The bioSocial Cognitive Theory of Eating (bSCT-e): Applying and Elaborating on a Biopsychosocial Substance Use Theory for Food Addiction.

Obesity rates are increasing globally, and food addiction (FA1) may be an important contributing factor but there is a lack of understanding of the key psychological mechanisms that contribute to FA. The bioSocial Cognitive Theory (bSCT) proposes that substance use is predicted by biologically based personality traits and their influence on social cognitive mechanisms. While validated in substance use, bSCT has not been applied to a behavioural or non-substance addiction. However, the bSCT does not include a negative affective personality component, of which there is clear theoretical and empirical support as risk factors for FA. Thus, this study sought to test both the original bSCT model and an elaborated version related to eating (bSCT-e) that included direct and indirect punishment sensitivity pathways to identify the individual risk factors of FA. Data were collected from 204 university students (75.5% female; Mage = 24.82, SD = 9.17) via an online survey. Both original bSCT and bSCT-e models provided a good fit to the data, with the latter providing slightly better fit and accounting for more variance in FA. The findings suggest that individuals who are more reward driven and punishment sensitive hold exaggerated beliefs about the reinforcing and emotion regulation effects of eating, which may undermine eating control and increase risk of FA. This study provides potential new insights into the complex biopsychosocial mechanisms of FA, and points to potential intervention targets.

The prognostic role of food addiction for weight loss treatment outcomes in individuals with overweight and obesity: A systematic review and meta-analysis.

Food addiction (FA) could be a potential prognostic factor of weight loss intervention outcomes. This systematic review with meta-analysis aimed to (1) estimate this prognostic effect of FA diagnosis and symptom count in individuals with overweight or obesity and (2) explore potential sources of heterogeneity based on properties of the weight loss intervention, study, and sample (e.g., age, gender, ethnicity). We searched PubMed, PsycINFO, and Web of Science for studies reporting on associations between pre-intervention FA (assessed with the Yale Food Addiction Scale) and weight outcomes after weight loss intervention in individuals with overweight or obesity without a medically diagnosed eating disorder. Twenty-five studies met inclusion criteria, including 4904 individuals (71% women, Mage = 41 years, BMI = 40.82 kg/m2), k = 18 correlations of weight loss with FA symptom count, and k = 21 mean differences between FA diagnosis groups. Pooled estimates of random-effects meta-analyses found limited support for a detrimental effect of FA symptom count and diagnosis on weight loss intervention outcomes. Negative associations with FA increased for behavioral weight loss interventions and among more ethnically diverse samples. More research on the interaction of FA with pre-existing mental health problems and environmental factors is needed.

Development and validation of the modified Yale Food Addiction Scale for Children 2.0.

OBJECTIVE: Scientific interest in the concept of food addiction is growing, but more studies are needed in youth samples. Brief, psychometrically valid, and developmentally appropriate measures are needed to support the assessment of food addiction in large-scale studies of youth that need to minimize participant burden. While a brief version of the Yale Food Addiction Scale 2.0 (YFAS 2.0) exists for adults, no comparable scale exists for youth. Thus, the current study aimed to develop a brief and valid measure of food addiction for use in youth populations (the modified YFAS for children 2.0). METHOD: Data stem from the Food Addiction Denmark (FADK) Project, where random samples of 559 adolescents from the general population and 413 adolescents from a population with mental disorder completed the 35-item original YFAS for children 2.0 (YFAS-C 2.0). An abbreviated 13-item version was developed, and the psychometric properties of the modified YFAS-C 2.0 (mYFAS-C 2.0) were then evaluated. RESULTS: The mYFAS-C 2.0 exhibited a one-factor structure and was found to have sound psychometric properties regarding internal consistency and convergent, discriminant, and incremental validity. This was evident in both the general adolescent population sample and the sample of adolescents with mental disorders. CONCLUSIONS: The mYFAS-C 2.0 provides a brief and psychometrically valid measure of food addiction for youth, which may be beneficial for study designs (e.g., epidemiological samples) that aim to minimize participant burden. Future research on the test-retest reliability of the mYFAS-C 2.0 and its psychometric properties in younger children are important next steps.

Food Addiction.

In this review, we aim to draw a connection between drug addiction and overconsumption of highly palatable food (OHPF) by discussing common behaviors and neurochemical pathways shared by these two states. OHPF can stimulate reward pathways in the brain that parallel those triggered by drug use, increasing the risk of dependency. Behavioral similarities between food and drug addiction can be addressed by tracking their stages: loss of control when eating (bingeing), withdrawal, craving, sensitization, and cross-sensitization. The brain adapts to addiction by way of the mesolimbic dopamine system, endogenous opioids and receptors, acetylcholine and dopamine balance, and adaptations of serotonin in neuroanatomy. Studies from the current literature are reviewed to determine how various neurological chemicals contribute to the reinforcement of drug addiction and OHPF. Finally, protocols for treating food addiction are discussed, including both clinical and pharmacological modalities. There is consistent evidence that OHPF changes brain chemistry and leads to addiction in similar ways to drugs. However, more long-term research is needed on food addiction, binge eating, and their neurobiological effects.

Validation of the Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) in Spanish University Students.

OBJECTIVE: The aim of this study was to explore the factorial structure, psychometric properties and association with anthropometric and clinical variables of the Modified Yale Addiction Scale 2.0 (mYFAS 2.0) in a Spanish university population. METHODS: A cross-sectional study of n = 270 university students in Spain was conducted. VARIABLES MEASURED: mYFAS 2.0, Emotional Eater Questionnaire (EEQ), Alcohol Use Disorder Identification Test (AUDIT), Pittsburg Sleep Quality index (PSQI) and Perceived Stress Scale (PSS). In mYFAS 2.0 were performed an Exploratory Factor Analysis (EFA), an Unweight Least Square (ULS), a model fit using comparative fit index (CFI) and nomological validity. RESULTS: EFA revealed that a two-factor structure is the most appropriate in a non-clinical population of Spanish university students. The factors accounted for 18.54% and 16.33% of the variance, and the correlation between them was moderate-0.487 (p < 0.001). This different structure from that reported in the original scale could be derived from the cultural characteristics and intrinsic eating habits of the study population. The correlation matrix reported an inverse association of mYFAS 2.0 with Body Mass Index (BMI). In addition, participants with a BMI below 25 showed a higher mYFAS 2.0 and EEQ score. CONCLUSIONS: These results suggest some changes in the psychometric assessment structure of the mYFAS 2.0 in a non-clinical population of university students, as well as the usefulness of this questionnaire to identify individuals with an adequate BMI but with compensatory behaviours that predispose to different eating disorders.

Internalized weight stigma and psychological distress mediate the association of perceived weight stigma with food addiction among young adults: A cross-sectional study.

BACKGROUND: Perceived weight stigma (PWS) and internalized weight stigma (IWS) are both associated with psychological distress and food addiction (FA). Using the previously proposed 'cyclic obesity/weight-based stigma' (COBWEBS) model, the present study extended the framework to investigate the mediating effects of IWS and psychological distress in the association between PWS and FA among young adults. Given that individuals who are overweight/have obesity have different vulnerabilities, this population was separately analyzed alongside the total study population. METHODS: An online survey comprising the Perceived Weight Stigma Scale, Weight Bias Internalization Scale (WBIS), Depression, Anxiety and Stress Scale-21 (DASS-21), and modified Yale Food Addiction Scale Version 2 was completed by 601 participants (59.6% females; mean age 29.3 years [SD = 6.07]). A total of 219 participants were categorized as being overweight/having obesity. RESULTS: A direct correlation was found between PWS and FA (standardized coefficient [ß] = 0.28, p < 0.001) among both populations, and was mediated by IWS and psychological distress (ß [95% CI] = 0.03 [0.01, 0.05] for WBIS score and 0.10 [0.06, 0.14] for DASS-21 score) among the total participants, but only mediated by psychological distress among participants who were overweight/had obesity (ß [95% CI] = 0.14 [0.06, 0.24]). CONCLUSIONS: The results demonstrated novel perspectives by showing the direct association between PWS and FA and the mediating roles of IWS and psychological distress. Treatment strategies such as psychological acceptance and psychoeducation could be used to reduce weight stigma, which could have positive downstream benefits of ameliorating FA. Future research may seek to study strategies for reducing weight stigma and psychological distress, to investigate their efficacy in improving disordered eating.

Food addiction in patients on weight loss treatment.

Background: Food addiction (FA) is defined as hedonic eating behavior involving the consumption of highly palatable foods (i.e., ultra processed foods in quantities beyond homeostatic energy requirements). FA is present in a subset of patients with overweight or obesity and could contribute to the response to weight loss treatments. Aim: Determine FA in individuals that fulfil the criteria of FA as measured by the YFAS 2.0, and its association with anthropometric and body composition variables in a clinical sample of patients undergoing weight loss treatment. Also, to determine the most prevalent FA criteria. Methods: An observational, analytical, and cross-sectional study was conducted. Sampling was non-probabilistic, convenience based. A total of 158 participants were recruited from two clinical centers (private and public) focused on managing non-communicable chronic diseases. The Chilean version of YFAS 2.0 was administrated through the online REDCap platform. Anthropometric measurements were measured, and body mass index (BMI) was calculated. Results: The mean age was 47.8 (SD 14.9) and BMI 28.7 (SD 5.3) kg/m2. There were 12.7% patients who screened positive on the YFAS 2.0 Chilean version (3.2% for mild, 2.5% for moderate and 7.0% for severe), the mean symptom count was 2.2 (SD 2.6), with withdrawal being the most prevalent criterion (33.5%). FA patients had significantly higher body weight compared to non-FA subjects (p = 0.045). We observed a slight and significant correlation between FA symptom count and body weight (p = 0.020), waist circumference (p = 0.005), and BMI (p = 0.023). Conclusion: This is the first study in Chile that showed that FA was present in patients undergoing weight loss treatment and was associated with anthropometric measurements. In addition, it showed that withdrawal was the most prevalent criterion. Future studies should investigate whether the presence of FA and the withdrawal criterion could contribute to suboptimal clinical response to weight loss treatment.

Association between dopamine genes, adiposity, food addiction, and eating behavior in Chilean adult.

Background: A frequent consumption of high sugar/fat foods can affect dopamine signaling in the brain and cause sustained stimulation of the reward system. It has been hypothesized that a hypodopaminergic trait results in an individual overeating in order to increase brain DA. Genetic variants in this route have been connected with addiction and eating behaviors. Most studies focus on a specific SNP, and few studies have used multilocus genetic scores, which quantify genetic risk on a continuum. Aim: To assess the relationship between multilocus genetic scores based on multiple gene variants in the dopaminergic pathway and measurements of anthropometry, eating behavior, food reinforcement, and food addiction (FA) in Chilean adults. Methods: We recruited 221 Chilean adults for a cross-sectional study. A standard anthropometric measurement procedure was followed and eating behavior was examined using the Three Factor Eating questionnaire (TFEQ), Food Reinforcement Value Questionnaire (FRVQ), Yale Food Addiction Scale (YFAS) and 24-h diet recall. Multilocus genetic scores were calculated using TaqMan assays (rs1800497-rs1799732-rs6277-rs4680). Results: No differences were found in the entire sample for anthropometric measurements, by MLGS. We found that participants with a score ≥ 2.0 in the MLGS showed higher food choices on the RVFQ and lower energy intake in protein, lipids, SAFA, MUFA, PUFA, dietary cholesterol, omega-3 and Omega-6 fatty acids in the 24-h recall (p < 0.05). Stratified by nutritional condition, the group with obesity had inferior scores on cognitive restriction, greater scores on uncontrolled eating, emotional eating, and responding to palatable food in the RVFQ. Also, in subjects with obesity, there was more food addiction in the group scoring "MLGS ≥2.0 or low dopamine signaling" (53%), compared to the group scored "MLGS <2.0 or high dopamine signaling" (23%) (p-value; 0.05). Emotional Eating scores correlated positively with MLGS in subjects with obesity. Conclusion: In adults with obesity, the MLGS of the dopamine pathway, reflecting hypodopaminergic signaling, was associated with greater scores on food addiction and altered eating behavior traits.

Cost-utility and cost consequence of a telehealth intervention targeting improvement in addictive eating for Australian adults (the TRACE program).

BACKGROUND: The TRACE (Targeted Research for Addictive and Compulsive Eating) intervention was evaluated in a 3-month randomized controlled trial which demonstrated significant improvement in Yale Food Addiction Scale scores favoring dietitian-led telehealth (active intervention) compared with passive and control groups. This study aimed to determine intervention costs and cost-utility. METHODS: Costs of each intervention (2021$AUD) and incremental net monetary benefit (iNMB; incremental benefit, defined as Quality-Adjusted Life Years (QALY) gained, multiplied by willingness to pay threshold minus incremental cost) were calculated to estimate differences between groups. RESULTS: The active intervention (n = 38) cost $294 (95% UI: $266, $316) per person compared to $47 (95% UI: $40, $54) in the passive intervention (n = 24), and $26 in the control group (n = 37). At a cost-effectiveness threshold of $50 000 per QALY score gained, the active intervention iNMB was -$186 (95% UI: -$1137, $834) and the passive group $127 (95% UI: -$1137, $834). Compared to the control group, estimates indicate a 30% chance of the active intervention, and a 60% chance of the passive intervention being cost effective. CONCLUSION: Although the overall cost of the active intervention was low, this was not considered cost-effective in comparison to the passive intervention, given small QALY score gains. TRIAL REGISTRATION: Australia New Zealand Clinical Trial Registry ACTRN12621001079831.

The role of pituitary adenylate cyclase-activating polypeptide neurons in the hypothalamic ventromedial nucleus and the cognate PAC1 receptor in the regulation of hedonic feeding.

Obesity is a health malady that affects mental, physical, and social health. Pathology includes chronic imbalance between energy intake and expenditure, likely facilitated by dysregulation of the mesolimbic dopamine (DA) pathway. We explored the role of pituitary adenylate cyclase-activating polypeptide (PACAP) neurons in the hypothalamic ventromedial nucleus (VMN) and the PACAP-selective (PAC1) receptor in regulating hedonic feeding. We hypothesized that VMN PACAP neurons would inhibit reward-encoding mesolimbic (A10) dopamine neurons via PAC1 receptor activation and thereby suppress impulsive consumption brought on by intermittent exposure to highly palatable food. Visualized whole-cell patch clamp recordings coupled with in vivo behavioral experiments were utilized in wildtype, PACAP-cre, TH-cre, and TH-cre/PAC1 receptor-floxed mice. We found that bath application of PACAP directly inhibited preidentified A10 dopamine neurons in the ventral tegmental area (VTA) from TH-cre mice. This inhibitory action was abrogated by the selective knockdown of the PAC1 receptor in A10 dopamine neurons. PACAP delivered directly into the VTA decreases binge feeding accompanied by reduced meal size and duration in TH-cre mice. These effects are negated by PAC1 receptor knockdown in A10 dopamine neurons. Additionally, apoptotic ablation of VMN PACAP neurons increased binge consumption in both lean and obese, male and female PACAP-cre mice relative to wildtype controls. These findings demonstrate that VMN PACAP neurons blunt impulsive, binge feeding behavior by activating PAC1 receptors to inhibit A10 dopamine neurons. As such, they impart impactful insight into potential treatment strategies for conditions such as obesity and food addiction.

Addiction to ultra-processed foods as a mediator between psychological stress and emotional eating during the COVID-19 pandemic.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic induced psychological distress, which is linked to emotional eating and symptoms of addiction to ultra-processed foods (UPFs). OBJECTIVE: This study aimed to investigate whether symptoms of addiction to UPFs mediate the relationship between psychological stress due to the COVID-19 pandemic and emotional eating behaviour. METHODS: A cross-sectional online study was conducted from May to November 2021 among 368 undergraduate Brazilian students. The participants answered demographic questions and completed validated scales, including the Coronavirus Stress Measure, Modified Yale Food Addiction Scale 2.0 and Emotional Eating Questionnaire. Mediation analysis was employed to examine the hypothesised relationships. RESULTS: The results revealed a significant indirect effect, indicating that symptoms of food addiction mediated the association between perceived stress during the COVID-19 pandemic and emotional eating behaviour. Specifically, 61% of the influence of perceived stress on emotional eating during the pandemic was explained by symptoms of UPF addiction. CONCLUSION: These findings suggest that addressing symptoms of UPF addiction could be pivotal in public health strategies aimed at promoting healthy eating habits among distressed undergraduate students in the post-COVID-19 era.

Reliability and validity of the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) in a sample of individuals with depressive disorders.

BACKGROUND: Food addiction (FA) is strongly associated with depressive symptoms. The reliability and validity of the Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) were not previously determined in clinical samples in Brazil. This study aimed to assess the psychometric properties of the Brazilian version of the mYFAS 2.0 in adult individuals with depressive disorders. METHODS: The data stems from a survey investigating FA in a convenience sample of subjects diagnosed with a depressive disorder. Participants answered mYFAS 2.0 and scales for binge eating, depressive and anxiety symptoms, and alcohol and nicotine use. Height and weight were measured to calculate the Body Mass Index (BMI). We evaluated the factor structure, reliability, convergent, discriminant, criterion, and incremental validity. RESULTS: The sample encompassed 303 participants with a mean age of 37.03 ± 11.72 years, 84.16% of whom were women. The Cronbach's alpha for the mYFAS 2.0 was satisfactory (alpha = 0.915). The best goodness-of-fit model was a single factor, and mYFAS 2.0 showed convergent validity with binge eating and discriminant validity with the alcohol and nicotine use measures. Food addiction presented a weak positive correlation with depressive and anxiety symptoms and BMI. Three food addiction symptoms provided the best balance between sensitivity (80.95%) and specificity (74.81%). Incremental validity over binge eating symptoms was confirmed (t = 4.040, ß = 0.681, p < 0.001). CONCLUSIONS: The Brazilian mYFAS 2.0 performed satisfactorily in this clinical sample of participants with a depressive disorder. These findings suggest it may be a brief, useful, and valid food addiction screening tool for this group.

Food addiction is a dysfunctional consumption of energetically dense, hyper-palatable, and ultra-processed foods that may lead to addictive behaviors. It is associated with mental disorders such as eating, mood, and anxiety disorders, which negatively impact the quality of life for individuals affected. Therefore, healthcare providers need to assess food addiction. The Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) is a brief instrument consisting of 13 questions developed to assess FA. Although it was previously adapted for Brazilian Portuguese in a non-clinical sample, this is the first study in Brazil to investigate this tool in a psychiatric sample. The main aim of our study was to evaluate the psychometric properties of the Brazilian version of the mYFAS 2.0 in individuals with a Depressive Disorder. The results suggested that mYFAS 2.0 had satisfactory psychometric properties in this sample, and it may be a brief, useful, and valid scale to screen food addiction in individuals with depressive states.

Caffeine consumption of medical students in Korea: amount and symptoms based on a 2023 survey.

PURPOSE: To investigate the form and level of daily caffeine intake recommended above 400 mg in medical students expected to consume caffeinated beverages to enhance their performance. METHODS: From May to June 2023, freshman through senior medical students at a medical school in Korea were administered a seven-item questionnaire designed to measure the amount of caffeine-containing foods consumed, the weekly interval between consumption, the reason for consumption, and the level of caffeine-induced symptoms experienced. RESULTS: Out of 443 students, 361 responded (81.5%). The most commonly consumed caffeine beverages were coffee (79.2%), followed by soda (33.2%), tea (27.4%), chocolate (25.2%), and energy drinks (20.5%). The estimated (average±standard deviation) daily intake was estimated to 274.6±276.5 mg, and they consumed caffeine on an average of 4.25±2.26 days per week. Students who consumed 400 mg or more of caffeine daily consumed 19.9%. The primary motivation for caffeine intake was "to improve academic performance" (60.9%) and "preferred food" (51.8%). Among the responders, 98% of them replied they had symptoms that could be caused by caffeine, in order of palpitations (47.4%), frequent urination (42.9%), anxiety (27.1%), indigestion (17.5%), and excitement (17.5%). A total of 45.7% reported two symptoms, and 24.7% reported three or more. CONCLUSION: Caffeinated beverage consumption was routine among current medical students, with 20% consuming more than the recommended daily amount. Most students experienced at least one caffeine-induced symptom, with two symptoms in half, suggesting the need for policy measures and warnings about caffeine-containing foods.

Validity of the Addiction-like Eating Behavior Scale among Patients with Compulsive Eating.

Food addiction (FA) and binge eating disorder (BED) co-occur and share compulsive eating symptoms. When using an FA measure, it is important to evaluate its performance in a population presenting compulsive eating. The study aims to validate the Addiction-like Eating Behavior Scale (AEBS) among a clinical sample characterized by compulsive eating and overweight/obesity and to evaluate its incremental validity over the Yale Food Addiction Scale 2.0 (YFAS). Patients seeking help for compulsive eating (n = 220), between January 2020 and July 2023, completed online questionnaires, including FA, compulsive eating, and BMI evaluations. The factor structure, internal consistency, and convergent, divergent, and incremental validity were tested. The sample had a mean age of 44.4 years old (SD = 12.7) and a mean BMI of 38.2 (SD = 8.0). The two-factor structure provided a good fit for the data, with factor loadings from 0.55 to 0.82 (except for item 15) and the internal consistency was high (ω = 0.84-0.89). The AEBS was positively correlated with the YFAS (r = 0.66), binge eating (r = 0.67), grazing (r = 0.47), craving (r = 0.74), and BMI (r = 0.26), and negatively correlated with dietary restraint (r = -0.37), supporting good convergent and divergent validity. For each measure of compulsive eating, linear regression showed that the AEBS "appetite drive" subscale had a unique contribution over the YFAS. This study provided evidence that the AEBS is a valid measure among a clinical sample of patients with compulsive eating and overweight/obesity. However, questions remain as to whether the AEBS is a measure of FA or compulsive eating.

Validation of the Chilean version of the Yale food addiction scale 2.0 in a non-clinical sample.

AIMS: The aim was to translate and culturally adapt the Yale Food Addiction Scale 2.0 (YFAS 2.0) to the Chilean population, evaluate its psychometric properties in a non-clinical sample, and assess the correlations between symptoms count of food addiction (FA) with demographic and anthropometric variables. METHODS AND PARTICIPANTS: We evaluated 301 participants (59.1% women) with a mean age of 29.7 ± 12.4 years recruited from two universities and two businesses (non-clinical sample). The Chilean YFAS 2.0 was administered, and anthropometric measurements were carried out. The internal consistency of the items was estimated, and factor structure was tested by confirmatory factor analysis. Test-retest reliability was also examined. The correlations between symptoms count of FA and weight, waist circumference (WC), Body Mass Index (BMI), percentage of body fat (BF%), and lean mass were evaluated. RESULTS: The Chilean YFAS 2.0 presented good internal consistency, and confirmatory factor analysis supported the one-factor structure, in accordance with the original version. The ICC indicated excellent test-retest reliability. The prevalence of FA was 10.3%, and the symptom count of FA was 2.1 ± 2.8. A small positive correlation between WC, BMI, and BF % and FA symptom count was found. CONCLUSION: The Chilean YFAS 2.0 may be a useful tool to investigate FA in Chile. Level of evidence Level V, cross-sectional descriptive study.

Clinical Relevance of Food Addiction in Higher Weight Patients across the Binge Eating Spectrum.

Food addiction (FA) is associated with greater severity on many eating-related correlates when comorbid with binge eating disorder (BED) but no study has established this relation across the whole spectrum of binge eating, i.e., from no BED to subthreshold BED to BED diagnosis. This study aims to examine the effect of the presence of FA on the severity of eating behaviors and psychological correlates in patients without BED, subthreshold BED or BED diagnosis. Participants (n = 223) were recruited at a university center specialized in obesity and eating disorder treatment and completed a semi-structured diagnostic interview and questionnaires measuring eating behaviors, emotional regulation, impulsivity, childhood interpersonal trauma, and personality traits. They were categorized by the presence of an eating disorder (no BED, subthreshold BED, or BED) and the presence of FA. Group comparisons showed that, in patients with BED, those with FA demonstrated higher disinhibition (t(79) = -2.19, p = 0.032) and more maladaptive emotional regulation strategies (t(43) = -2.37, p = 0.022) than participants without FA. In patients with subthreshold BED, those with FA demonstrated higher susceptibility to hunger (t(68) = -2.55, p = 0.013) and less cooperativeness (t(68) = 2.60, p = 0.012). In patients without BED, those with FA demonstrated higher disinhibition (t(70) = -3.15, p = 0.002), more maladaptive emotional regulation strategies (t(53) = -2.54, p = 0.014), more interpersonal trauma (t(69) = -2.41, p = 0.019), and less self-directedness (t(70) = 2.14, p = 0.036). We argue that the assessment of FA provides relevant information to complement eating disorder diagnoses. FA identifies a subgroup of patients showing higher severity on many eating-related correlates along the binge eating spectrum. It also allows targeting of patients without a formal eating disorder diagnosis who would still benefit from professional help.

Effects of Probiotic Supplementation Added to a Weight Loss Program on Anthropometric Measures, Body Composition, Eating Behavior, and Related Hormone Levels in Patients with Food Addiction and Weight Regain After Bariatric Surgery: A Randomized Clinical Trial.

PURPOSE: Weight regain after metabolic bariatric surgery is a common problem. Food addiction is an eating disorder that can be one of the reasons for weight regain in these patients. This study aimed to evaluate the effects of probiotic supplementation with a weight loss program and cognitive behavioral therapy (CBT) on anthropometric measures, eating behavior, food addiction, and related hormone levels, in patients with food addiction and weight regain after metabolic bariatric surgery. MATERIALS AND METHODS: This randomized, triple-blind, placebo-controlled clinical trial was conducted on patients with food addiction and weight regain after metabolic bariatric surgery. Participants (n = 50) received a weight loss program and CBT plus probiotic, or placebo for 12 weeks. Then, anthropometric measurements, biochemical markers, eating behavior, and food addiction were assessed. RESULTS: Weight and body mass index (BMI) decreased significantly in the probiotic group compared to placebo (p = 0.008, p = 0.001, respectively). Fat mass was significantly decreased in the probiotic group (p < 0.001). Moreover, a significant improvement was observed in the probiotic group's eating behavior and food addiction compared to the placebo group (p < 0.001). Serum levels of leptin decreased significantly (p = 0.02), and oxytocin serum levels increased significantly (p = 0.008) in the probiotic group compared to the placebo group. CONCLUSION: Adding probiotic supplements to the weight loss program and CBT is superior to the weight loss program and CBT alone in improving weight loss, eating behavior, and food addiction in patients with food addiction and weight regain after metabolic bariatric surgery.

Predictive factors of weight loss in obese patients referred to an obesity specialized centre.

INTRODUCTION AND AIMS: In obese patients, long-term weight loss maintenance remains challenging. Identifying factors predicting adhesion to lifestyle therapy and weight loss would help optimizing obesity management. AIMS: to identify predictive factors of weight loss after one year of medical therapy in obese patients (primary) and predictive factors of drop-out during the year of therapy (secondary). METHODS: In this retrospective study, obese patients consulting for the first time in an obesity specialized center were included. All patients fulfilled the criteria for obesity surgery and were managed to change their lifestyle by following a 1-year therapeutical education program based on intuitive eating. Significant weight loss was defined by ≥ 5 % after 1 year. Patients were considered as dropouts, i.e. absence of adhesion to therapy, once they missed one consultation without informing the unit. Stepwise multivariable analyses determined the predictive factors. RESULTS: Of the 310 patients (mean age, 44.5 ± 11.9 yr, 79% women) included, 155 (50%) maintained their follow-up at 1 year and 37 (24%) experienced weight loss ≥5%. Male gender (odds ratio (OR) = 6.25 [95% confidence interval, 1.78; 21.92], P = 0.004), ≥5 consultations with intuitive eating (OR = 3.69 [1.14; 11.87], P = 0.03), and tobacco addiction (OR = 0.18 [0.04; 0.82], P = 0.03) were associated to weight loss ≥5%. Older age (OR = 0.97 [0.95; 0.99], P = 0.014), physical activity (OR = 0.11 [0.05; 0.24], P < 0.0001) and the patient desire for obesity surgery (OR = 0.22 [0.12; 0.41], P < 0.0001) were associated with a better adhesion to therapy. CONCLUSION: The identified predictive factors would help identifying the patients with the greater chance of losing weight and adhering to therapy. Offering more therapeutic education sessions should increase therapy success in obese patients fulfilling the criteria for obesity surgery.

The potential effect of α7 nicotinic receptors modulation on palatable food-induced dependence-like behaviors.

Background: The recent global increase in obesity rates, coupled with excessive palatable food (PF) consumption, has become a serious societal concern. Literature indicates that rewarding PF, especially upon cessation, can lead to overeating, binge eating, and compulsive eating, potentially resulting in obesity. Challenges in dietary paradigms, alongside limitations in approved treatments for eating disorders and anti-obesity medications, underscore the need to explore novel targets. In this context, α7nAChR (alpha-7 nicotinic acetylcholine receptor) may serve as a promising therapeutic target in combating food dependence and obesity. The present study aims to assess the role of α7nAChR in palatable food-induced dependence-like behaviors. Method: The study involved male C57BL/6J mice exposed to three different feeding paradigms over 6 weeks to induce obesity and food addiction. On day 43, palatable food was replaced with standard chow, and the mice received treatments (vehicle, PNU-282987 [α7nAChR agonist], or methyllycaconitine citrate [MLA; α7nAChR antagonist]). Addiction-like behaviors, including craving for palatable food, motivation-effort interaction tests, and compulsive eating-like behavior, were measured during abstinence with and without treatment. Results: The present study shows that chronic intermittent and continuous exposure to palatable food induces craving, motivation, and effort interaction behaviors as well as compulsive eating-like behaviors in palatable food-abstinent mice. Administration of the α7nAChR agonist, PNU-282987, significantly attenuated the craving behavior only in mice continuously fed palatable food (reduced calorie intake from 63.19 % to 48.21 %; p = 0.0053). Also, PNU-282987 suppressed the effort behaviors in either intermittently or continuously fed mice (significant reduction in the Δ number of active events per minute; p-values = 0.038 and 0.0098, respectively). However, it attenuated the compulsive-like eating behavior exclusively in the continuously fed group (p = 0.0433). Active and total interaction efforts were reversed by the MLA. These findings indicate the involvement of α7nAChR in dependence-like behaviors toward palatable food in mice. Conclusion: Our findings demonstrate that dependence-like behaviors toward palatable food can emerge after prolonged exposure. Mice fed on palatable food continuously exhibited more dependence-like behaviors toward palatable food, and activation of α7nAChR signaling attenuated the vulnerability to develop such behaviors.