Ann Koehler1, Trina Aguirre2, Erica Schulte3,4, Rebecca Bowman5,6, Leeza Struwe7. 1. College of Nursing-West Nebraska Division, University of Nebraska Medical Center, 1601 East 27th Street, Scottsbluff, NE, 69361, USA. ann.koehler@unmc.edu. 2. College of Nursing-West Nebraska Division, University of Nebraska Medical Center, 1601 East 27th Street, Scottsbluff, NE, 69361, USA. 3. Department of Psychology, University of Michigan, 1004 East Hall, 530 Church Street, Ann Arbor, MI, 48109, USA. 4. Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3032, Philadelphia, PA, 19104, USA. 5. Regional West Physicians Clinic, Medical Plaza North, 4021 Avenue B, Scottsbluff, NE, 69361, USA. 6. , River Hills Health, 201 S. Market, Ottumwa, IA, 52501, USA. 7. College of Nursing-Niedfelt Nursing Research Center, University of Nebraska Medical Center, 550 N 19th Street, Lincoln, NE, 68588, USA.
Abstract
PURPOSE: Understanding the complexities of obesity is important for developing 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.
RCT Entities:
PURPOSE: Understanding the complexities of obesity is important for developing 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.