Advertisement

An examination of the mechanisms and personality traits underlying food addiction among individuals with severe obesity awaiting bariatric surgery

  • Anne-Sophie Ouellette
  • Christopher Rodrigue
  • Simone Lemieux
  • André Tchernof
  • Laurent Biertho
  • Catherine BéginEmail author
Original Article

Abstract

Purpose

The aetiology underlying addiction has often been investigated to shed more light on the factors contributing to the development and maintenance of various disorders. In the field of addictive eating behaviours, data on the aetiological factors related to food addiction (FA) in the bariatric context remain scarce. The present study aimed to explore mechanisms and variables underlying FA among individuals suffering from severe obesity and awaiting bariatric surgery.

Methods

Participants (N = 146) were recruited at the Quebec Heart and Lung Institute during their pre-operative visit and were invited to complete questionnaires. Participants with and without FA were compared on reward sensitivity, impulsivity, emotion dysregulation, and personality traits.

Results

Findings showed that bariatric candidates with FA (16%) presented more emotion dysregulation, more harm avoidance, and less self-directedness. Further exploration showed that the association between harm avoidance and the number of FA criteria endorsed was mediated by emotion dysregulation, while the association between self-directedness and the number of FA criteria endorsed was mediated by reward sensitivity.

Conclusions

These results indicate that an inability to regulate affect by strategies other than eating highly palatable food, in a context where negative affect and long-term goals can hardly be sustained, underlies a diagnostic of FA among bariatric candidates. From a clinical standpoint, the presence of a double vulnerability leading to FA symptomatology could help design better-targeted interventions to maximise weight loss maintenance in the bariatric context.

Level of evidence

Level V, descriptive study.

Keywords

Food addiction Bariatric surgery Emotion regulation Personality traits 

Notes

Acknowledgements

We thank the Research Chair in Bariatric and Metabolic Surgery of the Quebec Heart and Lung Institute, especially Marc Lapointe and Mélanie Nadeau, and the whole surgery team for their assistance in data collection. We thank Hélène Paradis for assisting with data analysis.

Compliance with ethical standards

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

Dr. Tchernof as well as Dr. Biertho report grants from Johnson & Jonhson Medical Companies, outside the submitted work. The other authors declare no conflict of interest.

References

  1. 1.
    Dawe S, Gullo MJ, Loxton NJ (2004) Reward drive and rash impulsiveness as dimensionsof impulsivity: implications for substance misuse. Addict Behav 29:1389–1405. doi: 10.1016/j.addbeh.2004.06.004 CrossRefPubMedGoogle Scholar
  2. 2.
    Moeller FG, Dougherty DM, Barratt ES, Schmitz JM, Swann AC, Grabowski J (2001) The impact of impulsivity on cocaine use and retention in treatment. J Subst Abuse Treat 21:193–198. doi: 10.1016/S0740-5472(01)00202-1 CrossRefPubMedGoogle Scholar
  3. 3.
    Alessi SM, Petry NM (2003) Pathological gambling severity is associated with impulsivity in a delay discounting procedure. Behav Process 64:345–354. doi: 10.1016/S0376-6357(03)00150-5 CrossRefGoogle Scholar
  4. 4.
    Genovese JE, Wallace D (2007) Reward sensitivity and substance abuse in middle school and high school students. J Genet Psychol 168:465–469. doi: 10.3200/GNTP.168.4.465-469 CrossRefPubMedGoogle Scholar
  5. 5.
    Gaher RM, Hahn AM, Shishido H, Simons JS, Gaster S (2015) Associations between sensitivity to punishment, sensitivity to reward, and gambling. Addict Behav 42:180–184. doi: 10.1016/j.addbeh.2014.11.014 CrossRefPubMedGoogle Scholar
  6. 6.
    Fox HC, Axelrod SR, Paliwal P, Sleeper J, Sinha R (2007) Difficulties in emotion regulation and impulse control during cocaine abstinence. Drug Alcohol Depend 89:298–301. doi: 10.1016/j.drugalcdep.2006.12.026 CrossRefPubMedGoogle Scholar
  7. 7.
    Fox HC, Hong KA, Sinha R (2008) Difficulties in emotion regulation and impulse control in recently abstinent alcoholics compared with social drinkers. Addict Behav 33:388–394. doi: 10.1016/j.addbeh.2007.10.002 CrossRefPubMedGoogle Scholar
  8. 8.
    Williams AD, Grisham JR, Erskine A, Cassedy E (2012) Deficits in emotion regulation associated with pathological gambling. Br J Clin Psychol 51:223–238. doi: 10.1111/j.2044-8260.2011.02022.x CrossRefPubMedGoogle Scholar
  9. 9.
    Cloninger CR, Svrakic DM, Przybeck TR (1993) A psychobiological model of temperament and character. Arch Gen Psychiatry 50:975–990. doi: 10.1001/archpsyc.1993.01820240059008 CrossRefPubMedGoogle Scholar
  10. 10.
    Milivojevic D, Milovanovic SD, Jovanovic M, Svrakic DM, Svrakic NM, Svrakic SM, Cloninger CR (2012) Temperament and character modify risk of drug addiction and influence choice of drugs. Am J Addict 21:462–467. doi: 10.1001/archpsyc.1993.01820240059008 CrossRefPubMedGoogle Scholar
  11. 11.
    Hosák L, Preiss M, Halíř M, Čermáková E, Csémy L (2004) Temperament and character inventory (TCI) personality profile in metamphetamine abusers: a controlled study. Eur Psychiatry 19:193–195. doi: 10.1016/j.eurpsy.2004.04.003 CrossRefPubMedGoogle Scholar
  12. 12.
    Nordin C, Nylander PO (2007) Temperament and character in pathological gambling. J Gambl Stud 23:113–120. doi: 10.1007/s10899-006-9049-x CrossRefPubMedGoogle Scholar
  13. 13.
    Galanti K, Gluck ME, Geliebter A (2007) Test meal intake in obese binge eaters in relation to impulsivity and compulsivity. Int J Eat Disord 40:727–732. doi: 10.1002/eat.20441 CrossRefPubMedGoogle Scholar
  14. 14.
    Franken IH, Muris P (2005) Individual differences in reward sensitivity are related to food craving and relative body weight in healthy women. Appetite 45:198–201. doi: 10.1016/j.appet.2005.04.004 CrossRefPubMedGoogle Scholar
  15. 15.
    Davis C, Patte K, Levitan R, Reid C, Tweed S, Curtis C (2007) From motivation to behaviour: a model of reward sensitivity, overeating, and food preferences in the risk profile for obesity. Appetite 48:12–19. doi: 10.1016/j.appet.2006.05.016 CrossRefPubMedGoogle Scholar
  16. 16.
    Eichen DM, Chen E, Boutelle KN, McCloskey MS (2017) Behavioral evidence of emotion dysregulation in binge eaters. Appetite 111:1–6. doi: 10.1016/j.appet.2016.12.021 CrossRefPubMedGoogle Scholar
  17. 17.
    Gianini LM, White MA, Masheb RM (2013) Eating pathology, emotion regulation, and emotional overeating in obese adults with binge eating disorder. Eat Behav 14:309–313. doi: 10.1016/j.eatbeh.2013.05.008 CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Sullivan S, Cloninger CR, Przybeck TR, Klein S (2007) Personality characteristics in obesity and relationship with successful weight loss. Int J Obes 31:669–674. doi: 10.1038/sj.ijo.0803464 CrossRefGoogle Scholar
  19. 19.
    Fassino S, Leombruni P, Pierò A, Daga GA, Amianto F, Rovera G, Rovera GG (2002) Temperament and character in obese women with and without binge eating disorder. Compr Psychiatry 43:431–437. doi: 10.1053/comp.2002.35906 CrossRefGoogle Scholar
  20. 20.
    Dawe S, Loxton NJ (2004) The role of impulsivity in the development of substance use and eating disorders. Neurosci Biobehav Rev 28:343–351. doi: 10.1016/j.neubiorev.2004.03.007 CrossRefPubMedGoogle Scholar
  21. 21.
    Davis C, Carter JC (2009) Compulsive overeating as an addiction disorder. A review of theory and evidence. Appetite 53:1–8. doi: 10.1016/j.appet.2009.05.018 CrossRefPubMedGoogle Scholar
  22. 22.
    American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders fourth edition text revision (DSM-IV-TR). American Psychiatric Association, Arlington, VAGoogle Scholar
  23. 23.
    Gearhardt AN, Corbin WR, Brownell KD (2009) Preliminary validation of the Yale food addiction scale. Appetite 52:430–436. doi: 10.1016/j.appet.2008.12.003 CrossRefPubMedGoogle Scholar
  24. 24.
    Murphy CM, Stojek MK, MacKillop J (2013) Interrelationships among impulsive personality traits, food addiction and body mass index. Appetite 73:45–50. doi: 10.1016/j.appet.2013.10.008 CrossRefGoogle Scholar
  25. 25.
    Loxton NJ, Tipman RJ (2016) Reward sensitivity and food addiction in women. Appetite 115:28–35. doi: 10.1016/j.appet.2016.10.022 CrossRefPubMedGoogle Scholar
  26. 26.
    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. doi: 10.1002/eat.20957 CrossRefPubMedGoogle Scholar
  27. 27.
    Bégin C, St-Louis MÈ, Turmel S, Tousignant B, Marion LP, Ferland F, Blanchette-Martin N, Gagnon-Girouard MP (2012) Does food addiction distinguish a specific subgroup of overweight/obese overeating women? Health (London) 4:1492–1499. doi: 10.4236/health.2012.412A214 CrossRefGoogle Scholar
  28. 28.
    Wolz I, Hilker I, Granero R, Jiménez-Murcia S, Gearhardt AN, Dieguez C, Casanueva FF, Crujeiras AB, Menchon JM, Fernández-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 7:1–10. doi: 10.3389/fpsyg.2016.00061 CrossRefGoogle Scholar
  29. 29.
    Koball AM, Clark MM, Collazo-Clavell M, Kellogg T, Ames G, Ebbert J, Grothe KB (2016) The relationship among food addiction, negative mood, and eating-disordered behaviors in patients seeking to have bariatric surgery. Surg Obes Relat Dis 12:165–170. doi: 10.1016/j.soard.2015.04.009 CrossRefPubMedGoogle Scholar
  30. 30.
    Clark SM, Saules KK (2013) Validation of the Yale food addiction scale among a weight-loss surgery population. Eat Behav 14:216–219. doi: 10.1016/j.eatbeh.2013.01.002 CrossRefPubMedGoogle Scholar
  31. 31.
    Pepino MY, Stein RI, Eagon JC, Klein S (2014) Bariatric surgery-induced weight loss causes remission of food addiction in extreme obesity. Obesity 22:1792–1798. doi: 10.1002/oby.20797 CrossRefPubMedGoogle Scholar
  32. 32.
    Miller-Matero LR, Armstrong R, McCulloch K, Hyde-Nolan M, Eshelman A, Genaw J (2014) To eat or not to eat; is that really the question? An evaluation of problematic eating behaviors and mental health among bariatric surgery candidates. Eat Weight Disord 19:377–382. doi: 10.1007/s40519-014-0118-3 CrossRefPubMedGoogle Scholar
  33. 33.
    Meule A, Heckel D, Jurowich CF, Vogele C, Kubler A (2014) Correlates of food addiction in obese individuals seeking bariatric surgery. Clin Obes 4:228–236. doi: 10.1111/cob.12065 CrossRefPubMedGoogle Scholar
  34. 34.
    Brunault P, Ducluzeau PH, Bourbao-Tournois C, Delbachian I, Couet C, Réveillère C, Ballon N (2016) Food addiction in bariatric surgery candidates: prevalence and risk factors. Obes Surg 26:1650–1653. doi: 10.1007/s11695-016-2189-x CrossRefPubMedGoogle Scholar
  35. 35.
    Torrubia R, Avila C, Moltó J, Caseras X (2001) The sensitivity to punishment and sensitivity to reward questionnaire (SPSRQ) as a measure of Gray’s anxiety and impulsivity dimensions. Personal Individ Differ 31:837–862. doi: 10.3389/fpsyg.2010.00239 CrossRefGoogle Scholar
  36. 36.
    Gray JA (1981) A critique of Eysenck’s theory of personality. In: Eysenck HJ (ed) A model for personality. Springer, New York, pp 246–276CrossRefGoogle Scholar
  37. 37.
    O’Connor RM, Colder CR, Hawk LW (2004) Confirmatory factor analysis of the Sensitivity to Punishment and Sensitivity to Reward Questionnaire. Personal Individ Differ 37:985–1002. doi: 10.1016/j.paid.2003.11.008 CrossRefPubMedGoogle Scholar
  38. 38.
    Caci H, Deschaux O, Baylé FJ (2007) Psychometric properties of the French versions of the BIS/BAS scales and the SPSRQ. Personal Individ Differ 42:987–998. doi: 10.1016/j.paid.2006.09.008 CrossRefGoogle Scholar
  39. 39.
    Steinberg L, Sharp C, Stanford MS, Tharp AT (2013) New tricks for an old measure: the development of the Barratt impulsiveness scale-brief (BIS-brief). Psychol Assess 25:216–226. doi: 10.1037/a0030550 CrossRefPubMedGoogle Scholar
  40. 40.
    Barratt ES (1959) Anxiety and impulsiveness related to psychomotor efficiency. Percept Mot Skills 9:191–198. doi: 10.2466/PMS.9.3.191-198 CrossRefGoogle Scholar
  41. 41.
    Gratz KL, Roemer L (2004) Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess 26:41–54. doi: 10.1007/s10862-008-9102-4 CrossRefGoogle Scholar
  42. 42.
    Hayes AF (2013) Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. The Guilford Press, New York, NYGoogle Scholar
  43. 43.
    Preacher KJ, Hayes AF (2004) SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behav Res Method Instrum Comput 36:717–731. doi: 10.3758/BF03206553 CrossRefGoogle Scholar
  44. 44.
    Kozak AT, Davis J, Brown R, Grabowski M (2016) Are overeating and food addiction related to distress tolerance? An examination of residents with obesity from a US metropolitan area. Obes Res Clin Pract. doi: 10.1016/j.orcp.2016.09.010 CrossRefPubMedGoogle Scholar
  45. 45.
    Litwin R, Goldbacher EM, Cardaciotto L, Gambrel LE (2016) Negative emotions and emotional eating: the mediating role of experiential avoidance. Eat Weight Disord 22:97–104. doi: 10.1007/s40519-016-0301-9 CrossRefPubMedGoogle Scholar
  46. 46.
    Wolz I, Granero R, Fernández-Aranda F (2017) A comprehensive model of food addiction in patients with binge-eating symptomatology: the essential role of negative urgency. Compr Psychiatry 74:118–124. doi: 10.1016/j.comppsych.2017.01.012 CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.School of PsychologyLaval UniversityQuebec CityCanada
  2. 2.School of NutritionLaval UniversityQuebec CityCanada
  3. 3.Institute of Nutrition and Functional FoodsLaval UniversityQuebec CityCanada
  4. 4.Quebec Heart and Lung InstituteQuebec CityCanada
  5. 5.Department of SurgeryLaval UniversityQuebec CityCanada

Personalised recommendations