Longitudinal Changes in Food Addiction Symptoms and Body Weight among Adults in a Behavioral Weight-Loss Program

Abstract

Interest in food addiction (FA) has increased, but little is known about its clinical implications or potential treatments. Using secondary analyses from a randomized controlled trial, we evaluated the associations between changes in FA, body weight, and “problem food” consumption during a 22-month behavioral weight-loss program consisting of an initial four-month in-person intervention, 12-month extended-care, and six-month follow-up (n = 182). Food addiction was measured using the Yale Food Addiction Scale. “Problem foods” were identified from the literature and self-reporting. Multilevel modeling was used as the primary method of analysis. We hypothesized that reductions in problem food consumption during the initial treatment phase would be associated with long-term (22-month) FA reductions. As expected, we found that reductions in problem foods were associated with greater initial reductions in FA symptoms; however, they were also associated with a sharper rebound in symptoms over time (p = 0.016), resulting in no significant difference at Month 22 (p = 0.856). Next, we hypothesized that long-term changes in FA would be associated with long-term changes in body weight. Although both FA and weight decreased over time (ps < 0.05), month-to-month changes in FA were not associated with month-to-month changes in weight (p = 0.706). Instead, higher overall FA (i.e., mean scores over the course of the study) were associated with less weight loss (p = 0.008) over time. Finally, we hypothesized that initial reductions in problem food consumption would be associated with long-term reductions in weight, but this relationship was not significant (ps > 0.05). Given the complexity of the findings, more research is needed to identify interventions for long-term changes in FA and to elucidate the associations between problem foods, FA, and weight.

Metabolic, Affective and Neurocognitive Characterization of Metabolic Syndrome Patients with and without Food Addiction. Implications for Weight Progression

“…Our results indicate that the presence of FA at baseline resulted in a significant higher weight regain after three years, when following a Mediterranean diet. These findings are consistent with prior research that observed an association between the presence of FA and worse results while seeking a weight loss [ 71 , 72 , 73 ]. Previous results from our group showed that among individuals with obesity seeking bariatric surgery, the presence of FA at baseline predicted poorer weight loss achievement after a dietary and lifestyle intervention before the surgical intervention [ 6 ].…”

Advances and Future Directions in the Clinical Utility of Food Addiction

“…This special issue presents a collection of articles, contributed by renowned experts, researchers, and clinicians spanning different disciplines, that adds to the knowledge on the clinical utility of food addiction and eating addiction. The articles in this collection include reviews [1][2][3][4][5] as well as original research utilizing a variety of methodologies and study designs such as clinical trials [6][7][8], cross-sectional studies [9,10], and surveys [11].…”

“…In a sample of individuals with obesity and binge eating disorder participating in a behavioural weight loss program, Wiedemann et al [7] found that those with food addiction reported a stronger negative reaction to weekly weighing and less acceptance of their weight and shape throughout treatment, and the authors recommended that body image concerns be targeted in treatment given that both of these factors prospectively predicted greater eating disorder psychopathology. Gordon et al [8] found that food addiction symptoms improved during a behavioural weight loss program; however, more severe food addiction symptomatology was associated with less weight loss. Interestingly, reduced intake of hyperpalatable foods during the program was associated with short-term improvements in food addiction symptoms but not with long-term improvements in food addiction symptoms or weight, suggesting that the association among hyperpalatable foods, food addiction, and weight is a complex one.…”

Advances and Future Directions in the Clinical Utility of Food Addiction

“…This special issue presents a collection of articles, contributed by renowned experts, researchers, and clinicians spanning different disciplines, that adds to the knowledge on the clinical utility of food addiction and eating addiction. The articles in this collection include reviews [ 1 , 2 , 3 , 4 , 5 ] as well as original research utilizing a variety of methodologies and study designs such as clinical trials [ 6 , 7 , 8 ], cross-sectional studies [ 9 , 10 ], and surveys [ 11 ].…”

“…In a sample of individuals with obesity and binge eating disorder participating in a behavioural weight loss program, Wiedemann et al [ 7 ] found that those with food addiction reported a stronger negative reaction to weekly weighing and less acceptance of their weight and shape throughout treatment, and the authors recommended that body image concerns be targeted in treatment given that both of these factors prospectively predicted greater eating disorder psychopathology. Gordon et al [ 8 ] found that food addiction symptoms improved during a behavioural weight loss program; however, more severe food addiction symptomatology was associated with less weight loss. Interestingly, reduced intake of hyperpalatable foods during the program was associated with short-term improvements in food addiction symptoms but not with long-term improvements in food addiction symptoms or weight, suggesting that the association among hyperpalatable foods, food addiction, and weight is a complex one.…”