The burden of overweight/obesity and weight-related behaviors attributable to food addiction in emerging adults

While food addiction has been positively associated with excess weight and disordered eating behaviors, this has not been examined in representative samples of emerging adults, who are at elevated risk for these outcomes. This study investigated relationships of food addiction with weight outcomes, weight perception, and weight-control behaviors in emerging adults and estimated the population attributable fraction to food addiction. Data from an observational cohort study were collected in seven annual waves from 2010–2016. A nationally representative sample of 2785 10th grade students was recruited from schools within each U.S. census region (73% participation) (mean±SD baseline age=16.3±0.5years). Wave 7 retention was 81% (n=2323, 60% female, mean±SD=22.6±0.5 years). Outcomes included current BMI, BMI change from baseline – wave 7, increased weight status in wave 7 (increased weight status from baseline-wave 7), perceived overweight, dieting, any weight-control behavior, and extreme weight-control behaviors. Food addiction was measured in wave 7 using the modified Yale Food Addiction Scale. Relative risk of the outcomes associated with food addiction, and population attributable fraction, were estimated using adjusted log-binomial or robust Poisson regression analyses accounting for the complex survey design. Food addiction prevalence was 4.7%. Participants with food addiction were primarily females (91%); food addiction was uncorrelated with other sociodemographics. Food addiction was associated with 48%-167% increased RR for all outcomes, but these were attenuated after adjustment for confounders (31% - 64%). The population attributable fraction for food addiction ranged from 2% (high wave 7 BMI) – 5% (extreme weight-control behaviors). Although the population attributable fraction estimates indicate that the public health burden of these outcomes attributable to food addiction may be relatively minor, food addiction may signal the presence of several adverse mental health symptoms.