Frontiers in psychology · 2026
Multidimensional psychosocial correlates of food addiction status and symptom count in Chinese candidates for bariatric surgery: a cross-sectional study.
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Zhang Yuyang, Xu Ting, Zhao Yacong, Liu Luyao, Lin Ziyan, Li Linwei, Di Jianzhong
Аннотация
OBJECTIVE: To examine the associations of sociocultural appearance pressure, depressive and anxiety symptoms and body appreciation with food addiction status and symptom count among Chinese candidates for bariatric surgery.
METHODS: This cross-sectional study included 240 candidates for bariatric surgery. Food addiction status and symptom count were assessed using the Yale Food Addiction Scale 2.0 (YFAS 2.0); psychosocial measures included the depressive symptoms (PHQ-9), anxiety (GAD-7), body appreciation (BAS-2), sociocultural attitudes toward appearance (SATAQ-4). Logistic regression was used to analyze food addiction status, and negative-binomial regression was used to analyze food addiction symptom count. The primary analysis used the full Model 3, which simultaneously included demographic, lifestyle and psychological variables. Hierarchical comparisons of Models 1 and 2 were treated as exploratory analyses.
RESULTS: Among the 240 participants, 95 (39.6%) met the criteria for food addiction. In the full logistic model, BMI (OR per SD = 1.549, 95% CI 1.094-2.193; p = 0.014) and family pressure (OR per SD = 1.516, 95% CI 1.030-2.232; p = 0.035) were positively associated with food addiction status. PHQ-9 (OR per SD = 1.421, 95% CI 0.886-2.278; p = 0.145) and BAS-2 (OR per SD = 0.719, 95% CI 0.511-1.011; p = 0.058) were not statistically significant. In the full negative-binomial model, family pressure (IRR per SD = 1.171, 95% CI 1.023-1.340; p = 0.022) and PHQ-9 (IRR per SD = 1.284, 95% CI 1.087-1.518; p = 0.003) were positively associated with symptom count, whereas BAS-2 was inversely associated (IRR per SD = 0.883, 95% CI 0.785-0.992; p = 0.037). Formal tests did not distinguish the coefficients for the three pressure sources. The apparent AUC of the logistic model was 0.761, and the optimism-corrected AUC was 0.707.
CONCLUSION: Associations differed by outcome. BMI and family pressure were associated with food addiction status, whereas family pressure, depressive symptoms and body appreciation were associated with symptom count. Family pressure was the only pressure source with a statistically significant independent coefficient in the full models, but its coefficient did not differ significantly from peer or media pressure. These cross-sectional findings describe associations and require prospective research and external validation.
METHODS: This cross-sectional study included 240 candidates for bariatric surgery. Food addiction status and symptom count were assessed using the Yale Food Addiction Scale 2.0 (YFAS 2.0); psychosocial measures included the depressive symptoms (PHQ-9), anxiety (GAD-7), body appreciation (BAS-2), sociocultural attitudes toward appearance (SATAQ-4). Logistic regression was used to analyze food addiction status, and negative-binomial regression was used to analyze food addiction symptom count. The primary analysis used the full Model 3, which simultaneously included demographic, lifestyle and psychological variables. Hierarchical comparisons of Models 1 and 2 were treated as exploratory analyses.
RESULTS: Among the 240 participants, 95 (39.6%) met the criteria for food addiction. In the full logistic model, BMI (OR per SD = 1.549, 95% CI 1.094-2.193; p = 0.014) and family pressure (OR per SD = 1.516, 95% CI 1.030-2.232; p = 0.035) were positively associated with food addiction status. PHQ-9 (OR per SD = 1.421, 95% CI 0.886-2.278; p = 0.145) and BAS-2 (OR per SD = 0.719, 95% CI 0.511-1.011; p = 0.058) were not statistically significant. In the full negative-binomial model, family pressure (IRR per SD = 1.171, 95% CI 1.023-1.340; p = 0.022) and PHQ-9 (IRR per SD = 1.284, 95% CI 1.087-1.518; p = 0.003) were positively associated with symptom count, whereas BAS-2 was inversely associated (IRR per SD = 0.883, 95% CI 0.785-0.992; p = 0.037). Formal tests did not distinguish the coefficients for the three pressure sources. The apparent AUC of the logistic model was 0.761, and the optimism-corrected AUC was 0.707.
CONCLUSION: Associations differed by outcome. BMI and family pressure were associated with food addiction status, whereas family pressure, depressive symptoms and body appreciation were associated with symptom count. Family pressure was the only pressure source with a statistically significant independent coefficient in the full models, but its coefficient did not differ significantly from peer or media pressure. These cross-sectional findings describe associations and require prospective research and external validation.