A comprehensive model of food addiction in patients with binge-eating symptomatology: The essential role of negative urgency

Background: Food addiction has been widely researched in past years. However, there is a debate on the mechanisms underlying addictive eating and a better understanding of the processes associated to these behaviors is needed. Previous studies have found characteristic psychological correlates of food addiction, such as high negative urgency, emotion regulation difficulties and low self-directedness, in different samples of adults with addictive eating patterns. Still, it seems difficult to disentangle effects independent from general eating disorder psychopathology. Therefore, this study aimed to test a comprehensive model under control of eating disorder severity, in order to find independent predictors of food addiction. Methods: 315 patients with eating disorder diagnoses on the binge-eating spectrum were assessed in personality, emotion regulation, negative urgency, eating disorder symptomatology, and food addiction by self-report. Hypothesis-driven structural equation modeling was conducted to test the comprehensive model. Results: The only independent predictor found for food addiction was negative urgency, while self-directedness and emotion regulation predicted negative urgency and were highly related to eating disorder symptomatology, but not to food addiction. Conclusions: Altogether the model suggests that low self-directedness and difficulties in emotion regulation are related to higher eating disorder symptomatology in general. Those patients who, in addition to these traits, tend to act impulsively when in negative mood states, are at risk for developing addictive eating patterns. Urgency-based treatments are therefore recommended for this subgroup of patients. (C) 2017 Elsevier Inc. All rights reserved.