Food addiction and lifetime alcohol and illicit drugs use in specific eating disorders

Background and aims: Food addiction (FA) and substance use (SU) have frequently been reported in patients with eating disorders (EDs). Our study aimed to assess the prevalence rates of FA and/or lifetime problematic alcohol and illicit drug use among patients with specific ED, such as: bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorder (OSFED). We sought to identify clinical, psychopathological, and personality profiles involved in these addictive behavior-based phenotypes. Methods: The total sample was 527 patients (176 BN, 115 BED, and 236 OSFED). FA was assessed through the Yale Food Addiction Scale 2.0. To determine lifetime SU, a semi structured clinical interview was carried out. Results: Patients with BN had the highest rates of FA both with and without SU. No gender differences were obtained for the prevalence of current FA and/or lifetime SU. Patients reporting at least one addictive-related behavior exhibited increased clinical severity compared to those who reported none. Increased impulsivity (such as high lack of premeditation, sensation seeking, and positive urgency) and low self-directedness were differentiating factors for presenting one or two addictive behaviors. Discussion and Conclusions: Overall, patients presenting with at least one addictive-like behavior reported a poorer clinical status than those without. Also, patients with FA and SU exhibited a more dysfunctional profile characterized by high impulsivity and low selfdirectedness. These findings would support the need for targeted treatments to reduce impulsivity and increase self-directedness, especially in patients with any addictive-related behavior, as a step towards improving their treatment outcome

Sample characteristics for the overall sample and by latent class.

Sample characteristics for the overall sample and by latent class.</p

Full results from multiple regression models with covariates and coping by AUD interaction terms.

Full results from multiple regression models with covariates and coping by AUD interaction terms.</p

Item probabilities of latent class endorsement for the five positive coping behaviors.

Item probabilities of latent class endorsement for the five positive coping behaviors.</p

Endorsement of negative coping behaviors by positive coping latent classes.

Endorsement of negative coping behaviors by positive coping latent classes.</p

Multiple regression analyses modeling the main and interaction effects of coping classes and history of AUD on alcohol-related and mental health outcomes.

Multiple regression analyses modeling the main and interaction effects of coping classes and history of AUD on alcohol-related and mental health outcomes.</p

Alcohol-related and mental health outcomes by latent classes and history of AUD.

Alcohol-related and mental health outcomes by latent classes and history of AUD.</p

Model fit indices for the latent class models.

ObjectiveTo identify latent classes of positive coping behaviors during the COVID-19 pandemic and examine associations with alcohol-related and mental health outcomes across participants with and without a history of alcohol use disorder (AUD).MethodsBaseline data from 463 participants who were enrolled in the NIAAA COVID-19 Pandemic Impact on Alcohol (C19-PIA) Study were analyzed. Latent class analysis (LCA) was applied to five positive coping behaviors during COVID-19: taking media breaks, taking care of their body, engaging in healthy behaviors, making time to relax, and connecting with others. Latent class differences and the moderating role of history of AUD on six alcohol-related and mental health outcomes were examined using multiple regression models.ResultsLCA revealed two latent classes: 83.4% High Positive Coping and 16.6% Low Positive Coping. Low Positive Coping was associated with higher levels of perceived stress, anxiety symptoms, and loneliness. A history of AUD was consistently associated with higher levels of alcohol-related and mental health outcomes. Significant interactions between Coping Latent Classes and history of AUD indicated that the associations of Low Positive Coping with problematic alcohol use, depressive symptoms, and drinking to cope motives were either stronger or only significant among individuals with a history of AUD.ConclusionsIndividuals with a history of AUD may be particularly vulnerable to depressive symptoms and alcohol-related outcomes, especially when they do not utilize positive coping strategies. The promotion of positive coping strategies is a promising avenue to address alcohol-related and mental health problems during a public health crisis and warrants future research.</div