Helen K. Ruddock

The development and validation of the Addiction-like Eating Behaviour Scale

Background:Overeating and obesity are frequently attributed to an addiction to food. However, there is currently a lack of evidence to support the idea that certain foods contain any specific addictive substance. An alternative approach is to focus on dimensions of observable behaviour, which may underpin a behavioural addiction to eating. To facilitate this, it is necessary to develop a tool to quantify addiction-like eating behaviour, which is not based on the clinical criteria for substance dependence. The current study provides initial validation of the Addiction-like Eating Behaviour Scale (AEBS).Methods:English speaking male and female participants (N=511) from a community sample completed the AEBS, alongside a range of other health- and eating-related questionnaires including the Yale Food Addiction Scale (YFAS) and Binge Eating Scale (BES). Participants also provided their height and weight to enable calculation of body mass index (BMI). Finally, to assess test–retest reliability, an additional 70 participants completed the AEBS twice, 2 weeks apart.Results:Principle components analysis revealed that a two-factor structure best accounted for the data. Factor 1 consisted of items that referred to appetitive drive, whereas factor two consisted of items that referred to dietary control practices. Both subscales demonstrated good internal reliability and test–retest reliability, and a confirmatory factor analysis confirmed the two-factor scale structure. AEBS scores correlated positively with body mass index (BMI) (P<0.001) and other self-report measures of overeating. Importantly, the AEBS significantly predicted variance in BMI above that accounted for by both the YFAS and BES (P=0.027).Conclusions:The AEBS provides a valid and reliable tool to quantify the behavioural features of a potential ‘eating addiction’. In doing so, the AEBS overcomes many limitations associated with applying substance-dependence criteria to eating.

Food Addiction Beliefs Amongst the Lay Public: What Are the Consequences for Eating Behaviour?

Purpose of ReviewThe current paper reviews recent research on perceptions of food addiction in the lay public. It also examines the potential consequences of such beliefs for eating behaviour.Recent FindingsSurveys suggest that, within community samples, the majority of individuals believe that certain foods are addictive, and that food addiction causes obesity. Further, many people believe themselves to be ‘food addicts’, and these individuals demonstrate increased patterns of aberrant eating. However, there is also initial experimental evidence to suggest that believing oneself to be a food addict leads to short-term food restriction.SummaryTo reconcile these findings, a self-perpetuating relationship between food addiction beliefs and aberrant eating is proposed. Specifically, in the short term, food addiction beliefs may encourage individuals to avoid certain foods. However, attempts at restriction may eventually lead to increased cravings and disinhibition, thus reinforcing perceptions of oneself as a food addict. These possibilities merit scrutiny in future research.

Response to “How much does the Addiction-Like eating behaviour scale add to the debate regarding food versus eating addictions?”

International Journal of Obesity accepted article preview online, 30 November 2017. doi:10.1038/ijo.2017.291.

Response to 'Jangle fallacy epidemic in obesity research: a comment on Ruddock et al. (2017)'

1 Ruddock HK, Christiansen P, Halford JCG, Hardman CA. The development and validation of the Addiction-like Eating Behaviour Scale. Int J Obes 2017; 41: ijo2017158; doi: https://doi.org.10.1038/ijo.2017.158. 2 Kelley TL. Interpretation of Educational Measurements. World Book Co.: Oxford, England, 1927. 3 Vainik U, Neseliler S, Konstabel K, Fellows LK, Dagher A. Eating traits questionnaires as a continuum of a single concept. Uncontrolled eating. Appetite 2015; 90: 229–239. 4 Gearhardt AN, Corbin WR, Brownell KD. Preliminary validation of the Yale Food Addiction Scale. Appetite 2009; 52: 430–436. 5 Mason AE, Vainik U, Acree M, Tomiyama AJ, Dagher A, Epel ES et al. Improving assessment of the spectrum of reward-related eating: the RED-13. Front Psychol 2017; 8: 795. 6 Price M, Higgs S, Lee M. Self-reported eating traits: Underlying components of food responsivity and dietary restriction are positively related to BMI. Appetite 2015; 95: 203–210. 7 Meule A, Heckel D, Jurowich CF, Vögele C, Kübler A. Correlates of food addiction in obese individuals seeking bariatric surgery. Clin Obes 2014; 4: 228–236. 8 Goodman A. Addiction: definition and implications. Br J Addict 1990; 85: 1403–1408. 9 Westfall J, Yarkoni T. Statistically controlling for confounding constructs is harder than you think. PLoS One 2016; 11: e0152719. 10 Karlsson J, Persson LO, Sjöström L, Sullivan M. Psychometric properties and factor structure of the Three-Factor Eating Questionnaire (TFEQ) in obese men and women. Results from the Swedish Obese Subjects (SOS) study. Int J Obes Relat Metab Disord 2000; 24: 1715–1725.

Response to “The potential impact of body mass index, cognitive dissonance, and stigma”

TO THE EDITOR: We thank Vella and Pai for their letter regarding our article “Believing in food addiction: Helpful or counterproductive for eating behavior” (1). In this work, we found that leading people to believe they scored highly on food addiction resulted in increased dietary concern and reduced food intake. Vella and Pai propose three alternative explanations for the results, specifically body mass index (BMI), cognitive dissonance, and perceived stigmatization. We were unable to discuss these issues at length in our article due to the word limit; therefore, we are grateful for the opportunity to do so now.