College of Nursing-West Nebraska Division, University of Nebraska Medical Center, Scottsbluff, Nebraska, USA.
River Hills Health, Ottumwa, Iowa, USA.
Nurs Forum. 2022 Jan;57(1):152-164. doi: 10.1111/nuf.12662. Epub 2021 Oct 17.
This concept analysis aims to clarify the highly processed food addiction (HPFA) concept and discuss its implications for treating obesity.
Emerging empirical evidence suggests addictive-like eating may contribute to obesity in some individuals, increasing interest in HPFA's role in obesity. Clarifying the HPFA concept will aid in developing individualized interventions for patients with obesity and HPFA.
This concept analysis followed Walker and Avant's approach. The case studies are of participants in a study that included individuals with and without HPFA (Yale Food Addiction Scale 2.0-diagnosed).
We searched PubMed, CINAHL, PsychInfo, and Ebscohost databases. Keywords were "food addiction" and "food addiction concept."
Criteria included recent reviews and empirical studies that measured HPFA and focused on HPFA characteristics and/or treatment implications.
The model case displayed all 11-substance use disorder (SUD) symptoms and clinical significance, supporting a severe HPFA diagnosis. The contrary case was negative for all YFAS 2.0 symptoms and clinical significance and did not eat compulsively or experience cravings. The borderline case met the minimum symptom criteria for severe HPFA but not clinical significance. Clinical interviews may help determine whether such individuals truly exhibit addictive-like eating behaviors.
Growing empirical evidence and our case studies support the HPFA concept and the utility of the YFAS/YFAS 2.0 for identifying a distinct subset of individuals with overweight/obesity who may benefit from interventions developed to treat established SUDs. Future research should examine HPFA separately and in relation to obesity and eating disorders and include longitudinal studies and gender-balanced samples.
本概念分析旨在阐明高度加工食品成瘾(HPFA)的概念,并探讨其对肥胖治疗的意义。
新兴的实证证据表明,类似成瘾的进食行为可能导致某些个体肥胖,这增加了对 HPFA 在肥胖中的作用的兴趣。阐明 HPFA 的概念将有助于为肥胖和 HPFA 患者制定个性化的干预措施。
本概念分析遵循 Walker 和 Avant 的方法。案例研究的参与者包括参加一项研究的个体,该研究包括有和没有 HPFA 的个体(耶鲁食品成瘾量表 2.0 诊断)。
我们在 PubMed、CINAHL、PsychInfo 和 Ebscohost 数据库中进行了搜索。关键词是“food addiction”和“food addiction concept”。
入选标准包括最近的综述和衡量 HPFA 并侧重于 HPFA 特征和/或治疗意义的实证研究。
典型案例表现出所有 11 项物质使用障碍(SUD)症状和临床意义,支持严重的 HPFA 诊断。相反的案例对所有 YFAS 2.0 症状和临床意义均为阴性,且没有强迫性进食或出现渴求。边界案例符合严重 HPFA 的最低症状标准,但不符合临床意义标准。临床访谈可能有助于确定这些个体是否真正表现出类似成瘾的进食行为。
越来越多的实证证据和我们的案例研究支持 HPFA 的概念以及 YFAS/YFAS 2.0 用于识别超重/肥胖的特定亚组个体,这些个体可能受益于针对既定 SUD 开发的干预措施。未来的研究应单独研究 HPFA,并将其与肥胖和饮食障碍相关联,包括进行纵向研究和性别平衡的样本。