The relationship between food addiction and patterns of disordered eating with exercise dependence: in amateur endurance athletes

PURPOSE: Examine the prevalence and potential relationships among food addiction (FA)—as measured by Yale Food Addiction Scale 2.0 (YFAS 2.0), eating disorders (ED)—as measured by Eating Disorder Diagnostic Scale (EDDS)—and exercise dependence (EXD)—as measured by Questionnaire to Diagnose Exercise Dependence in Endurance Sports (FESA), for the first time worldwide, in amateur endurance athletes. METHODS: A total of 1022 German-speaking endurance athletes (44% male, Ø 36 years, Ø BMI 23 kg/m(2)) replied to an online questionnaire consisting of demographics, related parameters, and the German versions of YFAS 2.0, EDDS, and FESA. RESULTS: Prevalence of FA, ED, and EXD was 6.2, 6.5, and 30.5%. The probability for FA increases with BMI, thoughts about food and EXD score, and decreases with age and when an ED is present. People with FA and people with ED vs. people with both, FA&ED, differed significantly in this cohort. Strong significant relationships were found between FA and EXD (X(2) (1) = 15.117, p < 0.001, n = 1022). CONCLUSIONS: A considerable number of amateur endurance athletes may suffer from FA. The association between FA and EXD is stronger than between ED and EXD, indicating FA as a potentially more relevant subject—than ED—for prevention or therapy in people with EXD. Further studies are needed to investigate parameters and relationships between the possibly involved types of ED, FA, and EXD. LEVEL OF EVIDENCE: Level III, well-designed cohort analytic study.