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Association between food addiction and body image dissatisfaction in bariatric surgery candidates: a cross-sectional study

Year: 2025

Type: article

Abstract: The pursuit of highly palatable foods as a reward can lead to dysfunctional eating behaviors. In bariatric surgery candidates, symptoms of food addiction may impact postoperative weight loss, increase the risk of developing psychological and behavioral disorders, and influence body image perception. The objective was to determine the association between food addiction and body image dissatisfaction in bariatric surgery candidates. This cross-sectional study was conducted at the Multidisciplinary Outpatient Clinic for Surgical Obesity at Hospital de Clínicas of the Federal University of Paraná, Curitiba, Brazil. The sample included 124 participants. The Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) was used to assess food addiction symptoms, the Body Shape Questionnaire (BSQ) to evaluate body dissatisfaction. Anthropometric measurements included weight and height, which were used to calculate Body Mass Index (BMI). Associations between categorical variables were analyzed using the chi-square test or Fisher’s exact test. The Mann-Whitney test was used to compare numerical variables between groups. The relationship between food addiction and body dissatisfaction was assessed using binary logistic regression, adjusted for covariates. Model fit was verified using the Hosmer-Lemeshow test (χ² = 9.47, df = 7, p = 0.221), and the absence of multicollinearity was confirmed by variance inflation factor (VIF) values (< 2). The majority of participants were female (n = 102; 80%), with a mean age of 40 ± 13 years and a BMI of 46 ± 7 kg/m². Body dissatisfaction was observed in 69% (n = 86), and food addiction symptoms in 21% (n = 26). Individuals with moderate/severe body dissatisfaction had significantly higher odds of exhibiting FA symptoms compared to those with no/low dissatisfaction, both in univariate (OR = 2.53; 95% CI: 1.05–6.31; p = 0.041) and adjusted analyses (OR = 2.85; 95% CI: 1.12–7.60; p = 0.030), for age, BMI, sex, and race/ethnicity. The findings of this study suggest that the absence or low levels of body dissatisfaction are associated with a decreased likelihood of food addiction symptoms. These findings highlight the need for an integrated approach in the treatment of bariatric surgery candidates, considering psychological and behavioral aspects to ensure long-term success. Trial registration: Trial registration number RBR-5yf2zv5. Food addiction is characterized by the compulsive intake of highly palatable foods that stimulate the brain’s reward pathways, often resulting in a loss of control and emotional distress. This pattern of behavior can hinder effective weight management and is particularly pertinent among individuals preparing for bariatric surgery. Additionally, body image dissatisfaction is prevalent within this population and may negatively impact eating behaviors and psychological health.In this study, 124 participants were assessed. Food addiction symptoms were measured using the Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0), while body dissatisfaction was evaluated with the Body Shape Questionnaire (BSQ). Anthropometric data were also collected. Results indicated that individuals with food addiction reported significantly higher BSQ scores. Moreover, participants with moderate to severe body dissatisfaction were significantly more likely to exhibit symptoms of food addiction compared to those with low or no dissatisfaction.These findings highlight the need for an integrated approach in the treatment of bariatric surgery candidates, considering psychological and behavioral aspects to ensure long-term success.

Source: Journal of Eating Disorders

DOI: 10.1186/s40337-025-01431-7