 48.9 % en hombres). La adicción a la comida se asoció a IMC (RM = 1.89, p ≤ 0.05), alto consumo calórico (RM = 1.14, p ≤ 0.05) y hemoglobina glicada > 7 % (RM = 1.43, p ≤ 0.05). CONCLUSIONES: La adicción a la comida es frecuente en pacientes con sobrepeso/obesidad y DMT2 recientemente diagnosticada y se asocia al consumo calórico superior a lo recomendado, grado de obesidad y pobre control terapéutico.

Childhood sexual abuse and food addiction severity in a clinical sample of individuals with overweight or obesity.

PURPOSE: A higher risk of food addiction (FA) in individuals reporting childhood sexual abuse (CSA) has been well demonstrated with community samples, but studies including clinical samples failed to replicate this relation. This study examined, among individuals presenting eating and weight disorders, the risk of FA for those reporting CSA while considering the severity of CSA and other types of traumas. METHODS: Participants (N = 187) completed a DSM-5 diagnosis assessment and questionnaires on LimeSurvey evaluating FA, interpersonal traumas, depressive level, body esteem, dieting/weight preoccupations, and body mass index (BMI). Logistic regressions were used to calculate the odds ratio (OR) of FA using interpersonal traumas as risk factors, and t tests were used to compare individuals with FA and CSA and those with FA without CSA. RESULTS: Of all interpersonal traumas, CSA was associated with the highest risk of FA, with ORs of 1.73 (p = 0.094) and 2.07 (p = 0.034). The relationship with the abuser, the type of sexual abuse and the number of abuses were significant or marginally significant risk factors, with ORs ranging from 1.26 to 1.50. Finally, no significant difference was found between FA with CSA and FA without CSA. CONCLUSION: Using a clinical sample, this study showed a higher risk of FA in individuals reporting CSA and provided evidence that the relationship with the abuser, the type of sexual abuse, and the number of abuses are relevant factors. Additionally, in individuals with FA, the presence or absence of CSA did not influence depressive level, body esteem, dieting/weight preoccupations, or BMI. LEVEL OF EVIDENCE: Level V, cross-sectional, descriptive study.

Assessment of the relationship between food addiction and nutritional status in schizophrenic patients.

OBJECTIVE: Obesity is one of today's most important public health problems. It is suggested that overeating and substance addiction show similarities, and addiction to food may be an important factor in the obesity epidemic. This study aimed to determine the prevalence of food addiction among schizophrenic patients and to examine the relationship between food addiction and anthropometric measurements and dietary nutrient intake. METHODS: Study participants included a total of 104 schizophrenic outpatients, 62 females and 42 males. Food addiction was assessed by using the Yale Food Addiction Scale, and the anthropometric measurements of participants and their three-day food consumption were recorded. RESULTS: This study found that more than half of the schizophrenic patients (60.6%) had food addiction, and that female schizophrenic patients had a higher prevalence (62.9%) of food addiction than male patients (57.1%). More than one-third of the schizophrenic patients with food addiction (41.3%) were found to be obese and their BMI, body weight, waist circumference, and body-fat ratio were higher than those of schizophrenic patients who did not have food addiction (P > 0.05). Moreover, the schizophrenic patients with food addiction were found to take significantly more energy, carbohydrate, and fat in their diet (P < 0.05). CONCLUSION: It was observed that the development of food addiction in schizophrenic patients increased the risk of obesity and cardiovascular diseases, which were found to be at higher levels in these patients. Educational programs should be planned for these patients to acquire health dietary habits and to increase their physical activity levels, and an additional psychosocial support should be provided for patients with food addiction.

Compulsive eating behaviors in Parkinson's disease.

PURPOSE: Eating disorders are common in Parkinson's disease (PD) patients and often class in Impulse control disorders, however, little is known about their phenomenology. Specific symptoms and comorbidities were described in a group of PD patients in this preliminary study. METHODS: Over a period of 6 months, 51 PD patients who experienced significant changes in eating habits following diagnosis of PD and were interviewed during regularly scheduled follow-up visits. We assessed each patient's height and weight, impulsivity, psychological distress, current eating disorder symptoms, food addiction, food habits and craving. RESULTS: Among the PD patients who experienced modified dietary habits following diagnosis, few exhibited binge eating disorders (BED) full criteria (3.9%). However, 21.6% of patients experienced episodes of out-of-control eating with a large quantity of food in short time and 39.2% satisfied food addiction (FA) criteria without binge eating disorder. Food cravings more than once a week were experienced in approximately half of the population including all FA patients. Regarding comorbidities, FA PD patients present impulsive features and anxiety. CONCLUSIONS: This study confirms the existence of FA profile in PD patients. Eating disorders even in PD are complex and have a cross-cutting criteria related to out-of-control eating, FA, and BED. The association of anxiety with PD-related food addiction, contrary to L-dopa equivalent daily dose mean score or the presence of dopamine agonists, underline the complex sustainability of the dopaminergic brainstem support. A study on their detailed prevalence in this population could be helpful to better understand unspecified feeding or eating disorder. CLINICAL TRIAL NUMBER: DR-2012-007. NAME OF THE REGISTRY: French Committee for the Protection of Persons (CPP) & French National Commission on Computing and Liberty (CNIL). LEVEL OF EVIDENCE: Level V, descriptive study.

Relationship between Food Dependence and Nicotine Dependence in Smokers: A Cross-Sectional Study of Staff and Students at Medical Colleges.

Background and objectives: The aim of this study was to examine the relationship between nicotine dependence and food dependence in smokers. Smoking and obesity are both serious public health problems that give rise to diseases and increased medical expenses. Nicotine dependence is one of the sources of difficulty in smoking cessation, while food dependence is one of the causes of obesity. Materials and Methods: We examined the data of 72 (smoking vs. nonsmoking) and 62 (nicotine dependence vs. no nicotine dependence) subjects among 321 staff and students at medical colleges in Kagawa and Okayama prefectures in Japan. Results: There was a significant difference in food dependence (except women) between the smoking and nonsmoking groups (total: smoking 4.7 ± 6.1, nonsmoking 2.1 ± 2.0, p = 0.0411; men: smoking 4.0 ± 4.7, nonsmoking 2.0 ± 2.1, p = 0.0490). There was also a significant difference in food dependence (except women) between the nicotine dependence and no nicotine dependence groups (total: nicotine dependence 4.6 ± 6.3, no nicotine dependence 2.0 ± 2.1, p = 0.0370; men: nicotine dependence 3.6 ± 4.8, no nicotine dependence 1.6 ± 1.8, p = 0.0489). Conclusion: The findings showed that the smoking group (and nicotine dependence group) had higher food dependence than the nonsmoking group (and no nicotine dependence group). Our results indicate an interdependence between nicotine and food dependences.

The prevalence of food addiction in a large sample of adolescents and its association with addictive substances.

The prevalence of overweight and obesity is increasing, due to, among other factors, increased availability of highly palatable food (food high in fat, salt and/or sugar). It has been proposed that certain foods and/or eating behaviours may be addictive, to a degree comparable to substances of abuse. The Yale Food Addiction Scale (YFAS) measures 'food addiction' by translating the diagnostic criteria for substance use disorder to eating behaviour. So far, only a few studies have examined the prevalence of food addiction in children with the YFAS for children (YFAS-C). Large-scale studies, especially among adolescents, are lacking. Adolescence is of particular interest because it is a period wherein unhealthy eating behaviours or addictive tendencies are likely to develop. The current study examines the prevalence of food addiction using the YFAS-C in a large group of Dutch adolescents (N = 2653) aged 14-21 years. With Generalized Estimation Equation (GEE) analysis we tested the relationship between food addiction symptoms and smoking, cannabis use, alcohol use, and sugar intake through drinks, while controlling for gender, age, educational level and weight class. In the total sample 2.6% met the criteria for a food addiction 'diagnosis', and the average symptom count was 1.0 (SD = 1.3, range 0-7). Symptoms of food addiction were positively associated with smoking, alcohol use, cannabis use and sugar intake. We propose that future studies focus on possible genetic/(neuro)biological mechanisms involved in both food addiction and substance use and that longitudinal designs are needed to examine possible causal pathways.

The association of addictive-like eating with food intake in children.

OBJECTIVES: The potential role of an addictive process in problematic eating is a growing area of interest and debate. Children are more vulnerable to the negative effects of addictive substances than adults and may be at increased risk for addictive-like eating behavior. No prior study has evaluated the association of addictive-like eating with objectively measured eating behavior in adults or children. We examined the association between "food addiction" and observed food consumption among children and whether age moderated this association. METHOD: Seventy children participated in an observed dinner meal, completed a dietary recall interview, and answered the Yale Food Addiction Scale for Children (YFAS-C), a questionnaire assessing symptoms of "food addiction". Children's total calories ordered, calories consumed at dinner, calories consumed post-dinner, and a total of calories consumed at dinner and post-dinner were calculated along with their BMI percentile. We used generalized estimated equation models to investigate the relationship between the YFAS-C and food consumption. RESULTS: Elevated "food addiction" symptoms, but not BMI percentile, were positively associated with an increased amount of calories consumed at dinner and post-dinner. Age significantly moderated the relationship between YFAS-C and caloric intake, with only younger children exhibiting this association. CONCLUSIONS: As the first study of objectively measured eating behavior, we found addictive-like eating scores in children were positively associated with the total amount of calories consumed. Among younger children, "food addiction" was more strongly associated with the total calories consumed than BMI percentile, highlighting the importance of assessing behavioral phenotypes when evaluating caloric intake. This association between addictive-like eating and caloric intake among younger, but not older children may be due to differences in inhibitory control and dietary restraint.

Development and Validation of a Brief Measure of Eating Compulsivity (MEC).

Food addiction is increasingly being recognised as a contributory factor in overweight and obesity. Management of eating compulsivity, a key component of food addiction, may assist greatly in the successful treatment of obesity. Measurement of food addiction and its core characteristic of eating compulsivity is fundamental to increasing understandings of the concept of food addiction, its prevalence among people with and without obesity and its utility within a treatment context. The current study describes the development and initial validation of a brief measure of eating compulsivity that can be used within clinical and research settings to establish a person's level of eating compulsivity. Sixty five participants with a BMI ≥30 (mean BMI 38.1) were recruited from a general population sample within Christchurch, New Zealand. Participants completed the test version of the Measure of Eating Compulsivity (MEC) and the Yale Food Addiction Scale (YFAS) as well as providing self-reported measures of height and weight. The 10-item MEC was developed. This measure was shown to have excellent internal consistency (Cronbach's alpha =.946), based on a single factor accounting for 67.4% of the variance and excellent test-retest reliability (r =.923). MEC10 score was strongly predictive of being categorised as having food addiction based on the YFAS, although not associated with BMI. This brief tool is likely to have high utility in clinical and research settings and requires further validation with a range of populations including those with and without obesity, binge eating disorder and other eating disorders.

Food addiction as a proxy for eating disorder and obesity severity, trauma history, PTSD symptoms, and comorbidity.

PURPOSE: Food addiction (FA) is a newly defined yet still controversial condition that has important etiological, developmental, treatment, prevention, and social policy implications. In this review, the case is made that FA (or high scores on the Yale Food Addiction Scale) may be used as a proxy measure for a matrix of interrelated clinical features, including greater eating disorder severity, greater obesity severity, more severe trauma histories, greater symptoms of posttraumatic stress disorder (PTSD), greater psychiatric comorbidity, as well as greater medical morbidity and mortality. METHODS: A Medline search was undertaken using the following terms: food addiction cross-referenced with eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder, and binge eating), obesity, trauma, posttraumatic stress disorder, and comorbidity. RESULTS: The thesis is that the identification and acknowledgment of the concept of FA, when integrated into an overall, trauma-focused and transdiagnostic treatment approach, are supported and can be useful in understanding clinically the "big picture." CONCLUSIONS: Food addiction (FA) may be used as a proxy for (1) bulimic eating disorder severity, (2) complex trauma histories, (3) severity of PTSD and PTSD symptoms, (4) intensity of psychiatric comorbidity, (5) severity of obesity, as well as (6) their combination. Implications for developing treatment strategies are discussed. The case for a comprehensive management that requires careful attention to medical and psychiatric assessment and integrated care that incorporates trauma-focused treatment is made.

An examination of the mechanisms and personality traits underlying food addiction among individuals with severe obesity awaiting bariatric surgery.

PURPOSE: The aetiology underlying addiction has often been investigated to shed more light on the factors contributing to the development and maintenance of various disorders. In the field of addictive eating behaviours, data on the aetiological factors related to food addiction (FA) in the bariatric context remain scarce. The present study aimed to explore mechanisms and variables underlying FA among individuals suffering from severe obesity and awaiting bariatric surgery. METHODS: Participants (N = 146) were recruited at the Quebec Heart and Lung Institute during their pre-operative visit and were invited to complete questionnaires. Participants with and without FA were compared on reward sensitivity, impulsivity, emotion dysregulation, and personality traits. RESULTS: Findings showed that bariatric candidates with FA (16%) presented more emotion dysregulation, more harm avoidance, and less self-directedness. Further exploration showed that the association between harm avoidance and the number of FA criteria endorsed was mediated by emotion dysregulation, while the association between self-directedness and the number of FA criteria endorsed was mediated by reward sensitivity. CONCLUSIONS: These results indicate that an inability to regulate affect by strategies other than eating highly palatable food, in a context where negative affect and long-term goals can hardly be sustained, underlies a diagnostic of FA among bariatric candidates. From a clinical standpoint, the presence of a double vulnerability leading to FA symptomatology could help design better-targeted interventions to maximise weight loss maintenance in the bariatric context. LEVEL OF EVIDENCE: Level V, descriptive study.

Physiopathology and Treatment of Obesity and Overweight: A Proposal for a New Anorectic.

The "new epidemic," as WHO calls obesity, is caused by overeating, which, having exceeded the body's actual needs, accumulates in the form of health-damaging fat deposits. Moving more and eating less is the main remedy, but eating belongs to vital instincts, which are beyond the control of reason. In this sense, eating is different from drinking and breathing because without food it is possible to survive for a few weeks, without water for a few days, without oxygen for a few minutes. The first part of this article provides an overview of obesity and its treatment, focusing on the new anorectic anticipated in the title. The second part focuses on compulsive obesity, typically represented by constitutional obesity and food addiction. The article concludes with a discussion of the pharmacological treatment of compulsive diseases, to which some forms of obesity belong.

Plasma concentration of leptin is related to food addiction in gambling disorder: Clinical and neuropsychological implications.

Background: Data implicate overlaps in neurobiological pathways involved in appetite regulation and addictive disorders. Despite different neuroendocrine measures having been associated with both gambling disorder (GD) and food addiction (FA), how appetite-regulating hormones may relate to the co-occurrence of both entities remain incompletely understood. Aims: To compare plasma concentrations of ghrelin, leptin, adiponectin, and liver-expressed antimicrobial peptide 2 (LEAP-2) between patients with GD, with and without FA, and to explore the association between circulating hormonal concentrations and neuropsychological and clinical features in individuals with GD and FA. Methods: The sample included 297 patients diagnosed with GD (93.6% males). None of the patients with GD had lifetime diagnosis of an eating disorder. FA was evaluated with the Yale Food Addiction Scale 2.0. All patients were assessed through a semi-structured clinical interview and a psychometric battery including neuropsychological tasks. Blood samples to measure hormonal variables and anthropometric variables were also collected. Results: From the total sample, FA was observed in 23 participants (FA+) (7.7% of the sample, 87% males). When compared participants with and without FA, those with FA+ presented both higher body mass index (BMI) (p < 0.001) and leptin concentrations, after adjusting for BMI (p = 0.013). In patients with FA, leptin concentrations positively correlated with impulsivity, poorer cognitive flexibility, and poorer inhibitory control. Other endocrine measures did not differ between groups. Discussion and conclusions: The present study implicates leptin in co-occurring GD and FA. Among these patients, leptin concentration has been associated with clinical and neuropsychological features, such as impulsivity and cognitive performance in certain domains.

Sex Differences in the Relationship between Chronotype and Eating Behaviour: A Focus on Binge Eating and Food Addiction.

BACKGROUND: Men are more likely than women to have subthreshold overeating disorders. Lifestyle plays a role as a determinant, while chronotype is an emerging factor. Chronotype explains the natural preferences of wakefulness and activity throughout the day: evening chronotypes (E-Types), those most productive in the evening, have been linked with unhealthy dietary patterns and a higher propensity to substance addiction than morning types (M-Types). METHODS: We carried out a cross-sectional study on 750 overweight or obese adults (70% females, 48 ± 10 years, BMI 31.7 ± 5.8 kg/m2). The Binge-Eating Scale, the Yale Food Addiction Scale 2.0 (YFAS 2.0), the reduced Morningness-Eveningness Questionnaire (rMEQ), and the MEDAS questionnaire were used to assess binge eating, food addiction, chronotype, and adherence to the Mediterranean diet, respectively. RESULTS: No differences in BES binge-eating and FA food-addiction scores occurred between chronotypes, but we found significant interactions between sex × rMEQ score. While women showed the same prevalence for binge eating and food addiction across all chronotypes, binge eating and food addiction risk increased with reducing rMEQ score in men, indicating that being male and E-Type increases the risk association of binge eating and/or food addiction prevalence. CONCLUSIONS: chronotype is associated with binge eating and food addiction in men, emphasizing the link between chronobiology and sex differences as determinants in appetite and eating behaviour dysregulation and in overweight and obesity.

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

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.

Linking drug and food addiction via compulsive appetite.

BACKGROUND AND PURPOSE: 'Food addiction' is the subject of intense public and research interest. However, this nosology based on neurobehavioural similarities among obese individuals, patients with eating disorders and those with substance use disorders (drug addiction) remains controversial. We thus sought to determine which aspects of disordered eating are causally linked to preclinical models of drug addiction. We hypothesized that extensive drug histories, known to cause addiction-like brain changes and drug motivation in rats, would also cause addiction-like food motivation. EXPERIMENTAL APPROACH: Rats underwent extensive cocaine, alcohol, caffeine or obesogenic diet histories and were subsequently tested for punishment-resistant food self-administration or 'compulsive appetite', as a measure of addiction-like food motivation. KEY RESULTS: Extensive cocaine and alcohol (but not caffeine) histories caused compulsive appetite that persisted long after the last drug exposure. Extensive obesogenic diet histories also caused compulsive appetite, although neither cocaine nor alcohol histories caused excess calorie intake and bodyweight during abstinence. Hence, compulsive appetite and obesity appear to be dissociable, with the former sharing common mechanisms with preclinical drug addiction models. CONCLUSION AND IMPLICATIONS: Compulsive appetite, as seen in subsets of obese individuals and patients with binge-eating disorder and bulimia nervosa (eating disorders that do not necessarily result in obesity), appears to epitomize 'food addiction'. Because different drug and obesogenic diet histories caused compulsive appetite, overlapping dysregulations in the reward circuits, which control drug and food motivation independently of energy homeostasis, may offer common therapeutic targets for treating addictive behaviours across drug addiction, eating disorders and obesity.

Daytime sleepiness, addictive-like eating, and obesity sequelae in Black and African American youth with obesity.

OBJECTIVES: The purpose of the current study was to examine the association between poor sleep health (ie, excessive daytime sleepiness), obesity sequelae (ie, percent overweight and serum leptin levels), and addictive-like eating behaviors, an obesity phenotype, in a sample of Black/African American (B/AA) adolescents. DESIGN: The current study analyzed archival baseline data from a sample of B/AA adolescents with obesity enrolled in a sequential randomized clinical trial. SETTING: Data were collected in the participants' homes by trained research assistants unaware of treatment condition. PARTICIPANTS: A sample of 181 B/AA adolescents with obesity between the ages of 12 and 16 years (M = 14.26, SD = 1.46) and having a body mass index (BMI) above the 95th percentile for age and gender were sampled. MEASUREMENTS: Self-report measures included the Cleveland Adolescent Sleepiness Questionnaire and the Yale Food Addiction Scale-Children (YFAS-C). Anthropomorphic data and blood samples were used to determine BMI and serum leptin levels, respectively. RESULTS: Excessive daytime sleepiness was positively correlated with YFAS-C symptom count, r = 0.295, P < .001. Serum leptin levels and percent overweight were both positively correlated with each other, r = 0.445, P < .001 and with YFAS-C symptom count, r = 0.215, P = .006. After controlling for age and gender, results supported an indirect effect from daytime sleepiness to both serum leptin levels (estimate = 2.210, SE = 0.932, P = .018) and percent overweight (estimate = 2.817, SE = 1.415, P = .046) through YFAS-C symptom count. CONCLUSIONS: Culturally informed interventions on eating behaviors (ie, addictive-like eating) when excessive daytime sleepiness is reported are needed. Early intervention may help prevent the onset or worsening of obesity among adolescents.

Can a Behavioral Weight-Loss Intervention Change Adolescents' Food Addiction Severity?

Objective: This study examines changes in the Yale Food Addiction Scale symptom count over a 24-week, weight-loss mobile Health (mHealth) intervention incorporating elements of addiction medicine. Methods: Adolescents (n = 117) with obesity (15.5 ± 1.3 years; 66% Hispanic) were randomized to the following: (1) mHealth intervention (AppAlone), (2) mHealth intervention+coaching (AppCoach), or (3) in-person intervention (Control). A multivariate mixed Poisson regression model was used to evaluate changes in symptom counts across intervention arms after adjusting for sex, age, depressive symptomatology, stress, and executive function. Results: After the intervention, 57% of adolescents showed a decrease in symptom count (median change: -0.3 [0 to -1.5]), with a significant change by intervention arm in the intention-to-treat analysis (p = 0.045). There was a positive linear relationship between change in symptom count and change in depressive symptomatology (p < 0.01) and stress (p < 0.01), with no association with change in weight (p = 0.3). Discussion: Both mHealth and in-person obesity interventions seemed to confer benefits in food addiction symptomatology associated with change in mood and stress. Clinical Trial Registration number: NCT035008353.