Food Addiction in a Spanish Sample of Eating Disorders: DSM‐5 Diagnostic Subtype Differentiation and Validation Data

Abstract

Although the concept of 'food addiction' (FA) has raised growing interest because of evidence for similarities between substance dependence and excessive food intake, there is a lack of studies that explore this construct among the wide spectrum of eating disorders (EDs). Besides providing validation scores of a Spanish version of the Yale FA Scale (YFAS-S), this study examined the prevalence of 'FA' among ED subtypes compared with healthy-eating controls (HCs) and the association between 'FA' scores, eating symptomatology and general psychopathology. A sample of 125 adult women with ED, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders 5 criteria, and 82 healthy-eating women participated in the study. All participants were assessed with the YFAS-S, the ED Inventory-2 and the Symptom Checklist-Revised. Results showed that the internal structure of the one-dimensional solution for the YFAS-S was very good (α = 0.95). The YFAS-S has a good discriminative capacity to differentiate between ED and controls (specificity = 97.6% and sensitivity (Se) = 72.8%; area under receiver operating characteristic curve = 0.90) and a good Se to screen for specific ED subtypes. YFAS-S scores were associated with higher levels of negative affect and depression, higher general psychopathology, more severe eating pathology and greater body mass index. When comparing the prevalence of 'FA' between ED subtypes, the lowest prevalence of 'FA', measured with the YFAS-S, was for the anorexia nervosa (AN) restrictive subtype with 50%, and the highest was for the AN binge-purging subtype (85.7%), followed by bulimia nervosa (81.5%) and binge eating disorder (76.9%). In conclusion, higher YFAS-S scores are associated with bingeing ED-subtype patients and with more eating severity and psychopathology. Although the 'FA' construct is able to differentiate between ED and HC, it needs to be further explored.

Prevalence of ‘Food Addiction' as Measured with the Yale Food Addiction Scale 2.0 in a Representative German Sample and Its Association with Sex, Age and Weight Categories

“…The higher YFAS 2.0 ‘food addiction' prevalence among underweight individuals is unexpected, though consistent with previous work [29]. Notably, in the current study, all three participants with underweight were in the youngest age range (18-29 years old), and their BMIs are within the range for anorexia nervosa according to the DSM-5 [40].…”

“…Among persons with obesity, the occurrence of ‘food addiction' will be higher compared to those with normal weight [23]. The authors furthermore hypothesize that the occurrence of ‘food addiction' is higher among underweight individuals, compared to those with normal weight, as one previous study observed that ‘food addiction' prevalence is elevated in eating disorders associated with underweight (e.g., anorexia nervosa) [29]. Consistent with previous literature, we expect that ‘food addiction' will be more prevalent among women [22,24,25] and negatively related to age [38].…”

“…Generally, approximately 5-10% of individuals in community-based samples exhibit indicators of YFAS ‘food addiction' [24,25], though prevalence is higher among individuals with obesity [26] and binge eating disorder [27,28]. The YFAS has been translated into multiple languages to assess the prevalence of addictive-like eating behavior worldwide [23,26,29]. …”

Eating Disorders as New Forms of Addiction

“…The lowest scores on the YFAS were associated with the restrictive subtype of AN and the highest ones with the subtypes of ED associated with binge eating: purging AN (85.7%), BN (81.5%), and BED (76.9%). Higher YFAS scores were also associated with higher levels of negative affect, depressive symptoms, higher BMI, more severe eating pathology, and general psychopathology [44].…”

Traducción al español de la escala de adicción a los alimentos de Yale (Yale Food Addiction Scale) y su evaluación en una muestra de población mexicana. Análisis factorial

“…26 La YFAS se ha utilizado en numerosos estudios y las traducciones de sus versiones en alemán, francés y español (aplicado en España) ya han sido validadas obteniendo un α de Cronbach de 0.81 -0.83, 0.90 y 0.82, respectivamente. [27][28][29][30][31] Se ha desarrollado también una versión corta de la escala, misma que comprende únicamente nueve ítems, uno para cada aspecto conductual de la adicción (siete ítems) más dos ítems para evaluar manifestaciones clínicas significativas (α = 0.75-0.84). 32 Así mismo, existe una versión de la escala adaptada para niños (α = 0.78).…”