Institute for Nutrition and Psychology at the Georg-August-University Göttingen, University Medical Center Göttingen, Göttingen, Germany.
Clinic for Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Göttingen, Germany.
Obes Facts. 2023;16(5):465-474. doi: 10.1159/000531528. Epub 2023 Aug 4.
Food addiction (FA) is a promising construct regarding the multifactorial aetiology of obesity and the search for therapeutic approaches. However, there is an ongoing debate regarding the overlap/differentiation with eating disorders and the classification as a substance- or behaviour-related addiction. Energy-dense foods, especially those combining carbohydrates and fat, are associated with addictive eating and suspected of playing a role in the genesis of FA. This study aims to further understand the clinical significance of FA and to identify possible therapeutic targets. A special focus is set on potentially addictive foods (combination of carbohydrates and fat).
Based on the Yale Food Addiction Scale 2.0, a cohort of 112 German adults with morbid obesity was divided into two sub-samples (patients with and without FA), which were examined for differences in the variables listed below.
The prevalence of FA was 25%. Patients meeting criteria for FA showed higher degrees of hunger, emotional, binge, and night eating than patients without FA. In addition, hunger and disinhibition were found to be significant predictors of FA. FA was not associated with sex, age, body mass index (BMI), cognitive restraint, rigid and flexible control, prevalence of substance use, age of onset of obesity, stress level, level of social support, reduction of BMI during a weight loss programme, or programme withdrawal rate. There was no significant difference in the consumption of foods rich in both carbohydrates and fat, nor of fat or carbohydrates alone.
FA can be considered as a sub-phenotype of obesity, occurring in approximately 25% of obesity cases. Dysfunctional emotional coping mechanisms associated with low distress tolerance showed to be significantly related to FA and should be targeted therapeutically. Behavioural interventions should include a bio-psycho-social model. Binge eating episodes were found to be characteristic for FA and the already stated overlap between FA and binge eating behaviour can be confirmed. The results do not support a decisive difference due to a substance-related component of FA. Despite this, the existence of FA as a distinct entity cannot be excluded, as not all patients with FA exhibit binges.
食物成瘾（FA）是肥胖多因素病因学和治疗方法研究中很有前途的一个概念。然而，关于其与进食障碍的重叠/区别，以及将其归类为物质相关或行为相关成瘾，目前仍存在争议。高热量食物，尤其是碳水化合物和脂肪结合的食物，与成瘾性进食有关，并且被怀疑在 FA 的发病机制中起作用。本研究旨在进一步了解 FA 的临床意义，并确定可能的治疗靶点。特别关注可能具有成瘾性的食物（碳水化合物和脂肪的组合）。
基于耶鲁食物成瘾量表 2.0，对 112 名患有病态肥胖的德国成年人进行了分组，将他们分为两组（有 FA 和无 FA 的患者），并对以下列出的变量进行了检查。
FA 的患病率为 25%。符合 FA 标准的患者比无 FA 的患者表现出更高程度的饥饿感、情绪性暴食、暴食和夜间进食。此外，饥饿感和抑制失控被发现是 FA 的显著预测因子。FA 与性别、年龄、体重指数（BMI）、认知约束、刚性和弹性控制、物质使用的流行率、肥胖发病年龄、压力水平、社会支持水平、减肥计划中 BMI 的降低或计划退出率无关。同时，富含碳水化合物和脂肪的食物、脂肪或碳水化合物的单独摄入并无显著差异。
FA 可被视为肥胖的亚表型，约 25%的肥胖病例存在 FA。与低压力耐受力相关的功能失调性情绪应对机制与 FA 显著相关，应作为治疗靶点。行为干预应包括生物-心理-社会模式。暴食发作是 FA 的特征，并且已经证实 FA 与暴食行为之间存在重叠。结果不支持由于 FA 具有物质相关成分而导致的决定性差异。尽管如此，FA 作为一种独特的实体存在的可能性不能被排除，因为并非所有 FA 患者都有暴食行为。
