Food Addiction is Associated with Higher Neuroticism, Lower Conscientiousness, Higher Impulsivity, but Lower Extraversion in Obese Patient Candidates for Bariatric Surgery.

BACKGROUND: The "food addiction" phenotype identifies a subpopulation of individuals experiencing substance-dependence symptoms toward specific foods. In the current debate on whether the "food addiction" phenotype should be considered as an addictive disorder, assessment of the personality traits associated with this phenotype would provide arguments for or against the "food addiction" phenotype and its inclusion in the "substance-related and addictive disorder" category. OBJECTIVES: To assess the personality characteristics associated with the "food addiction" phenotype in obesity surgery candidates (i.e., big five personality dimensions, alexithymia and impulsivity). METHODS: We assessed food addiction (Yale Food Addiction Scale), personality dimensions (Big Fig Inventory), impulsivity (Barratt Impulsiveness Scale-11th version) and alexithymia (Toronto Alexithymia Scale-20 items) in 188 bariatric surgery candidates recruited between July 2013 and November 2015 in the Nutrition Department of the University Hospital of Tours. We used chi-squared tests and Student's tests or Mann-Whitney-U-tests to determine the factors associated with food addiction. RESULTS: Prevalence of current food addiction was 16.5%. Patients with (vs. without) food addiction had lower conscientiousness (p = .047), higher neuroticism and lower extraversion (ps < 0.001), but there was no difference in terms of agreeableness (p = 0.42) or openness (p = 0.16). They were more frequently single (p = .021) and reported higher alexithymia (ps < .001) and higher impulsivity sub-scores (ps<.05). Conclusions/Importance: Food addiction shares personality traits with substance-related disorders (regarding neuroticism, conscientiousness, impulsivity, alexithymia), and one distinctive trait (low extraversion). This study provides additional data that enrich the discussion on whether the "food addiction" phenotype should be included or not in the "substance-related and addictive disorder" category.

Food Addiction in Bariatric Surgery Candidates: Prevalence and Risk Factors.

BACKGROUND: This study assessed the prevalence and risk factors for food addiction (FA) in bariatric surgery candidates. METHODS: We assessed BMI, FA (Yale Food Addiction Scale), quality of life (Quality Of Life, Obesity and Dietetics), depression (Beck Depression Inventory), and binge eating (Binge Eating Scale) in 188 obese patients. RESULTS: The most prevalent addiction criteria were persistent desire to control food consumption (93.1 %), continuing to eat certain foods despite problems (40.4 %), and tolerance (38.8 %); current prevalence of FA was 16.5 %. Patients with (vs. without) FA were more often single and had lower physical, psycho-social, and sexual quality of life and higher depression and binge eating. CONCLUSIONS: Systematic screening for and treatment of FA symptoms before obesity surgery is critical because FA symptoms are prevalent and associated with poorer psychosocial outcome.

Predictors of changes in physical, psychosocial, sexual quality of life, and comfort with food after obesity surgery: a 12-month follow-up study.

PURPOSE: Although obesity surgery provides significant postoperative improvement in quality of life (QoL), it is still unclear which factors might predict improvement in QoL after surgery. We aimed to determine which factors might predict changes in physical, psychosocial, sexual QoL, and comfort with food 12 months after surgery, by putting to the test a QoL model based on Wilson and Cleary's model. METHODS: We included 126 obese patients (48.4% had gastric banding, 34.1% had sleeve gastrectomy, and 17.5% had gastric bypass). At baseline, we assessed QoL (Quality of Life, Obesity and Dietetics rating scale), BMI, depression (Beck Depression Inventory), and binge eating (Bulimic Investigatory Test, Edinburgh). At 12 months, we assessed QoL and BMI. To determine the predictors for changes in each QoL dimension after surgery, we used linear mixed models adjusted for preoperative age, BMI, time, type of surgery, preoperative binge eating severity, and preoperative depression severity. RESULTS: After 12 months, we found significant improvement in physical, psychosocial, sexual QoL, but not in comfort with food. Increased weight loss was associated with better improvement in physical and psychosocial QoL. Higher preoperative depression severity predicted poorer improvement in physical, psychosocial, and sexual QoL. Higher preoperative binge eating severity predicted poorer improvement in psychosocial, sexual QoL, and comfort with food. CONCLUSIONS: In addition to weight loss, preoperative levels of binge eating and depression should be considered as important predictors for QoL changes after bariatric surgery. Screening and treatment for preoperative depression and binge eating might improve QoL after bariatric surgery.

The benefits of metformin therapy during continuous subcutaneous insulin infusion treatment of type 1 diabetic patients.

OBJECTIVE: This study was designed to assess the insulin-sparing effect of oral administration of metformin along with a continuous subcutaneous insulin infusion (CSII) for the treatment of type 1 diabetic patients. RESEARCH DESIGN AND METHODS: A total of 62 patients (25 women and 37 men) were studied in a monocenter, randomized, double-blind placebo-controlled study, comparing metformin (850 mg b.i.d.) with placebo in association with CSII during a 6-month period. RESULTS: Treatment with metformin was associated with a reduction in daily insulin requirements between V0 and V6 of -4.3 +/- 9.9 units (-7.8 +/- 18%) compared with an increase with placebo treatment of 1.7 +/- 8.3 units (2.8 +/- 12.7%) (P = 0.0043). A decrease in basal requirement of insulin was also observed in patients treated with metformin of -2.6 +/- 3.2 units (-7.9 +/- 23.8%) compared with an increase with placebo treatment of 1.9 +/- 5.7 units (8.8 +/- 27.1%) (P = 0.023). HbA(1c) remained unchanged in treatment with metformin and placebo between V0 and V6. The number of hypoglycemic events (<60 mg/dl) was similar in both groups. Significant reductions of total cholesterol (P = 0.04) and LDL cholesterol (P = 0.05) were observed in patients treated with metformin. Gastrointestinal events, including diarrhea and abdominal pain, were reported in three patients in the metformin group who discontinued the trial. Mild or moderate gastrointestinal side effects were also reported in eight patients treated with metformin and two patients treated with placebo (P = 0.069). CONCLUSIONS: Metformin was found to be a safe insulin-sparing agent, when used in combination with CSII for the treatment of type 1 diabetes.

Erythrocyte membrane phospholipid composition is related to hyperinsulinemia in obese nondiabetic women: effects of weight loss.

The complex mechanisms by which obesity predisposes to insulin resistance are not clearly understood. According to a cell membrane hypothesis of insulin resistance, the defects in insulin action could be related to changes in membrane properties. The purpose of this work was to examine the relationship between 2 markers of insulin resistance (fasting plasma insulin [FPI] and homeostasis model assessment [HOMA IR]) and erythrocyte membrane lipid composition. In the first cross-sectional study, 24 premenopausal nondiabetic overweight women (body mass index [BMI], 32.5 +/- 0.9 kg/m(2); age, 35.7 +/- 2.2 years) were compared to 21 lean healthy women (BMI, 21 +/- 0.4 kg/m(2); age, 35.4 +/- 2.2 years). The second study examined whether a 3-month diet-induced weight loss, which usually improves insulin resistance, could also affect the membrane phospholipid (PL) composition and fluidity in the overweight group. Overweight women had significantly higher FPI levels (P <.0001), HOMA IR (P <.0001), membrane sphingomyelin (SM) (P <.05), and cholesterol (P <.05) contents than lean women. Baseline FPI and HOMA IR were positively correlated with membrane SM (P <.005), phosphatidylethanolamine (PE) (P <.005), and phosphatidylcholine (PC) (P <.05) contents, and negatively with phosphatidylinositol (PI) (P <.05) contents in the whole population. Multivariate regression analyses showed that 2 membrane parameters, PE and SM, were among the independent predictors of FPI or HOMA IR in the whole population, but also in the lean and the obese groups separately. Intervention induced a significant reduction in body weight (-5.7% +/- 0.7%), fat mass (-11.3% +/- 1.4%), and FPI (-10.2% +/- 5.4%). An improvement in membrane lipid composition was only observed in the insulin resistant subgroup (FPI > 9.55 mU/L). The reduction in FPI or HOMA IR was directly associated with reduction in SM and PE contents, a finding independent of the reduction in fat mass. A stepwise multiple regression analysis indicated that the changes in SM accounted for 26.6% of the variance in the changes in FPI as an independent predictor, with the changes in fat mass and PE as other determinants (27.8% and 20%, respectively, adjusted r(2) =.704, P <.0001). These results suggest that the abnormalities in the membrane PL composition could be included in the unfavorable lipid constellation of obesity which correlated with impaired insulin sensitivity.