Early life influences on the development of food addiction in college attending young adults

Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity https://doi.org/10.1007/s40519-023-01546-3 (2023) 28:14 ORIGINAL ARTICLE Early life influences on the development of food addiction in college attending young adults Rachel A. Wattick1 · Melissa D. Olfert1 Cassie Brode5 · Elizabeth Claydon2 · Rebecca L. Hagedorn‑Hatfield3 · Makenzie L. Barr4 · Received: 13 July 2022 / Accepted: 25 January 2023 © The Author(s) 2023 Abstract Purpose There is little investigation into the causes of food addiction. The aim of this study was to determine the impact of early life influences on the development of food addiction in college-attending young adults aged 18–29. Methods This study utilized a sequential explanatory mixed-methods research design. College-attending young adults were invited to complete an online survey measuring Adverse Childhood Experiences (ACEs), food addiction, depression, anxiety, stress, and demographic information. Correlations between food addiction and the other variables were analyzed and significant variables were placed into a nominal logistic regression model to predict the development of food addiction. Participants who met the criteria for food addiction were invited to participate in interviews to examine their childhood eating environment and when their symptoms emerged. Interviews were transcribed and thematically analyzed. Quantitative analysis was conducted using JMP Pro Version 16.0 and qualitative analysis was conducted using NVIVO Software Version 12.0. Results Survey respondents (n = 1645) had an overall 21.9% prevalence of food addiction. Significant correlations were observed between food addiction and ACEs, depression, anxiety, stress, and sex (p < .01 for all). Depression was the only significant predictor of the development of food addiction (OR = 3.33 95% CI 2.19, 5.05). The most common eating environment described by interview participants (n = 36) was an emphasis on diet culture, ideal body image, and restrictive environments. Symptoms frequently emerged after transitioning into college and having the ability to make their own food choices. Conclusion These results show the impact of early life eating environments and young adulthood mental health on the development of food addiction. These findings contribute to the understanding of underlying causes of food addiction. Level of evidence: Level V, Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees. Keywords Food addiction · College student · Young adult · Mixed-methods · ACEs Introduction Within the United States, approximately 42.4% of individuals are overweight or obese [1]. Despite decades of research on treating obesity, little progress has been made on reducing its prevalence [2]. Obesity is a health problem of concern as it increases an individual’s risk of developing type 2 diabetes, coronary heart disease, end-stage renal disease, and facing psychosocial complications such as weight-related stigma [1, 3]. The focal cause of obesity has been an excess intake of calories through overeating, but more recently the * Melissa D. Olfert Extended author information available on the last page of the article focus has been on biological and environmental factors, or psychosocial factors [2]. Today’s food environment is characterized by the widespread prevalence of highly-palatable foods [4], such as foods with added sugars or highly processed or refined foods, and an increase in the consumption of foods for pleasure rather than sustenance [5]. These societal trends co-occurring with the rise in obesity has led to the examination of the potential addictive properties of food, or the study of food addiction. Food addiction can be defined as “a chronic and relapsing condition caused by the interaction of many complex variables that increase cravings for certain specific foods in order to achieve a state of high please, energy, or excitement, or to relieve negative emotional or physical states” [6]. Food addiction has shown multiple neurological similarities 13 Vol.:(0123456789) 14 Page 2 of 13 Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity to drug addiction. Individuals with food addiction display high activation of reward systems when anticipating intake of highly palatable foods. Illicit drugs and food have been shown to cause the same feelings of gratification through activation of the dopamine neurons in the ventral tegmental area followed by release of dopamine in the nucleus accumbens [7]. Emotionally, there are similarities between populations with substance use disorder (SUD) and food addiction, including a lack of emotional clarity, poor impulse control, higher emotional dysregulation, and higher non-acceptance of emotional responses [8]. Within examination of psychosocial causes of obesity, there is a strong body of evidence on adverse childhood experiences (ACEs), which can take the form of emotional, physical, or sexual abuse, neglect, or household dysfunction. [9–13] Additionally, other methods of measuring childhood abuse and trauma have been associated with adulthood obesity [14–16]. From this research, it has been shown that individuals with ACEs can develop mal-adaptive coping strategies to stress and other negative emotions, including overeating [12, 17]. ACEs can disrupt an individual’s chronic stress response by altering the function of the hypothalamic–pituitary–adrenal (HPA) axis, leaving these individuals more vulnerable to high stress and subsequently higher risk for negative coping mechanisms [9]. ACEs have also been shown to lead to adulthood SUD [18, 19]. There are similarities between the populations with SUD and obesity, including reduced sensitivity to reward [20, 21], which can lead to addictive behavior [13]. The growth in food addiction research rapidly increased in 2009 after Gearhardt et al. developed the Yale Food Addiction Scale (YFAS) to diagnose food addiction [22]. It has been investigated as a possible mediator between childhood trauma and adulthood obesity [23]. However, there is still little known about the causes of food addiction. Overall, research on childhood trauma and food addiction has found interesting outcomes in the clinical population, such as bariatric surgery candidates [10, 24] and individuals with eating disorders [25], and in the population of females over age 35 [3, 20]. While this is important, more non-clinical investigations are needed in at-risk populations. Additionally, there is evidence of ACEs leading to the development of eating disorders [26, 27]. Although food addiction is similar to other eating disorders, it is still not entirely the same construct, [7] and therefore needs separate investigation. Additionally, there are other influences on eating behavior and obesity, such as parental feeding style [28] and general parenting style [29]. For example, in order to help their children have (...truncated)