Is food addiction a predictor of treatment outcome among patients with eating disorder?
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OBJECTIVES: The study aimed to examine whether food addiction (FA) was associated with greater severity in both binge eating disorders (BED) and bulimia nervosa and, therefore, to determine if FA was predictive of treatment outcome. METHOD: Seventy-one adult patients with bulimia nervosa and BED (42 and 29, respectively) participated in the study. FA was assessed by means of the Yale Food Addiction Scale. RESULTS: The results confirmed a high prevalence of FA in patients with binge disorders (around 87%) and also its association with a greater severity of the disorder (i.e., related to an increased eating psychopathology and greater frequency of binge eating episodes). Although FA did not appear as a predictor of treatment outcome in general terms, when the diagnostic subtypes were considered separately, FA was associated with poor prognosis in the BED group. In this vein, FA appeared as a mediator in the relationship between ED severity and treatment outcome. DISCUSSIONS: Our findings suggest that FA may act as an indicator of ED severity, and it would be a predictor of treatment outcome in BED but not in BN.
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FA predicts a worse treatment outcome in patients with binge eating disorder (BED).
“It has also been shown that FA predicts a worse treatment outcome in patients with binge eating disorder (BED) [50].”
From Food Addiction and Psychosocial Adversity: Biological Embedding, Contextual Factors, and Public Health Implications (2020) · cites this paper as [50]
When diagnostic subtypes are considered separately, food addiction is associated with a poor prognosis in the binge eating disorder group.
“One study suggested that when diagnostic subtypes are considered separately, FA is associated with a poor prognosis in the BED group [61].”
From Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint (2020) · cites this paper as [61]
Recent studies have identified different phenotypic characterizations of the FA construct.
“Recent studies have identified different phenotypic characterizations of the FA construct [60,61,202,203].”
From Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint (2020) · cites this paper as [61]
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“It has also been shown that FA predicts a worse treatment outcome in patients with binge eating disorder (BED) [50].”
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“One study suggested that when diagnostic subtypes are considered separately, FA is associated with a poor prognosis in the BED group [61].”
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“Food addiction may also be associated with a poorer prognosis in binge eating disorder treatment outcomes (Romero et al., 2019).”
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“Treatment outcome was explored as well, not only to relate it with the presence of FA, being that other studies have already approach the subject [14,32], but to add to a better characterization of FA construct in well-defined phenotypes that consider FA presence and other clinical variables.”
BackgroundInfluentialDietary Habits, Obesity, and Bariatric Surgery: A Review of Impact and Interventions
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“For obesity, the main therapeutic goals are weight loss and the maintenance of long-term weight reduction [42].”
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“First, like most of the studies on eating behaviors or FA, the participants were mostly females (Romero et al., 2019, Şahan et al., 2021).”
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“Prior research has already demonstrated that patients who have obesity with and without BED and comorbid FA exhibit more severe psychosocial presentations (Burrows, Skinner, McKenna, & Rollo, 2017; Jiménez-Murcia et al., 2019; Munguía et al., 2022; Romero et al., 2019).”
Bonder, R., & Davis, C. A. (2022) · Current Addiction Reports · doi:10.1007/s40429-022-00443-6 · Cited by 18 · see citing works
Food addiction and lifetime alcohol and illicit drugs use in specific eating disorders
Miranda‐Olivos, R., Agüera, Z., Granero, R., Vergeer, R. R., Diéguez, C., Jiménez‐Múrcia, S., Gearhardt, A. N., & Fernández‐Aranda, F. (2022) · Journal of Behavioral Addictions · doi:10.1556/2006.2021.00087 · Cited by 18 · see citing works
“FA is highly prevalent in patients with binge eating symptomatology such as BN, BED, and OSFED (Gearhardt, White, & Potenza, 2011; Granero et al., 2014; Jimenez-Murcia et al., 2019; Romero et al., 2019).”
BackgroundInfluentialEtxandi, M., Baenas, I., Munguía, L., Mestre‐Bach, G., Granero, R., Gómez‐Peña, M., Moragas, L., del Pino‐Gutiérrez, A., Codina, E., Mora‐Maltas, B., et al. (2021) · Journal of Gambling Studies · doi:10.1007/s10899-021-10071-w · Cited by 16 · see citing works
“, 2015), previous studies have reported that women are more likely to engage in FA behaviors (Schulte & Gearhardt, 2018) and experience abnormal eating and weight disorders (Jiménez-Murcia et al., 2019; Romero et al., 2019; Schulte & Gearhardt, 2018), with initial studies suggesting similar relationships in patients w…”
ResultCorrelates of Food Addiction and Eating Behaviours in Patients with Morbid Obesity
Schankweiler, P., Raddatz, D., Ellrott, T., & Hauck, C. (2023) · Obesity Facts · doi:10.1159/000531528 · Cited by 14 · see citing works
“The average prevalence of FA is 10% in healthy populations [11] and is higher in populations with obesity (25% on average [11]) and especially among individuals with eating disorders such as binge eating (70% – 90% [13]) and bulimia nervosa (95”
BackgroundAgüera, Z., Riesco, N., Valenciano‐Mendoza, E., Granero, R., Sánchez, I., Andreu, A., Jiménez‐Múrcia, S., & Fernández‐Aranda, F. (2021) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-020-01083-3 · Cited by 14 · see citing works
“This is in line with a previous study that found FA as an indicator of ED severity [25].”
BackgroundResultInfluentialThe Role of Food Addiction and Lifetime Substance Use on Eating Disorder Treatment Outcomes
Miranda‐Olivos, R., Agüera, Z., Granero, R., Jiménez‐Múrcia, S., Llobet, M. P., Lluch‐Canut, T., Gearhardt, A. N., & Fernández‐Aranda, F. (2023) · Nutrients · doi:10.3390/nu15132919 · Cited by 13 · see citing works
“[4] found that the association between FA and treatment outcomes appeared to be mediated by the severity of the ED.”
BackgroundResultInfluentialSkinner, J. A., Leary, M., Whatnall, M. C., Collins, R. A., Pursey, K., Verdejo‐García, A., Hay, P., Baker, A., Hides, L. M., Paxton, S. J., et al. (2024) · Appetite · doi:10.1016/j.appet.2024.107211 · Cited by 13 · see citing works
“…with recurrent binge eating episodes (Hay P et al., 2022; Hilbert A et al., 2017), research suggests that in individuals with co-morbid food addiction and binge eating disorder, addictive eating behaviours may be acting as a maintenance factor for binge eating episodes (Romero X et al., 2019).”
Halbeisen, G., Pahlenkemper, M., Sabel, L., Richardson, C., Agüera, Z., Fernández‐Aranda, F., & Paslakis, G. (2024) · Obesity Reviews · doi:10.1111/obr.13851 · Cited by 14 · see citing works
Impact of Food Addiction in Therapy Response in Obesity and Eating Disorders
Camacho‐Barcia, L., Munguía, L., Gaspar‐Pérez, A., Jiménez‐Múrcia, S., & Fernández‐Aranda, F. (2022) · Current Addiction Reports · doi:10.1007/s40429-022-00421-y · Cited by 12 · see citing works
“This higher severity in ED symptomatology was associated with a poor prognosis among BED patients [21].”
BackgroundDismantling the myth of “all foods fit” in eating disorder treatment
Brewerton, T. D., Dennis, K., & Wiss, D. A. (2024) · Journal of Eating Disorders · doi:10.1186/s40337-024-01017-9 · Cited by 10 · see citing works
“The presence of UPFA has also been associated with a poorer treatment outcome for binge eating disorder [89], which is known to be highly comorbid with addiction-like eating [90–92].”
BackgroundEating disorder in gambling disorder: A group with increased psychopathology
Lemón, L., Fernández‐Aranda, F., Jiménez‐Múrcia, S., & Håkansson, A. (2021) · Journal of Behavioral Addictions · doi:10.1556/2006.2021.00060 · Cited by 10 · see citing works
LaFata, E. M., Worwag, K. E., Derrigo, K., Hessler, C., Allison, K. C., Juarascio, A. S., & Gearhardt, A. N. (2024) · Psychological Assessment · doi:10.1037/pas0001340 · Cited by 9 · see citing works
Agüera, Z., Vintró‐Alcaraz, C., Baenas, I., Granero, R., Sánchez, I., Sánchez‐González, J., Menchón, J. M., Jiménez‐Múrcia, S., Treasure, J. L., & Fernández‐Aranda, F. (2021) · Nutrients · doi:10.3390/nu13062034 · Cited by 9 · see citing works
Exploring Food Addiction Across Several Behavioral Addictions: Analysis of Clinical Relevance
Gaspar‐Pérez, A., Granero, R., Fernández‐Aranda, F., Rosińska, M., Artero, C., Ruiz-Torras, S., Gearhardt, A. N., Demetrovics, Z., Guàrdia‐Olmos, J., & Jiménez‐Múrcia, S. (2025) · Nutrients · doi:10.3390/nu17071279 · Cited by 8 · see citing works
“To date, multiple studies have examined whether the presence of FA in EDs is related to greater severity as well as worse response to treatment [82,83].”
Predictors of neurofeedback treatment outcome in binge‐eating disorder : An exploratory study
Rösch, S. A., Schmidt, R., & Hilbert, A. (2023) · International Journal of Eating Disorders · doi:10.1002/eat.24062 · Cited by 7 · see citing works
Guerrero‐Pérez, F., Rojas, N. V., Sánchez, I., Munguía, L., Jiménez‐Múrcia, S., Artero, C., Sobrino, L., Lazzara, C., Monseny, R., Montserrat, M., et al. (2025) · Nutrients · doi:10.3390/nu17132114 · Cited by 6 · see citing works
“…the general population and mental disorders [18], was associated with greater eating symptomatology, general psychopathology, and more dysfunctional personality traits [19], but also with poor therapy response in eating disorder patients living with obesity, namely binge eating disorders [20,21].”
Legendre, M., & Bégin, C. (2023) · Eating Behaviors · doi:10.1016/j.eatbeh.2023.101720 · Cited by 5 · see citing works
The Assessment of Food Addiction and the Yale Food Addiction Scale in Bariatric Surgery Populations
Stanley, P., O’Donovan, A., Schwartz, J., & Edwards-Hampton, S. A. (2021) · Behaviour Change · doi:10.1017/bec.2021.21 · Cited by 3 · see citing works
“, 2011) and disordered eating (Davis et al., 2011; Fauconnier et al., 2020; Romero et al., 2019) are associated with higher rates of FA.”
BackgroundNeurocognitive impairments in eating disorders patients with and without comorbid food addiction
Munguía, L., Granero, R., Supit, K., Lucas, I., Gearhardt, A. N., Jiménez‐Múrcia, S., & Fernández‐Aranda, F. (2025) · Journal of Eating Disorders · doi:10.1186/s40337-025-01494-6 · Cited by 2 · see citing works
Can Intuitive Eating Be Helpful to Individuals with Ultra-Processed Food Addiction?
Wiss, D. A., & Brewerton, T. D. (2025) · doi:10.1093/med/9780197688908.003.0009 · Cited by 1 · see citing works
Unique and Shared Symptoms Across Food Addiction and Binge‐Eating Measures: A Content Analysis
Graver, H., McCausland, H. C., Kruger, M., Rubino, L. G., Moussaoui, J. R., Parnarouskis, L., LaFata, E. M., & Manasse, S. M. (2026) · International Journal of Eating Disorders · doi:10.1002/eat.70033 · Cited by 1 · see citing works
Association Between Childhood Obesity and the Risk of Food Addiction: A Matched Case-Control Study
Brito, N. B., Robayna, B. P., Sosa, J. I. C., Bello, M. Á. G., Rodríguez, E., Roger, J. E. D. L. H., Pons, M. R., Brito, I. M. D., Romero, C. D., & Ramallo‐Fariña, Y. (2025) · Nutrients · doi:10.3390/nu17162654 · Cited by 1 · see citing works
“The relationship between FA and ED is beginning to be increasingly studied, although the clinical relevance of this connection is still in its infancy, making it difficult to draw definitive conclusions [25,26].”
Clinical Applications of the Food Addiction Concept
Wilcox, C. E. (2021) · Springer eBooks · doi:10.1007/978-3-030-83078-6_14 · Cited by 1 · see citing works
Evaluation of Food Addiction: Importance, Epidemiology, Diagnosis, and Assessment
Wilcox, C. E. (2021) · Springer eBooks · doi:10.1007/978-3-030-83078-6_12
Reis, E., Çakır, G., Demirkaya, H., Kuzu, N., Atay, T., & Özenoğlu, A. (2022) · Cyprus Journal of Medical Sciences · doi:10.4274/cjms.2020.3155
Evidências de validade do Food Cravings Questionnaire Trait-reduced (FCQ T-r)
Oliveira, M. D. S., dos Santos, R. R. G., & Brilmann, M. (2024) · Psico · doi:10.15448/1980-8623.2024.1.41655
Food Addiction and Obesity Treatment Outcomes
Paslakis, G., Halbeisen, G., Agüera, Z., Jiménez‐Múrcia, S., & Fernández‐Aranda, F. (2024) · doi:10.1093/oso/9780190671051.003.0044
Food Addiction and Treatment of Eating Disorders
Munguía, L., Camacho‐Barcia, L., Jiménez‐Múrcia, S., & Fernández‐Aranda, F. (2024) · doi:10.1093/oso/9780190671051.003.0042
Kaya, S., & Kumova, F. (2024) · Beykoz Akademi Dergisi · doi:10.14514/beykozad.1522077
Camacho-Barcia, L., Jiménez-Murcia, S., & Fernández-Aranda, F. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-13825-6.00331-9
Miranda‐Olivos, R., Soriano‐Mas, C., la Peña‐Arteaga, V. D., Baenas, I., Lucas, I., Camacho‐Barcia, L., Sánchez, I., Granero, R., Gaspar‐Pérez, A., Sánchez‐González, J., et al. (2026) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-026-10097-8
- Authors
- Romero, X., Agüera, Z., Granero, R., Sánchez, I., Riesco, N., Jiménez‐Murcia, S., Gisbert‐Rodriguez, M., Sánchez‐González, J., Casalé, G., Baenas, I., Valenciano‐Mendoza, E., Menchon, J. M., Gearhardt, A. N., Dieguez, C., & Fernández‐Aranda, F.
- Affiliations
- Bellvitge University Hospital (ES)
- Instituto de Salud Carlos III (ES)
- Universitat Autònoma de Barcelona (ES)
- Department of Clinical Sciences, School of Medicine and Health Sciences University of Barcelona Barcelona Spain
- Department of Psychiatry University Hospital of Bellvitge‐IDIBELL Barcelona Spain
- University of Michigan (US)
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn) Instituto Salud Carlos III Barcelona Spain
- Corresponding author
- Agüera, Zaida
- Fernández‐Aranda, Fernando
- ORCID
- Venue
- European Eating Disorders Review
- Publisher
- Wiley
- Published
- 2019-10-21
- Volume
- 27
- Issue
- 6
- Pages
- 700-711
- ISSN
- 1072-4133 (ISSN-L)
- 1099-0968
- OpenAlex
- W2982005265
- Cited by
- 47
- References
- 70
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 10 · 2023: 4 · 2022: 7 · 2021: 8 · 2020: 9
- FWCI
- 7.01
- 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, other-oa)
- Deep Blue (University of Michigan) (submittedVersion)
- Funders
- European Regional Development Fund (ERDF)
- Generalitat de Catalunya (CERCA programme, SLT006/17/00077)
- Instituto de Salud Carlos III (CIBERSAM, CIBERobn, PI17/01167)
- Ministerio de Economía y Competitividad (PSI2015‐68701‐R)
- Ministerio de Sanidad, Servicios Sociales e Igualdad (PR338/17)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- food addiction, binge eating disorder, bulimia nervosa, treatment outcomes, prognosis, Yale Food Addiction Scale, eating disorder severity, binge eating episodes, eating disorder psychopathology
- MeSH terms
- Food Addiction, Adult, Female, Humans, Male, Middle Aged, Treatment Outcome, Bulimia Nervosa, Young Adult, Binge-Eating Disorder
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