The food addiction (FA) construct has become a topic of great interest in the scientific community; however, its diagnostic, clinical and potential therapeutic implications remain unresolved. Although there is not enough evidence to confirm its diagnostic utility, given that some of the findings obtained in preclinical research associating the addictive capacity of certain palatable foods have not yet been replicated in humans, there are signs of neurobiological vulnerability and greater susceptibility to using food as a means of coping with problems and negative affect. While the first human studies focused on obesity and the general population, later research concentrated on eating disorders (ED), bariatric surgery patients and other psychiatric disorders. FA seems to reflect a transdiagnostic condition that is shown to be more prevalent in subjects with obesity (ranging from 18 to 24%) and even higher in patients with ED, particularly binge eating disorder and bulimia nervosa (ranging from 70% to 95%, respectively), but also in behavioral addictions. Considering the literature, published so far, FA is frequently associated with higher ED severity and more general psychopathology, but also with more dysfunctional personality traits and neuropsychological impairments, associated with decision making and attentional bias to food neural circuitry. The few prospective studies have shown higher food addiction to be negatively associated with treatment outcome, as well in bulimia nervosa, as pre and post-operatively in bariatric surgery. The addictive model has the potential to open new avenues of conceptualization and management in obesity and eating disorders, providing potentially new targets that might be complementary to the complex models of treatment needed in those disorders.
18 - 21 May 2019
European Society of Endocrinology