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Examining the construct validity of food addiction severity specifiers

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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Purpose

Food addiction (FA) is related to greater body mass index (BMI), eating-disorder psychopathology, food craving, and psychosocial impairment. Less is known regarding the utility of the FA severity specifiers, as measured by the number of symptoms endorsed on the Yale Food Addiction Scale (YFAS 2.0).

Methods

Participants (N = 1854) were recruited from Amazon Mechanical Turk to complete an online survey on eating behaviors. Participants completed self-report measures assessing FA, eating-disorder psychopathology (Eating Disorder Examination Questionnaire), and food craving (Food Craving Inventory). Based on the YFAS 2.0 specifiers, participants were classified into four FA groups: No FA (n = 1643), mild (n = 40), moderate (n = 55), and severe (n = 116).

Results

There were significant differences found in age, sex, BMI, and frequency of objective binge-eating episodes (OBEs) among the FA groups. Using ANCOVA, adjusted for multiple comparisons and covariates (e.g., BMI, sex, OBEs), the No FA group reported significantly lower levels of shape concern (η2 = 0.05; p < 0.001), weight concern (η2 = 0.04; p < 0.001), eating concern (η2 = 0.15; p < 0.001), and global eating-disorder psychopathology (η2 = 0.06; p < 0.001) than mild, moderate, or severe FA groups. The No FA group reported significantly lower levels of dietary restraint (η2 = 0.01; p < 0.01) than mild and severe FA groups. The severe FA group reported higher food craving scores (η2 = 0.02; p < 0.001) compared to the No FA group.

Conclusion

Our findings parallel the severity specifiers literature for eating and substance use disorders by also indicating the limited utility of severity specifiers based on symptom count. Future research should investigate alternative targets for discriminating among levels of FA.

Level of evidence

Level V, cross-sectional descriptive study.

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References

  1. Gearhardt AN, Davis C, Kuschner R, Brownell KD (2011) The addiction potential of hyperpalatable foods. Curr Drug Abuse Rev 4:140–145. https://doi.org/10.2174/1874473711104030140

    Article  PubMed  Google Scholar 

  2. Gearhardt AN, Boswell RG, White MA (2014) The association of "food addiction" with disordered eating and body mass index. Eat Behav 15:427–433. https://doi.org/10.1016/j.eatbeh.2014.05.001

    Article  PubMed  PubMed Central  Google Scholar 

  3. Pursey KM, Stanwell P, Gearhardt AN, Collins CE, Burrows TL (2014) The prevalence of food addiction as assessed by the Yale Food Addiction Scale: a systematic review. Nutrients 6:4552–4590. https://doi.org/10.3390/nu6104552

    Article  PubMed  PubMed Central  Google Scholar 

  4. Davis C, Curtis C, Levitan RD, Carter JC, Kaplan AS, Kennedy JL (2011) Evidence that 'food addiction' is a valid phenotype of obesity. Appetite 57:711–717. https://doi.org/10.1016/j.appet.2011.08.017

    Article  PubMed  Google Scholar 

  5. Maxwell AL, Gardiner E, Loxton NJ (2020) Investigating the relationship between reward sensitivity, impulsivity, and food addiction: a systematic review. Eur Eat Disord Rev. https://doi.org/10.1002/erv.2732

    Article  PubMed  Google Scholar 

  6. Gearhardt AN, Corbin WR, Brownell KD (2009) Preliminary validation of the Yale Food Addiction Scale. Appetite 52:430–436. https://doi.org/10.1016/j.appet.2008.12.003

    Article  PubMed  Google Scholar 

  7. Gearhardt AN, Corbin WR, Brownell KD (2016) Development of the Yale Food Addiction Scale version 2.0. Psychol Addict Behav 30:113–121. https://doi.org/10.1037/adb0000136

    Article  PubMed  Google Scholar 

  8. Linardon J, Messer M (2019) Assessment of food addiction using the Yale Food Addiction Scale 2.0 in individuals with binge-eating disorder symptomatology: factor structure, psychometric properties, and clinical significance. Psychiatry Res. https://doi.org/10.1016/j.psychres.2019.03.003

    Article  PubMed  Google Scholar 

  9. Raymond KL, Kannis-Dymand L, Lovell GP (2018) A graduated food addiction classification approach significantly differentiates obesity among people with type 2 diabetes. J Health Psychol 23:1781–1789. https://doi.org/10.1177/1359105316672096

    Article  PubMed  Google Scholar 

  10. Carter JC, Van Wijk M, Rowsell M (2019) Symptoms of 'food addiction' in binge eating disorder using the Yale Food Addiction Scale version 2.0. Appetite 133:362–369. https://doi.org/10.1016/j.appet.2018.11.032

    Article  PubMed  Google Scholar 

  11. Schienle A, Unger I, Wabnegger A (2020) Comparison of women with high vs. low food addiction tendency: a pilot study with voxel-based morphometry. J Eat Disord 8:13–13. https://doi.org/10.1186/s40337-020-00288-2

    Article  PubMed  PubMed Central  Google Scholar 

  12. Behrend TS, Sharek DJ, Meade AW, Wiebe EN (2011) The viability of crowdsourcing for survey research. Behav Res Methods 43:800–813. https://doi.org/10.3758/s13428-011-0081-0

    Article  PubMed  Google Scholar 

  13. Schulte EM, Gearhardt AN (2017) Development of the Modified Yale Food Addiction Scale version 2.0. Eur Eat Disord Rev 25:302–308. https://doi.org/10.1002/erv.2515

    Article  PubMed  Google Scholar 

  14. Fairburn CG, Beglin SJ (1994) Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord 16:363–370

    CAS  PubMed  Google Scholar 

  15. White MA, Whisenhunt BL, Williamson DA, Greenway FL, Netemeyer RG (2002) Development and validation of the food-craving inventory. Obes Res 10:107–114. https://doi.org/10.1038/oby.2002.17

    Article  PubMed  Google Scholar 

  16. White MA, Grilo CM (2005) Psychometric properties of the Food Craving Inventory among obese patients with binge eating disorder. Eat Behav 6:239–245. https://doi.org/10.1016/j.eatbeh.2005.01.001

    Article  PubMed  Google Scholar 

  17. Cohen J (1992) A power primer. Psychol Bull 112:155–159. https://doi.org/10.1037//0033-2909.112.1.155

    Article  CAS  PubMed  Google Scholar 

  18. Schulte EM, Joyner MA, Schiestl ET, Gearhardt AN (2017) Future directions in “food addiction”: next steps and treatment implications. Curr Psychiatry Rep 4:165–171. https://doi.org/10.1007/s40429-017-0140-4

    Article  Google Scholar 

  19. Burrows T, Kay-Lambkin F, Pursey K, Skinner J, Dayas C (2018) Food addiction and associations with mental health symptoms: a systematic review with meta-analysis. J Hum Nutr Diet 31:544–572. https://doi.org/10.1111/jhn.12532

    Article  CAS  PubMed  Google Scholar 

  20. Wolz I, Hilker I, Granero R, Jimenez-Murcia S, Gearhardt AN, Dieguez C, Casanueva FF, Crujeiras AB, Menchon JM, Fernandez-Aranda F (2016) "Food Addiction" in patients with eating disorders is associated with negative urgency and difficulties to focus on long-term goals. Front Psychol 7:61. https://doi.org/10.3389/fpsyg.2016.00061

    Article  PubMed  PubMed Central  Google Scholar 

  21. Gearhardt AN, White MA, Masheb RM, Morgan PT, Crosby RD, Grilo CM (2012) An examination of the food addiction construct in obese patients with binge eating disorder. Int J Eat Disord 45:657–663. https://doi.org/10.1002/eat.20957

    Article  PubMed  Google Scholar 

  22. Imperatori C, Fabbricatore M, Lester D, Manzoni GM, Castelnuovo G, Raimondi G, Innamorati M (2019) Psychometric properties of the modified Yale Food Addiction Scale version 2.0 in an Italian non-clinical sample. Eat Weight Disord 24:37–45. https://doi.org/10.1007/s40519-018-0607-x

    Article  PubMed  Google Scholar 

  23. Manzoni GM, Rossi A, Pietrabissa G, Mannarini S, Fabbricatore M, Imperatori C, Innamorati M, Gearhardt AN, Castelnuovo G (2020) Structural validity, measurement invariance, reliability and diagnostic accuracy of the Italian version of the Yale Food Addiction Scale 2.0 in patients with severe obesity and the general population. Eat Weight Disord. https://doi.org/10.1007/s40519-020-00858-y

    Article  PubMed  Google Scholar 

  24. Ivezaj V, Barnes RD, Cooper Z, Grilo CM (2018) Loss-of-control eating after bariatric/sleeve gastrectomy surgery: similar to binge-eating disorder despite differences in quantities. Gen Hosp Psychiatry 54:25–30. https://doi.org/10.1016/j.genhosppsych.2018.07.002

    Article  PubMed  PubMed Central  Google Scholar 

  25. Hauck C, Cook B, Ellrott T (2020) Food addiction, eating addiction and eating disorders. Proc Nutr Soc 79:103–112. https://doi.org/10.1017/s0029665119001162

    Article  PubMed  Google Scholar 

  26. Gearhardt AN, White MA, Masheb RM, Grilo CM (2013) An examination of food addiction in a racially diverse sample of obese patients with binge eating disorder in primary care settings. Compr Psychiatry 54:500–505. https://doi.org/10.1016/j.comppsych.2012.12.009

    Article  PubMed  PubMed Central  Google Scholar 

  27. Grilo CM, Ivezaj V, White MA (2015) Evaluation of the DSM-5 severity indicator for binge eating disorder in a community sample. Behav Res Ther 66:72–76. https://doi.org/10.1016/j.brat.2015.01.004

    Article  PubMed  PubMed Central  Google Scholar 

  28. Grilo CM, Ivezaj V, White MA (2015) Evaluation of the DSM-5 severity indicator for binge eating disorder in a clinical sample. Behav Res Ther 71:110–114. https://doi.org/10.1016/j.brat.2015.05.003

    Article  PubMed  PubMed Central  Google Scholar 

  29. Ehlers CL, Stouffer GM, Corey L, Gilder DA (2015) The clinical course of DSM-5 alcohol use disorders in young adult native and Mexican Americans. Am J Addict 24:713–721. https://doi.org/10.1111/ajad.12290

    Article  PubMed  PubMed Central  Google Scholar 

  30. Lane SP, Sher KJ (2015) Limits of current approaches to diagnosis severity based on criterion counts: an example with DSM-5 alcohol use disorder. Clin Psychol Sci 3:819–835. https://doi.org/10.1177/2167702614553026

    Article  PubMed  Google Scholar 

  31. Carr MM, Catak PD, Pejsa-Reitz MC, Saules KK, Gearhardt AN (2017) Measurement invariance of the Yale Food Addiction Scale 2.0 across gender and racial groups. Psychol Assess 29:1044–1052. https://doi.org/10.1037/pas0000403

    Article  PubMed  Google Scholar 

  32. Racine SE, Hagan KE, Schell SE (2019) Is all nonhomeostatic eating the same? Examining the latent structure of nonhomeostatic eating processes in women and men. Psychol Assess 31:1220–1233. https://doi.org/10.1037/pas0000749

    Article  PubMed  Google Scholar 

  33. Kuczmarski MF, Kuczmarski RJ, Najjar M (2001) Effects of age on validity of self-reported height, weight, and body mass index: findings from the Third National Health and Nutrition Examination Survey, 1988–1994. J Am Diet Assoc 101:28–34. https://doi.org/10.1016/s0002-8223(01)00008-6(quiz 35–26)

    Article  CAS  PubMed  Google Scholar 

  34. Connor GS, Tremblay M, Moher D, Gorber B (2007) A comparison of direct vs. self-report measures for assessing height, weight and body mass index: a systematic review. Obes Rev 8:307–326. https://doi.org/10.1111/j.1467-789X.2007.00347.x

    Article  Google Scholar 

  35. Hasin DS, O'Brien CP, Auriacombe M, Borges G, Bucholz K, Budney A, Compton WM, Crowley T, Ling W, Petry NM (2013) DSM-5 criteria for substance use disorders: recommendations and rationale. Am J Psychiatry 170:834–851. https://doi.org/10.1176/appi.ajp.2013.12060782

    Article  PubMed  PubMed Central  Google Scholar 

  36. Fielding-Singh P, Patel ML, King AC, Gardner CD (2019) Baseline psychosocial and demographic factors associated with study attrition and 12-month weight gain in the DIETFITS Trial. Obesity (Silver Spring) 27:1997–2004. https://doi.org/10.1002/oby.22650

    Article  Google Scholar 

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Funding

This research was supported, in part, by NIH Grants: K23-DK092279 and T32 DA019426-15.

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Authors and Affiliations

  1. Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT, 06520, USA

    Ashley A. Wiedemann, Meagan M. Carr & Valentina Ivezaj

  2. General Internal Medicine, University of Minnesota Medical School, Minneapolis, MN, USA

    Rachel D. Barnes

Authors
  1. Ashley A. Wiedemann
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  2. Meagan M. Carr
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  3. Valentina Ivezaj
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  4. Rachel D. Barnes
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Contributions

The authors contributions were as follows—AAW, MMC, VI, and RDB designed the research; AAW and MMC performed the statistical analysis; AAW, MMC, VI, and RDB contributed to interpretation of the data; AAW and MCC drafted the manuscript and all authors contributed to revisions of the manuscript. AAW, MMC, and RDB had full access to all of the data in the study and take responsibility for the integrity and accuracy of the data analysis.

Corresponding author

Correspondence to Ashley A. Wiedemann.

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Conflict of interest

The authors Wiedemann, Carr, Ivezaj, and Barnes report no conflicts of interest. Dr. Ivezaj reports broader interests including Honoraria for Journal Editorial Role and lectures.

Ethics approval

This study received approval from the University Institutional Review Board at the Yale School of Medicine. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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All participants provided electronic informed consent.

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Not applicable.

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The article is part of the Topical Collection on Food and addiction.

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Wiedemann, A.A., Carr, M.M., Ivezaj, V. et al. Examining the construct validity of food addiction severity specifiers. Eat Weight Disord 26, 1503–1509 (2021). https://doi.org/10.1007/s40519-020-00957-w

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  • DOI: https://doi.org/10.1007/s40519-020-00957-w

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