Food Addiction, Weight Perception, Dieting, and Maladaptive Eating Behaviors in U.S. Young Adults: An Observational, Prospective, Nationally Representative Cohort Study

OBJECTIVES: This study examines relations of food addiction with weight-related and maladaptive eating behaviors in a nationally representative sample of U.S. young adults. METHODS: Data come from the final annual assessment of the NEXT Generation Health Study, which followed a cohort of U.S. emerging adults from 2010–2017 (year 7 n = 2323, age 22.6 ± 0.5 years, 81% retention). Food addiction was assessed using the modified Yale Food Addiction Scale. Participants self-reported height, weight, weight perception (underweight, about right, overweight), currently attempting weight loss (vs. not), and 10 maladaptive eating behaviors (e.g., self-induced vomiting, laxative use, diet pills). Logistic (rare outcomes) and log-binomial (common outcomes) regression analyses accounting for the complex survey design estimated relations of food addiction with dieting, perceived overweight, and maladaptive eating behaviors. RESULTS: The prevalence of food addiction was 4.7% (95% CI: 3.6% −6.2%). Forty-seven percent of young adults (95% CI: 46.9%, 52.1%) reported attempting weight loss; 45.6% reported perceived overweight (95% CI: 40.9%, 50.3%) and 7.1% (95% CI: 4.5%, 11.0%) reported any maladaptive eating behavior. In bivariate regressions, females had greater odds of food addiction, maladaptive eating behaviors, perceived overweight, and attempting weight loss; outcomes were not associated with other sociodemographics. Attempting weight loss (RR = 3.4, 95% CI: 1.7, 7.1, p = .002), perceived overweight (RR = 6.3, 95% CI: 2.9, 13.6, p < .001), and maladaptive eating behaviors (OR = 3.3, 95% CI: 1.7, 6.5, p = .001) were positively associated with food addiction adjusted for sex and weight status. CONCLUSIONS: Findings indicate considerable overlap between food addiction, perceived overweight, weight loss attempt, and subclinical maladaptive eating behaviors. Food addiction may be an important consideration in the treatment and management of young adults with multiple aspects of problematic eating. FUNDING SOURCES: Funding was provided by the NICHD Intramural Research Program, NIAAA, MCHB of HRSA, and NIDA.