Food addiction in a spanish sample of eating disorders: Dsm-5 diagnostic subtype differentiation and validation data
Open accessAbstract
Although the concept of 'food addiction' (FA) has raised growing interest because of evidence for similarities between substance dependence and excessive food intake, there is a lack of studies that explore this construct among the wide spectrum of eating disorders (EDs). Besides providing validation scores of a Spanish version of the Yale FA Scale (YFAS-S), this study examined the prevalence of 'FA' among ED subtypes compared with healthy-eating controls (HCs) and the association between 'FA' scores, eating symptomatology and general psychopathology. A sample of 125 adult women with ED, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders 5 criteria, and 82 healthy-eating women participated in the study. All participants were assessed with the YFAS-S, the ED Inventory-2 and the Symptom Checklist-Revised. Results showed that the internal structure of the one-dimensional solution for the YFAS-S was very good (α = 0.95). The YFAS-S has a good discriminative capacity to differentiate between ED and controls (specificity = 97.6% and sensitivity (Se) = 72.8%; area under receiver operating characteristic curve = 0.90) and a good Se to screen for specific ED subtypes. YFAS-S scores were associated with higher levels of negative affect and depression, higher general psychopathology, more severe eating pathology and greater body mass index. When comparing the prevalence of 'FA' between ED subtypes, the lowest prevalence of 'FA', measured with the YFAS-S, was for the anorexia nervosa (AN) restrictive subtype with 50%, and the highest was for the AN binge-purging subtype (85.7%), followed by bulimia nervosa (81.5%) and binge eating disorder (76.9%). In conclusion, higher YFAS-S scores are associated with bingeing ED-subtype patients and with more eating severity and psychopathology. Although the 'FA' construct is able to differentiate between ED and HC, it needs to be further explored.
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When separating anorexia nervosa restrictive type from binge-purge type, food addiction prevalence is highest in anorexia nervosa binge-purge type.
“some studies suggest that when separating anorexia nervosa restrictive type (AN-R) with the binge–purge type (AN-BP), FA prevalence is the highest in AN-BP [51].”
From Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint (2020) · cites this paper as [51]
The area of greatest controversy surrounding food addiction appears to be in those with clinically significant eating disorders, particularly those with purging behaviors where food addiction symptoms can become elevated.
“The area of greatest controversy surrounding FA appears to be in those with clinically significant EDs, particularly those with purging behaviors where FA symptoms can become elevated [51].”
From Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint (2020) · cites this paper as [51]
The YFAS was translated into Spanish and validated in the Spanish adult and eating disorder population, with good validity and reliability scores.
“The YFAS was translated into Spanish and validated in the Spanish adult and ED population, with good validity and reliability scores (Granero et al., 2014).”
From “Food Addiction” in patients with eating disorders is associated with negative urgency and difficulties to focus on long-term goals (2016) · cites this paper as Granero et al., 2014
In a recent study using the YFAS in eating disorder patients, 72.8% fulfilled criteria for food addiction compared with 2.4% of healthy controls, and those eating disorder patients reporting food addiction showed higher eating disorder severity and more general psychopathology.
“In a recent study using the YFAS in ED patients, 72.8% of the sample fulfilled the criteria for FA compared to 2.4% of healthy controls, those ED patients who report FA showing higher ED severity and more general psychopathology (Granero et al., 2014).”
From “Food Addiction” in patients with eating disorders is associated with negative urgency and difficulties to focus on long-term goals (2016) · cites this paper as Granero et al., 2014
Because age significantly differed between groups and eating disorder subtype is known to influence the probability of food addiction, age and eating disorder subtype were entered as covariates.
“Since age significantly differed between groups and ED subtype is known to influence the probability of FA (Granero et al., 2014), these two variables were entered as covariates.”
From “Food Addiction” in patients with eating disorders is associated with negative urgency and difficulties to focus on long-term goals (2016) · cites this paper as Granero et al., 2014
Prevalence of food addiction is high in patients with eating disorders.
“Prevalence of FA is high in ED (Gearhardt et al., 2013; Granero et al., 2014; Meule et al., 2014b)”
From “Food Addiction” in patients with eating disorders is associated with negative urgency and difficulties to focus on long-term goals (2016) · cites this paper as Granero et al., 2014
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- Authors
- Granero, R., Hilker, I., Agüera, Z., Jiménez‐Murcia, S., Sauchelli, S., Islam, M. A., Fagundo, A. B., Sánchez, I., Riesco, N., Dieguez, C., Soriano, J., Salcedo‐Sánchez, C., Casanueva, F. F., De la Torre, R., Menchón, J. M., Gearhardt, A. N., & Fernández‐Aranda, F.
- Affiliations
- Universitat Autònoma de Barcelona (ES)
- Department of Psychiatry Bellvitge University Hospital‐IDIBELL Barcelona Spain
- Instituto de Salud Carlos III (ES)
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERObn) Instituto de Salud Carlos III Madrid Spain
- Bellvitge University Hospital (ES)
- Hospital de Sant Pau (ES)
- Department of Psychiatry University Hospital of Sant Pau Barcelona Spain
- University of Michigan (US)
- Corresponding author
- Fernández‐Aranda, Fernando
- ORCID
- Venue
- European Eating Disorders Review
- Publisher
- Wiley
- Published
- 2014-08-20
- Volume
- 22
- Issue
- 6
- Pages
- 389-396
- ISSN
- 1072-4133 (ISSN-L)
- 1099-0968
- OpenAlex
- W1567366751
- Cited by
- 153
- References
- 53
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 12 · 2023: 8 · 2022: 18 · 2021: 11 · 2020: 19 · 2019: 18 · 2018: 20 · 2017: 16 · 2016: 12 · 2015: 5 · 2014: 2
- FWCI
- 13.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Eating Disorders Review (publishedVersion)
- PubMed (publishedVersion)
- Dipòsit Digital de Documents de la UAB (Universitat Autònoma de Barcelona) (submittedVersion, cc-by-nc-nd)
- Deep Blue (University of Michigan) (submittedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
- RUNA. Repositorio Institucional del Sergas (Servicio Gallego de Salud (SERGAS)) (submittedVersion, other-oa)
- Funders
- FIS (ISCIII, Spain) (PI11/210)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- food addiction, eating disorders, Yale Food Addiction Scale, Spanish adaptation, anorexia nervosa, bulimia nervosa, binge eating disorder, psychopathology, depression, negative affect, eating pathology, body mass index, scale validation
- MeSH terms
- Adult, Anorexia Nervosa, Feeding and Eating Disorders, Depression, Depressive Disorder, Feeding Behavior, Female, Food, Humans, Psychiatric Status Rating Scales, Psychometrics, Surveys and Questionnaires, Spain, Reproducibility of Results, Body Mass Index, Prevalence, Behavior, Addictive, Diagnostic and Statistical Manual of Mental Disorders, White People, Bulimia Nervosa, Binge-Eating Disorder
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