An examination of the mechanisms and personality traits underlying food addiction among individuals with severe obesity awaiting bariatric surgery
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The aetiology underlying addiction has often been investigated to shed more light on the factors contributing to the development and maintenance of various disorders. In the field of addictive eating behaviours, data on the aetiological factors related to food addiction (FA) in the bariatric context remain scarce. The present study aimed to explore mechanisms and variables underlying FA among individuals suffering from severe obesity and awaiting bariatric surgery.
Participants (N = 146) were recruited at the Quebec Heart and Lung Institute during their pre-operative visit and were invited to complete questionnaires. Participants with and without FA were compared on reward sensitivity, impulsivity, emotion dysregulation, and personality traits.
Findings showed that bariatric candidates with FA (16%) presented more emotion dysregulation, more harm avoidance, and less self-directedness. Further exploration showed that the association between harm avoidance and the number of FA criteria endorsed was mediated by emotion dysregulation, while the association between self-directedness and the number of FA criteria endorsed was mediated by reward sensitivity.
These results indicate that an inability to regulate affect by strategies other than eating highly palatable food, in a context where negative affect and long-term goals can hardly be sustained, underlies a diagnostic of FA among bariatric candidates. From a clinical standpoint, the presence of a double vulnerability leading to FA symptomatology could help design better-targeted interventions to maximise weight loss maintenance in the bariatric context.
Level of evidence
Level V, descriptive study.
KeywordsFood addiction Bariatric surgery Emotion regulation Personality traits
We thank the Research Chair in Bariatric and Metabolic Surgery of the Quebec Heart and Lung Institute, especially Marc Lapointe and Mélanie Nadeau, and the whole surgery team for their assistance in data collection. We thank Hélène Paradis for assisting with data analysis.
Compliance with ethical standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Conflict of interest
Dr. Tchernof as well as Dr. Biertho report grants from Johnson & Jonhson Medical Companies, outside the submitted work. The other authors declare no conflict of interest.
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