İçen Sarper, Taş Torun Yasemin, Döğer Esra, Gül Hesna
Department of Child and Adolescent Psychiatry, Ahi Evran University Faculty of Medicine, Kırşehir, Turkey.
Department of Child and Adolescent Psychiatry, Gazi University Faculty of Medicine, Ankara, Turkey.
J Eat Disord. 2025 Aug 25;13(1):183. doi: 10.1186/s40337-025-01377-w.
Executive functioning (EF) difficulties may play a significant role in the vicious cycle of overeating and metabolic disturbances. We aimed to investigate the correlates of EF difficulties in terms of food addiction symptoms, eating attitudes, and metabolic syndrome markers among adolescents seeking obesity treatment.
Thirty-five adolescents seeking obesity treatment were included. Executive functioning difficulties were assessed using both performance tasks (i.e. Stroop's task and Cancellation task) and parent reports on the Behavior Rating Inventory of Executive Function (BRIEF). Other measurements included adolescent self-reports of food addiction symptoms on the Yale Food Addiction Scale (YFAS) and eating attitudes on the Eating Attitudes Test-40 (EAT-40).
The mean total symptom score was 4.66 (± 1.45) on the YFAS. The most commonly endorsed symptoms were 'Repeated unsuccessful attempts to stop or decrease food consumption' in 94.3% (N = 32), 'Tolerance to the same amount of certain foods and consuming increasing amounts' in 80.0% (N = 28), and 'Continuing to eat despite knowing the negative consequences' in 77.1% (N = 27) of the sample. 48.6% of the adolescents with obesity (N = 17) met the criteria for diagnostic evaluation threshold according to YFAS, which was related to worse performance in Stroop Task and parent-reported difficulties in Emotional Control (p < .05 for both). Food addiction symptoms had differences in correlations with EF difficulties. "Eating for longer durations and higher amounts than intended" was related to difficulties in Emotional Control and Working Memory (p < .05 for both). "Continuing to eat despite knowing the negative consequences" was associated with difficulties in Shift, Emotional Control, Initiate, Plan/Organize, and Organization of Materials (p < .05 for all). Dieting was the only disordered eating attitude significantly correlated with EF difficulties. Specifically, less endorsement of dieting was correlated with difficulties in Inhibit and Working Memory (p < .05). Moreover, executive functioning difficulties were related to increased body mass index and waist circumference, in addition to worse metabolic parameters including fasting blood glucose, insulin, HOMA-IR, triglycerides, and blood pressure measurements.
Our study points out that specific EF difficulties were related to food addiction symptoms, dieting, and metabolic syndrome markers among adolescents with obesity. Further studies are needed to with larger and more diverse samples.
执行功能（EF）困难可能在暴饮暴食和代谢紊乱的恶性循环中起重要作用。我们旨在研究寻求肥胖治疗的青少年中，执行功能困难与食物成瘾症状、饮食态度和代谢综合征标志物之间的相关性。
纳入35名寻求肥胖治疗的青少年。使用执行任务（即斯特鲁普任务和划消任务）以及家长对执行功能行为评定量表（BRIEF）的报告来评估执行功能困难。其他测量包括青少年在耶鲁食物成瘾量表（YFAS）上对食物成瘾症状的自我报告以及在进食态度测试-40（EAT-40）上的饮食态度报告。
YFAS上的平均总症状评分为4.66（±1.45）。最常出现的症状是“多次尝试停止或减少食物摄入但未成功”，样本中有94.3%（N = 32）；“对相同量的某些食物产生耐受性并摄入增加量”，有80.0%（N = 28）；“尽管知道负面后果仍继续进食”，有77.1%（N = 27）。48.6%的肥胖青少年（N = 17）根据YFAS达到诊断评估阈值标准，这与斯特鲁普任务中较差的表现以及家长报告的情绪控制困难有关（两者p均<0.05）。食物成瘾症状与执行功能困难的相关性存在差异。“进食时间比预期长且量比预期多”与情绪控制和工作记忆困难有关（两者p均<0.05）。“尽管知道负面后果仍继续进食”与转换、情绪控制、启动、计划/组织和材料组织方面的困难有关（所有p均<0.05）。节食是唯一与执行功能困难显著相关的紊乱饮食态度。具体而言，较少认可节食与抑制和工作记忆方面的困难有关（p<0.05）。此外，执行功能困难与体重指数增加和腰围增大有关，还与包括空腹血糖、胰岛素、HOMA-IR、甘油三酯和血压测量在内的更差代谢参数有关。
我们的研究指出，特定的执行功能困难与肥胖青少年的食物成瘾症状、节食和代谢综合征标志物有关。需要进一步开展更大规模、更多样化样本的研究。
