Addictive Tendencies Towards Food: A Multi-Method Analysis of ‘Food Addiction’ and Related Psychopathologies

This dissertation comprises two sequential multi-method studies: a quantitative followed by a qualitative study. The primary aim of the first study was to confirm our previous research examining compulsive grazing in a clinical population with obesity and a higher prevalence and severity of food addiction (FA). Moderating effects of weight and sex on the severity and frequency of FA were also explored. Adults with obesity (aged 20 to 50 years) were recruited from a weight-management clinic (n=437). Participants completed an online questionnaire assessing various eating behaviours and related personality measures. Multiple and logistic regression modelling were used with the Yale Food Addiction Scale symptom count and diagnosis as the dependent variables, respectively. A chi-square test of independence and an analysis of variance were used to determine sex differences. Compulsive grazing was a significant factor in FA diagnosis and symptom severity, confirming previous findings. Females from a weight-management clinic sample were more likely to receive an FA diagnosis than females from the general population.

The purpose of the second study was three-fold: 1) to explore perceptions of compulsive grazing in individuals with overweight and obesity; 2) to understand where compulsive grazing fits within the spectrum of overeating, particularly in relation to FA; and 3) to assess if the FA concept reflects participants’ experiences. Females (n=34) from the first study were recruited and interviewed virtually using semi-structured interviews. Interviews were transcribed verbatim. A flexible coding system was developed, which led to a final list of three categories.

Notably, findings indicated varied eating behaviours among those with FA (binge eating, compulsive grazing, or a combination of both). Accordingly, a new conceptualization of FA was proposed. Lastly, participants identified bariatric surgery and pharmacologic treatments as effective for managing cravings and compulsive eating.

Overall, this dissertation provided a holistic understanding of FA and its associated behaviors. This dissertation contributes to the increasing recognition of FA as a genuine substance-use disorder, which can hopefully have an impact on public health by reducing obesity stigma and enhancing treatment access for individuals with FA.