Pre-intervention characteristics in weight loss participants scoring positive and negative for food addiction

Abstract

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.

Impact of four obesity interventions on biometric measures of individuals positive and negative for food addiction

“…The Yale Food Addiction Scale (YFAS) is a relatively new, validated instrument that is used to assess individuals for food addiction (FA) [6,7]. Recent studies report FA prevalence of 20-25% in overweight/obese populations [5,8], whereas prevalence was 37.1% in this study [9]. No known obesity interventions speci ically target individuals who are positive for FA.…”

Impact of Interventions used to Treat Addictive Disorders on Food Addiction and Depression in Individuals with Obesity

“…Though presently not a clinical diagnosis, the FA construct identifies distinctive obesity phenotypes [14,7]. Previous analyses from this pilot study revealed that those who are FA+ may require more intensive intervention to achieve biometric results [15] and that prevalence/severity of depression was greater in those who were FA+ [7]. These secondary analyses demonstrated that prevalence and/or severity of FA and depression declined with intervention, particularly in those who were FA+ at baseline.…”

“…We recruited 83 participants from adults (age 19-65 years) with obesity referred by providers at the Regional West Physicians Clinic (RWPC) in Scottsbluff, Nebraska and through snowballing. Most were Caucasian (71%, Hispanics 28%, black 1%) women (89%, men 11%) [7].…”

“…There is growing interest in identifying subtypes of obesity [11,12] and tailoring treatments for those with different vulnerabilities [4,13,14]. Though presently not a clinical diagnosis, the FA construct identifies distinctive obesity phenotypes [14,7]. Previous analyses from this pilot study revealed that those who are FA+ may require more intensive intervention to achieve biometric results [15] and that prevalence/severity of depression was greater in those who were FA+ [7].…”

“…Analysis of baseline responses revealed that 37% of individuals screened were FA+, 82% of participants experienced depression, and prevalence and severity of depression was greater in those who were FA+ [7]. The high incidence of depression suggests that depression may contribute to obesity and/or complicate its treatment.…”