An examination of the mechanisms and personality traits underlying food addiction among individuals with severe obesity awaiting bariatric surgery

Anne-Sophie Ouellette, Christopher Rodrigue, Simone Lemieux, André Tchernof, Laurent Biertho, Catherine Bégin

The aetiology underlying addiction has often been investigated to shed more light on the factors contributing to the development and maintenance of various disorders. In the field of addictive eating behaviours, data on the aetiological factors related to food addiction (FA) in the bariatric context remain scarce. The present study aimed to explore mechanisms and variables underlying FA among individuals suffering from severe obesity and awaiting bariatric surgery. Participants (N = 146) were recruited at the Quebec Heart and Lung Institute during their pre-operative visit and were invited to complete questionnaires. Participants with and without FA were compared on reward sensitivity, impulsivity, emotion dysregulation, and personality traits. Findings showed that bariatric candidates with FA (16%) presented more emotion dysregulation, more harm avoidance, and less self-directedness. Further exploration showed that the association between harm avoidance and the number of FA criteria endorsed was mediated by emotion dysregulation, while the association between self-directedness and the number of FA criteria endorsed was mediated by reward sensitivity. These results indicate that an inability to regulate affect by strategies other than eating highly palatable food, in a context where negative affect and long-term goals can hardly be sustained, underlies a diagnostic of FA among bariatric candidates. From a clinical standpoint, the presence of a double vulnerability leading to FA symptomatology could help design better-targeted interventions to maximise weight loss maintenance in the bariatric context. Level V, descriptive study.