Symptoms of Addictive Eating: What Do Different Health Professions Think?

The symptoms of addictive eating are often debated, with some overlap in symptoms with substance addictions or other disorders such as binge eating disorder. This study explored the levels of agreement with symptoms of addictive eating among different health professions, the conditions they provide advice for, and the population group/s they work with. An online cross-sectional survey was conducted in February-April 2020 including 142 health professionals (87% female, 65% residing in Australia, 28% each working in private practice/hospital settings). Of these, 47% were dietitians, 20% psychologists/psychotherapists/counsellors, 16% other health practitioners (e.g., social workers), 13% health researchers, and 5% medical professionals. Agreement with 11 statements relating to addictive eating symptoms was assessed on a scale of 1/strongly disagree to 5/strongly agree (e.g., certain foods produce physiological effects in the brain rewards system). Differences in agreement by health profession were assessed by one-way analysis of variance. There were significant differences in agreement with individual statements between health professions. Psychologists, psychotherapists, and counsellors reported lower agreement to statements relating to physiological effects in the reward system, withdrawal symptoms, and over-eating to alleviate stress/anxiety, than other professions (p < 0.05). Those providing advice for disordered eating only reported lower agreement across statements compared with those providing advice for overweight/obesity or both (p < 0.001). There were minimal differences based on the population group/s that health professionals work with. There is some agreement among health professionals regarding addictive eating symptoms, however, this differs by profession and the conditions they treat. This study provides a novel perspective on health professionals' views on addictive eating symptoms, and there is a need for more research to explore the concepts further.

Health Professionals' and Health Professional Trainees' Views on Addictive Eating Behaviours: A Cross-Sectional Survey.

Despite increasing research on the concept of addictive eating, there is currently no published evidence on the views of health professionals who potentially consult with patients presenting with addictive eating behaviours, or of students training to become health professionals. This study aimed to explore the views and understanding of addictive eating behaviours among health professionals and health professionals in training and to identify potential gaps in professional development training. An international online cross-sectional survey was conducted in February-April 2020. The survey (70 questions, 6 key areas) assessed participants' opinions and clinical experience of addictive eating; opinions on control, responsibility, and stigma relating to addictive eating; and knowledge of addictive eating and opinions on professional development training. In total, 142 health professionals and 33 health professionals in training completed the survey (mean age 38.1 ± 12.5 years, 65% from Australia/16% from the U.K.) Of the health professionals, 47% were dietitians and 16% were psychologists. Most participants (n = 126, 72%) reported that they have been asked by individuals about addictive eating. Half of the participants reported that they consider the term food addiction to be stigmatising for individuals (n = 88). Sixty percent (n = 105) reported that they were interested/very interested in receiving addictive eating training, with the top two preferred formats being online and self-paced, and face-to-face. These results demonstrate that addictive eating is supported by health professionals as they consult with patients presenting with this behaviour, which supports the views of the general community and demonstrates a need for health professional training.

Amygdala NPY Circuits Promote the Development of Accelerated Obesity under Chronic Stress Conditions.

Neuropeptide Y (NPY) exerts a powerful orexigenic effect in the hypothalamus. However, extra-hypothalamic nuclei also produce NPY, but its influence on energy homeostasis is unclear. Here we uncover a previously unknown feeding stimulatory pathway that is activated under conditions of stress in combination with calorie-dense food; NPY neurons in the central amygdala are responsible for an exacerbated response to a combined stress and high-fat-diet intervention. Central amygdala NPY neuron-specific Npy overexpression mimics the obese phenotype seen in a combined stress and high-fat-diet model, which is prevented by the selective ablation of Npy. Using food intake and energy expenditure as readouts, we demonstrate that selective activation of central amygdala NPY neurons results in increased food intake and decreased energy expenditure. Mechanistically, it is the diminished insulin signaling capacity on central amygdala NPY neurons under combined stress and high-fat-diet conditions that leads to the exaggerated development of obesity.