Obesity is a major health issue in the United States. It has been suggested that addictive-like tendencies toward foods, especially highly processed foods, contributes to this epidemic. If so, interventions used to treat substance-use disorders may be effective for treating overweight/obese patients with food addiction (FA; based on the Yale Food Addiction Scale, version 2.0). This pilot study evaluated four interventions, selected because of their effectiveness in the treatment of substance-use disorders [motivational interviewing (MI), pharmacotherapy (P; naltrexone-bupropion), MI with pharmacotherapy (MI+P), information control (IC; diet and physical activity instruction)], in overweight/obese individuals with and without FA (FA+ and FA-, respectively). Here we report the baseline (pre-intervention) characteristics of FA+ and FA-participants based on their intake documents. FA was fairly common in this population (37.1% of those screened). Most participants experienced depression (81.9%, FA+ 94.3%, FA-73.0%) and anxiety (60.2%, FA+ 74.3%, FA-50%) with greater prevalence (p<.01) and severity in those who were FA+. Many participants screened positive for binge eating (42.2%, FA+ 65.7%, FA-25.0%) and to a lesser extent PTSD (18.1%, FA+ 37.1%, FA-4.2%), with greater prevalence among those who were FA+ (p<.01). Drug abuse (20.5%) and mood disorder (8.4%) were relatively uncommon and prevalence did not differ between FA phenotypes (p>.05). The FA construct identified a distinctive subset of overweight/obese individuals. Differences in baseline characteristics suggest that FA+ and FA-individuals may differ in their response to interventions and the types of support they need to achieve their weight/body fat loss goals.

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Objectives: Empirical evidence is growing that addictive-like tendencies toward foods may contribute to obesity. This pilot study evaluated interventions used to treat addictive disorders for the treatment of obesity in individuals with and without food addiction (FA). FA and depression were common in the study population at baseline, with greater prevalence and severity of depression in those with FA. This secondary analysis evaluated whether prevalence and/or severity of FA and depression changed with intervention. Methods: Participants within each obesity phenotype (FA+, FA-) were randomly assigned to treatment groups [motivational interviewing, pharmacotherapy (naltrexone-bupropion), motivational interviewing with pharmacotherapy, information control]. Interventions were delivered following data collection at baseline, 1, 2, 3, and 4 weeks and 2, 3, 4, 5, and 6 months. FA and depression were assessed at baseline and 6 months using the Yale Food Addiction Scale and Patient Health Questionnaire-9, respectively. Results: Prevalence and severity of FA declined between baseline and 6 months (P < .001). The decline in symptoms was greater among those who were FA+ than among those who were FA-(P < .001), reflecting that those who were FA+ had higher symptom totals at baseline. Depression scores and severity also declined between baseline and 6 months in both obesity phenotypes (P < .001). Conclusion: Both FA and depression were common in this study population and may contribute to obesity and/or complicate its treatment. That interventions used to treat addictive disorders lessened the prevalence and severity of both FA and depression is promising for the treatment of obesity.

We report a preliminary study on whether syphilis serology might be reactive in some blood donors at risk for human immunodeficiency virus (HIV) infection. We retrospectively analyzed voluntary blood donations with reactive Treponema pallidum antibody (TPA) tests according to the type of donation, the presence of other safety markers, confidential unit exclusion, syphilis diagnosis, and HIV risk factors. Over 2 years (1987-1988), 1 in 8,900 regular homologous donations (n = 258,610) was TPA positive as compared with 1 in 2,200 directed donations (n = 6,685) and 1 in 300 autologous donations (n = 8,870; p<0.05 for both). The rate in directed donations was not significantly higher than in first-time regular donors (1 in 4,800; n = 57,000). TPA-positive donations had higher rates of antibody to hepatitis B core antigen and confidential unit exclusion than TPA-negative donations. Ten TPA-positive homologous or directed donors had latent or previously treated syphilis (1 in 26,500 such donations), and 2 of these had HIV risk factors. None of the autologous donors were determined to have active syphilis. Syphilis serology in blood donors bears further scrutiny as a possible surrogate marker for HIV risk.