There is growing interest in conceptualizing obesity as a “food addiction.” The current study investigated the prevalence and correlates of “food addiction” (FA), as defined by the Yale Food Addiction Scale (YFAS) in 178 (133 F, 45M) persons seeking weight loss treatment. Participants had a mean age of 51.2±11.7 years and a body mass index of 36.1±4.8 kg/m2. Fifteen percent of individuals met the YFAS proposed diagnostic criteria for FA. Those who met criteria for FA reported significantly greater depressive symptomatology. There were no differences in BMI, age, race, or gender between participants with and without FA. Among those not meeting criteria, 35% reported 3 or more symptoms in the absence of self-reported clinical distress or impairment. YFAS symptom count was also significantly correlated with depressive symptoms. These findings suggest that 15% of adults presenting for weight loss treatment meet YFAS criteria for FA. The clinical significance of this classification is unknown and needs to be validated in prospective studies.

Key Points Question Does a coached, digital, cognitive behavior therapy (CBT) intervention result in improved outcomes among college women with eating disorders (EDs) compared with referral to usual care? Findings In this cluster randomized clinical trial that included 690 women with binge-purge EDs from 27 US universities, the digital CBT intervention was superior to referral to usual care in decreasing ED psychopathology, compensatory behaviors, depression, and clinical impairment through long-term follow-up, as well as in realized treatment access. There was no difference in abstinence from all ED behaviors or academic impairment between groups. Meaning These results support the efficacy of a coached, digital, CBT intervention for college women with EDs, which has the potential to bridge the treatment gap for this problem.

Disordered eating behaviors and substance use are two risk factors for the development of serious psychopathology and health concerns in adulthood. Despite the negative outcomes associated with these risky behaviors, few studies have examined potential associations between these risk factors as they occur during adolescence. The importance of accurate or inaccurate weight perception among adolescents has received increased interest given documented associations with nutritional beliefs and weight management strategies. This study examined the associations among the perceptions of weight and substance use with disordered eating behaviors among a diverse sample of normal weight and overweight adolescent males and females. Data came from the 2007 National Youth Risk Behavior Survey (YRBS). The sample consisted of 11,103 adolescents (53.4% female; 44% Caucasian, 21% African American; 13% Hispanic; age responses ranged from 12 and under to 18 and over), with 31.5% meeting criteria for being either at-risk for obesity or already obese (i.e., overweight). As hypothesized, overestimation of weight among normal weight adolescents and accurate perceptions of weight among overweight adolescents were associated with higher rates of disordered eating behaviors. In normal weight adolescents, use of all three substances (tobacco, binge drinking, and cocaine) was associated with each disordered eating behavior. In contrast, findings revealed differences for overweight adolescents between the type of substance use and disordered eating behavior. Post hoc analyses revealed that gender moderated some of these relationships among overweight individuals. Implications for the development and implementation of secondary prevention programs aimed at reducing disordered eating behaviors, substance use, and obesity risk among normal and overweight adolescents are considered.

While there have been important recent advances in the development of effective universal prevention and intervention programs, it is not yet clear how to engage large numbers of students in these programs. In this paper, we report findings from a two-phase pilot study. In the first phase, we used a population-level, online survey to assess eating disorder symptom level and habits/attitudes related to service utilization (N=2,180). Using validated screening tools, we found that roughly one in three students have significant symptoms of eating disorders or elevated weight concerns, the vast majority of whom (86.5%) have not received treatment. In the second phase, we referred students to online prevention and selective/indicated intervention programs based on symptom classification (N=1,916). We find that program enrollment is highest for students in the indicated intervention (18.1%) and lowest for students in the universal prevention (4.1%). We find that traditionally-emphasized barriers such as stigma, misinformation, and financial limitations do not appear to be the most important factors preventing treatment-seeking. Rather students report not seeking help for reasons such as lack of time, lack of perceived need, and a desire to deal with the issue “on my own.” Findings offer insight into the treatment-seeking habits and attitudes of college students, including those barriers that may be overcome by offering online programs and those that persist despite increased access to and convenience of relevant resources.

ObjectiveThis study prospectively examined the relationship between food addiction (FA) and weight and attrition outcomes in overweight and obese adults participating in weight loss interventions.Design and MethodsParticipants were 178 adults (51.2±11.7 y, 36.1±4.8 kg/m2) in one of two outpatient weight-loss treatment programs for approximately six months. The Yale Food Addiction Scale (YFAS) assessed FA diagnosis and symptom count. The relationship between FA and weight loss and attrition was assessed.ResultsAfter controlling for treatment arm, gender and baseline weight, there was no effect of FA status on weight loss (p=0.17) or attrition (p=0.37). Similarly, baseline FA symptom count was not associated with weight loss (p=0.14) or attrition (p=0.10).ConclusionsNeither FA status nor symptom count affects weight loss or attrition during weight loss treatment.