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

Romina Miranda-Olivos, Zaida Agüera, Roser Granero, Rhianna R Vergeer, Carlos Dieguez, Susana Jiménez-Murcia, Ashley N Gearhardt, Fernando Fernández-Aranda

Research output: Contribution to journalArticleResearchpeer-review

3 Citations (Scopus)


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 self-directedness. 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.

Original languageEnglish
Pages (from-to)102-115
Number of pages14
JournalJournal of Behavioral Addictions
Issue number1
Publication statusPublished - 28 Mar 2022


  • Binge-Eating Disorder/epidemiology
  • Bulimia Nervosa/epidemiology
  • Feeding and Eating Disorders/epidemiology
  • Food Addiction/epidemiology
  • Humans
  • Illicit Drugs
  • substance use
  • personality
  • Eating disorders
  • impulsivity
  • food addiction


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