Food addiction and its associations with mental and physical health comorbidities and with quality of life in the general population

Background and aims: There is limited information on the prevalence and characteristics of Food Addiction (FA) in representative samples of the general population, and particularly in low- and middle-income countries. This study aimed to estimate the prevalence of FA and its associations with mental and physical health comorbidities, and with quality of life in Brazil. Methods: A population-based household survey of 2297 individuals aged 18 to 60 years with 3-staged sampling was conducted in the city of Rio de Janeiro, Brazil from 2019 to 2020. FA was assessed with the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0). Psychiatric comorbidity was evaluated with validated instruments and physical health conditions with close-ended questions. The prevalence of FA and all analyses were adjusted with sample weights. Multivariate logistic regression was used to assess associations between psychiatric and physical comorbidities and FA. Results: The prevalence of FA was 2.78% (95% CI: 1.40 to 4.17) and was significantly higher in women than men [4.08% vs. 1.39% respectively, p <.001] and in younger compared to older individuals. Individuals with FA were significantly more likely to have depression (75.4%), anxiety (77.0%), attention deficit hyperactivity disorder (32.7%) and alcohol use disorder (19.7.%) symptoms compared to those without FA. Eating disorders (binge eating disorder and bulimia nervosa) were more than 10 more likely to occur in individuals with FA compared to those without FA. Furthermore, FA was significantly associated with all eating disorder, mental and physical health comorbidities, such as diabetes, stroke, asthma, chronic asthma, headaches, muscle problems, and gastroesophageal reflux, adjusting for Body Mass Index (BMI), sex and race, and poorer quality of life. Conclusions: The prevalence of FA in the general population of a metropolitan city of Brazil lower than reported in other populations. However, FA was associated with notable mental and physical health comorbidity and a lower quality of life.