Food addiction (FA) appears among bariatric weight loss surgery candidates who struggle to control the intake of hyperpalatable/refined foods have high rates of psychopathology and related health problems. Despite this, prevalence rates of FA in the bariatric sector are reported as low or variable. We investigated the prevalence of FA and the applicability of conventionally used metrics for 166 pre-surgery candidates from a weight management centre (USA) and a major metropolitan hospital (Australia). Self-report measures assessed FA (Yale Food Addiction Scale (YFAS)), body mass index (BMI), disordered eating, addictive personality, psychopathology, and diet. Consistent with prior research, standard YFAS scoring, requiring the endorsement of a distress/impairment (D/I) criterion (FA + D/I), yielded a FA prevalence rate of 12.7%, compared to 37.3% when D/I was omitted (FA − D/I). We compared profiles for those with FA using each scoring method against those ‘without’, who did not meet a minimum of three YFAS symptoms (non-FA ≤ 2). Both methods differentiated those with and without FA on addictive traits, disordered eating and hyperpalatable food consumption. Only FA + D/I differentiated markers of psychological distress or impairment, including depression, anxiety and quality of life. Results indicate a need for further FA research in bariatric settings.

Le concept d’addiction à l’alimentation a été récemment proposé en appliquant les critères diagnostiques DSM de dépendance à une substance dans le champ de l’alimentation . Selon ces auteurs, il est possible de développer vis-à-vis de l’alimentation (et notamment vis-à-vis de certains aliments riches en graisse ou en sucre) une relation de dépendance similaire aux autres addictions. L’intérêt de ce concept est de pouvoir identifier un sous-groupe plus homogène de patients pour lesquels il serait possible de proposer des stratégies thérapeutiques plus ciblées. Bien qu’il ne soit pas démontré que l’addiction à l’alimentation mène nécessairement à l’obésité, la plupart des travaux sur l’addiction à l’alimentation ont été réalisés chez des patients obèses car ce trouble y est plus fréquent qu’en population générale. Ainsi, l’addiction à l’alimentation (mesurée à l’aide de la Yale Food Addiction Scale ) était plus fréquente chez certains patients obèses : patients célibataires, présentant certaines caractéristiques psychopathologiques (symptômes de dépression, de TDAH, de stress post-traumatique, antécédent de traumatisme physique ou sexuel dans l’enfance, difficultés de régulation émotionnelle) et ayant des altérations du circuit opioïde et du système de la récompense . L’addiction à l’alimentation était plus fréquente chez les individus consommant plus fréquemment et en plus grande quantité des aliments riches en graisse, à fort index glycémique ou industriels, mais n’était pas associée à la sévérité de l’obésité. Ces résultats soulignent la pertinence de considérer l’addiction à l’alimentation comme une addiction à part entière ainsi que l’intérêt de proposer à ces patients des prises en charge classiquement efficaces en addictologie (entretiens motivationnels, prévention de la rechute, psychothérapies, traitements médicamenteux ciblant les systèmes neurobiologiques impliqués dans les addictions, voire traitements de substitution, prévention et politique de réduction des risques) .

The concept of food addiction is currently a highly debated subject within both the general public and the scientific communities. The term food addiction suggests that individuals may experience addictive-like responses to food, similar to those seen with classic substances of abuse. An increasing number of studies have established the prevalence and correlates of food addiction. Moreover, food addiction may be associated with obesity and disordered eating. Thus, intervening on food addiction may be helpful in the prevention and therapy of obesity and eating disorders. However, controversy exists about if this phenomenon is best defined through paradigms reflective of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) substance-related disorders (e.g. food addiction) or non-substance-related disorders (e.g. eating addiction) criteria. This review paper will give a brief summarisation of the current state of research on food addiction, a more precise definition of its classification, its differentiation from eating addiction and an overview on potential overlaps with eating disorders. Based on this review, there is evidence that food addiction may represent a distinct phenomenon from established eating disorders such as bulimia nervosa or binge-eating disorder. Future studies are needed to further examine and establish orthogonal diagnostic criteria specific to food addiction. Such criteria must differentiate the patterns of eating and symptoms that may be similar to those of eating disorders to further characterise food addiction and develop therapy options. To date, it is too premature to draw conclusions about the clinical significance of the concept of food addiction.