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The FODRAT study (FOod addiction, DRugs, Alcohol and Tobacco): first data on food addiction prevalence among patients with addiction to drugs, tobacco and alcohol

Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity volume 26, pages 449–455 (2021)Cite this article

Abstract

Objectives

The main focus of this study was to evaluate the prevalence of food addiction (FA) in a population of 575 subjects, all affected by drugs, alcohol and/or tobacco addiction.

Methods

Patients were enrolled in Addiction Service Centers and 25 items YFAS questionnaire was administered. Prevalence of FA was studied among patients who already have an addiction and then this prevalence was compared between groups of abusers (by type of substance), comparing mono abusers with polyabusers, as well as regressions by age, BMI, sex, through multiple regression analysis.

Results

Prevalence of FA in the sample is 20.17%. Risk of FA increases with the number of substances used (polyabuse). Results show a positive correlation, in addicted people, between BMI values and FA, with significant values (OR 1.08; 95% CI 1.04–1.13; p = 0.006). Age is inversely correlated with FA (OR 0.97; 95% CI 0.95–0.99; p = 0.01). Female sex is positively associated (OR 2.60; 95% CI 1.59–4.27, p = 0.000). No significant association appears with any substance, even if the highest prevalence is recorded among cannabis users (31.03%), and heroin (21.07%), followed by cocaine (18.53%), alcohol (14.49%) and tobacco (11.61%). A comparison between the FA prevalence in our study and that from another study in the Italian general population (11%) shows a significant difference (p < 0.001).

Conclusions

Prevalence of FA among addicted people is greater than in the general population. Risk of FA increases with the increase in number of used substances (polyabuse). Age is inversely correlated with FA. There is a positive and significant correlation between BMI and FA among substance/tobacco abusers.

Level of evidence

Level V, observational cross-sectional descriptive study.

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References

  1. Nizzoli U (2018) Il Disturbo da Uso di Sostanze (DUS). In: Lugoboni F, Zamboni L (eds) In Sostanza - Manuale sulle dipendenze patologiche, 1st edn. Edizioni CLAD-Onlus, Verona, pp 13–21

    Google Scholar 

  2. West R, Brown J (2013) Theory of addiction. Wiley, New York

    Book  Google Scholar 

  3. von Deneen KM, Liu Y (2011) Obesity as an addiction: why do the obese eat more? Maturitas 68(4):342–345. https://doi.org/10.1016/j.maturitas.2011.01.018

    Article  Google Scholar 

  4. Parylak SL, Koob GF, Zorrilla EP (2011) The dark side of food addiction. Physiol Behav 104(1):149–156. https://doi.org/10.1016/j.physbeh.2011.04.063

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Meule A (2015) Back by popular demand: a narrative review on the history of food addiction research. Yale J Biol Med 88(3):295–302

    PubMed  PubMed Central  Google Scholar 

  6. Fletcher PC, Kenny PJ (2019) Correction: food addiction: a valid concept? Neuropsychopharmacology 44(4):834. https://doi.org/10.1038/s41386-018-0288

    Article  PubMed  Google Scholar 

  7. Long CG, Blundell Finlayson G (2015) A systematic review of the application and correlates of YFAS-diagnosed ‘food addiction’ in humans: are eating-related ‘addictions’ a cause for concern or empty concepts? Obes Facts 8(6):386–401. https://doi.org/10.1159/000442403

    Article  PubMed  PubMed Central  Google Scholar 

  8. Gearhardt AN, Corbin WR, Brownell KD (2009) Preliminary validation of the Yale Food Addiction Scale. Appetite 52(2):430–436. https://doi.org/10.1016/j.appet.2008.12.003

    Article  PubMed  Google Scholar 

  9. Gearhardt AN, Corbin WR, Brownell KD (2009) Food addiction: an examination of the diagnostic criteria for dependence. J Addict Med 3(1):1–7. https://doi.org/10.1097/ADM.0b013e318193c993

    Article  PubMed  Google Scholar 

  10. Hone-Blanchet A, Fecteau S (2014) Overlap of food addiction and substance use disorders definitions: analysis of animal and human studies. Neuropharmacology 85:81–90. https://doi.org/10.1016/j.neuropharm.2014.05.019

    Article  CAS  PubMed  Google Scholar 

  11. Imperatori C, Fabbricatore M, Vumbaca V, Innamorati M, Contardi A, Farina B (2016) Food addiction: definition, measurement and prevalence in healthy subjects and in patients with eating disorders. Riv Psichiatr 51(2):60–65. https://doi.org/10.1708/2246.24196

    Article  PubMed  Google Scholar 

  12. Weingarten HP, Elston D (1990) The phenomenology of food cravings. Appetite 15(3):231–246

    Article  CAS  Google Scholar 

  13. Weingarten HP, Elston D (1991) Food cravings in a college population. Appetite 17(3):167–175

    Article  CAS  Google Scholar 

  14. White MA et al (2002) Development and validation of the food-craving inventory. Obes Res 10(2):107–114

    Article  Google Scholar 

  15. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders. American Psychiatric Association, Philadelphia

    Book  Google Scholar 

  16. Biondi M, Bersani FS, Valentini M (2014) The Italian edition of DSM-5. Riv Psichiatr 49(2):57–60

    PubMed  Google Scholar 

  17. Kozlowski LT, Wilkinson DA (1987) Use and misuse of the concept of craving by alcohol, tobacco, and drug researchers. Br J Addict 82(1):31–45. https://doi.org/10.1111/j.1360-0443.1987.tb01430.x

    Article  CAS  PubMed  Google Scholar 

  18. Meule A, Kübler A (2012) Food cravings in food addiction: the distinct role of positive reinforcement. Eat Behav 13(3):252–255. https://doi.org/10.1016/j.eatbeh.2012.02.001. (Erratum in: Eat Behav 2012;13(4):433)

    Article  PubMed  Google Scholar 

  19. van der Ster Wallin G, Norring C, Holmgren S (1994) Binge eating versus nonpurged eating in bulimics: is there a carbohydrate craving after all? Acta Psychiatr Scand 89(6):376–381. https://doi.org/10.1111/j.1600-0447.1994.tb01532.x

    Article  PubMed  Google Scholar 

  20. Waters A, Hill A, Waller G (2001) Bulimics’ responses to food cravings: is binge-eating a product of hunger or emotional state? Behav Res Ther 39(8):877–886. https://doi.org/10.1016/s0005-7967(00)00059-0

    Article  CAS  PubMed  Google Scholar 

  21. Moreno S et al (2008) Clinical validation of the trait and state versions of the food craving questionnaire. Assessment 15(3):375–387. https://doi.org/10.1177/1073191107312651

    Article  PubMed  Google Scholar 

  22. Gendall KA, Sullivan PF, Joyce PR, Bulik CM (1997) Food cravings in women with a history of anorexia nervosa. Int J Eat Disord 22(4):403–409. https://doi.org/10.1002/(sici)1098-108x(199712)22:4%3c403:aid-eat5%3e3.0.co;2-q

    Article  CAS  PubMed  Google Scholar 

  23. White MA, Grilo CM (2005) Psychometric properties of the food craving inventory among obese patients with binge eating disorder. Eat Behav 6(3):239–245. https://doi.org/10.1016/j.eatbeh.2005.01.001

    Article  PubMed  Google Scholar 

  24. Fabbricatore M, Imperatori C, Pecchioli L, Micarelli T, Contardi A, Tamburello S, Tamburello A, Innamorati M (2011) Binge eating and BIS/BAS activity in obese patients with intense food carving who attended weight control programs. Obes Metab 7(1):28–35

    Google Scholar 

  25. Jarosz PA et al (2007) Disordered eating and food cravings among urban obese African American women. Eat Behav 8(3):374–381. https://doi.org/10.1016/j.eatbeh.2006.11.014

    Article  PubMed  Google Scholar 

  26. Szmukler GI, Tantam D (1948) Anorexia nervosa: starvation dependence. Br J Med Psychol 57(4):303–310

    Article  Google Scholar 

  27. Allison KC et al (2010) Proposed diagnostic criteria for night eating syndrome. Int J Eat Disord 43(3):241–247. https://doi.org/10.1002/eat.20693

    Article  PubMed  PubMed Central  Google Scholar 

  28. Umberg EN et al (2012) From disordered eating to addiction. J Clin Psychopharmacol 32(3):376–389. https://doi.org/10.1097/JCP.0b013e318252464f

    Article  PubMed  Google Scholar 

  29. Gearhardt AN, White MA, Potenza MN (2011) Binge eating disorder and food addiction. Curr Drug Abuse Rev 4(3):201–207. https://doi.org/10.2174/1874473711104030201

    Article  PubMed  PubMed Central  Google Scholar 

  30. Meule A, von Rezori V, Blechert J (2014) Food addiction and bulimia nervosa. Eur Eat Disord Rev 22(5):331–337. https://doi.org/10.1002/erv.2306

    Article  PubMed  Google Scholar 

  31. Innamorati M et al (2015) Psychometric properties of the Italian Yale Food Addiction Scale in overweight and obese patients. Eat Weight Disord 20:119–127. https://doi.org/10.1007/s40519-014-0142-3

    Article  PubMed  Google Scholar 

  32. Wang GJ et al (2001) Brain dopamine and obesity. Lancet 357(9253):354–357. https://doi.org/10.1016/s0140-6736(00)03643-6

    Article  CAS  PubMed  Google Scholar 

  33. Volkow ND, Wang GJ, Fowler JS, Telang F (2008) Overlapping neural circuits in addiction and obesity: evidence of systems pathology. Philos Trans R Soc Lond B Biol Sci 363(1507):3191–3200. https://doi.org/10.1098/rstb.2008.0107

    Article  PubMed  PubMed Central  Google Scholar 

  34. Volkow ND, Wise RA (2005) How can drug addiction help us understand obesity? Nat Neurosci 8(5):555–560. https://doi.org/10.1038/nn1452

    Article  CAS  PubMed  Google Scholar 

  35. Shriner R, Gold M (2014) Food addiction: an evolving nonlinear science. Nutrients 6(11):5370–5391. https://doi.org/10.3390/nu6115370

    Article  PubMed  PubMed Central  Google Scholar 

  36. Avena NM, Hoebel BG (2003) Amphetamine-sensitized rats show sugar-induced hyperactivity (cross-sensitization) and sugar hyperphagia. Pharmacol Biochem Behav 74(3):635–639. https://doi.org/10.1016/s0091-3057(02)01050-x

    Article  CAS  PubMed  Google Scholar 

  37. Colantuoni C et al (2002) Evidence that intermittent, excessive sugar intake causes endogenous opioid dependence. Obes Res 10(6):478–488. https://doi.org/10.1038/oby.2002.66

    Article  CAS  PubMed  Google Scholar 

  38. Colantuoni C et al (2001) Excessive sugar intake alters binding to dopamine and mu-opioid receptors in the brain. NeuroReport 12(16):3549–3552. https://doi.org/10.1097/00001756-200111160-00035

    Article  CAS  PubMed  Google Scholar 

  39. O’Malley SS et al (2002) Naltrexone decreases craving and alcohol self-administration in alcohol-dependent subjects and activates the hypothalamo-pituitary-adrenocortical axis. Psychopharmacology 160(1):19–29. https://doi.org/10.1007/s002130100919

    Article  CAS  PubMed  Google Scholar 

  40. Drewnowski A et al (1995) Naloxone, an opiate blocker, reduces the consumption of sweet high-fat foods in obese and lean female binge eaters. Am J Clin Nutr 61(6):1206–1212. https://doi.org/10.1093/ajcn/61.6.1206

    Article  CAS  PubMed  Google Scholar 

  41. Harrop EN, Marlatt GA (2010) The comorbidity of substance use disorders and eating disorders in women: prevalence, etiology, and treatment. Addict Behav 35(5):392–398. https://doi.org/10.1016/j.addbeh.2009.12.016

    Article  PubMed  Google Scholar 

  42. Center on Addiction and Substance Abuse (CASA) (2003) Food for thought: substance abuse and eating disorders. The National Center on Addiction and Substance Abuse, Columbia University, New York. https://www.centeronaddiction.org/addiction-research/reports/food-thought-substance-abuse-and-eating-disorders

  43. Denoth F, Siciliano V, Iozzo P, Fortunato L, Molinaro S (2011) The association between overweight and illegal drug consumption in adolescents: is there an underlying influence of the sociocultural environment? PLoS ONE 6(11):e27358. https://doi.org/10.1371/journal.pone.0027358

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Glasner-Edwards S et al (2011) Bulimia nervosa among methamphetamine dependent adults: association with outcomes three years after treatment. Eat Disord 19(3):259–269. https://doi.org/10.1080/10640266.2011.566149

    Article  PubMed  PubMed Central  Google Scholar 

  45. Krug I et al (2009) Lifetime substance abuse, family history of alcohol abuse/dependence and novelty seeking in eating disorders: comparison study of eating disorder subgroups. Psychiatry Clin Neurosci 63(1):82–87. https://doi.org/10.1111/j.1440-1819.2008.01908.x

    Article  PubMed  Google Scholar 

  46. Vander Wal JS, Johnston KA, Dhurandhar NV (2007) Psychometric properties of the State and Trait Food Cravings Questionnaires among overweight and obese persons. Eat Behav 8(2):211–223. https://doi.org/10.1016/j.eatbeh.2006.06.002

    Article  PubMed  Google Scholar 

  47. Root TL et al (2010) Patterns of co-morbidity of eating disorders and substance use in Swedish females. Psychol Med 40(1):105–115. https://doi.org/10.1017/S0033291709005662

    Article  CAS  PubMed  Google Scholar 

  48. Calero-Elvira A et al (2009) Meta-analysis on drugs in people with eating disorders. Eur Eat Disord Rev 17(4):243–259. https://doi.org/10.1002/erv.936

    Article  PubMed  Google Scholar 

  49. Mies GW et al (2017) The prevalence of food addiction in a large sample of adolescents and its association with addictive substances. Appetite 118:97–105. https://doi.org/10.1016/j.appet.2017.08.002

    Article  PubMed  Google Scholar 

  50. Jiménez-Murcia S et al (2017) Food addiction in gambling disorder: frequency and clinical outcomes. Front Psychol 8:473. https://doi.org/10.3389/fpsyg.2017.00473

    Article  PubMed  PubMed Central  Google Scholar 

  51. Hodgkins C, Jacobs S, Gold MS (2003) Weight gain after adolescent drug addiction treatment and supervised abstinence. Psychiatr Ann 33(2):112–116. https://doi.org/10.3928/0048-5713-20030201-07

    Article  Google Scholar 

  52. Hatcher AS (2004) Weight matters during recovery: unhealthy eating behaviors can impede client progress. Addict Prof 2(6):23–24

    Google Scholar 

  53. Hauck C et al (2019) The relationship between food addiction and patterns of disordered eating with exercise dependence: in amateur endurance athletes. Eat Weight Disord. https://doi.org/10.1007/s40519-019-00794-6

    Article  PubMed  PubMed Central  Google Scholar 

  54. Murray SM et al (2019) A longitudinal preliminary study of addiction-like responses to food and alcohol consumption among individuals undergoing weight loss surgery. Obes Surg 29(8):2700–2703. https://doi.org/10.1007/s11695-019-03915-3

    Article  PubMed  Google Scholar 

  55. Kirrilly M et al (2014) The prevalence of food addiction as assessed by the Yale Food Addiction Scale: a systematic review. Nutrients 6(10):4552–4590. https://doi.org/10.3390/nu6104552

    Article  Google Scholar 

  56. Pedram P et al (2013) Food addiction: its prevalence and significant association with obesity in the general population. PLoS ONE 8(e74832):2013. https://doi.org/10.1371/journal.pone.0074832

    Article  CAS  Google Scholar 

  57. Innamorati M et al (2015) Psychometric properties of the Italian Yale Food Addiction Scale in overweight and obese patients. Eat Weight Disord 20(1):119–127. https://doi.org/10.1007/s40519-014-0142-3

    Article  Google Scholar 

  58. Tarrini G, Oliva R, Oliva L, Zanetti C, La MN (2014) “Yale Food Addiction Scale”: YF&AS.A.It. Uno strumento per la valutazione su un campione clinico con DA&O della Food&Addiction. Congresso Nazionale ANDID, Padova. http://sisdcadisturbialimentari.weebly.com/uploads/5/5/6/1/5561705/poster-1.andid.pdf

  59. Imperatori C et al (2019) Psychometric properties of the modified Yale Food Addiction Scale version 2.0 in an Italian non-clinical sample. Eat Weight Disord 24(1):37–45. https://doi.org/10.1007/s40519-018-0607-x

    Article  PubMed  Google Scholar 

  60. Manzoni GM et al (2018) Validation of the Italian Yale Food Addiction Scale in postgraduate university students. Eat Weight Disord 23(2):167–176. https://doi.org/10.1007/s40519-018-0495-0

    Article  PubMed  Google Scholar 

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Acknowledgements

Special thanks to: Bersani Nicoletta, Caruso Antonio, Chiesa Elisabetta, Cifelli Giuseppina, Cipollina Roberto, Gaiga Manuela, Guarda Federica, Meneghello Daniela, Monti Ilaria, Quarella Elisabetta, Sara Rosa, Zerman Maristella.

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Authors and Affiliations

  1. UO Alcologia e Nuove Dipendenze, Dipartimento di Salute Mentale e Dipendenze, ASST di Vimercate, Vimercate, Italy

    B. Tinghino & C. Grosina

  2. UO Medicina delle Dipendenze, Ospedale Universitario di Verona, Verona, Italy

    F. Lugoboni & S. Giusti

  3. Dipartimento di Salute Mentale e Dipendenze, ASST di Vimercate, Vimercate, Italy

    A. Amatulli

  4. SER.D ULSS 9 Scaligera, Verona, UOC Bussolengo e Legnago, Legnago, Italy

    C. Biasin & D. Cantiero

  5. UO Tossicodipendenze, Dipartimento di Salute Mentale e Dipendenze, ASST di Vimercate, Vimercate, Italy

    M. Bramani Araldi

  6. Dipartimento Cure Primarie, ATS di Bergamo, Bergamo, Italy

    M. Cremaschini

  7. UOSD Dipendenze, Dipartimento di Salute Mentale e Dipendenze, ASST di Monza, Monza, Italy

    G. L. Galimberti

  8. Medico specializzando in Scienza dell’Alimentazione, Università Statale di Milano, Milano, Italy

    G. E. G. Mulazzani

  9. Società Italiana Studio Disturbi Comportamento Alimentare, SISDCA, Roma, Italy

    U. Nizzoli

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  1. B. Tinghino
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  2. F. Lugoboni
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  4. C. Biasin
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  5. M. Bramani Araldi
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  12. U. Nizzoli
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Contributions

BT designed the study, analyzed the data and drafted the manuscript. FL contributed significantly to the recruitment of the participating centers. UN and FL supervised the work. MC managed the statistical aspects. GEGM contributed to the translation and revision. SG contributed to the writing of the text. The other authors have read and approved the final version.

Corresponding author

Correspondence to B. Tinghino.

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Conflict of interest

The authors declare they have not conflict of interest.

Ethical approval

The study was approved by the ethical committee of the province of Monza and Brianza (San Gerardo Hospital, Monza).

Informed consent

Patients were asked to sign informed consent for the scientific study and publication. All data has been processed anonymously

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Tinghino, B., Lugoboni, F., Amatulli, A. et al. The FODRAT study (FOod addiction, DRugs, Alcohol and Tobacco): first data on food addiction prevalence among patients with addiction to drugs, tobacco and alcohol. Eat Weight Disord 26, 449–455 (2021). https://doi.org/10.1007/s40519-020-00865-z

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Keywords

  • Food addiction
  • Bulimia nervosa
  • Weight
  • Addiction
  • Food craving